New Coronavirus News from 28 Aug 2022

Japan-specific COVID strains set loose at same time as Games | The Asahi Shimbun: Breaking News, Japan News and Analysis [Asashi Shimbun, 28 Aug 2022]

By KENTA NOGUCHI

Strains of the novel coronavirus rampant in Japan in the summer of last year when the delayed 2020 Tokyo Olympics were held spread afterward to at least 20 countries and regions, research shows.

Researchers primarily from the Institute of Medical Science of the University of Tokyo (IMSUT) concluded they could not rule out the possibility that the Games were responsible for the spread of the AY.29, a Delta subvariant that originated in Japan.

The Summer Olympics were held from July 23 through Aug. 8, followed by the Paralympics between Aug. 24 and Sept. 5.

Referring to a document from the organizing committee for the Games, the researchers noted that 863 people associated with the event, including athletes and staff members, were diagnosed with COVID-19 during the sessions.

Off that figure, many were Japanese residents. Contractors responsible for event site management, security and other duties accounted for the largest portion with 502 cases.

Those engaged directly in the Games made up 201. Athletes tested positive in 41 cases.

Around that time, Tokyo was under a third state of COVID-19 emergency. Because the AY.29 subvariant of the Delta variant, which was unique to Japan, was often detected while the sports extravaganza was on, its later discovery overseas strongly indicates the virus came from Japan.

The research team analyzed the genome, or the complete set of genetic information, of new coronaviruses confirmed overseas through Jan. 10, 2022. The results revealed that 118 of them were linked to the AY.29 subvariant.

The viruses were spotted in 20 countries and regions, including the United States, Britain, Canada, Germany and South Korea.

The 118 samples were divided into 55 differing strains based on their genome’s tiny but distinctive differences.

Among them were cases that had no links with the sports events. One of the strains is believed to have reached Hawaii from Japan before the Games. Another is thought to have been transmitted by personnel associated with the U.S. military stationed in Japan’s southernmost prefecture of Okinawa.

After excluding those irrelevant cases, the researchers found that in the remaining 41 cases, their ancestral strains had been collected from domestic patients in the Japanese capital, neighboring Kanagawa Prefecture and elsewhere in the Tokyo metropolitan region.

Though the team said, “There remains a possibility that these 41 strains are associated with the Olympic and Paralympic participants,” whether the AY.29 was actually carried by visitors to the Games when they returned to their home countries could not be confirmed.

According to Seiya Imoto, a professor of biology at the IMSUT’s Human Genome Center who did the research, no information has been disclosed that is necessary for ancestral research of viruses’ variants detected from athletes and staff during the Games.

On top of that, the viruses’ genome analysis alone could not determine who actually was the unwitting carrier on leaving Japan.

Individuals with no ties to Olympic and Paralympic Games may have left Japan during these periods as data from the Japan National Tourism Organization shows that 40,000 to 60,000 Japanese departed each month for overseas destinations between July and September 2021.

Few strains deriving from the AY.29 have been reported anywhere in the world since winter 2021. The Omicron variant then emerged and quickly ravaged Japan and other parts of the world.

Imoto called the team’s findings important, noting that much tougher anti-virus approaches designed to reduce infections as much as possible can place a heavy burden on athletes, lowering their performance.

“Some infections inevitably go undetected even though people are screened at the time of their arrival and departure,” said Imoto. “What is significant is comparing the Games’ countermeasures with their outcomes to provide lessons for future international events. I want our achievement to be utilized for that purpose.

The team’s findings were published Aug. 3 in the Swiss academic journal Frontiers in Microbiology at (https://www.frontiersin.org/articles/10.3389/fmicb.2022.883849).

New Coronavirus News from 25 Apr 2022

Korea reports 113,371 new Covid-19 cases [The Korea JoongAng Daily, 25 Aug 2022]

BY CHO JUNG-WOO

Korea reported 113,371 new Covid-19 cases on Thursday, a slight fall from Wednesday's figure.

The number of critically ill patients reached 566, according to the Korea Disease Control and Prevention Agency (KDCA) Thursday. There were 108 deaths, the highest figure in almost four months.

The accumulative total of confirmed cases in Korea stood at 22,701,921.

N. Korea sees suspected COVID-19 cases after victory claim [The Washington Post, 25 Aug 2022]

By Kim Tong-Hyung

Pyongyang citizens pay tribute to the statues of their late leaders Kim Il Sung and Kim Jong Il on Mansu Hill on the occasion of the 62nd anniversary of Kim Jong Il’s first field guidance for the revolutionary armed forces in Pyongyang, North Korea Thursday, Aug. 25, 2022. (AP

SEOUL, South Korea — North Korea on Thursday said it found four new fever cases in its border region with China that may have been caused by coronavirus infections, two weeks after leader Kim Jong Un declared a widely disputed victory over COVID-19.

North Korea’s state-run Korean Central News Agency said health workers were conducting genetic tests on the samples taken from four people in Ryanggang province who exhibited fevers to confirm whether they were caused by the “malignant epidemic.” North Korea often uses that term, along with “malignant virus,” to describe COVID-19 and the coronavirus.

North Korea reports suspected Covid cases on China border two weeks after declaring victory over virus [CNN, 25 Aug 2022]

By Gawon Bae, Paula Hancocks and Tara Subramaniam

(CNN)Two weeks after North Korea declared victory over the coronavirus, the country has reported four suspected cases in a province near its border with China.

The area where the suspected cases were found was "immediately locked down," state news agency KCNA reported Tuesday.

Citing the country's State Emergency Epidemic Prevention Headquarters, KCNA said four "fever cases suspected of being infected with malignant epidemic occurred at a unit in Ryanggang province on August 23."

North Korea has limited testing capabilities and refers to suspected Covid infections as "fever cases."

It acknowledged its first confirmed cases of Covid-19 in May, when it reported what it referred to as an "explosive" outbreak and a "major national emergency".

It has since gone on to record 4.77 million suspected cases, but has reported no new ones since July 29 and on August 11 leader Kim Jong Un declared victory over the virus.

However, many experts -- including those at the World Health Organization -- have cast doubts on its claims.

One source of skepticism is its death rate, which to many experts appears unusually low especially given the vast majority of its people are thought to be unvaccinated. The country of 25 million has officially reported 74 deaths, with KCNA previously attributing this to what it called an "unprecedented miracle."

North Korea has also attributed its claimed successes to its use of lockdowns, intensive medical checks, and what Kim called the "advantageous Korean-style socialist system."

It has also hailed its use of daily PCR tests on water collected in border areas and claimed to have developed new methods to detect the virus and other diseases including monkeypox, according to Reuters.

In reporting the latest suspected cases, KCNA emphasized that there had been "no persons infected with the malignant epidemic since the spread of malignant virus was exterminated in the country."

It said anti-epidemic teams had been mobilized to investigate the cases in the latest "fever outbreak."

The absence of independent data in the country means CNN can't verify Pyongyang's claims.

However, recent trade figures showed that despite its claimed victory the country imported Covid prevention and control products including more than a million face masks and 15,000 pairs of rubber gloves from China in July.

Some analysts have claimed that North Korea has used the pandemic as an excuse to tighten social controls; others have suggested its declaration of victory over the virus may clear the way for it to conduct its first nuclear weapon test since 2017.

New Coronavirus News from 22 Aug 2022

White House Covid adviser Anthony Fauci announces departure from government [FRANCE 24 English, 25 Aug 2022]

Anthony Fauci, the top infectious disease expert who became the face of America's fight against Covid-19, announced Monday that he will leave government service after more than 50 years in December, stepping down as advisor to President Joe Biden.

In the chaotic early days of the pandemic, Fauci became the nation's most trusted expert on Covid -- but his clashes with former president Donald Trump over the virus response drew anger from the right, and he now lives with security protection following death threats against his family.

The 81-year-old, who has served under seven presidents beginning with Ronald Reagan, said in a statement he would be leaving both his position as director of the National Institute of Allergy and Infectious Diseases (NIAID), and that of chief medical advisor to Biden.

But he added: "I am not retiring." Instead Fauci, who had said he would leave by the end of Biden's current term, said he now intended to "pursue the next chapter of my career."

Biden extended his "deepest thanks" to Fauci in a White House statement, adding that the country "is stronger, more resilient, and healthier because of him."

Fauci has helmed the United States' response to infectious disease outbreaks since the 1980s, from HIV/AIDS to Covid-19.

When Covid first spread globally from China in 2020, he became a credible source of reliable information, reassuring the public with his calm and professorial demeanor during frequent media appearances.

His straight-talking approach won him legions of fans, who bought T-shirts and bobbleheads in his likeness and made cocktails named after him.

But his honest takes on America's early failures to get to grips with the virus brought Fauci into conflict with Trump. The White House at one point barred him from doing TV interviews and launched a media blitz against him.

The clash helped turn him into a hate figure for many on the right -- already incensed by the pandemic protections Fauci was advocating, from masks and vaccines to school and business closures.

Earlier this year, Fauci recounted "threats upon my life, harassment of my family, and my children with obscene phone calls."

This month a West Virginia man was sentenced to three years in prison for threatening to drag Fauci and his family into the street and beat them to death.

But despite the threats, Fauci has been conciliatory towards Trump in recent interviews, telling Politico last year that they developed "an interesting relationship."

'Honor of a lifetime'
It was not the first time he has faced criticism and clashes. In the 1980s he became a lightning rod for accusations the government was not doing enough to stem the rise of HIV/AIDS -- but he later forged a close collaboration with activists.

His accomplishments include implementing a fast-track system that widened access to antiretroviral medicines, and working with former president George H.W. Bush to plow in more resources.

Later, under president George W. Bush, Fauci was the architect of the President's Emergency Plan For AIDS Relief (PEPFAR), credited with saving millions of lives in sub-Saharan Africa.

As a scientist, he is credited with developing effective treatments for formerly fatal inflammatory diseases, as well as for contributions into understanding how HIV destroys the body's defenses.

Despite his many duties, he had continued to treat patients at the NIH's Clinical Center in Bethesda, Maryland. It was not clear if that was part of his plans going forward.

Biden said that after winning the 2020 election, as he was trying to build a team to lead the Covid-19 response, Fauci was "one of my first calls."

"In that role, I've been able to call him at any hour of the day for his advice as we've tackled this once-in-a-generation pandemic," the president stated.

Fauci said it had been the "honor of a lifetime" to lead the NIAID, which he has done since 1984.

He did not spell out what he will do next, but said he wants to inspire and mentor the next generation, citing the "energy and passion" he still has for the field despite his decades of service.

"I am proud to have been part of this important work," he said.

Bulletin on Novel Corona Virus : JK reports 131 fresh positive cases, 469103 recovered [5 Dariya News, 22 Aug 2022]

The Government today informed that 131fresh positive cases of novel Corona virus (COVID-19)have been reported today; 14 from Jammu division and 117 from Kashmir division, thus taking the total number of positive cases to 476175.

Moreover, 435 more COVID-19 patients have recovered and been discharged from various hospitals including 51fromJammu division and 384from Kashmir division.According to the daily Media Bulletin on novel Corona virus (Covid-19), out of 476175positive cases, 2293are Active Positive (411in Jammu Division and 1882in Kashmir Division), 469103have recovered and 4779have died; 2347 in Jammu division and 2432in Kashmir division.

The Bulletin also informs that 31,028 doses of COVID Vaccine have been administered in the last 24 hours across Jammu and Kashmir bringing the cumulative number of doses administered to 2,41,07,155 till date.

The Bulletin further said that out of 26374108 test results available, 476175samples have tested positive and 25897933 samples have been tested as negative till date. Besides, 7,934COVID tests have been conducted in last 24 hours.

Till date 6699097 persons have been enlisted for observation which included 153persons in home quarantine including facilities operated by government, 2293in isolation and 359in home surveillance.Besides, 6691513 persons have completed their surveillance period.

Providing district-wise breakup for positive cases for today, the Bulletin informs that in Kashmir division, Srinagar reported 24 cases, Baramulla reported 37 cases, Budgam 12 cases, Pulwama reported 03cases, Kupwara reported17 cases, Anantnag reported04 cases, Bandipora reported 04 cases, Ganderbal reported 15 cases, Kulgam reported 01casewhile as Shopian reported no fresh cases for today.

Similarly in Jammu division, Jammu reported 07 cases, Udhampur 00, Rajouri 00, Doda 01, Kathua 01, Samba 00, Kishtwar 05, Poonch 00, Ramban 00 and Reasi also reported no fresh case for today.The bulletin informs that in case of any help, the general public can call J&K UT Centralised Health Helpline- Toll Free No. 104.

In case of emergency, people can avail free ambulance services 24x7 by calling toll free number 108 while as pregnant women and sick infants can avail free services by dialling toll free number 102, the bulletin reads.It also informs that the public can reach national helpline by dialling 1075.

New Virus Discovered In India - Tomato Flu Is Like Corona [Nation World News, 22 Aug 2022]

only children are infected New virus discovered in India – Tomato flu is like corona

Monkeypox came after Corona. And now scientists are already warning of a new virus. Name: Tomato flu or Tomato fever. As the “Journal of Lancet Respiratory Medicine” writes, the virus was first discovered in the Indian state of Kerala on May 6, 2022.

The virus has an unusual name because the organs can change color in infected people, the study authors write. At least 82 cases have been reported so far. Shockingly, so far only children below the age of five have been affected.

Affected people show symptoms of fever, fatigue and headache. But vomiting, diarrhea and skin rashes are also possible. Experts recognize similarities in the symptoms of corona. “Rare virus infection is endemic and is not considered life-threatening,” the researchers wrote in their report. You definitely have to monitor the virus and spread and contain the outbreak.

Infected people should be isolated
In their article, the researchers write that the new virus is not related to COVID-19. So they believe that tomato flu in children may be more of an after-effects than chikungunya or dengue fever. It is also speculated that it is a new form of viral hand, foot and mouth disease. Because: It is not yet possible to determine if an adult tomato is infected with the flu.


Similar to other types of flu, tomato flu is considered highly contagious. Researchers recommend that sick people isolate themselves for five to seven days from the onset of symptoms. To date, there are no medicines or vaccines available to treat or prevent tomato flu.
According to the researchers, the following also applies here: The best prevention against disease is compliance with hygiene measures and disinfecting your hands. People who have tomato fever are advised to drink plenty of fluids and stay in bed. (ooo)

A new virus is spreading rapidly in India. 82 children have been infected with the so-called tomato flu. Symptoms are similar to corona.

New Coronavirus News from 24 Aug 2022

Higher education of children orphaned in Corona will be free, govts big announcement [News Track English, 24 Aug 2022]

By Laxman Chaurasiya

Mumbai: The Corona epidemic had caused a huge outcry across the country, due to which many people lost their lives. On Monday, Maharashtra Minister Chandrakant Patil announced that the state government will cover the entire fees of higher education for college students who have lost both their parents in the Corona epidemic. The announcement was made by the state Higher and Technical Education Minister in the state assembly in response to a question by Congress leader Shirish Chaudhary.

Chandrakant Patil said, "931 undergraduate and 228 postgraduate students of various government colleges have lost both their parents to the corona pandemic. The government will pay their entire course fees." He said that this option would cost the state exchequer more than Rs 2 crore per year.

Let us tell you that in the second wave of the Corona epidemic, children lost their parents in big numbers. Thereafter, most of the state governments announced free education for school children who were orphaned in the pandemic. Maharashtra has now announced to pay fees for students pursuing undergraduate or postgraduate courses in higher education as well.

Dengue Outbreak News since 18 Aug 2022

Collier County reports first case of dengue fever by locally infected mosquitoes [Naples Daily News, 25 Aug 2022]

by Liz Freeman

A human case of dengue fever that was locally acquired has been confirmed in Collier County and it is causing heightened concern of more infection, according to health officials.

"The Florida Department of Health in Collier County has not reported a case of locally acquired dengue fever in over 20 years," according to Kristine Hollingsworth, spokesperson for the state Department of Health in Collier.

The discovery prompted the department to issue an advisory.

“The risk of transmission to humans has increased,” the Collier health department said in a news release. “Collier County Mosquito Control and the (health department) continue surveillance and prevention efforts.”

Hollingsworth said residents should be on alert.

"It is mosquito borne and cannot be transmitted through person to person contact," she said. "The last locally acquired case was before 2000. We reported a case acquired outside of the United States in July."

As a result, Collier residents can expect to see more treatments and increased data gathering activities by the Collier Mosquito Control.

Specifically, the mosquito that transmits dengue fever lives in urban and highly populated environments because it prefers to feed on humans, according to Mosquito Control officials.

It is a day-time biter and breeds in containers holding water around homes and businesses.

“A mosquito picks up dengue fever in its salivary glands when biting a person infected with the virus,” Patrick Linn, the district's executive director, said in a news release. “The mosquito then passes the virus to each human she bites."

Linn said the district tests area mosquitoes for disease in its laboratory weekly, and currently none have tested positive for any mosquito-borne diseases, including dengue.

Dengue fever: The state reported the first local case of 2022 in Miami-Dade

Last month, the state reported the first local case of 2022 in Miami-Dade. A second case was identified in Miami-Dade on Aug. 1.

Last week, the state health department in Lee County reported detecting the West Nile virus in chickens.

Nationwide there have been 183 cases reported, acording to the U.S. Centers for Disease Control and Prevention. The CDC reported that Florida far outpaces any other states with cases 96 travel-related cases and two cases acquired within the state sd of Aug. 4. No other states have cases that were acquired locally.

In 2020, dengue transmission was detected in Key Largo and Marion County experienced an outbreak in 2013. In 2010, there were 66 cases of locally acquired dengue in Key West were reported from March through November of that year. In the fall of 2009, there were 22 cases in Key West.

Four human cases of West Nile infection in Collier County; no new cases in Lee

What is dengue fever?
Mild dengue fever causes a high fever and flu-like symptoms. The severe form that is also called dengue hemorrhagic fever can cause serious bleeding, a sudden drop in blood pressure, shock and death, according to the Mayo Clinic.

There is no treatment for dengue fever or dengue hemorrhagic fever, but quick recognition of symptoms and complications is effective at preventing deaths, according to the state health department.

Symptoms appear as early as three days but can take as long as two weeks after the bite of an infected mosquito and include sudden onset of fever, severe headache, eye pain, muscle and joint pain.

Gastrointestinal symptoms like vomiting and diarrhea may also be present in some cases. Dengue fever symptoms usually lasts 4-7 days. The disease is often diagnosed incorrectly because the symptoms are similar to influenza and other viruses.

There is currently no vaccine for dengue and the research has been challenging due to variation in the four viral types, but multiple vaccine candidates are currently in development.

“(Y)ou can get immunity to a version of dengue virus once you’ve been infected with it,” according to Cleveland Clinic. “Your immune system has tools it can use to recognize infections and get better at fighting them off. As your body fights a virus, it looks through its toolbox to find out which tool (antibody) it has that can destroy that specific threat.”

Dengue is spread from bites of the Aedes mosquitoes that also spread the chikungunya and Zika virus.

Millions of cases of dengue infection occur worldwide each year in tropical and subtropical areas. It is most common in Southeast Asia, the western Pacific islands, Latin America and Africa. But the disease has been spreading to new areas, including local outbreaks in Europe and southern parts of the United States.

Tips to be safe
Here are tips from the health department that involve outdoor activity, use of repellent, clothing and safety for children:
• Drain standing water to stop mosquitoes from multiplying, which includes water from garbage cans, house gutters, buckets, pool covers, coolers, toys, flower pots or any other containers where sprinkler or rain water has collected.
• Discard old tires, drums, bottles, cans, pots and pans, broken appliances and other items that aren't being used.
• Empty and clean birdbaths and pet's water bowls at least once or twice a week.
• Protect boats and vehicles from rain with tarps that don’t accumulate water.
• Maintain swimming pools in good condition and appropriately chlorinated. Empty plastic swimming pools when not in use.
• Cover doors and windows with screens to keep mosquitoes out of your house, and repair broken screening on windows, doors, porches, and patios.
• Cover skin with clothing by wearing shoes, socks, long pants and long-sleeves. This type of protection may be necessary for people who must work in areas where mosquitoes are present.
• Use repellent and use it according to the label. Apply insect repellent to exposed skin, or onto clothing, but not under clothing.
• Repellents with DEET, picaridin, oil of lemon eucalyptus, para-menthane-diol, 2-undecanone and IR3535 are effective.
• Use mosquito netting to protect children younger than 2 months old. Always read label directions carefully for the approved usage before you apply a repellent. Some repellents are not suitable for children.
• Products with concentrations of up to 30 percent DEET (N, N-diethyl-m-toluamide) are generally recommended. Other U.S. Environmental Protection Agency-approved repellents contain picaridin, oil of lemon eucalyptus, para-menthane-diol, 2-undecanone or IR3535. These products are generally available at local pharmacies. Look for active ingredients to be listed on the product label.

Dengue fever outbreaks in Hazara [Associated Press of Pakistan, 23 Aug 2022]

ABBOTTABAD, Aug 23 (APP): Dengue Fever has hit back all over Hazara division where dozens of the people were admitted to various hospitals in the region.

After reporting of dengue virus case in Khalabat Chhohar Colony Sector No. 2 district Haripur, District Health Officer (DHO) Haripur Dr. Manoor Khan Afridi ordered spray in the Khalabat township, the spray campaign for the prevention of dengue virus was completed in Chhohar Colony.

Health department has also started fog spray in several areas of Haripur including GT road, Circular road and inside the city areas. The department also issued directives for precautionary measures against dengue fever.

The situation of Dengue fever in district Mansehra is alarming as more than 20 patients including 5 women of the same village Phagla caught by the virus and have been admitted to King Abdullah Hospital Mansehra.

The dengue fever patients have the facility of Sehat Insaf Card for treatment. During the last few years district Mansehra is the worst hit by dengue fever where hundreds of patients had been registered from almost every union council.

People have complained that in the affected areas of Mansehra district administration and health department have sprayed only once or twice despite the outbreak of the disease.
They claimed that during the incubation period of the larva through August health department did nothing for the eradication and now Dengue is on the peak.

In Abbottabad, mostly the dengue fever cases have been registered from Sherwan circle while 4-5 case of Tehsil Havelian has been reported.

Takeda gets first approval for its dengue vaccine - [pharmaphorum, 23 Aug 2022]

by Phil Taylor

Japan’s Takeda has secured its first regulatory approval – in Indonesia – for its dengue fever vaccine TAK-003, which has been tipped as a potential blockbuster product.

Indonesia’s National Agency for Drug and Food Control (BPOM) has approved the vaccine as Qdenga to protect against the virus in people aged six to 45, on the back of data showing that it can cut dengue-related hospitalisations by 84%, with 61% protective efficacy against symptomatic illness seen up to three years after vaccination.

It isn’t the first dengue vaccine to reach the market, but is free of the severe restrictions that have held back its only predecessor, Sanofi’s Dengvaxia, which was cleared for marketing in 2015.

Dengvaxia can however only be used in seropositive children aged 9 to 16, after it emerged that it could cause more serious illness in those who were seronegative – i.e. they have not been infected with the virus before – relegating it to niche status.

Dengue fever is unusual in that a first infection is rarely serious, but a second can lead to much more serious disease. Shortly after launch Sanofi was forced to pull Dengvaxia off the market in the Philippines, where publicly-funded rollout of the shot had been started, after deaths were seen in vaccinated children.

Qdenga has been approved for use regardless of prior dengue exposure, so can be prescribed without the need for pre-vaccination testing, said Takeda.

Indonesia has experienced almost half of the dengue disease burden within Southeast Asia and continues to suffer from one of the highest burdens of dengue in the world, according to the drugmaker.

In the first half of this year, the country reported over 63,000 dengue cases and nearly 600 deaths from the virus. Dengue makes most people it infects seriously ill. Symptoms often include severe joint pain, vomiting, severe rashes, and a high fever.

Takeda has also filed for approval of TAK-003 in the EU and some other markets where the potentially deadly mosquito-borne disease is endemic, and is due to submit it to the US FDA in the coming months.

“Dengue can affect anyone living in or traveling to endemic areas – regardless of age, health and socio-economic circumstances,” said Gary Dubin, president of Takeda’s vaccines business unit.

“Developing this innovative dengue vaccine has been an exciting challenge, and its approval in Indonesia is an important achievement for Takeda and for public health,” he added.

Qdenga is also the first of the company’s vaccine products to be marketed outside Japan.

Takeda's dengue fever vaccine picks up first global nod in Indonesia [FiercePharma, 22 Aug 2022]

by Zoey Becker

For years, Takeda has been working hard to bring the first travel vaccine for dengue fever to the market. Now, the company can breathe a sigh of relief as the program snagged an approval from the Indonesia National Agency for Drug and Food Control⁠—its first anywhere in the world.

The vaccine, called Qdenga, is approved in the country for use in people 6 to 45 years of age regardless of prior dengue exposure. The country's regulator granted the approval based on results from the company’s ongoing phase 3 Tetravalent Immunization against Dengue Efficacy Study (TIDES), which enrolled more than 20,000 healthy children aged 4 to 16 living in dengue-endemic areas in Asia and Latin America.

Takeda's dengue vaccine efficacy slips between 12- and 18-month analyses Three years after vaccination, the vaccine delivered efficacy of 62% and was “generally well tolerated,” Takeda said in a statement. The vaccine prevented hospitalization from dengue fever by 83.6%.

Four and a half years after the second dose, Qdenga showed efficacy of 61.2% against virologically confirmed dengue and 84.1% efficacy against hospitalization from dengue.

Qdenga is based on a live-attenuated dengue serotype 2 virus that “provides the genetic backbone” for all four dengue virus serotypes. It's designed to protect against any and all of the serotypes, Takeda says, and is a 0.5-mL dose in a two-dose series.

Takeda's dengue shot 80% effective in massive phase 3 test
Dengue fever is a mosquito-borne viral disease that’s prevalent in over 125 countries.
Recently, Indonesia has experienced “almost half” of the dengue disease burden in Southeast Asia and continues to suffer from one of the “highest burdens of dengue in the world,” the company said in a statement. In the first half of 2022, the country reported more than 63,000 dengue cases and nearly 600 deaths across 455 cities in 34 provinces.

Takeda said last December that the vaccine could reach up to $1.6 billion in peak sales.

Dengue claims one more life, infects 66 so far [The Express Tribune, 21 Aug 2022]

Surveillance, spraying increased in some neighbourhoods

RAWALPINDI:
Forty-six year-old Naseer Khan died of the dengue virus at the District Headquarters Hospital on Saturday.

According to District Health Authority Chief Executive Dr Ishaq, the patient was brought to the hospital suffering from cirrhosis of the liver upon tests he was confirmed to be dengue positive as well. Unfortunately, the patient died while the treatment was in progress.

Khan was the resident of Chongi No.22 and his residence was sprayed against dengue larvae, said Dr Ishaq. He added that after his death the health department began dengue surveillance spray in the area.

Despite several warnings, a large number of dengue larvae spots are being found in the district. It has also been revealed during anti-dengue surveillance that around 1,263 dengue spots were left out while 374 houses were found to be dengue positive.

Moreover, fines have been increased and buildings are being sealed to restrict the spread of dengue.

Moreover, a formal warning was issued again to ensure that the breeding of dengue larvae is restricted in such localities.

So far, 66 dengue patients have been reported across the district, out of which 10 were confirmed patients and 42 were suspected patients, and 11 showed symptoms of dengue virus.

Similarly, a fine of Rs3,079,500 was fined during the surveillance of the anti-dengue campaign, 5,231 notices have been issued, 1,123 challans have been issued, 347 buildings have been sealed and 881 FIRs have been registered.

Chief Executive District Health Authority Dr Ansar Ishaq claimed that citizens are being repeatedly informed and warned against the spread of dengue larvae.

Florida: Miami-Dade County dengue local transmission cases now at five - Outbreak News Today [Outbreak News Today, 20 Aug 2022]

The Florida Department of Health in Miami-Dade County (DOH-Miami-Dade) remains under a mosquito-borne illness advisory following the confirmation of two identified cases of dengue in two Miami-Dade residents. This is the fourth and fifth local cases of dengue infection in the county and in the state in 2022.

In addition, the Florida Department of Health has reported one hundred and seventy-two cases with onset in 2022 in individuals with travel history to a dengue endemic area in the two weeks prior to onset.

Counties reporting cases were: Brevard, Broward (10), Collier, Duval (4), Escambia, Hendry, Hillsborough (16), Lee (5), Manatee (2), Miami-Dade (106), Monroe (2), Orange (5), Osceola, Palm Beach (6), Pinellas (4), Polk (3), Sarasota, St. Johns, and St. Lucie (2). Four cases were reported in non-Florida residents.

Of the 172 travel associated cases, Cuba was the country of exposure for 150 cases.

Dengue is a virus spread through mosquito bites by Aedes mosquitoes which also spread the chikungunya and Zika virus. Most people infected with dengue have mild or no symptoms. Those that do develop symptoms typically recover after about one week.

The common symptoms of dengue are fever and one or more of the following symptoms: headache; eye pain (typically behind the eyes); muscle, joint, or bone pain; rash; nausea and vomiting; or unusual bleeding (nose or gum bleed, small red spots under the skin, or unusual bruising). Severe dengue can occur resulting in shock, internal bleeding, and death. If you or a family member develop the mentioned symptoms, visit your health care provider or local clinic.
DOH-Miami-Dade encourages the use of repellent when outdoors.

• Apply mosquito repellent to bare skin and clothing, but not under clothing.

• o Always read label directions carefully for the approved usage before you apply a repellent – Some repellents are not suitable for children.
o Always use repellents according to the label. Repellents with DEET, picaridin, oil of lemon eucalyptus, para-menthane-diol, and IR3535 are effective.
o Use mosquito netting to protect children younger than 2 months old.
Additional Tips on Repellent Use
• In protecting children, read label instructions to be sure the repellent is age-appropriate. According to the Centers for Disease Control and Prevention (CDC), mosquito repellents containing oil of lemon eucalyptus should not be used on children under the age of three years. DEET is not recommended on children younger than two months old.
• Avoid applying repellents to the hands of children. Adults should apply repellent first to their own hands and then transfer it to the child’s skin and clothing.
• If additional protection is necessary, apply a permethrin repellent directly to your clothing. Again, always follow the manufacturer’s directions.

Poor sanitation in Bangladesh's Rohingya camps breeding dengue mosquitos [Anadolu Agency | English, 20 Aug 2022]

By SM Najmus Sakib

About 10,000 Rohingya infected with dengue virus until mid-August, 7 died

DHAKA, Bangladesh
Dengue fever, a virus spread by mosquitos, has infected stateless Rohingya refugees in one of the world's largest and most congested refugee camps in Cox's Bazar, Bangladesh's southeastern coastal district. Health experts say these camps have become a breeding ground for dengue mosquitos that are different from ordinary mosquitoes in both shape and color.

Bangladesh is currently hosting about 1.2 million Rohingya, the majority of whom fled a brutal military crackdown in Myanmar's Rakhine state in August 2017.

An average of seven to eight people live in a 120-square-foot room in a house with a poor sewer system, making the camp a breeding ground for mosquitos, particularly those carrying the dengue virus.

Dengue fever outbreaks are common during the rainy season in many places across the country, notably Dhaka and Cox's Bazar, due to humid conditions.

According to Health Ministry data, nearly 10,000 Rohingya were infected with the dengue virus until mid-August of this year, with seven deaths. This disease killed 105 people last year and infected 28,429 more.

Ansar Ali, a Rohingya community leader, is concerned about the spread of dengue fever in his two-bed house with nine other people after his younger brother became infected with the virus and is treated at a refugee hospital.

"I share a room with my five-member family, while my brother shares a room with four other refugees. We are all worried about contracting dengue and other infections as we cannot maintain privacy and hygiene in such crowded living conditions," he told Anadolu Agency.

- Poor sewer and waste management
Refugees attributed the situation to the unsanitary surroundings and poor waste management in the camps.

Khin Maung, a member of the persecuted Rohingya living in Camp-13, told Anadolu Agency that they are frightened over the rise in dengue cases.

"Waste and garbage are strewn throughout the camps, and waterlogging have grown common as a result of poor waste management and drainage systems. The situation worsens during the rainy season," the refugee explained.

"There are hospitals in and out of the refugee camps," he said, claiming, "but these are insufficient to manage the rising number of dengue patients."

A mosquito naturally bites one person and transmits the dengue virus to others, according to health experts, who, along with rights groups, have urged coordinated efforts to bring the situation under control.

Rezaul Karim Chowdhury, head of Coastal Association for Social Transformation Trust (COAST), a non-profit organization that works for the Rohingya, told Anadolu Agency that Cox’s Bazar city has become one of the most polluted areas in the country, posing serious health risks to its residents.

And, the refugee camps in the area are the worst of it, he added.

The government has begun dozens of development projects in the tourist hub of Cox's Bazar, many of which generate environmental pollution.

“Some old canals that are crucial for normal water flow during the rainy season have been acquired for road construction. Pollution and destruction of water bodies have caused waterlogging in Cox’s Bazar, posing a potential threat of dengue breeding,” he explained.

- Collective efforts needed
Some health experts say the origin and prevalence of dengue fever are increasing due to accumulated water in various areas of the camp, and that collective efforts are required to bring the situation under control.

Chowdhury said they have repeatedly urged the relevant authorities to ban the use of plastic and to develop waste-to-energy mechanisms in refugee camps.

He did, however, emphasize that refugee health care facilities are good, citing COVID-19 as an example, which he believes is less common among refugees in comparison to their vast population.

Dr Abu Toha, a chief health coordinator at the office of the Refugee Relief and Repatriation Commissioner (RRRC), told Anadolu Agency that the dengue infection rate is not alarming given a large number of refugees in the congested camps.

He did, however, admit that the living conditions in so many tents are unclean, which is one of the reasons dengue mosquitos breed. The prevalence of skin diseases in refugee camps has also been exacerbated by overcrowding, he added.

However, medical care is provided to refugees in collaboration with the government, UN agencies, and international non-governmental organizations (INGOs), including a Turkish hospital and health support.

The UNHCR has recently set up an ICU-bed hospital for refugees.

The health and sanitation staff are working hard to keep the camps clean.

"I have worked in various refugee camps across the world, and what I am seeing in Bangladesh is far better than what I have seen in other places," Dr Abu Toha asserted.

World mosquito day 2022: Most dangerous kinds of mosquitoes [Newsd.in, 20 Aug 2022]

Mosquitoes can cause diseases like malaria and dengue fever, but there are other types of mosquitoes that can cause harm too.

World mosquito day 2022: Mosquitoes can be a nuisance, but they can also carry some serious diseases. Mosquitoes in the United States are most commonly mosquito-borne viruses like dengue, Zika and chikungunya. Here are the three types of mosquitoes that pose the most danger to humans in the United States.

Types of Mosquitoes
Mosquitoes can be grouped by the type of vector they use to spread disease. There are four main types of mosquitoes: biting midges, ticks, fleas, and lice. Each mosquito type is more dangerous to humans than the others.

Biting midges are the most common type of mosquito in North America. They spread diseases like Rocky Mountain spotted fever, West Nile virus, and malaria. Biting midges are also responsible for causing a lot of seasonal allergies.

Ticks are the second most common type of mosquito in North America. They spread Lyme disease, Anaplasmosis, and Ehrlichiosis. Ticks can also carry other diseases like Babesiosis and Rocky Mountain spotted fever.

Fleas are the most common type of insect that carries human disease. Fleas spread plague, typhoid fever, bubonic plague, and cat-scratch fever. Fleas are also responsible for causing heartworm disease in dogs and cats.

Lice are the least common type of mosquito but they cause the most human diseases. Lice spread head lice, chickenpox, ringworm, and scabies.

World Mosquito Day 2022: What to do to help prevent mosquito-borne diseases

How Mosquitoes Bite
Mosquitoes can cause diseases like malaria and dengue fever, but there are other types of mosquitoes that can cause harm too. Here are the five most dangerous kinds of mosquitoes:
1. The Asian tiger mosquito is a type of mosquito that is indigenous to parts of Asia. They are known to spread the Zika virus.

2. The Aedes aegypti mosquito is the main carrier of dengue fever. They are found in tropical and subtropical areas all over the world.

3. The Culex tarsalis mosquito is the main carrier of West Nile virus. They are found in North America, South America, and parts of Europe.

4. The Anopheles gambiae mosquito is the primary vector for malaria. They are found in Africa and parts of Asia.

5. The Aedes albopictus mosquito is responsible for spreading chikungunya and yellow fever viruses.

Curious Kids: What would happen if all the mosquitoes in the world disappeared?

What to Do if You Are Bitten by a Mosquito
If you are bitten by a mosquito, the first thing to do is wash the area thoroughly with soap and water. This will help to remove any of the blood or saliva that may have landed on you and can help reduce the risk of infection. You also might want to consider using an anti-itch cream or ointment to relieve any pain or swelling. If the bite starts to itch excessively, apply an over-the-counter antihistamine such as Benadryl. Finally, if you experience any difficulty breathing, seek medical attention.

Ways to Remove Mosquitoes from Your Home
Most people think of mosquitoes when they think of pests in their home, but there are other types of pests that can be harmful. Mosquitoes are only one type of mosquito; the others include chikungunya and dengue viruses.

There are many ways you can remove mosquitoes from your home. You can use insecticides, repellents, or traps. Insecticides kill mosquitoes on contact, repellents keep them away, and traps catch them when they land.

To use an insecticide, you will need to apply it to the area where the mosquitoes are congregating. You should spray it around windows and doors and on surfaces where mosquitoes like to rest, such as flower pots and furniture. Make sure to read the instructions carefully before applying the pesticide.

If you want to use a repellent, make sure to apply it evenly all over your body and clothing. The active ingredient in most repellents is DEET, which is known to be safe if applied correctly. However, be aware that DEET can cause skin irritation in some people. If you experience any problems after using a repellent, contact your doctor.

Higher mosquito blood meals increase malaria transmission
Prevention Tips for the Season
Prevention is the key to reducing your risk of getting mosquito-borne diseases, such as Zika and West Nile. Here are some tips to help keep you and your family safe this season:
1. Use an EPA-registered insect repellent containing DEET, picaridin, or IR3535. Apply it generously and regularly, including when you’re outdoors in mosquitoes’ breeding grounds.

Follow the product instructions for application sites and clothing. Choose a repellent with the right protection level for you and your family.

2. Cover up! Wear long-sleeved shirts and pants, hat, and shoes when outside. Use mosquito netting if available or cover windows and doors with screens.

3. Make sure your water is clean – do not drink water from lakes, rivers, ponds, or standing water. Check for mosquitoes in these places before filling up your jugs or containers. Use a water filter if possible.

4. Avoid being bitten – mosquitoes need blood to reproduce, so avoid being outdoors during evening hours when they’re most active (around dusk and dawn).

DOH reviewing different dengue vaccines; Dengvaxia still need to apply for new license [INQUIRER.net, 19 Aug 2022]

By: John Eric Mendoza

MANILA, Philippines — In light of the continuous rise of dengue cases in the country, the Department of Health (DOH) officer-in-charge Maria Rosario Vergeire on Friday said the agency is reviewing different kinds of vaccines available for dengue.

Dengvaxia, on the other hand, needs to apply for a certificate of product registration (CPR) from the Food and Drug Administration, according to Vergeire.

Dengvaxia’s vaccine license was revoked after being linked to the deaths of several children, according to Vergeire.

“In order for us para magamit ang bakuna na ito, kailangan (to use this vaccine) the manufacturers will undergo or go through these processes of applying for the CPR and then kailangan ma-evaluate ulit ng ating (it has to be evaluated by) health technology council,” Vergeire said of the dengvaxia vaccine.

“But while waiting for that, of course, the Department of Health, together with our experts, are already reviewing the different vaccines available against dengue,” she added.

Vergeire noted that Dengvaxia’s CPR was revoked due to non-compliance with the requirements of the FDA.

In late 2017, the DOH halted its massive anti-dengue immunization program using Dengvaxia after its manufacturer Sanofi Pasteur said patients who got vaccinated but had no prior exposure to the virus could suffer severe symptoms.

The Public Attorney’s Office filed complaints against health officials for the deaths of children allegedly caused by the anti-dengue vaccine, which is being widely used in other countries worldwide.

But in January 2019, DOH said no death was confirmed to have been directly caused by Dengvaxia.

Meanwhile, nine out of 17 regions have reported an increase of dengue cases in the country, according to Vergeire. She didn’t elaborate on which regions were included.

Vergeire also said the country logged 23,414 dengue cases based on reports from July 3, 2022 to July 30, 2022, of whom, 18,208 or 78 percent of the dengue cases have been hospitalized.

Looming dengue outbreak [The Express Tribune, 19 Aug 2022]

Dengue larvae have been breeding on a large scale during the ongoing monsoon season
While the threat of Covid-19 has temporarily dwindled, Pakistan continues to face a host of dangerous diseases that resurge annually and adversely affect the health of citizens. In this regard, health officials in Rawalpindi were baffled to detect large number of dengue mosquito larvae at 16,000 different locations — 15,601 houses and 1,000 other localities — during indoor and outdoor surveillance campaigns. This is indeed an alarming revelation which could lead to a deadly outbreak in the near future.

It is believed that these dengue larvae have been breeding on a large scale during the ongoing monsoon season that saw many places inundated with water. Where there is stagnant water, dengue mosquitoes are bound to increase in number and become a health threat. The district has been carrying out anti-dengue campaigns but unfortunately implementation has been lacking as 99 locations were left out and fake activities were recorded in 377 locations.
Officials have taken timely action by registering FIRs, sealing buildings, issuing challans and enforcing dengue SOPs but a systematic action plan must be carried out to destroy breeding grounds before these larvae mature. The ordeal also indicates the importance of draining rainwater in a timely manner. But with many provinces across Pakistan witnessing unprecedented levels of rain, dengue could very well escalate into a national health crisis. This merits attention from the very top.

Surveillance campaigns must be carried out across flood affected areas to identify and destroy breeding grounds. Urban cities must issue dengue SOPs and work towards draining the remaining water left in affected localities. Abandoned buildings along with ponds, pools and other bodies of water in recreational spaces must not be left unchecked. But most importantly, the healthcare sector must be notified and well-equipped to deal with any outbreak.

Alarming rise in dengue cases: 1,568 hospitalised in August [The Business Standard, 19 Aug 2022]

by Md Jahidul Islam

Alarming rise in dengue cases: 1,568 hospitalised in August

The outbreak of the Aedes mosquito-borne viral disease is increasing across the country at an alarming rate as 1,568 dengue patients were hospitalised in the first 19 days of this month, while 1,571 were hospitalised in the entire month of July.

A total of 4,228 people with dengue were admitted to health facilities across the country since January this year, according to the Health Emergency Operation Centre and control room of the Directorate General of Health Services (DGHS).

Entomologists say the DGHS data about dengue patients does not give a complete or true picture of the dengue outbreak. The organisation collects data from only 47 hospitals in Dhaka and many private clinics in Dhaka remain outside its data collection efforts.

Entomologist Kabirul Bashar told The Business Standard that the data provided by DGHS is not correct as they only provide data of hospitalised patients. However, more dengue patients undergo treatment without hospitalisation.

He said, "If we compare Bangladesh with other countries, we find we have fewer dengue cases but more deaths, due to lesser awareness about dengue. Dengue patients can easily be cured if they get proper treatment and care. Delayed admission to hospitals increases the death risk for patients. Besides, data about dengue cases in other countries is more accurate and they act accordingly."

Fifty-four more dengue patients were hospitalised across the country in 24 hours until Friday morning. Of them, 46 patients were in Dhaka hospitals and eight were outside Dhaka, according to the DGHS.

As many as 398 dengue patients, including 335 in the capital, are now receiving treatment at hospitals across the country. Some 3,813 people have so far been discharged from hospitals after being cured.

According to the DGHS, dengue cases have been reported in all the divisions except Sylhet.
After Dhaka, the second highest number of dengue cases was reported in Chattogram division. So far, 542 dengue cases have been reported in the division and 10 dengue patients have died in its Cox's Bazar district. Then there are the Khulna, Barisal, Mymensingh, Rajshahi and Rangpur divisions respectively, with only 136 patients.

The disease control unit of DGHS has started its Monsoon Aedes Survey-2022 from 13 August under the National Malaria Eradication and Aedes-borne Disease Control Program, which will continue until 22 August in 110 places of 98 wards in the two Dhaka city corporations.

The DGHS conducted a 10-day pre-monsoon Aedes Survey-2022 from 23 March when they found 94.09% Culex mosquitoes in their traps, while the remaining 5.01% were Aedes mosquitoes. Of those, 42.11% larvae of mosquitoes were found in under-construction buildings while 31.58% larvae were in high-rise buildings, which was more than in the previous year.

Entomologist Kabirul Bashar, associated with the survey, said that a little less Aedes larva were found in this survey than last year.

He told TBS, "However, it will be possible to ascertain dengue infections this season when the survey is done. We alerted the city corporations following the pre-monsoon survey and they launched mosquito eradication drives, which helped reduce the outbreak. Moreover, it has not been raining much for the past few days, which also helps diminish dengue cases."

From the European Centre for Disease Prevention and Control, the geographical distribution of dengue cases reported worldwide, (May to July 2022) shows that 2,357,301 cases and 1731 deaths were reported worldwide as of 27 July.

Brazil topped with the most cases (1827617), Vietnam (103433), Philippines (64797), Peru (56021) and Indonesia (52313). Brazil saw the most deaths (737), Indonesia (448), Philippines (274), Peru (65) and Timor Leste (56).

Diseases Mosquitoes Can Give to Humans Are Malaria, Zika, West Nile, Dengue, Yellow Fever, chikungunya [The Daily Beast, 19 Aug 2022]

by Jaishree Raman And Shüné Oliver,


Six Diseases Mosquitoes Can Give to Humans
You know about malaria—but there’s more misery these bugs can bring.

Most people instantly associate mosquitoes with malaria. But these tiny flying insects can transmit a number of other diseases too.

Viruses transmitted by insects like mosquitoes are called arthropod-borne or arboviruses. Like malaria, these viruses are transmitted to vertebrate hosts through the bite of a female mosquito when she takes a blood meal to assist with her egg development. Most vertebrate hosts for these arboviruses are non-human. They include birds, primates and agricultural animals. But some arboviruses can be transmitted to humans with severe negative outcomes.
Five of the most important arboviruses affecting communities in Africa include the chikungunya, dengue, West Nile, yellow fever and Zika viruses. It is estimated that half of the world’s population is at risk of being infected by an arbovirus.

Some mosquito-borne diseases—but not all—can be fatal to humans. This confirms that every effort must be made to prevent being bitten by a mosquito and infected using both pharmaceutical and non-pharmaceutical measures.

Chikungunya
The name chikungunya is derived from the Kimakonde language (used in Tanzania and Mozambique) and means “to become contorted”. The symptoms of chikungunya virus include headaches, a rash, fatigue, fever and muscle and joint pain. Generally these symptoms clear within a week. Occasionally, an infection can result in a severe fever and extremely painful joints, which can last for months or years, inducing a hunched, contorted appearance. Unfortunately, there are no antiviral or vaccine treatments available for chikungunya virus.
Deaths from chikungunya are rare and are generally associated with other underlying health problems.

The chikungunya virus was first identified in 1952 during an outbreak in Tanzania. It is transmitted by Aedes aegypti and Aedes albopictus mosquitoes. Over 100 countries across the globe have reported chikungunya virus cases. The risk of outbreaks is extremely high wherever these mosquito species are present around homes and urban areas.

Female Aedes mosquitoes tend to feed just after sunrise and around sunset. They lay eggs that can survive drying out. This makes vector control rather challenging. Current control strategies focus on reducing the number of water containers that these mosquitoes like to breed in, the use of insecticides against adult mosquitoes and personal protection to prevent mosquito bites.

Dengue
The World Health Organization has classified dengue virus as one of the top ten global health threats. It’s one of the fastest spreading mosquito-borne diseases. At least half of the world’s population is at risk of infection.

Like chikungunya virus, dengue is spread by Aedes aegypti and Aedes albopictus mosquitoes. Both viruses share the same control interventions and non-specific symptoms of headaches, a rash, fever and muscle and joint pain, so they are often misdiagnosed.

Most human cases of dengue are asymptomatic or present with mild symptoms, which last for two to seven days. In certain individuals, dengue virus progresses to severe disease and symptoms include persistent vomiting, bleeding gums or nose and enlarged liver. This must be treated as a medical emergency as these complications can be lethal. Dengue virus can be diagnosed using a rapid diagnostic test or a polymerase chain reaction (PCR) test.

But there is no treatment available. A vaccine has been developed and has been approved for use in a few countries—but is not widely available in Africa at present.

Zika
The Zika virus was identified in humans in the 1950s. But it only became a pathogen of major public concern in 2016 following the 2015 Zika virus pandemic. The virus is transmitted by Aedes aegypti and Aedes albopictus mosquitoes, and is generally non-lethal in humans. Most people infected with Zika virus do not show any symptoms. A few have non-specific symptoms like fever, rash, headaches, muscle and joint pains and conjunctivitis. These can last two to seven days.

Individuals infected with Zika virus while pregnant are at an increased risk of stillbirth, abortion, neurological disorders or delivering children with birth defects, including microcephaly. PCR testing can be used to diagnose Zika virus, but there is no treatment available.

Yellow fever
Aedes aegypti and Aedes albopictus mosquitoes are also responsible for the transmission of yellow fever, so named because the virus causes jaundice (yellowing of eyes and skin due to impaired liver function).

Symptoms in mild cases include fever, headaches, chills, back pain, fatigue, jaundice, vomiting and bleeding from the mouth, nose, eyes or stomach. These generally clear within five days. Approximately 50 percent of the small number of patients who develop severe symptoms will die within 10 days of becoming infected. Yellow fever can be diagnosed by PCR or enzyme-linked immunosorbent assay (ELISA). Although there is no treatment for yellow fever, a very effective vaccine is widely available. A single vaccine dose provides lifelong immunity, so all individuals living in or traveling to areas endemic for yellow fever should take the vaccine.

West Nile
The West Nile virus was first isolated from a woman in the West Nile region of Uganda. It is transmitted by mosquitoes belonging to the genus Culex. The natural vertebrate hosts are wild birds. But the virus can be transmitted to a number of different animals, including humans, through the bite of an infected mosquito. Approximately 80% of the people infected with West Nile virus will not show any symptoms. Those who do become symptomatic have mild non-specific symptoms that include headaches, fever, tiredness, body aches, nausea, vomiting and, occasionally, a rash. A small proportion of symptomatic patients, however, develop severe disease. This is associated with neurological impairment, and can be fatal in extreme cases.

West Nile virus infection can be diagnosed by PCR or ELISA, with only supportive treatment available for neurological impairment. It has been suggested that people who are older than 50 or immunocompromised are at greater risk of severe infection. An integrated approach comprising water management together with chemical and biological interventions is needed to control the spread of the Culex vectors.

First human case of dengue in Florida spurs mosquito-borne illness advisory [New York Post, 19 Aug 2022]

Health officials in Miami-Dade County issued a mosquito-borne illness advisory on Monday after the first case of dengue was confirmed this year in a Florida resident.

The dengue virus can be spread through Aedes mosquito bites, which also spread the chikungunya and Zika virus, according to the Miami-Dade Department of Health.

Symptoms can include fever, headache, eye pain, muscle, joint and bone pain; nausea, vomiting and unusual bleeding in the nose or gums.

According to the Centers for Disease Control and Prevention, about 1 in 4 people who get dengue will develop symptoms, and 1 in 20 will become seriously ill. Babies and pregnant women are at higher risk for developing severe dengue, according to the CDC.

According to the Department of Health, most people with symptoms recover after about a week.

There is no specific treatment for dengue. However, children between 9 and 16 years old who have previously been infected could be eligible for a new dengue vaccine, according to the CDC.
Just like most pests, the weather influences mosquitoes that carry the virus.

Miami-Dade Mosquito Control Division Manager Dr. Isik Unlu explains mosquitoes do well in warm but not extreme temperatures.

“Mosquitoes, just like the country song ‘Sunny and 75 Day,’ they like sunny and 75. They do not do well with extremes,” Unlu said. “If we talk about temperatures, around the 50s and 86, anything above 86 mosquitoes start struggling.”

Rainfall also affects the mosquito lifecycle because more rain helps create more habitats to lay eggs, according to Unlu. Meanwhile, too much rain can wipe out the eggs.

Miami-Dade Mosquito Control Division crews have been out treating for dengue in a two-block radius where the transmission happened.

As soon as health officials know the location of someone suspected of having a mosquito-borne illness such as dengue, a treatment team is sent out immediately.

“They inspect the property and other surrounding properties. Then spray for mosquitoes and for adult mosquitoes that evening. They continue to do truck-mounted larviciding every week to keep adult mosquitoes from emerging, particularly if there’s standing water lingering around,” Unlu said.

Treatments continue every two days until adult mosquito numbers start declining.

Florida health officials advise the “drain and cover” method to avoid attracting mosquitos that carry the virus.

Standing water from garbage cans, flower pots or other outdoor containers where rainwater collects should be drained regularly. Outside pet bowls and birdbaths should be cleaned at least twice a week. Swimming pools should be kept clean with chlorination.

“This mosquito is not coming from the saltmarsh, not coming from (a) big body of water. It is actually derived in our backyards,” Unlu said. “They may have their eggs and larvae and pupae in those containers, such as flower pots, old tires, bird baths. Anything that you can think of would hold water for seven days or more. So I strongly encourage the residents to be vigilant and drain and cover that.”

The “cover” method includes covering your body to avoid mosquito bites. This is especially necessary for people who work outside where the flies may be present. The health department recommends wearing shoes, socks, long pants and long sleeves. Mosquito repellent should be applied to bare skin and over the clothing.

How common is dengue in Florida?
According to the Florida Department of Health, after dengue was eradicated from the U.S., there were no dengue cases in Florida from 1934 to 2008. In 2009 and 2010, a dengue outbreak was identified in Key West that included 88 people over two years. Another outbreak in Monroe County in 2020 included nearly 50 people, according to the Florida DOH.

Several cases of the disease related to the West Nile Virus are confirmed in the Sunshine State every year. Most of these cases come from people who have traveled to dengue-endemic regions, including the Caribbean, Central and South America and Asia.

Dengue Concerns in the Americas Continue [Vax-Before-Travel, 18 Aug 2022]

(Vax Before Travel)
The U.S. Centers for Disease Control and Prevention (CDC) recently updated its Watch - Level 1, Practice Usual Precautions, regarding dengue virus cases in the Americas.

As of August 15, 2022, the CDC says 'dengue is a risk in many parts of Central and South America, Mexico, and the Caribbean. These countries are reporting increased numbers of cases of the disease.

For example, the Florida Department of Health in Miami-Dade County confirmed on August 14, 2022, that it remains under a mosquito-borne illness advisory following the identification of a third local case of dengue infection in 2022.

Travelers to areas of risk should protect themselves by preventing mosquito bites, says the CDC.

Dengue can take up to two weeks to develop, with the illness generally lasting less than a week.
However, dengue can become severe within a few hours and usually requires hospitalization.

In severe cases, health effects can include uncontrolled bleeding, seriously low blood pressure, organ failure, and death.

As of August 2022, the World Health Organization and the U.S. FDA recommend dengue vaccines should be given to persons as-risk for dengue.

The FDA authorized the Dengvaxia vaccine for limited use in May 2019 for people with laboratory-confirmed previous dengue infection and living in dengue-endemic areas.

This FDA recommendation is essential because preexisting cross-reactive antibodies have been implicated in protection and pathogenesis during subsequent infections with different dengue virus serotypes (DENV1-4).

Certified travel vaccination pharmacies in the USA can provide updated insights into dengue provention.

Codagenix wins $4.4M from Defense Dept. for dengue vaccine [Newsday, 18 Aug 2022]

By Ken Schachter

Codagenix Inc. has won a $4.4 million Defense Department award to develop a vaccine against dengue fever, which could pose a risk for soldiers and travelers in Asia, Latin America and elsewhere.

The Farmingdale-based biotechnology company, whose intranasal COVID-19 vaccine is undergoing clinical trials, received the three-year award for the dengue vaccine through the Joint Warfighter Medical Research Program.

Dengue, which is typically spread by Aedes mosquitos that have bitten humans or animals harboring the disease, sickens about a quarter of those infected. A much smaller minority who come down with a severe version of the disease may go into shock, vomit blood, bleed from the nose or gums and feel pain or tenderness in the belly, according to the Centers for Disease Control and Prevention. Those with severe symptoms should seek medical treatment immediately, the agency advises.

Destinations in the Caribbean (including Puerto Rico), Central and South America, Southeast Asia, and the Pacific Islands have reported outbreaks. In the United States, limited spread of dengue occurs sporadically in states with hot, humid climates like Hawaii and Florida. In July, for instance, Florida's Department of Health reported the year's first locally transmitted case of dengue fever in the Miami region.

In a statement, J. Robert Coleman, Codagenix co-founder and chief executive, said the funding will let the company push its vaccine candidate, CodaVax-DENV, toward clinical trials "and assess its potential as a safe and effective option for protecting our troops and high-risk populations across the globe."

U.S. troops seek to avoid mosquito-borne diseases with insect repellent applied to their skin and by wearing specially treated clothing.

There is no medicine to treat severe dengue. The sole vaccine approved by the Food and Drug Administration, Dengvaxia, made by Sanofi Pasteur Inc., only has clearance for children, aged 9-16, who had been previously infected by the disease. The vaccine's limitation to those who had earlier been infected was added after the company found that vaccinated children who had never been infected could come down with a more severe version of dengue.

In addition to Codagenix, several other life sciences companies are working to develop a vaccine to protect against dengue, whose four virus strains make creation of a single vaccine challenging.

Codagenix's software uses a computer algorithm to recode virus genomes and construct a live, but disabled, version that confers immunity.

Closely held Codagenix is funded by Adjuvant Capital, TopSpin Partners and Euclidean Capital.

Taiwan reports first domestic dengue fever case in over a year: CDC [Focus Taiwan, 18 Aug 2022]

By Chen Chieh-ling and William Yen

Taipei, Aug. 18 (CNA) Taiwan reported its first domestic case of dengue fever in over a year in a man from Taichung, who travels around central Taiwan for work, the Taiwan Centers for Disease Control (CDC) said Thursday.

The patient, a salesman in his 50s, lives in Taichung's Tanzi District and started showing symptoms including a fever, fatigue and discomfort on Aug. 9. He sought medical treatment five times from Aug. 10-17, CDC Deputy Director-General Chuang Jen-hsiang (莊人祥) told CNA.

On Aug. 17, the man's NS1 antigen test showed a positive result for the mosquito-borne illness and the CDC was notified, Chuang said.

The man has no recent history of overseas travel, but has visited Taichung and industrial areas in Changhua County, Chuang said, adding that the source of infection is being investigated.

However, investigations have so far showed that the vector mosquito index of places were the man has been is relatively high, and work has been carried out to remove breeding sources, Chuang said.

The man is now resting at home and family members who share the same residence have shown no suspected symptoms, Chuang said.

According to CDC data, Taiwan did not report any dengue fever cases last year.

Chuang said the recent case could be connected to the shortening of the quarantine period for incoming passengers as it was reduced this year from 14 days to three days of home quarantine and four days of self-initiated epidemic prevention.

Since it is possible for an incoming traveler to leave quarantine after three days, imported cases could have led to local transmission in the community, Chuang said.

There have already been 20 imported cases of dengue recorded so far this year, Chuang said.
Neighboring countries that have dengue fever include Vietnam, Indonesia, the Philippines, Singapore and Thailand, according to the CDC.

It urged the public to watch out for areas that may become breeding grounds for mosquitoes, especially after rain.

If individuals develop a fever, headache, pain behind the eyes, muscle and joint pain, red rash or other dengue fever symptoms they are advised to seek medical attention immediately and tell medical staff of their travel history, the CDC added.

New Coronavirus News from 18 Aug 2022

S.Korea reports 178574 new COVID-19 cases [Xinhua, 18 Aug 2022]

SEOUL, Aug. 18 (Xinhua) -- South Korea reported 178,574 new COVID-19 cases as of midnight Wednesday compared to 24 hours ago, raising the total number of infections to 21,861,296, the health authorities said Thursday.

The daily caseload was down from 180,803 in the previous day, but it was higher than 137,193 tallied a week earlier, according to the Korea Disease Control and Prevention Agency.

For the past week, the daily average number of confirmed cases was 125,487.

Among the new cases, 633 were imported from overseas, lifting the total to 53,537.

The number of infected people who were in a serious condition stood at 470, up one from the previous day.

Sixty-one more deaths were confirmed, leaving the death toll at 25,813. The total fatality rate was 0.12 percent. ■

New Coronavirus News from 17 Aug 2022

CDC director Rochelle Walensky announces shake-up of the organization, citing COVID mistake [CBS News, 17 Aug 2022]

The head of the nation's top public health agency on Wednesday announced a shake-up of the organization, saying it fell short responding to COVID-19 and needs to become more nimble.
The planned changes at the Centers for Disease Control and Prevention — CDC leaders call it a "reset"— come amid criticism of the agency's response to COVID-19, monkeypox and other public health threats. The changes include internal staffing moves and steps to speed up data releases.

The CDC's director, Dr. Rochelle Walensky, told the agency's staff about the changes on Wednesday. It's a CDC initiative, and was not directed by the White House or other administration officials, she said.

"I feel like it's my my responsibility to lead this agency to a better place after a really challenging three years," Walensky told The Associated Press.

The Atlanta-based agency, with a $12 billion budget and more than 11,000 employees, is charged with protecting Americans from disease outbreaks and other public health threats. It's customary for each CDC director to do some reorganizing, but Walensky's action comes amid a wider demand for change.

"I think our public health infrastructure in the country was not up to the task of handling this pandemic," Walensky told CBS News chief medical correspondent Dr. Jon LaPook. "We learned some hard lessons over the last three years and as part of that it's my responsibility, it's' the agency's responsibility, to learn from those lessons and do better."

The agency has long been criticized as too ponderous, focusing on collection and analysis of data but not acting quickly against new health threats. Public unhappiness with the agency grew dramatically during the COVID-19 pandemic. Experts said the CDC was slow to recognize how much virus was entering the U.S. from Europe, to recommend people wear masks, to say the virus can spread through the air, and to ramp up systematic testing for new variants.

"We saw during COVID that CDC's structures, frankly, weren't designed to take in information, digest it and disseminate it to the public at the speed necessary," said Jason Schwartz, a health policy researcher at the Yale School of Public Health.

Walensky, who became director in January 2021, has long said the agency has to move faster and communicate better, but stumbles have continued during her tenure. In April, she called for an in-depth review of the agency, which resulted in the announced changes.

"It's not lost on me that we fell short in many ways" responding to the coronavirus, Walensky said. "We had some pretty public mistakes, and so much of this effort was to hold up the mirror ... to understand where and how we could do better."

She told CBS News that the agency needs to have "special forces" that deploy during pandemics.

"I have no doubt that they're up to the task," she told LaPook.

Her reorganization proposal must be approved by the Department of Health and Human Services secretary. CDC officials say they hope to have a full package of changes finalized, approved and underway by early next year.

Some changes still are being formulated, but steps announced Wednesday include:
• Increasing use of preprint scientific reports to get out actionable data, instead of waiting for research to go through peer review and publication by the CDC journal Morbidity and Mortality Weekly Report.
• Restructuring the agency's communications office and further revamping CDC websites to make the agency's guidance for the public more clear and easier to find.
• Altering the length of time agency leaders are devoted to outbreak responses to a minimum of six months — an effort to address a turnover problem that at times caused knowledge gaps and affected the agency's communications.
• Creation of a new executive council to help Walensky set strategy and priorities.
• Appointing Mary Wakefield as senior counselor to implement the changes. Wakefield headed the Health Resources and Services Administration during the Obama administration and also served as the No. 2 administrator at HHS. Wakefield, 68, started Monday.
• Altering the agency's organization chart to undo some changes made during the Trump administration.
• Establishing an office of intergovernmental affairs to smooth partnerships with other agencies, as well as a higher-level office on health equity.

Walensky also said she intends to "get rid of some of the reporting layers that exist, and I'd like to work to break down some of the silos." She did not say exactly what that may entail, but emphasized that the overall changes are less about redrawing the organization chart than rethinking how the CDC does business and motivates staff.

"This will not be simply moving boxes" on the organization chart, she said.

Schwartz said flaws in the federal response go beyond the CDC, because the White House and other agencies were heavily involved.

While he said the reorganization is a positive step, he added that "I hope it's not the end of the story." He said he would like to see "a broader accounting" of how the federal government handles health crises.

New Coronavirus News from 16 August 2022

Gates eyes partnership with South Korea over global health [The Associated Press - en Español, 16 Aug 2022]

SEOUL, South Korea (AP) — Bill Gates on Tuesday called for South Korea to further step up in international efforts to prevent infectious diseases like COVID-19 as he stressed the need for the world to be better prepared for the next pandemic.

Speaking to South Korean lawmakers in Seoul, Gates called for stronger international cooperation, including efforts to develop vaccines that would be effective for a broader range of coronaviruses, to navigate what he described as a “crisis moment” in global health.

He said the Bill and Melinda Gates Foundation and South Korea’s government have committed to a partnership aimed at addressing health disparities between countries and supporting efforts to eradicate infectious diseases in the developing world.

He noted South Korea’s strength in public health tools, research and vaccine manufacturing and praised the country’s pledge to donate $200 million to the U.N.-backed COVAX distribution program that provides COVID-19 vaccines to lower-income nations.

“There’s a lot we need to do together – we need to reach deep, we need to build more partnership, we need to encourage the scientists,” Gates said during his speech at the National Assembly. “But I am confident that with these steps we can continue to radically improve global health, to cut the number of children dying in half again, to eradicate diseases like polio, measles and malaria, and improve the lives of all humans.”

Gates later met leaders of the SK business group to discuss further cooperation on health projects. SK’s pharmaceutical arm, SK Bioscience, produces COVID-19 vaccines and has received funds from the Gates foundation to develop nasal sprays designed to help prevent coronavirus infections.

Gates also met South Korean President Yoon Suk Yeol on Tuesday.

Langya virus infection since 3 August 2022

The newly-discovered Langya virus is related to the Nipah virus [The Star Online, 29 Aug 2022]

By DR MILTON LUM

Researchers from China, Singapore and Australia reported on Aug 4 (2022) the identification of the Langya henipavirus (LayV) in a throat swab sample from a 53- year-old woman in the town of Langya in Shandong, China.

Their finding was published in a letter in the New England Journal of Medicine.

The genome of the LayV is most closely related to the Mojiang henipavirus, which was first isolated from rats in an abandoned Yunnan mine in south China.

Henipaviruses belong to the Paramyxoviridae family of viruses, which includes measles, mumps and many respiratory viruses that infect humans.

Several other henipaviruses have been discovered in bats, rats and shrews, from Australia to South Korea and China, but only the Hendra, Nipah, and now LayV, viruses are known to infect people.

Langya virus
The researchers that identified LayV had been monitoring patients with fever at three hospitals in Shandong and Henan between April 2018 and August 2021.

They identified 35 patients – mostly farmers – with acute LayV, of whom 26 were infected with only LayV (and no other pathogens).
These 26 patients had:
• Fever (100% of the patients)
• Fatigue (54%)
• Cough (50%)
• Anorexia, or loss of appetite (50%)
• Myalgia, or muscle pain (46%)
• Nausea (38%)
• Headache (35%), and
• Vomiting (35%).

These symptoms were accompanied by:
• Thrombocytopenia, or low platelets (35%)
• Leukopenia, or low white blood cells (54%),
• Impaired liver function (35%), and
• Impaired kidney function (8%).

The symptoms ranged from severe pneumonia to a cough.

Most stated in a questionnaire that they had been exposed to an animal within a month of their symptoms appearing.

According to the researchers, findings from the patients with acute LayV infection suggest that it was the cause of febrile illness based on the following factors:
• LayV was the only potential pathogen detected in 26 of the 35 patients (74%).
• In paired serum samples that were obtained from 14 patients during the acute and convalescent phases of infection, the IgG (immunoglobulin G, a type of antibody) titres in 86% of the convalescent phase samples were four times as high as those in the acute phase samples.
• Viraemia (presence of viruses in the bloodstream) was associated with acute LayV infection.
• Patients with pneumonia had higher viral loads than those without pneumonia.

The researchers did not find strong evidence of LayV spreading between people as there was no obvious association between the cases either in location or time.

There was also no close contact or common exposure history among the patients, which suggests that the infection in the human population may be sporadic.

But retrospective contact-tracing was only done on 15 family members of nine patients.

The researchers said that it “revealed no close-contact LayV transmission, but the sample size was too small to determine the status of human-to-human transmission for LayV”.

To determine the potential animal origin of LayV, tests were done on goats, pigs and cattle in the villages of the infected patients.

Antibodies against LayV were found in goats (three out of 168, or 2%) and dogs (four out of 79, or 5%).

Tissue and urine samples were taken from 25 species of small wild animals to ascertain the presence of LayV RNA (ribonucleic acid).

LayV RNA was predominantly detected in shrews (71 out of 262, or 27%), a finding that suggests the shrew may be a natural reservoir of LayV, infecting themselves and infecting people by chance.

It was unclear how people were infected in the first place, whether directly from shrews or an intermediate animal.

The researchers conclude that a lot of work is needed to ascertain how LayV is spreading in shrews and how people get infected.

They stressed the need for a global surveillance system to detect viral spread from animals to humans, and rapid communication to avoid more pandemics like Covid-19.

Hendra and Nipah viruses
The Hendra virus (HeV) was first isolated in 1994, during an outbreak of respiratory and neurologic disease in horses and humans in the Brisbane suburb of Hendra, Australia.

The outbreak involved 21 stabled racehorses and two humans who died.

To date, seven humans have contracted HeV following exposure to the body fluids, tissues or excretions of infected horses, with four dying – a death rate of 57%.

HeV has not been reported outside of northeast Australia.

A commercial HeV vaccine for horses has recently been licensed in Australia.

Malaysia was the first country in the world to encounter the Nipah virus (NiV), which sparked an outbreak here in 1998-1999.

It resulted in the near decimation of the local pig-rearing industry, which was then the largest in Asean, with about a million pigs culled.

Many of the humans who survived the infection have been left with residual complications.
The initial NiV cases were reported near Ipoh in September 1998.

Four of these 28 cases tested positive for IgM (immunoglobulin M) antibodies against Japanese Encephalitis (JE) and a JE outbreak was declared by the Health Ministry.

The pigs were sold and transferred out of Perak.

By the end of 1998, more cases were reported in Bukit Pelandok in Port Dickson, Negri Sembilan.

In March 1999, Dr Chua Kaw Bing, then attached to Universiti Malaya’s Department of Medical Microbiology, isolated NiV from a patient being treated at the university’s hospital, who was from Sungai Nipah village.

The outbreak eventually caused 283 cases and 109 deaths with a death rate of 38.5%.

An NiV outbreak (11 cases, one death) was also reported in Singapore among slaughterhouse workers in March 1999.

Since then, there have been annual outbreaks in Bangladesh starting from 2001, as well as outbreaks in eastern India.

The death rate of NIV ranges from about 40% to 75% depending on the local clinical management capability.

Most human NiV infections in Malaysia resulted from unprotected exposure to secretions of sick pigs or their contaminated tissues.

Subsequent outbreaks in Bangladesh and India, however, were most likely due to consumption of fruits or fruit products that had contact with infected fruit bats.

These bats, which are the natural reservoir of NiV, have been found in Indonesia, Philippines, Thailand, Cambodia, Ghana and Madagascar.

Human-to-human NiV transmission have been reported among family and caregivers of the infected through close contact with their secretions and excretions.

Similarly, healthcare workers in Bangladesh and India have been reported to be infected due to providing care.

NiV outbreaks have also been reported in domestic animals like pigs, horses, goats, sheep, cats and dogs.

An infected pig can be asymptomatic (have no symptoms), but some develop fever, difficulty breathing and neurological symptoms like trembling, twitching and muscle spasms.

The death rate in pigs is usually low, except in young piglets.

There is no treatment or vaccine available for NiV in either humans or animals.

A need for surveillance
Only three henipaviruses – HeV, NiV, and now LayV – are known to infect humans.

Although there has been no NiV outbreak in Malaysia since about two decades ago, only the very brave can vouch that it will not recur.

Could LayV occur in Malaysia?
Only time will tell.

As such, it is very important for the Health and Agriculture ministries to provide the public updated information about its surveillance of both NiV and LayV in humans and animals.

Dr Milton Lum is a past president of the Federation of Private Medical Practitioners Associations and the Malaysian Medical Association. For more information, email [e-mail]. The views expressed do not represent that of organisations that the writer is associated with. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

New Langya virus discovered in China may only be ‘the tip of the iceberg’ for zoonotic cases globally, scienitsts say [PennLive, 12 Aug 2022]

By Deron Dalton

Scientists have suggested more surveillance of a new Langya virus found in dozens of people in China and hence, are now studying how easy it is for viruses to spread from animals to humans, and how these outbreak of diseases have gone undetected for so long.

The new virus is called Langya henipavirus. Nearly three dozen farmers and residents have been infected in eastern China. It is believed the virus has spread directly and/or indirectly from mole-like mammals called shrews.

While no deaths were reported, the pathogens were reported in 35 unrelated cases of fevers in hospitals in Henan and Shandong provinces between 2018 and 2021, according to CNN. The findings are aligned with long-standing warning animal viruses are spreading to humans and are left undetected on a global scale.

Leo Poon, a professor at the University of Hong Kong’s School of Public Health, wasn’t involved in the study, but called the virus “the tip of the iceberg.”

“We are hugely underestimating the number of these zoonotic cases in the world, and this (Langya virus) is just the tip of the iceberg,” said Poon.

Researchers published a study on the matter in the New England Journal of Medicine just last week. The issue has received global attention due to the concern over disease outbreaks and pandemics.

What Is the New Langya Virus, and Should We Be Worried? [Scientific American, 11 Aug 2022]

By Allen Cheng

The Langya virus, which is related to the Nipah and Hendra viruses, has infected at least 35 people in China in the two years before 2021

The following essay is reprinted with permission from The Conversation, an online publication covering the latest research.

A new virus, Langya henipavirus, is suspected to have caused infections in 35 people in China’s Shandong and Henan provinces over roughly a two-year period to 2021.

It’s related to Hendra and Nipah viruses, which cause disease in humans. However, there’s much we don’t know about the new virus – known as LayV for short – including whether it spreads from human to human.

Here’s what we know so far.

HOW SICK ARE PEOPLE GETTING?
Researchers in China first detected this new virus as part of routine surveillance in people with a fever who had reported recent contact with animals. Once the virus was identified, the researchers looked for the virus in other people.

Symptoms reported appeared to be mostly mild – fever, fatigue, cough, loss of appetite, muscle aches, nausea and headache – although we don’t know how long the patients were unwell.

A smaller proportion had potentially more serious complications, including pneumonia, and abnormalities in liver and kidney function. However, the severity of these abnormalities, the need for hospitalisation, and whether any cases were fatal were not reported.

WHERE DID THIS VIRUS COME FROM?
The authors also investigated whether domestic or wild animals may have been the source of the virus. Although they found a small number of goats and dogs that may have been infected with the virus in the past, there was more direct evidence a significant proportion of wild shrews were harbouring the virus.

This suggests humans may have caught the virus from wild shrews.

DOES THIS VIRUS ACTUALLY CAUSE THIS DISEASE?
The researchers used a modern technique known as metagenomic analysis to find this new virus. Researchers sequence all genetic material then discard the “known” sequences (for example, human DNA) to look for “unknown” sequences that might represent a new virus.

This raises the question about how scientists can tell whether a particular virus causes the disease.

We have traditionally used “Koch’s postulates” to determine whether a particular micro-organism causes disease:
• it must be found in people with the disease and not in well people
• it must be able to be isolated from people with the disease
• the isolate from people with the disease must cause the disease if given to a healthy person (or animal)
• it must be able to be re-isolated from the healthy person after they become ill.

The authors acknowledge this new virus doesn’t yet meet these criteria, and the relevance of these criteria in the modern era has been questioned.

However, the authors say they didn’t find any other cause of the illness in 26 people, there was evidence 14 people’s immune systems had responded to the virus, and people who were more unwell had more virus.

WHAT CAN WE LEARN FROM RELATED VIRUSES?
This new virus appears to be a close cousin of two other viruses that are significant in humans: Nipah virus and Hendra virus. This family of viruses was the inspiration for the fictional MEV-1 virus in the film Contagion.

Hendra virus was first reported in Queensland in 1994, when it caused the deaths of 14 horses and the trainer Vic Rail.

Many outbreaks in horses have been reported in Queensland and northern New South Wales since, and are generally thought to be due to “spillover” infections from flying foxes.

In total, seven human cases of Hendra virus have been reported in Australia (mostly veterinarians working with sick horses), including four deaths.

Nipah virus is more significant globally, with outbreaks frequently reported in Bangladesh.

The severity of infection can range from very mild to fatal encephalitis (inflammation of the brain).

The first outbreak in Malaysia and Singapore was reported in people who had close contact with pigs. However, it is thought more recent outbreaks have been due to food contaminated with the urine or saliva of infected bats.

Significantly, Nipah virus appears to be transmitted from person to person, mostly among household contacts.

WHAT DO WE NEED TO FIND OUT NEXT?
Little is known about this new virus, and the currently reported cases are likely to be the tip of the iceberg.

At this stage, there is no indication the virus can spread from human to human.

Further work is required to determine how severe the infection can be, how it spreads, and how widespread it might be in China and the region.

New ‘Langya’ virus identified in China: what scientists know so far [Nature.com, 11 Aug 2022]

By Smriti Mallapaty

The henipavirus can cause respiratory symptoms and is related to Nipah and Hendra viruses, but cannot spread easily in people.

A new animal virus that can infect people has been identified in eastern China. But scientists say they are not overly concerned because the virus doesn’t seem to spread easily between people, nor is it fatal.

The virus, named Langya henipavirus (LayV), can cause respiratory symptoms such as fever, cough and fatigue, and is closely related to two other henipaviruses known to infect people — Hendra virus and Nipah virus. These also cause respiratory infections, and can be fatal. Researchers think LayV is carried by shrews, which might have infected people directly or through an intermediate animal. The virus was described in the New England Journal of Medicine1 on 4 August.

Researchers say LayV has infected only 35 people since 2018, and none of the cases seems to be linked. “There is no particular need to worry about this, but ongoing surveillance is critical,” says Edward Holmes, an evolutionary virologist at the University of Sydney in Australia. Regularly testing people and animals for emerging viruses is important to understand the risk of zoonotic diseases — those that can be transmitted from other animals to humans, he says.

Large outbreaks of infectious diseases typically take off after a lot of false starts, says Emily Gurley, an infectious-diseases epidemiologist at Johns Hopkins University in Baltimore, Maryland. “If we are actively looking for those sparks, then we are in a much better position to stop or to find something early.”

Hospital surveillance
The research team that identified LayV did so while monitoring patients at three hospitals in the eastern Chinese provinces of Shandong and Henan between April 2018 and August 2021. Participants were recruited into the study if they had a fever.

The team sequenced the LayV genome from a throat swab taken from the first patient identified with the disease, a 53-year-old woman. The virus was named after a town called Langya, in Shandong, where she was from, says co-author Linfa Wang, a virologist at Duke–National University of Singapore Medical School in Singapore.

Throughout the study period, the researchers found 35 people who were infected with LayV, mostly farmers, with symptoms ranging from severe pneumonia to a cough. Most patients said in a questionnaire that they had been exposed to an animal within a month of their symptoms appearing.

The LayV genome shows that the virus is most closely related to Mojiang henipavirus, which was first isolated in rats in an abandoned mine in the southern Chinese province of Yunnan in 2012. Henipaviruses belong to the Paramyxoviridae family of viruses, which includes measles, mumps and many respiratory viruses that infect people. Several other henipaviruses have been discovered in bats, rats and shrews, from Australia to South Korea and China, but only Hendra, Nipah and now LayV are known to infect people.

The researchers did not find strong evidence of LayV spreading between people — there were no clusters of cases in the same family, within a short time span or in close geographical proximity. “Of the 35 cases, not a single one is linked,” says Wang. Gurley says that this is good news, but the study did retrospective contact tracing on only 15 family members of 9 infected individuals, which makes it difficult to determine how exactly the individuals were exposed. Still, she notes that she didn’t see anything in the data to “cause alarm from a pandemic-threat perspective”.

Animal origin
To determine the potential animal origin of the virus, the researchers tested goats, dogs, pigs and cattle living in the villages of infected patients for antibodies against LayV, and took tissue and urine samples from 25 species of wild small animals to look for the presence of LayV RNA. They found LayV antibodies in a handful of goats and dogs, and identified LayV viral RNA in 27% of the 262 sampled shrews. This suggested that shrews are a reservoir for the virus, passing LayV between themselves “and somehow infecting people here and there by chance”, says Gurley.

But it is not clear how people were infected in the first place — whether directly from shrews or an intermediate animal, says Gurley. A lot of research still needs to be done to work out how the virus is spreading in shrews and how people are getting infected, she says.

Holmes says there is an urgent need for a global surveillance system to detect virus spillovers and rapidly communicate those results to avoid more pandemics, such as the one sparked by COVID-19. “These sorts of zoonotic spillover events happen all the time,” he says. “The world needs to wake up.”

References
1. Zhang, X.-A. et al. N. Engl. J. Med. 387, 470–472 (2022).

Langya vs. Nipah: China's New Virus Spread by Shrews Has a Deadly Relative [Newsweek, 10 Aug 2022]

BY JESS THOMSON

Langya henipavirus (LayV), a virus that spreads by shrews which has been identified in 35 people in China, has an extremely deadly relative: Nipah virus

The latest Langya cases were announced in a letter published in the New England Journal of Medicine. In it, Xiao-Ai Zhang, from the Beijing Institute of Microbiology and Epidemiology, and colleagues said cases had been found in two provinces: Shandong and Henan.

As reported by Focus Taiwan, the Taiwan Centers for Disease Control (CDC) said it is starting to develop ways to track the Langya virus and that methods of sequencing its genome will be ready within a week.

Nipah virus outbreaks and symptoms

This new virus is a close relative of a previously reported, extremely deadly, Nipah virus. Both Nipah and Langya belong to the henipavirus family, which according to the World Health Organization (WHO) are classed as biosafety Level 4 viruses.

The Nipah virus is zoonotic, having evolved in fruit bats. It is able to be transmitted to humans via animals like bats or pigs, contaminated foods, and between humans.

It is fatal in between 40 to 75 percent of cases. The fatality rate, however, varies on local capabilities.

Nipah was first discovered during an outbreak among pig farmers in Malaysia in 1999. Two years later, cases were found in Bangladesh. There have been an outbreaks almost every year in India ever since.

Other regions known to be at risk include Cambodia, Ghana, Indonesia, Thailand, Madagascar and the Philippines, as natural reservoirs of the virus exist in bats in these regions.

Symptoms of Nipah virus are known to include fever, headaches, myalgia (muscle pain), vomiting and sore throat, as well as dizziness, drowsiness, and acute encephalitis. In serious cases, the patient may fall into a coma within 48 hours.

How does Langyna virus compare?
The NEJM letter describes the symptoms of the 35 Langya patients. It said that of the 26 patients who were infected with Langya alone, had a fever, 54 percent were experiencing fatigue, 50 percent had a cough, 46 percent had muscle aches and pain, 38 percent had nausea, and 35 percent had a headache. The same number reported vomiting.

Half of the patients had anorexia, while 35 percent developed thrombocytopenia—a condition where the platelet count in the blood drops too low. Over half developed leukopenia, where a person's white blood cell count drops. Thirty five percent developed impaired liver function, and eight percent had impaired kidney function.

The fatality rates of this new strain are not yet known, as nobody infected with the virus has yet died.

New Coronavirus News from 8 Aug 2022

DOCK2 is involved in the host genetics and biology of severe COVID-19 [Nature.com, 8 Aug 2022]

Authored by Ho Namkoong, Ryuya Edahiro, Tomomi Takano, Hiroshi Nishihara, Yuya Shirai, Kyuto Sonehara, Hiromu Tanaka, Shuhei Azekawa, Yohei Mikami, Ho Lee, Takanori Hasegawa, Koji Okudela, Daisuke Okuzaki, Daisuke Motooka, Masahiro Kanai, Tatsuhiko Naito, Kenichi Yamamoto, Qingbo S. Wang, Ryunosuke Saiki, Rino Ishihara, Yuta Matsubara, Junko Hamamoto, Hiroyuki Hayashi, Yukihiro Yoshimura, Natsuo Tachikawa, Emmy Yanagita, Takayoshi Hyugaji, Eigo Shimizu, Kotoe Katayama, Yasuhiro Kato, Takayoshi Morita, Kazuhisa Takahashi, Norihiro Harada, Toshio Naito, Makoto Hiki, Yasushi Matsushita, Haruhi Takagi, Ryousuke Aoki, Ai Nakamura, Sonoko Harada, Hitoshi Sasano, Hiroki Kabata, Katsunori Masaki, Hirofumi Kamata, Shinnosuke Ikemura, Shotaro Chubachi, Satoshi Okamori, Hideki Terai, Atsuho Morita, Takanori Asakura, Junichi Sasaki, Hiroshi Morisaki, Yoshifumi Uwamino, Kosaku Nanki, Sho Uchida, Shunsuke Uno, Tomoyasu Nishimura, Takashi Ishiguro, Taisuke Isono, Shun Shibata, Yuma Matsui, Chiaki Hosoda, Kenji Takano, Takashi Nishida, Yoichi Kobayashi, Yotaro Takaku, Noboru Takayanagi, Soichiro Ueda, Ai Tada, Masayoshi Miyawaki, Masaomi Yamamoto, Eriko Yoshida, Reina Hayashi, Tomoki Nagasaka, Sawako Arai, Yutaro Kaneko, Kana Sasaki, Etsuko Tagaya, Masatoshi Kawana, Ken Arimura, Kunihiko Takahashi, Tatsuhiko Anzai, Satoshi Ito, Akifumi Endo, Yuji Uchimura, Yasunari Miyazaki, Takayuki Honda, Tomoya Tateishi, Shuji Tohda, Naoya Ichimura, Kazunari Sonobe, Chihiro Tani Sassa, Jun Nakajima, Yasushi Nakano, Yukiko Nakajima, Ryusuke Anan, Ryosuke Arai, Yuko Kurihara, Yuko Harada, Kazumi Nishio, Tetsuya Ueda, Masanori Azuma, Ryuichi Saito, Toshikatsu Sado, Yoshimune Miyazaki, Ryuichi Sato, Yuki Haruta, Tadao Nagasaki, Yoshinori Yasui, Yoshinori Hasegawa, Yoshikazu Mutoh, Tomoki Kimura, Tomonori Sato, Reoto Takei, Satoshi Hagimoto, Yoichiro Noguchi, Yasuhiko Yamano, Hajime Sasano, Sho Ota, Yasushi Nakamori, Kazuhisa Yoshiya, Fukuki Saito, Tomoyuki Yoshihara, Daiki Wada, Hiromu Iwamura, Syuji Kanayama, Shuhei Maruyama, Takashi Yoshiyama, Ken Ohta, Hiroyuki Kokuto, Hideo Ogata, Yoshiaki Tanaka, Kenichi Arakawa, Masafumi Shimoda, Takeshi Osawa, Hiroki Tateno, Isano Hase, Shuichi Yoshida, Shoji Suzuki, Miki Kawada, Hirohisa Horinouchi, Fumitake Saito, Keiko Mitamura, Masao Hagihara, Junichi Ochi, Tomoyuki Uchida, Rie Baba, Daisuke Arai, Takayuki Ogura, Hidenori Takahashi, Shigehiro Hagiwara, Genta Nagao, Shunichiro Konishi, Ichiro Nakachi, Koji Murakami, Mitsuhiro Yamada, Hisatoshi Sugiura, Hirohito Sano, Shuichiro Matsumoto, Nozomu Kimura, Yoshinao Ono, Hiroaki Baba, Yusuke Suzuki, Sohei Nakayama, Keita Masuzawa, Shinichi Namba, Ken Suzuki, Yoko Naito, Yu-Chen Liu, Ayako Takuwa, Fuminori Sugihara, James B. Wing, Shuhei Sakakibara, Nobuyuki Hizawa, Takayuki Shiroyama, Satoru Miyawaki, Yusuke Kawamura, Akiyoshi Nakayama, Hirotaka Matsuo, Yuichi Maeda, Takuro Nii, Yoshimi Noda, Takayuki Niitsu, Yuichi Adachi, Takatoshi Enomoto, Saori Amiya, Reina Hara, Yuta Yamaguchi, Teruaki Murakami, Tomoki Kuge, Kinnosuke Matsumoto, Yuji Yamamoto, Makoto Yamamoto, Midori Yoneda, Toshihiro Kishikawa, Shuhei Yamada, Shuhei Kawabata, Noriyuki Kijima, Masatoshi Takagaki, Noah Sasa, Yuya Ueno, Motoyuki Suzuki, Norihiko Takemoto, Hirotaka Eguchi, Takahito Fukusumi, Takao Imai, Munehisa Fukushima, Haruhiko Kishima, Hidenori Inohara, Kazunori Tomono, Kazuto Kato, Meiko Takahashi, Fumihiko Matsuda, Haruhiko Hirata, Yoshito Takeda, Hidefumi Koh, Tadashi Manabe, Yohei Funatsu, Fumimaro Ito, Takahiro Fukui, Keisuke Shinozuka, Sumiko Kohashi, Masatoshi Miyazaki, Tomohisa Shoko, Mitsuaki Kojima, Tomohiro Adachi, Motonao Ishikawa, Kenichiro Takahashi, Takashi Inoue, Toshiyuki Hirano, Keigo Kobayashi, Hatsuyo Takaoka, Kazuyoshi Watanabe, Naoki Miyazawa, Yasuhiro Kimura, Reiko Sado, Hideyasu Sugimoto, Akane Kamiya, Naota Kuwahara, Akiko Fujiwara, Tomohiro Matsunaga, Yoko Sato, Takenori Okada, Yoshihiro Hirai, Hidetoshi Kawashima, Atsuya Narita, Kazuki Niwa, Yoshiyuki Sekikawa, Koichi Nishi, Masaru Nishitsuji, Mayuko Tani, Junya Suzuki, Hiroki Nakatsumi, Takashi Ogura, Hideya Kitamura, Eri Hagiwara, Kota Murohashi, Hiroko Okabayashi, Takao Mochimaru, Shigenari Nukaga, Ryosuke Satomi, Yoshitaka Oyamada, Nobuaki Mori, Tomoya Baba, Yasutaka Fukui, Mitsuru Odate, Shuko Mashimo, Yasushi Makino, Kazuma Yagi, Mizuha Hashiguchi, Junko Kagyo, Tetsuya Shiomi, Satoshi Fuke, Hiroshi Saito, Tomoya Tsuchida, Shigeki Fujitani, Mumon Takita, Daiki Morikawa, Toru Yoshida, Takehiro Izumo, Minoru Inomata, Naoyuki Kuse, Nobuyasu Awano, Mari Tone, Akihiro Ito, Yoshihiko Nakamura, Kota Hoshino, Junichi Maruyama, Hiroyasu Ishikura, Tohru Takata, Toshio Odani, Masaru Amishima, Takeshi Hattori, Yasuo Shichinohe, Takashi Kagaya, Toshiyuki Kita, Kazuhide Ohta, Satoru Sakagami, Kiyoshi Koshida, Kentaro Hayashi, Tetsuo Shimizu, Yutaka Kozu, Hisato Hiranuma, Yasuhiro Gon, Namiki Izumi, Kaoru Nagata, Ken Ueda, Reiko Taki, Satoko Hanada, Kodai Kawamura, Kazuya Ichikado, Kenta Nishiyama, Hiroyuki Muranaka, Kazunori Nakamura, Naozumi Hashimoto, Keiko Wakahara, Sakamoto Koji, Norihito Omote, Akira Ando, Nobuhiro Kodama, Yasunari Kaneyama, Shunsuke Maeda, Takashige Kuraki, Takemasa Matsumoto, Koutaro Yokote, Taka-Aki Nakada, Ryuzo Abe, Taku Oshima, Tadanaga Shimada, Masahiro Harada, Takeshi Takahashi, Hiroshi Ono, Toshihiro Sakurai, Takayuki Shibusawa, Yoshifumi Kimizuka, Akihiko Kawana, Tomoya Sano, Chie Watanabe, Ryohei Suematsu, Hisako Sageshima, Ayumi Yoshifuji, Kazuto Ito, Saeko Takahashi, Kota Ishioka, Morio Nakamura, Makoto Masuda, Aya Wakabayashi, Hiroki Watanabe, Suguru Ueda, Masanori Nishikawa, Yusuke Chihara, Mayumi Takeuchi, Keisuke Onoi, Jun Shinozuka, Atsushi Sueyoshi, Yoji Nagasaki, Masaki Okamoto, Sayoko Ishihara, Masatoshi Shimo, Yoshihisa Tokunaga, Yu Kusaka, Takehiko Ohba, Susumu Isogai, Aki Ogawa, Takuya Inoue, Satoru Fukuyama, Yoshihiro Eriguchi, Akiko Yonekawa, Keiko Kan-o, Koichiro Matsumoto, Kensuke Kanaoka, Shoichi Ihara, Kiyoshi Komuta, Yoshiaki Inoue, Shigeru Chiba, Kunihiro Yamagata, Yuji Hiramatsu, Hirayasu Kai, Koichiro Asano, Tsuyoshi Oguma, Yoko Ito, Satoru Hashimoto, Masaki Yamasaki, Yu Kasamatsu, Yuko Komase, Naoya Hida, Takahiro Tsuburai, Baku Oyama, Minoru Takada, Hidenori Kanda, Yuichiro Kitagawa, Tetsuya Fukuta, Takahito Miyake, Shozo Yoshida, Shinji Ogura, Shinji Abe, Yuta Kono, Yuki Togashi, Hiroyuki Takoi, Ryota Kikuchi, Shinichi Ogawa, Tomouki Ogata, Shoichiro Ishihara, Arihiko Kanehiro, Shinji Ozaki, Yasuko Fuchimoto, Sae Wada, Nobukazu Fujimoto, Kei Nishiyama, Mariko Terashima, Satoru Beppu, Kosuke Yoshida, Osamu Narumoto, Hideaki Nagai, Nobuharu Ooshima, Mitsuru Motegi, Akira Umeda, Kazuya Miyagawa, Hisato Shimada, Mayu Endo, Yoshiyuki Ohira, Masafumi Watanabe, Sumito Inoue, Akira Igarashi, Masamichi Sato, Hironori Sagara, Akihiko Tanaka, Shin Ohta, Tomoyuki Kimura, Yoko Shibata, Yoshinori Tanino, Takefumi Nikaido, Hiroyuki Minemura, Yuki Sato, Yuichiro Yamada, Takuya Hashino, Masato Shinoki, Hajime Iwagoe, Hiroshi Takahashi, Kazuhiko Fujii, Hiroto Kishi, Masayuki Kanai, Tomonori Imamura, Tatsuya Yamashita, Masakiyo Yatomi, Toshitaka Maeno, Shinichi Hayashi, Mai Takahashi, Mizuki Kuramochi, Isamu Kamimaki, Yoshiteru Tominaga, Tomoo Ishii, Mitsuyoshi Utsugi, Akihiro Ono, Toru Tanaka, Takeru Kashiwada, Kazue Fujita, Yoshinobu Saito, Masahiro Seike, Hiroko Watanabe, Hiroto Matsuse, Norio Kodaka, Chihiro Nakano, Takeshi Oshio, Takatomo Hirouchi, Shohei Makino, Moritoki Egi, The Biobank Japan Project, Yosuke Omae, Yasuhito Nannya, Takafumi Ueno, Kazuhiko Katayama, Masumi Ai, Yoshinori Fukui, Atsushi Kumanogoh, Toshiro Sato, Naoki Hasegawa, Katsushi Tokunaga, Makoto Ishii, Ryuji Koike, Yuko Kitagawa, Akinori Kimura, Seiya Imoto, Satoru Miyano, Seishi Ogawa, Takanori Kanai, Koichi Fukunaga & Yukinori Okada

Abstract
Identifying the factors underlying severe COVID-19 in the host genetics is an emerging issue1–5. We conducted a genome-wide association study (GWAS) involving 2,393 Japanese COVID-19 cases collected in initial pandemic waves with 3,289 controls, which identified a variant on 5q35 (rs60200309-A) near DOCK2 associated with severe COVID-19 in younger (<65 ages) patients (nCase=440, odds ratio=2.01, P=1.2×10-8). This risk allele was prevalent in East Asians but rare in Europeans, showing a value of non-European GWAS. RNA-seq of 473 bulk peripheral blood identified decreasing effect of the risk allele on DOCK2 expression in younger patients. DOCK2 expression was suppressed in severe forms of COVID-19. Single cell RNA-seq analysis (n=61) identified cell type-specific downregulation of DOCK2 and COVID-19-specific decreasing effects of the risk allele on DOCK2 in non-classical monocytes. Immunohistochemistry of lung specimens from severe COVID-19 pneumonia showed suppressed DOCK2. Moreover, inhibition of DOCK2 function using CPYPP induced much more severe pneumonia in a Syrian hamster model of SARS-CoV-2 infection characterized as weight loss, lung edema, enhanced viral loads, impaired macrophage recruitment and dysregulated type I interferon responses. We conclude that DOCK2 plays an important role in the host immune response to SARS-CoV-2 infection and development of severe COVID-19, and could be further explored as a potential biomarker and/or therapeutic target.