Utah has confirmed 300 measles cases in an ongoing outbreak, with the virus now spreading in Salt Lake County and new exposures at high schools in that county, according to an update yesterday from the Salt Lake County Health Department (SLCoHD).

“The first measles symptoms are often cold- or flu-like, with cough, runny nose, red/watery eyes, and fever, so you may think you have a common respiratory illness and can continue engaging in normal activities,” said Dorothy Adams, executive director of SLCoHD. “But please stay home if you have any signs of illness, especially now that we know measles is actively circulating in our community.”

Please stay home if you have any signs of illness, especially now that we know measles is actively circulating in our community

Salt Lake County has had 32 cases in the current outbreak, while Utah County has 41 and Southwest Utah health district has 194. Of the 300 measles cases, 58 have been identified in the past 3 weeks, and 255 occurred in patients who are unvaccinated. 

North Carolina: 22 cases since December 

In other measles news, the North Carolina Department of Health and Human Services (NCDHHS) announced earlier this week that the state has had 22 measles cases since late December. 

“The rise in measles cases is concerning, especially since most infections are affecting unvaccinated children,” said Zack Moore, MD, MPH, NCDHHS state epidemiologist. 

NCDHHS said most of the cases are related to known outbreaks, including the large ongoing outbreak in South Carolina. 

The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) has confirmed more H5N1 avian flu outbreaks in Pennsylvania poultry facilities this week, including six detections in Lancaster County, which has seen a dramatic uptick in H5N1 activity in the past several weeks.

The largest outbreaks are in commercial egg-layer sites, with 2.6 million birds affected in one Lancaster County location, and 1.4 million birds affected in another. Almost 30,000 commercial turkey birds in two Lancaster County facilities were also affected, as were 179,000 commercial broiler birds. 

In the past 30 days, 51 US flocks have been confirmed to have avian flu, including 23 commercial flocks and 28 backyard flocks. A total of 8.97 million birds nationwide have been affected. 

Pennsylvania is the epicenter of activity, with 11 affected commercial flocks, six affected backyard flocks, and 7,165,500 birds affected in this outbreak.

Libya has become the latest country to eliminate the world’s leading infectious cause of blindness.

The World Health Organization (WHO) said yesterday that Libya is the 28th country worldwide to officially eliminate trachoma, which is caused by the bacterium Chlamydia trachomitis. Trachoma spreads through personal contact with hands, clothing, or flies carrying infected eye discharge, and repeated infections can lead to scarring of the inner eyelid and blindness. It’s been documented in Libya for more than a century and remains endemic in many countries where access to water and sanitation is limited.

Libya’s Ministry of Health has prioritized trachoma elimination since 2017, aided by technical and operational support from the WHO. Libya’s acting minister of health said the achievement is a testament to the commitment of the country’s health workers.

“Even through difficult years, we maintained our focus on improving eye health services and ensuring no one was left behind,” Mohamed Al-Ghoj said in a WHO news release.

WHO officials said the achievement is notable given the country’s political instability, strained health services, and increased demand for basic services, including water, sanitation, and hygiene. 

“This milestone reflects Libya’s determination to safeguard the health of its people and reinforces our conviction that progress against neglected tropical diseases is possible everywhere,” said WHO Director-General Tedros Adhanom Ghebreyesus, PhD.

An analysis of more than 100 randomized clinical trials (RCTs) provides new insight into which antibiotic regimens are most effective at preventing surgical-site infection (SSI) following colorectal surgery, researchers reported today in JAMA Network Open.

The estimated incidence of SSI after elective colorectal surgery ranges from 10% to 25%, contributing to longer hospital stays for patients and increased use of antibiotics. While most international guidelines recommend dual-agent antibiotic prophylaxis prior to incision to reduce SSI risk, a variety of antibiotic combinations are used in clinical practice, and previous studies haven’t distinguished between antibiotic classes, a team led by researchers with McMaster University in Ontario noted.

“The optimal choice of antibiotic prophylaxis in elective colorectal surgery remains uncertain, with most reviews emphasizing timing and route of administration rather than direct comparisons of antibiotic classes,” they wrote.

The systematic review and meta-analysis examined 105 RCTs involving 18,273 patients undergoing elective colorectal surgery to determine which antibiotic prophylactic regimens are associated with the lowest risk of SSI. Thirty-day mortality, adverse events, and length of hospital stay were secondary outcomes. A total of 32 distinct antibiotic regimens were evaluated across the RCTs.

Evidence base for future guidance 

High-to-moderate certainty evidence indicated that, compared with compared placebo or no antibiotics, several regimens were associated with reduced risk of SSI, but broad-spectrum penicillins and third-generation cephalosporins were associated with the most substantial reduction (74% and 73%, respectively). Broad-spectrum penicillins were also associated with a 79% decrease in 30-day mortality. No significant differences were observed between antibiotic classes regarding length of hospital stay or adverse events.

The authors say the analysis “provides a more clinically meaningful perspective than prior reviews that focused primarily on route of administration.”

“These findings highlight the importance of antibiotic class selection in prophylactic strategies and provide an evidence base to guide future guideline updates and clinical practice,” they wrote.