More highly pathogenic avian flu outbreaks have been confirmed on commercial poultry farms in three states, Iowa, Minnesota, and South Dakota, as well as in backyard flocks in other states, the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) said in its latest updates today. The events are part of ramped-up activity that began in early October.

Iowa's latest outbreak involved a farm in Kossuth County that has 8,600 birds. The Iowa Department of Agriculture and Land Stewardship said the farm has game bird pheasants, peafowl, and commercial layers. Minnesota reported another outbreak at a turkey producer, this time at a location in Stearns County that houses 71,000 birds.

South Dakota reported two outbreaks, one at a commercial turkey farm in Charles Mix County that has 74,100 birds and one at a game bird producer in Clark County.

APHIS also reported events involving backyard flocks, one in Alaska's Matanuska Susitna County and Utah's Utah County.

Since early 2022, H5N1 outbreaks have led to the loss of a record 61.26 million birds across 47 states. Fifteen states have reported outbreaks in the past month.

H5N1 turns up again in Mexico, Europe

In other avian flu developments, Mexico reported highly pathogenic H5N1 detections in wild ducks at a nature park on Isla de Lobos and in different locations in Jalisco and Guanajuato states, according to a notification from the World Organization for Animal Health (WOAH).

Elsewhere, Hungary reported an outbreak on a poultry farm, its first since May, and Portugal reported the first in a wild bird, the first since last November.

The New Jersey Department of Health (NJDOH) said yesterday that is investigating a rise in Legionnaires' disease cases from Middlesex County and neighboring Union County.

In a statement, it said since August 3, 21 cases have been reported from Middlesex County, and 20 cases have been reported from Union County. No deaths have been reported. The two counties each averaged about six to eight Legionnaires' disease cases from August to October.

Middlesex County, with New Brunswick as its county seat, is part of the New York metropolitan area. Union County on its northern border includes Elizabethtown as its county seat.

NJDOH said it is working with local health departments to investigate the cases and identify potential infection sources. So far, no common exposure among the confirmed cases has been identified.

Kaitlan Baston, MD, NJDOH's acting health commissioner, said in the statement that early diagnosis is key to treating the disease. "Although the risk of contracting Legionnaires' disease if you live in or have recently visited Middlesex or Union counties remains low, individuals who develop pneumonia-like respiratory symptoms should visit their health care provider immediately to be evaluated," she said.

Infections are caused by exposure to Legionella bacteria, and past outbreaks have been linked to plumbing systems that can harbor the organism. Sources can include cooling towers, whirlpool spas, hot tubs, humidifiers, hot water tanks, and condensers of large air conditioning systems.

Symptoms can mimic other respiratory diseases such as COVID and flu. Older or middle-aged people, as well as smokers and those with chronic health conditions, are at higher risk of contracting Legionnaires' disease.

Mild COVID-19 infections can cause a loss of tase and smell, but a study today in JAMA Otolaryngology - Head & Neck Surgery suggests that almost all cases resolve within 3 years of initial infection.

In the small cohort study, 88 patients with loss of smell and taste were compared to 88 controls. All participants had tested positive for SARS-CoV-2 infection by polymerase chain reaction during March and April of 2020 in Trieste, Italy, and were enrolled in the study from March to June 2021.

The prevalence of self-reported smell or taste dysfunction was 64.8% (57/88), 31.8% (28/88), 20.5% (18/88), and 15.9% (17/88), during the acute phase of COVID-19, at 1-year, 2-year, and 3-year follow-up, respectively, the authors noted. If participants were age 50 or younger at the time of enrollment, they were less likely to report long-lasting loss of taste or smell.

By year 3, there were no statistically significant excess of olfactory dysfunction (OD) between cases and controls (13.6% vs 10.2%; absolute difference, 3.4%; 95% confidence interval, −7.3% to 14.1%).

Patients with PCC [post COVID condition] exhibiting chemosensory alterations should be reassured that a recovery of olfaction appears to continue over 3 years after initial infection."

"At the 3-year study endpoint, OD was comparable between both groups," the authors wrote. "Patients with PCC [post COVID condition] exhibiting chemosensory alterations should be reassured that a recovery of olfaction appears to continue over 3 years after initial infection."

The British Standards Institution (BSI) announced today that drugmakers Sandoz and Teva have become the first companies to be certified as meeting an international standard for responsible antibiotic manufacturing.

The Minimized Risk of Antimicrobial Resistance (AMR) certification, developed by BSI in collaboration with the AMR Industry Alliance, provides third-party independent verification that the concentration of antibiotic waste released into the environments by companies that manufacture antibiotics and their raw ingredients is below a threshold that could promote AMR in the environment. The threshold was established in a globally applicable responsible antibiotic manufacturing standard published in 2022.

Concerns about AMR in the environment

The certification attests to the fact that the companies are taking the necessary steps to control waste streams containing antibiotic active pharmaceutical ingredients. The Sandoz manufacturing site in Kundl, Austria, was the first to complete the assessment process. Annual surveillance will be conducted to ensure the standard is being maintained.

Controlling waste discharge of antibiotics from manufacturing can help retain the long-term effectiveness of antibiotics to treat infections, keeping medicine effective, boosting patient safety, and supporting a cleaner ecosystem.

BSI and the AMR Industry Alliance developed the certification to address concerns that discharge of antibiotics from manufacturing sites is contributing to the development and transmission of drug-resistant pathogens in the environment.

"Controlling waste discharge of antibiotics from manufacturing can help retain the long-term effectiveness of antibiotics to treat infections, keeping medicine effective, boosting patient safety, and supporting a cleaner ecosystem," Courtney Soulsby, global director of healthcare at BSI, said in a press release. "It's fantastic to see Sandoz and TEVA achieve certification, making clear their commitment to ensuring antibiotic manufacturing meets the best available scientific and environmental standards."