Half of all healthcare workers (HCWs) with symptomatic COVID-19 continued to go to work, even if they were involved with direct patient care, according to the results of a study yesterday on presenteeism among HCWs in Infection Control & Hospital Epidemiology.

Working while ill contributes to nosocomial transmission of respiratory viruses. Previous studies on HCWs with symptomatic influenza showed that a significant proportion—14% to 68%—still worked while sick.

The new observational cohort study included all HCWs at the Veterans Affairs Boston Healthcare System who tested positive for SARS-CoV-2 infection from December 1, 2020, to September 30, 2021.

All HCWs were required to perform a daily self-review of COVID-19 symptoms and to stay home or leave work if symptomatic, the authors said. During the study period, 327 HCWs tested positive for COVID-19, and 127 (49.8%) of 255 HCWs who had symptomatic infections reported presenteeism at the time of diagnosis.

HCWs cited a high workload burden for coworkers and personal responsibility as the main reasons for continuing to work while sick.

"Of the 127 HCWs with presenteeism, 66 (26% of 255 symptomatic HCW) worked at least part of a day and then returned to work for second and/or additional days with COVID-19 symptoms. HCWs with presenteeism did not differ significantly from those without presenteeism with respect to age, sex, race, vaccination status, or direct patient care," the authors wrote.

HCWs cited a high workload burden for coworkers and personal responsibility as the main reasons for continuing to work while sick, compared to limits on paid leave or perceived expectations to work while sick.

A survey of poultry farmers in two Nigerian states found that 98% gave prophylactic (preventive) antibiotics to day-old chicks, with 47 different products used across seven drug classes. The Nigeria-based researchers reported their findings this week in Antimicrobial Resistance & Infection Control.

Using a questionnaire adapted from the United Nations Food and Agriculture Organization (FAO) office in Ghana, they collected information on attitudes and practices regarding antimicrobial resistance (AMR) and antimicrobial use (AMU). Participants were from 50 farms in Plateau and Oyo states, chosen to represent northern and southern Nigeria. Researchers held a focus group in Plateau state with farmers and veterinary officials to fine-tune the questions.

Most farmers were aware of biosecurity practices but didn't understand the rationale behind them, which the researchers said contributed to the use of antibiotic prophylaxis. All farmers reported issues with poultry diseases, with Newcastle disease reported most frequently.

Most had heard about AMR and thought it would have a great impact on them, but most didn't know about antibiotic residues. Most thought that antibiotics were no longer effective because of the companies that made them, reduced strength of the drugs, and that diseases were becoming untreatable. "This highlights the low perception of AMR among farmers and the need for awareness creation and sensitization," the researchers wrote.

This highlights the low perception of AMR among farmers.

Antibiotics were easily accessible, and 74% of farmers bought them from poultry drug stores, commonly without a prescription and not based on lab tests.

Over the 3-month study period, 351 kilograms of active ingredients from seven classes were recorded: tetracyclines, penicillins, aminoglycosides, polypeptide, fluoroquinolones, amphenicol, and macrolides. Some products included a cocktail of antibiotics, with some including as many as six antibiotic classes at high concentrations and others not on the list of registered antimicrobials reported to the World Organization for Animal Health.

The team said the survey method could be used to help flesh out antimicrobial use and surveillance data elsewhere. "There is also the need to increase awareness among poultry farmers on the importance of biosecurity, disease preventive measures such as vaccination, and promote the use of probiotics to enhance production," they wrote.

Animal health officials in Texas yesterday announced that chronic wasting disease (CWD) has been detected in deer at farms in two more counties, Hamilton in the central part of the state and Frio in the south.

Both detections involved deer-breeding facilities, according to a statement from the Texas Parks and Wildlife Department and the Texas Animal Health Commission. The groups said the Hamilton County detection involved a single case from a live animal that was tested to see if it could be transferred to a registered release site. The Frio County detection came from routine postmortem surveillance sampling after the death of a deer.

The samples were sent to the Texas A&M Veterinary Medical Diagnostic Laboratory, with results confirmed by the National Veterinary Services Laboratory in Ames, Iowa. Texas officials said antemortem testing provides a baseline that can clarify where outbreaks originate and that early, proactive testing can greatly cut the risk of further spread.

CWD was first detected in Texas in 2012 and has since been found in captive and free-ranging cervids. The new detections follow a March announcement of similar detections in three separate deer-breeding facilities in Zavala, Washington, and Gonzales counties.

Highly contagious and always fatal, CWD affects cervids such as deer, elk, moose, and caribou. The disease has a long incubation period, so the first sign of infection may be through testing rather than clinical signs. CWD is a prion disease similar to bovine spongiform encephalopathy (mad cow disease). So far, CWD hasn't been detected in humans, but health officials recommend against eating meat from infected animals.