Marburg
BlueDot recently published an analysis of the risk relating to Marburg virus disease. Bearing in mind the mode of spread and the travel patterns for the area and beyond, they assess the outbreak as having high concern regionally (Tanzania and neighbouring countries) but low internationally. Similarly, WHO’s risk assessment is of high risk domestically, moderate risk sub-regionally, and low risk globally. The forecast highest frequency overseas destination from Tanzania is Dubai (at 18% of traffic), followed by DRC and Kenya (via land borders).
We see that a number of Middle Eastern countries (including Oman, Kuwait, UAE, Bahrain, Qatar), Indonesia, and others have advised their citizens against non-essential travel to the countries reporting Marburg cases. Given that the mode of spread requires close contact with people or animals who are symptomatic at the time, this travel advisory seems inappropriately cautious. Other advised precautions are more reasonable, including avoidance of sick people, of bats and their caves/mines, and of contact with others’ body fluids.
Marburg has now reached at least 34 cases (including 30 deaths) in Equatorial Guinea.
COVID-19
Yet another paper, this one from Copenhagen, pointing to optimal immune protection against COVID-19 being obtained from the combination of both prior infection and vaccination (hybrid immunity) is here: https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(23)00040-3/fulltext
Another investigation of suspected on-board spread of COVID-19 has been published, analysing a flight way back in December 2020, from Switzerland to Thailand. All of the 4 cases genomically matched to the likely index case (who was coughing and was frequently unmasked) were seated within a row of that case. https://he02.tci-thaijo.org/index.php/OSIR/article/view/262096/178855
COVID-19 case numbers continue to rise very steeply in India, 60% of new cases there are XBB.1.16 and the same subvariant is also rising in Australia, Brunei in Singapore. Globally however, although XBB.1.16 is being watched closely, it is a very small proportion of new cases; the dominant strain is still XBB.1.5 at around 60%, followed next by XBB.1.9.1 and XBB.1.9.2 together.
Other illnesses:
WHO reports concern over cholera: 24 countries in Africa, Asia, and the Caribbean are reporting outbreaks, with 4 African nations—Tanzania, South Africa, Zimbabwe, and Zambia—experiencing new outbreaks since mid-February. Malawi had among the highest total cases and the most deaths, 54 841 and 1684, respectively, as of March 20.
Note in US the current outbreak of salmonella, across 11 States, due to flour - with this advice from International SOS:
- Select safe food and pay attention to hygiene:
- Do not eat raw dough or batter.
- When preparing food, ensure that raw and cooked foods are separated. Don't use the same utensils for raw and cooked food unless washed in between.
- Choose food that has been thoroughly cooked.
- Wash your hands thoroughly before eating.
- Wash fruits and vegetables prior to consumption.
- Seek medical advice if symptoms develop.
Another interesting “outbreak” even if of limited relevance to aviation: In Europe there are now over 80 cases of botulism linked to intragastric injection of Botox (botulinum neurotoxin) in Turkish private hospital as a treatment (off-label) for obesity. Risk to the general public is low and the operation has been closed down.
Other matters:
Some Q&A on the work at WHO towards a new pandemic prevention/preparedness/response accord, here:
And here are documents outlining in detail the progress of the work on amendments to the International Health Regulations: A_WGIHR2_6-en.pdf (who.int) and WGIHR_Compilation-en.pdf (who.int)
In closing, here is early advice of the Aviation Health Conference later this year in London, at the Gloucester Millennium Hotel, 26-27 September 2023. I am the chair and already have received several very good presentation abstracts. Registration and details are available at: https://www.tickettailor.com/events/quaynote/794462
David Powell
IATA Medical Advisor