No UKHSA, MHRA or Green Book guidance change since Friday afternoon

The last infection guidance change was UKHSA’s influenza antiviral update (23 Oct). MHRA’s newest items are two non-infection approvals (23 Oct). There’s no new drug or device alert relevant to infection. The HCID country-specific risk page was last updated on 22 Oct (Kenya, Nigeria and the US).

Flu antivirals › · MHRA alerts › · HCID country risk ›

Nothing new from ECDC; Shamonda virus encephalitis paper circulating

ECDC’s newest items are still the Kenya/Nigeria Ebola threat brief (23 Oct) and the first human Shamonda virus infection in France (22 Oct). The week 43 CDTR still isn’t on the archive; the latest there is week 42. On 25 Oct FluTrackers highlighted the Eurosurveillance report of fatal encephalitis due to Shamonda virus Europe 1 (SHAV-EU1) in a severely immunocompromised patient in France, the same case ECDC announced on 22 Oct.

ECDC Shamonda › · ECDC CDTR › · @FluTrackers ›

DRC: health worker killed in Tshopo; Kenya sets out its 42-day countdown

• DRC, security: Dr Tedros (25 Oct) says a nurse was killed and another health worker severely injured on 24 Oct, attacked while responding to an Ebola alert in Bafwasende, Tshopo province.
• DRC, care capacity: WHO AFRO says the Isiro (Haut-Uélé) Ebola treatment centre has been expanded, and WHO has delivered more than a tonne of supplies, including oxygen equipment and PPE, to the general referral hospital.
• DRC, figures (secondary): FluTrackers relays DRC government figures of 60 new cases and 46 new deaths (31 community deaths), with a CFR of 48.6%. The reporting period isn’t stated and we haven’t checked these against WHO.
• Kenya: the Health CS says more than 4,900 health workers have been trained. Ebola-free status will be judged after 42 days in line with WHO, and there are no travel, trade or tourism restrictions. No new case count was published in the window (last: nine confirmed, one cluster).
• Vaccines: Africa CDC describes TUMAINI as an adaptive phase 2/3 trial that starts with Ervebo and then moves to Bundibugyo-specific candidates. It runs alongside frontline worker vaccination and the BRAVO healthcare worker study.

There’s been no new WHO DON since DON622 (23 Oct). Nigeria contact numbers and a weekly stipend for contacts appear only in an X-generated news summary, so we haven’t used them here.

@DrTedros › · WHO AFRO Isiro › · @FluTrackers (DRC figures) › · @MOH_Kenya (42 days) › · @MOH_Kenya (no restrictions) › · @AfricaCDC (TUMAINI) ›

Bronkhorstspruit, Tshwane: unchlorinated water linked to mixed-pathogen gastroenteritis

• Cause: the Bronkhorstspruit Water Treatment Works ran without chlorination from about 24 Sep to 14 Oct, drawing from a sewage-polluted river. DWS found very high E. coli and coliform counts in treated water and reservoirs (14 Oct).
• Microbiology (NICD): norovirus, Campylobacter and Shigella were detected in three of four stool specimens, together with other enteric pathogens. No cholera was found. Most cases are in children under four, and no deaths have been reported.
• Counts: 408 cases between 7 and 18 Oct (joint ministerial statement, 19 Oct); 595 between 7 and 19 Oct in health department figures presented to Parliament on 23 Oct (as reported by The Citizen), 262 of them in children aged up to four.
• In the window: an X news summary reports that the mayor has suspended the plant manager and ordered an independent probe. We haven’t confirmed this from an official source.

Numbers don’t line up: the official statement gives the peak as 72 cases on 13 Oct, but the presentation reported by The Citizen gives 75 on 11 Oct. Parliament also cited a media figure of 433. Moving from 408 to 595 means 187 cases added in a single day (47 reported for 19 Oct), so the later figure probably includes retrospective line-list additions. This is our inference. Tap water remains for toilet flushing only.

Joint statement (19 Oct) › · The Citizen (23 Oct) › · NICD alert › · X news summary ›

Science, not politics: the ESCMID view on protecting populations against measles, mumps and rubella

Brugger S, Fitzpatrick F, Friedland JS, Kluytmans J, Şahin GÖ, Paño-Pardo JR and colleagues (ESCMID Executive Committee and Vaccines Subcommittee; endorsed by SAS, EVASG and IDSA, according to ESCMID). The statement reaffirms support for MMR vaccination and argues that schedules and delivery should follow evidence, public health principles and cost-effectiveness rather than politics. A companion version is in CMI Communications.

We’ve read only the summary; the publisher pages blocked our check.

CMI (DOI) › · CMI Comms › · @ESCMID ›

Circulating IP-10/CXCL10 correlates with parasitaemia and disease severity in babesiosis: a pilot study

Plasma cytokines in 16 hospitalised patients with babesiosis versus 7 controls. Eight cytokines were raised (including IL-6, IL-10, IP-10 and TNF-α). IP-10 correlated with parasitaemia (Spearman R = 0.52, P = .04), and IP-10 and IL-5 were higher in severe disease. Immunosuppression was associated with low VEGF and basic FGF.

Takeaway: this is hypothesis-generating only. The sample is small, and IP-10 isn’t a validated severity marker.

Article ›