1. A short thread about the newly announced case of #Ebola in Cote d'Ivoire (Ivory Coast).
The diagnosis was confirmed by the Institut Pasteur in Cote d'Ivoire. This does not have the feel of a suspect case — the announcement sounds like @WHOAFRO is confident this is Ebola.
2. A critical point made by @MoetiTshidi, regional director of @WHOAFRO, is that this is the first time since 2014 that an #Ebola cases has been diagnosed in a major city. (I need to refresh my memory about the North Kivu outbreak.) Abidjan population: +4M.
Urban Ebola = not good
3. The @WHOAFRO statement says there's no indication this case, a man who traveled from Guinea, was linked to the Guinean #Ebola outbreak from earlier this year. Work is underway to determine the source of infection.
4. The @WHOAFRO press release says the species of #Ebola has not yet been determined. I was told by a source I trust that it is Ebola Zaire. And vaccine doses are being shipped from Guinea to Cote d'Ivoire. The Merck vaccine would not be expected to work if this isn't Zaire.
5. The only other time Cote d'Ivoire has reported a case of #Ebola was in 1994. That person was infected with the rarely seen Taï Forest strain of Ebola. But this case originated in Guinea, which is suggestive of Zaire ebolavirus.
6. I'll slip in a #Marburg update and then end this for now. No additional Marburg cases have been reported among the contacts of the man in Guinea who died on Aug. 2.

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More from @HelenBranswell

13 Aug
1. #ACIP is meeting now to vote on a recommendation that some severely immunocompromised people be given a 3rd dose of mRNA vaccine in their primary series, because they do not get enough protection from 2 doses. FDA cleared the way for this LATE last night.
I will be tweeting.
2. Here's the story we published last night about this change to the EUAs for the Pfizer and Moderna vaccines. The 3rd dose should be given at least 28 days after the 2nd dose in the series.
No change was made to the 1 dose Johnson & Johnson vaccine.
3. #ACIP has a new chair today. Grace Lee from Stanford takes over from José Romero, Arkansas' health secretary.
The committee is down 3 members today. The term of 3 previous members expired but 3 replacements haven't yet been "onboarded" -- which I think is a paperwork thing.
Read 43 tweets
10 Aug
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.
Read 8 tweets
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

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