• Another death has been reported in the fungal meningitis outbreak linked to spinal anesthesia in people from the United States who underwent  in a The latest fatality brings the total fatality count to three, according to an update from the Centers for Disease Control and Prevention (CDC). Of 185 people from the United States who underwent procedures at the clinics, 14 suspected cases have been reported, along with 11 probable infections. Two cases are listed as confirmed, meaning fungus has been isolated from patients' spinal tap samples. Of the deaths, two are among the probable cases and one involves a confirmed case.
• New Jersey's Department of Health reported two new mpox cases, its first since February, according to a statement late last week. It reminded residents to be aware of their risks and symptoms and that vaccination provides the best protection against serious illness. Health officials in other jurisdictions and countries have warned about an uptick in cases linked to summer festivals and gatherings.
• The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) has added Gabon, Guinea, and Moldova to its long list of countries affected by highly pathogenic avian flu outbreaks in poultry. The step comes with restrictions on the import of avian products that come from or through those countries.

Officials confirmed 64 farm outbreaks associated with 2,202 confirmed cases of COVID-19 in Ontario during 2020, according to new data presented in a CCDR report from the Canadian government, suggesting farms—especially greenhouse farms—played a significant role as a site of transmission during the early months of the pandemic.

Agricultural workers were deemed essential workers in Canada during the pandemic. According to government records, 32% of farmworkers in Ontario worked in indoor greenhouses, where humidity and ventilation allowed for easier viral transmission. Moreover, one third of farmworkers in Canada are temporary foreign workers, who share transportation and close living quarters.

The analysis studied outbreaks with a start date from January 1 to December 31, 2020; all cases associated with these outbreaks up to January 31, 2021; and trends in outbreaks by season and type of farm, the authors of the report said. The outbreaks took place in the pre-vaccine period of the pandemic.

Almost 60% of outbreaks involved greenhouses

Of the 64 outbreaks included in this study, the median size was 14.5 cases (range, 1 to 240), and the median duration was 23 days (range, 0 to 128). Most case-patients were male (83.2%), the median age was 35 years, and 10.0% had one or more comorbidities. Almost a third (31.2%) of patients were asymptomatic, 16 required hospitalization, and 3 died.

"A total of 37 (57.8%) farm outbreaks occurred on farms classified as greenhouses," the report stated. Farm-based outbreaks peaked in May 2020, slowed down during the summer months, and then spiked again in December.

"The indoor and crowded nature of greenhouse work, at a time when indoor masking was not routinely recommended or used, may have promoted the transmission of COVID-19 and could have contributed to outbreaks on farms even when there were lower levels of community transmission," the report concluded.

Hong Kong's Centre for Health Protection (CHP) today reported a H5N6 avian flu infection in a 54-year-old woman from Sichuan province on China's mainland.

In a statement, the CHP said the woman is from Nanchong, and her symptoms began on May 19. She was admitted to the hospital on the same day and is listed in serious condition. An investigation found that he had been exposed to domestic poultry before she got sick.

Her infection brings China's number of H5N6 infections since 2014 to 84.

The H5N6 strain is known to circulate in poultry in some Asian countries, including China. So far, only China and Laos have reported human cases, which are often severe or fatal.