Earlier this morning, Punxsutawney Phil saw his shadow, guaranteeing 6 more weeks of winter darkness with about the same amount of scientific basis as what we might be facing with a darkened CDC and other federal agencies. The original executive order limiting information release from federal agencies was said to last until February 1, but a day later MMWR is still silent.
We have now missed 2 MMWR reports, and I haven't been able to find any update on when/if this valuable resource might reappear. FluView Interactive and other CDC sites have similar notices though apparently are publishing some updates, which I'll show in the WRIS section later. Meanwhile, the world goes on.
Niger Eliminates Onchocerciasis Transmission
WHO announced that Niger joined Colombia (2013), Ecuador (2014), Guatemala (2016) and Mexico (2015) in eliminating transmission of Onchocerca volvulus, the cause of "river blindness." This is a major achievement, and I hope that funding cuts don't hinder WHO's disease elimination programs significantly.
African Outbreaks with Worldwide Significance
Sudan Virus in Uganda
This virus is in the Ebola virus family, and now Uganda is facing a new outbreak mostly involving healthcare providers (so far). WHO is advising against instituting any travel advisories, but the US State Department has had a Level 3 travel advisory in place since October, 2024, unrelated to any infectious disease outbreaks. (I was interested to note that this State Department site had no disclaimers about revamping the web site.)
Many readers will remember how Ebola virus came to the US via international travel. Certainly this new outbreak is still low risk for international spread, but the possibility remains and reminds all of us how distant outbreaks can hit home.
mpox
A new report in NEJM nicely describes the ongoing mpox outbreak in the Democratic Republic of Congo and surrounding areas. As emphasized in the accompanying editorial, spread from household close contact is prominent, with children sometimes experiencing severe disease. Pediatric cases are further described in another report, and the accompanying editorial emphasizes the challenges in trying to manage the outbreak. If you really want to dig deep into the numbers, WHO has an update. International spread so far has been limited but could increase.
MIS-C Phenotypes
This article caught my eye, even though MIS-C is less of a concern in our current covid situation.
The figure below is complicated, but suffice to say the researchers identified 3 clinical clusters: respiratory (cluster 1 above), shock/cardiac (cluster 2), and mild disease (cluster 3).
WRIS
Winter respiratory infection season is in full swing. It's not exactly great timing to have confusion in CDC's information restrictions during what is likely the height of flu season, not to mention ongoing concerns about avian flu. Already we were dealing with less data after the pandemic ended, a reasonable plan given less urgency surrounding covid. However, I admit to being confused about what might be changing in other surveillance systems now, with nary a peep (pun intended) about how the new administration's executive orders affect disease surveillance.
For what it's worth, here's a little bit of what I can find. I'm guessing that nothing much had changed with data collection methods by January 25, the closing date for the numbers used below.
Total acute respiratory illness is high or very high in much of the country.
Influenza is the main driver.
The Sound of Silence
Paul Simon has criticized most of the early work of Simon and Garfunkel, but the song that begins with "Hello darkness, my old friend" apparently is an exception. He is quoted in a 2023 interview regarding The Sound of Silence, “Somehow that song has changed its meaning over the years. It’s different. That’s good luck for me that that happened, you know?” I agree.
People talking without speaking
People hearing without listening