Flu Scan for Apr 21, 2022

News brief

Four states report more high-path avian flu outbreaks in poultry

Four states, including hard-hit Minnesota, reported more highly pathogenic avian flu outbreaks, pushing the nation's poultry losses to more than 28.8 million birds from 29 states.

Minnesota reported six more outbreaks, all involving turkey farms, in five counties. The state has now reported 46 outbreaks, with poultry losses now exceeding 2.1 million, according to the Minnesota Board of Animal Health (MBAH). Minnesota is the nation's top turkey producer.

Three other states reported more outbreaks, according to updates from the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS). In the Midwest, North Dakota reported an outbreak in backyard poultry in Stutsman County in the central part of the state, raising its total to 11.

In the West, Colorado reported it second outbreak, this time at a broiler farm in Montrose County in the southwest that houses 60,000 birds. And Idaho reported its third outbreak, which struck a flock of 30 backyard birds in Gooding County in the south central region.

The outbreaks involve a highly pathogenic Eurasian H5N1 strain that has also led to poultry losses in other parts of the world.
MBAH avian flu page
USDA APHIS poultry outbreak page

Earlier this year, Canada reported the appearance of Eurasian H5N1 in wild birds and poultry in the eastern provinces of Nova Scotia and Newfoundland and Labrador.

Since then, several more provinces have reported outbreaks, including those in the west, according to the Canadian Food Inspection Agency (CFIA) and provincial authorities. They included Ontario (16 outbreaks), Alberta (12), Quebec (4), Saskatchewan (2), and British Columbia (1). Manitoba yesterday confirmed H5N1 in samples from wild snow geese and a bald eagle.
CFIA avian flu outbreak page
Apr 20 Manitoba press release


WHO: Global flu still rebounding in the Northern Hemisphere

After global flu activity declined in January, levels rebounded in February and are still rising, the World Health Organization (WHO) said this week in its latest global flu update, which covers the end of March and the first few days of April.

In the Northern Hemisphere, flu activity increased in North America, though at lower levels than in pre-COVID seasons. Europe's flu activity has stabilized.

Countries reporting upticks of flulike illness include Tunisia and Georgia. China's influenza B activity is decreasing.

In the Southern Hemisphere, flu levels are low, but detections of the H3N2 strain continue in some temperate locations of South America and in South Africa.

Globally, of respiratory samples that tested positive for flu during the latest reporting period, 96.5% were influenza A. Of the subtyped influenza A samples, 94.5% were H3N2.
Apr 18 WHO global flu update

News Scan for Apr 21, 2022

News brief

Patient contracted Omicron just 20 days after Delta strain of COVID-19

A 31-year-old woman from Spain contracted COVID-19 twice within 3 weeks, despite being fully vaccinated and recently receiving a booster shot, according to a case report that will be presented at the upcoming European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) meeting. The case provides evidence that the Omicron strain is able to evade previous immunity.

The woman, a healthcare worker, first tested positive in December of 2021—12 days after receiving a booster dose of vaccine—during screening at work. She had no symptoms and isolated for 10 days. On Jan 10, 20 days after her first positive, she tested positive again after developing fever and a cough.

The 20-day gap between infections is the shortest recorded.

Whole-genome sequencing showed the first infection was caused by the Delta strain, and the second Omicron.

"This case highlights the potential of the Omicron variant to evade the previous immunity acquired either from a natural infection with other variants or from vaccines," said Gemma Recio, MD, of the Institut Cataa de Salut in Tarragona, Spain, in a press release. "In other words, people who have had COVID-19 cannot assume they are protected against reinfection, even if they have been fully vaccinated."
Apr 20 ECCMID press release


Antibiotic prescribing fell 23% to 38% in Australia during COVID-19

Data being presented at this month's European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) meeting and published in Clinical Infectious Diseases reveal that antibiotics prescribed in Australia fell 23% to 38% during COVID-19.

Australian researchers analyzed a representative sample of 10% of outpatient antibiotic prescriptions issued from January 2014 to April 2021. They found that, before 2020, antibiotic prescribing was 29% higher on average during the winter months of June, July, and August than during the summer months of December, January, and February.

That seasonal variation, however, disappeared during the pandemic. In winter 2020, practitioners prescribed 38% fewer antibiotics than in the winters of 2018 and 2019 (1,432,000 prescriptions per month vs 2,313,000). Summer 2021 showed a 23% reduction in prescriptions compared with the summers of 2018 and 2019 (1,374,000 per month vs 1,817,000).

Reductions were predominantly in antibiotics used to treat community-acquired respiratory infections such as pneumonia and bronchitis. For example, amoxicillin prescriptions fell 52% in the winter and 23% in summer. In a similar vein, prescriptions for amoxicillin-clavulanate followed a similar pattern: down 51% in the winter and 37% in the summer.

Decreases in antibiotic prescriptions were observed across all age-groups, with the greatest change in children, who saw a 52% decrease in winter and a 24% drop in summer. Further assessment revealed that 84% of winter and 97% of summer declines were driven by reductions in prescribing among general practitioners.

First author Jack Skeggs, MBBS, said in an ECCMID press release, "Existing community antimicrobial stewardship programmes, community education related to personal hygiene and handwashing, culture shifts in mask wearing and social distancing, and, possibly, reduced prescribing for viral syndromes may all play a role.

"However, the finding that significant reductions existed in states without high [COVID-19] case numbers or lockdowns is promising and suggests that we may be able to maintain at least some of these decreases after the pandemic by encouraging these same culture shifts."
Apr 20 ECCMID press release
Apr 11 Clin Infect Dis study


UK reports 34 additional acute hepatitis infections in children

The United Kingdom has added 34 more cases of unexplained hepatitis in kids under 10, bringing its total to 108. Of the 108 infected children, 8 have had liver transplants. All cases have been detected since January of this year.

Across the globe, clinicians are spotting a rise in acute hepatitis infections in children, possibly linked to recent viral infections with adenoviruses.

In a report from the UK Health Security Agency, officials said there is no link between the cases and the COVID-19 vaccine, as none of the sickened children had been vaccinated. 

The agency said that 77% of the 108 children tested were positive for adenovirus. The usual viruses that cause infectious hepatitis (hepatitis A to E) have not been detected.

"As it is not usual to see this pattern of disease from adenovirus, we are actively investigating other possible contributing factors, such as another infection (including COVID-19) or an environmental cause," the agency said.

Recently the United States, Spain, and Israel also reported a rise in acute hepatitis cases in young children. Today the US Centers for Disease Control and Prevention (CDC) issued a Health Alert Network advisory to notify clinicians and public health authorities of a cluster of children identified with hepatitis and adenovirus infections in Alabama.

"This Health Advisory serves to notify US clinicians who may encounter pediatric patients with hepatitis of unknown etiology to consider adenovirus testing and to elicit reporting of such cases to state public health authorities and to CDC," the advisory read.
Apr 21 UK Health Security Agency press release
Apr 21 CDC health advisory


More than 1 million African children have received malaria vaccine

More than 1 million children in Ghana, Kenya, and Malawi have now received at least one dose of the world's first malaria vaccine, the World Health Organization (WHO) reported today, in advance of World Malaria Day on Apr 25.

As part of a WHO-led pilot program, immunization campaigns first launched in Malawi in April 2019 have shown that the RTS,S/AS01 (RTS,S) vaccine substantially reduces severe malaria safely and is feasible to deliver to children at risk, the WHO said in a news release. The pilot program paved the way for the WHO to recommend expanded RTS,S rollout in October 2021 among children living in areas that have a moderate to high malaria risk.

If the vaccine were to be widely deployed, the WHO estimates that RTS,S could save the lives of 40,000 to 80,000 African children each year. 

The WHO has received more than $155 million from Gavi, the Vaccine Alliance to support the introduction, procurement, and delivery of the vaccine for Gavi-eligible countries in sub-Saharan Africa.

"As a malaria researcher in my early career, I dreamed of the day we would have an effective vaccine against this devastating disease," said WHO Director-General Tedros Adhanom Ghebreyesus, PhD, "This vaccine is not just a scientific breakthrough; it's life-changing for families across Africa. It demonstrates the power of science and innovation for health."
Apr 21 WHO news release

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