News Scan for Jul 16, 2020

News brief

DRC Ebola cases reach 56, exceed 2018 Equateur province outbreak

Officials have confirmed 4 more Ebola cases in the Democratic Republic of the Congo (DRC) Equateur province Ebola outbreak, raising the number to 56 and passing the total of an outbreak that occurred in the same province in 2018.

In a statement today, the World Health Organization's (WHO's) African regional office said the outbreak's continued growth causes major concerns as the WHO and its partners face critical funding gaps. So far, cases are spread across six of the province's health zones. Of 56 cases, 53 are confirmed and 3 are listed as probable. The outbreak was first identified in early June, and half of the cases have been reported over the past 3 weeks. Officials have confirmed 21 deaths.

Matshidiso Moeti, MBBS, who directs the WHO's regional office, said responding to Ebola during an ongoing COVID-19 pandemic raises complex challenges. "The current Ebola outbreak is running into headwinds because cases are scattered across remote areas in dense rain forests," she said. "This makes for a costly response, as ensuring that responders and supplies reach affected populations is extremely challenging."

She warned that the Ebola response faces funding shortfalls and the $1.75 million mobilized by the WHO will last only a few more weeks, with more support needed to scale up key response steps. Moeti also said responders have made significant achievements, including starting vaccinations within 4 days of the outbreak declaration and immunizing more than 12,000 people.
Jul 16 WHO statement


Amid COVID-19 surge, Rockefeller Foundation issues US action plan

The Rockefeller Foundation has released a 10-step national action plan for COVID-19 diagnostic testing, disease surveillance, and contact tracing that calls for the United States to invest another $75 billion to repair its "patchwork" response to the pandemic at a time when cases are surging and many people are returning to work and school.

The report details the nation's lack of progress toward goals outlined in its April action plan, which appealed for increasing diagnostic testing to 3 million assays a week by June and 30 million by October.

The updated plan says that the only way to avoid greater tragedy is to scale up the manufacture and distribution of at least 5 million diagnostic tests that have 48-hour turnaround times and 25 million screening tests each week within 3 months, understanding that even more testing will be needed. And the testing must be supplemented by robust contact tracing and strict isolation measures.

Recommended measures include increasing the use and speed of contact tracing by using community-based tracers; supporting people in quarantine through the provision of food and prescriptions, financial assistance to cover lost wages, and childcare, adult daycare, and disability accommodations; improving public trust in testing data by clearly describing how it works while keeping separate political and public health processes; and creating a national COVID-19 communications coalition to quell rumors, provide education, and promote safety measures.

"If professional baseball and basketball players can get routine tests, so should our teachers, students, essential workers, nurses and bus drivers—every American, free of charge," the report says. "Investing in the creation, delivery and administering of these tests will be far cheaper for the nation than the incalculable fiscal and social costs of another economic shutdown."
Jul 16 Rockefeller Foundation report


Mumps outbreak in Chicago disproportionately affected gay men, people with HIV

In 2018, men who have sex with men (MSM) and people living with HIV made up a large proportion of the 116 cases of mumps in adults in Chicago, which surpassed the number seen during the previous 5 years combined, according to a report released today in Morbidity and Mortality Weekly Report (MMWR).

Nineteen of the 116 mumps infections (17%) occurred in people living with HIV. Twenty-nine (31%) of 93 respondents to a supplementary questionnaire sent to adults diagnosed as having mumps in 2018 were women who have sex with men, 27 (29%) were men who have sex only with women, and 37 (34%) identified as MSM.

Chicago Department of Public Health (CDPH) investigators identified a 9-square-mile non-university area containing six adjacent communities as a hot spot. Eight of 10 residents with mumps were MSM, and the area was frequented by many others diagnosed as having mumps. Seven residents reported visiting multiple nearby bars, and two were bartenders or servers at those bars who worked while contagious. Median patient age was 29 years, and 76 (69%) of 110 questionnaire respondents were men.

Survey respondents indicated that 101 of 116 (92%) had had at least one dose of the measles, mumps, and rubella vaccine, but only 9 reports could be verified using vaccination records. Five patients said they had been exposed to someone with mumps at a university, two of them associated with a university outbreak outside of Chicago.

As a result of the investigation, the CDPH is formulating guidance to use real-time spatiotemporal analysis to more quickly identify clusters of vaccine-preventable diseases like mumps. The use of real-time spatiotemporal analysis, which gathers data across space and time to pinpoint hot spots, could have helped public health officials identify and respond to the outbreak more quickly, the report said.

"Spatiotemporal analyses could be used in real time to identify case clusters to target public health response efforts, including to guide recommendations for additional measles, mumps, and rubella (MMR) vaccine and to identify specific transmission venues," the authors concluded.
Jul 17 MMWR study

This week's top reads