Over the last few days the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service has reported four more H5N1 avian flu detections in dairy cattle, two from California and two from Idaho, lifting the national total to 1,009 from 17 states since March 2024.

Also, APHIS has confirmed more H5N1 detections in poultry flocks from two states. They include two more detections in live bird markets in New York’s Queens County and a backyard location in Jefferson County. The virus was also detected at two locations in New Mexico, including a poultry farm in Curry County and a backyard flock in Roosevelt County.

WHO H5 surveillance guidance, USDA livestock disease funding

In other H5N1 developments, the World Health Organization (WHO) on April 11 released new guidance on surveillance for human infections with H5 avian influenza viruses.  It said the goal is to rapidly detect and characterize any human H5 infections to allow prompt response actions, assess trends and health risks, and guide global flu pandemic preparedness.

The group emphasized that under the International Health Regulations, countries are required to notify the WHO within 24 hours of any lab-confirmed human case involving a new subtype, based on the WHO case definition of being unusual or unexpected and potentially posing a serious public health impact. The new guidance also included a data reporting guide.

In a related US development, the USDA’s APHIS last week announced $15.3 million in funding for research projects to enhance preparedness, early detection, and rapid response to the diseases that threaten US livestock. The funding will support 68 projects led by 24 state agriculture departments, five tribal entities, 35 universities, three livestock groups, and one federal partner. One third of the funding is geared toward enhanced biosecurity. 

Many cases of tuberculosis (TB) in prisons in Europe and the Americas during the COVID-19 pandemic were likely missed, putting both inmates and the community at risk for the deadly bacterial disease, Boston University (BU)-led researchers propose in The Lancet Public Health. 

The study team analyzed data from the World Health Organization's (WHO's) Pan American Health Organization (PAHO; 22 of 39 countries) and WHO Europe (25 of 53 countries) to model and predict prison populations and TB infections among 4.9 million inmates from 2020 to 2022. 

Case notifications fall up to 100%

TB notifications in prisons were much lower than predicted in 2020 (-26.2%), 2021 (-46.4%), and 2022 (-48.9%). These trends were consistent across Europe and the Americas, but larger drops occurred in countries with lower TB rates (low burden) in 2020 (-54.8%) and 2021 (-68.4%), high-burden settings in 2021 (-89.4%), and Central and North America in 2021 (-100.3%).

Reasons for this change in tuberculosis notifications might be multifactorial and include missed diagnoses and implementation of COVID-19 pandemic measures, reducing transmission.

Incarceration rates were similar to predicted levels (under 10% overall difference) during the entire pandemic.

"Reasons for this change in tuberculosis notifications might be multifactorial and include missed diagnoses and implementation of COVID-19 pandemic measures, reducing transmission," the authors wrote.

In a BU news release, first author Amy Zheng, MPH, a PhD student, said, "When countries are unable to detect tuberculosis in high-risk populations—such as people who are incarcerated—it increases the risk of transmission, both within prisons and to the broader community, when people are released from prison."

In a related commentary, Emma Plugge, MD, PhD, of the University of Southampton in England, and Nicola Cocco, MD, of ASST Santi Paolo e Carlo in Milan, Italy, said that while prisons released some inmates to slow COVID-19 transmission, the efforts were inconsistent across countries and didn't result in meaningful population decreases.

"Efforts to tackle tuberculosis inside prisons must be redoubled as they have outside," they wrote. "Such actions will have a positive effect on the whole community; no one is safe until we are all safe."

Valneva today announced that the Brazilian Health Regulatory Agency (ANVISA) has authorized its live attenuated single-dose chikungunya vaccine (Ixchiq) for use in people ages 18 and older, marking the first approval of a chikungunya vaccine in an endemic country.

Brazil has been the hardest hit country in the Americas, recording more than 1 million cases between January 2019 and July 2024. In its announcement, the company said the approval paves the way for large-scale clinical trials in Brazil, including phase 4 trials to generate more data on vaccine effectiveness in the wake of approvals in the United States and Europe.

Headway against a debilitating disease

The Coalition for Epidemic Preparedness Innovations (CEPI) is supporting those trials. Valneva said ANVISA continues to evaluate a chikungunya vaccine candidate that, if approved, will be made and distributed by Instituto Butantan in collaboration with Valneva.

Richard Hatchett, MD, CEPI’s chief executive officer, said Brazil’s approval is a significant step to expand the vaccine’s use for travelers as well as populations in chikungunya-affected countries. “ANVISA’s marketing authorization of the vaccine offers new hope in the fight against the debilitating disease and allows us to make headway in our goal to protect the tens of thousands in the country who suffer from chikungunya each year,” he said.