Quick takes: Polio in 3 nations, widespread cholera outbreaks, avian flu in US poultry

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  • Three countries reported more polio cases this week, all involving circulating vaccine-derived poliovirus type 2 (cVDPV2), according to the latest weekly update from the Global Polio Eradication Initiative (GPEI). Mali confirmed a case in Bamako, which is included in its 2023 total, which is now at 16. Nigeria reported one case in Sokoto, its fourth of 2024. And Yemen recorded three cases in three locations, which boost its total for 2023 to seven.
  • In its cholera update covering February, the World Health Organization (WHO) said yesterday that 20 countries from three regions reported 37,269 cases, 332 of them fatal, reflecting a 12% decrease from January. Also in February, Comoros reported its first cholera outbreak since 2008, which followed the arrival of a traveler from Tanzania who died from a suspected cholera infection. The WHO said the global cholera response continues to be affected by a critical shortage of oral cholera vaccine.
  • The US Department of Agriculture Animal and Plant Health Inspection Service (APHIS) has reported highly pathogenic avian flu outbreaks in two states, including a commercial turkey farm in South Dakota's Hutchinson County that houses more than 31,000 birds. APHIS also reported an outbreak involving a backyard flock in Klamath County, Oregon.

Study links social vulnerability with higher risk of resistant pneumococcal infections

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Streptococcus pneumoniae
Meredith Newlove / CDC

Higher levels of social vulnerability may increase the likelihood of having a resistant Streptococcus pneumoniae infection, researchers reported yesterday in Clinical Infectious Diseases.

Using S pneumoniae isolates collected from hospitalized and ambulatory patients at 177 US facilities from 2011 through 2022, researchers from Merck and Becton, Dickinson & Company evaluated associations between antibiotic resistance and the social vulnerability index (SVI). Created by the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry, the SVI measures four themes that contribute to social vulnerability: socioeconomic status (SES), household characteristics, racial and ethnic minority status, and housing type and transportation.

Of the 8,008 S pneumoniae isolates collected from 574 US counties in 39 states, the overall rate of antimicrobial resistance (AMR) was 49.9%, with 13.4% of isolates reported as multidrug-resistant. A multivariable analysis found that higher SVI scores were associated with increased risk of AMR, with the strongest links found for SES and household characteristics.

On average, a decile increase of SES, indicating greater vulnerability, was associated with a 1.28% increased risk of AMR (95% confidence interval [CI], 0.61% to 1.95%). A decile increase of household characteristic score, indicating household members ages 17 and younger or 65 and older, was associated with a 0.81% increased risk of AMR (95% CI, 0.13% to 1.49%).

No associations were found with racial and ethnic minority status, housing type and transportation, or overall SVI scores.

More pneumococcal vaccination could help

Resistant S pneumoniae infections account for roughly 830,000 deaths globally each year. The authors say that, in addition to shedding light on the role that social vulnerability may play in increasing the risk of acquiring a resistant S pneumoniae infection, the findings have important implications for pneumococcal vaccination, which has proven to be an effective strategy for reducing pneumococcal disease, including infections caused by resistant S pneumoniae strains.

"Important strategies to combat increasing SP [Streptococcus pneumoniae] AMR are increasing vaccination coverage, especially in those communities that face health inequities, as well development of vaccines with broader coverage of serotypes observed in adults," they wrote.

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