Travel Vaccine Breaking News

Scientists recently announced they used genomics to reveal distinct sexual networks for syphilis transmission in England.

On September 15, 2023, The Lancet Microbe published a study by researchers with the UK Health Security Agency and the Wellcome Trust Sanger Institute, which revealed infectious syphilis diagnoses tripled since 2010.

In England, new diagnoses of early syphilis increased from 3,011 in 2012 to 8,011 in 2019.

About 50% of the cases were in the greater London area.

By comparing the bacterial genomes from different individuals, the researchers could identify single-letter changes in the DNA – known as single nucleotide polymorphisms – to distinguish one bacterium strain or sublineage of T. pallidum from another.

They show distinct transmission chains between individuals and significant resistance to a commonly prescribed class of antibiotics in England.

These health officials believe the increase in syphilis cases reflects increased sexually transmitted disease testing and transmission.

Dr. Ana Cehovin, Senior Research Manager of Infectious Disease at Wellcome, commented in a press release, "Genomic surveillance is an invaluable tool for understanding how diseases are spreading, what populations are at increased risk, and which strains are developing drug resistance."

"Similarly, realizing the potential of genomic surveillance to identify and monitor drug resistance can help decision makers to implement necessary mitigation measures to control the spread of resistant strains, reducing the chance of disease escalation and protecting at-risk communities."

Syphilis is a sexually transmitted infection caused by T. pallidum.

While the genomes of T. pallidum are highly conserved compared to other bacterial pathogens - as they tend to transmit more frequently than they mutate - subtle differences can still exist as it spread through a population.

By comparing how genetically related T. pallidum samples are between individuals with a syphilis diagnosis, scientists hope to pinpoint the source of syphilis outbreaks and construct networks that capture its spread.

As of September 18, 2023, there are no approved syphilis vaccines.

Additionally, about 20 mpox patients were confirmed during 2023 in a similar population subset in London. And various poliovirus samples were confirmed in London in 2022.

The Republic of South Africa's year-long battle against measles outbreaks continues in September 2023.

In the past weeks (week 34 up until week 35), 17 laboratory-confirmed measles cases were detected across the country from four of the eight provinces.

As of September 2, 2023, Gauteng province reported most of the cases (11), Limpopo reported three, Kwa-Zulu Natal reported two, and North West reported one case.

Measles is highly contagious. Around 90% of people who are not protected will become infected following exposure to the virus.

The National Institute for Communicable Diseases (NICD) criteria for declaring the measles outbreak was met in the Northern Cape province in week 15, the North West province in week 24, and the Free State province in week 25. 

Since late 2022, the NICD has tested 6,816 serum samples for measles, of which 1160 (17%) were confirmed positive.

The NICD has implemented numerous vaccination programs throughout the measles outbreaks and continue in September 2023.

According to the U.S. Centers for Disease Control and Prevention (CDC), India leads all other countries over the past year with about 57,000 cases.

In addition, the CDC published a global Travel Health Notice on June 29, 2023, highlighting various measles outbreaks.

As India continues its battle against measles outbreaks, it has accelerated last-mile coverage for measles elimination across the country, reported the World Health Organization (WHO).

The good news is that both measles and rubella can be prevented through vaccination.

India is targeting a vaccination coverage of 95% with two doses of the Measles and Rubella vaccine to achieve measles and rubella elimination by 2023.

To achieve that goal, India is conducting three rounds of Intensified Mission Indradhanush 5.0 under the theme “A big leap towards measles and Rubella Elimination” – with an objective to identify and vaccinate all unvaccinated and under-vaccinated children till five years of age.

Targeted districts in the states of West Bengal, Delhi, Haryana, Rajasthan, Jharkhand, and Mumbai in Maharashtra vaccinated over 30 million children were vaccinated with the measles and rubella vaccine from November 2022 to May 2023.

India is not alone in confronting measles outbreaks in 2023, The WHO and the U.S. CDC have identified over 30 countries with measurable measles outbreaks this year.

As of early September 2023, the CDC reported 19 measles cases in the U.S., including recent cases in Chicago and Texas.

The World Health Organization (WHO) recently announced the initiation of the second round of polio vaccinations in six provinces within the Islamic Emirate of Afghanistan.

The WHO's goal is to ensure every child in the selected provinces.

These vaccinations are essential since five wild poliovirus type 1 cases were confirmed in Afghanistan in August 2023.

Although the number of positive samples in Afghanistan increased in 2023 compared to the year 2022, this was partly due to more intensive surveillance in the country, stated the WHO on August 25, 2023.

The WHO's International Travel and Health also recommends that all travelers to polio-affected areas be fully vaccinated against polio.

Residents (and visitors for more than four weeks) from infected areas should receive an additional dose of OPV or inactivated polio vaccine within four weeks to 12 months of travel.

As of September 2023, the Global Polio Eradication Initiative is focusing on reaching every last child in Afghanistan with vaccines, strengthening surveillance, and maintaining political commitment, financial resources, and technical support at all levels.

Gavi announced today that the Republic of Kenya Kenya surpassed its target of vaccinating 1.59 million people during a 10-day oral cholera vaccine (OCV) campaign conducted in early August 2023.

Speaking in Nairobi on August 28, 2023, the Acting head of the Health Ministry's Disease Surveillance and Response Unit, Dr. Emmanuel, said in a media statement the OCV campaign was in response to a Kenyan cholera outbreak, which was first reported in October 2022 and has so far resulted in 11,872 cases and 196 deaths across Kenya.

"The case fatality rate of the cholera outbreak stands at 1.7%, underscoring the severity of the situation," he said.

However, recent cholera epidemics in different parts of the world have far exceeded that standard, with the average case fatality rates across outbreaks in 2021 standing at 1.9% globally and 2.9% in Africa.

The World Health Organization calls for access to adequate life-saving treatment to maintain case fatality rates below 1%, achievable when appropriate interventions are deployed.

The U.S. Centers for Disease Control and Prevention has confirmed a recent, unprecedented global increase in cholera outbreaks, such as in Haiti. However, nearly all cholera cases reported in the U.S. are acquired during international travel.

According to media reports, the Dengue outbreak in Bangladesh accelerated in August 2023.

The Dhaka Tribune reported on August 26, 2023, that Bangladesh had its worst day ever for Dengue, with nine deaths and 1,960 hospitalized in a day.

This news increases Bangladesh's total number of dengue-related deaths to 537 in 2023.

Dengue is endemic in Bangladesh, resulting in high morbidity and mortality. 

The World Health Organization says Dengue is the fastest-spreading mosquito-borne infectious disease and has emerged as a global public health problem. 

As of August 28, 2023, two approved and various Dengue vaccine candidates are in development.

In addition to the ongoing Dengue outbreak, the U.S. CDC suggests various travel vaccines before visiting Bangladesh in 2023.

The ongoing, multi-country cholera outbreak was recently confirmed to impact African countries significantly.

The World Health Organization (WHO) Africa Region reported for Epidemiologic Week #31, seven African countries, Burundi, Cameroon, Kenya, Malawi, Mozambique, Uganda, and Zimbabwe reported 328 new cholera cases.

Cholera can kill people within hours when not treated, but immediate access to treatment saves lives.

Since January 2022, a cumulative number of 223,951 cholera cases has been reported to the WHO, including 4,125 deaths, with a case-fatality ratio of 1.8% as of early August 2023.

Based on the large number of cholera outbreaks and their geographic expansion, as well as a lack of oral cholera vaccines and other resources, the WHO continues to assess the risk at the global level as very high, as most cases are not reported.

The U.S. CDC previously confirmed an unprecedented global increase in cholera outbreaks in 2022 and 2023.

Nearly all cholera cases reported in the U.S. are acquired during international travel. The CDC's Clinician Outreach and Communication alert in 2023 identified Cholera as an acute intestinal infection that spreads through food and water contaminated with the bacterium Vibrio cholerae, often from feces. With safe water and sanitation, Cholera can be prevented.

As of August 27, 2023, access to cholera vaccines is constrained globally.