Save 25% on ProMED subscriptions before May 16th - access critical health alerts at a discount Dear ProMED User, We want to ensure that you don't miss out on your last chance to save 25% on a new ProMED subscription. At the end of the day on May 16th, the 25% promotion that has been running will expire, and the "Freemium" tier will revert back to its normal access of five full ProMED posts per month. By subscribing to the Standard Tier now for one year, you will save $25 and will have access to 30 full posts per month. By subscribing to the Pro Tier now for one year, you will save $250 and have unlimited access to posts as well as the option to have posts emailed to you! Subscribe Today If you haven't already created an account to login and look around, please do! Current subscribers have had the following feedback about the new user interface (UI): Heather D. Marshall (Ph.D., Public Health Content Manager, DynaMed, EBSCO) says the updated ProMED UI is a "more streamlined user interface," and Dale Menges (Pharm.D., Pharmacist at New Mexico State University) says, "Updated format is clean, easy to navigate." We also wanted to share a valuable comment from Mark S. Peppler (DPhil, Adjunct Associate Professor, Division of Medical Laboratory Science, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada). Mark wrote us and said "Delighted for the search function! I need that for my micro classes!....I'm thrilled you found a way to keep going, especially in this science-toxic environment we now are living with in the USA!" While many current and former ProMED subscribers are understandably upset about the decision to switch from a free, open access model to a paid subscription model with limited email options, it was not made lightly or without regards to the consequences to our longstanding users. The decision came after two full years of soliciting funding from both the public and private sector with limited success. Although ProMED was provided for free for many years, ProMED is far from free to run, with the "free" emails we sent to subscribers being a large line item. With no long-term funding options on the horizon, we were faced with the decision to either shut down completely, or move to a subscription model where we hope, over time, the largest data users will come to the table to pay the bulk of the cost, and our individual, front-line public health and health care workers can continue to access the information they need at low or no cost. It is also worth noting that many of our users believe ProMED is funded in whole or part by the WHO, UN, EIOS, US CDC, etc. Unfortunately that is simply not the case as ProMED has relied almost exclusively on large philanthropic donors whose support we have greatly appreciated, but who also have to make funding decisions that fit with their organization's programming guidance. The subscription model is a work in progress and we value your feedback immensely on how to improve it and other options you'd like to see offered. So, please, take a look around the new website and let us know what you think at support@isid.org. Subscribe Thank you, Jarod Hanson, ProMED Chief Content Officer Julia Maxwell, Director of Disease Surveillance ProMED Support 867 Boylston Street, 5th Floor #1985, Boston, MA 02116 Unsubscribe - Unsubscribe Preferences

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MALARIA - BELIZE: FIRST CASES IN 6 YEARS
****************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Wed 16 Apr 2025
Source: Associates Times [abridged, edited]
https://associatestimes.com/news/malaria-returns-to-belize-after-6-year-hiatus-4-cases-confirmed-in-2025


Malaria returns to Belize after 6-year hiatus: 4 cases confirmed in
2025
---------------------------------------------------------------
After 6 years of being malaria-free, Belize has confirmed 4 cases of
the disease in 2025. This has raised an alarming concern among
citizens of the nation as the country has recently experienced a major
outbreak of measles after a period of almost 30 years. The return of
these infectious diseases have highlighted the need for preventive
measures and for the public to remain vigilant regarding their health.
While confirming the cases of malaria, the Ministry of Health and
Wellness emphasized their efforts to prevent the re-establishment of
the diseases and reiterated their committed to making Belize a healthy
nation once again.

As per reports shared by the Health Authorities, the first case of
malaria was detected in January 2025, followed by the other cases
detected on 11 Mar and 5 Apr [2025]. Out of the 4 cases confirmed in
2025, 3 of them were originated in the nation and one imported from
Guatemala.

With a vision to make Belize a malaria-free nation, the ministry has
launched comprehensive response activities, which include the vector
control efforts like fogging, larviciding, and house-to-house fever
screenings. The authorities have also aimed at introduced community
awareness campaigns in order to ensure that the citizens of the nation
receive symptoms and understand prevention strategies. The Ministry is
also actively testing individuals who currently have or had a fever
within the past 30 days. They have also urged such citizens to visit
the nearest health facility for free malaria testing.

Malaria is spread by the bite of an infected female _Anopheles_
mosquito. It is also spread by transfusion of blood from infected
people or by the use of contaminated (dirty) needles or syringes. It
is crucial for the patients to receive thorough medical treatment for
the betterment of their health.

There are certain measures that can be taken to avoid mosquito bites:
- Apply mosquito repellent to exposed skin.
- Drape mosquito netting over beds.
- Put screens on windows and doors.
- Treat clothing, mosquito nets, tents, sleeping bags, and other
fabrics with an insect repellent called permethrin.
- Wear long pants and long sleeves to cover skin.
- Eliminate standing water around homes.

[Byline: Amara Campbell]

--
Communicated by:
ProMED

[The report does not state which species of _Plasmodium_ were
identified in the cases and where in the country they were found. Of
note, 3 of the cases were autochthonous in nature (locally acquired).
- Mod.LL

ProMED map:
Belize: https://promedmail.org/promed-post?place=8723722,19]

[See Also:
2024
----
Malaria - Mexico: (OA) migrants, increase
http://promedmail.org/post/20241112.8719962
Malaria - USA (04): (AR) vivax, autochthonous, 2023
http://promedmail.org/post/20241025.8719587
Malaria - USA (03): (CA) vivax, Chinese immigrants
http://promedmail.org/post/20240516.8716545
Malaria - USA (02): CDC, 3 southern border jurisdictions, increased
importations, 2023 http://promedmail.org/post/20240510.8716419
Malaria - USA (01): (OR) falciparum, probable prolonged presentation,
ex Africa, 2022 http://promedmail.org/post/20240113.8714202
2023
----
Malaria - Americas (16): USA (MD) autochthonous, falciparum, CDC
http://promedmail.org/post/20231012.8712600
Malaria - Americas (15): (Canada) ex Philippines, Plasmodium knowlesi
http://promedmail.org/post/20231007.8712508
Malaria - Americas (14): USA (AR) autochthonous
http://promedmail.org/post/20231005.8712469
Malaria - Americas (13): Costa Rica (PU)
http://promedmail.org/post/20230929.8712370
Malaria - Americas (12): USA (FL, TX) CDC
http://promedmail.org/post/20230908.8712013
Malaria - Americas (11): USA (MD) 1st report in 40 years
http://promedmail.org/post/20230819.8711760
Malaria - Americas (11): Colombia, increase in incidence
http://promedmail.org/post/20230723.8711323
Malaria - Americas (10): USA (FL) autochthonous
http://promedmail.org/post/20230718.8711230
Malaria - Americas (09): USA (FL, TX) autochthonous, update
http://promedmail.org/post/20230709.8711042
Malaria - Americas (08): USA (FL, TX) autochthonous, CDC, alert
http://promedmail.org/post/20230629.8710856
Malaria - Americas (07): USA (TX) autochthonous
http://promedmail.org/post/20230625.8710761
Malaria - Americas (06): USA (FL) autochthonous, RFI
http://promedmail.org/post/20230623.8710719
Malaria - Americas (05): Colombia, Venezuela
http://promedmail.org/post/20230501.8709785
Malaria - Americas (04): USA, imported, ex Liberia, fatal
http://promedmail.org/post/20230427.8709737
Malaria - Americas (03): (Costa Rica, Panama)
http://promedmail.org/post/20230424.8709665
Malaria - Americas (02): Costa Rica (LI)
http://promedmail.org/post/20230409.8709416
Malaria - Americas: Panama, increase
http://promedmail.org/post/20230315.8708952

Note: This content and the data herein may not be copied, reproduced,
scraped, redistributed, reused, or repurposed alone or together with
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under ISID's Terms and Conditions and Privacy Policy.]
.................................................ll/mo/tw/jh
*##########################################################*
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and completeness of the information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
be held responsible for errors or omissions or held liable for any damages incurred
as a result of use or reliance upon posted or archived material.
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HAND, FOOT & MOUTH DISEASE - VIET NAM (02): (HANOI) SEVERE
COMPLICATIONS
************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Tue 15 Apr 2025
Source: VN Express [in Vietnamese, machine trans., edited]
https://vnexpress.net/be-gai-suyt-chet-do-bien-chung-tay-chan-mieng-4874253.html


Girl almost dies from hand-foot-mouth disease complications
----------------------------------------------------------------
A 14-month-old girl suddenly had high fever, convulsions, respiratory
failure, and circulatory failure due to grade 4 hand-foot-mouth
disease complications.

On 15 Apr 2025, Dr. Nguyen Thi Lan Anh, Department of Paediatric
Intensive Care, Duc Giang General Hospital, said that the patient was
admitted to the hospital in serious condition, with many ulcers in the
throat, many blisters on the buttocks, respiratory failure, and
circulatory failure. Before that, the child had rashes on the groin
and thighs, and was taken to the emergency room when she had a high
fever and convulsions all over her body.

The medical team placed an endotracheal tube, put the child on a
ventilator, and used high doses of vasopressors. After 4 hours of
treatment, the child's condition did not improve, with a persistent
high fever, requiring gradually increasing doses of vasopressors.

According to the doctors, the baby had level 4 hand-foot-mouth
disease, "which progressed very quickly in less than 24 hours, with
central nervous system damage accompanied by respiratory and
circulatory failure." The consultation team decided to put the baby on
continuous dialysis for 40 hours.

After 5 days of treatment, the child's health was stable, vasopressors
and sedatives were stopped, the ventilator was removed, and the
endotracheal tube was removed. Currently, the child is awake,
breathing well on her own; hemodynamics are stable, and [she is]
eating better.

Hand-foot-mouth disease is an infectious disease caused by an
intestinal virus, transmitted from person to person mainly through the
digestive tract. The disease occurs year-round and occurs in all ages
but is common in children under 5 years old.

The main manifestation is skin and mucosal lesions in the form of
blisters in special locations such as the oral mucosa, palms, soles,
buttocks, and knees. The disease can cause many dangerous
complications such as encephalitis, meningitis, myocarditis, and acute
pulmonary edema leading to death if not detected early and treated
promptly.

Doctors advise families not to worry too much when their children show
signs of hand-foot-mouth disease, but also not to be subjective. When
children show symptoms such as a high fever that is difficult to
reduce, poor appetite, startle, trembling hands and feet, crying for
no reason, irritability, and vomiting a lot, they need to see a doctor
and get timely treatment.

[Byline: Thuy An]

--
Communicated by:
ProMED
via
ProMED-MBDS

["In southern Viet Nam, an outbreak of acute encephalitis associated
with HFMD was reported in Ho Chi Minh City in 2003. In 2005, 764
children were diagnosed with HFMD in Ho Chi Minh City through sentinel
surveillance at the largest pediatric hospital, with most cases
(96.2%) being 5 years of age or younger. All patients provided
specimens, and HEV was isolated from 411 patients. Of those, 173
(42.1%) were identified as EV71 and 214 (52.1%) as CA16. Of those
patients with EV71 infections, 51 (29.3%) were complicated by acute
neurological disease and 3 (1.7%) were fatal.

"In 2006-2007, sentinel surveillance at the same hospital reported 305
cases diagnosed as neurological disease, of which 36 cases (11%), and
3 deaths (0.01%), were associated with EV71.

"In 2007, 2008, and 2009, the numbers of reported and fatal cases were
5719 and 23, 10 958 and 25, and 10 632 and 23, respectively. The
majority of the cases were in the southern part of the country.

"In northern Viet Nam, EV71/C4 has only been identified in one patient
with acute encephalitis since 2003. Between 2005 and 2007, EV71/C5 was
identified in 7 patients with acute flaccid paralysis. All cases were
under 5 years of age. During 2008, 88 cases of HFMD were reported from
13 provinces. The results of virus isolation from the 88 cases
confirmed that 33 (37.5%) isolates were enterovirus-positive,
including 9 (27.3%) with EV71, 23 (69.7%) with CA16, and one with
CA10. No severe or fatal cases were reported. The majority of cases
were under 5 years of age."

"Observational studies of the spectrum of disease during previous
outbreaks suggest that severe disease is characterized by 3 distinct
stages: those with CNS involvement, those with ANS [autonomic nervous
system] dysregulation, and, later, those with frank cardiopulmonary
failure, including pulmonary oedema or haemorrhage. Those presenting
with neurological signs indicative of CNS involvement but without
signs of autonomic system dysregulation, such as persistent resting
tachycardia, hypertension, or profuse sweating, can be considered to
be in the CNS involvement stage (early stage of severe disease). This
can manifest as aseptic meningitis, brainstem encephalitis, and
encephalomyelitis (including acute flaccid paralysis)"
(https://iris.who.int/bitstream/handle/10665/207490/9789290615255_eng.pdf).

Attending physicians often face the challenges of clearly
communicating specific danger signs to parents, who may request
admission at the early course of the disease for fear of serious
health outcomes. - Mod.ST

ProMED map:
Hanoi, Ha Nội, Vietnam:
https://promedmail.org/promed-post?place=8723721,63331]

[See Also:
Hand, foot & mouth disease - Viet Nam: (HC) increase
http://promedmail.org/post/20250402.8723339
2024
----
Hand, foot & mouth disease - Viet Nam (05): (HC) increase
http://promedmail.org/post/20240601.8716809
Hand, foot and mouth disease - Viet Nam (04): (HC) increase
http://promedmail.org/post/20240522.8716646
Hand, foot & mouth disease - Viet Nam (03): (HI) peak season
http://promedmail.org/post/20240424.8716143
Hand, foot & mouth disease - Viet Nam (02): (HC) increase
http://promedmail.org/post/20240422.8716087
Hand, foot & mouth disease - Viet Nam: (HI) increase
http://promedmail.org/post/20240312.8715328
2020
----
Hand, foot & mouth disease update - Viet Nam: (HC)
http://promedmail.org/post/20201004.7835796
2018
----
Hand, foot & mouth disease update (10): Viet Nam, USA (CT), Australia
(QL) http://promedmail.org/post/20181020.6100738

Note: This content and the data herein may not be copied, reproduced,
scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................st/may/st/tw/jh
*##########################################################*
************************************************************
ProMED makes every effort to verify the reports that are posted, but the accuracy
and completeness of the information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
be held responsible for errors or omissions or held liable for any damages incurred
as a result of use or reliance upon posted or archived material.
************************************************************
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If you have any questions or need support, please contact us via the ProMED website at https://promedmail.org/support/.

MEASLES - CANADA (20): (ALBERTA)
********************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Wed 16 Apr 2025
Source: NBC Montana [edited]
https://nbcmontana.com/news/local/alberta-health-officials-warn-of-measles-case-in-canmore-banff-calgary-area


Alberta health officials warn of measles case in Canmore, Banff,
Calgary area
--------------------------------------------
The number of measles cases reported in recent outbreaks in Alberta
has risen to 77 cases, including a new case reported Tuesday [15 April
2025] to have been out in public while contagious in multiple settings
in Canmore, Banff, and Calgary. Of the 77 cases, 69 are now past their
period of communicability.

Health officials are warning that people may have been exposed to the
most recent case in the Calgary area in the following settings:

6 Apr 2025
Canmore - Save-On-Foods
950 Railway Ave. #2, Canmore AB
Exposure time period: Approx. 5 a.m. - 3 p.m.

7-10 Apr 2025
Calgary - Delmar College of Hair and Esthetics
5915 1a St. SW, Calgary AB
Exposure time period: Approx. 8:30 a.m. - 6:30 p.m.

11 Apr 2025
Banff - Lux Cinema
229 Bear St. Banff AB
Exposure time period: 4 p.m. - 7:45 p.m.

11 Apr 2025
Banff - Fairmont Banff Springs - Bowl Valley Five Pin & Pints
405 Spray Ave. Banff AB
Exposure time period: 6:30 p.m. - 11 p.m.

11 Apr 2025
Banff - Downtown Sally
229 Bear St. Banff AB
Exposure time period: 3:30 p.m. - 6 p.m.

The health department advises, "Anyone who attended these locations at
these times who was born in or after 1970 and has less than 2
documented doses of measles-containing vaccine is at risk for
developing measles and is strongly encouraged to review their
immunization records and monitor themselves for symptoms of measles."

Symptoms of measles include
- fever of 38.3 deg C (100.9 deg F) or higher; and
- cough, runny nose, and/or red eyes; and
- a red blotchy rash that appears 3 to 7 days after fever starts,
beginning behind the ears and on the face and spreading down the body
and then to the arms and legs.

--
Communicated by:
ProMED

[Although cases of measles in 2025 have been reported in most of the
Canadian provinces, the numbers are highest in southwestern Ontario.

Measles can be very dangerous, and it's especially likely to cause
serious complications such as
- encephalitis
- pneumonia
- deafness, and
- intellectual disability.

Even a single dose of the vaccine is highly effective in preventing
infection. Under usual circumstances, it is recommended that the
measles vaccine be given at 12 to 15 months and again at age 4 to 6
years. If exposure to measles is likely, however, either because of
planned travel to an area where measles occurs more frequently or
because of possible exposure during an outbreak, the second dose can
be given as soon as one month after the first, leading to 99%
protection. Also, when exposure is more likely, infants between 6 and
12 months of age can be immunized. Because the vaccine is less
effective at that age, a baby who receives the measles vaccine before
age 1 should later get 2 more doses under the regular schedule.

Additionally, besides all of the above, measles infection can cause an
immunologic amnesia, increasing susceptibility to other pathogens:

Behrens L, Cherry JD, Heininger U, Swiss Measles Immune Amnesia Study
Group. The susceptibility to other infectious diseases following
measles during a 3-year observation period in Switzerland. Pediatr
Infect Dis J. 2020;39(6):478-482.
https://doi.org/10.1097/INF.0000000000002599
--------------------------------------------------------------------------------
Abstract
--------
"Background: Measles virus infection leads to significant
immunosuppression. In developing countries, this translates to an
increased nonspecific mortality, whereas its effects in developed
countries are less clear.

"Methods: We performed a cohort study to investigate whether children
hospitalized with measles (cases) between 2000 and 2015 in Switzerland
would have a higher frequency of hospital admissions due to other
infectious diseases thereafter than children who did not have measles
(controls). Cases were identified by ICD-10 discharge diagnoses for
measles and/or keyword search and matched to 2 controls by time of
hospitalization, age, and sex. All hospitalizations ≤3 years after
original admission, infectious or noninfectious in origin, were
identified in cases and controls.

"Results: One hundred thirteen cases (56% males), mean age 9.0 years
(range 2 weeks-17.8 years), and 196 controls were identified. Twelve
rehospitalizations due to an infectious disease occurred in 11 cases
and 6 in 6 controls (episode rates 0.106 vs 0.031 per person; ratio
3.47; 95% CI: 1.20-11.3; P = 0.012) in 3 years of follow-up. Of these,
9 and 3 occurred in cases and controls, respectively, during year 1
[ratio 5.20 (95% CI: 1.30-29.88; P = 0.012)]. Infectious diseases
following measles affected various organ systems, were neither
particularly severe nor fatal and revealed no specific pattern.

"Conclusions: The increased risk for nonspecific infectious disease
hospitalizations supports the concept of immunologic amnesia after
measles. Universal immunization against measles provides additional
benefit beyond protection against measles itself." - Mod.LL

ProMED map:
Alberta Province, Canada:
https://promedmail.org/promed-post?place=8723714,263]

[See Also:
Measles - Canada (19): (PE)
http://promedmail.org/post/20250414.8723645
Measles - Canada (18): (ON, AB, SK)
http://promedmail.org/post/20250406.8723424
Measles - Canada (17): (ON, SK)
http://promedmail.org/post/20250327.8723196
Measles - Canada (16): (ON) transmission links
http://promedmail.org/post/20250325.8723127
Measles - Canada (15): (SK)
http://promedmail.org/post/20250317.8722939
Measles - Canada (14): (AB)
http://promedmail.org/post/20250316.8722909
Measles - Canada (13): government statistics
http://promedmail.org/post/20250314.8722821
Measles - Canada (12): (QC, ON) alert
http://promedmail.org/post/20250312.8722774
Measles - Canada (11): PHAC, alert
http://promedmail.org/post/20250310.8722736
Measles - Canada (10): (QC)
http://promedmail.org/post/20250304.8722567
Measles - Canada (09): (ON) increased caseload
http://promedmail.org/post/20250301.8722485
Measles - Canada (08): (QC, ON)
http://promedmail.org/post/20250224.8722392
Measles - Canada (07): (ON, BC)
http://promedmail.org/post/20250222.8722317
Measles - Canada (06): (BC) international traveler
http://promedmail.org/post/20250217.8722201
Measles - Canada (05): (ON) more cases in the unimmunized
http://promedmail.org/post/20250216.8722184
Measles - Canada (04): (ON) more cases in the unimmunized
http://promedmail.org/post/20250213.8722086
Measles - Canada (03): (MB, ON)
http://promedmail.org/post/20250206.8721872
Measles - Canada (02): (ON) health-care venues exposures
http://promedmail.org/post/20250202.8721761
Measles - Canada: (ON) http://promedmail.org/post/20250131.8721742
2024
----
Measles - Canada (08): (BC, ON, NB) ex Philippines, airplane exposure,
alert http://promedmail.org/post/20241030.8719699
Measles - Canada (07): more cases, potential vaccine shortage
http://promedmail.org/post/20240322.8715558
Measles - USA, Canada: up to date numbers
http://promedmail.org/post/20240317.8715438
Measles - Canada (06): (BC)
http://promedmail.org/post/20240304.8715179
Measles - Canada (05): (QC)
http://promedmail.org/post/20240303.8715157
Measles - Canada (04): (ON) local source suspected
http://promedmail.org/post/20240302.8715147
Measles - Canada (03): (ON) international traveler
http://promedmail.org/post/20240215.8714872
Measles - Canada (02): (QC) Montreal ex Africa
http://promedmail.org/post/20240209.8714743
Measles - Americas: PAHO http://promedmail.org/post/20240203.8714646
Measles - Canada (01): (SK) international travel
http://promedmail.org/post/20240120.8714348

Note: This content and the data herein may not be copied, reproduced,
scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................ll/tw/jh
*##########################################################*
************************************************************
ProMED makes every effort to verify the reports that are posted, but the accuracy
and completeness of the information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
be held responsible for errors or omissions or held liable for any damages incurred
as a result of use or reliance upon posted or archived material.
************************************************************
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PERTUSSIS - COLOMBIA (03): (BOGOTA)
***********************************
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ProMED-mail is a program of the
International Society for Infectious Diseases
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Date: Tue 15 Apr 2025
Source: Infobae, Argentina [in Spanish, machine trans., abridged,
edited]
https://www.infobae.com/colombia/2025/04/15/alerta-por-dramatico-aumento-de-casos-de-tos-ferina-en-bogota-en-medellin-tambien-estudian-evolucion-de-la-enfermedad/


Alert due to dramatic increase in whooping cough cases in Bogotá
------------------------------------------------------------
The increase in cases of whooping cough, a highly contagious disease,
has set off alarm bells in the Colombian capital. Bogotá's Secretary
of Health, Gerson Bermont, stated that so far in 2025, 107 cases of
this disease have been recorded, which represents a drastic increase
compared to the 11 reported during all of 2024. The epidemiological
surveillance system has also identified 390 probable cases, 4 times
more than the same period in 2024.

According to data presented by the Bogotá Ministry of Health, the
highest incidence is in children under 5 years of age, for whom the
risk of severe complications is greater. Diana Walteros, deputy
director of Public Health Surveillance for the entity, explained to
Blu Radio that this disease can be serious in children under 1 year of
age, especially those under 6 months old. It presents with coughing
fits and difficulty breathing, and the child may turn purple. She
urged parents to seek immediate medical attention if any suspicious
symptoms appear.

The impact of whooping cough has been unevenly distributed in the
capital. According to reports from the Ministry of Health, the towns
of San Cristóbal and Ciudad Bolívar lead the list of confirmed
cases, with 19 and 17, respectively, followed by Usme and Kennedy,
which have registered 9 each.

The analysis also details the most affected age groups: 70 cases
correspond to children under 5, 12 to children between 5 and 14 years
old, while 18 infections have occurred in adults. Walteros emphasized
to the media that, although children are the most vulnerable
population, adolescents and adults can act as silent transmitters, so
preventive measures must cover all ages.

In response to the increase in infections, the Bogotá Health
Secretariat has intensified its vaccination strategies, offering this
service free of charge at more than 200 locations throughout the city.
Educational campaigns on preventive measures, such as the use of masks
by people with respiratory symptoms and constant handwashing, have
also been strengthened. Authorities also recommend that pregnant women
receive the corresponding dose to protect newborns during their first
months of life.

Meanwhile, in Medellín, the situation is different. The city's
Ministry of Health confirmed that only 6 cases of whooping cough have
been recorded so far in 2025, with no evidence of an outbreak.
However, a significant increase in acute respiratory infections (ARI)
has local authorities on alert. So far in 2025, more than 138 600
outpatient consultations for ARI have been recorded, representing a
10% increase compared to the same period in 2025.

Rita Elena Almanza, head of Epidemiology in Medellín, shared her
concern about the impact of these infections: "We could say that we do
have a respiratory peak. It's important to draw attention to it
because those nearly 600 weekly hospitalizations correspond, for the
most part, 80%, to adults over 70 years of age, but also to young
children," she told Caracol Radio.

Regarding preventive measures, influenza vaccination has been
prioritized in Medellín, especially for at-risk groups such as
children aged 6 to 23 months, pregnant women, older adults, and people
with comorbidities.

[Byline: Diego Alejandro Buitrago]

--
Communicated by:
ProMED
via
ProMED-ESP

[Pertussis has always occurred in waves, with some years having many
more cases than others. If this is combined with an inadequate
immunization rate, dramatic increases can occur. Access to vaccination
in remote areas is always problematic.

The mortality from pertussis is primarily in infants. Neonatal
pertussis is observed to be especially severe, with as much as a 3%
risk of death. Symptoms can be substantially different, with periods
of apnea (breathing arrest), sometimes with hypoxia-induced (low
oxygen) seizures, usually the most common manifestation of infection.
The cough is present but so weak that it may be unrecognized.

In children with so-called malignant pertussis, leukocytosis,
particularly with white blood cell (WBC) counts of 30 000 to 100 000,
and severe pulmonary hypertension are ominous signs for mortality. In
a study comparing neonatal pertussis with other neonatal respiratory
infections, pertussis-positive neonates had longer hospital stays,
less fever, and more apnea and cyanosis spells; required more days of
supplemental oxygen in the hospital; and represented all the infants
discharged on respiratory supportive care.

In the USA, cocooning immunization is suggested by immunizing not only
the mother but also the father, as well as grandparents or any persons
likely to spend significant time with the infant. In the developing
world, such a process can be difficult.

A 2014 publication confirms the safety of maternal pertussis
immunization (Kharbanda EO, Vazquez-Benitez G, Lipkind HS, et al.
Evaluation of the association of maternal pertussis vaccination with
obstetric events and birth outcomes. JAMA. 2014;312:1897-1904.
https://doi.org/10.1001/jama.2014.14825). - Mod.LL

ProMED map:
Bogotá, Colombia:
https://promedmail.org/promed-post?place=8723720,55157]

[See Also:
Pertussis - Mexico (03): more cases, fatalities
http://promedmail.org/post/20250412.8723608
Pertussis - Peru: (LO) alert
http://promedmail.org/post/20250321.8723046
Pertussis - Mexico (02): infant, fatal, alert
http://promedmail.org/post/20250310.8722730
Pertussis - Mexico: increased cases
http://promedmail.org/post/20250305.8722628
Pertussis - Colombia (02): (Bogota) infant death
http://promedmail.org/post/20250303.8722541
Pertussis - Colombia: (AN) indigenous people, fatalities
http://promedmail.org/post/20250218.8722246
Pertussis - Bolivia: (SC) fatal
http://promedmail.org/post/20250213.8722091
Pertussis - Brazil: dramatic increases, fatalities
http://promedmail.org/post/20250120.8721412
2024
----
Pertussis - Bolivia: (SC) http://promedmail.org/post/20241212.8720598
Pertussis - Spain, USA http://promedmail.org/post/20240903.8718526
Pertussis - Honduras: (CM) infant, fatal
http://promedmail.org/post/20240828.8718432
Pertussis - UK (03): infant mortality
http://promedmail.org/post/20240613.8717011
Pertussis - USA (03): increasing case numbers
http://promedmail.org/post/20240602.8716819
Vaccine-preventable diseases - Guinea: update, alert
http://promedmail.org/post/20240525.8716710
Pertussis - USA (02): (OR)
http://promedmail.org/post/20240516.8716532
Pertussis - Malaysia: (KN) fatal
http://promedmail.org/post/20240401.8715729
Pertussis - Philippines (02): (MM) fatal
http://promedmail.org/post/20240326.8715624
Pertussis - Netherlands: pediatric fatalities
http://promedmail.org/post/20240320.8715498
Pertussis, diphtheria - Czech Republic: case surge, alert
http://promedmail.org/post/20240314.8715389
Pertussis - Philippines: (II) fatal
http://promedmail.org/post/20240218.8714915
Pertussis - UK (02): increased spread
http://promedmail.org/post/20240213.8714810
Pertussis - UK: 636 suspected cases
http://promedmail.org/post/20240128.8714502
Pertussis - Maldives: (GA)
http://promedmail.org/post/20240127.8714491
Pertussis update (01): USA (PA)
http://promedmail.org/post/20240107.8714112

Note: This content and the data herein may not be copied, reproduced,
scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................jt/ll/tw/jh
*##########################################################*
************************************************************
ProMED makes every effort to verify the reports that are posted, but the accuracy
and completeness of the information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
be held responsible for errors or omissions or held liable for any damages incurred
as a result of use or reliance upon posted or archived material.
************************************************************
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************************************************************
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If you have any questions or need support, please contact us via the ProMED website at https://promedmail.org/support/.

CRIMEAN-CONGO HEMORRHAGIC FEVER - IRAQ (04): (KIRKUK) NEW CASES
***************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

[1]
Date: Wed 16 Apr 2025
Source: Shafaq News [in Arabic, trans. Mod.NS, abridged, edited]
https://bit.ly/4lDei7W


A source in the Kirkuk Health Department reported on Wednesday [16 Apr
2025] the registration of a 2nd confirmed case of Crimean-Congo
hemorrhagic fever in the governorate.

The source said the new case was recorded in the Taza Khurmatu
subdistrict, south of Kirkuk. The infected person works in
slaughtering or has direct contact with livestock. The source
suggested the infection likely resulted from direct contact with
infected animals or a tick bite.

The source added that the infected person was transferred to Al-Shifa
Hospital for treatment. At the same time, health teams began
conducting the necessary tests on those in contact with the patient
and taking the necessary preventive measures in the area to prevent
the spread of the virus.

The source pointed out that Kirkuk had recorded its 1st case of
Crimean-Congo hemorrhagic fever yesterday, Tuesday [15 Apr 2025], in
Daquq District.

--
Communicated by:
ProMED
via
ProMED-MENA

[Crimean-Congo hemorrhagic fever is a zoonotic tick-borne viral
disease. People working with livestock and handling animal tissues,
such as butchers and slaughterhouse workers, are at high risk of
infection. Crimean-Congo hemorrhagic fever is endemic in Iraq, and
large outbreaks have occurred over the past 3 years (2022-2024).

The new case of Crimean-Congo hemorrhagic fever reported in the post
above is the 2nd case recorded in Kirkuk governorate in 2025 after the
1st case was recorded yesterday [15 Apr 2025] in a nearby area (see
section [2] below).

Wearing protective clothing while handling animals and their tissues,
using repellent on the skin and clothing, and treating animals with
pesticides are the primary protective measures against Crimean-Congo
hemorrhagic fever. - Mod.NS]

******
[2]
Date: Tue 15 Apr 2025 05:14 AST
Source: Shafaq News [in Arabic, summ. & trans. Mod.NS, abridged,
edited]
https://bit.ly/4lB3ya8


A source in the Kirkuk Health Department reported on Tuesday [15 Apr
2025] the first confirmed case of Crimean-Congo hemorrhagic fever in
2025 in one of the governorate's districts.

The source explained that "Kirkuk Health Department recorded the first
case of hemorrhagic fever in Daquq District, south of the governorate.
The infected person worked in slaughtering or handling livestock,
which suggests he contracted the disease through direct contact with
infected animals or through a tick bite."

The source added that "the infected person was transferred to Al-Shifa
Hospital to receive the necessary treatment, while health authorities
began conducting the necessary tests on those in contact with him and
implementing preventive measures in the area."

--
Communicated by:
ProMED
via
ProMED-MENA

[ProMED map of Kirkuk Governorate, Iraq:
https://promedmail.org/promed-post?place=8723715,25540]

[See Also:
Crimean-Congo hem. fever - Iraq (03): tick control campaign
http://promedmail.org/post/20250410.8723542
Crimean-Congo hem. fever - Iraq (02): (NI) new case
http://promedmail.org/post/20250330.8723271
Crimean-Congo hem. fever - Iraq: (DQ) new case
http://promedmail.org/post/20250308.8722701
2024
----
Crimean-Congo hem. fever - Asia (27): Iraq, MOH update
http://promedmail.org/post/20241016.8719421
Crimean-Congo hem. fever - Asia (25): Iraq, MOH update
http://promedmail.org/post/20240925.8718982
Crimean-Congo hem. fever - Asia (21): Iraq (DA) new cases
http://promedmail.org/post/20240914.8718749
Crimean-Congo hem. fever - Asia (20): Iraq (NI) susp.
http://promedmail.org/post/20240830.8718464
Crimean-Congo hem. fever - Asia (18): Pakistan, Iraq
http://promedmail.org/post/20240815.8718168
Crimean-Congo hem. fever - Asia (17): Iraq (NI) susp.
http://promedmail.org/post/20240729.8717818
Crimean-Congo hem. fever - Asia (15): Iraq, update
http://promedmail.org/post/20240710.8717494
Crimean-Congo hem. fever - Asia (14): Iraq (DQ) update
http://promedmail.org/post/20240706.8717426
Crimean-Congo hem. fever - Asia (13): Iraq (AR) new cases
http://promedmail.org/post/20240703.8717349
Crimean-Congo hem. fever - Asia (10): Iraq (SL, DQ) new cases, RFI
http://promedmail.org/post/20240630.8717279
Crimean-Congo hem. fever - Asia (09): Iraq
http://promedmail.org/post/20240628.8717275
Crimean-Congo hem. fever - Asia (07): Iraq (NI) new cases, fatal
http://promedmail.org/post/20240621.8717150
Crimean-Congo hem. fever - Asia (06): Iraq (DQ) research
http://promedmail.org/post/20240609.8716933
Crimean-Congo hem. fever - Asia (05): Iraq (DI) new case, fatal
http://promedmail.org/post/20240531.8716789
Crimean-Congo hem. fever - Asia (04): Iraq (DA) new cases, fatal
http://promedmail.org/post/20240523.8716675
Crimean-Congo hem. fever - Asia (03): Iraq (TS) new cases, MOH update
http://promedmail.org/post/20240518.8716587
Crimean-Congo hemorrhagic fever - Asia (02): Iraq (NI)
http://promedmail.org/post/20240510.8716427

Note: This content and the data herein may not be copied, reproduced,
scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................mo/ns/rd/gmm/tw/may/jh
*##########################################################*
************************************************************
ProMED makes every effort to verify the reports that are posted, but the accuracy
and completeness of the information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
be held responsible for errors or omissions or held liable for any damages incurred
as a result of use or reliance upon posted or archived material.
************************************************************
Donate to ProMED. Details available at: https://isid.networkforgood.com/projects/79924-invest-in-the-mission.
************************************************************
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RESEARCH & INNOVATION (71): SALMONELLA INFECTIONS, INTRAMACROPHAGE
ACTIVITY, HUMAN, ANIMAL
******************************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Mon 14 Apr 2025
Source: Phys.org [edited]
https://phys.org/news/2025-04-pathoblocker-salmonella-infections-early.html


New pathoblocker can stop _Salmonella_ infections early on
----------------------------------------------------------
Pathogenic _Salmonella_ injects effector proteins into the cells of
the gastrointestinal tract to penetrate and multiply within them. The
bacteria are usually ingested with contaminated food. They can cause
serious gastrointestinal inflammation and even systemic infections.

Now, an international research team led by Professor Samuel Wagner of
the University of Tübingen Cluster of Excellence Controlling Microbes
to Fight Infections (CMFI) and the German Center for Infection
Research (DZIF) has discovered a substance that can stop the process
of infection early on.

The synthetic substance C26 inhibits the injection of effector
proteins, and it could be developed into a drug for combating
_Salmonella_ infections in humans and animals. The discovery has been
published in the journal Science Advances. _Salmonella_ has developed
multiple resistance mechanisms to antibiotics that inhibit its growth
or kill the bacteria. As a result, alternative treatment is urgently
needed. Pathoblockers present such an alternative. The discovered
substance acts early, before the bacteria penetrate the tissues, by
specifically targeting and disrupting the infectious mechanisms of the
pathogen.

"As a medication, it has a very specific and targeted effect against
_Salmonella_. According to today's knowledge, the probability would
therefore be much lower that _Salmonella_ would acquire resistance
against these substances from other bacteria," says Wagner.

Targeting the central regulator
-------------------------------
While attacking their target tissue in the gastrointestinal tract,
_Salmonella_ set in motion secretion systems that rely on several
(transcriptional) regulators.

"Among these regulators, one named HilD has a central role in the
entry of _Salmonella_ into the host cell. We were able to find a
suitable target within the structure of HilD to identify new drug
candidates," says Dr. Abdelhakim Boudrioua of the CMFI Cluster of
Excellence and 1st author of the study. In order to transmit signals
for protein synthesis, the regulators must bind highly specifically to
other regulators and DNA and trigger further reactions. It turns out
that HilD has a druggable pocket. On a molecular level, it can be
imagined as an intricately shaped, 3-dimensional pocket.

The researcher explains that the discovered substances fit precisely
in this pocket, and as a result, disrupt the function of the
regulator. In this way, the process of infection can be stopped, he
continues. The research team screened large compound libraries for
potential candidates. "We were able to identify C26 as a promising
substance. We then proceeded with an extensive analysis of its mode of
action and its precise binding site on the structure of HilD," says
Boudrioua.

Numerous tests of the efficiency of C26 in disrupting infection
followed; for example, by proving that the inhibitor interferes with
the pathogenicity of bacteria hiding inside macrophages -- the cells
of the immune system of the host. "According to our results, C26 could
stop the process of _Salmonella_ infection early on at the central
regulator HilD. It seems to have a specific effect on the pathogen and
does not disturb the beneficial human microbiome," says Boudrioua. "We
now have a suitable precursor for further drug development."

"The discovery impressively underlines how our excellent basic
research at the University of Tübingen produces innovative solutions
for urgent medical problems," adds Professor Dr. Dr. h.c. (Dōshisha)
Karla Pollmann, President and Vice-Chancellor of the University of
Tübingen.

Still, Wagner says the route to treating _Salmonella_ infections with
pathoblockers such as HilD inhibitors is long. Aside from human use,
these treatments could also be developed for veterinary medicine,
particularly for poultry. The efforts could be worth it. Unlike
antibiotics, which also damage the patients' useful intestinal
bacteria in many ways, Wagner says specific pathoblockers are not
expected to have any negative effects on the body and its own
microbiome.

[Byline: Christfried Dornis]

--
Communicated by:
ProMED-AMR

[The citation and abstract of the article referenced above follow:

Boudrioua A, Joiner JD, Kronenberger T, et al. Discovery of synthetic
small molecules targeting the central regulator of _Salmonella_
pathogenicity. Sci. Adv., 11: eadr5235(2025)
doi:10.1126/sciadv.adr5235
--------------------------------------------------------------------------------
Abstract
--------
"The enteric pathogen _Salmonella enterica_ serovar Typhimurium relies
on the activity of effector proteins to invade, replicate, and
disseminate into host epithelial cells and other tissues, thereby
causing disease. Secretion and injection of effector proteins into
host cells is mediated by dedicated secretion systems, which hence
represent major virulence determinants. Here, we report the
identification of a synthetic small molecule with drug-like
properties, C26, which suppresses the secretion of effector proteins
and consequently hinders bacterial invasion of eukaryotic cells. C26
binds to and inhibits HilD, the transcriptional regulator of the major
secretion systems. Although sharing the same binding pocket as the
previously described long-chain fatty acid ligands, C26 inhibits HilD
with a unique binding mode and a distinct mechanism. We provide
evidence of intramacrophage activity and present analogs with improved
potency and suitability as scaffolds to develop antivirulence agents
against _Salmonella_ infections in humans and animals." - Mod.TTM]

[See Also:
Research & innovation (22): China, purpurin, Salmonella invasion,
combat AMR http://promedmail.org/post/20250209.8721984
Research & innovation (19): Salmonella stress & persisters, limited
impact, combat AMR http://promedmail.org/post/20250207.8721893
Antimicrobial stewardship (27): China, CL-R Salmonella, human sources,
tackle AMR http://promedmail.org/post/20250130.8721691

Note: This content and the data herein may not be copied, reproduced,
scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................ttm/may/tw/gmm
*##########################################################*
************************************************************
ProMED makes every effort to verify the reports that are posted, but the accuracy
and completeness of the information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
be held responsible for errors or omissions or held liable for any damages incurred
as a result of use or reliance upon posted or archived material.
************************************************************
Donate to ProMED. Details available at: https://isid.networkforgood.com/projects/79924-invest-in-the-mission.
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ProMED-PORT Digest, Vol 79, Issue 66

1. PRO/PORT> Cólera - Angola (09) (várias províncias), surto, atualização




-----------------------------------------------------------------------------------------------------

Message: 1
Date: 2025-04-16 02:54:13
Subject: PRO/PORT> Cólera - Angola (09) (várias províncias), surto, atualização


COLERA - ANGOLA (09) (VÁRIAS PROVÍNCIAS), SURTO, ATUALIZAÇÃO
****************************************************************
Uma mensagem / Una mensaje / de ProMED-PORT
http://www.promedmail.org
ProMED-mail e um programa da / es un programa de la
International Society for Infectious Diseases
http://www.isid.org

Data: Terça-feira, 15 de abril de 2025
Fonte: Notícias ao Minuto [15/04/2025] [editado]
https://www.noticiasaominuto.com/mundo/2768122/angola-regista-dois-mortos-e-232-novos-casos-de-colera-nas-ultimas-24-horas

Angola registra dois mortos e 232 novos casos de cólera nas últimas
24 horas
---------------------------------------------------------------------------------------------------------
Os dados do boletim epidemiológico sobre a evolução do surto até
segunda-feira [14/abril/2025] adiantam que 11 das 17 províncias
afetadas registaram novas infeções, sendo que Benguela lidera a
lista com 104 casos dos 232 notificados. No período em análise,
registraram-se mortos nas províncias do Bengo e de Benguela com uma
morte cada.

Nas últimas 24 horas, 209 pessoas receberam alta e continuam
internadas 1.257 outras com cólera.

As autoridades angolanas estão a braços com o surto de cólera,
declarado no dia 07 de janeiro do ano [2025] em curso, que afeta 17
das 21 províncias do país, acumulando 12.600 casos, maioritariamente
em Luanda, capital do país e o epicentro da doença, com a soma de
5.053 infeções nos últimos três meses.

No que se refere aos mortos, com uma taxa de letalidade de 3,8%,
Luanda também vai com 184 mortes do total reportado.

Na segunda-feira [14/abril/2025], a comissão multissetorial de luta
contra a cólera manifestou-se preocupada pela não observância das
medidas de prevenção e combate à doença, pela população. "Não
basta haver apenas uma ação do executivo quer a nível central quer
a nível local, mas precisamos todos de ter um engajamento para que
consigamos debelar este mal", disse à imprensa a ministra de Estado
para a área Social, Maria Bragança.

A governante angolana fez um apelo à sociedade no sentido de acatar
com as medidas de higiene. "Cada cidadão no mercado tem de ter
extremo cuidado no manuseio dos alimentos, a forma de depositar os
dejetos, defecação ao ar livre, é uma das formas muito graves de
propiciar a transmissão desta doença através de vetores", disse.

Segundo Maria Bragança, apesar da distribuição de água tratada
continua a verificar-se "falta de higiene", dificultando o combate
deste surto. "Temos a certeza que com as medidas que o Governo vai
agora implementar, de forma mais focada, priorizando as áreas com
maiores números de casos, em que há também uma maior mortalidade,
obviamente acompanhadas de medidas para fazer uma estabilização dos
casos e para prevenir esta situação noutras localidades, esperamos
vencer este surto de cólera", disse.

--
Comunicado por: ProMED-PORT https://promedmail.org/?lang=pt

[Veja também:
Cólera - Angola (08) (várias províncias), surto, atualização,
OMS/WHO http://promedmail.org/post/20250331.8723296
Cólera - Angola (07) (várias províncias), surto, atualização,
aumento do número de casos e de óbitos
http://promedmail.org/post/20250317.8722952
Cólera - Angola (06) (várias províncias), surto, atualização,
aumento do número de casos e de óbitos
http://promedmail.org/post/20250213.8722094
Cólera - Angola (05) (várias províncias), surto, atualização,
vacinação, OMS/WHO http://promedmail.org/post/20250203.8721821
Cólera - Angola (04) (várias províncias), surto, atualização,
aumento do número de casos e de óbitos
http://promedmail.org/post/20250125.8721594
Cólera - Angola (03) (LU), surto, atualização, aumento do número
de casos e de óbitos http://promedmail.org/post/20250115.8721376
Cólera - Angola (02) (LU, BO), surto, atualização, aumento do
número de óbitos http://promedmail.org/post/20250110.8721268
Cólera - Angola (LU), surto, óbitos
http://promedmail.org/post/20250109.8721229

--
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reaproveitados sozinhos ou em conjunto com quaisquer outros dados sem
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Condições e pela Política de Privacidade do ISID.

--
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ProMED-Ahead Digest, Vol 49, Issue 106

1. PRO/AH/EDR> Chikungunya (15): Indonesia (JR) susp
2. PRO/AH/EDR> African swine fever - Asia (31): India (MZ) domestic, spreading
3. PRO/AH/EDR> Yellow fever - Africa (02): Uganda (KO) mass vaccination
4. PRO/AH/EDR> BSE - Japan: L-type, transmission to primates
5. PRO/AH/EDR> Streptococcus suis - Viet Nam (02): (TB) pig intestine consumption
6. PRO/AH/EDR> Rabies (44): Viet Nam (BT) human, bite from neighbor's dog, fatal




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Message: 1
Date: 2025-04-15 21:25:31
Subject: PRO/AH/EDR> Chikungunya (15): Indonesia (JR) susp


CHIKUNGUNYA (15): INDONESIA (WEST JAVA) SUSPECTED
*************************************************
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International Society for Infectious Diseases
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Date: Sat 12 Apr 2025 20:25 WIB
Source: Jurnas [edited] [in Indonesian, machine trans., edited]
https://www.jurnas.com/mobile/artikel/171755/Mengenal-Penyakit-Chikungunya-Seperti-yang-Dijangkit-Puluhan-Warga-Cianjur/


Around 38 residents of Cibiuk Village, Sukaratu Village, Bojongpicung
District, Cianjur Regency, West Java, have reportedly experienced
symptoms that point to chikungunya disease. Currently, all residents
suspected of being infected with the virus have received medical
treatment and are under the supervision of health workers.

Head of Bojongpicung Health Center, Heni Supenti, as quoted by Antara
on April 9, 2025, said that some patients experienced temporary
paralysis, especially children. The symptoms they experienced included
high fever, body aches, and severe pain in the joints.

So, what is chikungunya disease? How does chikungunya disease actually
occur? What are the symptoms? How to prevent it? Here is a review
quoted from various sources.

What is chikungunya disease?
----------------------------
Chikungunya is a tropical disease caused by the chikungunya virus
(CHIKV) and transmitted through the bite of the _Aedes aegypti_ or
_Aedes albopictus_ mosquito -- a type of mosquito also known as the
vector for dengue fever.

Chikungunya infection can cause symptoms such as sudden fever,
weakness, and long-lasting joint and muscle pain. In some cases, this
pain can persist for months, even years, and reduce the quality of
life of sufferers.

Therefore, understanding how the disease develops is the first step to
preventing it. After a person is bitten by a mosquito carrying the
virus, symptoms usually appear within a few days.

The course of the disease is divided into 3 phases, from acute to
chronic:
1. Acute phase (0-10 days): Symptoms include high fever, joint pain,
rash, and headache.
2. Post-acute phase (1-3 months): In this phase, symptoms include
joint pain that is still felt, weakness, and begins to improve
slowly.
3. Chronic phase (more than 3 months): Some patients, especially the
elderly or those with a history of joint disease, can experience
chronic arthritis.

Unfortunately, there is currently no antiviral drug specifically
designed to treat chikungunya. Treatment is still supportive, such as
rest, adequate fluid intake, and pain relievers.

Chikungunya prevention
----------------------
Since treatment is not yet specific, prevention is the best way to
protect yourself and your family from this disease. Prevention efforts
are mainly focused on controlling the mosquito population in the
residential environment.

Simple steps such as keeping the house and surroundings clean, and
eliminating puddles of water that can become mosquito breeding
grounds, are highly recommended. The public is also advised to adopt a
clean lifestyle by draining, covering, and recycling used water
containers.

In addition, the use of mosquito repellent, the installation of wire
screens in windows, and the sprinkling of abate powder in water
reservoirs can help break the mosquito life cycle. The more
disciplined the community is in maintaining the environment, the less
likely the virus is to spread.

Chikungunya treatment
---------------------
Although the mortality rate for chikungunya is low, the infection can
be serious in vulnerable groups such as the elderly or those with
chronic illnesses. This makes early treatment and monitoring of
symptoms very important.

Current chikungunya treatment is still focused on symptom relief.
Steps such as adequate rest, maintaining fluid intake, and taking
painkillers and fever reducers are the main forms of treatment.

Once a person recovers from chikungunya, their body usually develops
natural immunity to the virus. Thus, the chance of being reinfected in
the future is relatively small.

[Byline: Agus Mughni]

--
Communicated by:
ProMED

[Although the 38 cases are listed as suspected because they have not
been laboratory confirmed, the symptoms and signs that the above
report describes are very compatible with chikungunya virus
infections. As the above report notes, the arthralgia resulting from
infection with this virus can be incapacitating and last for weeks,
months and even years. Occurrence of chikungunya virus in West Java is
not surprising. The virus is endemic in the Indonesian archipelago,
and sporadic cases are reported from various islands, most recently in
Bali. The See Also section below provides a good overview of the
geographic distribution of cases over the past 2 decades. Avoidance of
mosquito bites is a practical preventive measure that should be
implemented by local people. - Mod.TY

ProMED map:
West Java, Indonesia:
https://promedmail.org/promed-post?place=8723665,547]

[See Also:
2022
----
Chikungunya (02): Indonesia (BA)
http://promedmail.org/post/20220819.8705113
2020
----
Chikungunya (04): Americas, Asia, Africa, research
http://promedmail.org/post/20200830.7729284
2019
----
Chikungunya (04): Americas, Africa, Asia, Indian Ocean
http://promedmail.org/post/20190507.6457494
2017
----
Chikungunya (06): Americas, Asia, research
http://promedmail.org/post/20170206.4817959
2013
----
Chikungunya (06): Germany ex Indonesia (Bali) 2012
http://promedmail.org/post/20130227.1562598
2008
----
Chikungunya (42): Indonesia (Riau Islands)
http://promedmail.org/post/20081010.3206
Chikungunya (28): Indonesia (Bali)
http://promedmail.org/post/20080720.2198
Chikungunya (22): Indonesia (Java)
http://promedmail.org/post/20080528.1733
Chikungunya - Taiwan ex Indonesia: 2007
http://promedmail.org/post/20080109.0106
Chikungunya - Indonesia: (Sumatra)
http://promedmail.org/post/20080104.0051
2007
----
Chikungunya (05): India (KA), RFI
http://promedmail.org/post/20071222.4113
Chikungunya (04): Indonesia (Java), RFI
http://promedmail.org/post/20071217.4062
2006
----
Chikungunya - Indonesia: background
http://promedmail.org/post/20060908.2554
Chikungunya - Indonesia: RFI http://promedmail.org/post/20060907.2542
2005
----
Chikungunya - Indonesia (Tangerang)
http://promedmail.org/post/20050717.2059
2004
----
Chikungunya fever - Indonesia 2003
http://promedmail.org/post/20040226.0604
Chikungunya - Indonesia (Java) (03)
http://promedmail.org/post/20040125.029
Chikungunya - Indonesia (Java) (02)
http://promedmail.org/post/20040117.0183
Chikungunya - Indonesia (Java)
http://promedmail.org/post/20040115.0164
2003
----
Chikungunya - Indonesia (East Java)
http://promedmail.org/post/20031209.3019
Dengue/DHF update 2003 (11) http://promedmail.org/post/20030317.0666
Chikungunya - Indonesia (03) http://promedmail.org/post/20030226.0485
Chikungunya - Indonesia (Java) (02)
http://promedmail.org/post/20030223.0469
Chikungunya - Indonesia (Java)
http://promedmail.org/post/20030217.0410

Note: This content and the data herein may not be copied, reproduced,
scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................mo/jh/ty/rd/jh
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and completeness of the information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
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Message: 2
Date: 2025-04-15 21:26:25
Subject: PRO/AH/EDR> African swine fever - Asia (31): India (MZ) domestic, spreading


AFRICAN SWINE FEVER - ASIA (31): INDIA (MIZORAM) DOMESTIC, SPREADING
********************************************************************
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International Society for Infectious Diseases
http://www.isid.org

Date: Mon 14 Apr 2025 21:04 IST
Source: Hindustan Times [abridged, edited]
https://www.hindustantimes.com/cities/others/over-1-000-pigs-died-in-a-month-due-to-african-swine-fever-in-mizoram-101744644894446.html


At least 1916 pigs have died due to African swine fever in Mizoram
since the outbreak began on March 20 [2025], according to officials
from the Mizoram Animal Husbandry & Veterinary (AH&V) Department. The
disease has been detected in 41 villages and localities in the state
with the southern districts of Lawngtlai and Siaha bearing the brunt
of the outbreak.

"[A total of] 932 pigs have died in Siaha district and 462 have been
culled till date [14 Apr 2025], the ASF has affected 25 villages and
localities in Siaha. There are also 843 reported deaths and 174 culled
in Lawngtlai district," said Dr. Esther Lalzoliani Ralte from the
Livestock Health Division of the Mizoram AH&V Department.

The outbreak was first identified through laboratory tests conducted
in Guwahati in March [2025]. Five districts in the state have enforced
a ban on the import and export of pigs, pork, and related products.
Efforts are ongoing to control the spread and minimize further
losses.

African swine fever is a large, double-stranded DNA virus belonging to
the Asfarviridae family. It causes hemorrhagic fever in pigs and often
leads to high mortality rates. Some virus strains can kill infected
pigs within a week.

Veterinary officials, working in coordination with village councils,
have been conducting culling operations in 4 affected districts. So
far, 686 pigs have been culled, officials reported.

Nevertheless, containment remains a challenge, Dr. Ralte said, adding
that it is currently the peak spreading season for ASF. "All efforts
are made to contain the disease," he said.

[Byline: Sangzuala Hmar]

--
Communicated by:
ProMED
via
ProMED-SoAs

[African swine fever (ASF) is seemingly spreading across Mizoram state
of India. The occurrences of the disease in 13 villages and localities
over a period of 2 weeks in March this year (2025) in Lawngtlai and
Mamit districts of the state were reported previously (see archive no.
http://promedmail.org/post/20250401.8723291).

As indicated in the news report above, the disease has now been
detected in another district, Siaha, where 932 pigs have died and 462
have been culled as of 14 April 2025 in addition to 843 deaths plus
174 culled so far from Lawngtlai district. In total, around 1916 pigs
have died in the state from the disease so far since its reemergence
and laboratory conformation on 20 March 2025.

ASF is a viral disease in pigs caused by the African swine fever
virus. As such, the African swine fever virus is not zoonotic, and
thus "it is not a danger to human health, but it has devastating
effects on pig populations and the farming economy.

"The virus is highly resistant in the environment, meaning that it can
survive on clothes, boots, wheels, and other materials. It can also
survive in various pork products, such as ham, sausages, or bacon.
Therefore, human behaviours can play an important role in spreading
this pig disease across borders if adequate measures are not taken"
(https://www.woah.org/en/disease/african-swine-fever/).

Because there is currently no effective vaccine against the disease,
farmers and others concerned should strictly follow the measures
recommended in the National Action Plan for Control, Containment, and
Eradication of African swine fever in India, available at
http://megahvt.gov.in/miscellaneous/ASF_NAP.pdf. - Mod.PKB

ProMED map:
Mizoram State, India:
https://promedmail.org/promed-post?place=8723686,313]

[See Also:
African swine fever - Asia (28): India (MZ) domestic
http://promedmail.org/post/20250402.8723321
2024
----
African swine fever - Asia (73): India (KL, MZ) domestic
http://promedmail.org/post/20241216.8720704
African swine fever - Asia (63): India (NL) domestic
http://promedmail.org/post/20241019.8719479
African swine fever - Asia (57): India (MZ) domestic
http://promedmail.org/post/20240912.8718719
African swine fever - Asia (12): India (MH) domestic
http://promedmail.org/post/20240224.8715027
2023
----
African swine fever - Asia (23): India (MN) domestic, spread
http://promedmail.org/post/20231108.8713055
African swine fever - Asia (21): India (MN) domestic, spread
http://promedmail.org/post/20231030.8712888
African swine fever - Asia (17): India (MN) domestic pig
http://promedmail.org/post/20231015.8712639
2022
----
African swine fever - Asia (14): India (MZ) domestic, wild, vacc plan
http://promedmail.org/post/20220807.8704921
African swine fever - Asia (13): India (KL) domestic, 1st rep
http://promedmail.org/post/20220723.8704616
African swine fever - Asia (12): India (UP) domestic, conf
http://promedmail.org/post/20220720.8704531
African swine fever - Asia (11): India (MN) domestic, spread
http://promedmail.org/post/20220628.870412
2021
----
African swine fever - Asia (18): India (AS) domestic, spread
http://promedmail.org/post/20210717.8526195

Note: This content and the data herein may not be copied, reproduced,
scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
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.................................................mo/jh/pkb/rd/pkb/rd/jh
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thereon, are not guaranteed. The reader assumes all risks in using information
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Message: 3
Date: 2025-04-16 00:33:05
Subject: PRO/AH/EDR> Yellow fever - Africa (02): Uganda (KO) mass vaccination


YELLOW FEVER - AFRICA (02): UGANDA (KALIRO) MASS VACCINATION
************************************************************
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International Society for Infectious Diseases
http://www.isid.org

Date: Mon 14 Apr 2025
Source: Nile Post [edited]
https://nilepost.co.ug/health/253511/kaliro-targets-50000-in-yellow-fever-vaccination-drive


Health authorities in Kaliro District are targeting to immunise over
50 000 people in the ongoing nationwide yellow fever vaccination
campaign that began on 10 Apr 2025 and is expected to run until 16 Apr
2025. To meet this ambitious goal, youth mobilisers armed with
megaphones have been deployed to traverse villages, urging residents
to visit nearby health centres and receive the vaccine.

Eric Kiduba, the district health educator, reassured residents of the
vaccine's safety and effectiveness, citing approvals from both the
Ministry of Health and the World Health Organisation. He dismissed
misinformation circulating in some communities that the vaccine causes
impotence.

"Some people had been moving around trying to lie to the public that
the vaccines cause impotency in men and women, which is not true,"
Kiduba said during the official campaign launch at Bumanya Health
Centre IV. He revealed that over 300 health personnel had been
deployed across the district to ensure timely and effective delivery
of services throughout the campaign period.

John Bosco Mubitto, the Resident District Commissioner, warned leaders
of religious sects against discouraging their followers from taking
the vaccine. He said such acts amounted to sabotage of a government
programme and offenders would face arrest and prosecution.

"Security personnel have been put on high alert to monitor any leader
found guilty of discouraging participation in the vaccination
exercise," Mubitto said. He also urged religious leaders to use their
pulpits to mobilise their congregations for the campaign, noting that
spiritual well-being must go hand in hand with physical health.

Lydia Akoth, the Central Supervisor for Advocacy, Communication, and
Social Mobilisation in the Yellow Fever Reactive Campaign, told the
Nile Post that the campaign was prompted by a confirmed case of yellow
fever in neighbouring Kibuku District.

"The campaign is scheduled for 7 days, from 10 to 16 Apr 2025,
targeting people aged between 1 and 60 years," Akoth said. "We
encourage everyone who has not received the vaccine to either go to a
health facility or visit the vaccination post in their community." She
added that yellow fever has no cure and urged continued access to the
vaccine at health centres even after the campaign ends.

District Chairperson Elijah Kagoda called on political leaders at all
levels to support the mobilisation effort. He noted that residents
intending to travel abroad should take advantage of the campaign since
yellow fever vaccination is mandatory for international travel.

Dr Ivan Munigwa, the in-charge of Bumanya Health Centre IV, confirmed
that the facility had enough personnel to handle the expected
numbers.

As Kaliro steps up mobilisation efforts, officials are banking on a
mix of community engagement, youth participation and local leadership
to make the yellow fever vaccination campaign a success.

[Byline: Teven Kibumba]

--
Communicated by:
ProMED
via
ProMED-EAFR

[In response to a recent outbreak, Uganda has launched a mass yellow
fever vaccination campaign in the eastern region. Kaliro District is
one of the districts in the eastern part of Uganda and is targeting to
vaccinate 50 000 individuals. Yellow fever is a viral disease
transmitted by infected mosquitoes, which can cause severe illness and
death if left untreated. Health officials emphasize the importance of
this campaign in preventing further spread of the disease, especially
given the high-risk nature of the region. - Mod.KJ

ProMED map:
Uganda: https://promedmail.org/promed-post?place=8723695,97]

[See Also:
2024
----
Yellow fever - Africa (05): Uganda (KS)
http://promedmail.org/post/20241218.8720731
Yellow fever - Africa (03): Uganda, vaccination hesitancy
http://promedmail.org/post/20240528.8716737
Yellow fever - Africa (02): WHO
http://promedmail.org/post/20240321.8715531
Yellow fever - Africa: Uganda vaccination
http://promedmail.org/post/20240313.8715362
2023
----
Yellow fever - Africa (05): update
http://promedmail.org/post/20231108.8713046
Yellow fever - Africa (01)
http://promedmail.org/post/20230105.8707616
2022
----
Yellow fever - Africa (05): Uganda
http://promedmail.org/post/20220402.8702353
Yellow fever - Uganda: suspected
http://promedmail.org/post/20220720.8704517
Yellow fever - Africa (05): Uganda
http://promedmail.org/post/20220402.8702353
2020
----
Yellow fever - Africa (06): Uganda, WHO
http://promedmail.org/post/20200222.7015224
Yellow fever - Africa (03): Uganda (BL, MY)
http://promedmail.org/post/20200124.6913409
2019
----
Yellow fever - Africa (09): Uganda (OK,MQ)
http://promedmail.org/post/20190530.6492199

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.................................................kj/rd/jh/may/jh
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thereon, are not guaranteed. The reader assumes all risks in using information
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************************************************************
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############################################################
############################################################


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Message: 4
Date: 2025-04-16 02:30:51
Subject: PRO/AH/EDR> BSE - Japan: L-type, transmission to primates


BOVINE SPONGIFORM ENCEPHALOPATHY - JAPAN: L-TYPE, TRANSMISSION TO
PRIMATES
**************************************************************************
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http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Tue 15 April 2025
Source: Emerging Infectious Diseases [edited]
https://wwwnc.cdc.gov/eid/article/31/5/24-1257_article


Citation: Imamura M, Hagiwara K, Tobiume M, et al.: Administration of
L-type bovine spongiform encephalopathy to macaques to evaluate
zoonotic potential. Emerg Infect Dis. May 2025 [early access]
--------------------------------------------------------------------------------
Abstract
--------
We administered L-type bovine spongiform encephalopathy prions to
macaques to determine their potential for transmission to humans.
After 75 months, no clinical symptoms appeared, and prions were
undetectable in any tissue by Western blot or immunohistochemistry.
Protein misfolding cyclic amplification, however, revealed prions in
the nerve and lymphoid tissues.

Worldwide emergence of classical bovine spongiform encephalopathy
(C-BSE) is associated with variant Creutzfeldt-Jakob disease in humans
(1). Two other naturally occurring BSE variants have been identified,
L-type (L-BSE) and H-type. Studies using transgenic mice expressing
human normal prion protein (PrPC) (2) and primates (3-5) have
demonstrated that L-BSE is more virulent than C-BSE. Although L-BSE is
orally transmissible to minks (6), cattle (7), and mouse lemurs (5),
transmissibility to cynomolgus macaques, a suitable model for
investigating human susceptibility to prions, remains unclear. We
orally inoculated cynomolgus macaques with L-BSE prions and explored
the presence of abnormal prion proteins (PrPSc) in tissues using
protein misfolding cyclic amplification (PMCA) along with Western blot
(WB) and immunohistochemistry (IHC). PMCA markedly accelerates prion
replication in vitro, and its products retain the biochemical
properties and transmissibility of seed prion strains (8).

The Study
---------
Two macaques orally inoculated with L-BSE prions remained asymptomatic
and healthy but were euthanized and autopsied at 75 months
postinoculation. WB showed no PrPSc accumulation in any tissue (Table
[for tables/figures/appendixes, see original URL - Mod.LL]), IHC
revealed no PrPSc accumulation, hematoxylin and eosin staining
revealed no spongiform changes in brain sections, and pathologic
examination revealed no abnormalities.

We next attempted to detect PrPSc using PMCA, performed as previously
described (9), with minor modifications (Appendix). First, we
evaluated the sensitivity of PMCA. Using serial amplification with
10-fold stepwise dilutions of prion-infected brain homogenates as
seeds, we amplified PrPSc-like proteinase K (PK)-resistant prion
protein (PrPres) from a 10^-7 dilution of 10% brain homogenate (BH)
obtained from macaque intracerebrally inoculated with L-BSE prions in
the 5th amplification round (Figure 1, panel A). This method also
enabled propagation of PrPres from a 10^-8 dilution of BH from
C-BSE-affected cattle during the 2nd amplification round (Figure 1,
panel B), suggesting PMCA's higher efficiency and sensitivity for
detecting C-BSE prions than macaque L-BSE prions.

We attempted to detect prions in the lymphoid and nervous systems,
among other tissues, of the 2 orally inoculated macaques using refined
PMCA (Figure 2; Appendix Figure, Table). In lymphoid tissue samples
prepared using sodium phosphotungstic acid precipitation (Appendix),
we amplified PrPres in the inguinal and mesenteric lymph nodes, ileum,
and tonsils of both macaques (Figure 2, panels A, B), as well as in
the spleen of 1 macaque (#18) and the thymus of the other (#19), in
the 2nd or 3rd amplification round of PMCA (Figure 2, panel C). We
observed no PrPres in the submandibular lymph nodes (Appendix Figure
1). Examining the central nervous system, we observed no PrPres
amplification in the cerebral cortex (Figure 2, panel C), whether
seeded with phosphate-buffered saline homogenates or phosphotungstic
acid precipitates. The spinal cord showed no PrPres amplification upon
ethanol precipitation. However, PrPres was amplified in the cervical
spinal cord of macaque #19 and in the thoracic spinal cord of both
macaques with phosphate-buffered saline homogenates (Figure 2, panel
D). We also confirmed PrPres in the median nerve of both macaques but
not in the sciatic nerve (Figure 2, panel E). We noted PrPres signals
in the submandibular glands of both animals. In contrast, we found no
PrPres amplification in any tissues from uninoculated control
macaques.

PrPres obtained from the orally inoculated macaques exhibited diverse
banding patterns distinct from those generated by PMCA using
L-BSE-affected cattle BH and L-BSE intracerebrally inoculated macaque
BH as seeds (Figure 3, panels A-C). Of note, the
lowest-molecular-weight PrPres variants from the ileum, spleen,
inguinal lymph nodes, thoracic cord, submaxillary gland, and
mesenteric lymph nodes of orally inoculated macaques exhibited
remarkable PK resistance similarity and banding patterns
indistinguishable from those of PrPres generated by PMCA with
C-BSE-affected cattle BH as a seed (Figure 3, panel C, Appendix
Figures 2 and 3). In contrast, the higher-molecular-weight PrPres
variants from the ileum of macaque #18 exhibited a unique banding
pattern distinct from those of L-BSE, C-BSE, and H-type BSE prions
(Figure 3, panel C). Banding patterns and PK resistance of PrPres
amplified from L-BSE-affected cattle BH and L-BSE intracerebrally
inoculated macaque BH were notably similar.

This PMCA method was initially designed for the high-sensitivity
detection of L-BSE intracerebrally inoculated macaque PrPSc but was
even more efficient and sensitive in detecting bovine C-BSE PrPSc
(Figure 1, panel B). Therefore, we believe that this method enabled
the detection of both C-BSE-like PrPSc and potentially novel PrPSc
variants.

Conclusion
----------
We noted no detectable evidence of PrPSc by WB or IHC in any tissues
of L-BSE orally inoculated macaques. Nevertheless, PMCA successfully
amplified PrPres from lymphatic and neural tissues. The PrPres
exhibited electrophoretic patterns distinct from those detected by
PMCA using L-BSE-affected cattle BH as the seed (Figure 3, panel C),
indicating that the PrPSc used as the template for PrPres
amplification in orally inoculated macaques did not originate from the
bovine L-BSE prions used as inoculum. Instead, PrPSc were newly
generated by the conversion of macaque PrPC by bovine L-BSE prions.
Our results provide strong evidence that L-BSE can infect macaques via
the oral route.

We found no evidence that PrPSc reached the brain in orally inoculated
macaques; however, the macaques euthanized 6 years postinoculation
might have been in the preclinical period. At low infection levels,
lymph nodes play a vital role in prion spread to the central nervous
system (11). Therefore, had the macaques been maintained for a longer
period, they might have developed prion disease. Retrospective
surveillance studies using the appendix and tonsil tissues suggested a
considerable number of humans harboring vCJD in a carrier state (12).
Thus, we cannot exclude that L-BSE orally inoculated macaques could
similarly remain in a potentially infectious state.

The brain of L-BSE intracerebrally inoculated macaque accumulated
prions with biochemical properties resembling bovine L-BSE prions
(Figure 3, panel C; Appendix Figure 2); however, we observed no PrPSc
accumulation in lymphoid tissues by WB or IHC (4). In contrast,
macaques orally inoculated with C-BSE prions showed PrPSc accumulation
in lymphoid tissues, including the spleen, tonsils, and mesenteric
lymph nodes by WB and IHC (13). In our study, L-BSE orally inoculated
macaques harbored C-BSE-like prions in their lymphoid and neural
tissues. Interspecies transmission of L-BSE prions to ovine PrP
transgenic mice can result in a shift toward C-BSE-like properties
(14,15). Our data suggest that L-BSE prions may alter biophysical and
biochemical properties, depending on interspecies transmission and
inoculation route, acquiring traits similar to those of C-BSE prions.
This transformation might result from structural changes in the L-BSE
prion to C-BSE-like prions and other lymphotropic prions within
lymphoid tissues or from the selective propagation of low-level
lymphotropic substrains within the L-BSE prion population.

The 1st limitation of our study is that the oral inoculation
experiment involved only 2 macaques and tissues collected at 6 years
postinoculation, before disease onset. Consequently, subsequent
progression of prion disease symptoms remains speculative. A larger
sample size and extended observation periods are required to
conclusively establish infection in orally inoculated macaques.
Furthermore, we performed no bioassays for PMCA-positive samples,
leaving the relationship between PMCA results and infectious titers
undefined. Considering that PrPres amplifications from tissues from
the orally inoculated macaque tissues required 2 rounds of PMCA, the
PrPSc levels in positive tissues might have been extremely low and
undetectable in the bioassay.

Previous studies have demonstrated that L-BSE can be orally
transmitted to cattle (7) and might have caused prion disease in
farm-raised minks (6), indicating that L-BSE could naturally affect
various animal species. Our findings suggest that L-BSE can also be
orally transmitted to macaques. Therefore, current control measures
aimed at preventing primary C-BSE in cattle and humans may also need
to consider the potential risk of spontaneous L-BSE transmission.

[References can be found at the original URL - Mod.LL]

--
Communicated by:
ProMED

[Transmission via the oral route of L-BSE prions produced evidence of
extra-cerebral infection and might have caused disease with a longer
period of incubation.

Previously, as referenced in the paper, the L strain (low molecular
weight) of BSE has been transmitted to primates via the intracerebral
route:

Ono F, Tase N, Kurosawa A, Hiyaoka A, et al.: Atypical L-type bovine
spongiform encephalopathy (L-BSE) transmission to cynomolgus macaques,
a non-human primate. Jpn J Infect Dis. 2011;64:81-84.
https://pubmed.ncbi.nlm.nih.gov/21266763/
--------------------------------------------------------------------------------
Abstract
--------
"A low molecular weight type of atypical bovine spongiform
encephalopathy (L-BSE) was transmitted to 2 cynomolgus macaques by
intracerebral inoculation of a brain homogenate of cattle with
atypical BSE detected in Japan. They developed neurological signs and
symptoms at 19 or 20 months post-inoculation and were euthanized 6
months after the onset of total paralysis. Both the incubation period
and duration of the disease were shorter than those for experimental
transmission of classical BSE (C-BSE) into macaques. Although the
clinical manifestations, such as tremor, myoclonic jerking, and
paralysis, were similar to those induced upon C-BSE transmission, no
premonitory symptoms, such as hyperekplexia and depression, were
evident. Most of the abnormal prion protein (PrPSc) was confined to
the tissues of the central nervous system, as determined by
immunohistochemistry and Western blotting. The PrPSc glycoform that
accumulated in the monkey brain showed a similar profile to that of
L-BSE and consistent with that in the cattle brain used as the
inoculant. PrPSc staining in the cerebral cortex showed a diffuse
synaptic pattern by immunohistochemistry, whereas it accumulated as
fine and coarse granules and/or small plaques in the cerebellar cortex
and brain stem. Severe spongiosis spread widely in the cerebral
cortex, whereas florid plaques, a hallmark of variant
Creutzfeldt-Jakob disease in humans, were observed in macaques
inoculated with C-BSE but not in those inoculated with L-BSE."

And to lemurs (a "lower" primate):

Mestre-Francés N, Nicot S, Rouland S, et al.: Oral transmission of
L-type bovine spongiform encephalopathy in primate model. Emerg Infect
Dis. 2012;18:142-145.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3310119/
--------------------------------------------------------------------------------
Abstract
--------
"We report transmission of atypical L-type bovine spongiform
encephalopathy to mouse lemurs after oral or intracerebral inoculation
with infected bovine brain tissue. After neurologic symptoms appeared,
transmissibility of the disease by both inoculation routes was
confirmed by detection of disease-associated prion protein in samples
of brain tissue."

Now it is reported in oral administration to a "higher" primate -
Mod.LL

ProMED map:
Japan: https://promedmail.org/promed-post?place=8723694,156]

[See Also:
2024
----
BSE, cattle - Ireland: atypical form
http://promedmail.org/post/20241005.8719170
2020
----
BSE, bovine - Ireland: (TY) atypical H-type, OIE
http://promedmail.org/post/20200526.7380366
2017
---
BSE, bovine - Ireland (02): (GY) atypical L-type, OIE20170124.4789081
BSE, bovine - Ireland: (GY) atypical
http://promedmail.org/post/20170119.4775368

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scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................ll/may/jh
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************************************************************
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thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
be held responsible for errors or omissions or held liable for any damages incurred
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############################################################
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Message: 5
Date: 2025-04-16 02:34:52
Subject: PRO/AH/EDR> Streptococcus suis - Viet Nam (02): (TB) pig intestine consumption


STREPTOCOCCUS SUIS - VIET NAM (02): (THAI BINH) PIG INTESTINE
CONSUMPTION
*************************************************************************
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International Society for Infectious Diseases
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Date: Mon 14 Apr 2025 15:12 ICT
Source: VN Express [in Vietnamese, machine trans., edited]
https://vnexpress.net/nhiem-lien-cau-khuan-sau-an-long-lon-4873820.html


After eating pig intestines, a 49-year-old man suffered from full-body
hemorrhage and facial necrosis. Doctors determined he had
streptococcal infection and a high risk of death.

About a week ago, he ate pig intestines, then suddenly had a high
fever of 40 degrees Celsius [104 deg F], chills, severe abdominal
pain, and diarrhea. The patient was intubated by a lower-level
facility, maintained vasopressor, then urgently transferred to the
Intensive Care Center, Central Hospital for Tropical Diseases.

Test results confirmed that he had _Streptococcus suis_ -- dangerous
bacteria that can be transmitted from pigs to humans through
undercooked food or open wounds. Doctors determined that the cause may
be related to him eating pig intestines. The origin of the food the
patient consumed is currently unknown.

The patient was treated intensively with antibiotics, resuscitation,
mechanical ventilation, blood filtration and transfusion of blood
products (platelets, fresh plasma). However, the condition is still
very serious, the prognosis is poor, and the risk of death is high.

Dr. Dong Phu Khiem, Deputy Director of the Intensive Care Center, said
that there is currently no vaccine to prevent _Streptococcus suis_. If
not detected and treated promptly, the disease can leave serious
sequelae such as deafness, nerve damage or multiple organ failure.
Therefore, early diagnosis and timely treatment are key factors in
improving treatment effectiveness and reducing mortality from
_Streptococcus suis_ infection in humans.

Doctors recommend that people absolutely do not eat blood pudding, pig
intestines or any other undercooked pork products. When buying meat,
choose products with clear origins, avoid meat with unusual color,
signs of swelling or bleeding. People involved in slaughtering and
processing pork must wear gloves, masks and clean their hands after
contact.

If there are open wounds on the hands or feet, they should be covered
with waterproof gauze before handling raw food. In addition, with
ready-to-eat food bought from stores, people should blanch it in
boiling water or cook it thoroughly before eating to ensure food
safety and hygiene.

[Byline: Thuy Quynh]

--
Communicated by:
ProMED
via
ProMED-MBDS

[The citation, abstract, and concluding remarks and perspectives from
a study on _Streptococcus suis_ infection follow:

Feng Y, Zhang H, Wu Z, et al. _Streptococcus suis_ infection: an
emerging/reemerging challenge of bacterial infectious diseases?
Virulence. 2014;5(4):477-497. https://doi.org/10.4161/viru.28595.
--------------------------------------------------------------------------------
Abstract
--------
"_Streptococcus suis_ (_S. suis_) is a family of pathogenic
gram-positive bacterial strains that represents a primary health
problem in the swine industry worldwide. _S. suis_ is also an emerging
zoonotic pathogen that causes severe human infections clinically
featuring with varied diseases/syndromes (such as meningitis,
septicemia, and arthritis). Over the past few decades, continued
efforts have made significant progress toward better understanding
this zoonotic infectious entity, contributing in part to the
elucidation of the molecular mechanism underlying its high
pathogenicity. This review is aimed at presenting an updated overview
of this pathogen from the perspective of molecular epidemiology,
clinical diagnosis and typing, virulence mechanism, and protective
antigens contributing to its zoonosis."

Concluding Remarks and Perspectives
-----------------------------------
"As a zoonotic agent, _S. suis_ is gathering increasing accumulated
attention from public health officials as well as the relevant
academic community. With respect to _S. suis_ epidemiology, we believe
that current situation of human SS2 [serotype 2 of _S. suis_]
infections should be re-evaluated using comprehensive approaches. To
minimize the occupational infections by _S. suis_, it is suggested
that advances be made to improve public awareness of _S. suis_
infection by science education and popularization. Although progress
has been obtained toward understanding _S. suis_ pathogenicity
(especially identifying a group of bacterial virulence factors), it
still sounds fragmentary, and lacks an insightful dissection of
integrated regulatory networks of bacterial virulence. In the future,
an important direction would be to link posttranscriptional regulation
(e.g., ncRNA and riboswitch) and modification (such as acetylation and
de-acetylation) to the bacterial virulence of _Streptococcus suis_.
Moreover, structural information on these virulence factors is very
limited. We therefore believe it is necessary to strengthen the study
of pathogenesis-related structural biology, which could establish a
solid basis for design of small molecule drugs targeting bacterial
virulence factors.

"It is of interest to search for other virulence-related or
immunological regulatory elements, different from 89K PAI, because of
recent exciting findings on this issue. Safe and effective vaccines
that can be used for patients is still not available, which is due to
lack of comprehensive knowledge of _S. suis_ infections. Description
of a full picture of _S. suis_ surface antigen proteins might be
helpful to screen and/or design vaccine molecules candidate. The fact
that non-SS2 serotypes of _S. suis_ can affect humans and even lead to
fatal infections, has put the situation of _S. suis_ infection in a
much more complicated and serious status in public health. This might
be an alternate way to decode the genome sequences of all 35 kinds of
different serotypes, providing new insights into evolution and
diversity of heterogeneous species, as well as distinct clues for
preventing and controlling severe infections by these pathogens.
Systematic proteomic approaches are also encouraged to further address
this question, which can complement genomics-based explorations.

"In summary, our understanding and response to the situation of _S.
suis_ infections occurring especially in southeast Asia is not
satisfactory. It would be helpful to integrate representative
virulent/avirulent strains from different countries/regions for
collaborative investigations. Therefore, there is a long way to go
toward the complete conquest of _S. suis_, an emerging human
pathogen." - Mod.ST

ProMED map:
Vietnam: https://promedmail.org/promed-post?place=8723697,152]

[See Also:
Streptococcus suis - Viet Nam: (QN) pig blood pudding
http://promedmail.org/post/20250323.8723076
2024
----
Streptococcus suis - Viet Nam (04): (HI) pig slaughter-associated
http://promedmail.org/post/20241205.8720442
Streptococcus suis - Thailand: northeastern provinces, uncooked pork,
fatal http://promedmail.org/post/20241007.8719226
Streptococcus suis - Viet Nam (03): (TY) fatal
http://promedmail.org/post/20240811.8718082
Streptococcus suis - Viet Nam (02): (HI) fatal
http://promedmail.org/post/20240807.8718001
Streptococcus suis - Viet Nam: case slaughtered & ate sick pig
http://promedmail.org/post/20240724.8717724
Meningitis - Viet Nam: (PT) Streptococcus suis, pork offal
http://promedmail.org/post/20240704.8717373
Streptococcus suis - Thailand: raw or undercooked pork/pork product,
fatal, alert http://promedmail.org/post/20240108.8714122
2023
----
Streptococcus suis - Thailand: raw or undercooked pork/pork product,
fatal, alert http://promedmail.org/post/20231105.8713007
Streptococcus suis - Viet Nam: raw pork meat/blood consumption, alert
http://promedmail.org/post/20230315.8708940
2022
----
Streptococcus suis - Thailand: increase, raw pork meat/blood
consumption, 2021 http://promedmail.org/post/20220214.8701455
2021
----
Streptococcus suis - Thailand: raw pork or pork blood
http://promedmail.org/post/20210109.8087251
2019
----
Streptococcus suis - Thailand (03): raw pork or pork blood
http://promedmail.org/post/20190906.6660853
Streptococcus suis - Thailand (02): raw pork or pork blood, background
http://promedmail.org/post/20190423.6436086
Streptococcus suis - Thailand: raw pork or pork blood
http://promedmail.org/post/20190422.6433945

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under ISID's Terms and Conditions and Privacy Policy.]
.................................................st/rd/st/may/jh
*##########################################################*
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############################################################
############################################################


-----------------------------------------------------------------------------------------------------

Message: 6
Date: 2025-04-16 02:36:32
Subject: PRO/AH/EDR> Rabies (44): Viet Nam (BT) human, bite from neighbor's dog, fatal


RABIES (44): VIET NAM (BINH THUAN) HUMAN, BITE FROM NEIGHBOR'S DOG,
FATAL
*************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Tue 15 Apr 2025 09:39 ICT
Source: VN Express [in Vietnamese, machine trans., edited]
https://vnexpress.net/them-mot-nguoi-chet-do-benh-dai-o-binh-thuan-4874090.html


A man has died 2 months after being bitten by a neighbor's dog, the
4th such death this year [2025] in the province.

On the morning of 15 Apr 2025, Dr. Vo Van Hanh, Director of the Binh
Thuan Center for Disease Control, said that the person who had just
died was a 57-year-old patient residing in Ham Liem commune, Ham Thuan
Bac district.

Two months ago, this person was walking on the street when a dog
belonging to a family in the neighborhood jumped out and bit him on
the right leg. The wound was moderately deep and bled, but the patient
only washed it with cold water at home and did not get a rabies
vaccine.

On 9 Apr 2025, the male patient began to show signs of fatigue and
sore throat. The next day [10 Apr 2025], his condition worsened with
symptoms of extreme fatigue, difficulty breathing, fear of water, fear
of wind, choking. The family called an ambulance to take him to Binh
Thuan General Hospital for emergency care.

With clinical symptoms combined with medical history, he was diagnosed
with rabies at the hospital. After the doctor explained the condition
and prognosis, the family asked to take him home and the patient died
at home on 11 Apr 2025.

The dog that bit the patient has now been beaten to death. Three other
people in the same area who were also bitten by the same animal have
been vaccinated and given anti-rabies serum.

This is a suspected rabies death in 2025. Previously, 2 people in Ham
Thuan Bac district and one person in Tanh Linh district also died
after being bitten by dogs and cats but did not get rabies
vaccination.

There is currently no specific treatment for rabies, and 100% of
people who develop the disease die. Vaccination is the only
preventative measure.

In 2024, Binh Thuan was also a hot spot for rabies with 10 deaths.

--
Communicated by:
ProMED
via
ProMED-MBDS

["The incubation period of rabies is both prolonged and variable,
depending on the exposure site and dose of viral inoculum. Exposure of
highly innervated tissue is associated with a shorter incubation
period for the development of CNS signs.

"Typically, rabies virus remains at the inoculation site for a
considerable time. The unusual length of the incubation period helps
to explain the effective action of local infiltration of rabies immune
globulin during human post-exposure prophylaxis, even days after
exposure.

"Most clinical cases of rabies in dogs develop within 21-80 days after
exposure; however, the incubation period may be shorter or
considerably longer. One recorded case of rabies in a person in the
United States had an incubation period estimated reliably to be > 8
years"
(https://www.msdvetmanual.com/nervous-system/rabies/rabies-in-animals#Epidemiology_v83306256).

It is assumed that the incriminated dog had not exhibited any clinical
symptoms until the damage was done; otherwise, it could have been
euthanized earlier. The fact that the 3 other people bitten by the
same dog only sought medical attention when the fatal case was known
may suggest that they or their relatives are not fully aware of the
urgency for preventive medical treatment after the bite. They still
deserve praise and this practice must immediately follow the exposure.
- Mod.ST

ProMED map:
Vietnam: https://promedmail.org/promed-post?place=8723698,152]

[See Also:
Rabies (43): Viet Nam (BT) stray cat bite
http://promedmail.org/post/20250413.8723621
Rabies (42): Viet Nam (HO) stray dog bite
http://promedmail.org/post/20250410.8723545
Rabies (31): Viet Nam (DN) dog and cat vaccination campaign
http://promedmail.org/post/20250329.8723242
Rabies (12): Viet Nam (DN) pet dog bite, fatal
http://promedmail.org/post/20250215.8722174
Rabies (10): Viet Nam (DL) rabid dog bite
http://promedmail.org/post/20250212.8722083
Rabies (08): Viet Nam (GL)
http://promedmail.org/post/20250205.8721847
Rabies (03): Viet Nam (DL)
http://promedmail.org/post/20250114.8721335
2024
----
Rabies (104): Viet Nam (BV) dog meat restaurant owner, fatal
http://promedmail.org/post/20241223.8720864
Rabies (102): Viet Nam, national summary, Bangladesh (DH) dog bites,
human exp http://promedmail.org/post/20241214.8720661
Rabies (99): Viet Nam (NA) traditional medicine, fatal
http://promedmail.org/post/20241203.8720411
Rabies (95): Viet Nam (BV) cat scratch
http://promedmail.org/post/20241129.8720317
Rabies (88): Viet Nam (QM) schoolboy, fatal
http://promedmail.org/post/20241102.8719742
Rabies (76): Viet Nam (DN) pet dog bite
http://promedmail.org/post/20240908.8718644
Rabies (66): Viet Nam (HI) stray dog, spread
http://promedmail.org/post/20240815.8718176
Rabies (61): Viet Nam, national summary, increase
http://promedmail.org/post/20240801.8717879
Rabies (59): Viet Nam (GL) cat bite, fatal
http://promedmail.org/post/20240716.8717601
Rabies (57): Viet Nam (GL) long incubation period
http://promedmail.org/post/20240705.8717391
Rabies (54): Viet Nam (TQ, HO) increase, fatal
http://promedmail.org/post/20240620.8717125
Rabies (50): Viet Nam (HI) new directive on dog and cat meat trade
http://promedmail.org/post/20240611.8716978
Rabies (38): Viet Nam, increase
http://promedmail.org/post/20240426.8716166
Rabies (30): Viet Nam, financial implication
http://promedmail.org/post/20240329.8715680
Rabies (29): Viet Nam (HC) human, increase, urgent response
http://promedmail.org/post/20240324.8715592
Rabies (24): Viet Nam (PY) stray dog, human exp
http://promedmail.org/post/20240314.8715393
Rabies (18): Viet Nam (QN) human, dog
http://promedmail.org/post/20240305.8715187
Rabies (16): Viet Nam, increase
http://promedmail.org/post/20240302.8715146
Rabies (13): Viet Nam (CM) dog bite, restaurant owner
http://promedmail.org/post/20240216.8714883
Rabies (04): Viet Nam (PY) dog bite mistaken as scratch from collar,
fatal http://promedmail.org/post/20240113.8714212

Note: This content and the data herein may not be copied, reproduced,
scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................st/rd/st/may/jh
*##########################################################*
************************************************************
ProMED makes every effort to verify the reports that are posted, but the accuracy
and completeness of the information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
be held responsible for errors or omissions or held liable for any damages incurred
as a result of use or reliance upon posted or archived material.
************************************************************
Donate to ProMED. Details available at: https://isid.networkforgood.com/projects/79924-invest-in-the-mission.
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GONORRHEA - WORLDWIDE: GEPOTIDACIN EFFICACY, PHASE 3 TRIAL
**********************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Tue 15 April 2025
Source: CIDRAP [edited[
https://www.cidrap.umn.edu/antimicrobial-stewardship/phase-3-trial-suggests-gepotidacin-could-be-new-treatment-option


Phase 3 trial suggests gepotidacin could be a new treatment option for
gonorrhea
--------------------------------------------------------------------------------
An antibacterial agent recently approved for treatment of urinary
tract infections also shows efficacy against gonorrhea, according to
the results of a phase 3 randomized trial published yesterday [14 Apr
2025] in The Lancet. The multicenter trial, which involved more than
600 people in 5 countries with _Neisseria gonorrhoeae_ infections,
found that oral gepotidacin was noninferior to the standard regimen of
intramuscular ceftriaxone plus azithromycin, with a treatment success
rate of 93% and no new safety concerns. Gepotidacin is a 1st-in-class
triazaacenaphthylene antimicrobial that inhibits bacterial DNA
replication by targeting a distinct binding site.

The findings are significant given the lack of alternative treatment
options for one of the most prevalent sexually transmitted infections
in the world. Ceftriaxone is the last remaining empiric treatment
option for _N. gonorrhoeae_, a bacterium that has quickly developed
resistance to every antibacterial that has been used for treatment.
But resistance to ceftriaxone is already high in parts of Asia and has
been spreading to other parts of the world.

The threat of untreatable gonorrhea, which can cause pelvic
inflammatory disease, ectopic pregnancy, and infertility in women, has
led the WHO and CDC to label drug-resistant _N. gonorrhoeae_ a serious
and urgent public health threat. The last new therapy for gonorrhea
was introduced in the 1990s. "The potential introduction of a novel
oral antibacterial with proven in-vitro activity and in-vivo efficacy
would represent a significant advancement in patient care for
uncomplicated gonorrhoea," trial investigators wrote.

For the EAGLE-1 trial, USA, UK, and Australian investigators enrolled
628 participants from Australia, Germany, Mexico, Spain, and the USA
who were ages 12 and over and had suspected uncomplicated urogenital
gonorrhea, a positive lab test for _N. gonorrhoeae_, or both.
Participants were randomized 1:1 to receive two 3000 milligram (mg)
doses of oral gepotidacin or 500 mg intramuscular ceftriaxone plus 1
gram of oral azithromycin. The primary efficacy endpoint was
microbiologic success, defined as culture-confirmed bacterial
eradication of _N. gonorrhoeae_ at test-of-cure (days 4 to 8). The
outcome was assessed in the microbiologic intention-to-treat
(micro-ITT) population, which included 406 participants (202 in the
gepotidacin group and 204 in ceftriaxone plus azithromycin group),
most of whom were male (92%), White (74%), and men who have sex with
men (71%). The noninferiority margin was -10%.

The primary outcome analysis found microbiologic success rates of
92.6% (95% confidence interval [CI], 88.0% to 95.8%) in the
gepotidacin group and 91.2% (95% CI, 86.4% to 94.7%) in the
ceftriaxone plus azithromycin group, for an adjusted treatment
difference of -0.1% (95% CI, -5.6% to 5.5%). No bacterial persistence
for urogenital _N. gonorrhoeae_ was observed at test-of-cure for
either treatment group. Gepotidacin also maintained efficacy against
drug-resistant or non-susceptible _N. gonorrhoeae_ isolates, and no
reduction in gepotidacin susceptibility was identified. The potential
introduction of a novel oral antibacterial with proven in-vitro
activity and in-vivo efficacy would represent a significant
advancement in patient care for uncomplicated gonorrhoea.

In the safety population (309 in the gepotidacin group and 311 in the
ceftriaxone plus azithromycin group), the percentage of patients with
at least one treatment-emergent adverse event was higher in the
gepotidacin group (74% vs 33%) than the ceftriaxone plus azithromycin
group. A similar pattern was observed with drug-related adverse events
(68% vs 14%). Adverse events were mainly gastrointestinal and almost
all were mild or moderate.

The investigators say one of the benefits of gepotidacin is that it
can be taken orally, which could make it a more attractive option for
patients than receiving an injection of ceftriaxone. "New oral
treatment options, which are often an appealing alternative to
parenteral therapy due to their ease of administration, lower
health-care resource use, decreased risk of needle-stick injuries, and
increased patient satisfaction by avoiding injections, especially in
those with needle phobias, are urgently required," they wrote.

The results are more good news for British drugmaker GSK, which
developed gepotidacin in collaboration with the USA government's
Biomedical Advanced Research and Development Authority (BARDA). Late
last month [March 2025], the US Food and Drug Administration approved
gepotidacin for uncomplicated urinary tract infections (uUTIs).

But in an accompanying commentary, experts from the WHO caution
regular use of gepotidacin for uUTIs raises concerns for resistance
selection in _N. gonorrhoeae_, which could limit its effectiveness.
"Implementation of gepotidacin for the treatment of uUTIs and
gonorrhoea must use evidence-based guidelines and stewardship
strategies to minimise the risk of resistance development," Magnus
Unemo, PhD, and Teodora Wi, MD, wrote.

Furthermore, they note that gonococci's ability to quickly develop
resistance means that clinical work on other gonorrhea treatment
options remains necessary. One candidate, zoliflodacin, has also
demonstrated noninferiority to ceftriaxone plus azithromycin in a
phase 3 trial, but the full results of that study have yet to be
published. In addition to new treatments, Unemo and Wi say multiple
strategies are needed to maintain effective control and management of
gonorrhea, which caused 82.4 million infections in people ages 15 to
49 years in 2020. These include improved prevention, development of
rapid and affordable point-of-care diagnostic tests, prompt treatment
of patients and contacts, enhanced surveillance, antimicrobial
stewardship, and creation of a gonococcal vaccine.

"In conclusion, gepotidacin is promising for the treatment of
gonorrhoea, but the challenges to retain gonorrhoea as a treatable
infection will continue," they wrote.

[Byline: Chris Dall]

--
Communicated by:
ProMED

[Ross JDC, Wilson J, Workowski KA, et al.: Oral gepotidacin for the
treatment of uncomplicated urogenital gonorrhoea (EAGLE-1): a phase 3
randomised, open-label, non-inferiority, multicentre study. Lancet
2025, early publication,
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00628-2/abstract
--------------------------------------------------------------------------------
Summary
-------
"Background: Gepotidacin, a 1st-in-class, bactericidal,
triazaacenaphthylene antibacterial that inhibits bacterial DNA
replication, was shown to be efficacious and well tolerated in the
treatment of uncomplicated urinary tract infections. We evaluated the
efficacy and safety of gepotidacin for the treatment of uncomplicated
urogenital gonorrhoea.

Methods: EAGLE-1 (NCT04010539) was a phase 3, open-label,
sponsor-blinded, multicentre, non-inferiority study evaluating oral
gepotidacin (two 3000 mg doses administered 10-12 h apart) compared
with 500 mg intramuscular ceftriaxone plus 1 g oral azithromycin for
the treatment of gonorrhoea. Eligible participants were aged 12 years
and older, had a bodyweight over 45 kg, and had suspected
uncomplicated urogenital gonorrhoea (including mucopurulent
discharge), a positive laboratory test for _Neisseria gonorrhoeae_, or
both. Participants were randomly allocated in a 1:1 ratio to each
treatment group, stratified by sex (original urogenital anatomy at
birth) and sexual orientation (men who have sex with men [MSM], men
who have sex with women [MSW], and female) in combination, and age
group (age < 18 years, ≥ 18 to 65 years, or > 65 years). The primary
efficacy endpoint was microbiological success, defined as
culture-confirmed bacterial eradication of N gonorrhoeae from the
urogenital body site at test-of-cure (days 4-8). The non-inferiority
margin was prespecified at -10%. The primary outcome was assessed in
the microbiological intention-to-treat (micro-ITT) population, all
participants randomly allocated to a study treatment who received at
least one dose of their study treatment and had confirmed
ceftriaxone-susceptible _N. gonorrhoeae_ isolated from the baseline
culture of their urogenital specimen. The safety population comprised
all participants who received one or more doses of any study
treatment.

Findings: Between 21 Oct 2019, and 10 Oct 2023, 628 participants were
randomly allocated (314 allocated to each treatment group). Overall,
39 (6%) of 628 participants discontinued the study prematurely (20 in
the gepotidacin group and 19 in the ceftriaxone plus azithromycin
group), with the primary reason being lost to follow-up. The micro-ITT
population included 406 participants (202 in the gepotidacin group and
204 in the ceftriaxone plus azithromycin group). Most participants in
the micro-ITT population were male (372 [92%] vs 34 [8%] female), and
there was a higher percentage of participants who were MSM (290 [71%])
compared with participants who were MSW (82 [20%]). Participants were
predominantly White (299 [74%]) or Black or African American (61
[15%]), with 70 (17%) identifying as Hispanic or Latino. Results of
the primary analysis of microbiological response at test-of-cure
demonstrated microbiological success rates of 92·6% (187 of 202 [95%
CI 88·0 to 95·8]) in the gepotidacin group and 91·2% (186 of 204
[86·4 to 94·7]) in the ceftriaxone plus azithromycin group (adjusted
treatment difference -0·1% [95% CI -5·6 to 5·5]). Gepotidacin was
non-inferior to ceftriaxone plus azithromycin. No bacterial
persistence of urogenital _N. gonorrhoeae_ was observed at
test-of-cure for either group. The gepotidacin group had higher rates
of adverse events and drug-related adverse events, mainly due to
gastrointestinal adverse events, and almost all were mild or moderate.
No treatment-related severe or serious adverse events occurred in
either group.

Interpretation: Gepotidacin demonstrated non-inferiority to
ceftriaxone plus azithromycin for urogenital _N. gonorrhoeae_, with no
new safety concerns, offering a novel oral treatment option for
uncomplicated urogenital gonorrhoea."

In 2004, the US Congress passed the Project BioShield Act, which
established the Biomedical Advanced Research and Development
Authority, also known as BARDA. Created in the shadow of the tragedy
on 11 Sep 2001 and the global war on terror, BARDA was established to
support the development and approval of medical countermeasures, which
are FDA-regulated products used to prepare our country to respond to
chemical, biological, radiological, and nuclear threats posed by our
nation's adversaries. - Mod.LL]

[See Also:
2024
----
Gonorrhea: Finland, Denmark, RFI
http://promedmail.org/post/20240306.8715206
2022
----
Syphilis, gonococcal disease - Australia: (VI) rebound post COVID,
2022 http://promedmail.org/post/20230616.8710620
2022
----
Syphilis, gonorrhea - Australia: increasing, women, MSM, congenital,
Indigenous http://promedmail.org/post/20221209.8707161
2018
----
Syphilis, gonococcal disease, chlamydia - USA, UK, Australia (02):
background http://promedmail.org/post/20181210.6201105
Syphilis, gonococcal disease, chlamydia - USA, UK, Australia
http://promedmail.org/post/20181208.6192757

Note: This content and the data herein may not be copied, reproduced,
scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................ll/may/jh
*##########################################################*
************************************************************
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thereon, are not guaranteed. The reader assumes all risks in using information
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RABIES (44): VIET NAM (BINH THUAN) HUMAN, BITE FROM NEIGHBOR'S DOG,
FATAL
*************************************************************************
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ProMED-mail is a program of the
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Date: Tue 15 Apr 2025 09:39 ICT
Source: VN Express [in Vietnamese, machine trans., edited]
https://vnexpress.net/them-mot-nguoi-chet-do-benh-dai-o-binh-thuan-4874090.html


A man has died 2 months after being bitten by a neighbor's dog, the
4th such death this year [2025] in the province.

On the morning of 15 Apr 2025, Dr. Vo Van Hanh, Director of the Binh
Thuan Center for Disease Control, said that the person who had just
died was a 57-year-old patient residing in Ham Liem commune, Ham Thuan
Bac district.

Two months ago, this person was walking on the street when a dog
belonging to a family in the neighborhood jumped out and bit him on
the right leg. The wound was moderately deep and bled, but the patient
only washed it with cold water at home and did not get a rabies
vaccine.

On 9 Apr 2025, the male patient began to show signs of fatigue and
sore throat. The next day [10 Apr 2025], his condition worsened with
symptoms of extreme fatigue, difficulty breathing, fear of water, fear
of wind, choking. The family called an ambulance to take him to Binh
Thuan General Hospital for emergency care.

With clinical symptoms combined with medical history, he was diagnosed
with rabies at the hospital. After the doctor explained the condition
and prognosis, the family asked to take him home and the patient died
at home on 11 Apr 2025.

The dog that bit the patient has now been beaten to death. Three other
people in the same area who were also bitten by the same animal have
been vaccinated and given anti-rabies serum.

This is a suspected rabies death in 2025. Previously, 2 people in Ham
Thuan Bac district and one person in Tanh Linh district also died
after being bitten by dogs and cats but did not get rabies
vaccination.

There is currently no specific treatment for rabies, and 100% of
people who develop the disease die. Vaccination is the only
preventative measure.

In 2024, Binh Thuan was also a hot spot for rabies with 10 deaths.

--
Communicated by:
ProMED
via
ProMED-MBDS

["The incubation period of rabies is both prolonged and variable,
depending on the exposure site and dose of viral inoculum. Exposure of
highly innervated tissue is associated with a shorter incubation
period for the development of CNS signs.

"Typically, rabies virus remains at the inoculation site for a
considerable time. The unusual length of the incubation period helps
to explain the effective action of local infiltration of rabies immune
globulin during human post-exposure prophylaxis, even days after
exposure.

"Most clinical cases of rabies in dogs develop within 21-80 days after
exposure; however, the incubation period may be shorter or
considerably longer. One recorded case of rabies in a person in the
United States had an incubation period estimated reliably to be > 8
years"
(https://www.msdvetmanual.com/nervous-system/rabies/rabies-in-animals#Epidemiology_v83306256).

It is assumed that the incriminated dog had not exhibited any clinical
symptoms until the damage was done; otherwise, it could have been
euthanized earlier. The fact that the 3 other people bitten by the
same dog only sought medical attention when the fatal case was known
may suggest that they or their relatives are not fully aware of the
urgency for preventive medical treatment after the bite. They still
deserve praise and this practice must immediately follow the exposure.
- Mod.ST

ProMED map:
Vietnam: https://promedmail.org/promed-post?place=8723698,152]

[See Also:
Rabies (43): Viet Nam (BT) stray cat bite
http://promedmail.org/post/20250413.8723621
Rabies (42): Viet Nam (HO) stray dog bite
http://promedmail.org/post/20250410.8723545
Rabies (31): Viet Nam (DN) dog and cat vaccination campaign
http://promedmail.org/post/20250329.8723242
Rabies (12): Viet Nam (DN) pet dog bite, fatal
http://promedmail.org/post/20250215.8722174
Rabies (10): Viet Nam (DL) rabid dog bite
http://promedmail.org/post/20250212.8722083
Rabies (08): Viet Nam (GL)
http://promedmail.org/post/20250205.8721847
Rabies (03): Viet Nam (DL)
http://promedmail.org/post/20250114.8721335
2024
----
Rabies (104): Viet Nam (BV) dog meat restaurant owner, fatal
http://promedmail.org/post/20241223.8720864
Rabies (102): Viet Nam, national summary, Bangladesh (DH) dog bites,
human exp http://promedmail.org/post/20241214.8720661
Rabies (99): Viet Nam (NA) traditional medicine, fatal
http://promedmail.org/post/20241203.8720411
Rabies (95): Viet Nam (BV) cat scratch
http://promedmail.org/post/20241129.8720317
Rabies (88): Viet Nam (QM) schoolboy, fatal
http://promedmail.org/post/20241102.8719742
Rabies (76): Viet Nam (DN) pet dog bite
http://promedmail.org/post/20240908.8718644
Rabies (66): Viet Nam (HI) stray dog, spread
http://promedmail.org/post/20240815.8718176
Rabies (61): Viet Nam, national summary, increase
http://promedmail.org/post/20240801.8717879
Rabies (59): Viet Nam (GL) cat bite, fatal
http://promedmail.org/post/20240716.8717601
Rabies (57): Viet Nam (GL) long incubation period
http://promedmail.org/post/20240705.8717391
Rabies (54): Viet Nam (TQ, HO) increase, fatal
http://promedmail.org/post/20240620.8717125
Rabies (50): Viet Nam (HI) new directive on dog and cat meat trade
http://promedmail.org/post/20240611.8716978
Rabies (38): Viet Nam, increase
http://promedmail.org/post/20240426.8716166
Rabies (30): Viet Nam, financial implication
http://promedmail.org/post/20240329.8715680
Rabies (29): Viet Nam (HC) human, increase, urgent response
http://promedmail.org/post/20240324.8715592
Rabies (24): Viet Nam (PY) stray dog, human exp
http://promedmail.org/post/20240314.8715393
Rabies (18): Viet Nam (QN) human, dog
http://promedmail.org/post/20240305.8715187
Rabies (16): Viet Nam, increase
http://promedmail.org/post/20240302.8715146
Rabies (13): Viet Nam (CM) dog bite, restaurant owner
http://promedmail.org/post/20240216.8714883
Rabies (04): Viet Nam (PY) dog bite mistaken as scratch from collar,
fatal http://promedmail.org/post/20240113.8714212

Note: This content and the data herein may not be copied, reproduced,
scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................st/rd/st/may/jh
*##########################################################*
************************************************************
ProMED makes every effort to verify the reports that are posted, but the accuracy
and completeness of the information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
be held responsible for errors or omissions or held liable for any damages incurred
as a result of use or reliance upon posted or archived material.
************************************************************
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BOVINE SPONGIFORM ENCEPHALOPATHY - JAPAN: L-TYPE, TRANSMISSION TO
PRIMATES
**************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Tue 15 April 2025
Source: Emerging Infectious Diseases [edited]
https://wwwnc.cdc.gov/eid/article/31/5/24-1257_article


Citation: Imamura M, Hagiwara K, Tobiume M, et al.: Administration of
L-type bovine spongiform encephalopathy to macaques to evaluate
zoonotic potential. Emerg Infect Dis. May 2025 [early access]
--------------------------------------------------------------------------------
Abstract
--------
We administered L-type bovine spongiform encephalopathy prions to
macaques to determine their potential for transmission to humans.
After 75 months, no clinical symptoms appeared, and prions were
undetectable in any tissue by Western blot or immunohistochemistry.
Protein misfolding cyclic amplification, however, revealed prions in
the nerve and lymphoid tissues.

Worldwide emergence of classical bovine spongiform encephalopathy
(C-BSE) is associated with variant Creutzfeldt-Jakob disease in humans
(1). Two other naturally occurring BSE variants have been identified,
L-type (L-BSE) and H-type. Studies using transgenic mice expressing
human normal prion protein (PrPC) (2) and primates (3-5) have
demonstrated that L-BSE is more virulent than C-BSE. Although L-BSE is
orally transmissible to minks (6), cattle (7), and mouse lemurs (5),
transmissibility to cynomolgus macaques, a suitable model for
investigating human susceptibility to prions, remains unclear. We
orally inoculated cynomolgus macaques with L-BSE prions and explored
the presence of abnormal prion proteins (PrPSc) in tissues using
protein misfolding cyclic amplification (PMCA) along with Western blot
(WB) and immunohistochemistry (IHC). PMCA markedly accelerates prion
replication in vitro, and its products retain the biochemical
properties and transmissibility of seed prion strains (8).

The Study
---------
Two macaques orally inoculated with L-BSE prions remained asymptomatic
and healthy but were euthanized and autopsied at 75 months
postinoculation. WB showed no PrPSc accumulation in any tissue (Table
[for tables/figures/appendixes, see original URL - Mod.LL]), IHC
revealed no PrPSc accumulation, hematoxylin and eosin staining
revealed no spongiform changes in brain sections, and pathologic
examination revealed no abnormalities.

We next attempted to detect PrPSc using PMCA, performed as previously
described (9), with minor modifications (Appendix). First, we
evaluated the sensitivity of PMCA. Using serial amplification with
10-fold stepwise dilutions of prion-infected brain homogenates as
seeds, we amplified PrPSc-like proteinase K (PK)-resistant prion
protein (PrPres) from a 10^-7 dilution of 10% brain homogenate (BH)
obtained from macaque intracerebrally inoculated with L-BSE prions in
the 5th amplification round (Figure 1, panel A). This method also
enabled propagation of PrPres from a 10^-8 dilution of BH from
C-BSE-affected cattle during the 2nd amplification round (Figure 1,
panel B), suggesting PMCA's higher efficiency and sensitivity for
detecting C-BSE prions than macaque L-BSE prions.

We attempted to detect prions in the lymphoid and nervous systems,
among other tissues, of the 2 orally inoculated macaques using refined
PMCA (Figure 2; Appendix Figure, Table). In lymphoid tissue samples
prepared using sodium phosphotungstic acid precipitation (Appendix),
we amplified PrPres in the inguinal and mesenteric lymph nodes, ileum,
and tonsils of both macaques (Figure 2, panels A, B), as well as in
the spleen of 1 macaque (#18) and the thymus of the other (#19), in
the 2nd or 3rd amplification round of PMCA (Figure 2, panel C). We
observed no PrPres in the submandibular lymph nodes (Appendix Figure
1). Examining the central nervous system, we observed no PrPres
amplification in the cerebral cortex (Figure 2, panel C), whether
seeded with phosphate-buffered saline homogenates or phosphotungstic
acid precipitates. The spinal cord showed no PrPres amplification upon
ethanol precipitation. However, PrPres was amplified in the cervical
spinal cord of macaque #19 and in the thoracic spinal cord of both
macaques with phosphate-buffered saline homogenates (Figure 2, panel
D). We also confirmed PrPres in the median nerve of both macaques but
not in the sciatic nerve (Figure 2, panel E). We noted PrPres signals
in the submandibular glands of both animals. In contrast, we found no
PrPres amplification in any tissues from uninoculated control
macaques.

PrPres obtained from the orally inoculated macaques exhibited diverse
banding patterns distinct from those generated by PMCA using
L-BSE-affected cattle BH and L-BSE intracerebrally inoculated macaque
BH as seeds (Figure 3, panels A-C). Of note, the
lowest-molecular-weight PrPres variants from the ileum, spleen,
inguinal lymph nodes, thoracic cord, submaxillary gland, and
mesenteric lymph nodes of orally inoculated macaques exhibited
remarkable PK resistance similarity and banding patterns
indistinguishable from those of PrPres generated by PMCA with
C-BSE-affected cattle BH as a seed (Figure 3, panel C, Appendix
Figures 2 and 3). In contrast, the higher-molecular-weight PrPres
variants from the ileum of macaque #18 exhibited a unique banding
pattern distinct from those of L-BSE, C-BSE, and H-type BSE prions
(Figure 3, panel C). Banding patterns and PK resistance of PrPres
amplified from L-BSE-affected cattle BH and L-BSE intracerebrally
inoculated macaque BH were notably similar.

This PMCA method was initially designed for the high-sensitivity
detection of L-BSE intracerebrally inoculated macaque PrPSc but was
even more efficient and sensitive in detecting bovine C-BSE PrPSc
(Figure 1, panel B). Therefore, we believe that this method enabled
the detection of both C-BSE-like PrPSc and potentially novel PrPSc
variants.

Conclusion
----------
We noted no detectable evidence of PrPSc by WB or IHC in any tissues
of L-BSE orally inoculated macaques. Nevertheless, PMCA successfully
amplified PrPres from lymphatic and neural tissues. The PrPres
exhibited electrophoretic patterns distinct from those detected by
PMCA using L-BSE-affected cattle BH as the seed (Figure 3, panel C),
indicating that the PrPSc used as the template for PrPres
amplification in orally inoculated macaques did not originate from the
bovine L-BSE prions used as inoculum. Instead, PrPSc were newly
generated by the conversion of macaque PrPC by bovine L-BSE prions.
Our results provide strong evidence that L-BSE can infect macaques via
the oral route.

We found no evidence that PrPSc reached the brain in orally inoculated
macaques; however, the macaques euthanized 6 years postinoculation
might have been in the preclinical period. At low infection levels,
lymph nodes play a vital role in prion spread to the central nervous
system (11). Therefore, had the macaques been maintained for a longer
period, they might have developed prion disease. Retrospective
surveillance studies using the appendix and tonsil tissues suggested a
considerable number of humans harboring vCJD in a carrier state (12).
Thus, we cannot exclude that L-BSE orally inoculated macaques could
similarly remain in a potentially infectious state.

The brain of L-BSE intracerebrally inoculated macaque accumulated
prions with biochemical properties resembling bovine L-BSE prions
(Figure 3, panel C; Appendix Figure 2); however, we observed no PrPSc
accumulation in lymphoid tissues by WB or IHC (4). In contrast,
macaques orally inoculated with C-BSE prions showed PrPSc accumulation
in lymphoid tissues, including the spleen, tonsils, and mesenteric
lymph nodes by WB and IHC (13). In our study, L-BSE orally inoculated
macaques harbored C-BSE-like prions in their lymphoid and neural
tissues. Interspecies transmission of L-BSE prions to ovine PrP
transgenic mice can result in a shift toward C-BSE-like properties
(14,15). Our data suggest that L-BSE prions may alter biophysical and
biochemical properties, depending on interspecies transmission and
inoculation route, acquiring traits similar to those of C-BSE prions.
This transformation might result from structural changes in the L-BSE
prion to C-BSE-like prions and other lymphotropic prions within
lymphoid tissues or from the selective propagation of low-level
lymphotropic substrains within the L-BSE prion population.

The 1st limitation of our study is that the oral inoculation
experiment involved only 2 macaques and tissues collected at 6 years
postinoculation, before disease onset. Consequently, subsequent
progression of prion disease symptoms remains speculative. A larger
sample size and extended observation periods are required to
conclusively establish infection in orally inoculated macaques.
Furthermore, we performed no bioassays for PMCA-positive samples,
leaving the relationship between PMCA results and infectious titers
undefined. Considering that PrPres amplifications from tissues from
the orally inoculated macaque tissues required 2 rounds of PMCA, the
PrPSc levels in positive tissues might have been extremely low and
undetectable in the bioassay.

Previous studies have demonstrated that L-BSE can be orally
transmitted to cattle (7) and might have caused prion disease in
farm-raised minks (6), indicating that L-BSE could naturally affect
various animal species. Our findings suggest that L-BSE can also be
orally transmitted to macaques. Therefore, current control measures
aimed at preventing primary C-BSE in cattle and humans may also need
to consider the potential risk of spontaneous L-BSE transmission.

[References can be found at the original URL - Mod.LL]

--
Communicated by:
ProMED

[Transmission via the oral route of L-BSE prions produced evidence of
extra-cerebral infection and might have caused disease with a longer
period of incubation.

Previously, as referenced in the paper, the L strain (low molecular
weight) of BSE has been transmitted to primates via the intracerebral
route:

Ono F, Tase N, Kurosawa A, Hiyaoka A, et al.: Atypical L-type bovine
spongiform encephalopathy (L-BSE) transmission to cynomolgus macaques,
a non-human primate. Jpn J Infect Dis. 2011;64:81-84.
https://pubmed.ncbi.nlm.nih.gov/21266763/
--------------------------------------------------------------------------------
Abstract
--------
"A low molecular weight type of atypical bovine spongiform
encephalopathy (L-BSE) was transmitted to 2 cynomolgus macaques by
intracerebral inoculation of a brain homogenate of cattle with
atypical BSE detected in Japan. They developed neurological signs and
symptoms at 19 or 20 months post-inoculation and were euthanized 6
months after the onset of total paralysis. Both the incubation period
and duration of the disease were shorter than those for experimental
transmission of classical BSE (C-BSE) into macaques. Although the
clinical manifestations, such as tremor, myoclonic jerking, and
paralysis, were similar to those induced upon C-BSE transmission, no
premonitory symptoms, such as hyperekplexia and depression, were
evident. Most of the abnormal prion protein (PrPSc) was confined to
the tissues of the central nervous system, as determined by
immunohistochemistry and Western blotting. The PrPSc glycoform that
accumulated in the monkey brain showed a similar profile to that of
L-BSE and consistent with that in the cattle brain used as the
inoculant. PrPSc staining in the cerebral cortex showed a diffuse
synaptic pattern by immunohistochemistry, whereas it accumulated as
fine and coarse granules and/or small plaques in the cerebellar cortex
and brain stem. Severe spongiosis spread widely in the cerebral
cortex, whereas florid plaques, a hallmark of variant
Creutzfeldt-Jakob disease in humans, were observed in macaques
inoculated with C-BSE but not in those inoculated with L-BSE."

And to lemurs (a "lower" primate):

Mestre-Francés N, Nicot S, Rouland S, et al.: Oral transmission of
L-type bovine spongiform encephalopathy in primate model. Emerg Infect
Dis. 2012;18:142-145.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3310119/
--------------------------------------------------------------------------------
Abstract
--------
"We report transmission of atypical L-type bovine spongiform
encephalopathy to mouse lemurs after oral or intracerebral inoculation
with infected bovine brain tissue. After neurologic symptoms appeared,
transmissibility of the disease by both inoculation routes was
confirmed by detection of disease-associated prion protein in samples
of brain tissue."

Now it is reported in oral administration to a "higher" primate -
Mod.LL

ProMED map:
Japan: https://promedmail.org/promed-post?place=8723694,156]

[See Also:
2024
----
BSE, cattle - Ireland: atypical form
http://promedmail.org/post/20241005.8719170
2020
----
BSE, bovine - Ireland: (TY) atypical H-type, OIE
http://promedmail.org/post/20200526.7380366
2017
---
BSE, bovine - Ireland (02): (GY) atypical L-type, OIE20170124.4789081
BSE, bovine - Ireland: (GY) atypical
http://promedmail.org/post/20170119.4775368

Note: This content and the data herein may not be copied, reproduced,
scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................ll/may/jh
*##########################################################*
************************************************************
ProMED makes every effort to verify the reports that are posted, but the accuracy
and completeness of the information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
be held responsible for errors or omissions or held liable for any damages incurred
as a result of use or reliance upon posted or archived material.
************************************************************
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CHOLERA, DIARRHEA & DYSENTERY UPDATE (36): SOUTH SUDAN (WARRAP) FATAL
*********************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Tue 15 Apr 2025
Source: Radio Tamazuj [edited]
https://www.radiotamazuj.org/en/news/article/48-cholera-deaths-registered-in-warrap-state


The health authorities in Warrap State on Tuesday [15 Apr 2025] said
48 people died of cholera in Gogrial East and Gogrial West counties
since last month [March 2025].

John Akol, the Warrap State health surveillance officer, told Radio
Tamazuj Tuesday [15 Apr 2025] that the health situation is alarming in
the 2 counties of Gogrial East and Gogrial West and that they need a
quick humanitarian response as over 100 cholera patients are admitted,
with the number rising daily.

"As per yesterday, Monday [14 Apr 2025], the total of death cases
reached 48 with the recent 4 deaths recorded in Gogrial East County
and one in Kuajok Hospital. These statistics started from 17 Mar 2025
to today, Tuesday [15 Apr 2025]," he said. "I went to Gogrial East
County with the director general of health and other health staff to
sensitize people and to take patients to nearby health facilities."

"The challenges are not only getting worse but also alarming,
especially in the areas of Gogral Town to Alek Aguok, the area of
Malual Awein in Gogrial West County, and one cholera case was reported
in Twic County, but it was managed," Akol added. He said that areas in
Gogrial East County like Majook Akot, Pinydit, Lietnhom, Luony-Aker
and Mayom Chol have many patients admitted in health facilities.

Meanwhile, Donato Agiim, the director of the Gogrial East County
Health Department, confirmed that they have run out of medicines at
the health centers.

"Two cholera cases appeared on 1 Apr 2025 in the villages bordering
Gogrial West County, and it spread to the areas of Pinydit, Lietnhom,
and Mayom Chol, where 14 cases have been reported because it is highly
populated," he stated. "We have 12 death cases in Gogrial East County
as of yesterday [14 Apr 2025]. Today, Tuesday [15 Apr 2025] we have
recorded 2 death cases in Manieu Village, making the total 14."

Agiim urged elders, communities, NGOs, and the government to support
the situation.

"I appreciate the state ministry of health and MSF [Médecins Sans
Frontières] for being responsive and supplying the medicines that
just got finished," he said. "We call for support from our elders in
Juba, relatives, NGOs, and the government and urge them to quickly
intervene because the health conditions are deteriorating every day in
the county."

--
Communicated by:
ProMED
via
ProMED-EAFR

[The cholera outbreak in South Sudan is still ongoing as the Warrap
State in South Sudan is facing a severe cholera outbreak, with the
death toll reaching 48 and more than 1500 cases reported as of 15 Apr
2025. The hardest-hit areas include Gogrial West and Gogrial East
counties, where inadequate access to clean water and sanitation
facilities has exacerbated the spread of the disease. Health
authorities have established treatment centers and initiated
vaccination campaigns; however, challenges such as shortages of
intravenous fluids and vaccines persist. The situation is further
strained by the influx of displaced individuals from neighboring
regions, increasing the risk of transmission and overwhelming the
already fragile conditions there. - Mod.KJ

ProMED map:
South Sudan: https://promedmail.org/promed-post?place=8723693,8402]

[See Also:
Cholera, diarrhea & dysentery update (32): Ethiopia, ex South Sudan,
refugees, alert, NGO http://promedmail.org/post/20250406.8723435
Cholera, diarrhea & dysentery update (30): South Sudan (WR) fatal
http://promedmail.org/post/20250406.8723431
Cholera, diarrhea & dysentery update (29): South Sudan (WE) awareness
campaign http://promedmail.org/post/20250404.8723366
Cholera, diarrhea & dysentery update (24): South Sudan (JG) surge,
fatal http://promedmail.org/post/20250326.8723144
Cholera, diarrhea & dysentery update (21): South Sudan (JG) increasing
incidence, fatal http://promedmail.org/post/20250315.8722880
Cholera, diarrhea & dysentery update (15): South Sudan (EB) surge,
fatal http://promedmail.org/post/20250217.8722208
Cholera, diarrhea & dysentery update (11): South Sudan (EE, EB) surge,
fatal http://promedmail.org/post/20250204.8721845
Cholera, diarrhea & dysentery update (08): South Sudan, increasing
incidence, fatal, MOH http://promedmail.org/post/20250119.8721480
Cholera, diarrhea & dysentery update (06): South Sudan (UT) surge,
fatal http://promedmail.org/post/20250115.8721374
Cholera, diarrhea & dysentery update (03): South Sudan (JG) alarm,
fatal http://promedmail.org/post/20250110.8721270
Cholera, diarrhea & dysentery update (01): South Sudan, vaccine
http://promedmail.org/post/20250101.8721046
2024
----
Cholera, diarrhea & dysentery update (92): South Sudan, increasing
incidence, fatal, alert, NGO
http://promedmail.org/post/20241228.8720950
Cholera, diarrhea & dysentery update (87): South Sudan, increase,
fatal, Ministry of Information
http://promedmail.org/post/20241218.8720728
Cholera, diarrhea & dysentery update (84): South Sudan, surge, fatal
http://promedmail.org/post/20241212.8720612
Cholera, diarrhea & dysentery update (82): South Sudan (UN) increasing
incidence, alert, NGO http://promedmail.org/post/20241209.8720544
Cholera, diarrhea & dysentery update (79): South Sudan (UT) surge,
fatal http://promedmail.org/post/20241203.8720414
Cholera, diarrhea & dysentery update (67): South Sudan (UN) increasing
incidence, refugee camps, MOH
http://promedmail.org/post/20241102.8719743
and other items in the archives

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any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
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thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
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as a result of use or reliance upon posted or archived material.
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SURVEILLANCE (136): EGYPT, ESCHERICHIA COLI, ANTIMICROBIAL RESISTANCE,
CHICKENS, FARM WORKERS, ZOONOTIC RISKS, 2022-23
**********************************************************************************************************************
A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Sat 12 Apr 2025
Source: Scientific Reports [edited]
https://doi.org/10.1038/s41598-025-94177-w


Citation: Ahmed ZS, Hashad ME, Atef Y, et al. Public health threat of
antimicrobial resistance and virulence genes in _Escherichia coli_
from human-chicken transmission in Egypt. Sci Rep. 2025;15:12627.
--------------------------------------------------------------------------------

Abstract
--------
_Escherichia coli_ (_E. coli_) infections cause significant losses in
the poultry industry and pose zoonotic risks due to rising
antimicrobial resistance (AMR) and virulence factors. This study
investigates _E. coli_ prevalence, AMR, and virulence genes (papC,
vgrG1, iss) in Egyptian chickens and farm workers. A total of 35 dead
chickens from 14 flocks and 17 farm workers urine samples were
examined bacteriologically to investigate _E. coli_ presence followed
by biochemical identification. Antimicrobial susceptibility testing
was performed on 14 antibiotics using the disk diffusion method on
Mueller-Hinton agar, following Clinical and Laboratory Standards
Institute (CLSI) (2020) guidelines with extended-spectrum β-lactamase
(ESBL) activity evaluated via the Double Disc Synergy Test (DDST) with
ceftazidime, cefotaxime, and their clavulanate combinations following
CLSI protocols. virulence genes were detected through polymerase chain
reaction (PCR) and phylogenetic analysis of the vgrG1 gene evaluated
genetic relatedness between the chicken and human isolates. The study
analysed 52 samples, identifying _E. coli_ in 18 chicken organs
(51.4%) and 11 human urine samples (64.7%), with no significant
difference. various antimicrobic sensitivity profiles were identified
phenotypically among all isolates in which 29 isolates, 58.6% were
ESBL-producing, and 96.5% exhibited multidrug resistance (MDR), with
chicken isolates showing higher resistance overall. Virulence genes
were detected in similar proportions across the isolates highlighting
significant public health risks due to resistant and virulent _E.
coli_. This study emphasized the public health risks of
multidrug-resistant _E. coli_ with virulence genes, highlighting
potential zoonotic transmission and antibiotic use and food safety.

--
Communicated by:
ProMED-AMR

[The study above investigates "the prevalence of _E. coli_ in chickens
and farm workers in Egypt through analysing its antimicrobial
resistance and virulence gene profiles assessing the potential
zoonotic risks of severe, untreatable infections transmitted through
the food chain."

The following review article focuses on the mechanisms of underlying
antibiotic resistance in foodborne pathogens, necessary preventive
measures, and the challenges associated:
https://doi.org/10.1007/s10068-024-01767-x. - Mod.SF

ProMED map:
Egypt: https://promedmail.org/promed-post?place=8723677,55]

[See Also:
2024
----
Food safety (18): Ethiopia, E. coli O157:H7, chicken meat,
slaughterhouses http://promedmail.org/post/20240308.8715254
2022
----
Surveillance (105): Egypt, E. coli, chicken meat, human, PAI markers,
AMR, ARGs http://promedmail.org/post/20220906.8705433
2021
----
Surveillance (54): Nigeria, MDR E. coli in humans, chickens, poultry
environment http://promedmail.org/post/20210516.8364819

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scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................sb/sf/rd/gmm
*##########################################################*
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ProMED makes every effort to verify the reports that are posted, but the accuracy
and completeness of the information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
be held responsible for errors or omissions or held liable for any damages incurred
as a result of use or reliance upon posted or archived material.
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RESEARCH & INNOVATION (70): MYCOBACTERIUM ABSCESSUS, IDENTIFICATION OF
NOVEL INHIBITORS, IN SILICO
**************************************************************************************************
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ProMED-mail is a program of the
International Society for Infectious Diseases
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Date: Mon 14 Apr 2025
Source: Scientific Reports [edited]
https://doi.org/10.1038/s41598-025-97513-2


Citation: Abbas M, Alanzi AR, Sahibzada KI, et al. Identification of
novel inhibitors targeting _Mycobacterium abscessus_ InhA through
virtual screening, docking, and molecular dynamic simulations. Sci
Rep. 2025;15:12795.
--------------------------------------------------------------------------------

Abstract
--------
Effective treatment options for _Mycobacterium abscessus_ (MAB)
pulmonary diseases (PD) are limited due to inadequate drug efficacy,
rising drug resistance, and genetic mutations. New compounds are
urgently needed to treat MAB-PD. The MAB Enoyl Acyl Carrier Protein
(ACP) Reductase InhA (MAB-InhA) plays a crucial role in mycobacterial
cell death and mycolic acid (MA) biosynthesis, making it a potential
drug target for new lead identification. The purpose of this study was
to identify new potential inhibitors of MAB-InhA in MAB-PD by using
structure-based virtual screening, docking, molecular mechanics-based
generalized born surface area (MM/GBSA), Absorption, Distribution,
Metabolism, and Excretion (ADME), and molecular dynamics (MD)
simulations. The Enamine antibacterial library containing 32 000
compounds was prepared using phase to create the database. The
identified hits were analysed using the phase score, which combines
vector alignments, volume score, and root-mean-square deviation (RMSD)
site matching. Based on the docking results and obtained scores of the
Glide docking tool, we identified Z2378320480 (Z1), Z1188959831 (Z2),
Z5292493137 (Z3), Z2437620504 (Z4), Z2440336150 (Z5), and Z3390516726
(Z6) ligand molecules as potential hits. MD simulations (200 ns) were
conducted on the best-docked poses of potential hits Z4, Z5, and Z6 to
analyse stability and interaction at the MAB-InhA active site. The MD
simulation trajectories, including RMSD, root mean square fluctuation
(RMSF), ligand-protein interaction, 2D principal component analysis
(PCA), and molecular dynamics secondary structure analysis (SSE), were
analysed to interpret the stability.

--
Communicated by:
ProMED-AMR

[The study concluded: "This research involved a comprehensive
in-silico approach to identify potential inhibitors for _Mycobacterium
abscessus_ (MAB), focusing on the Enoyl Acyl Carrier Protein Reductase
InhA (MAB-InhA), which is essential for the biosynthesis of mycolic
acid and contributes to mycobacterial cell death. Initially, a
structure-based pharmacophore model was established to screen the
compounds, and subsequently, the selected hits were docked to the InhA
protein to identify the plausible binding poses. The hits showed
strong interactions with the InhA protein. Further, the dynamic
behavior of the hits with protein was assessed by measuring the RMSD
of alpha atoms of protein and ligands and residual fluctuations, which
showed stable confirmations. The interaction contacts showed strong
binding between protein and ligands, while the PCA indicated a high
static number of hydrogen bonds. Lastly, the MM/GBSA indicated the
strong binding of the hits with the InhA protein. Thus, these
compounds can be used as lead compounds to study their biophysical
activity against the InhA protein."

Elsewhere, findings from a study by Alcaraz et al collectively
indicate that "InhAMAB is an attractive target to be exploited for
future chemotherapeutic developments against this difficult-to-treat
mycobacterium and highlight the potential of NITD-916 derivatives for
further evaluation in preclinical settings"
(https://doi.org/10.1021/acsinfecdis.2c00314). - Mod.TTM]

[See Also:
2024
----
Antimicrobial therapy (04): China, M. abscessus & M. massiliense, AB
suscept., pulmonary infect.
http://promedmail.org/post/20240508.8716375
2023
----
Antimicrobial therapy (01): China, MABC, TZD Most synergistic with BDQ
http://promedmail.org/post/20230115.8707798

Note: This content and the data herein may not be copied, reproduced,
scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................sb/gmm/ttm/rd/gmm
*##########################################################*
************************************************************
ProMED makes every effort to verify the reports that are posted, but the accuracy
and completeness of the information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
be held responsible for errors or omissions or held liable for any damages incurred
as a result of use or reliance upon posted or archived material.
************************************************************
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ANTIMICROBIAL THERAPY (04): ORAL GEPOTIDACIN, UNCOMPLICATED UROGENITAL
GONORRHEA, 2019-2023
*******************************************************************************************
A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Mon 14 Apr 2025
Source: Medical Xpress [edited]
https://medicalxpress.com/news/2025-04-antibiotic-resistant-gonorrhea-pill.html


Gepotidacin, an antibiotic currently used to treat urinary tract
infections, could be a new treatment to treat gonorrhea, protecting
against the threat of treatment-resistant gonorrhea and improving
patient treatment experiences, suggests the results of a phase 3
randomized control trial published in The Lancet and presented at the
ESCMID (https://www.escmid.org/congress-events/escmid-global/)
conference.

Gonorrhea is a common sexually transmitted infection that -- if not
treated promptly -- can result in serious complications, especially
for women, in whom it can lead to increased risks of ectopic pregnancy
and infertility. Cases of drug-resistant gonorrhea have increased
rapidly in recent years, reducing the options for treatment. There is
an urgent need for new treatments for gonorrhea with no new
antibiotics since the 1990s.

This trial of 622 patients compared a potential new treatment for
uncomplicated gonorrhea (gepotidacin, an oral pill) with the current
standard treatment (ceftriaxone, an injection; and azithromycin, a
pill) and found the new pill to be as effective as the current
standard treatment at treating the infection. Crucially, the new pill
was effective against strains of the gonorrhea bacteria that are
resistant to existing antibiotics. There were no treatment-related
severe or serious side effects for those treated with either
medication.

Authors say the new treatment could be an important tool in combating
the rise of gonorrhea strains that are becoming resistant to the
standard treatment. Additionally, treatment as a pill alone without
the need for an injection would likely improve patient experiences and
reduce health care resources.

However, the authors also caution that this study looked primarily at
urogenital gonorrhea and that most of the study group were white men.
Therefore, more research is needed to see the impact of the new
treatment on gonorrhea of the rectum and throat, and in women,
adolescents, and diverse ethnicities.

--
Communicated by:
ProMED-AMR

[The citation and abstract of the article referenced above follow:
Ross JDC, Wilson J, Workowski KA, et al. Oral gepotidacin for the
treatment of uncomplicated urogenital gonorrhoea (EAGLE-1): a phase 3
randomised, open-label, non-inferiority, multicentre study. Lancet.
2025. https://doi.org/10.1016/S0140-6736(25)00628-2.

Summary
------
"Background: Gepotidacin, a first-in-class, bactericidal,
triazaacenaphthylene antibacterial that inhibits bacterial DNA
replication, was shown to be efficacious and well tolerated in the
treatment of uncomplicated urinary tract infections. We evaluated the
efficacy and safety of gepotidacin for the treatment of uncomplicated
urogenital gonorrhoea.

"Methods: EAGLE-1 (NCT04010539) was a phase 3, open-label,
sponsor-blinded, multicentre, non-inferiority study evaluating oral
gepotidacin (two 3000 mg doses administered 10-12 h apart) compared
with 500 mg intramuscular ceftriaxone plus 1 g oral azithromycin for
the treatment of gonorrhoea. Eligible participants were aged 12 years
and older, had a bodyweight over 45 kg, and had suspected
uncomplicated urogenital gonorrhoea (including mucopurulent
discharge), a positive laboratory test for _Neisseria gonorrhoeae_, or
both. Participants were randomly allocated in a 1:1 ratio to each
treatment group, stratified by sex (original urogenital anatomy at
birth) and sexual orientation (men who have sex with men [MSM], men
who have sex with women [MSW], and female) in combination, and age
group (age <18 years, ≥18 to 65 years, or >65 years). The primary
efficacy endpoint was microbiological success, defined as
culture-confirmed bacterial eradication of _N. gonorrhoeae_ from the
urogenital body site at test-of-cure (days 4-8). The non-inferiority
margin was prespecified at -10%. The primary outcome was assessed in
the microbiological intention-to-treat (micro-ITT) population, all
participants randomly allocated to a study treatment who received at
least one dose of their study treatment and had confirmed
ceftriaxone-susceptible _N. gonorrhoeae_ isolated from the baseline
culture of their urogenital specimen. The safety population comprised
all participants who received one or more doses of any study
treatment.

"Findings: Between October 21, 2019 and October 10, 2023, 628
participants were randomly allocated (314 allocated to each treatment
group). Overall, 39 (6%) of 628 participants discontinued the study
prematurely (20 in the gepotidacin group and 19 in the ceftriaxone
plus azithromycin group), with the primary reason being lost to
follow-up. The micro-ITT population included 406 participants (202 in
the gepotidacin group and 204 in the ceftriaxone plus azithromycin
group). Most participants in the micro-ITT population were male (372
[92%] vs 34 [8%] female), and there was a higher percentage of
participants who were MSM (290 [71%]) compared with participants who
were MSW (82 [20%]). Participants were predominantly White (299 [74%])
or Black or African American (61 [15%]), with 70 (17%) identifying as
Hispanic or Latino. Results of the primary analysis of microbiological
response at test-of-cure demonstrated microbiological success rates of
92.6% (187 of 202 [95% CI 88.0 to 95.8]) in the gepotidacin group and
91.2% (186 of 204 [86.4 to 94.7]) in the ceftriaxone plus azithromycin
group (adjusted treatment difference -0.1% [95% CI -5.6 to 5.5]).
Gepotidacin was non-inferior to ceftriaxone plus azithromycin. No
bacterial persistence of urogenital N gonorrhoeae was observed at
test-of-cure for either group. The gepotidacin group had higher rates
of adverse events and drug-related adverse events, mainly due to
gastrointestinal adverse events, and almost all were mild or moderate.
No treatment-related severe or serious adverse events occurred in
either group.

"Interpretation: Gepotidacin demonstrated non-inferiority to
ceftriaxone plus azithromycin for urogenital _N. gonorrhoeae_, with no
new safety concerns, offering a novel oral treatment option for
uncomplicated urogenital gonorrhoea." - Mod.TTM]

[See Also:
Research & innovation (57): quinolone N-oxide, targets N. gonorrhoeae,
toxin-antitoxin system http://promedmail.org/post/20250404.8723378
N. gonorrhoeae: doxyPEP, tetracycline resistance, review, 2021-24
http://promedmail.org/post/20250320.8723000
Surveillance (57): Europe, drug-resistant gonorrhea, emerging threat,
STIs increasing, 2023 http://promedmail.org/post/20250213.8722049
2024
----
N. gonorrhoeae (08): Asia-Pacific region, ceftriaxone resistant,
2015-22 http://promedmail.org/post/20240807.8717993
N. gonorrhoeae (06): global trends of AMR rates, review
http://promedmail.org/post/20240709.8717453
N. gonorrhoeae (05): Cambodia, increase in XDR, emerging resistant
clones, 2023 http://promedmail.org/post/20240623.8717189
N. gonorrhoeae (04): Cambodia, high prevalence of
ceftriaxone-resistant & XDR
http://promedmail.org/post/20240407.8715820
N. gonorrhoeae (03): China, ceftriaxone-resistant gonorrhea
http://promedmail.org/post/20240330.8715689
N. gonorrhoeae (01): China, efficacy of different antibiotics
http://promedmail.org/post/20240121.8714367
2023
----
N. gonorrhoeae (08): China, bacitracin/ceftriaxone synergism
http://promedmail.org/post/20231122.8713270
N. gonorrhoeae (07): key aspects, ceftriaxone use, uncomplicated
infections http://promedmail.org/post/20231107.8713017
N. gonorrhoeae (04): China, evaluation of antimicrobial
susceptibility, 2007-21 http://promedmail.org/post/20230316.8708969
2022
----
N. gonorrhoeae (04): WHO African & Western Pacific regions, MDR
http://promedmail.org/post/20220829.8705292
N. gonorrhoeae (03): systems to monitor AMR, global systematic review,
2012-20 http://promedmail.org/post/20220508.8703124
2021
----
Antimicrobial therapy (07): China, CRO resistant N. gonorrhoeae, mod
res to AZM http://promedmail.org/post/20211020.8699159
Antimicrobial therapy (06): China, N. gonorrhoeae, in vitro activity,
ertapenem http://promedmail.org/post/20211014.8699014
Antimicrobial development (01): cannabidiol, Neisseria gonorrhoeae
http://promedmail.org/post/20210123.8129379

Note: This content and the data herein may not be copied, reproduced,
scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................ttm/rd/gmm
*##########################################################*
************************************************************
ProMED makes every effort to verify the reports that are posted, but the accuracy
and completeness of the information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
be held responsible for errors or omissions or held liable for any damages incurred
as a result of use or reliance upon posted or archived material.
************************************************************
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ANTIMICROBIAL STEWARDSHIP (92): DIVERSITY AND REPRESENTATION
IMPORTANCE, SCIENCE, ANTIMICROBIAL RESISTANCE, COMMENT
*******************************************************************************************************************
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http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Fri 11 Apr 2025
Source: npj Antimicrobials and Resistance [edited]
https://doi.org/10.1038/s44259-025-00101-7


Citation: Perez-Sepulveda BM, Cunningham-Oakes E, Waters EV.
Importance of diversity and representation in science: benefits
towards strengthening our response to global challenges. npj
Antimicrob Resist. 2025;3:26.
--------------------------------------------------------------------------------

Abstract
--------
Diversity is a mechanism that pathogens use to adapt and survive new
challenges, like the introduction of antimicrobials in modern
medicine. With antimicrobial resistance increasing and antibiotic
development slowing, this arms race is tipping in favour of pathogens.
This paper highlights how fostering diversity and representation in
science -- through outreach, collaboration, and inclusive practices --
can mirror nature's adaptability, drive innovation, and deliver
relevant solutions to tackle such global challenges.

--
Communicated by:
ProMED-AMR

[The comment above highlights the need for greater diversity and
representation in science to better tackle global challenges like
antimicrobial resistance.

The following are 2 insightful articles: the first explores social
bias and discrimination in healthcare
(https://doi.org/10.1016/j.bjae.2021.11.011), and the second
examines barriers to inclusivity and the benefits of diversity in
research (https://doi.org/10.1186/s13104-025-07096-4). - Mod.SF]

[See Also:
Note: This content and the data herein may not be copied, reproduced,
scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................sb/sf/rd/gmm
*##########################################################*
************************************************************
ProMED makes every effort to verify the reports that are posted, but the accuracy
and completeness of the information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
be held responsible for errors or omissions or held liable for any damages incurred
as a result of use or reliance upon posted or archived material.
************************************************************
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ANTIMICROBIAL ENVIRONMENTAL CONTAMINATION (26): POLAR AQUATIC
ECOSYSTEMS, EMERGING ANTIMICROBIAL RESISTANCE, REVIEW
*******************************************************************************************************************
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ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Thu 10 Apr 2025
Source: Antibiotics [edited]
https://doi.org/10.3390/antibiotics14040394


Citation: Bisaccia M, Berini F, Marinelli F, Binda E. Emerging trends
in antimicrobial resistance in polar aquatic ecosystems. Antibiotics.
2025;14(4):394.
--------------------------------------------------------------------------------

Abstract
--------
The global spread of antimicrobial resistance (AMR) threatens to
plummet society back to the pre-antibiotic era through a resurgence of
common everyday infections' morbidity. Thus, studies investigating
antibiotic resistance genes (ARGs) and antibiotic-resistant bacteria
(ARB) in urban, agricultural, and clinical settings, as well as in
extreme environments, have become increasingly relevant in the One
Health perspective. Since the Antarctic and Arctic regions are
considered amongst the few remaining pristine environments on Earth,
the characterization of their native resistome appears to be of the
utmost importance to understand whether and how it is evolving as a
result of anthropogenic activities and climate change. In the present
review, we report on the phenotypic (e.g., disk diffusion test) and
genotypic (e.g., PCR, metagenomics) approaches used to study AMR in
the aquatic environment of polar regions, as water represents one of
AMR main dissemination routes in nature. Their advantages and limits
are described, and the emerging trends resulting from the analysis of
ARB and ARGs diffusion in polar waters discussed. The resistome
detected in these extreme environments appears to be mostly comparable
to those from more anthropized areas, with the predominance of
tetracycline, β-lactam, and sulfonamide resistance (and related
ARGs). Indeed, AMR is, in all cases, more consistently highlighted in
sites impacted by human and wildlife activities with respect to more
pristine ones. Surprisingly, aminoglycoside and fluroquinolone
determinants seem to have an even higher incidence in the Antarctic
and Arctic aquatic environment compared to that from other areas of
the world, corroborating the need for a more thorough AMR surveillance
in these regions.

--
Communicated by:
ProMED-AMR

[The following paragraph is from the Conclusion section of the study
above:
"The analysis of AMR in these remote regions, which still show low
anthropogenic influence, may help to clarify the evolution of this
phenomenon, and, at the same time, lead to a better understanding of
the origins of ARGs beyond clinical conditions. Indeed, the presence
of ARGs in these areas of the world cannot be solely attributed to
human influence, as AMR is firstly a natural defense mechanism of
bacteria, and ARGs have also been identified in samples predating the
antibiotic era. However, AMR was found more dominant in polar areas
where human and wildlife activities have been consistently reported
(e.g., tourism, research stations, old sewerage systems,
microplastics, animal migration) compared to more pristine ones. In
this regard, the aquatic environment plays a particularly important
role as it can collect ARGs released via WWTPs [wastewater treatment
systems], and then act as a reservoir and/or actively participate in
their dissemination. This phenomenon seems especially relevant in the
polar regions where wastewater disposal practices are antiquated."

"Until recently, it was believed that the anthropogenic influence in
the polar regions was negligible. However, the development of tourism,
the growing number of inhabitants as well as the number of researchers
in the Arctic and Antarctic may carry the risk of introducing alien
microbes associated with humans with unknown consequences.
Microplastics are also potential vectors for chemical contamination,
and recent discoveries show that they can also be a carrier of
antibiotic-resistant bacteria"
(https://doi.org/10.2147/IDR.S369023).

Antimicrobial resistance (AMR) in polar regions, once considered
pristine environments, has emerged as a critical indicator of global
anthropogenic influence. While AMR occurs naturally as a bacterial
defense mechanism, human activities are accelerating its spread even
in remote areas like the Arctic and Antarctica. Addressing AMR in
polar ecosystems is not just a regional concern but a vital component
of global public health strategies. - Mod.TTM]

[See Also:
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.................................................ttm/rd/gmm
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YELLOW FEVER - AFRICA (02): UGANDA (KALIRO) MASS VACCINATION
************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Mon 14 Apr 2025
Source: Nile Post [edited]
https://nilepost.co.ug/health/253511/kaliro-targets-50000-in-yellow-fever-vaccination-drive


Health authorities in Kaliro District are targeting to immunise over
50 000 people in the ongoing nationwide yellow fever vaccination
campaign that began on 10 Apr 2025 and is expected to run until 16 Apr
2025. To meet this ambitious goal, youth mobilisers armed with
megaphones have been deployed to traverse villages, urging residents
to visit nearby health centres and receive the vaccine.

Eric Kiduba, the district health educator, reassured residents of the
vaccine's safety and effectiveness, citing approvals from both the
Ministry of Health and the World Health Organisation. He dismissed
misinformation circulating in some communities that the vaccine causes
impotence.

"Some people had been moving around trying to lie to the public that
the vaccines cause impotency in men and women, which is not true,"
Kiduba said during the official campaign launch at Bumanya Health
Centre IV. He revealed that over 300 health personnel had been
deployed across the district to ensure timely and effective delivery
of services throughout the campaign period.

John Bosco Mubitto, the Resident District Commissioner, warned leaders
of religious sects against discouraging their followers from taking
the vaccine. He said such acts amounted to sabotage of a government
programme and offenders would face arrest and prosecution.

"Security personnel have been put on high alert to monitor any leader
found guilty of discouraging participation in the vaccination
exercise," Mubitto said. He also urged religious leaders to use their
pulpits to mobilise their congregations for the campaign, noting that
spiritual well-being must go hand in hand with physical health.

Lydia Akoth, the Central Supervisor for Advocacy, Communication, and
Social Mobilisation in the Yellow Fever Reactive Campaign, told the
Nile Post that the campaign was prompted by a confirmed case of yellow
fever in neighbouring Kibuku District.

"The campaign is scheduled for 7 days, from 10 to 16 Apr 2025,
targeting people aged between 1 and 60 years," Akoth said. "We
encourage everyone who has not received the vaccine to either go to a
health facility or visit the vaccination post in their community." She
added that yellow fever has no cure and urged continued access to the
vaccine at health centres even after the campaign ends.

District Chairperson Elijah Kagoda called on political leaders at all
levels to support the mobilisation effort. He noted that residents
intending to travel abroad should take advantage of the campaign since
yellow fever vaccination is mandatory for international travel.

Dr Ivan Munigwa, the in-charge of Bumanya Health Centre IV, confirmed
that the facility had enough personnel to handle the expected
numbers.

As Kaliro steps up mobilisation efforts, officials are banking on a
mix of community engagement, youth participation and local leadership
to make the yellow fever vaccination campaign a success.

[Byline: Teven Kibumba]

--
Communicated by:
ProMED
via
ProMED-EAFR

[In response to a recent outbreak, Uganda has launched a mass yellow
fever vaccination campaign in the eastern region. Kaliro District is
one of the districts in the eastern part of Uganda and is targeting to
vaccinate 50 000 individuals. Yellow fever is a viral disease
transmitted by infected mosquitoes, which can cause severe illness and
death if left untreated. Health officials emphasize the importance of
this campaign in preventing further spread of the disease, especially
given the high-risk nature of the region. - Mod.KJ

ProMED map:
Uganda: https://promedmail.org/promed-post?place=8723695,97]

[See Also:
2024
----
Yellow fever - Africa (05): Uganda (KS)
http://promedmail.org/post/20241218.8720731
Yellow fever - Africa (03): Uganda, vaccination hesitancy
http://promedmail.org/post/20240528.8716737
Yellow fever - Africa (02): WHO
http://promedmail.org/post/20240321.8715531
Yellow fever - Africa: Uganda vaccination
http://promedmail.org/post/20240313.8715362
2023
----
Yellow fever - Africa (05): update
http://promedmail.org/post/20231108.8713046
Yellow fever - Africa (01)
http://promedmail.org/post/20230105.8707616
2022
----
Yellow fever - Africa (05): Uganda
http://promedmail.org/post/20220402.8702353
Yellow fever - Uganda: suspected
http://promedmail.org/post/20220720.8704517
Yellow fever - Africa (05): Uganda
http://promedmail.org/post/20220402.8702353
2020
----
Yellow fever - Africa (06): Uganda, WHO
http://promedmail.org/post/20200222.7015224
Yellow fever - Africa (03): Uganda (BL, MY)
http://promedmail.org/post/20200124.6913409
2019
----
Yellow fever - Africa (09): Uganda (OK,MQ)
http://promedmail.org/post/20190530.6492199

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scraped, redistributed, reused, or repurposed alone or together with
any other data without the express consent of ISID or as permitted
under ISID's Terms and Conditions and Privacy Policy.]
.................................................kj/rd/jh/may/jh
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************************************************************
ProMED makes every effort to verify the reports that are posted, but the accuracy
and completeness of the information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in using information
posted or archived by ProMED. ISID and its associated service providers shall not
be held responsible for errors or omissions or held liable for any damages incurred
as a result of use or reliance upon posted or archived material.
************************************************************
Donate to ProMED. Details available at: https://isid.networkforgood.com/projects/79924-invest-in-the-mission.
************************************************************
Visit ProMED's website at https://www.promedmail.org/.
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