According to a new update from @WHO, the #Marburg outbreak in Equatorial Guinea is now up to 15 confirmed cases plus 23 probable cases.
All of the probable and at least 11 of the 15 confirmed cases have died (3 recovered, fate of one is unknown)
Of the last 5 cases, 4 were reported in Bata district.
„The presence of confirmed cases in Bata increases the risk of disease spread, as it is the most populated city and economic hub of Equatorial Guinea, with an international airport and port.“
Of the four Bata cases, three have an epidemiological link through a family cluster or through health care setting.
„The fourth and most recent case was reported on 7 April; an investigation of this case is ongoing to establish transmission chains…“
It all still sounds pretty bad and there are clearly a lot of things that need to be improved in the response.
As the report notes:
„Equatorial Guinea is facing an outbreak of MVD for the first time and the country's capacity to manage the outbreak needs to be strengthened.“
„Implemented infection prevention and control measures are insufficient…“
„The diagnostic capacity for Marburg virus in the country is limited in terms of the number of samples that can be analyzed per day (a maximum of around 50 a day)“
„The community's perception of risk is estimated to be very low. There are frequent population movements between the different districts of the mainland region, as well as with the island region, despite the quarantine measures implemented in several of the affected areas.„
„Frequent population movements and very porous land borders are also reported in the districts bordering Cameroon and Gabon, with surveillance at land entry points being suboptimal, and countless uncontrolled paths or trails along the border with Cameroon and Gabon.“
„Also, surveillance at the entry points of the international Bata airport or international seaport, is not optimal.“
So what have I learnt about #misinformation research? I tried to condense it into a list of the 5 biggest challenges the field faces.
Second story in my package of stories about misinformation research is up here (and thread to come):
Let me start with the first:
What even is misinformation?
When I started reporting on the field, eager to delve into things I was really frustrated that I kept coming back to this basic question. I told friends it felt like trying to take a deep dive in a puddle, always forced back to the surface.
In retrospect, it seems obvious that this was going to be a thorny problem that I would have to spend a lot of time on. The definition you use really defines the shape of the problem and it also kinda helps to be sure you're talking about the same thing as your interview partner...
I’ve reported on infectious diseases for 15 years, but during the covid-19 pandemic and even more during the global outbreak of mpox clade IIb, I was shocked by the amount of misinformation I was seeing. Misinfo had always been part of any outbreak, but this felt different.
I ended up spending almost a year at MIT as a Knight Science Journalism Fellow (@KSJatMIT) to try and understand misinformation/disinformation better, to - I hope - be a better infectious disease journalist.
It’s been an interesting experience in turns fascinating and frustrating and when I went back to full-time science writing earlier this year I decided to try and put at least some of what I’ve learnt into words.
I'm seeing a lot of confusion already out there about #mpox and the differences between clades and lineages. I will get into this in more detail later, but for now:
We really don't know for sure whether there is any material difference between clade Ia, Ib, IIa and IIb.
The differences we see might have very little to do with the virus and everything to do with it affecting different populations in different places and spreading different ways once it gets into certain contact networks. Real world data is not comparing apples and apples here...
We will learn a lot in the coming weeks and months and things will become much clearer. But for now there is a lot of uncertainty. My advice as always: Don’t trust anyone who pretends that things are clear and obvious.
In May I wrote about researchers' plans to infect cows in high-security labs with avian influenza #H5N1 to better understand the infections and how easily the virus is transmitted. The results from two of these experiments are now out here in a preprint: biorxiv.org/content/10.110…
WHAT DID THEY DO?
In one experiment (at Kansas State University) 6 calves were infected with an #H5N1 isolate from the current outbreak oronasally and then housed together with three uninfected animals ("sentinels") two days later.
In the other experiment (at Friedrich Loeffler Institut) 3 lactating cows were infected through the udder with an #H5N1 isolate from the US outbreak and 3 other lactating cows the same way with a different #H5N1 isolate from a wild bird in Europe.
One question at the heart of the #h5n1 outbreak in US cows has been: Is there something special about this virus? Or is H5N1 generally able to do this and this particular version was just "in the right place at the right time"?
Quick thread, because it seems we have an answer
Researchers in Germany have done an experiment in a high-security lab infecting cows directly with the strain of #H5N1 circulating in cows in the US (B3.13) and infecting others with an #h5n1 strain from a wild bird in Germany.
(I wrote about the plans here: )science.org/content/articl…
In both cases they infected the udders directly through the teats and in both cases the animals got sick. They "showed clear signs of disease such as a sharp drop in milk production, changes in milk consistency and fever." That suggests there is nothing special about B3.13.
The thing that I find most frustrating about the entire mpox/gain-of-function debate is how the uncertainties that lie at the base of it all just become cemented as certainties that are then carried forward.
(If you know anything about me you know I love me some uncertainty...)
Most importantly: The interim report on the investigation into these experiments released on Tuesday numerous times calls clade II "more transmissible" or even "much more transmissible".
But that is a claim that has very little evidence at all.
In fact you can find plenty of literature that argue the exact opposite, that in fact clade I is more transmissible.
Just, as an example, here is Texas HHS:
"Clade I MPXV, which may be more transmissible and cause more severe infection than Clade II..." dshs.texas.gov/news-alerts/he…