Zimbabwe reported its first mpox cases yesterday, a child and an adult from two separate towns who had traveled recently, according to an African media report.

At a briefing yesterday, the country’s health minister, Douglas Mombeshora, MD, said the cases were detected in Harare and Mberengwa, according to NewZimbabwe, an online newspaper. The patients include an 11-year-old child and a man who had traveled to South Africa and Tanzania, respectively.

The cases push the number of African countries that have reported mpox cases to 17. The report didn’t say what mpox clade or clades were involved. Africa is battling a complex mpox outbreak involving different clades. 

The patients are isolating at home and are in stable condition. 

On August 14, the World Health Organization declared a public health emergency of international concern due to a surge in mpox activity in Africa, with some of the circulation involving a novel clade of the virus. The region continues to report about 3,000 cases a week, along with a slow but steady stream of newly affected countries.

The Sabin Vaccine Institute has delivered 1,000 more doses of its investigational Marburg virus vaccine to Rwanda, following an initial shipment of 700 doses. In an update yesterday, Rwanda’s health ministry said 669 vaccine doses have already been administered.

The immunization campaign is part of a phase 2 open-label trial sponsored by the Rwanda Biomedical Centre. The single-dose vaccine is being given according to a clinical trial that been reviewed by Rwandan ethics and regulatory authorities, Sabin said in a statement.

Amy Finan, Sabin’s chief executive officer, said every moment counts in an outbreak and that seamless collaboration with the Rwandan government was key to accelerating the process. “On our side, we moved quickly by leveraging our experience with other outbreaks and having vaccine doses and supporting documents ready, thanks to a strong partnership with ReiThera,” she said. ReiThera is a vaccine manufacturer based in Italy.

Recoveries outpace cases and deaths

In updates over the past 3 days, Rwanda’s health ministry reported one new case and another death, raising the outbreak total to 62 infections, 15 of them fatal. Twenty six people have now recovered from their illnesses.

Rwanda declared the Marburg outbreak, the country’s first, on September 27. Most cases are linked to two hospital clusters in Kigali.

The Global Preparedness Monitoring Board (GPMB), which tracks and monitors global pandemic preparedness, launched its annual report today.

"Outbreaks of avian influenza H5N1 in cattle and its spillover to humans, and a new strain of mpox in Central Africa are the most recent signals of concern," the report begins. "The high likelihood that they will spread further should be a wake-up call for the global community."

The report outlines 15 key drivers of pandemic risk, categorized as social, technological, environmental, economic, and political. Despite an interconnectedness among the scientific community, the report says distrust in governments at home and abroad threatens global health.

Renewing trust in public health and science is of the utmost importance before a future pandemic, the report said. Also emphasized is that the next pandemic will likely not be similar to COVIV-19.

There is a risk that focusing solely on lessons learned from the COVID-19 pandemic could result in preparing for the last battle rather than the next one.

"There is a risk that focusing solely on lessons learned from the COVID-19 pandemic could result in preparing for the last battle rather than the next one," the report says. 

Threat of tropical diseases

Overall, the report said countries will need to adopt a One Health approach as the animal-to-human interface will be the likely source of the next pandemic. 

“Places that have a dense human-animal-environment interface and are undergoing rapid change are ripe to become new hotspots of emergence of novel diseases with epidemic potential," the authors wrote. "Soon temperate countries may see outbreaks of diseases that are usually seen in tropical areas, such as epidemics transmitted by mosquitoes, including dengue or yellow fever."

The report also noted the ongoing outbreak of mpox in the Democratic Republic of the Congo and the polio detection in Gaza to highlight how political instability can have major public health consequences. 

Researchers from Brigham and Women’s Hospital published new research in Science Translational Medicine showing that natural killer (NK) cells in some children may make them more prone to severe cases of respiratory syncytial virus (RSV). 

The findings come from the results of airway swabs and blood samples taken from 47 critically ill children hospitalized with RSV and bronchiolitis and compared them to samples from healthy controls. 

The authors found airway NK cells were increased in intubated children, those with severe hypoxemia, and those with prolonged duration of mechanical ventilation. Blood NK cells, however, were lower in sick kids compared to controls. 

Similar pattern seen in COVID patients 

An NK cell is one of the "first responders" to viral infection, the authors explained, but too many NK cells in the airway can trigger lung inflammation. Conversely, too few NK cells in . peripheral blood samples suggest ill children had altered activating receptor expression, and their NK cells did not perform their immunological function of killing diseased cells.

The research group also found similar patterns in literature on NK cells and COVID-19 patients. 

Our findings fit with data from some studies in COVID-19, which reported that patients with the most severe symptoms also had increased NK cells in their airways.

"Our findings fit with data from some studies in COVID-19, which reported that patients with the most severe symptoms also had increased NK cells in their airways, " said study author Melody G. Duvall, MD, PhD, in a press release from Brigham and Women’s Hospital. "Together with previous studies, our data link NK cells with serious viral illness, suggesting that these cellular pathways merit additional investigation. "

The US Department of Health and Human Services (HHS) is funding a new project that seeks to harness the power of the microbiome to fight bacterial infections and antimicrobial resistance (AMR).

The Pro/Prebiotic Regulation for Optimized Treatment and Eradication of Clinical Threats (PROTECT) project, funded through the Advanced Research Project Agency for Health (ARPAH), aims to develop a platform to identify and develop treatments based on beneficial bacteria and nutrients that can outcompete and suppress harmful bacteria and prevent infections before they take hold, spread, or become resistant.