News Scan for Sep 19, 2018

DRC Ebola vaccination
Smallpox vaccine sent to UK
Childhood deaths worldwide
Low global flu levels

DRC Ebola vaccination drive tops 10,000 as cases hold steady

As the number of Ebola cases and deaths held steady in the Democratic Republic of the Congo (DRC) over the last 2 days, the number of people vaccinated passed the 10,000 mark.

Peter Salama, MD, director-general of emergency preparedness with the World Health Organization (WHO), said on Twitter yesterday that the country topped the 10,000-vaccinee mark on Sep 17 and noted that officials are focusing on individual families and communities where there is less acceptance to answer questions and explain more about the intervention.

Meanwhile, the DRC health ministry today said no new Ebola cases or deaths have been reported over the past 2 days, though health officials are investigating 6 suspected cases. The outbreak total remains at 142 cases, 111 of them confirmed and 31 listed as probable. The number of deaths held steady at 97.

In a related development, the WHO yesterday posted a weekly situation report that detailed disease activity and response actions. It said officials have made a lot of progress in limiting the spread of Ebola to new areas in the more than 6 weeks since the outbreak was declared. It added that the situation in Mangina in the Mabalako health zone has stabilized and that Beni has become the new hot spot, with most new cases occurring there or related to a Beni transmission chain. "Teams must continue to enhance response activities to mitigate potential clusters in the city of Butembo and Masereka Health Zone," the agency said.

The WHO added that there are still significant threats of further spread, including contacts lost to follow-up, delayed recognition of Ebola illness in health centers, poor infection control in health centers, and patients leaving health centers and refusing transfer to Ebola treatment centers.

Since the last WHO report, 6 more patients received experimental treatment, raising the total to 35. They include 19 who received mAb115, 9 who got the antiviral drug remdesivir, and 7 who were treated with ZMapp. Of the treated patients, 16 were discharged, 11 are still receiving care, and 8 died. The WHO said all of the deaths occurred in patients who had advanced disease, including organ failure, upon admission.
Peter Salama Twitter account
Sep 19 DRC update
Sep 18 WHO situation report


Smallpox vaccine sent to UK after monkeypox cases

Healthcare workers who treated Britain's first monkeypox patients earlier this month will now be vaccinated with Imvanex smallpox vaccine in an effort to prevent further spread of the virus. Though the vaccine, manufactured by Bavarian Nordic, is not approved for use in monkeypox outbreaks, smallpox vaccines have previously proved efficacious in preventing monkeypox, the company said in a news release today.

Two people were diagnosed as having monkeypox in the past 2 weeks in the United Kingdom. The cases appear unrelated, but Public Health England (PHE) said both patients recently traveled to Nigeria, where monkeypox infection is more common.

"We are pleased to assist the PHE in this emergency situation, which has required the prompt action from all involved parties, and I am happy that we have been able to respond with such short notice," said Paul Chaplin, president and CEO of Bavarian Nordic. 

Monkeypox is not easily transmitted among humans. It is also much less deadly than smallpox, with an estimated fatality rate of 1% to 10%, the company said.
Sep 19 Bavarian Nordic press release


WHO: 6.3 million deaths in children in 2017, with most preventable

In estimates of childhood mortality for 2017, the World Health Organization (WHO) and its partners said 6.3 million kids younger than 15 died, or 1 every 5 seconds. Most of the fatalities were from preventable causes, including infectious diseases, according to the report, which also included the involvement of UNICEF, the United Nations Population Division, and the World Bank Group.

The youngest children were hardest hit, with the vast majority of fatalities—5.4 million—occurring in the first 5 years of life and newborns accounting for half of the deaths.

Laurence Chandy, UNICEF's director of data, research, and policy, said in a WHO statement that although health officials have made remarkable progress toward saving children's lives since 1990, "Millions are still dying because of who they are and where they are born. With simple solutions like medicines, clean water, electricity, and vaccines, we can change that reality for every child." He added that without urgent action, 56 million children under 5 will die from now until 2030, half of them newborns.

Kids and under age 5 in sub-Saharan Africa bore an especially high fatality burden, accounting for half of all deaths in the youngest children. Another 30% were from Southern Asia. The WHO said that in sub-Saharan Africa 1 in 13 children die before they turn 5, compared with 1 in 185 in high-income countries. In general, mortality rates were higher in rural areas than in urban areas and in children with uneducated mothers compared with moms who had secondary or higher education.

The most common treatable causes in children under 5 were complications during birth, pneumonia, diarrhea, neonatal sepsis, and malaria. In the next older age-group, injuries, especially from drowning and road traffic, become more common.
Sep 18 WHO statement


Flu levels still elevated as Southern Hemisphere nears end of season

Influenza activity remained elevated in South America, while it appeared to decrease in southern Africa, according to the latest global flu update from the WHO.

South American countries still, however, reported flu and respiratory syncytial virus (RSV) activity, most notably influenza 2009 H1N1 circulation.

Australia and New Zealand reported low seasonal levels of flu, and most of the temperate zone in the Northern Hemisphere reported typical inter-seasonal levels. In the Caribbean and Central America, influenza detections remained low.

Flu appears to have peaked in most Asian regions, with some detections in Cambodia and the Philippines.

Of lab-tested samples collected from Aug 20 to Sep 2, the WHO said 82.6% were typed as influenza A and 17.4% as influenza B. Of subtyped influenza A viruses, 64.9% were H1N1 and 35.1% were influenza A(H3N2).
Sep 17 WHO update

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