While many studies have shown that COVID-19 pandemic-era school closures had negative effects on student mental health, a new study in JAMA Network Open shows the opposite: the re-opening of schools trigged an increased incidence of acute psychiatric emergencies, suggesting school can be a substantial source of stress for some students. 

The study is based on 13,014 psychiatric emergency department (ED) visits at 9 university hospitals in Italy from January 1, 2018, to December 31, 2021.

The number of ED visits increased across the study period. The authors found school opening, but not social lockdown restrictions, were associated with an increase in the number of ED psychiatric visits (incidence rate ratio [IRR]1.29; 95% confidence interval [CI], 1.23 to 1.34).

Eating disorders, suicide attempts increased 

For psychiatric visits overall, there was a notable increase in both females (IRR, 1.29; 95% CI, 1.25 to 1.33) and males (IRR, 1.18; 95% CI, 1.14 to 1.2).

Three areas of mental health saw the biggest jump in ED visits during the study period: eating disorders (increase of 294.8%), suicidal ideation (297.8%), and suicide attempt (249.1%).

For some students, the avoidance of stress-provoking social situations in school may translate into a temporary relief when school is closed

" For some students, the avoidance of stress-provoking social situations in school may translate into a temporary relief when school is closed," the study authors wrote. "The lack of habituation to managing social stress during school closure may then be associated with greater distress upon school reopening. Possible stress from risk of contagion upon returning to school is another factor to consider." 

The Pan American Health Organization (PAHO) recently issued an epidemiological alert for rising Oropouche virus infections, urging countries to step up surveillance amid spread to new areas, reports of the first deaths, and suspected maternal transmission.

Oropouche virus is typically spread by a species of biting midge called Culicoides paraensis, but multiple factors including climate change, deforestation, and urbanization have contributed spread beyond Brazil's Amazon region to countries that haven't reported cases before, including Bolivia and Cuba.

Since the first of the year, 8,078 cases have been reported from five countries, mostly from Brazil. The others include Bolivia, Peru, Colombia, and Cuba. Two deaths have been reported, both from Brazil. Both of the fatal cases occurred in young women who didn't have underlying health conditions.

Brazilian officials are investigating a link between Oropouche virus and poor fetal outcomes. So far, the country has reported one fetal death, a miscarriage, and four newborns with microcephaly. The country is also investigating three more possible cases of maternal transmission, all involving fetal deaths reported from Pernambuco state. In one of the three cases, the Oropouche virus genome was detected in fetal tissue and blood samples.

In an updated risk assessment, PAHO said the investigation into the rise in activity is still underway and the trajectory is unknown. However, it upgraded the risk for the region to high based on a moderate level of confidence.

European countries report 10 imported cases

In a related development, three countries in Europe have now reported 10 imported Oropouche virus cases, the European Centre for Disease Prevention and Control (ECDC) said in its latest weekly communicable disease update. Italy and Spain had reported earlier cases, and now Germany has also reported two similar illnesses. Nine cases involved people who visited Cuba, and one person had traveled to Brazil. 

The ECDC said the risk to European travelers is low if they protect themselves from midges or mosquitoes that spread the virus. It also added the risk of local spread in Europe is low, due to the absence of competent vectors.

Cambodia's health ministry on August 3 announced a second human H5N1 avian influenza in less than a week, which involves a 16-year-old girl who is hospitalized in serious condition, according to a statement translated and posted by Avian Flu Diary, an infectious disease news blog. 

The girl is from the same province (Svay Rieng), but a different town, as a case announced earlier in the week.

About 4 days before her symptoms began, she touched and held dead chickens that died at her house and her neighbor's house. The girl's illness marks Cambodia's ninth case this year. So far, the clade isn't known, but the country's earlier cases were linked to an older 2.3.2.1c clade that circulates in some Asian countries, including Cambodia. 

Since early 2023, Cambodia has reported a rise in H5N1 infections, which are often severe of fatal. The country has now reported 15 cases since February 2023.

The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) has confirmed three more H5N1 avian influenza outbreaks in dairy cattle, raising the national total to 181 from 13 states.

The latest confirmations are from Colorado, South Dakota, and Texas. 

In other updates, APHIS also reported more detections in wild birds in mammals. The group reported about more than 100 more H5N1 detections in wild birds across several states. Some were waterfowl taken by hunters and were sampled last fall. However, several were agency-harvested birds from Colorado's Weld County, which has been a recent hot spot for dairy cow outbreaks, poultry outbreaks, and human illnesses. Species in Weld County that tested positive included doves, sparrows, starlings, and pigeons.

Regarding mammals, APHIS over the past few days has reported 27 more detections, raising its confirmed number to 373. Most of the newly confirmed positives involve deer mice and house mice from Weld County in Colorado. The group also included three domestic cats from Larimer County in Colorado, plus a rabbit and a vole from Weld County.