Low-level mpox transmission continues across the world, though reported cases continue to decline, underestimating of the true burden of the disease, the World Health Organization (WHO) said in its latest situation report, which covers illness reported in April.

The WHO received reports of 528 new cases in April, down 21.1% from March. Regions reporting the most cases were the Americas, followed by Africa and Europe. Most of Africa's cases were reported in the Democratic Republic of the Congo (DRC), which is experiencing an ongoing outbreak due to a novel clade 1 virus.

Overall risk is moderate in countries and neighboring countries where mpox has historically circulated and is also moderate for people in the highest-risk groups, including men who have sex with men and sex workers, the WHO said. However, the risk is high for the general population in the DRC.

Editor's Note: The BMJ announced on June 13, 2024, that it is investigating the quality of the research used in this study and will place an expression of concern on the paper. Since its publication, the study has been criticized for implying a direct causal link between COVID-19 vaccination and mortality, though the study assessed only trends in excess mortality over time, not causes.

See also: June 17, 2024, commentary by Lone Simonsen, PhD, and Rasmus Pedersen, PhD, on why they believe the study should be retracted.

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New COVID-19 excess death rate estimates from 47 countries show that rates remained high for 3 consecutive pandemic years.

"Excess mortality has remained high in the Western World for three consecutive years, despite the implementation of COVID-19 containment measures and COVID-19 vaccines. This is unprecedented and raises serious concerns," the authors wrote. 

This is unprecedented and raises serious concerns.

The study, published yesterday in BMJ Public Health, assessed people who died from any cause above and beyond what would normally be expected from January 2020 to December 2022 in 47 countries in Europe, North America, Australia and New Zealand. Death rates were compared to historical death data in each country from 2015 until 2019, and matched by both week and month. 

Death rates 14% higher in 2021

In total, the number of excess deaths in the 47 countries was 3,098,456 from January 1, 2020, until December 31, 2022. In 2020, 1,033,122 excess deaths were recorded, and that number rose in 2021 to 1,256, 942 excess deaths despite containment measures and widespread use of vaccine in Western countries. 

That was 14% more deaths than expected. 

"In 2022, the year in which most containment measures were lifted and COVID-19 vaccines were continued, preliminary available data counts 808,392 excess deaths," the authors wrote. 

Forty-one countries reported excess deaths in 2020, 42 in 2021, and 43 in 2022. The only country to not report excess deaths from 2020 through 2022 was Greenland.  

"Government leaders and policymakers need to thoroughly investigate underlying causes of persistent excess mortality and evaluate their health crisis policies," the authors concluded. 

Despite no evidence that the measles, mumps, and rubella (MMR) vaccine causes autism, a quarter of US adults still think it does, and the false belief is fueling rising measles cases amid falling vaccination rates, finds a survey by the University of Pennsylvania's Annenberg Public Policy Center (APPC).

"The persistent false belief that the MMR vaccine causes autism continues to be problematic, especially in light of the recent increase in measles cases," APPC Director Kathleen Hall Jamieson, PhD, said in a center press release. "Our studies on vaccination consistently show that the belief that the MMR vaccine causes autism is associated not simply with reluctance to take the measles vaccine but with vaccine hesitancy in general."

In April 2024, APPC scientists surveyed more than 1,500 adults about measles transmission, symptoms, and vaccination recommendations for pregnant women.

1 in 10 knew vaccine not recommended in pregnancy

In total, 24% of adults said that they don't believe the MMR vaccine doesn't cause autism, and another 3% weren't sure. 

Nearly 6 in 10 participants understood that measles spreads through coughing, sneezing, and touching their face after contact with contaminated surfaces, while more than 1 in 5 (22%) incorrectly said it can be sexually contracted. Only 12% of respondents correctly indicated that an infected person can spread the measles virus for 4 days before a rash appears—12% thought it was 1 week, and 55% weren't sure. 

Only 1 in 10 knew that pregnant women shouldn't receive the measles vaccine because it contains a weakened live form of the virus and therefore may pose a risk to the fetus. 

Fewer than 4 in 10 panelists correctly indicated that measles is a risk factor for premature birth and low birth weight, and only 1 in 10 knew that pregnant women shouldn't receive the measles vaccine because it contains a weakened live form of the virus and therefore may pose a risk to the fetus. 

The Centers for Disease Control and Prevention (CDC) recommends two doses of MMR vaccine for children, with the first dose at 12 to 15 months and the second dose at ages 4 to 6 years. It should also be given to women a month or more before they plan to become pregnant, if they weren't vaccinated as a child.

Japanese drugmaker Shionogi yesterday announced plans to expand its infectious disease and antibiotic research and development (R&D) operations in the United States.

During a panel discussion at the BIO International Convention, Shionogi officials said they plan to establish the company's first US discovery laboratory. The lab will expand the existing R&D facility for San Diego–based Qpex Biopharma, which was acquired by Shionogi in 2023 and has an existing contract with the Biomedical Advanced Research and Development Authority to develop the investigational beta-lactamase inhibitor xeruborbactam.

"We need to address known health threats, including antibiotic-resistant bacteria, as well as prepare for rapidly emerging threats that could lead to future pandemics," Qpex President and CEO Michael Dudley, PharmD, said in a Shionogi press release. "This is a landmark opportunity to build upon the excellent track record of our organizations in discovering innovative antimicrobial drugs and bringing them to patients."

Shionogi officials say the company's expanded presence in the United States will advance its partnership network with antibiotic researchers in the public and private sector. Shionogi is one of the few large pharmaceutical companies that remains active in antibiotic R&D.

"In the race between antibiotic drug development and increasing resistance, the pathogens are winning," said John Keller, PhD, senior executive officer and senior vice president of the R&D supervisory unit at Shionogi. "If new antibiotics are not discovered and developed, we cannot overcome this public health crisis and are at risk of jeopardizing global health security."