• Another death has been reported in the fungal meningitis outbreak linked to spinal anesthesia in people from the United States who underwent  in a The latest fatality brings the total fatality count to three, according to an update from the Centers for Disease Control and Prevention (CDC). Of 185 people from the United States who underwent procedures at the clinics, 14 suspected cases have been reported, along with 11 probable infections. Two cases are listed as confirmed, meaning fungus has been isolated from patients' spinal tap samples. Of the deaths, two are among the probable cases and one involves a confirmed case.
• New Jersey's Department of Health reported two new mpox cases, its first since February, according to a statement late last week. It reminded residents to be aware of their risks and symptoms and that vaccination provides the best protection against serious illness. Health officials in other jurisdictions and countries have warned about an uptick in cases linked to summer festivals and gatherings.
• The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) has added Gabon, Guinea, and Moldova to its long list of countries affected by highly pathogenic avian flu outbreaks in poultry. The step comes with restrictions on the import of avian products that come from or through those countries.

Officials confirmed 64 farm outbreaks associated with 2,202 confirmed cases of COVID-19 in Ontario during 2020, according to new data presented in a CCDR report from the Canadian government, suggesting farms—especially greenhouse farms—played a significant role as a site of transmission during the early months of the pandemic.

Agricultural workers were deemed essential workers in Canada during the pandemic. According to government records, 32% of farmworkers in Ontario worked in indoor greenhouses, where humidity and ventilation allowed for easier viral transmission. Moreover, one third of farmworkers in Canada are temporary foreign workers, who share transportation and close living quarters.

The analysis studied outbreaks with a start date from January 1 to December 31, 2020; all cases associated with these outbreaks up to January 31, 2021; and trends in outbreaks by season and type of farm, the authors of the report said. The outbreaks took place in the pre-vaccine period of the pandemic.

Almost 60% of outbreaks involved greenhouses

Of the 64 outbreaks included in this study, the median size was 14.5 cases (range, 1 to 240), and the median duration was 23 days (range, 0 to 128). Most case-patients were male (83.2%), the median age was 35 years, and 10.0% had one or more comorbidities. Almost a third (31.2%) of patients were asymptomatic, 16 required hospitalization, and 3 died.

"A total of 37 (57.8%) farm outbreaks occurred on farms classified as greenhouses," the report stated. Farm-based outbreaks peaked in May 2020, slowed down during the summer months, and then spiked again in December.

"The indoor and crowded nature of greenhouse work, at a time when indoor masking was not routinely recommended or used, may have promoted the transmission of COVID-19 and could have contributed to outbreaks on farms even when there were lower levels of community transmission," the report concluded.

A Rutgers University–led  study suggests that New Jersey's early release of prison inmates to quell COVID-19 transmission in the first year of the pandemic didn't result in a spike in substance use disorder–related emergency department (ED) visits or hospitalizations in the next 45 days.

In November 2020, New Jersey's Public Health Emergency Credit Act (PHECA) reduced some sentences by up to 8 months to control SARS-CoV-2 spread among the incarcerated. The state released a greater proportion of inmates than any other state.

The researchers linked New Jersey Department of Corrections records to state Department of Health all-payer hospital release and death records. Median inmate age among the 10,115 participants (11,177 releases) was 34 years, and 93.3% were men.

"There were concerns that this mass release would overwhelm reentry services, especially for individuals with substance use disorders (SUDs), who have a high risk of post-release overdose and acute care use," the study authors wrote.

Fatal overdoses in 0.3%

From January 1, 2019, to March 10, 2020 (pre-pandemic), 57.0% of the releases took place, while 25.6% occurred from March 11 to November 3, 2020, and 17.4% occurred from November 4 to December 31, 2020.

SUD-related ED visits or hospitalizations occurred among 526 inmates (4.7%), and fatal overdoses occurred after 32 releases (0.3%), in the 45 days after release. Adjusted models showed that the risk of a SUD-related acute-care visit did not differ among the three periods.

"Risk of relapse and adverse health events is high following prison release, with risk of fatal overdose as much as 129 times greater in the two weeks post-release than in the general population," lead author Peter Treitler, MSW, said in a Rutgers press release.

New Jersey offers robust support to released inmates with SUD (eg, Medicaid enrollment, prerelease medications for opioid use disorder, statewide peer navigator program), which Treitler said may have reduced the post-release risks. "N.J.'s decarceration experience may provide a model for future policy reform as correctional systems seek to reduce incarceration without increasing health risk," he said.