Prepared by Sunita Shamsul (Assistant Research Officer, SIDC).
Edited by Prof Andrew Kiyu
Summary
- Globally, COVID-19 activity has remained low – the report to be taken with caution due to decreasing reports from sentinel and non-sentinel outputs.
- New funding for pathogen surveillance has been announced by the
- The WHO has updated its seasonal flu
- The WHO is considering to include zoonotic influenza A viruses for seasonal influenza candidate vaccine development as part of pandemic preparedness.
- An updated guideline for tuberculosis will be published before the year
- Anti-microbial stewardship is important in controlling anti-microbial
- Outbreaks of food-borne diseases in the US highlight the importance of food security, from farms to plate.
- Zoonotic diseases that have the potential to jump host to humans and establish themselves continue to be of concern.
- Symptoms evolve/change as the mpox epidemic moves
1.0 Situational summary: cases and related issues
1.1 COVID-19 updates from the WHO
According to the WHO’s latest integrated updates on respiratory infections, including COVID- 19 and influenza,1 globally, SARS-CoV-2 positivity from sentinel surveillance remained below 10% (~8.2%) in all WHO Regions except for the Americas. The positivity there increased to approximately 20%. The SARS-CoV-2 positivity from non-sentinel surveillance decreased to approximately 10% globally.
1.2 Why the COVID-19 pandemic should dwindle longer, and not be over yet
The US
COVID-19 disease severity marker levels in the US have remained on a downward trend.
Hospitalisations remain elevated in two groups: older people and infants ≤ 12 months old. Emergency department visits declined 12.4% from the previous reporting week. Early disease indicators also showed downward trends; the national test positivity rate was at 8.1%, with some variation in different parts of the country. Wastewater SARS-CoV-2 virus detections, however, remained high. For the week ending 17 February 2024, the levels were higher in the southern region than in the rest of the country.2 The current COVID-19 situation remains less severe than earlier in the pandemic.3 4
Respiratory syncytial virus (RSV) levels continued on its downward trend with hospitalisation for seniors and infants declining further. Deaths have remained stable.
Flu levels, however, continue to remain high – national test positivity was 14.8%, and reports of outpatient visits were “a steady” of 4.5%. According to the CDC, hospitalisation indicators have remained stable and have been decreasing since the beginning of the year. There have been 91 deaths since November 2023.
2.0 Planning
2.1 International Pathogen Surveillance Network grants
The WHO announced USD 4 million in funding from donors to create a catalytic grant fund for organisations working in pathogen genomic surveillance. The fund will “support projects across the world, particularly in low- and middle-income countries, to pilot projects and in doing so, create an evidence base for how to quickly scale up pathogen genomic surveillance”. The results of this type of surveillance will help countries and the world to respond more quickly and effectively to prevent outbreaks and to respond to them.5
The initial grants for the catalytic fund have been provided by the Bill & Melinda Gates Foundation, The Rockefeller Foundation, and Wellcome, to support the International Pathogen Surveillance Network (IPSN).6 IPSN is a new global network of pathogen surveillance group convened by WHO through a Secretariat at the WHO Hub for Pandemic and Epidemic Intelligence in Berlin. The fund is hosted by the UN Foundation on behalf of the IPSN.7
2.2 Flu vaccine updates, the WHO
The WHO announced the flu vaccine viral composition based on the recommendations from its advisory group.8 9 The agency has determined that the composition for the Northern Hemisphere 2024-25 flu season be the same as recommended for the Southern Hemisphere’s 2024 season. The agency recommends the use of trivalent vaccines that contain the following (paraphrased):
- Egg-based vaccines:
- an A/Victoria/4897/2022 (H1N1)pdm09-like virus;
- an A/Thailand/8/2022 (H3N2)-like virus; and
- a B/Austria/1359417/2021 (B/Victoria lineage)-like
- Cell culture- or recombinant-based vaccines:
- an A/Wisconsin/67/2022 (H1N1)pdm09-like virus;
- an A/Massachusetts/18/2022 (H3N2)-like virus; and
- a B/Austria/1359417/2021 (B/Victoria lineage)-like
The vaccine strain does not include influenza B Yamagata lineage viruses as the last naturally occurring cases have not been confirmed since March 2020. The WHO has recommended the use of vaccines with a strain similar to the Yamagata Phuket/3073/2013 lineage virus for countries that still use the quadrivalent (four-strain) versions of the vaccine.
The advisory group also proposed two new candidate strains, both targeting recent variant H1N1 viruses (zoonotic) to be considered seasonal flu vaccines; one is antigenically similar toA/Catalonia/NSAV198289092/2023, and the other is similar to A/England/234600203/2023.10
2.3 Tuberculosis, updated guidelines from the WHO
The WHO, on 13 February 2024, announced updates on tuberculosis preventive treatment (TPT).11
It includes a recommendation to use a regimen of 6 months of levofloxacin as TPT for contacts of patients with multidrug- or rifampicin-resistant tuberculosis (MDR/RR-TB). This primary update was on the results of two randomised controlled trials in VietNam and South Africa that supported the use of the regimen in all age groups.
Other changes include (a) updated drug dosages for TPT regimens, (b) integration of recommendations on screening strategies to rule out TB ahead of starting TPT and the use of TB tests, as well as (c) an update of the algorithm for the management of TPT in contacts.
The full version of the updated guidelines will be released later in the year.
3.0 Others
3.1 Flu
3.1.1 Updates from the WHO
While global detections of the flu have generally declined, the activity remains elevated in many parts of the Northern Hemisphere. A summary is as follows (paraphrased):1 12
- In Europe and Central Asia, where flu hotspots are located, hospitalisations and intensive care unit (ICU) admissions remained elevated. Very high activity was reported from Russia and Slovakia.
- In North America, flu levels remained elevated (indicated by hospitalisations) but stable. The 2009 H1N1 virus [also known as Influenza A(H1N1)pdm09 virus] remains dominant, with a slight uptick in influenza B in the US and Canada.
- Flu activity in China is elevated; however, it is declining in both the northern and southern Most detections involved influenza B. Flu hospitalisations in Hong Kong remain above the seasonal threshold.
- In Southeast Asia, activity showed an overall increase, especially in Malaysia, Singapore, and Thailand.
- In Western Asia, flu activity rose in Armenia, Georgia, Israel, and Turkey.
- Flu remained stable in parts of tropical Asia, with rises in the Maldives and Nepal.
- In Africa, flu detections increased in several western countries, including Mauritania and Niger, as well as Cameroon.
- In the temperate zones of the southern hemisphere, indicators of influenza activity were reported at low levels or below the seasonal threshold in most reporting countries.
A summary of the proportion of respiratory specimens which tested positive for influenza, by influenza transmission zone 13 is shown in Figure 1.
Figure 1. Global distribution of natural plague foci as of 2016. There were 3,248 cases of plague reported worldwide from 2010 to 2015, including 584 deaths. The map was obtained from plague-map-2016.png (1195×625) (who.int).
2.0 Planning
4.1 Zoonosis
4.1.1 Alaskapox fatality, Alaska, the US
The Alaska health authorities reported the first fatality of Alaskapox on 9 February 2024. The infection involved an elderly man with underlying healt
