CWD detected in Marshall County, Iowa, for first time

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Buck in cattails
Nancy Girard Bégin / Flickr cc

A deer has tested positive for chronic wasting disease (CWD) in Marshall County, Iowa, for the first time, pushing the state total to 260 CWD-positive deer in 16 counties since 2013.

In a news release, the Iowa Department of Natural Resources (DNR) said that tissue from the road-killed buck was collected in mid-June in Marshall County, in the west-central part of the state.

Two public meetings slated

The DNR has scheduled two public meetings in Baxter and Wellsburg on CWD surveillance and management in Jasper, Marshall, and Grundy counties. At a minimum, the DNR said, the tissue-collection goal will increase in Marshall County from 15 to 20 deer to 100 or more in the coming year.

"Our hunters are an important partner in managing and monitoring for this disease," DNR wildlife biologist Steve Woodruff said in the release. "Hunters provide the tissue samples we need to determine to what extent the disease is on the landscape in Marshall County and elsewhere in Iowa."

Our hunters are an important partner in managing and monitoring for this disease.

Woodruff added that DNR staff will contact hunters to arrange for tissue collection after the hunting season starts.

CWD is a fatal neurodegenerative prion disease caused by infectious prions, or misfolded proteins, that affects cervids such as deer, elk, and moose. The disease creates cavities in the brain that resemble those of sponges, causing the animal to lose weight, behave abnormally, and lose body functions. While CWD isn't known to infect humans, some experts fear it could jump species.

Infectious disease expert Jeanne Marrazzo to replace Fauci as NIAID director

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Jeanne Marrazzo, MD
Jeanne Marrazzo, MD

Photo courtesy of UAB

Infectious disease expert and HIV researcher Jeanne M. Marrazzo, MD, of the University of Alabama at Birmingham (UAB), will be the new director of the National Institute of Health's (NIH's) National Institute of Allergy and Infectious Diseases (NIAID) starting in the fall, replacing Anthony Fauci, MD, who retired at the end of last year.

Marrazzo is the director of the Division of Infectious Diseases at UAB. Her research has focused on HIV and other sexually transmitted infections (STIs); the human microbiome, especially as it relates to STIs and hormonal contraception in women; managing bacterial vaginosis; and antibiotic resistance in gonorrhea. She has been a principal investigator on NIH grants since 1997 and has served often as a peer reviewer and advisory committee member, according to an NIH news release.

NIAID conducts and supports research to better understand, treat, and prevent infectious and immunologic and allergy-related diseases. Marrazzo will oversee NIAID's annual budget of $6.3 billion.

Leader, mentor, scientist

"Dr. Marrazzo brings a wealth of leadership experience from leading international clinical trials and translational research, managing a complex organizational budget that includes research funding and mentoring trainees," said Lawrence A. Tabak, DDS, PhD, NIH acting director.

Dr. Marrazzo brings a wealth of leadership experience.

"As director of our Division of Infectious Diseases during the COVID-19 pandemic, Jeanne served as a trusted advisor and friend who gave us the insights, guidance and confidence that allowed our institution to thrive in spite of immense challenges," said UAB President Ray Watts, MD, and Senior VP of Medicine Anupam Agarwal, MBBS, in a UAB press release. "She also helped inform the world, as she participated in constant local, national and global media interviews throughout the pandemic, sharing critical information and perspectives."

Carlos Del Rio, MD, president of the Infectious Diseases Society of America (IDSA), said in an IDSA statement, "Dr. Marrazzo is an exceptional infectious diseases physician, leader, mentor, and scientist who has dedicated her career to key areas of research … IDSA and its members have experienced firsthand Dr. Marrazzo's effective, engaging, and visionary leadership."

Reported global COVID-19 cases remain fairly low

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Omicron variant

Official COVID-19 case counts are rising only in the Western Pacific region globally—mainly due to transmission in South Korea, Australia, New Zealand, and Singapore—according to the latest update today from the World Health Organization (WHO).

The numbers come with the usual WHO caveat: "Currently, reported cases do not accurately represent infection rates due to the reduction in testing and reporting globally." The agency underscored that reality by noting that only 46% of 234 countries have reported any COVID cases. The WHO said that proportion has been declining since mid-2022.

Globally, more than 1 million new confirmed COVID-19 cases and more than 3,100 deaths were reported in the past 28 days (through July 30). In total, the world has seen 768 million confirmed cases and more than 6.9 million COVID-19 deaths.

Deaths down across globe

Deaths are down across all global regions. The nations with the most new cases in the past 4 weeks are South Korea (751,484 new cases), Brazil (45,642), Australia (30,144), New Zealand (23,443), and Singapore (23,216). Of those countries, only South Korea reported a case increase. The most new deaths were in Brazil (695 deaths in the past 4 weeks), Peru (321), Australia (260), Russia (251), and South Korea (199).

Of 16 countries that report hospitalizations and intensive care unit (ICU) admissions, none noted rises of 20% or more. The only variants that are rising in proportion are XBB.1.9.2, EG.5, and XBB.2.3.

In its weekly COVID update, the European Centre for Disease Prevention and Control notes that low COVID-19 levels continue in Europe, though 5 of 20 reporting nations confirm increased case rates, while 2 of 7 report increased hospital cases, ICU visits, or both. The XBB.1.5 subvariant continues to dominate on the continent.

Study: Antimicrobial stewardship programs in rural hospitals lack resources, infectious disease expertise

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Emergency sign
Taber Andrew Bain / Flickr cc

A review of antimicrobial stewardship programs (ASPs) at critical-access hospitals (CAHs) in Iowa and Nebraska found they are hampered by a lack of resources and infectious disease (ID) expertise, researchers reported today in Infection Control & Hospital Epidemiology.

For the study, researchers reviewed self-assessments from ASPs in 21 CAHs (5 in Nebraska and 16 in Iowa) that had self-identified as not meeting all of the Centers for Disease Control and Prevention's seven core elements of antibiotic stewardship and conducted interviews with ASP experts to assess adherence to the core elements.

Full or partial adherence to all seven core elements was reported in only 6 (28.6%) of the 21 hospitals, and five (23.8%) had at least two deficient core elements. The greatest deficiencies were in accountability and education.

Our findings suggest a need for greater emphasis on developing [antimicrobial stewardship programs] in [critical-access hospital] settings.

The most common barriers reported by ASP staff at the 21 hospitals were lack of dedicated resources (75%), lack of ID physicians or knowledge (45%), and lack of electronic medical records (25%). The most frequent high-priority recommendations were providing physician and pharmacist ASP leadership training (90.5%), tracking antimicrobial stewardship interventions (57.1%), and providing and tracking educational activities (57.1%).

Telestewardship could help

The study authors said the lack of ID expertise is not surprising, given that CAHs are located in rural areas and tend to lack staff with ID expertise.

"Our findings suggest a need for greater emphasis on developing ASPs in CAH settings, given unique barriers to establishing and maintaining successful ASPs," they wrote. They add that one potential strategy is the use of telestewardship, which enables hospitals that don't have ID physicians on staff to virtually connect with ID experts.

BARDA orders more Jynneos mpox vaccine

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NIAID / Flickr cc

Bavarian Nordic has received a US government contract for $120 million to manufacture more of its Jynneos smallpox/mpox vaccine, the company said in a news release today.

The order comes from the US Biomedical Advanced Research and Development Authority (BARDA), part of the Administration for Strategic Preparedness and Response at the Department of Health and Human Services. It primarily covers the manufacturing of new vaccine. 

The bulk product, valued at $96 million, will be manufactured and invoiced this year and will only partly restore the inventory, which was used to manufacture vaccines in response to last year's mpox outbreak. Bavarian has made nearly 5.5 million doses for the federal government in 2022 and 2023, and replenishment of the bulk inventory is necessary to fulfil the company's long-term commitment to deliver a freeze-dried version of the vaccine for US smallpox preparedness in the event of a bioterror attack.

Bavarian Nordic will also manufacture and supply liquid-frozen doses of the vaccine in 2023, valued at $3 million.

Paul Chaplin, PhD, Bavarian Nordic president & CEO, said, "The U.S. government's foresight enabled us last year to rapidly respond to the global mpox outbreak by converting readily available bulk product into final vaccine doses. Together with our U.S. manufacturing partner, we have completed the manufacturing of all doses ordered by the U.S. government during the mpox outbreak."

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