Probable plague cluster reported at Uganda-DRC border
Health officials are investigating a pneumonic plague outbreak at the border between Uganda and the Democratic Republic of the Congo (DRC), the World Health Organization (WHO) regional office for Africa said today in its weekly emergencies and outbreaks report.
The initial patient is a 35-year-old woman who got sick in the DRC and whose family brought her to Zombo district in Uganda for medical care. She was seen at a health facility in Uganda for fever, cough, bloody sputum, and difficulty breathing on Mar 1, but died shortly after. She was given a pneumonia diagnosis, and no specimens were taken.
On Mar 4, the woman's 23-year-old cousin presented to the same clinic with the same symptoms. Lab tests were positive for malaria, but the medical team suspected plague, and a rapid test done by the Uganda Virus Research Institute was positive for plague. Additional tests are pending, and tests for viral hemorrhagic fever illnesses were negative.
So far, 55 high-risk contacts—including 11 health workers—are under monitoring, and 59 more who attended the burial but did not have direct contact with either of the women have been identified.
Investigators found that the woman had lived in Mahagi district in the DRC's eastern Ituri province, which borders Uganda and is one of two provinces affected by the country's recent Ebola outbreak. Her 4-year-old child had recently died, and relatives from Uganda attended the burial in the DRC, where they found the mother sick. Also, investigators learned that three other people died of similar illnesses in the DRC.
Plague is caused by Yersinia pestis, a bacterium spread by infected rats via flea bites. Human-to-human transmission fuels the spread of the pneumonic form of plague.
Mar 12 WHO African regional office weekly report
Lassa fever outbreak in Nigeria grows to 420 cases
According to the latest update from the WHO African regional office, the decline in case counts in a Lassa fever outbreak in Nigeria has stagnated, with 39 new confirmed cases and 8 deaths reported in the week ending on Mar 3.
Cases had been on the decline for a month, and in the previous week, only 23 cases were confirmed, including 6 deaths. Between Jan 1 and Mar 3, Nigeria has confirmed 420 Lassa fever cases and 93 deaths, resulting in a case-fatality rate of 22.1%. Fifteen cases and one death have occurred in healthcare workers.
Though cases have been reported across the country, 65% of cases originated in Edo or Ondo states.
"The Lassa fever outbreak in Nigeria continues, with more cases registered during the reporting week. While good progress has been made in the response to contain the outbreak, important underlying predisposing factors still exist," the WHO said. Those factors include poor environmental sanitation and limited implementation of vector control strategies.
Mar 12 WHO African regional office update
Bavarian Nordic notes FDA review delay for smallpox vaccine candidate
Bavarian Nordics today announced that the US Food and Drug Administration (FDA) is extending its review of the company's Biologics License Application (BLA) for smallpox vaccine candidate, MVA-BN, because of the amount of data submitted.
"The BLA for MVA-BN is unusual as we have already manufactured 28 million doses prior to a full regulatory approval and the development involved generating safety and immunogenicity data from 22 clinical studies," said Paul Chaplin, president and chief executive officer of Bavarian Nordic, in a press release. "So while the review process has not raised any significant concerns to date, we understand that the MVA-BN BLA is unusually large and that the FDA requires more time to complete the review."
The BLA was given priority review in December 2018, with a target of a 6-month review process. The new target review date is September 2019.
MVA-BN is based on a live-attenuated vaccine and is currently used in Europe under the name Imvanex. The product is in use in Canada under the name Imvamune.
Mar 12 Bavarian Nordics press release
National Academies launches vaccine facts website
To counter misinformation about vaccines that is fueling measles outbreaks in the United States and other countries, the National Academies last week launched a website that provides clear, concise, and evidence-based information on common vaccine safety questions.
In a joint statement, the three National Academies presidents said the evidence base includes a number of the group's studies that examined vaccine access, safety, scheduling, and possible side effects. "Our work has validated that the science is clear—vaccines are extremely safe," they said.
The presidents are Marcia McNutt, PhD, with the National Academy of Sciences, C.D. Mote, Jr, PhD, with the National Academy of Engineering, and Victor Dzau, MD, with the National Academy of Medicine.
"Given our shared congressional mandate to advise the nation, we are compelled to draw attention to these facts in order to inform better decision-making at a time when it is urgently needed to protect the health of communities in our country and around the world," they wrote.
Mar 8 National Academies presidents' statement
National Academies Vaccines Are Safe website
In international vaccination developments, Italian parents yesterday reached a deadline for having their children vaccinated as requirement for attending school, the BBC reported today. Parents face fines for not having their children vaccinated against chickenpox, polio, measles, mumps, and rubella.
The requirement, called the Lorenzin law, came into effect during Italy's previous government, and the current one initially said it would drop mandatory immunizations, though it later reversed its position following accusations that it was anti-vaccine.
Italy is among the countries in Europe reporting large numbers of measles cases.
Mar 12 BBC story
