IATA Medical Contact Group - COVID-19, Monkeypox, other outbreaks

COVID-19:

WHO’s Emergency Committee on COVID-19 met again, and once again advised that this is still a PHEIC. The Committee’s report is here:
https://www.who.int/news/item/12-07-2022-statement-on-the-twelfth-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic.

Travel-related recommendations are essentially unchanged, calling for continued adjustment of international travel-related measures based on risk assessment, and against vaccination being obligatory for travellers.

New guidance from WHO on travel came out a few days prior, although some of the referenced data and some of the text is far from new:

https://www.who.int/publications/i/item/WHO-2019-nCoV-Policy-Brief-Risk-based-international-travel-2021.1

https://www.who.int/publications/i/item/WHO-2019-nCoV-Risk-based-international-travel-2021.1

According to Airfinity, vaccine effectiveness against BA.4/.5 may remain similar to BA.2:

While the impact of Omicron on vaccine effectiveness is well documented, it remains unclear whether the recent BA.4/5 Omicron sub-lineages have an additional impact relative to previous sub-lineages. Preliminary data from UKHSA suggests this is not the case, with broadly equal odds of infection of BA.4/5 vs BA.2, in the vaccinated, suggesting similar effectiveness. While further analysis is required, currently there is no evidence to suggest BA.4/5 significantly further impacts the effectiveness of current vaccines.

A new subvariant first detected in India, BA.2.75 appears to be outcompeting BA.5 and BA.2 (with a growth advantage of 17% thus far) suggesting the potential to cause a wave. BA.2.75 cases have been identified in other countries, including Australia, New Zealand, UK and Germany, but remain low at this time.

Separately, the city of Shanghai had a COVID-19 case involving a new subvariant Omicron BA.5.2.1, an official told a briefing on Sunday, signalling the complications China faces to keep up with new mutations as it pursues its “zero-COVID” policy.

On incubation periods (and serial generation intervals) for Omicron vs Delta, here – Park et al: https://www.medrxiv.org/content/10.1101/2022.07.02.22277186v1

And on long COVID, a pre-print of a study by large consortium shows that new onset psychiatric diagnoses are predicted by post-acute sequelae of COVID-19 – Coleman et al: https://www.medrxiv.org/content/10.1101/2022.07.08.22277388v1

FYI the recording and presentations from the webinar on Post COVID-19 Condition focused on neurology and mental health is now on WHO website for your reference.

 

OTHER INFECTIONS:

Ghana announced two suspected cases of Marburg virus disease; if confirmed these would the first such infections recorded in the country. Marburg is a highly infectious viral haemorrhagic fever in the same family as Ebola.  Marburg is transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials. Illness begins abruptly, with high fever, severe headache and malaise. Many patients develop severe haemorrhagic signs within seven days. Case fatality rates have varied from 24% to 88% in past outbreaks.

As you know, There has been a substantial increase in monkeypox approaching 10,000 cases now across over 60 non-endemic countries, with a different clinical profile to previous outbreaks. The WHO is expected to have a further emergency committee meeting on Monkeypox in July. The most recent WHO update is here:  Multi-country monkeypox outbreak: situation update: 27 June 2022

A new update from WHO on the childhood cases of acute hepatitis, now at around 1000 cases, is here: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON400

Many countries in the Americas and in South-East Asia continue to face large dengue fever outbreaks, driven by dengue’s high R0 (reproduction rate) of more than 4.5 in the presence of the relevant mosquito vector.

The DRC saw 351 total cases of Plague from 27 March to 26 June 2022. Plague is endemic in the region where the outbreak is occurring but neighbouring regions are at risk.

Finally some good news:  Malaria vaccine may have prevented 272,000 malaria cases and 85,000 deaths in sub-Saharan Africa:  According to the WHO, as of 21 April 2022, > 3 million doses of the RTS, S vaccine have been administered since 2019. Assuming that each vaccinated individual received 4 doses, it was estimated that > 750,000 children have been vaccinated. The number of malaria cases and deaths prevented from vaccination was estimated using mean VE estimates against clinical and severe malaria of 36.3% and 32.2%, respectively. Up to 272,250 clinical and 241,600 severe malaria cases may have been prevented by vaccination. Between 3,600 and 85,800 deaths may have been prevented, calculated by applying a range of case fatality rates to prevented severe cases.


Best wishes,
David Powell

IATA Medical Advisor