Virus World

PULLMAN, Wash. — A new mobile phone-based facial recognition application for dogs has the potential to significantly improve rabies vaccination efforts in endemic areas like Africa and Asia, according to a study on the research published in the journal Scientific Reports. Led by researchers at Washington State University, a team used the app to test its effectiveness at a rabies vaccination clinic in rural Tanzania where they microchipped, vaccinated and registered dogs. The technology proved remarkably accurate during a subsequent visit to surrounding villages once poor images and improperly recorded information were removed from its database. Using the app, operators identified 76.2% of vaccinated dogs and 98.9% of unvaccinated dogs. “Because domestic dogs are the main reservoir for human rabies, controlling human rabies globally requires the mass vaccination of dogs,” WSU Associate Professor Felix Lankester, the principal investigator of the study, said. “When carrying out mass vaccination, one of the major problems that we face is trying to identify which dogs have and haven’t been vaccinated. For example, microchips are too expensive to use at the scales needed to eliminate rabies, and collars can be removed by owners. We developed this app to see if facial recognition might work, and it’s showing great promise in helping us to achieve that goal.”

Rabies kills an estimated 60,000 people annually. Nearly all cases occur in Africa and Asia, and more than 99% are the result of dog bites. Systematic and consistent vaccination efforts, like those led by WSU’s Rabies Free Africa program, are effective at controlling the disease, but approximately 40% of dogs in an area must be vaccinated at any one time to achieve herd immunity and prevent sustained virus transmission. This makes the ability to accurately and efficiently identify vaccinated dogs vital for successful rabies elimination programs. The facial recognition algorithm used within the application, developed in collaboration with PiP My Pet, a company located in Vancouver, Canada, and researchers in WSU’s Paul G. Allen School for Global Health, identifies a dog by examining key components of its face and comparing it to images of the faces of other dogs in its archive of previously stored images. Images with the highest number of similar components are returned as possible matches, and the user must decide if there is a match.

The app depends on image quality and information about each dog, including its age, color and sex, being properly recorded. Before poor quality images and incorrect information were removed from the database, users were only able to match 65% of the vaccinated dogs. Lankester, who also serves as a director of Rabies Free Africa, said the app’s effectiveness could be improved with better technology – like newer smartphones with high-quality cameras – and additional operator training. In addition to its potential as a tool in identifying vaccinated dogs, the technology holds promise for use in other species, disease control efforts and research purposes where animals might need to be identified. Currently, users must be online to operate the facial matching component, however, Lankester said the team is also working to compress the size of the “engine” that drives the app’s matching facility to allow it to be downloaded and used offline, which would reduce the app’s reliance on internet access, which is not always available in more remote areas. “We’re not quite there yet, but I think with investment, the technology  can get there. I’m excited by its potential,” Lankester said, “but we have to find some funding to invest in pushing it forward. I welcome people to get in touch if they have funding ideas or would like to collaborate on this.”

Research published in Scientific Reports (Dec. 12, 2023):

https://doi.org/10.1038/s41598-023-49522-2 

HIV BREAKTHROUGH - Genetic study identifies Africa-specific variant near CHD1L gene associated with lower HIV-1 viral load in populations of African descent. New research has found a genetic variant that may explain why some people of African ancestry have naturally lower viral loads of HIV, reducing their risk of transmitting the virus and slowing progress of their own illness. The paper, published today in Nature, demonstrates the first new genetic variant related to HIV infection discovered in nearly 30 years of research. It could, in the future, help direct the development of new treatments and approaches for those living with HIV. HIV-1 remains a significant global health crisis, and identifying new targets for therapies is crucial. The study focuses on individuals of African descent due to the disproportionate burden of HIV-1 in Africa and the high genetic diversity in the region. An international team of researchers analysed the DNA of almost 4,000 people of African ancestry living with HIV-1, the most common type of the virus. They identified a variant within a region on chromosome 1 containing the gene CHD1L which is associated with reduced viral load in carriers of the variant. Between 4% and 13 % of people of African origin are thought to carry this particular variant.  Viral load is the amount of a virus in a patient’s system. Higher levels are known to correlate with faster disease progression and increased risk of transmission. But viral load varies widely among infected individuals, influenced by a number of factors including an individual’s genetic makeup. Co-Senior author Professor Manjinder Sandhu, Chair in Population Health and Data Science in the School of Public Health, said: “With more than a million new HIV infections a year, it’s clear that we still have a long way to go in the fight against HIV – we are yet to have a vaccine to prevent infection, have yet to find a cure and still see drug resistance emerging in some individuals. The next step is to fully understand exactly how this genetic variant controls HIV replication.”

Understanding African populations

Most of what we know about the relationship between our DNA and HIV comes from studies among European populations. But given that HIV disproportionately affects people on the African continent – more than 25 million people who are HIV-positive live on the continent – it’s important to better understand the role of genetics in HIV infection in African populations.  Paul McLaren from the Public Health Agency of Canada’s National Microbiology Laboratory and joint first author on the paper, said: “African populations are still drastically underrepresented in human DNA studies, despite experiencing the highest burden of HIV infection. By studying a large sample of people of African ancestry, we’ve been able to identify a new genetic variant that only exists in this population and which is linked to lower HIV viral loads.”

Reducing viral load

CHD1L is known to play a role in repairing damaged DNA, though it is not clear why the variant should be important in reducing viral load. However, as HIV attacks immune cells, researchers at the University of Cambridge’s Department of Medicine, led by Dr Harriet Groom and Professor Andrew Lever, used stem cells to generate variants of cells that HIV can infect in which CHD1L had either been switched off or its activity turned down. HIV turned out to replicate better in a type of immune cell known as a macrophage when CHD1L was switched off. In another cell type, the T cell, there was no effect – perhaps surprising since most HIV replication occurs in the latter cell type.  Dr Harriet Groom said: “This gene seems to be important to controlling viral load in people of African ancestry. Although we don’t yet know how it’s doing this, every time we discover something new about HIV control, we learn something new about the virus and something new about the cell. The link between HIV replication in macrophages and viral load is particularly interesting and unexpected.

Original study published (August 2, 2023) in Nature:

https://doi.org/10.1038/s41586-023-06370-4 

The geographic and evolutionary origins of the SARS-CoV-2 Omicron variant (BA.1), which was first detected mid-November 2021 in Southern Africa, remain unknown. We tested 13,097 COVID-19 patients sampled between mid-2021 to early 2022 from 22 African countries for BA.1 by real-time RT-PCR. By November-December 2021, BA.1 had replaced the Delta variant in all African sub-regions following a South-North gradient, with a peak Rt of 4.1. Polymerase chain reaction and near-full genome sequencing data revealed genetically diverse Omicron ancestors already existed across Africa by August 2021. Mutations, altering viral tropism, replication and immune escape, gradually accumulated in the spike gene. Omicron ancestors were therefore present in several African countries months before Omicron dominated transmission. These data also indicate that travel bans are ineffective in the face of undetected and widespread infection.

Published in Science (Dec. 1, 2022):

https://doi.org/10.1126/science.add8737 

In past Ebola outbreaks, fatality rates have varied from 25% to 90% - but effective treatments are now available, and patients who receive care early see their chances of survival improve significantly.  An outbreak of Ebola has been declared in the Democratic Republic of the Congo - four months after the last one ended. A case was confirmed in a 31-year-old man on 5 April. He was admitted to an Ebola treatment centre on Thursday, but died hours later. The World Health Organisation's regional director for Africa, Dr Matshidiso Moeti, said: "Time is not on our side. The disease has had a two-week head start and we are now playing catch-up." Overall, this is the 14th Ebola outbreak that the Democratic Republic of the Congo has seen since 1976, which is when the virus was first discovered.

Efforts to stem the current outbreak have already begun, with officials confirming that the patient who died has received a safe and dignified burial.  More than 70 of his contacts are also being traced - and vaccinations in the city of Mbandaka are going to be stepped up. Ebola is transmitted by coming into contact with the bodily fluids of an infected person or contaminated materials.  Early symptoms include muscle aches and a fever, which resemble those seen in other common diseases such as malaria. In past Ebola outbreaks, fatality rates have varied from 25% to 90% - but effective treatments are now available, and patients who receive care early see their chances of survival improve significantly. Dr Moeti added: "The positive news is that health authorities in the Democratic Republic of the Congo have more experience than anyone else in the world at controlling Ebola outbreaks quickly."

Malaria kills about 500,000 people each year, about half of them children in Africa. The new vaccine isn’t perfect, but it will help turn the tide, experts said.  The world has gained a new weapon in the war on malaria, among the oldest known and deadliest of infectious diseases: the first vaccine shown to help prevent the disease. By one estimate, it will save tens of thousands of children each year. Malaria kills about half a million people each year, nearly all of them in sub-Saharan Africa — including 260,000 children under 5. The new vaccine, made by GlaxoSmithKline, rouses a child’s immune system to thwart Plasmodium falciparum, the deadliest of five malaria pathogens and the most prevalent in Africa. The World Health Organization on Wednesday endorsed the vaccine, the first step in a process that should lead to wide distribution in poor countries. To have a malaria vaccine that is safe, moderately effective and ready for distribution is “a historic event,” said Dr. Pedro Alonso, director of the W.H.O.’s global malaria program. Malaria is rare in the developed world. There are just 2,000 cases in the United States each year, mostly among travelers returning from countries in which the disease is endemic. The vaccine, called Mosquirix, is not just a first for malaria — it is the first developed for any parasitic disease. Parasites are much more complex than viruses or bacteria, and the quest for a malaria vaccine has been underway for a hundred years. “It’s a huge jump from the science perspective to have a first-generation vaccine against a human parasite,” Dr. Alonso said. In clinical trials, the vaccine had an efficacy of about 50 percent against severe malaria in the first year, but the figure dropped close to zero by the fourth year. And the trials did not directly measure the vaccine’s impact on deaths, which has led some experts to question whether it is a worthwhileinvestment in countries with countless other intractable problems.

Scientists have detected Zika virus RNA in free-ranging African bats. RNA, or ribonucleic acid, is a molecule that plays a central role in the function of genes. A team of Colorado State University scientists, led by veterinary postdoctoral fellow Dr. Anna Fagre, has detected Zika virus RNA in free-ranging African bats. RNA, or ribonucleic acid, is a molecule that plays a central role in the function of genes.  According to Fagre, the new research is a first-ever in science. It also marks the first time scientists have published a study on the detection of Zika virus RNA in any free-ranging bat. The findings have ecological implications and raise questions about how bats are exposed to Zika virus in nature. The study was recently published in Scientific Reports, a journal published by Nature Research. Fagre, a researcher at CSU's Center for Vector-Borne Infectious Diseases, said while other studies have shown that bats are susceptible to Zika virus in controlled experimental settings, detection of nucleic acid in bats in the wild indicates that they are naturally infected or exposed through the bite of infected mosquitoes. "This provides more information about the ecology of flaviviruses and suggests that there is still a lot left to learn surrounding the host range of flaviviruses, like Zika virus," she said. Flaviviruses include viruses such as West Nile and dengue and cause several diseases in humans. CSU Assistant Professor Rebekah Kading, senior author of the study, said she, Fagre and the research team aimed to learn more about potential reservoirs of Zika virus through the project.

The team used 198 samples from bats gathered in the Zika Forest and surrounding areas in Uganda and confirmed Zika virus in four bats representing three species. Samples used in the study date back to 2009 from different parts of Uganda, years prior to the large outbreaks of Zika virus in 2015 to 2017 in North and South Americas. "We knew that flaviviruses were circulating in bats, and we had serological evidence for that," said Kading. "We wondered: Were bats exposed to the virus or could they have some involvement in transmission of Zika virus?" The virus detected by the team in the bats was most closely related to the Asian lineage Zika virus, the strain that caused the epidemic in the Americas following outbreaks in Micronesia and French Polynesia. The first detection of the Asian lineage Zika virus in Africa was in late 2016 in Angola and Cape Verde. "Our positive samples, which are most closely related to the Asian lineage Zika virus, came from bats sampled from 2009 to 2013," said Fagre. "This could mean that the Asian lineage strain of the virus has been present on the African continent longer than we originally thought, or it could mean that there was a fair amount of viral evolution and genomic changes that occurred in African lineage Zika virus that we were not previously aware of."

Fagre said the relatively low prevalence of Zika virus in the bat samples indicates that bats may be incidental hosts of Zika virus infection, rather than amplifying hosts or reservoir hosts. "Given that these results are from a single cross-sectional study, it would be risky and premature to draw any conclusions about the ecology and epidemiology of this pathogen, based on our study," she said. "Studies like this only tell one part of the story." The research team also created a unique assay for the study, focusing on a specific molecular component that flaviviruses possess called subgenomic flavivirus RNA, sfRNA. Most scientists that search for evidence of Zika virus infection in humans or animals use PCR, polymerase chain reaction, to identify bits of genomic RNA, the nucleic acid that results in the production of protein, said Fagre.

Kading said her team will continue their research to try and learn more about how long these RNA fragments persist in tissues, which will allow them to approximate when these bats were infected with Zika virus. "There is always a concern about zoonotic viruses," she said. "The potential for another outbreak is there and it could go quiet for a while. We know that in the Zika forest, where the virus was first found, the virus is in non-human primates. There are still some questions with that as well. I don't think Zika virus has gone away forever."

See Scientific Reports (April 26, 2021):

https://doi.org/10.1038/s41598-021-87816-5 

The mortality rate among patients in the Democratic Republic of the Congo with severe or critical cases of COVID-19 is nearly 50%, according to a study in The American Journal of Tropical Medicine and Hygiene. The study was the first to explore the clinical characteristics and outcome management of COVID-19 patients in an African country. Jean Nachega, MD, PhD, MPH, FRCP, FAAS, associate professor of epidemiology, infectious diseases and microbiology at University of Pittsburgh and adjunct professor of medicine at Stellenbosch University in Cape Town, and colleagues conducted a retrospective cohort study using data from the Democratic Republic of the Congo (DRC) health ministry’s COVID-19 database that was collected between March 10, 2020, and July 31, 2020. The study included data from 766 patients with COVID-19 admitted to the seven largest health facilities in Kinshasa.

“Whilst it is generally thought that COVID-19 in Africa causes lower mortality rates than in Western countries, COVID-19 is an important disease and does cause mortality in elderly adults with comorbidities,” Sir Alimuddin Zumla, KBE, FRCP, FRCPath, FRSB, senior co-author and professor of infectious diseases and international health at University College London, told Healio. “Physicians should not become complacent.” Among the patients in the study, overall hospital mortality was 13.2% (95% CI, 10.9-15.8), with a higher rate of mortality among patients with severe and critical disease than those with mild or moderate disease (45% vs. 2.6%; P < .001). According to the study, 34.6% of patients had at least one comorbidity and 48.5% had more than one. The most common comorbidities were hypertension (25.4%) and diabetes (14%). Of the patients who died, four were children. “One surprising finding was the high COVID-19 death rate among young patients”— 11.8% among patients aged 20 years or younger — “when compared to the United States, where hospitalization rates and death rates in children and adolescents with COVID-19 are lower than those in adults,” Nachega, told Healio.

Published in American J. Topical Medicine and Hygiene (Oct. 2, 2020):

https://doi.org/10.4269/ajtmh.20-1240

The country is now battling two Ebola outbreaks, the coronavirus and the world's largest measles epidemic. A second Ebola outbreak has been confirmed in the Democratic Republic of Congo, some 600 miles from an ongoing epidemic that has claimed more than 2,200 lives. According to the World Health Organization six cases of the highly contagious haemorrhagic fever have been identified and four people have so far died near Mbandaka, the regional capital of Équateur Province.

The outbreak was first announced on local radio by the region's governor, Bobo Boloko Bolumbu, on Monday morning. He said samples from the cases were sent to the INRB, the country’s national medical research organisation in Kinshasa, for secondary confirmation. “The laboratory has given us the information that all the deaths analysed since the 18th of May are a consequence of the Ebola virus,” the governor said. “However, for precision, the samples have been sent to the INRB for quality control. 

“I ask the population to be calm and to continue to respect hygiene measures. Regularly wash your hands with soap. Don’t, say, greet with your hands. Don’t touch ill or dead people who had a fever or bleeding,” he added. DRC's health minister, Eteni Longondo, and the WHO later confirmed the outbreak in Wangata, near Mbandaka. Of the initial six cases, three of  have been confirmed with laboratory testing. Four people have died and two are receiving critical care. ...

South Africa declares “state of disaster” after virus is found to spread locally and cases rise to 61. Late on Sunday evening, South African President Cyril Ramaphosa, in a televised address to the nation, declared that COVID-19, the respiratory disease spreading globally, had become a “national disaster.” The declaration allows his government to access special funding and instigate harsh regulations to combat the viral outbreak. “Never before in the history of our democracy have we been confronted by such a severe situation,” Ramaphosa said before announcing a raft of measures to curb the virus’ spread, including school closures, travel restrictions, and bans on large gatherings.

So far, the official numbers seemed to suggest that sub-Saharan Africa, home to more than 1 billion people, had been lucky. The interactive map of reported COVID-19 cases run by Johns Hopkins University shows big red blobs almost everywhere—except sub-Saharan Africa. But now the numbers are rising quickly. South Africa, which had its first case 10 days ago, now has 61. According to Ramaphosa, the virus has begun spreading inside the country. And just yesterday, Rwanda, Equatorial Guinea, and Namibia all reported their first cases, bringing the number of affected countries to 23. Some scientists believe COVID-19 is circulating silently in other countries as well. "My concern is that we have this ticking time bomb," says Bruce Bassett, a data scientist at the University of Cape Town who has been tracking COVID-19 data since January.

And while Africa’s handling of the pandemic has received scant global attention so far, experts worry the virus may ravage countries with weak health systems and a population disproportionately affected by HIV, tuberculosis (TB) and other infectious diseases. "Social distancing" will be hard to do in the continent’s overcrowded cities and slums. “We really have no idea how COVID-19 will behave in Africa,” says pediatrician and HIV researcher Glenda Gray, president of the South African Medical Research Council. Last month, World Health Organization Director-General Tedros Adhanom Ghebreyesus, who is Ethiopian, said his “biggest concern” was COVID-19 spreading in countries with weak health systems.....

Here’s another growing problem with climate change that politicians and business leaders can ignore—the spread of CCHF. CCHF is not a rock band. That would be CCR or Creedence Clearwater Revival. Instead, CCHF stands for Crimean-Congo Hemorrhagic Fever. And it’s not like cowbell fever. It’s a potentially deadly fever caused by a virus that’s on the list of World Health Organization (WHO) priority pathogens that can cause outbreaks and pandemics. The problem is that the Earth is essentially warming up to the spread of this virus. Rising temperatures around the world have been expanding the habitat of the ticks that can carry and transmit the nairovirus that causes CCHF into more temperate regions such as Europe. For example, Spain had its first cases of CCHF in 2011 and 2016. Yes, folks this is yet another ticking time bomb from climate change. Before you claim that CCHF is not a big deal. Go to the bathroom. Put down your G.I. Joe doll. Open one of your hands. And slap yourself on the face. CCHF is absolutely, positively not like a cold. It’s fun thing to have. That’s unless you find the sudden onset of headaches, high fevers, back pain, joint pain, stomach pain, and vomiting to be a fun things. Oh, and there’s all the well-red stuff, so to speak, like the red eyes, flushed face, red throat, and red spots on your palate, according to the Centers for Disease Control and Prevention (CDC). You can also suffer jaundice. Hmm, what else? You could possibly have changes in your mood. That’s beyond the fact that you’re upset that you have freaking CCHF.

The tip off that CCHF is really bad is the “hemorrhagic” in its name. Very few things with this word—which means a lot of bleeding—are good. For example, if you happen to see “hemorrhagic ice cream” as one of the flavors in an ice cream shop, avoid that flavor. In fact, you may want to avoid the ice cream shop all together. After about four days of symptoms, CCHF can progress to some bloody awful problems such as severe bruising, severe nosebleeds, and uncontrolled bleeding at any part of the skin that may be penetrated with something like a needle. This bleeding can last for two weeks. Death has resulted in 9% to 50% of hospitalized patients during CCHF outbreaks. That’s a pretty high risk of death. Even if you do survive CCHF, recovery can take a long time because bleeding all over the place is not something you simply walk off when it subsides. Here’s some more great news. There no real specific treatments for CCHF. The antiviral drug ribavirin may help. But the jury is still out on that. The main things to do is stay well hydrated, have your electrolytes closely monitored and corrected where needed, and receive extra oxygen and blood when needed. Of course, things could spiral down, requiring ventilator and other types of cardiopulmonary support. You’ve got to beware of getting secondary bacterial infections as well. Yeah, all of this really bites and sucks. Speaking of bites and sucks, Ixodid (hard) ticks such as the Hyalomma ones can carry the CCHF virus. These ticks can bite and transmit the virus to all sorts of animals besides humans such as cattle, goats, sheep and hares. So if you are planning that sheep and hare rave for this Saturday night and a tick brings along the virus, you may have a Saturday night fever situation. The tick can transmit the virus among humans and other animals through biting and sucking. You know what else sucks? Infectious blood or other body fluids can transmit the virus as well. So, you’ve got to make sure that medical equipment and other supplies are properly sterilized.

The flare-up of one of the world’s most infectious diseases has taken hold among church congregations that have rejected vaccinations.  A measles outbreak in Zimbabwe has now killed nearly 700 children, in a rapidly accelerating and “deeply concerning” flare-up of the highly contagious disease.  Health officials told the Telegraph they were alarmed by both the speed of the spread and the high fatality rate of the outbreak, which has seen the recent death toll jump by dozens each day. The flare-up of one of the world’s most infectious diseases has taken hold among church congregations that have rejected vaccinations for religious reasons. Deaths had reached 698 by September 4, according to the nation’s health ministry, up from less than a quarter of that a fortnight earlier. Officials reported that 37 children died on September 1 alone.  The outbreak is thought to be the worst for some time in the southern African nation of 15 million. The last outbreak 11 years ago was far less severe, health sources told the Telegraph. Unicef said that in the worst affected eastern province of Manicaland, nearly one-in-10 of those getting the disease were dying. That rate is higher than in other recent African outbreaks. The UN body said it was “deeply concerned with the numbers of cases and deaths among children due to a measles outbreak in Zimbabwe”. Cases first emerged in April and the virus has since spread quickly among congregations of Zimbabwe’s Apostolic churches, who have long rejected vaccinations and modern medicine.

Faith healers and anti-vaxxers

Dr Johannes Marisa, the president of the Medical and Dental Private Practitioners of Zimbabwe Association, told The Associated Press that the government may need to force children to be vaccinated. He said: “Because of the resistance, education may not be enough so the government should also consider using coercive measures to ensure that no one is allowed to refuse vaccination for their children.” He urged the government to “consider enacting legislation that makes vaccination against killer diseases such as measles mandatory”.  Zimbabwe’s Cabinet has already invoked a law used to respond to disasters to deal with the outbreak and has launched a mass vaccination campaign, which will target two million children under five years. Nationwide, the vaccination rate was around 85 per cent in 2020, having fallen back on previous years when it at times touched 95 per cent.  The country’s Apostolic churches or sects are thought to be followed by around one-in-five of the population. Their teachings regularly include a potent mix of opposition towards Western medicine and belief in faith healing and prayer, meaning the congregations have become a stronghold of anti-vaccination sentiment.  As the outbreak has worsened and pressure has mounted, some church leaders have in recent weeks appeared to change their stance and called on followers to get their children vaccinated. The virus causes fever, coughing and a tell-tale rash, but in some cases it causes complications that can be fatal. Complications include blindness, brain swelling, severe diarrhoea and dehydration, ear infections, or severe respiratory infections such as pneumonia. It is one of the world’s most contagious diseases, with a reproduction rate as high as 18 – compared to an R rate of between 2 and 3 for the original strain of Covid.  Before mass vaccinations began in the 1960s, the disease flared up in occasional epidemics, killing an estimated 2.6m children each year. More than 140,000 people died from measles in 2018 – mostly children under the age of five years, despite the availability of a safe and effective vaccine, according to the World Health Organization. The virus is so contagious that more than 90 per cent of the population needs to be immunised to prevent outbreaks.

Malawi has declared a polio outbreak after a case was detected in a young child in the capital Lilongwe, the first case of wild poliovirus in Africa in more than five years, the World Health Organization (WHO) said. Africa was declared free of indigenous wild polio in August 2020 after going 4 years without a recorded case. Because testing showed that the new case detected in Malawi is linked to a strain from Pakistan, it does not affect Africa’s polio-free status, WHO noted.  “As long as wild polio exists anywhere in the world, all countries remain at risk of importation of the virus,” Matshidiso Moeti, MD, MPH, WHO’s regional director for Africa, said in a statement. The incidence of wild polio has declined nearly 100% since 1988. It continues to be endemic in only two countries, Afghanistan and Pakistan, although only six total cases have been detected in those two countries since the beginning of 2021, according to the Global Polio Eradication Initiative (GPEI).  The GPEI reported that the child in Malawi is a 3-year-old girl who experienced an onset of paralysis on Nov. 19 last year. It said the virus was genetically linked to a strain detected in Pakistan’s Sindh province in October 2019.

“Detection of [wild poliovirus] outside the world’s two remaining endemic countries, Pakistan and Afghanistan, is a serious concern and underscores the importance of prioritizing polio immunization activities,” the GPEI said in a statement. “Until polio is fully eradicated, all countries remain at risk of importation and must maintain high vaccination coverage to protect all children from polio.” According to WHO, health authorities in Malawi have responded to the case with increased surveillance and supplemental immunizations, supported by WHO. Neighboring countries have also ramped up surveillance. A GREI rapid response team based in WHO’s Africa office is deploying to Malawi to support efforts. “Any case of wild polio virus is a significant event, and we will mobilize all resources to support the country’s response,” Modjirom Ndoutabe, MD, polio coordinator at WHO’s Regional Office for Africa, said in a statement.

A patient with the rare, but highly infectious Marburg virus disease has died in Guinea, according to a World Health Organization (WHO) statement on Monday. It's the first case of the Ebola-like virus in West Africa.  Samples of the virus, which causes hemorrhagic fever, were taken from the patient in Gueckedou. The statement added that the detection comes less than two months after Guinea declared an end to its most recent Ebola outbreak. "Gueckedou, where Marburg has been confirmed, is also the same region where cases of the 2021 Ebola outbreak in Guinea as well as the 2014--2016 West Africa outbreak were initially detected," according to the WHO statement. "Samples taken from a now-deceased patient and tested by a field laboratory in Gueckedou as well as Guinea's national haemorrhagic fever laboratory turned out positive for the Marburg virus. Further analysis by the Institut Pasteur in Senegal confirmed the result." Health authorities on Monday were attempting to find people who may have had contact with the patient as well as launching a public education campaign to help curb the spread of infection. An initial team of 10 WHO experts are on the ground to probe the case and support Guinea's emergency response. "We applaud the alertness and the quick investigative action by Guinea's health workers.

The potential for the Marburg virus to spread far and wide means we need to stop it in its tracks," Dr. Matshidiso Moeti, WHO regional director for Africa, said in the statement. According to WHO, the virus is transmitted to humans from fruit bats and can then be spread human-to-human through direct contact with the bodily fluids of infected people or surfaces and materials contaminated with these fluids. There are no vaccines or antiviral treatments to treat Marburg; however, there are treatments for specific symptoms that can improve patients' chances for survival. "Case fatality rates have varied from 24% to 88% in past outbreaks depending on virus strain and case management," the statement said. "In Africa, previous outbreaks and sporadic cases have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda." Marburg virus was first identified in 1967, when 31 people became sick in Germany and Yugoslavia in an outbreak that was eventually traced back to laboratory monkeys imported from Uganda. Since then the virus has appeared sporadically, with just a dozen outbreaks on record. Many of those involved only one diagnosed case. Marburg virus causes symptoms similar to Ebola, beginning with fever and weakness and often leading to internal or external bleeding, organ failure and death.

The wife of a survivor of a large Ebola outbreak in the Democratic Republic of the Congo has died from the disease nearly 8 months after the outbreak was declared over, WHO said, raising concerns about a resurgence of the virus.According to WHO, the DRC Ministry of Health reported the new case in Butembo, a city in North Kivu, the eastern province where the 2018-2020 outbreak took place.  The woman, whose samples tested positive for Ebola, sought medical attention for Ebola-like symptoms and later died. So far, more than 70 contacts have been identified, WHO said. “The expertise and capacity of local health teams has been critical in detecting this new Ebola case and paving the way for a timely response,” WHO Regional Director for Africa Matshidiso Moeti, MBBS, MSc, said in a press release. “WHO is providing support to local and national health authorities to quickly trace, identify and treat the contacts to curtail the further spread of the virus.”

The North Kivu outbreak lasted nearly 2 years and was declared over in June 2020. There were 3,481 cases and 2,299 deaths attributed to the outbreak, and more than 1,160 people recovered. It was the second largest Ebola outbreak on record after the West African epidemic, which lasted from 2014-2016 and killed more than 11,000 people. WHO reported that genome sequencing is currently underway to identify the strain of Ebola the woman had and to determine if it is linked to the previous outbreak. It is unclear if the woman had been vaccinated against Ebola or how she was infected. WHO warned last year that the region could see flare-ups of Ebola, which occurred frequently following the West African epidemic. Ebola survivors who no longer have symptoms can still carry the virus — in semen, for example — allowing for its reintroduction.

After a 32-year campaign to rid the African continent of wild poliovirus, the World Health Organization declared Africa entirely polio-free. Nobody will ever know the identity of the thousands of African children who were not killed or paralyzed by polio this year. They would have been hard to keep track of no matter what because in ordinary times, they would have followed thousands last year and thousands the year before and on back in a generations-long trail of suffering and death. Instead, no African children were claimed by polio this year or last year or the year before. It was in 2016 that the last case of wild, circulating polio was reported in Nigeria—the final country on the 54-nation African continent where the disease was endemic. And with a required multi-year waiting period now having passed with no more cases, the World Health Organization today officially declared the entirety of Africa polio-free. A disease that as recently as the late 1980s was endemic in 125 countries, claiming 350,000 children per year, has now been run to ground in just two remaining places, Pakistan and Afghanistan, where there have been a collective 102 cases so far in 2020. That’s 102 too many, but there is no denying the scope of the WHO announcement. “Today’s victory over the wild poliovirus in the African region is a testament to what can happen when partners from a variety of sectors join forces to accomplish a major global health goal,” says John Hewko, general secretary and CEO of Rotary International. “[It is] something the world can and should aspire to during these turbulent times.”

It was Rotary, an international nonprofit service organization, that kicked off the polio endgame in 1988 with the launch of the Global Polio Eradication Initiative (GPEI). That program aimed to leverage the power of Rotary’s 35,000 clubs and 1.22 million members in 200 countries and territories worldwide to make polio only the second human disease—after smallpox—to be pushed over the brink of extinction. The job was made easier by the partners Rotary immediately attracted: the WHO, the U.S. Centers for Disease Control and Prevention (CDC) and UNICEF. The Bill and Melinda Gates Foundation joined in 2007, followed by Gavi, the Vaccine Alliance, just last year. The 32-year initiative has depended on volunteer workers and charitable donations, which together have produced an army of 20 million field workers administering vaccines to over 2.5 billion children at a cost of $17 billion. Some countries were a lighter lift than others. In the U.S. the disease was eradicated in 1979, well before the GPEI even began its work. Other nations followed: In 1994 the Americas were declared polio-free. Europe as a whole got a clean bill of health in 2002, when all 53 countries in the WHO’s designated European region were declared free of the virus. Massive vaccination efforts began in India in 1997, which eradicated the virus in 2014. 

How Polio Was Eradicated from the African Continent

But Africa, with its vast sprawl of village populations, long distances to urban hospitals, spotty infrastructure like adequate roads and reliable “cold chains”—refrigerated transport networks to keep vaccines viable—was always going to present special challenges. In 1996, when the case count on the continent regularly reached 75,000 victims every year, South African President Nelson Mandela partnered with Rotary to launch the “Kick Polio Out of Africa” Campaign, and the group scrambled fast—or as fast as was possible with so many children to vaccinate on so vast a land mass. In 2000, the first synchronized campaigns began in 17 countries, with 76 million children being vaccinated by tens of thousands of volunteers. The work fanned out across the continent from there, including an especially heavy push from 2008 to 2010, when an outbreak in 24 countries in western and central Africa was met by a large-scale, multi-national vaccination of 85 million children. Finally, Nigeria stood alone as the only African nation where the disease was still endemic, in part because of resistance by religious leaders in the northern part of the country who objected western interference in local affairs and claimed that the vaccine was unsafe. That opposition broke down, partly thanks to Muhammad Sanusi II, the Emir of the city of Kano—a hereditary leader descended from a ruling family—who appeared at a public ceremony before the kick off of a seasonal vaccination campaign in 2016, called for a vial of polio vaccine to be brought to the stage, and with the audience watching, broke its seal and drank down its entire contents. That year, the country recorded its last case of polio, and this year, Nigeria’s WHO certification is the reward for its efforts....

As many as 190,000 people across Africa could die in the first year of the coronavirus pandemic if crucial containment measures fail, the World Health Organization (WHO) warns. The new research also predicts a prolonged outbreak over a few years. "It likely will smoulder in transmission hot spots," says WHO Africa head Matshidiso Moeti. This patchier and slower pattern of transmission sets Africa apart from other regions, WHO experts say.

Other factors taken into account are the region's younger populations who have "benefitted from the control of communicable diseases such as HIV and tuberculosis", as well as lower mortality rates. The WHO's warning comes as Africa's most populous nation, Nigeria, plus others including South Africa and Ivory Coast, have begun relaxing some of their lockdown measures. 

The study finds that between 29 million and 44 million people in the WHO African region could get infected in the first year of the pandemic. Between 83,000 and 190,000 could die in the same period, it warns. The estimates are based on prediction modelling, and focus on 47 countries in the WHO African region with a combined population of one billion - Egypt, Libya, Tunisia, Morocco, Eritrea, Sudan, Somalia and Djibouti are not included. 

Better knowledge of the face of the current dengue virus (DENV) epidemiology in Africa can help to implement efficient strategies to curb the burden of dengue fever. We conducted this systematic review and meta-analysis to determine the prevalence of DENV infection in Africa. We searched PubMed, EMBASE, African Journals Online, and Africa Index Medicus from January 1st, 2000 to June 10th, 2019 without any language restriction.

We used a random-effects model to pool studies. A total of 76 studies (80,977 participants; 24 countries) were included. No study had high risk of bias. Twenty-two (29%) had moderate and 54 (71%) had low risk of bias. In apparently healthy individuals, the pooled prevalence of DENV was 15.6% (95% confidence interval 9.9–22.2), 3.5% (0.8–7.8), and 0.0% (0.0–0.5) respectively for immunoglobulins (Ig) G, IgM, and for ribonucleic acid (RNA) in apparently healthy populations. In populations presenting with fever, the prevalence was 24.8% (13.8–37.8), 10.8% (3.8–20.6k) and 8.4% (3.7–14.4) for IgG, IgM, and for RNA respectively. There was heterogeneity in the distribution between different regions of Africa.

The prevalence of DENV infection is high in the African continent. Dengue fever therefore deserves more attention from healthcare workers, researchers, and health policy makers.

Study Published on Scientific Reports (Open Access):

https://doi.org/10.1038/s41598-019-50135-x