1. @Eurosurveillanc published a trove of papers today on #monkeypox outbreaks in Europe. A 🧡
A paper from @UKHSA suggests the UK outbreak may be 3 separate events. It doesn't confirm it because there's no discussion of genetic sequence data but the authors may have it becoz ...
2. ... they frame the #monkeypox cases in the UK as constituting 3 incidences. #1 was an imported case from Nigeria; no onward spread. #2 was a family cluster with the first onset date being April 17. No links #1 or #3, which was the start of the cases detected in MSM.
3. Vaccine acceptance among people who were identified as contacts of the UK #monkeypox cases wasn't great. Only 69% of health workers who had contact with cases agreed to be vaccinated; among other contacts of the cases, it was 14%.
4. The @UKHSA paper describes a very challenging task of trying to contact trace in this outbreak. As with a number of #monekypox updates I've seen of late, there's a hint of pessimism about the chances for containment. Note the beginning & end of the text in the screenshot.
5. The table of contents for today's issue of @Eurosurveillanc is here: #monkeypox eurosurveillance.org/content/eurosu…. .

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More from @HelenBranswell

Jun 3
1. The wonkiness that is this year's #influenza season continues. @CDCgov says activity is increasing in parts of the country. Not common for this to be happening at the end of May. (This report is for the week ending May 28.)
cdc.gov/flu/weekly/ Image
2. #Flu appeared to peak this past winter around New Year's. By late February (map on left) it was looking like flu was done. But that was a pivot point, with activity starting to increase again in parts of the country from March until now. Very weird to see deep red so late. ImageImage
3. Intriguingly, there were more people hospitalized for #flu in the US in the last week of May than there were in the week ending Jan. 1, when it looked like flu peaked. But maybe the issue is who is getting sick now. Seniors' flu vax protection has probably waned, Image
Read 4 tweets
May 25
1. A #Monkeypox thread.
There's a new update out from @ECDC_EU. Numbers change by the minute and theirs are a little different from the ones I tweeted earlier. 219 confirmed globally.
They list the US as having 9 cases. Most of those are still presumptive, but presume positive.
2. @UKHSA has just updated their #monkeypox total: 77 (ie, +7) cases in England, 1 in Scotland for a total of 78 in the UK.
Think about that for a second. 78 cases of monkeypox have been discovered in the UK. gov.uk/government/new…
3. Of interest in the @ECDC_EU update: Their case definition gives March 1 as a cutoff date. Anyone who had #monkeypox symptom onset on/after March 1 should be investigated as a possible case.
This is a clue to how long they believe it has been spreading in Europe.
Why March 1?
Read 5 tweets
May 21
1. Short #monkeypox 🧡
@WHO issued a lengthy update just now that includes case definitions for suspected, probable and confirmed cases. To date 12 countries have reported 92 confirmed cases and 28 suspected cases. who.int/emergencies/di…
2. @WHO says the cases are mainly but not exclusively in men who have sex with men. To date all the genetic sequences generated have indicated virus from the West African clade of #monkeypox, the milder clade.
3. The West African clade of #monkeypox is milder than the Congo Basin clade, but according to the scientific literature has a case fatality ratio of ~ 3.6%. As this virus continues to spread we'll see if that CFR is accurate.
Read 5 tweets
May 13
1. Interesting update on #PediatricHepatitis from @ECDC_EU + @WHO_Europe. It contains the first epicurve I've seen, which is very helpful because reported cases include current & previous cases found through record searches. The 1st case here dates to Sept 2021.
2. A large majority of the European #PediatricHepatitis cases are really young β€”Β 76% under the age of 5.
3. The @ECDC_EU/@WHO_Europe #PediatricHepatitis update says as of May 13, a total of 232 cases have been reported. Puzzled by the UK number (131) because yesterday @UKHSA reported 176 cases.
This report reports 3 epidemiologically linked cases, which is interesting.
Read 7 tweets
May 10
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.
Read 8 tweets
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

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