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. 

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. 

• A second round of polio vaccination began today in Gaza, with a plan to reach 591,700 children younger than 10 years old, according to a statement from the World Health Organization (WHO). At least two doses of the novel oral polio vaccine type 2 (nOPV2) are needed to interrupt transmission. As in the first round in early September, the second round involves three phases over a 3-day period, with one catch-up day. The first round reached 95% of eligible kids at the governorate level. Hanan Balkhy, MD, who leads the WHO Eastern Mediterranean regional office, on X today said a second area-specific humanitarian pause is needed to safely deliver the vaccines and ensure all children are protected. “We call on all parties to allow unimpeded access for health workers to complete this vital campaign. Every child must have the chance to receive their vaccine, no matter where they live.”  The outbreak of vaccine-derived poliovirus type 2 was detected on July 16.
• RedHill Biopharma today announced that it has received a cost-sharing contract with the Biomedical Advanced Research and Development Authority (BARDA) to advance the development of opaganib, a small-molecule treatment for Ebola virus. The drug has shown mutation-resistant antiviral and anti-inflammatory activity, likely to counteract the vascular impacts of Ebola infection. The company is pursuing an animal-rule pathway for potential approval for Ebola treatment. The host-directed, broad-acting drug is orally administered and is the first in its class. Other US agencies are evaluating opaganib as a countermeasure for mustard gas and acute radiation exposure. BARDA is part of the Department of Health and Human Services (HHS) Administration for Strategic Preparedness and Response (ASPR).
• Vietnamese officials have reported the H5N1 avian flu deaths of captive tigers, lions, and other cats at two zoos, one in Dong Nai province and the other in Long An province, both located in the southern part of the country. According to the notification from the World Organization for Animal Health (WOAH), the outbreak at the My Quynh zoo in Long An province began in early August, killing 27 tigers and 3 lions. The outbreak in the Vuon Xoai Eco-tourism area began on September 8, killing 1 leopard and 20 tigers. The source of the virus isn’t noted, and officials included vaccination data for poultry in the two areas.