A study published yesterday in JAMA Network Open suggests that listening to music significantly lowered stress levels and improved mood among Austrian and Italian adults during lockdowns early in the pandemic.

University of Vienna researchers used a smartphone app to prompt 711 adults to report data on their mood and stress levels while listening to music during strict lockdowns 5 times a day from Apr 1 to May 8, 2020. Participants used visual analog scales to report their emotions on a scale of 0 to 100, with 0 indicating "not at all" and 100 indicating "very much."

Median respondent age was 27.0 years, and 69.9% were women. Participants provided 19,641 total data points, including 4,677 music-listening reports.

'An easily accessible tool'

Listening to music was tied to lower momentary stress levels (β, −0.92) and improved mood (β, 1.90), particularly if listeners viewed the music as happy, even in those reporting higher levels of chronic stress (β, 0.12).

The authors noted that lockdown-linked social and economic disruption has been tied to stress, worry, and mental illness in the general population. "This disruption was aggravated by the fact that many leisure activities that were previously pursued to regulate stress and mood (eg, meeting friends, attending cultural events) were banned because of the lockdown," they wrote.

Music listening may be a means to modulate stress and mood during psychologically demanding periods.

Music, they said, is an easy, low-cost way to improve health and well-being during a crisis such as COVID-19.

"The present findings suggest that music listening may be a means to modulate stress and mood during psychologically demanding periods," the researchers wrote. "Individuals experiencing heightened momentary and/or chronic stress because of the challenges brought about by COVID-19 pandemic–related restrictions might consider music as an easily accessible tool for the management of stress and mood in daily life."

In the wake of H5N1 avian flu detections in wild birds and poultry in South America over the past few months, Ecuador's health ministry yesterday reported the country's first human infection involving H5 avian influenza.

The patient is a 9-year-old girl from Bolivar province, an Andes Mountain area in the central part of the country, according to a ministry statement translated and posted by Avian Flu Diary, an infectious disease news blog.

The report had few details about the case, but it said the girl presumably had contact with birds that carried the virus. So far, investigators haven't found any other human cases.

Her illness marks the world's seventh infection from the circulating H5 clade. The others were from the United Kingdom, the United States, Spain, Vietnam, and China. All involved exposure to sick poultry. Four of the cases were mild, but the ones from Vietnam and China were severe, according to a recent risk assessment from the World Health Organization, which said the overall threat remains low, but the virus bears close watch.

Three H9N2 cases in China

Meanwhile, China confirmed three more H9N2 avian flu cases in different provinces, according to a regular avian flu update from the Hong Kong Centre for Health Protection.

The illness onsets occurred in October and November. The patients include a 58-year-old man from Hunan province, a 5-year-old girl from Gansu province, and a 3-year-old boy from Anhui province.

H9N2 is known to circulate in poultry in parts of Asia, with most human cases reported in China. Infections are typically mild and affect children. The country's most recent cases involved two children, one from Guangdong province and the other from Gansu province, who became ill in August and September, respectively.

Genomic analysis of extensively drug-resistant (XDR) typhoid isolates in Pakistan revealed numerous XDR variants circulating in the country, a team of Pakistani and US researchers reported this week in the American Journal of Tropical Medicine and Hygiene.

To get a better understanding of the genetic diversity of the sublineage of XDR Salmonella enterica serovar Typhi that emerged in Pakistan's Sindh Province in 2016 and has subsequently spread to other parts of the country, the researchers conducted whole-genome sequencing (WGS) on 58 XDR Salmonella Typhi isolates collected from November 2018 to December 2020.

XDR typhoid is defined as resistant to all recommended antibiotics for typhoid fever, including third-generation cephalosporins and fluoroquinolones. Susceptibility testing showed all isolates were resistant to ampicillin and ceftriaxone, and 54 of 58 were resistant to ciprofloxacin.

WGS showed that all isolates were related to the outbreak strain that emerged in Sindh, that multiple XDR variants exist, and that nearly one third of the isolates had integrated the plasmid containing the extended-spectrum beta-lactamase (ESBL) gene blaCTX-M-15 into the chromosome, which could enable them to acquire additional drug resistance and virulence genes.

"Our results reveal there are many circulating typhoid variants in Pakistan that have lost the IncY plasmid after integrating the ESBL into the chromosome," the study authors wrote. "These could acquire new plasmids to make them resistant to the few antibiotics to which it is susceptible (pan-resistant)."

These could acquire new plasmids to make them resistant to the few antibiotics to which it is susceptible (pan-resistant).

More than 15,000 cases of XDR typhoid have been reported in Pakistan since 2016. XDR strains have also been identified in Southeast Asia and eastern and southern Africa, and have been introduced into the United Kingdom, Canada, and the United States by travelers.

The authors say that, given the continued spread of XDR typhoid and the associated genomic diversity, countries need to take steps to reduce the burden of typhoid, which is transmitted by contaminated food and water and person-to-person contact and tends to spread in areas with poor sanitation. Among the steps they recommend are improving vaccination rates and the quality of drinking water and promoting good hygiene.