Re-Emergence of Measles

In 2018-19, even before the pandemic, the world experienced major outbreaks of measles with 140,000 reported deaths mostly in low income countries where children suffer from malnutrition and overcrowding. In areas recovering from natural disasters and conflict areas and most children remain unvaccinated, outbreaks occur. The Philippines suffered similarly, with a devastating outcome and deaths of more than 800 children, even adults, in more than 40,000 hospitalized cases reported in 2019 over a 2 month period. A massive loss of vaccine confidence in 2018, brought about by the controversial introduction of a dengue vaccine reduced childhood vaccination coverage at an all-time low of 40-50%. Previous rates were in the 80-90% and measles was almost on the verge of elimination with no deaths and no cases between 2005-2009. The basic elements of complacency, convenience and confidence plus frequent occurrence of natural disasters over the years contributed much to these measles outbreaks. As a strategy, the government went into a massive supplementary immunization program with measles campaign including home visits to prevent another outbreak in the next 2 years after the pandemic begun. It has been implemented but targets are still wanting. The lessons learned from Measles resurgence are echoing all throughout the world and as the global response to the COVID19 continues, the measles as well as polio and other vaccine- preventable diseases need to be addressed with strategies that each country would find appropriate for them. Without sustained attention, the gains that have been achieved previously could easily get lost.Copyright © 2023

Metavirome in Sewage and Fecally-Tainted River Waters in the Philippines: Highlighting the Role of Environmental Surveillance in the Covid-19 Pandemic

Intro: The COVID-19 pandemic has triggered global collaborative efforts on response and research to detect SARS-CoV-2 particles not just in the human population but also in wastewater. While the examination of clinical samples from COVID-19 patients links SARS-CoV-2 to specific individuals, the analysis of an amalgam of human feces through environmental surveillance (ES) links SARSCoV-2 to populations and communities served by the wastewater system. Studies on SARS-CoV-2 in the environment were already done in high-resource countries. However, its epidemiology in wastewater bodies in the Philippines is limited. In this study, we used the National ES for Polio and Other Pathogens Network to investigate the molecular epidemiology and transmission dynamics of SARS-CoV-2 at the outset of the pandemic. Method(s): This is a retrospective study of 250 wastewater samples collected from May 2020 to July 2021. Samples were processed using the two-phase concentration technique. Pepper mild mottle virus RNAs were quantified as the internal control. Real-time PCR was used to detect the N-gene of the SARS-CoV-2. Whole genomes were sequenced using the COVID-19 ARTIC v4.0. Phylogenetic and mutation analysis were done and lineage assignments were established using the PANGOLIN software. Finding(s): Forty-two percent (107/250) of the environmental samples detected SARS-CoV-2 particles. Fifty-nine samples with Ct values <=38 were sequenced and the whole genome analysis revealed B.1.1 and B.6. lineages of SARS-CoV-2. When viral load were plotted with the weekly cases in the respective site, we observed that SARS-CoV2 can be detected in wastewater weeks before the spike of cases in the community. Conclusion(s): This is the first report on the detection of B.1.1 and B.6 SARS-CoV-2 particles in waste/surface waters in the Philippines. With the declining incidence of COVID-19 cases, this study provided data regarding the feasibility of establishing environmental surveillance for SARS-CoV-2 as a supplemental tool for human or case monitoring especially in resource-limited settings.Copyright © 2023

Public Health Events' Assessment Per Annex-2 Decision- Instrument of the Ihr (2005) and Communication with the World Health Organization's Ihr State Parties in the Who European-Region

Intro: Guided by the annex-2 decision instrument of the International Health Regulations (IHR) 2005, public health events are assessed and notified to WHO by the IHR State Parties. Similarly, using the secure Event Information Site (EIS), the WHO shares information with the IHR State Parties through their National Focal Points (NFPs). This summarizes information about such events associated with the WHO European Region (EURO). Method(s): From the EIS, a list of events that may constitute a public health emergency of international concern shared by the WHO with the NFPs was extracted. This descriptive analysis includes data from 2007-2022 within the European Region or travel-associated while events occurred elsewhere. Finding(s): Of all the events (from six WHO Regions), 15% were associated with the European Region. The annual proportion varied such as 8% in 2007 and 22% in 2022. Events' classification by hazards and syndromes showed infectious (89%) and acute respiratory syndromes (42%) as the most common causes. Per annex-2 of the IHR (2005), about 88% and 66% of events qualified for unusual/unexpected or serious public health impact respectively and 60% simultaneously qualified both the criteria. About 61% of events qualified for unusual/unexpected and having risk of international spread concurrently. Similarly, 55% events had risk of international spread and serious public health impact, simultaneously. About 16% had risk of interference with international travel/trade. The recent EIS communications (2019-2022) were related to monkeypox, COVID-19, hepatitis of unknown aetiology, human influenza caused by a new subtype and polio. Conclusion(s): The events' assessment shared with the NFPs through the secure EIS platform is promptly accessible to all the IHR State Parties. Over the past fifteen years, such communications can improve situational awareness of events and facilitate information exchange for IHR State-Parties. Moreover, this encourages handling hazards at their source and strengthen readiness and response.Copyright © 2023

Increasing polio coverage with safer vaccines: a pressing need in Latin America

Given the actual risk of poliomyelitis outbreaks in the region due to poliovirus derived from the Sabin vaccine or the importation of wild poliovirus, the Latin American Society of Pediatric Infectious Diseases commissioned an ad hoc group of experts from the institution's Vaccines and Biologicals Committee, to draft an official position paper on the urgent need to increase immunization levels against the disease in the region and incorporate inactivated polio vaccine exclusive schedules in all national immunization programs. This publication discusses the main conclusions and recommendations generated as a result of such activity.Copyright © 2022, Sociedad Chilena de Infectologia. All rights reserved.

Worldwide poliomyelitis outbreaks: should mass gathering organizers be concerned?

The polio is the longest PHEIC and the continued occurrence of outbreaks of cVDPV would put further risks globally. The binary nature of PHEIC declarations would not support the continued polio PHEIC due to the requirement of tiered or graded strategies to combat such diseases.