1. Does it feel like we're seeing far more filovirus outbreaks (#Ebola, #Marburg) in recent years? It does to me so I plotted outbreaks into a graph. No lab accident cases, or outbreaks with only lab animals, ie 1967 Marburg. Each outbreak is only counted on the year it started. Image
2. Likewise, I didn't count spread to other countries as distinct outbreaks, like the #Ebola cases in Spain, the US & Nigeria, etc from the 2014 West African outbreak.
So it definitely feels like #Ebola & #Marburg outbreaks have been more frequent since the mid-1990s. Image
3. Some of that increase in frequency could be real. Climate change? Better detection of outbreaks. But some of it is probably due to the fact that #Ebola outbreaks beget more Ebola outbreaks. The more Ebola survivors there are, the higher the risk of survivor-ignited cases. Image
4. In recent years genome sequencing tells us that the 2021 outbreak in Guinea was triggered by a survivor of the 2014-16 outbreak. I don't think we know that for outbreaks from 15-20+ years ago.
What am I missing? Gotta be missing stuff.
(info source: CDC, WHO) Image

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More from @HelenBranswell

Sep 30
1. It's Friday, so time for a #flu 🧵
@CDCgov reports that two more kids died from #flu in the 2021-22 flu season. They died in the weeks ending July 30 & Aug. 20. Not super usual time for pediatric flu deaths. They bring the 2021-22 total to 39. Image
2. The rate of outpatient visits by kids under 4 (& to a lesser extent kids, teens & young adults aged 5-24) for a respiratory illness is ticking up. Not surprising to see. Could presage upticks in other ages.
Some of this could be #flu but lots of RSV, rhinoviruses around. Image
3. What's really interesting to me is that #flu remains at super low levels in long-term health facilities. It's been this way pretty much since the Covid pandemic took off. Flu typically takes its greatest toll on frail seniors. Image
Read 6 tweets
Sep 27
1. Short #monkeypox 🧵
US cases have topped 25,000, with 1 confirmed MPX death. Top five states by total numbers: California, New York, Florida, Texas, Georgia.
2. The UK #monkeypox case count has risen by 50 over the past week, to 3,635. The UK has recorded zero deaths so far. The most recent MPX technical brief from @UKHSA came out late last week; some interesting stuff in there. gov.uk/government/pub…
3. The 8th @UKHSA #monkeypox technical brief tries to get at what may be behind the slowdown in new cases. It suggests vaccination is having an effect.
Read 5 tweets
Sep 23
1. A short #flu 🧵
Two more pediatric flu deaths have been reported to @CDCgov for the 2021-22 flu season. One occurred the week ending April 16, the other the week ending May 28. There is often a reporting delay; dunno why.
A total of 37 kids have died from flu this season.
2. And @CDCgov reports there has been another swine #flu infection, the 8th detected this year. The case was someone under 18, from Georgia. Infected with an H1N2 swine flu virus. Individual, who has recovered, had exposure to pigs. No sign of onward spread from this person.
3. #Flu activity is still pretty low — 0.8% of flu tests run by clinical labs were positive for flu the week ending Sept. 17.
But respiratory illnesses among young kids (orange) is ticking up, as @dr_kkjetelina & @cmyeaton explain here: yourlocalepidemiologist.substack.com/p/the-common-v…
Read 4 tweets
Sep 22
1. Short #Ebola
The case count in Uganda's Ebola Sudan outbreak is already up to 7, with 1 death so far. There are 10 other suspect cases & 45 contacts have been identified to date. The outbreak is in a part of the country with a very mobile population; could be a challenge.
2. @WHO is working with the Ugandan govt, which has a lot of experience dealing with #Ebola. There is no licensed Ebola Sudan vaccine, but a number of experimental ones, three of which have Phase 1 data. Could any be tested here? Depends if there are human grade doses available.
3. An update: During today's @WHO press conference, @DrTedros revealed that #Uganda's outbreak is probably bigger than it already seems to be.
7 confirmed #Ebola cases, including 1 confirmed death.
But 7 other deaths are being investigated as probable cases.
Read 6 tweets
Sep 20
1. An #Ebola 🧵.
@MinofHealthUG said today it had detected a case of #Ebola Sudan, more properly called Sudan ebolavirus these days. It's the first time this species of Ebola has been reported anywhere in a decade. Last outbreak was in 2012 in Uganda.
2. The new detection occurred in Uganda's Mubende District, which is west of Kampala, sort of half way between the capital and the border with DRC.
The case was a 24 yo man who has died. But there are likely other cases. Image
3. A report from @WHOAFRO says that there have been six suspicious deaths in Mubende district this month. And an additional 8 suspect cases are being cared for in a health facility. 15 potential cases from the jump is not a small start to an #Ebola outbreak.
Read 8 tweets
Sep 8
1. #NIAID is launching its clinical trial of Jynneos, the Bavarian Nordic #monkeypox vaccine. I wrote about the fact that they were working on designing this clinical trial back in early August.
A short 🧵 statnews.com/2022/09/08/fen…
2. Since I wrote about the trial, things have changed. For starters, @US_FDA authorized use of Jynneos by intradermal administration, using 1/5th of a full dose of vaccine. So this trial is in part studying something that is already being done. Trial sites here. #monkeypox Image
3. The trial will compare safety, tolerability & immunogenicity (not efficacy) of 2 full doses, 2 one-fifth doses & interestingly, 2 one-tenth doses. Curious as to the rationale for such a low dose, especially given the preprint that came out last week. statnews.com/2022/09/02/stu…
Read 4 tweets

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