1. A thread on #PediatricHepatitis of unknown etiology.
@WHO issued an update today. It reports that 35 countries have reported 1010 cases. There've been 22 deaths (2%) & 46 (5%) of the children have needed liver transplants.
2. @WHO says it appears that the trend of cases is decreasing, but notes this should be interpreted with caution because there are reporting delays, likely under-reporting, and limited surveillance for such cases in many countries.
3. To that end, @WHO has launched an effort to try to assess whether there is a true increase in #PediatricHepatitis cases in the past 10 months or so. This comes on the heels of data from @CDCgov showing there has not been an increase of liver transplants among kids in the US.
4. That @CDCgov study, which I reported on last month, suggests we may be seeing something that was previously occurring but had gone undetected with these #PediatricHepatitis cases, rather than a new phenomenon. statnews.com/2022/06/17/a-c…
5. @WHO says of the 1010 cases of #PediatricHepatitis reported to it, the majority of kids are aged 5 or younger.
6. Adenovirus detections are still commonly reported among cases. SARS-2 infections, less common. It is still not clear if either, both or a combination of the two is behind these cases of #PediatricHepatitis.
7. You can read the @WHO #PediatricHepatitis update here: who.int/emergencies/di…

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More from @HelenBranswell

Jul 14
1. Short #MPX 🧵
There's an interesting #monkeypox paper today in @Eurosurveillanc from researchers in Barcelona. They took 147 specimens from 12 MPX patients, sampling saliva, semen and feces as well as skin/lesion samples and swabs of the throat and anus.
2. They found a high level of positivity among those samples — including finding #MPX DNA in the saliva of all 12 patients in their study. They also found #monkeypox virus DNA in semen (7/9 cases), urine (9/12 cases) and feces (8/12 cases). This raises an obvious question.
3. Sadly, this paper can't answer that question, which is: Can #MPX be transmitted through contact with bodily fluids/products? It can't answer it because the researchers didn't try to grow virus from the specimens, so it's not clear if this was viral debris or infectious virus.
Read 7 tweets
Jul 7
1. Short #MPXV thread, based on data from @WHO_Europe & @ECDC:
The Euro #monkeypox outbreak continues to grow. Of +5200 cases reported here, 29 were women — which seems to be an increase. 15 health workers among cases; not clear if exposure was on the job.
monkeypoxreport.ecdc.europa.eu
2. This may not be new-new, but I haven't noticed this previously: @WHO has pushed back the date on its case definition for suspected #monkeypox cases. They'd previously said March 15; now saying since Jan. 1. Suggests they believe the outbreak started earlier.
3. These regular #monkeypox updates from @WHO_Europe & @ECDC_EU contain really useful information, like this breakdown of symptomology among cases.
Read 9 tweets
Jul 1
1. A #MPXV 🧵
The director of @WHO_Europe issued a stark warning today about the state of the #monkeypox outbreak. Case counts have tripled in Europe in the past 2 weeks, @hans_kluge said.
who.int/europe/news/it…
2. @hans_kluge also noted while the majority of cases are still men who have sex with men, infections are being reported outside of that demographic. There is no reason #monkeypox will restrict itself to spread within a single group. Given the opportunity to transmit, it will.
3. @hans_kluge appeared to predict the #monkeypox outbreak will be declared a public health emergency of international concern sometime soon. An expert committee met last week & advised against declaring a #PHEIC for now.
Read 9 tweets
Jun 23
1. #ACIP is talking #monkeypox right now. Gonna try to live tweet.
This is the prior history in the US with #MPXV.
2. "Everything changed in May of 2022," @CDCgov's Agam Rao tells #ACIP.
3. The US #monkeypox case total is up to 176, @CDCgov says. There is some local transmission occurring, Rao said.
Read 18 tweets
Jun 18
1. #MPXV 🧵
@WHO has issued an update on the #monkeypox situation. In it they announce they're no longer going to report cases from the outbreak outside of Africa; rather, they're going to report all reported cases of/deaths from MPX together.
2. The rationale is clear: why should #MPXV cases in some countries be treated differently — treated as if they are more important — than #monkeypox cases in other countries? Makes sense & is just.
3. On the other hand, will this make it harder to track the outbreak? Isn't it possible there may be differences in cases that are caused by continuous human-2-human spread rather than animal-2-human events where spread stops after 1 or a few cases? Even if this is a DNA virus?
Read 9 tweets
Jun 17
1. Short #flu 🧵
Looks like flu activity in the US is finally declining pretty much nationwide. @CDCgov says it is moving to the shortened FluView format next week, the one it uses in the off-season. Typically is does that from May-Sept, but this year has been different.
2. A child died from #flu last week, the 29th of the 2021-22 flu season. That's a low number compared to pre-Covid years, but as this chart shows, flu has been making a return after its early Covid hiatus. That's bad news for kids and their families.
3. Even though @CDCgov says #flu activity is decreasing, +2000 people were hospitalized for flu last week. In mid-June,
Read 4 tweets

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