More global mpox spread as clade 1b confirmed in Thailand, the 2nd case outside Africa

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Mpox viruses
CDC / Cynthia Goldsmith

The mpox case in a European traveler from Africa to Thailand that was reported yesterday has now been confirmed as caused by clade 1b, the deadly strain that has spread widely in the Democratic Republic of the Congo and neighboring countries.

It is the second recent clade 1b case reported outside of Africa, after Sweden confirmed a case a week ago. The strain is distinct from clade 2, which caused a large global outbreak in 2022, the first outside of Africa.

Man traveled from Africa, with stop in Mideast

Somsak Thepsuthin, Thailand minister of public health, confirmed the mpox test results and assigned Dr. Thongchai Keerati Hatthayakorn, director general of the Department of Disease Control, to take the lead on implementing strict measures for disease prevention and control. Hatthayakorn said test results were confirmed by scientists with the Department of Medical Sciences laboratory.

The patient is a 66-year-old European man who had arrived in Thailand last week from an unspecified African country in which mpox spreading, Reuters reported. Thailand's health ministry said his travels to Thailand included a stop in an unnamed Middle Eastern nation.

Thai officials are monitoring 43 close contacts of the patient, but at this time no one else has been found to be ill. The Department of Disease Control will monitor the man's symptoms until 21 days have passed from symptom onset.

The country is screening international travelers as they enter Thailand.

FDA green-lights season's updated mRNA COVID vaccines

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Approved vaccines
solarseven / iStock

Today, amid rising US COVID-19 cases, the Food and Drug Administration (FDA) announced its approval of the updated 2024-25 monovalent (single-strain) mRNA COVID-19 vaccines for people aged 12 and older and granted emergency use authorization for those aged 6 months to 11 years. 

The updated vaccines are called 2024-2025 Pfizer/BioNTech COVID-19 Vaccine and Moderna COVID-19 Vaccine (2024-2025 Formula) for those aged 6 months through 11 years and Comirnaty (made by Pfizer/BioNTech) and Spikevax (by Moderna) for those 12 years and older.

Updated vaccine dose strongly encouraged 

The vaccine, intended as a single dose for those 5 years and older previously vaccinated at least 2 months earlier, is adapted to the currently circulating Omicron KP.2 strain of the JN.1 SARS-CoV-2 lineage to better protect against hospitalization and death. 

Vaccination continues to be the cornerstone of COVID-19 prevention.

Peter Marks, MD, PhD

Unvaccinated children aged 6 months to 4 years are eligible to receive three doses of the Pfizer vaccine or two doses of the Moderna vaccine. Vaccinated children in this age-group can receive one or two doses of the Moderna or Pfizer vaccine, depending on the timing and number of previous doses received.

People with weakened immune systems and those who haven't completed a three-dose series with previous formulations may be eligible for more than one dose.

"Vaccination continues to be the cornerstone of COVID-19 prevention," Peter Marks, MD, PhD, director of the FDA's Center for Biologics Evaluation and Research, said in the news release. "Given waning immunity of the population from previous exposure to the virus and from prior vaccination, we strongly encourage those who are eligible to consider receiving an updated COVID-19 vaccine to provide better protection against currently circulating variants."

Barring the emergence of other, much more infectious variants, the FDA said the composition of COVID-19 vaccines will likely need to be revisited each year, as occurs with seasonal flu vaccines.

Eating a Mediterranean diet may offer some protection against COVID-19

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Mediterranean diet
Fiona Moore / Flickr cc

Closely following the Mediterranean Diet may help protect against COVID-19, but its benefits against symptoms or severity are unclear, Indonesian researchers report in PLOS One.

The systematic review, conducted in August 2023, identified six observational studies from five countries published from 2020 to 2023 that were based on food-frequency questionnaires. They had a total sample size of 55,489 patients.

The Mediterranean Diet, which mainly consists of plant-derived foods such as fruits, vegetables, legumes, nuts, and olive oil, is a rich source of antioxidants and is tied to a lower risk of infection and faster viral clearance, the authors said.

"Mediterranean Diet has been reported to possess immunomodulatory and anti-inflammatory properties," they wrote. "These properties are closely associated with the immunopathogenesis of COVID-19."

No link found with symptoms, severity

Four of the six studies identified a statistically significant correlation between closer adherence to the Mediterranean Diet and lower COVID-19 infection risk, while one study found a nonsignificant link. 

One study reported a significant tie between better adherence to the diet and reduced COVID-19 symptoms, but three showed a nonsignificant association. While one study found that highly adherent participants were less likely to develop severe COVID-19, two others were inconclusive.

Overall, the analyses suggest higher Mediterranean diet adherence significantly reduced odds of COVID-19, with non-significant results against COVID-19 symptoms and severity.

One study concluded that dietary adherence significantly reduced the likelihood of all reported COVID-19 symptoms, with odds ratios (ORs) varying from 0.06 to 0.34 for each symptom. But three found a nonsignificant association (ORs, 0.84 to 0.992), and one analysis concluded that the link was nonsignificant.

One report found that participants with top-tertile dietary adherence were less likely to develop severe COVID-19 (OR, 0.23) than those in the bottom tertile. Two studies reported a nonsignificant link (ORs, 0.22 to 0.89).

Of two studies that analyzed the effects of individual dietary components against disease severity, one found no significant link, while another reported that consumption of more vegetables, fruits, legumes, nuts, whole grains, and fish were protective.

"Overall, the analyses suggest higher Mediterranean diet adherence significantly reduced odds of COVID-19, with non-significant results against COVID-19 symptoms and severity," the researchers wrote.

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