1. @WHO held a press briefing today. Some interesting but disparate points made at it.
Pediatric #hepatitis: To date 348 probable cases from 5 regions of the world have met the case definition; 70 more are being studied. Only 6 countries have reported more than five cases.
2. Of the pediatric #hepatitis cases, 70% have tested positive for adenovirus, mostly type 41. ~18% of the cases tested positive for #Covid19. @WHO's Philippa Easterbrook says while adenovirus is still the chief suspect, prior or current Covid as a cofactor is still in the mix.
3. @WHO's Easterbrook says "within the week" there should be data from a UK case control study comparing adenovirus rates between kids with hepatitis of unknown etiology and other hospitalized children. Will help to see if #adenovirus is an incidental finding, she said.
4. #Ebola: The case count in the outbreak in NW #DRC remains at 3; all 3 have died. Investigations are ongoing to find how the first case caught the virus. It was previously reported the first case had been vaccinated, but @SoceFallBirima says the man wasn't on the vax registry.
5. #Covid: @mvankerkhove says the world's ability to track evolution of the #SARSCoV2 virus is abating because of a substantial decline in testing & sequencing worldwide. "Our ability to track this virus, to understand its circulation is being diminished."
6. @mvankerkhove pointed to the BA.4 & BA.5 subvariants of Omicron as an example of how this is a problem. People are trying to understand the threat they pose but there are only a few hundred sequences of each available to study.
7. @WHO's @DrTedros was in #Ukraine on the weekend & met with child refugees. He said that from experiences in his own childhood, "I know war very well. I know the sound of it, the smell of it, the distraction associated with it."
8. @DrTedros said of the children he met who had fled #Ukraine: "You can see the impact of this conflict will be generational. Like other conflicts."

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More from @HelenBranswell

Apr 28
1. @ECDC_EU has characterized the cases of pediatric #hepatitis of unknown origin as a "public health event of concern." In a risk assessment posted Thursday, ECDC said cases are rare & the risk for kids can't be accurately assessed but when it occurs, the impact can be high.
2. The numbers of cases of pediatric #hepatitis of unknown origin are changing all the time, as are the number of countries reporting. Even though this just came out from @ECDC, the numbers are already out of date. At present, at least 4 US states have detected 21 cases.
3. Unusual pediatric #hepatitis cases in the US have been detected in Alabama, Ill., NC & Calif. There may be additional states that I don't know of.
@ECDC_EU reports there are 55 cases in 12 EU countries. Israel, Japan + Canada has reported cases. The UK has found as least 114.
Read 7 tweets
Apr 26
1. @UKHSA published a technical brief today on the unusual #hepatitis cases in young children. It contains a bunch of interesting information. You can find it here: assets.publishing.service.gov.uk/government/upl…
2. So far the UK has found 114 of these unusual #hepatitis cases in kids. (111 in the screenshot is out of date.) Most of the kids are under 5. 10 required liver transplants. The UK is reporting the largest number of these cases so far.
3. The unusual #hepatitis cases date back to the beginning of this year in the UK (to October in Alabama) but the preponderance of them have been seen in March & April. The UK is also seeing a lot of adenovirus activity. Adenovirus is the main suspect here.
Read 7 tweets
Apr 26
1. It's rare to have a single #Ebola case. How big will the current outbreak in #DRC get? Anyone's guess at this point. But authorities have confirmed a 2nd person has died at Mbandaka, the sister-in-law of the first identified case.
2. The woman died yesterday; she started experiencing symptoms 12 days earlier, ie about a week after her now dead brother-in-law. No word yet if she was treated in hospital & if so, if the hospital realized she had #Ebola & staff took appropriate precautions.
3. @WHOAFRO says that 145 contacts of these two people have been identified and are being monitored to see if they develop symptoms of #Ebola and need to be isolated.
No word yet if the 2nd case had been previously vaccinated; the 1st case was.
Read 5 tweets
Apr 25
1. This was fast! Genetic sequencing of #Ebola viruses collected from a man in NW #DRC who died on April 21 reveals that this is a new spillover event, not resurgence of activity from earlier outbreaks in this part of DRC.
The sequencing was done at @inrb_kinshasa.
Short 🧵
2. In the past getting an answer to this would have taken a lot more time. Impressive to see how quickly this question was answered.
The sequencing information was contained in a report that discloses important details about this new #Ebola case. virological.org/t/april-2022-e…
3. The man who died of #Ebola on April 21 in Mbandaka was vaccinated against Ebola in 2020 during an earlier outbreak there.
The main purpose of the Merck Ebola vaccine is to extinguish outbreaks. Questions remain about how long it protects. This is n=1, but 😟.
Read 6 tweets
Apr 23
1. #Ebola thread.
#DRC has declared a new #Ebola outbreak after diagnosing the disease in a 31 yo man who died in Mbandaka in NW DRC. This is across the country from the terrible North Kivu-Ituri outbreak that raged from 2018-2020.
afro.who.int/countries/demo…
2. The man began experiencing symptoms on April 5 but only ended up in an #Ebola treatment unit on April 21. That means there were probably unsafe exposures during that time. Or as @MoetiTshidi put it: "The disease has had a two-week head start and we are now playing catch-up."
3. On the positive side: at the #Ebola treatment unit, staff recognized what they were dealing with & were protected. The man was given a safe burial.
And there are a lot of people in Mbandaka & surrounding region who have been vaccinated with the Merck Ebola vaccine. #DRC
Read 7 tweets
Apr 22
1. A short #flu thread.
@CDCgov's latest flu report, for the week ending April 16, shows flu chugging along pretty much at levels seen over the past number of weeks. A bit surprising it isn't dropping off by now, but flu in the time of Covid is even more unpredictable than usual.
2. Three more pediatric #flu deaths were reported to @CDCgov last week. They occurred in late Jan., late Feb., and mid-March. (There's often a reporting delay.) This season 22 children have died from flu in the US.
3. The Covid pandemic has really disrupted #flu transmission; there was almost no flu in the winter of 2020-21 and very low rates this year.
In the US, virtually the only type of flu to have made it through the Covid bottleneck was H3N2.
Read 4 tweets

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