CDC issues Ebola alert for clinicians, officials announce airport screening
The US Centers for Disease Control and Prevention (CDC) urged clinicians to consider Ebola and other viral hemorrhagic fever illness in the workup of people who have symptoms of the diseases and to immediately take a travel history with an eye toward identifying those who have been in parts of Uganda affected by the recent Ebola Sudan outbreak.
In a Health Alert Network (HAN) notice, the CDC said no suspected, probable, or confirmed cases have been reported in the United States. It said Uganda's outbreak is limited to five districts in the central part of the country, with none confirmed from Kampala or the travel hub city of Entebbe. The CDC added that there are no direct flights to the United States from Uganda, but travelers from or passing through affected parts of Uganda can enter the United States on flights from other countries.
Early consideration of Ebola is important for providing prompt patient care and preventing virus spread, the CDC said. On Twitter today, Rochelle Walensky, MD, MPH, said CDC staff are on the ground in Uganda supporting the outbreak response.
The CDC said the outbreak is occurring in the same location as Uganda's last outbreak involving the Sudan strain in 2012. So far, 44 lab-confirmed cases have been reported. The number of deaths in confirmed patients is 10. There are 18 probable cases, based on earlier reports, and 20 probable deaths.
Also, the US government today announced that all US-bound passengers who have been in Uganda during the past 21 days will need to be routed through one of five airports for enhanced screening. The locations are Newark, Atlanta, Chicago, or Washington, DC. In a statement, the US Embassy in Uganda said government it was taking the step out of an abundance of caution and that the domestic risk is low. In the early days of the COVID pandemic, the government took similar steps to funnel people from high-risk country to certain airports for enhanced screening.
Oct 6 CDC HAN notice
Oct 6 Walensky tweet
Oct 6 US Embassy statement
Up to 88% of sub-Saharan African adolescents COVID-19 vaccine-hesitant
A 2021 survey published yesterday in PLOS Global Public Health finds COVID-19 vaccine hesitancy of up to 88% among adolescents in some sub-Saharan countries, mostly because of concerns about vaccine safety and effectiveness.
A team led by George Mason University researchers fielded the survey via computer-assisted phone interviewing in Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania from July to December 2021. The survey was a follow-up to one conducted with the same respondents in July to November 2020.
Respondents included about 300 adolescents aged 10 to 19 years from randomly selected households in a rural and urban area in each country but Ghana, which included only a rural area, for a total of 2,662.
The rate of COVID-19 vaccine hesitancy, defined as declining or being undecided about vaccination, was 14% in rural Kersa, Ethiopia; 23% in rural Ibadan, Nigeria; 31% in rural Nouna, Burkina Faso; 32% in urban Ouagadougou, Burkina Faso; 37% in urban Addis Ababa, Ethiopia; 48% in rural Kintampo, Ghana; 65% in urban Lagos, Nigeria; 76% in urban Dar es Salaam, Tanzania; and 88% in rural Dodoma, Tanzania.
Despite the proven safety and efficacy of COVID-19 vaccines, the top reasons for vaccine hesitancy were concerns about vaccine safety (adjusted prevalence ratio [aPR], 3.52) and effectiveness (aPR, 3.46). The people most likely to influence vaccine willingness were healthcare workers, parents or family members, and schoolteachers.
The study authors noted that while adolescents are less likely than adults to develop severe COVID-19, they can still spread the virus, and some do become severely ill and develop complications. In sub-Saharan Africa, adolescents aged 10 to 19 years make up 23% of the population, making vaccination of this group all the more crucial.
"Therefore, getting COVID-19 vaccines into the arms of adolescents is crucial for Africa to achieve the World Health Organization's target of 70% COVID-19 vaccination coverage by mid-2022," they wrote. "Further, adolescents may serve as agents of advocacy that encourage their family members and friends to get vaccinated. COVID-19 vaccination campaigns among sub-Saharan African adolescents should address their concerns and misconceptions about vaccine safety and effectiveness."
Oct 5 PLOS Glob Public Health study
New Mexico reports its first avian flu outbreak in a poultry flock
The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) today announced that highly pathogenic avian influenza in the current outbreak has been identified for the first time in New Mexico poultry, raising the number of affected states to 41. The virus had not been reported earlier in New Mexico's wild birds.
In a statement, it said the virus was found in a backyard flock in Bernalillo County, which surrounds Albuquerque. According to the APHIS outbreak update page, the flock has 40 birds.
In related developments, nine states reported more outbreaks in poultry, mostly involving backyard birds. However, three reported outbreaks in commercial flocks, including California (layers, ducks, turkeys) and Nebraska (gamebirds).
States reporting more outbreaks in backyard birds include Alaska (Matanuska Susitna County), Connecticut (New Haven County), Montana (Glacier County), Pennsylvania (Berks, Monroe, and Westmoreland counties), Nebraska (Box Butte County), Michigan (Tuscola County), Ohio (Portage County), and Utah (Cache County).
So far, outbreaks involving the Eurasian strain have led to the loss of more than 47 million birds across 41 states.
In related developments, APHIS reported 96 more H5N1 detections in wild birds, bringing the total to 2,746. The reports were from several states, mostly involving waterfowl. Several of the detections involved hunter-harvested birds from Oklahoma.
Oct 6 USDA APHIS statement
USDA APHIS poultry avian influenza updates
USDA APHIS wild bird avian influenza updates
