COVID-19 Scan for Dec 06, 2021

News brief

Study: COVID vaccine-related myocarditis mild, resolves quickly

Today in Circulation, researchers report that most cases of rare yet potentially serious episodes of myocarditis related to COVID-19 vaccinations in teens and young adults were mild, and the case-patients recovered quickly.

Myocarditis, an inflammation of the heart muscle, often follows bacterial or viral infections. In June 2021, the US Centers for Disease Control and Prevention reported a link between mRNA COVID-19 vaccines and increased incidents of myocarditis, especially in boys and men 12 to 29.

In this study, researchers analyzed data on 139 cases of myocarditis in young adults and teens ages 12 to 20, reviewing medical records from 26 pediatric medical centers in the United States and Canada. They included myocarditis cases within 1 month of vaccination.

The authors found that myocarditis usually began within 2 days of vaccine administration of the second dose of mRNA vaccine, and 99.3% of patients reported chest pain, while 30.9% reported fever.

No patients died, but one in five patients (18.7%) required intensive care unit hospitalization, for an average of 2 to 3 days. Three fourths (77.3%) of patients who received cardiac imaging showed evidence of inflammation of or injury to the heart muscle, and 18.7% had at least mildly decreased left ventricular function at presentation, but heart function had returned to normal in all who returned for follow-up, the authors said.

"These data suggest that most cases of suspected COVID-19 vaccine-related myocarditis in people younger than 21 are mild and resolve quickly," said study author Dongngan T. Truong, MD, a pediatric cardiologist at Intermountain Primary Children's Hospital in Salt Lake City, in an American Heart Association (AHA) press release.
Dec 6 Circulation
Dec 6 AHA
press release


Hispanic race, diabetes, poverty tied to higher rates TB plus COVID-19

Tuberculosis (TB) and COVID-19 were disproportionately diagnosed in close succession and more than twice as likely to lead to death among Californians who were Hispanic, had diabetes, or lived in areas of low health equity than those diagnosed as having TB before the pandemic, finds a study published late last week in JAMA Network Open.

Researchers from California public health departments and the Centers for Disease Control and Prevention (CDC) examined state health surveillance records for residents diagnosed as having TB from Sep 3, 2019, to Dec 31, 2020, and COVID-19 up to Feb 2, 2021, and compared them with those diagnosed as having TB from Jan 1, 2017, to Dec 31, 2019, or COVID-19 alone until Feb 2, 2021.

Included in the analysis were 3,402,713 Californians who had COVID-19 alone, 6,280 who had TB before the pandemic, and 91 diagnosed as having COVID-19 within 120 days of a TB diagnosis. Among the latter group, median age was 58.0 years, 57.1% were men, 89.0% were born outside of the United States, 60.4% were Hispanic, 30.8% were Asian or Pacific Islander, 4.4% were Black, and 4.4% were White.

In Californians who received a TB diagnosis from Sep 3, 2019, to Dec 31, 2020, the rate of COVID-19 infection was 10.2%, which was similar to that in the rest of the state (8.6%). Relative to residents who had TB before the pandemic, those with TB and COVID-19 were more likely to be Hispanic (60.4% vs 36.4%), live in a census tract with low health equity (44.9% vs 32.9%), have lived in the United States longer before receiving a TB diagnosis (median, 23.1 vs 19.7 years), and have diabetes (46.2% vs 27.6%).

The death rate among Californians with both TB and COVID-19 diagnosed within 30 days of each other was more than twice as high as those diagnosed with TB before the pandemic (23.5% vs 11.4%) and 20 times higher than in those with COVID-19 alone (1.2%). People with TB and COVID-19 who died were older than those who survived (median, 81.0 vs 54.0 years).

"Addressing health inequities and integrating prevention efforts could avert the occurrence of concurrent COVID-19 and TB and potentially reduce deaths," the study authors wrote.
Dec 3 JAMA Netw Open study

News Scan for Dec 06, 2021

News brief

CWD detected for first time in southern Arkansas

The Arkansas Game and Fish Commission (AGFC) recently announced the first positive chronic wasting disease (CWD) test in a hunter-harvested deer in Union County, far from the nearest known positive finding in the state.

The white-tail deer was taken in Felsenthal National Wildlife Refuge, with the sample collected at a check station for the annual modern gun deer hunt. CWD was confirmed by the Wisconsin Veterinary Diagnostic Laboratory in Madison. The detection is especially concerning, because the CWD-positive animal was shot in deer management zone 12, which is known as the state's "deer factory," according to the Arkansas Democrat Gazette.

In a Dec 2 statement, the AGFC said the source of the CWD isn't known. The closest earlier detection occurred in Mississippi's Issaquena County, which is more than 70 miles away. The closest detection in Arkansas was in the northern part of the state, more than 200 miles away. The location is also near the border with Louisiana.

Cory Gray, who heads the AGFC's research division, said, "With this positive case being so far from any previously known source, we've already begun working on ways to gather more samples from the surrounding area to determine the extent of the infection in this part of the state." The hunter who shot the deer was notified, and arrangements are under way to dispose of the meat.

CWD is a fatal prion disease in cervids such as deer, elk, and moose that is similar to bovine spongiform encephalopathy ("mad cow disease"). It has been found in 27 states, as well as four Canadian provinces. No human cases have been detected, but health officials warn of eating meat from CWD-infected animals.
Dec 2 AGFC press release
Dec 5 Democrat Gazette story


Malaria cases, deaths rose amid pandemic healthcare disruptions

Pandemic-related disruptions to malaria services contributed to a marked increase in cases and deaths in 2020, according to a report today from the World Health Organization (WHO).

The 2021 world malaria report shows there were an estimated 241 million malaria cases and 627,000 deaths in 85 malaria endemic countries in 2020, an increase of 14 million cases and 69,000 deaths compared with 2019. The WHO estimates that roughly two-thirds of those deaths were linked to disruptions in malaria prevention, diagnosis, and treatment.

But the agency also noted that it could have been much worse, as worst-case scenario projections had suggested severe service disruptions could lead to a doubling in malaria deaths in 2020. Overall, most malaria-endemic countries experienced moderate levels of disruption.

"Thanks to the hard work of public health agencies in malaria-affected countries, the worst projections of COVID's impact have not come to pass," WHO Director-General Tedros Adhanom Ghebreyesus, PhD, said in a press release. "Now, we need to harness that same energy and commitment to reverse the setbacks caused by the pandemic and step up the pace of progress against this disease."

From 2000 to 2019, global malaria case incidence fell from 81 per 1,000 population at risk to 56, then climbed to 59 in 2020. The report also found that some of the global gains made against the disease were starting to fall off before 2020. The global malaria mortality rate was cut in half from 2000 to 2015, then declined at a slower rate through 2019 before climbing again in 2020.

Overall, 29 countries accounted for 96% of malaria cases globally, with the WHO Africa region accounting for about 95% of cases. Six African countries—Nigeria, the Democratic Republic of the Congo, Uganda, Mozambique, Angola, and Burkina Faso—accounted for just over half of all malaria deaths in 2020.

"While African countries rallied to the challenge and averted the worst predictions of fallout from COVID-19, the pandemic’s knock-on effect still translates to thousands of lives lost to malaria," said Matshidiso Moeti, MBBS, WHO regional director for Africa.

The report also notes that while artemisinin-based combination therapies for malaria remain effective in Africa, recent reports of emerging artemisinin partial resistance in the region are "of great global concern."
Dec 6 WHO world malaria report 2021
Dec 6 WHO press release


Avian flu outbreaks strike more poultry in 4 European countries

Four European nations reported more highly pathogenic avian flu outbreaks in poultry, with outbreaks in Germany and the United Kingdom confirmed as H5N1, according to official reports and notifications.

Germany reported two H5N1 events, one that began on Nov 30 in backyard layers in Upper Bavaria killing 9 of 45 susceptible birds, according to a notification from the World Organisation for Animal Health (OIE). The other occurred in Thuringia state at a farm housing multiple species, including geese, turkeys, ducks, broilers, and layers. That outbreak started on Dec 1, killing 40 of 330 susceptible birds.

The UK's Department for Environment, Food, and Rural Affairs (DEFRA) reported an H5N1 outbreak at a seventh location in North Yorkshire and at a premises in Gloucestershire. So far, 28 outbreaks have been reported in England. Scotland and Wales have also reported outbreaks.

Bulgaria reported two highly pathogenic events, with tests under way to determine the subtype, according to two separate OIE reports. They include four outbreaks in Plovdiv province, which affected a backyard facility, two commercial farms, and a pheasant hunting area. Taken together, the virus killed 1,113 of 119,187 birds. In the other event, the virus struck a backyard facility in Pazardzhik province, killing 8 of 103 birds.

Russia reported an H5 outbreak at a poultry farm in Stavropol in the country's southwest. The event began on Dec 1, killing 13 of 213,020 susceptible birds.
Dec 3 OIE report on H5N1 in Upper Bavaria
Dec 3 OIE report on H5N1 in Thuringia
Dec 5 DEFRA update
Dec 3 OIE report on high-path avian flu in Bulgaria (Plovdiv)
Dec 3 OIE report on high-path avian flu in Bulgaria (Pazardzhik)
Dec 6 OIE report on H5 in Russia

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