1. @WHO put out a meaty release today on the confirmation of Guinea's first detected #Marburg case. A thread.
The first known case, described in the local media as a 46 yo father of five, developed symptoms on July 25. No word yet on the source of his infection. Image
2. This #Marburg case occurred at Gueckédou, which is near where the 2014-16 #Ebola outbreak is thought to have started. Guinea's health system is underfunded, which helped Ebola take off there. But Gueckédou now has a lab to test for viral hemorrhagic fevers. Beneficial legacy. Image
3. The man sought medical care but his illness wasn't diagnosed as #Marburg. He was tested for malaria — a common occurrence when health workers don't know a viral hemorrhagic fever is circulating. After his Aug. 2 death, Marburg was diagnosed pretty quickly.
4. There was recently a small flare up of #Ebola cases linked to the 2014-16 outbreak at Gueckédou. Consequently work was being done in the area to improve surveillance for VHFs. The teams working on that project were redeployed to work on the #Marburg case. Helpful. Image
5. So far, 4 people have been designated as high-risk contacts of the #Marburg case — 3 family members & a health care worker. All are being monitored and are currently asymptomatic.
There were media reports suggesting the man's wife had fled. No mention of that from @WHO. Image
6. Though there are only 4 high-risk contacts at the moment, many other contacts have been identified and are being monitored. Image
7. There are no vaccines for #Marburg & no proven therapies either. Marburg outbreaks haven't been as frequent or as big as #Ebola outbreaks, & so there's been even less work on/opportunity to test vaccines & therapies. Image
8. Finally, to put this in context: The people who were around the man who died are at risk. There's a pretty high risk for that part of Guinea & neighbors Sierra Leone & Liberia. But the global risk is low. If you aren't in that corner of West Africa your greater risk is #Covid. Image

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More from @HelenBranswell

6 Aug
1. Short thread on flu-like activity in the U.S.
#Flu has been at historically low levels around the world during the pandemic. At some point, it will come back. When? Not sure.
Interesting FluView today, @cdcgov's weekly flu report. cdc.gov/flu/weekly/
2. From about late May thru the end of Sept, @CDCgov issues a pared down weekly #flu report, because it's off-season for flu. So there isn't a lot of detail to explain this.
This graph shows out-patient visits for influenza-like illnesses, a.k.a. ILIs.
3. It looks like right now there are more people going to doctors or clinics for ILIs than there were at any point last winter during what would normally be flu season. That red line is the 2020-21 flu season. (In @CDCgov reporting terms, flu season runs from Oct. through Sept.)
Read 7 tweets
6 Aug
1. @SoceFallBirima confirms there is a possible case of #Marburg in Guinea, at Gueckédou — where the 2014-16 West African #Ebola outbreak was first reported.
Samples have been sent to a reference laboratory for confirmation.
This would be West Africa's first Marburg outbreak.
2. For those who don't know Marburg fever, it is very similar to #Ebola — a dangerous hemorrhagic fever that transmits through contact with a sick or dead person's bodily fluids. Marburg outbreaks have been less frequent and generally smaller than Ebola outbreaks.
3. Things to know about #Marburg: There is no licensed vaccine & no approved drugs to treat it. There's been work on experimental vaccines & some Phase 1 trials, which suggests there may be some human grade vaccine available. How much would be a question.
Read 5 tweets
22 Jul
1. @CDCgov's vaccine advisors, #ACIP, are meeting today. I'll try to tweet, but also writing so tweets may be spotty.
Issues are: The suspected link between the J&J #Covid vaccine & Guillain Barre syndrome & whether immunocompromised people should get an additional dose of vax.
2. On the issue of whether immunocompromised people should get +1 dose of #Covid vax, don't expect a decision today. The emergency use authorizations that allow use of the vaccines specify how many doses can be given. Until @US_FDA changes that, #ACIP can't recommend more doses.
3. J&J presented #ACIP some new immunogenicity data for their 1 dose vaccine just now, with data by variant type. The T-cell responses are similar across all variants, the company shows. Persistent humoral and cellular immune responses, over 8 months.
Read 14 tweets
16 Jul
1. @CDCgov announced today that a case of #monkeypox has been detected in Dallas. The person recently returned to the US from Nigeria. The person was traveling alone.
A thread.
2. @CDCgov, state/local health authorities are looking for people who traveled on 2 flights with the person who later was diagnosed with #monkeypox. The 1st was a direct red-eye flight from Lagos, Nigeria to Atlanta that arrived July 9. The second was from ATL to Dallas July 9.
3. #Monkeypox is related to smallpox. It is less dangerous, but it's not not dangerous. About 1 in 100 people infected with the strain that has infected the person in Dallas die from it.
Read 4 tweets
7 Jul
1. @WHO DG @Drtedros says the world is in a perilous position re: #Covid19. The global toll has topped 4M, vaccine nationalism has left many countries with little access to vaccine. That health workers in many countries are still unvaccinated is "morally abhorrent."
2. "Now is the time for the world to come together ... to end the acute phase of this pandemic," @drtedros said during today's @WHO #Covid19 press conference. "It's not charity," he said of working out ways to share vaccines & therapies. "It's the best way to end the pandemic."
3. @WHO's expert panel on vaccines, SAGE, recommends that older people & health workers around the world be vaccinated before young children, because the risk to the former is so much greater, Anne Lindstrom (spg?) from WHO tells the daily newser.
Read 6 tweets
23 Jun
1. The impact of #Covid19 vaccines on the US epidemic. This graphic, from today's #ACIP meeting, speaks volumes.
I will try to tweet from the meeting, but it might be intermittent. First up: myocarditis & pericarditis in some people who've received mRNA vaccines.
2. #ACIP will also be discussing #Covid19 booster shots. Committee was just told it's not yet clear *if* boosters will be needed, but that it's important to plan for boosters if it becomes clear they are needed.
3. #ACIP hearing an explanation of traditional (ie not vaccine-related) myocarditis & pericarditis. The former is mostly seen in males & rates are higher in 15-18 yos than in younger children.
Read 22 tweets

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