Kai Kupferschmidt Profile picture
Apr 15, 2023 9 tweets 2 min read Read on X
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) Image
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.“
Full report is here: who.int/emergencies/di…

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More from @kakape

Jun 20
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.
Read 8 tweets
Jun 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…
Read 7 tweets
May 30
Some more details on the latest (3rd) human case of #H5N1 #avianflu linked to the current outbreak in dairy cows:
- second case in Michigan but not linked to the other case (different farm)
- reported cough and eye discomfort with watery discharge
- given oseltamivir, isolating at home
"As with the previous two cases (one in Texas, one in Michigan), the person is a dairy farm worker with exposure to infected cows, making this another instance of probable cow-to-person spread."
"The patient reported upper respiratory tract symptoms including cough without fever, and eye discomfort with watery discharge.  The patient was given antiviral treatment with oseltamivir, is isolating at home, and their symptoms are resolving."
Read 5 tweets
May 16
A thought on communication:
In today’s presser's opening statement @USDA presented work on killing H5N1 in ground beef through cooking. They mentioned no virus being present at 160°F and 145°F. Only later when someone asked, they mentioned that at 120°F there was some virus left.
@USDA I have thought a lot about trust and transparency in the wake of the #covid19 pandemic and to me this seems exactly the kind of communication style that does not build trust.
Yet another lesson not learnt in my book...
@USDA For reference, my thread on this:
Read 4 tweets
May 16
Researchers at @USDA have done a “ground beef cooking study” to test at what temperature #H5N1 in meat is killed. To be clear: Tests have found no H5N1 in beef samples, so this was done “in the interest of scientific inquiry and to further reaffirm consumer confidence”
@USDA So researchers added #H5N1 to ground beef patties then cooked them:
“There was no virus present in the burgers cooked to 145° [Fahrhenheit] internal temperature, or roughly medium, or 160°, which equates with a well done burger, which is the recommended cooking temperature”
@USDA At lower temperatures, some virus survived. "Cooking to I believe it was 120° [Fahrenheit] did show that there was virus still in the cooked hamburger patty, although at much, much reduced levels."
(But remember that these were experimentally infected burgers.)
Read 4 tweets
May 16
#h5n1 presser by @USDA and @HHSGov just ended. Had some some interesting bits (but what I would really love to see is still... serology):
@USDA @HHSGov - USDA researchers have done a “ground beef cooking study” to test at what temperature #H5N1 in meat is killed. To be clear: Tests have found no H5N1 in beef samples, so this was done “in the interest of scientific inquiry and to further reaffirm consumer confidence”
@USDA @HHSGov So the researchers added H5N1 to ground beef patties then cooked them. “There was no virus present in the burgers cooked to 145 degrees internal temperature, or roughly medium, or 160 degrees, which equates with a well done burger, which is the recommended cooking temperature”
Read 9 tweets

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