The upcoming meeting of the Advisory Committee on Immunization Practices (ACIP) has been postponed.

The committee, which advises the Centers for Disease Control and Prevention (CDC) on US vaccine policy, had been scheduled to meet February 26 to 28. But the meeting has been postponed "to accommodate public comment in advance of the meeting," according to a statement from a Department of Health and Human Services (HHS) spokesman.

"The ACIP workgroups met as scheduled this month and will present at the upcoming ACIP meeting," HHS communications director Andrew Nixon said in an email. But Nixon did not respond to a question about when the meeting will be rescheduled.

The postponement was first reported by Stat.

Concerns about ACIP's future

According to a draft agenda of the meeting, ACIP advisers were scheduled to discuss and vote on the use of newly approved meningococcal and chikungunya vaccines, as well as new recommendations on flu and RSV vaccines. 

The group had also planned to review data on human papillomavirus, mpox, and COVID-19 vaccines. The CDC bases its vaccine recommendations and adult and child immunization schedules on ACIP recommendations. 

The postponing of the ACIP meeting comes amid concerns that newly confirmed HHS Secretary Robert F. Kennedy Jr., a longtime vaccine critic, could make changes to the group, or get rid of it altogether. Kennedy has suggested in the past that ACIP members have conflicts of interest. Politico reports that Kennedy is planning to remove some members of outside committees that advise the federal government on health issues, and that ACIP is among the committees likely to be targeted.

Prior to Kennedy's confirmation, Sen. Bill Cassidy (R-LA), a physician and key member of the committee that advanced Kennedy's nomination to the full Senate, said Kennedy had made several assurances on vaccines to win Cassidy's vote. Among them was a promise to uphold ACIP recommendations.

Testing in two unexplained illness clusters in Equateur Province in the Democratic Republic of the Congo (DRC) has ruled out Ebola and Marburg viruses, and further testing and investigations are under way, the World Health Organization (WHO) African regional office said in its latest weekly outbreak and health emergencies update.

The newest cluster is centered in Bromate Villega in Basankusu Health Zone and was reported to provincial officials on February 9. Initially, 32 cases were reported, including 20 deaths in the community. As of February 15, a total of 419 suspected cases and 45 deaths have been reported. Half of the deaths occurred within 2 days of symptom onset. Symptoms include fever, headache, body ache, neck stiffness, cough, and gastrointestinal symptoms. 

Specimens from 13 patients were tested at the National Institute of Biomedical Research (INRB) in Kinshasa, all negative for Ebola and Marburg viruses. "Differential diagnosis under investigation include malaria, viral haemorrhagic fever, food or water poisoning, typhoid fever, and meningitis," the WHO said. Both Ebola and Marburg viruses produce hemorrhagic (bleeding-related) fevers.

Children in initial cluster exposed to bats

The earlier unexplained outbreak was initially reported on January 21 and is centered in Boloko Village in Bolomba Health District. Three community deaths in children were noted earlier in the month, with reports that they had consumed bat carcasses and experienced hemorrhagic symptoms before they died. Other similar illnesses have been reported in children, with 12 cases—including 8 deaths—in Boloko Village and 2 cases and 1 death in nearby Danda Village. Testing at the provincial and INRB labs were negative for Ebola and Marburg viruses.

"The exact circumstances of exposure have not yet been established in both outbreaks. Additionally, no epidemiological links have been established between the cases in the two affected health zones," the WHO said.

Equateur Province is in the northwestern part of the DRC and has been affected by Ebola outbreaks in the past.

The number of new cholera cases is down worldwide to start the year, despite a new outbreak in Angola, according to the latest update from the World Health Organization (WHO).

As of January 26, a total of 34,799 new cholera cases were reported in 19 countries across three WHO regions, marking a 27% decrease from December 2024. The African Region reported the most cases (17,644), followed by the Eastern Mediterranean Region (16,530) and the Southeast Asia Region (625). The 349 cholera deaths reported globally marked a 33% decrease from the previous month. The WHO said the seasonal decline in cholera transmission during the winter months may partly explain the reduction in cases in some regions, though the overall data remain incomplete.

While most of the cholera outbreaks reported are continuations from the previous year, the outbreak in Angola is new. According to the latest weekly outbreak bulletin from the WHO African Region, 4,107 cholera cases have been reported in 10 provinces from the beginning of the year through February 16, with 147 deaths. Children aged 5 years and younger account for 15.4% of the cases and 15.0% of the deaths.

"The cholera outbreak in Angola is showing signs of both stabilization and escalation, highlighting disparities in response effectiveness across affected provinces," the WHO said.

Cases have been rising since 2021

Cholera cases have been surging globally since 2021, with conflicts, mass displacement, and extreme climate events intensifying outbreaks and severely hampering efforts to contain the highly infectious bacterial disease, which spreads through water and food contaminated with the Vibrio cholerae bacterium. Cholera causes severe diarrhea and dehydration and can be life-threatening if it goes untreated. 

The WHO also said oral cholera vaccine production has ramped up because of significant efforts from suppliers and partners, reaching 6.2 million doses in January. But demand continues to outstrip supply, the agency said, "hindering efforts to control cholera outbreaks, respond rapidly to the disease's spread, and implement preventative campaigns."

A prospective cohort study of patients with drug-resistant tuberculosis (TB) in Belarus and Uzbekistan found that the 6-month, all-oral treatment regimens recommended by the World Health Organization (WHO) were safe and highly effective, researchers reported this week in Clinical Infectious Diseases.

The study, led by researchers with Medecins San Frontieres, analyzed data on adult patients with microbiologically confirmed multidrug-resistant or rifampicin-resistant (MDR/RR)-TB and pre-extensively drug-resistant (pre–XDR)-TB who received treatment with one of two BPaL (bedaquiline, pretomanid, and linezolid)-based regimens from February 2022 to June 2023. The aim of the trial was to assess the performance of BPaL-based regimens in non-clinical trial settings that have a high burden of drug-resistant TB. 

While the regimens have demonstrated treatment success rates of 90% or higher in clinical trials and were recommended by the WHO in 2022, data from real-world settings are lacking.

Findings support WHO recommendation

Of the 667 patients enrolled in the study, 440 (65%) had MDR/RR-TB and 237 (35%) had pre–XDR-TB. MDR/RR-TB patients were treated with BPaL plus moxifloxacin, and pre–XDR-TB patients received BPaL plus clofazimine. Overall, 93.6% of patients had a successful treatment outcome: 95.3% of MDR/RR-TB patients and 90.4% of pre–XDR-TB patients. Sixty-nine of 667 patients (10.2%) experienced serious adverse events during treatment, including 24 deaths (3.5%), 11 of which occurred during treatment. Of the 24 deaths, 20 (83.3%) were not related to TB or TB treatment.

Among the 383 patients who were successfully treated and completed 12-month follow-up, 2 (0.5%) experienced TB recurrence.

The study authors note that the treatment success rates are comparable to results from multiple phase 3 clinical trials for BPaL-based regimens, including the TB-PRACTECAL, Nix-TB, and ZeNix trials.

"Overall, our results contribute important real-world evidence on the effectiveness of BPaL-based regimens, lending support to the new WHO guidance recommending their global implementation," they wrote. They added that further research is needed in other key populations, including children and people with severe forms of extrapulmonary TB.