1. Short thread from @WHO's weekly press conference. Covid-19 remains a Public Health Emergency of International Concern (PHEIC), the @WHO emergency committee decided at a meeting last week. Today @drtedros said he agrees.
2. The EC chair, Didier Houssin, said for the first time at this meeting, the committee talked about the possibility of terminating the PHEIC. But the committee concluded it was too early to do so. Among other things, they want to see how this winter goes in the NHemisphere.
3. @DrTedros revealed that @WHO and partners have decided to effectively ration #Cholera vaccines, because of a global shortage. Normally cholera vax is given in 2 doses but will be used as a 1 dose vaccine. This strategy has been shown to be effective before.
4. @DrMikeRyan noted that vaxes like #cholera don't earn big money for the manufacturers, which makes it hard to keep production at levels that can meet the burgeoning need.
5. On #Ebola, @drtedros said @WHO is concerned that there may be more chains of transmission in Uganda than have been recognized. For instance, eight recent cases were not among known contacts of cases — that is a bad sign.
6. Back to cholera: @drmikeryan noted pointedly that there would be no problem finding the money to boost #cholera vaccine production if cholera was affecting affluent countries. @WHO
7. @SCBriand notes that with climate change, the number of places that could be endemic for #cholera is increasing. She said the world needs to invest not only in production of more vaccine but in ensuring access to clean water in places where the causative bacterium is found.
8. @WHO's emergency committee on #monkeypox meets tomorrow. The number of new cases has dropped for 8 weeks in a row, @drtedros said, noting though that risks and uncertainties remain.
9. @drtedros pleaded for the world to address the situation in Ethiopia, his home country. "I am running out of diplomatic language for the deliberate targeting of civilians in Tigray," he said.
10. "There is no other situation globally in which nearly 6M people have been kept under siege for nearly 2 yrs," @drtedros said. "Banking, fuel, food, electricity & health care are being used as weapons of war....The world is not paying enough attention."
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1. #ACIP is meeting today & tomorrow. This is one of their 3 scheduled meetings that take place every year.
There will be some discussion of Covid vaccines today, but this meeting will not be primarily about Covid vaccines. Lots of items on this agenda. cdc.gov/vaccines/acip/…
2. I will NOT be live tweeting much in this meeting. When I do tweet, I will do it in this thread.
There are not going to be many votes during these 2 days. Many of the sessions will be about informing #ACIP members on vaccines in development (eg. chikungunya).
3. There'll be a vote about adding Covid vaxes to the Vaccines for Children program. With federal money for Covid all but exhausted, the full cost of future boosters will be paid by individuals or their insurance. This is about ensuring kids without insurance can get vaxed. #ACIP
1. Two fascinating reports from 2 different @CDCgov journals today on #monkeypox acquisition via needlestick injuries. The takeaway message for me: If you are a HCP & you have a sharps injury involving MPX, you probably want to get vaccinated right away.
2. The first report came out in #MMWR. A Florida nurse who was using a syringe to extract fluid from a suspected #monkeypox lesion pricked her finger, drawing blood. She got the first of 2 doses of Jynneos within 15 hours & only developed 1 lesion. cdc.gov/mmwr/volumes/7…
3. The 2nd report, in @EIDjournal, is about a Portuguese doctor who had a similar needlestick injury while sampling a suspected #monkeypox lesion. There was no bleeding, he thought his glove was intact, and he didn't report the exposure. He was not vaccinated.
1. A short #flu update: @CDCgov has posted the FluView report for the week ending Oct. 8. It is the first FluView report for the 2022-23 flu season.
Flu activity is ticking up a bit, especially in the southeast and southcentral parts of the US.
2. The increase in #influenza-like illness (not all #flu) seems to be most marked in young kids, which isn't much of a surprise. Little kids always catch a lot of respiratory infections; kids who were protected from them in the early part of the pandemic may catch more for awhile
3. Something I do find surprising is that #flu outbreaks in long-term care facilities are still really rare. 0.3% of LTCF reported a flu outbreak last week. Seniors are really susceptible to flu & LTC outbreaks were common in the before-times. Will be again, no doubt.
1. Turning this into a short #Ebola thread:
Uganda's health ministry is producing daily or near daily situation reports (I've seen some), but they are not being released to the media, as far as I can tell. It's been challenging finding up to date data on what's going on there.
2. There have been at least 10 #Ebola infections in health workers. To date 4 have died. The following info comes from the twitter account of Uganda's health minister. The deceased are: Ms. Nabisubi Margaret, an anesthetic officer; Dr Mohammed Ali; an unnamed midwife and ...
3. ...and an unnamed health assistant in Kagadi District. Tragic losses.
Cases have been reported in at least 5 districts in the country.
I am not sure at this point how many confirmed & probable cases there have been. Between 61 or 63, I think. I think there've been ~30 deaths
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.
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.
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.
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.
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.
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.