Gavi, the Vaccine Alliance, and Bavarian Nordic today announced an advanced purchase agreement to secure 500,000 doses of Jynneos mpox vaccine for African countries, which will be delivered this year.

In a statement, Gavi said it will buy the vaccine with a new response fund created in June, which is designed to free up cash to rapidly buy vaccines in health emergencies. Africa is facing a complex and quickly escalating mpox outbreak, with a novel clade 1b clade spreading in parts of the Democratic Republic of the Congo and a handful of neighboring countries. The endemic clade 1 strain and the global clade 2 virus are fueling cases in several countries. 

Today's announcement follows the World Health Organization's recent prequalification of Bavarian Nordic's mpox vaccine.

Sania Nishtar, MD, PhD, Gavi's chief executive officer, thanked the response fund donors and said, "We are committed to working with affected governments and our partners to turn these vaccines into vaccinations as quickly and effectively as possible and, over time, to build a global vaccine stockpile if sufficient funding is secured for Gavi's work through 2030." 

The US Centers for Disease Control and Prevention (CDC) yesterday reported 22 more imported Oropouche virus cases, raising the national total to 74 in five states. So far, 1 case of the neuroinvasive form of the disease has been reported.

Most of the illnesses are in Florida, which has reported 70 cases. The Florida Department of Health (Florida Health) said in its latest weekly arbovirus report that all of the state's cases involve travel to Cuba, one of the newly affected countries in the Americas experiencing an outbreak. Florida has reported cases in 11 counties, but most have been in Miami-Dade County.

Oropouche virus isn't a nationally notifiable condition, but in the middle of August the CDC issued an alert about the rise in imported cases and encouraged jurisdictions to voluntarily report cases to its ArboNET surveillance system.

The virus, most commonly transmitted by biting midges, has recently spread beyond endemic areas in South America, with outbreaks in Brazil and Cuba leading to travel-associated cases. Another alarming aspect of the outbreak are sporadic reports of severe fetal outcomes, including deaths and congenital abnormalities. Initial symptoms are similar to dengue, Zika, and chikungunya infections and include acute fever onset, chills, headache, and myalgia. 

Analysis of Campylobacter isolates in East Africa found that multidrug resistance (MDR) was significantly higher in poultry than in people, researchers reported yesterday in Emerging Infectious Diseases.

For the study, an international team of researchers collected and explored the population structure of 178 Campylobacter isolates from Kenya and Tanzania, including 81 from patients with diarrhea and 97 from poultry samples. Africa has the world's highest incidence of campylobacteriosis, and previous studies have found a high prevalence of antimicrobial resistance (AMR) in Campylobacter isolated from humans and poultry in Africa. The researchers conducted antimicrobial susceptibility testing and used whole genome sequencing (WGS) to explore the differences and similarities between the human and poultry isolates.

MDR Campylobacter identified in 41% of poultry isolates

AMR was detected in 75.3% and MDR (defined as resistance to three or more antibiotic classes) in 2.5% of the 81 patient isolates. In the 97 poultry isolates, the estimated AMR prevalence was 85.7%, but MDR prevalence was 40.9%. Five poultry isolates were resistant to five of the six antibiotics tested. WGS identified 57 Campylobacter sequence types (STs) from patients and 29 STs in poultry samples, including many previously unreported STs. Common STs included Campylobacter jejuni ST353 (4 human and 10 poultry isolates from 6 farms), ST2122 (10 poultry isolates from 4 farms), and ST1932 (9 poultry isolates from 5 farms) and Campylobacter coli ST8043 (11 poultry isolates from 5 farms).

The researchers say the study, which is one of the largest using WGS to characterize Campylobacter in East Africa, provides several valuable insights.

"The high prevalence of MDR and the identification of previously undescribed STs highlights the need for ongoing investigation of enteric pathogens, such as Campylobacter spp., in low-resource settings," they wrote. "That effort would require genomic tools to be embedded within formal and transparent surveillance systems, in addition to a greater understanding of the role of antimicrobial use and biosecurity measures as drivers of the emergence of resistance in human health and food production and improved governance of antimicrobial use in both sectors."