Vaccine News

With eight fatalities and numerous infections reported, the Republic of Rwanda's Marburg virus disease (MVD) outbreak has raised global alarms as the origin of these infections has yet to be determined.

Since September 29, 2024, Rwandan health authorities have reported 26 confirmed cases in seven of the country's 30 districts.

Additionally, 161 people who came into contact with the reported cases have been identified and are being monitored. Staff at two hospitals in Kigali, home to about 1.7 million residents, are also being evaluated.

In support of the ongoing efforts, the World Health Organization (WHO) is mobilizing expertise, outbreak response tools, and emergency medical supplies to reinforce the control measures rolled out to curb the virus.

The WHO says illness caused by Marburg infections begins abruptly, with high fever, severe headache, and severe malaise. Many patients develop severe hemorrhagic symptoms within seven days. The virus is transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces, and materials.

"We're rapidly setting all the critical outbreak response aspects in motion to support Rwanda halt the spread of this virus swiftly and effectively," said Dr. Matshidiso Moeti, WHO Regional Director for Africa, in a press release on September 28, 2024.

WHO is also coordinating efforts to reinforce collaborative cross-border measures for readiness and response in countries neighboring Rwanda to ensure timely detection and control of the virus to avert further spread.

As of September 30, 2024, the WHO has not issued a travel alert regarding this Marburg outbreak. However, Rwanda is included in the clade I mpox outbreak in Africa.

Since 1967, when MVD was first recognized in a German lab spillover event, countries such as DR Congo, Equatorial Guinea, Cameroon, Germany, Ghana, Guinea, Kenya, Serbia, South Africa, Tanzania, Yugoslavia, Uganda, and Rwanda have confirmed cases.

The WHO is coordinating a consortium of experts to promote the preclinical and clinical development of vaccines and therapeutics against MVD.

In March 2022, the WHO R&D Blueprint team defined the Strategic Agenda for Filovirus Research and Monitoring to establish research priorities for developing vaccines targeting filovirus diseases during the next decade.

While no product has been approved yet, one innovative Marburg vaccine candidate has progressed in 2024.

Public Health Vaccines, LLC launched its Phase 1 clinical trial (NCT06265012) in March 2024 to evaluate the safety and immunogenicity of its single-dose PHV01 (rVSV∆G-MARV-GP [Angola]) vaccine. The PHV01 vaccine is leveraging the proven recombinant vesicular stomatitis virus vector platform initially developed by the Public Health Agency of Canada.

The U.S. Biomedical Advanced Research and Development Authority (BARDA) has funded this vaccine research. If PHV01's development continues to succeed, BARDA has the option to provide up to $72 million in funding to continue development through Phase 2 clinical testing.

Update: As of September 30, 2024, Rwanda reported its 9th Marburg-related fatality.

The U.K. Foreign, Commonwealth & Development Office (FCDO) recently issued a travel alert advising against all but essential travel to parts of Peru.

As of September 29, 2024, the FCDO posted new information regarding the Oropouche virus disease (OROV) and Yellow Fever outbreaks this year.

There is also a risk of infection when visiting Peru with Malaria and Zika virus through mosquito bites.

Over 2 million people visit Peru annually, visiting places such as Machu Picchu.

To alert international travelers to these health risks, the U.S. Centers for Disease Control and Prevention (CDC) reissued a Level 1 Practice Usual Precautions, Travel Health Advisory on September 25, 2024. The CDC advisory states that Oropouche fever is spread through the bites of infected midges (flies) and Culicoides paraenesis mosquitoes.

Seperately, a Level 2 Travel Health Notice has been issued for Oropouche outbreaks in Cuba.

While there are no specific medications or vaccines to prevent OROV, the risk of infection can be minimized by following bite avoidance measures when visiting areas with the infection. Treatment for Oropouche virus disease is supportive.

The FCDO and the U.S. CDC recommend that visitors to Yellow Fever endemic areas such as Peru and Brazil be vaccinated.

In the U.S., Sanofi Pasteur's YF-VAX® vaccine is offered at certified travel clinics and pharmacies.

The Minnesota Department of Health today announced it is investigating a human rabies death in a person who had exposure to a bat in western Minnesota in July 2024. This is Minnesota’s fourth case of human rabies since 2000.

This new rabies case is an essential reminder that bats can spread the virus and that the public should avoid contact with them. Bats with rabies are found in all U.S. states except Hawaii.

Recently, a resident of Brantford-Brant, Ontario, Canada, was also confirmed with bat-bite transmitted rabies.

And in Texas, numerous bats have been confirmed with rabies in 2024.

Globally, rabies continues to claim about 59,000 lives annually, with Africa shouldering over 60% of these fatalities. Dogs, not bats, cause most rabies infections worldwide.

According to the U.S. CDC, rabies treatment (vaccines) has proven to be nearly 100% effective at preventing the disease after exposure, but it must be started before symptoms of rabies appear.

Left untreated, rabies is almost always fatal.

The CDC establishes recommendations for international travelers by evaluating the risk of rabies exposure and access to high-quality postexposure prophylaxis (PEP, including rabies immunoglobulin and vaccine) in each destination country.

Bavarian Nordic's RabAvert® vaccine is offered at many travel vaccine clinics and pharmacies in 2024.

The World Health Organization (WHO) today announced its influenza vaccine strain recommendations for the Southern Hemisphere's 2025 flu season. The WHO makes these recommendations twice yearly, once for each hemisphere.

The WHO recommends manufacturers produce trivalent (three-strain) vaccines for the Southern Hemisphere's upcoming flu season.

"The periodic update of viruses contained in influenza vaccines is necessary for the vaccines to be effective due to the constantly evolving nature of influenza viruses, including those circulating and infecting humans," the WHO wrote on September 27, 2024.

From February through August 2024, the WHO reported influenza activity was detected in all transmission zones. Overall, detections were higher compared to the same reporting period in 2023, primarily due to higher detections in the Americas.

According to Google Maps, the Southern Hemisphere is the half of the Earth below the equator. It includes Antarctica, Australia, and parts of Africa, Asia, and South America.

As of September 2024, the flu season in the United States has been reported as mild, and millions of flu shots have already been delivered to local health clinics and pharmacies.

According to local media Taarifa, the Rwanda Ministry of Health reported its first Marburg virus disease outbreak today.

As of September 27, 2024, Rwanda's communique stated a 'few' Marburg cases are being investigated. The Ministry added that the situation is closely monitored and that further updates will be provided regularly.

Like Ebolavirus, Marburg virus disease is highly virulent and causes hemorrhagic fever, with a fatality ratio exceeding 80%.

Marburg cases were first recognized in 1967 in West Germany and Serbia. 

As of September 2024, Angola, DR Congo, Equatorial Guinea,  Cameroon, Germany, Ghana, Guinea, Kenya, Serbia, South Africa, Tanzania, Uganda, and Rwanda have previously confirmed Marburg cases. 

The World Health Organization published the Marburg virus vaccine development landscape on February 13, 2023. While various vaccine candidates conduct clinical research, no approved vaccines prevent Marburg virus infections.

Unlike Marburg, approved vaccines that prevent and treat Zaire Ebola disease are available in 2024.

Bavarian Nordic A/S announced an agreement with UNICEF to supply 500,000 MVA-BN® mpox vaccines for African countries impacted by the mpox clade 1 outbreak. 

Under the agreement, UNICEF will procure 1 million doses of the vaccine, including the 500,000 doses recently committed by Gavi. Bavarian Nordics intends to make all doses available for supply before the end of 2024.

In the agreement, UNICEF has negotiated a price of up to $65 per vaccine dose, the lowest price in the market.

UNICEF says, 'The mpox virus does not discriminate. Anyone exposed to the virus can become infected, and children, immunocompromised individuals, and pregnant women are at risk of severe disease.'

Paul Chaplin, President & CEO of Bavarian Nordic, said in a press release on September 26, 2024, “Combined with donations by various governments, institutions, and Bavarian Nordic, this agreement has helped to secure more than 2.5 million doses of MVA-BN, thus fulfilling the short-term requirement as expressed by the Africa CDC."

MVA-BN or Modified Vaccinia Ankara-Bavarian Nordic is the only non-replicating mpox - smallpox vaccine approved in the U.S., Switzerland, Singapore, Mexico (marketed as JYNNEOS®), Canada (IMVAMUNE®), and the EU/EAA and United Kingdom (IMVANEX®). 

In the U.S., JYNNEOS vaccines are commercially offered at health clinics and pharmacies.

When vacationing in Costa Rica this winter, it's best to avoid mountainous areas where mosquitos are transmitting diseases to people.

The Costa Rica Health Department's Boletín Epidemiológico N°36 was posted on September 20, 2024. It confirms that mosquito-transmitted Chikungunya, Dengue, Malaria, or Zika virus infections have occurred this year and vary by location. 

For example, 30 chikungunya infections have been reported this year, led by the Central Norte, Pacifico Central, and Central Sur regions. Last year, 82 chikungunya cases were confirmed in Costa Rica.

As of 2024, Canada, the United Kingdom, the World Health Organization (PAHO/WHO), and the U.S. CDC have issued travel advisories and vaccine recommendations for Costa Rica.

The CDC recommends checking the recommended vaccine list and seeing a healthcare provider at least a month before  visiting Costa Rica. In particular, the CDC now endorses Valneva SE's IXCHIQ® monovalent, single-dose vaccine when visiting Chikungunya endemic areas.

Additionally, the U.S. Embassy in San Jose publishes health topics and recommends visitors enroll in NEWSMART to make it easier to contact you during an emergency while in Costa Rica.