Italian child had COVID back in December 2019
A 4-year-old boy living outside of Milan with no travel history is now the earliest confirmed SARS-CoV-2 case in Italy, a team based in Italy reported in a research letter to Emerging Infectious Diseases yesterday.
The patient was one of the 39 consenting people in Italy's Measles and Rubella Network who had suspected measles in the fall of 2019 but eventually tested negative. His sample was the only one to test positive for COVID-19 via polymerase chain-reaction (PCR) testing. Using Sanger technology, the researchers were able to match it 100% to the reference sequence Wuhan-HU-1 as well as other COVID-19 strains found in circulation later.
On Nov 21, 2019, the patient developed a cough and runny nose, required an emergency department visit due to respiratory issues and vomiting a little over a week later on Nov 30, experienced a measles-like rash Dec 1, and received an oropharyngeal swab Dec 5, which was later used for the PCR test.
Prior to this case, the earliest known case was discovered in the Lombardy region on Feb 21. However, other studies have suggested that COVID-19 could have been brought to Italy in the fall from China and Germany, and as early as mid-December 2019, the SARS-CoV-2 virus was detectable in untreated wastewater in Milan.
Dec 8 Emerg Infect Dis research letter
Essential workers have up to 7-fold severe COVID risk
Healthcare workers in the United Kingdom are more than seven times more likely to contract a severe COVID-19 infection than non-essential workers, according to a new study published yesterday in Occupational & Environmental Medicine, and social care and transportation workers are twice as likely. The results also showed a disproportionate probability of severe infection in minorities whether they were essential or non-essential workers.
The researchers used UK Biobank data from 2006 to 2010 data to collect sociodemographic and employment information on 120,075 employees who were between ages 40 and 64 between Mar 16 and Jul 26, and corresponding data from Public Health England found that 271 (0.2%) had experienced severe COVID-19 infections resulting in hospitalizations or at least partial cause of death (0.8% mortality rate). Healthcare workers were 7.43 times more likely ton contract severe disease (95% confidence interval [CI] RR 5.52 to 10.00).
Looking more closely at the healthcare sector, the researchers found that healthcare professionals, medical support staff, and health associate professionals had 8.99, 6.64, and 7.65 RR when adjusting for all factors such as overall health, demographics, and socioeconomics. When applying the same Poisson regression model, social care workers had a 2.13 (95% CI 1.25, 3.63) RR and transport workers had 1.43 RR (95% CI 078, 2.63), the latter specifically being noted by the researchers as the only RR that changed significantly.
Police, protective, and education workers were also more likely to have severe COVID-19 infections, and in an additional analysis using Standard Occupation Classification 2000 occupation groupings, associate professional and technical occupations had a 2.18 adjusted RR (95% CI 1.79, 4.29) compared to senior officials and management.
Only 7.8% of the study cohort was not white, but the findings still indicated that nonwhite workers were up to 4 times more likely to get severe COVID-19 infections than white essential workers even when adjusting for covariates. Mixed raced persons had the lowest adjusted increased likelihood at 32% (95% CI 0.42, 4.11) and Blacks had the highest adjusted increased likelihood at 300% (95% CI 2.26, 4.11) compared to white British persons.
Dec 1 J Occup Environ Med study
Dec 8 BMJ press release
WHO: global health estimates show notable communicable disease death burden for low-income countries
In its latest global health estimates, which cover 2000 through 2019, the World Health Organization (WHO) said today that among communicable diseases, tuberculosis (TB) is no longer in the top 10 causes of death, while pneumonia and other lower respiratory infections are the fourth leading cause of death. The rankings don't cover the COVID-19 pandemic months.
Compared to 2000, lower respiratory infections are claiming fewer lives than in the past, a finding that's in line with reductions in communicable diseases such as HIV/AIDS, which is still the fourth leading cause of death in Africa, though yearly numbers have dropped by more than half.
TB fell from 7th place in 2000 to 13th place in 2019, reflecting a 30% reduction in global deaths from the disease. However, the WHO emphasized that TB is still among the top 10 leading causes of death in the African region, where it ranks 8th, and the Southeast Asian region, where it ranks 5th.
The WHO said the new estimates also show the toll communicable diseases continue to take on low-income countries, where 6 of the 10 top causes of death are still communicable diseases such as malaria, TB, and HIV/AIDS. It added that the report's findings raise concerns about plateaus in progress against deaths from those diseases.
Dec 9 WHO press release
High path H5 outbreaks reported in Polish poultry, wild birds in 4 other countries
Poland reported more highly pathogenic H5N8 avian influenza outbreaks in poultry, with four other European countries reporting more H5N8, H5N5, and H5 detections in wild birds, according to the latest notifications from the World Organization for Animal Health (OIE).
In Poland, the H5N8 virus struck two locations in Weilkoposkie province in the country's west, one a turkey broiler farm and the other a layer farm. The events began on Dec 3 and Dec 4, respectively, and taken together the outbreaks killed 635 of 787,122 susceptible birds. Also, an H5N8 outbreak occurred at a layer farm in Pomorskie province in the northwest, beginning on Dec 3 and leading to the deaths of 6,000 of 176,871 birds.
In wild bird outbreaks, Sweden reported an H5N5 detection in a wild goose found sick in Skane county in the far south and two events involving H5N8 in the same county. Also, the Netherlands and France both reported two more H5N8 outbreaks in wild birds, both involving captive pheasants. And France reported H5N8 in a dead duck found in Calvados and Belgium reported H5 in captive birds at a private home.
Dec 8 OIE report on H5N8 in Poland's Weilkopolskie province
Dec 8 OIE report on H5N8 in Poland's Pomorskie province
Dec 9 OIE report on H5N5 in Swedish wild birds
Dec 8 OIE report on H5N8 in Swedish wild birds
Dec 9 OIE report on H5N8 in Dutch wild birds
Dec 9 OIE report on H5N8 in French wild birds
Dec 9 OIE report on H5 in Belgian wild birds