From 11 November to 28 December, 2020 a total of 67 suspected cholera cases presenting with diarrhea and vomiting, including two deaths a case fatality ratio (CFR: 3%) were reported from the municipalities “Golfe 1” and “Golfe 6” in Lomé, Togo. A total of four health areas (Katanga, Adakpamé, Gbétsogbé in Golfe 1, and Kangnikopé in Golfe 6) in the affected municipalities reported at least one case.

On 17 November, cholera was confirmed by culture in the laboratory of the National Institute of Hygiene (INH) in Lomé, Togo and WHO was informed. On 19 November, the Minister of Health, Public Hygiene and Universal Access to Care of Togo issued a press release declaring a cholera outbreak and on 24 November WHO was officially notified. From 11 November to 28 December 2020, a total of 17 out of 41 stool samples tested positive for Vibrio cholerae O1 serotype Ogawa by culture in the National Institute of Hygiene (INH) in Lomé, Togo.

On 15 December 2020, the Brazil Ministry of Health reported the second confirmed human infection with influenza A(H1N2) variant virus [A(H1N2)v] in Brazil in 2020.

SARS-CoV-2, the virus that causes COVID-19, has had a major impact on human health globally; infecting a large number of people; causing severe disease and associated long-term health sequelae; resulting in death and excess mortality, especially among older and vulnerable populations; interrupting routine healthcare services; disruptions to travel, trade, education and many other societal functions; and more broadly having a negative impact on peoples physical and mental health. Since the start of the COVID-19 pandemic, WHO has received several reports of unusual public health events possibly due to variants of SARS-CoV-2. WHO routinely assesses if variants of SARS-CoV-2 result in changes in transmissibility, clinical presentation and severity, or if they impact on countermeasures, including diagnostics, therapeutics and vaccines. Previous reports of the D614G mutation and the recent reports of virus variants from the Kingdom of Denmark, the United Kingdom of Great Britain and Northern Ireland, and the Republic of South Africa have raised interest and concern in the impact of viral changes.

A variant of SARS-CoV-2 with a D614G substitution in the gene encoding the spike protein emerged in late January or early February 2020. Over a period of several months, the D614G mutation replaced the initial SARS-CoV-2 strain identified in China and by June 2020 became the dominant form of the virus circulating globally. Studies in human respiratory cells and in animal models demonstrated that compared to the initial virus strain, the strain with the D614G substitution has increased infectivity and transmission. The SARS-CoV-2 virus with the D614G substitution does not cause more severe illness or alter the effectiveness of existing laboratory diagnostics, therapeutics, vaccines, or public health preventive measures.

A 59-year-old female patient received an allogenic hematopoietic cell transplantation (HCT) for relapsed multiple myeloma from a matched unrelated donor, after reduced-intensity conditioning with fludarabine, treosulfan, and lymphocytic globulin. Her post-HCT course was complicated by engraftment syndrome and cutaneous acute graft-versus-host disease (GvHD) grade II, on post-HCT day +20 treated with high-dose steroids by the day after. After remission of symptoms, a progressive tapering was ongoing, when her cutaneous GvHD relapsed on post-HCT day +119 and she was started on high-dose intravenous corticosteroids (2 mg/kg per day) and photopheresis. Her prophylaxis regimen consisted of the following: valacyclovir 500 mg once daily, cotrimoxazole double-strength (DS) 3 times weekly, posaconazole 300 mg daily, and penicillin V 1 million international units once daily. By post-HCT day +163, with her prednisone dose tapered to 30 mg/day, she was admitted with febrile agranulocytosis with a thoraco-abdominal computed tomography showing suspicion of periportal abscess in the liver, transverse colitis, and a suspected superinfected perianal hematoma. During the second week of her hospitalization, on post-HCT day +172, the patient developed mild confusion and recent retrograde memory loss. A brain magnetic resonance imaging (MRI) scan (Figure 1) was performed on post-HCT day +174 showing multiple lesions of the limbic system bilaterally, involving the temporal and frontal lobes, the anterior part of the body of the caudate nucleus and the cerebellum, leptomeningeal enhancement, with some of these lesions having hemorrhagic changes. A lumbar puncture was performed on post-HCT day +174 with cerebrospinal fluid (CSF) analysis showing 17 white blood cells with 65% lymphocytes, 9% monocytes, 22% neutrophils, 3% plasma cells, 1% macrophages, 1.82 g/L protein (range: 0.15–0.45), and 4.2 mmol/L glucose (range: 2.8–4). Cerebrospinal fluid bacterial cultures and polymerase chain reaction (PCR) for cytomegalovirus, enterovirus, herpes simplex virus 1 and 2, varicella-zoster virus, JC virus, and human herpes virus-6 were negative. Microscopic CSF analysis is shown in Figure 2.

The following errors appeared in the article [Daley CL, Iaccarino JM, Lange C, et al. Treatment of Nontuberculous Mycobacterial Pulmonary Disease: An Official ATS/ERS/ESCMID/IDSA Clinical Practice Guideline: Executive Summary. Clin Infect Dis 2020. https://doi.org/10.1093/cid/ciaa241]. This guideline was erroneously published with the term “Executive Summary” in its title, which has been removed. The suffix ‘Jr’ was also incorrectly listed as part of the author Jonathan M. Iaccarino’s name in the byline and has been reassigned to Richard J. Wallace. The article is a joint publication between Clinical Infectious Diseases and the European Respiratory Journal, and was corrected before appearing in ERJ.