The global dengue burden has increased substantially over the past 5 years, and in 2024 so far, more than 7.6 million cases have been reported, which includes 16,000 severe infections and more than 3,000 deaths, the World Health Organization (WHO) said today.

The America's region has seen the biggest impact, where cases this year have already topped 7 million—well above its record 4.3 million cases in 2023. So far this year, 90 countries globally have reported active dengue transmission, but the WHO warned that many endemic countries don't have strong surveillance and reporting systems.

Dashboard tracks global hot spots

To strengthen global tracking, the WHO has launched a new dashboard. So far, it has data from 103 countries. All regions except Europe have reported locally acquired cases this year. 

In Southeast Asia, Indonesia has reported a surge, and cases in Bangladesh, Nepal, and Thailand are trending higher than the same period in 2023. In the Western Pacific, Malaysia and Vietnam are most affected. In Africa, 13 countries have ongoing transmission, and in the Eastern Mediterranean region, dengue outbreaks continue to be reported in fragile, conflict-ridden areas.

Several factors are responsible for the dengue surge, including shifts in circulating serotypes and climate change. The WHO said urbanization and population movements are also playing a role. "At least five countries (Bangladesh, India, Myanmar, Nepal and Thailand) are currently grappling with the initiation of monsoon season, which creates suitable conditions for Aedes mosquito breeding and survival," the agency noted.

Bavarian Nordic and the Coalition for Epidemic Preparedness Innovations (CEPI) yesterday announced a partnership to advance the development of Bavarian Nordic's mpox vaccine for children in Africa.

CEPI has awarded $6.5 million to support phase 2 clinical trials of the MVA-BN nonreplicating vaccine in children ages 2 to 12 as compared to adults. The study will enroll 460 people in endemic regions who don't have a history of mpox illness or vaccination. Participants will receive two doses of the vaccine.

The study is expected to launch this year in one or more African countries.

Children hit especially hard

CEPI said the new partnership dovetails with a plan by African countries to coordinate efforts in to battle the virus, which was announced in April.

Richard Hatchett, MD, CEPI's chief executive officer, said children suffer disproportionately from mpox, a concerning and neglected disease that has spread rapidly in recent years. 

Multiple countries in East and Central Africa are battling mpox outbreaks, and so far this year the Democratic Republic of the Congo has reported more than 6,500 cases, 345 of them fatal, with children accounting for most infections and deaths.

Centers for Disease Control and Prevention (CDC) investigators report that about one in five US children had parents reporting vaccine hesitancy (VH) from 2019 to 2022, and VH increased after the authorization of the COVID-19 vaccine for children aged 5 to 11 years and declined for children aged 6 months to 4 years. 

The findings are published in Vaccine, and come as the US Food and Drug Administration's VRBPAC (Vaccines and Related Biological Products Advisory Committee) prepares to meet next week to pick COVID and influenza strains to include in updated vaccines.

The study was based on responses to the 2019 through 2022 National Immunization Surveys.

Overall, VH levels in the United States remained fairly consistent, at 19%, from quarter 2 in 2019 to quarter 3 in 2022. But at various points during the pandemic, certain demographic groups saw increases and decreases in VH. 

Hesitancy up in parents living below poverty line

Parents of children ages 5 to 11 had an average quarterly increase in parental VH from the first quarter of 2021 to quarter 3 of 2022. Parents living below the poverty level also had increasing VH throughout the study period. 

Official US approval of COVID-19 vaccines for children had varying effects on VH, depending on child age: For children ages 6 months to 4 years, VH dropped from 21.6% to 19.4%, a decrease of 2.2 percentage points (95% confidence interval, −3.9 to −0.6).

But VH increased among parents of children 5 to 11; after the authorization, 21.0% had a parent that reported VH, compared with 19.8% before. 

Due to concerns about COVID-19 vaccine safety and increased misinformation about vaccines during the COVID-19 pandemic, parental acceptance and confidence in routine childhood vaccines may have been altered.

"Parents of children aged 5–11 had a sharp increase in VH from Q1 2021 to Q3 2022. Similarly, those living below poverty also saw a gradual increase in VH throughout the study period. Due to concerns about COVID-19 vaccine safety and increased misinformation about vaccines during the COVID-19 pandemic, parental acceptance and confidence in routine childhood vaccines may have been altered," the authors concluded.