• Following the discovery of dead birds on several Galapagos Islands, samples were collected and three of five were positive for highly pathogenic H5N1 avian flu in preliminary tests, according to information released by Galapagos National Park. The samples will be sent to the National Public Health Research Institute in Guayaquil on Ecuador's mainland for confirmation. Officials have closed affected sites to visitors and urged tour operators to take biosafety precautions. Technical teams from the Galapagos National Park Directorate and the Agency for Control and Regulation of Biosafety and Quarantine for Galapagos are monitoring the situation, including in endemic bird populations that include penguins and cormorants. Ecuador's Environment Minister Jose Antonio Davalos said officials will deploy all available resources to reduce the impact on the archipelago's unique ecosystem. 

   

• Two institutions have announced grants to fund work into the diagnosis and treatment of Lyme disease, with an emphasis on the management of patients with chronic infections. Yesterday Tufts University announced $7 million in new grants, including more than $4.5 million from the Department of Defense (DOD) and the National Institutes of Health (NIH) to understand the underlying causes of chronic Lyme disease and to test a screening tool for diagnosing acute disease sooner. Veterinary researchers from the school received an $885,000 grant from Tarsus Pharmaceuticals to develop an oral drug that can be used  to kill ticks that are feeding on humans. Other Tufts groups received grants from other sources to develop a test to predict chronic Lyme disease and to study the altered immune response. In a related development, Mount Sinai Hospital and School of Medicine today announced a $6.2 million research grant from the Steven & Alexandra Cohen Foundation to fund new research programs to explore the similarities and differences between long COVID and chronic Lyme disease and to expand the facility's clinical care center for patients with complex chronic illnesses.
• The World Health Organization (WHO) today detailed a botulism cluster in France linked to eating homemade preserved sardines that has so far led to 15 infections, 1 of them fatal. Investigators found that the patients had eaten in the same restaurant in Bordeaux between September 4 and September 10, when the restaurant was serving Rugby World Cup fans. Of the 15 patients, 10 were hospitalized and 8 are in intensive care. Fourteen of the patients are from six countries outside of France. Botulism is a serious neurological condition caused by a toxin produced by Clostridium botulinum, which can develop in improperly preserved foods. The incubation, as long as 8 days, suggests that more cases could be identified, the WHO said.

Mpox activity continues at a low levels, with sustained transmission mainly occurring in the Southeast Asia and Western Pacific regions, the World Health Organization (WHO) said yesterday in a monthly update.

Since its last update in the middle of August, the WHO received reports of 1,131 new cases and 5 more related deaths, with a 1.3% rise in cases. Laos and Malaysia reported their first cases.

On September 8, China reported a batch of 501 new cases that were recorded in August, similar to what the country reported in July. The WHO added that China has reported cases from 25 of 31 provinces and that the epidemiologic picture fits with the global outbreak pattern of transmission mainly in men who have sex with men. The WHO also noted that Thailand has also reported a significant rise in mpox cases in recent months, with cases expanding beyond Bangkok.

In Africa, where mpox is regularly reported, cases declined during the reporting period, but the WHO said it's unclear if the drop is due to a decrease in cases or reporting delays.

In May amid an ongoing drop in cases, the WHO ended the public health emergency of international concern for mpox, and in August, its emergency committee issued standing recommendations to help countries battle the virus.

Just one of four internationally recommended sepsis screening tools that emergency medical services (EMS) use can identify the life-threatening condition with any accuracy, according to research presented today at the European Emergency Medicine Congress in Barcelona, Spain.

A Universitätsmedizin Berlin–led team linked health insurance data from 221,429 patients seen by EMS in Germany in 2016 and 2017 with information on 110,419 patients from paramedics and emergency department (ED) doctors in 2016.

Sepsis, which occurs when the body mounts an outsized response to an infection, can lead to organ damage or death. Early identification and treatment of sepsis improves survival. The Society of Critical Care Medicine's Surviving Sepsis Campaign Guidelines 2021 recommend four screening tools.

NEWS-2 tool most predictive

The National Early Warning Score (NEWS-2) accurately predicted 72.2% of sepsis cases, followed by the Modified Early Warning Score (MEWS; 46.8%), the Systemic Inflammatory Response Syndrome (SIRS; 30.4%), and the quick Sequential Organ Failure Assessment (qSOFA; 24.0%). Those are sensitivity scores. For specificity, NEWS-2 correctly identified 81.4% of non-septic cases, compared with 88.4% for MEWS, 93.8% for SIRS, and 96.6% for qSOFA.

Piedmont said that positive NEWS-2 results should be flagged for potential sepsis. "If EMS insist on using the qSOFA, they should be aware that a positive qSOFA makes sepsis likely, but also, that a negative qSOFA cannot rule out sepsis conclusively," she said.