The Kansas Department of Health and Environment (KDHE) in its weekly update reported 2 more measles cases today, lifting the state's total to 48, with the number of affected counties remaining at eight, all in the southwestern corner of the state.

Kansas is among a handful of states that have reported cases linked to a large outbreak centered in West Texas. Of the 48 cases, 43 were unvaccinated or have an unknown vaccination status. The number of hospitalizations remains at one, and no deaths have been reported in the state.

Separately, the Sedgwick County Health Department, which covers the Wichita area in the south central part of Kansas, said a measles case has been confirmed in an unvaccinated child between the ages of 5 and 10 years old. The case marks the county's first since 2017, and a local media report from a press briefing said the child was likely exposed during travel out of the country. 

New cases in New Mexico, New York

The New Mexico Department of Health yesterday reported the first measles case in Curry County, which borders Texas, bringing the number of affected counties to five. The patient is an infant who is too young to be vaccinated. 

Also, officials reported three more cases in Lea County, putting the state's total at 71. New Mexico's outbreak is linked to the event in West Texas, which is just across the border.

Elsewhere, New York's Orange County today reported three measles cases in children younger than 5 years old, but it didn't list exposure source or vaccination status. A local media report said two of the patients were babies younger than 12 months old from separate households who were too young to be vaccinated. Officials said the families had recently returned from Europe.

Excess bodyweight is linked to experiencing long-COVID neurologic symptoms, including headaches, vertigo, sleep problems and depression, according to a meta-analysis of studies involving almost 140,000 participants published yesterday in PLOS One.

Overall, the studies included 79,050 people with excess weight compared to 57,926 normal-weight people and 30,694 individuals with obesity compared to 107,612 non-obese individuals.

Excess weight was associated with a higher rate of depression in long COVID (risk ratio [RR], 1.21 (95% confidence interval [CI], 1.03 to 1.42), memory issues (RR 1.43; 95% CI, 1.24 to 1.65), and sleep disturbance (RR, 1.30; 95% CI, 1.16 to 1.48), or increases of 21%, 43%, and 30%, respectively.

Obesity was significantly associated with persistent headache (RR 1.45; 95% CI, 1.37 to 1.53), and numbness (RR 1.61; 95% CI, 1.46 to 1.78). Obesity was also linked to persistent loss of taste and smell. 

Fat tissue may act as virus reservoir 

"These findings suggest that EW [excess weight] might contribute to the development of these symptoms that persist for more than 12 weeks after COVID-19 onset," the authors concluded.  "Moreover, this study is opportune as we transition into the post-pandemic period facing the challenges of managing the co-occurrence of pandemics, including overweight/obesity, mental health issues, and the burden of PCC [post-COVID condition, or long COVID]."

The authors explain that the mechanisms behind the association between neurologic symptoms and excess weight are not clear, but it may be because of metabolic disorders already found in the overweight participants before COVID infection. 

The adipose tissue plays a role in SARS-CoV-2 entry and deposition, and it may serve as a reservoir for virus spread.

Alternatively, the authors wrote, "The role of EW in the progression of COVID-19 is not fully understood, though it may be linked to an exaggerated inflammatory response or pre-existing genetic factors that these conditions share. The adipose tissue plays a role in SARS-CoV-2 entry and deposition, and it may serve as a reservoir for virus spread."

Cholera cases are still on the rise in Africa, with four high-burden countries—especially South Sudan and Angola—accounting for about 90% of cases in the most recent reporting week, a top official from the Africa Centre for Disease Control and Prevention (Africa CDC) said today at a weekly briefing.

"The cholera situation is still of great concern," Ngashi Ngongo, MD, PhD, MPH, who leads Africa CDC's mpox incident management team, told reporters. For the most recent week, 3,781 cases were reported, up just over 9% for the previous week. Also, 103 people died from their infection, an increase of 78% from the week before.

Severe crisis requires regional, coordinated response

South Sudan has the highest incidence, followed by Angola. The Democratic Republic of the Congo (DRC) and Sudan round out the four hardest-hit countries.

In Angola, where nearly 18,000 cases have been reported this year, males make up just over half of cases, and children younger than 15 years old are the most affected age-group, Ngongo said. Cases showed a slight decline last week but remain high, and nearly one third of deaths occurred outside of hospital settings.

The outbreaks in Angola, South Sudan, and the DRC signify a severe crisis, and Ngongo said the cholera situation needs an African regional coordinated response, similar to that for mpox, to curb the spread.

Two papers published this week in the journal Vaccine suggest outer membrane vesical (OMV)-based meningococcal B (MenB) vaccines could reduce gonorrhea incidence.

The two systematic reviews and meta-analyses, one conducted by researchers from Semmelweis University in Hungary and the other by a team from the University of West Attica in Greece, looked at studies that compared the incidence of gonorrhea in those who received OMV-based MenB vaccines and either unvaccinated individuals or recipients of other meningococcal vaccines.

With an estimated 82 million cases annually, gonorrhea is one of the most common sexually transmitted infections. But rising antibiotic resistance in Neisseria gonorrhoeae has limited the antibiotic treatment options, leading to growing interest in a gonorrhea vaccine.

Because of the challenges in developing a vaccine against gonorrhea, researchers have also considered whether vaccines that successfully target Neisseria meningitidis could promote cross-protection. Recent research has suggested that the four-component serogroup B meningococcal vaccine (4CMenB) and other OMV-based MenB vaccines might offer such protection.

Evidence of moderate protection

Both papers found evidence from the published literature that OMV-based MenB vaccines could offer moderate protection against gonorrhea. In a quantitative analysis of seven studies, six of which investigated the 4CMenB vaccine, the Hungarian researchers found a pooled vaccine effectiveness (VE) of 38% against gonorrhea infection. Complete vaccination with the full two-dose series was 24% more effective than partial vaccination. When they looked only at the studies of the 4CMenB vaccine, pooled VE was 41%. 

"4CMenB OMV vaccine should be prioritised for sexually active individuals over non-OMV alternatives, with emphasis on completing the full vaccination series," the Semmelweis University researcher wrote. 

In the other review and meta-analysis, which included nine studies (eight investigating the 4CMenB vaccine), the pooled VE was 30%.

"While randomized clinical trials are necessary, the findings of this systematic review and meta-analysis highlight the potential effectiveness of OMV-based vaccines in terms of gonorrhea prevention," the University of West Attica researchers concluded.

Both groups added that targeting high-risk groups, such as men who has sex with men, should be considered.