Flu Scan for Sep 19, 2022

News brief

CDC reports H1N2v flu case in Wisconsin

In its weekly flu update on Sep 16, the Centers for Disease Control and Prevention (CDC) reported two more variant H1N2 (H1N2v) infections, in Michigan and Wisconsin.

The case in Michigan is presumably the one announced earlier in the week by Michigan health officials, which involved a child who had contact with pigs at the Berrien County Youth Fair. The CDC report said that investigators found that a household contact of the patient had a respiratory illness.

The child had attended the same agricultural fair and was sick at the same time as the patient with the confirmed H1N2v infection. The CDC said no person-to-person transmission of the virus has been identified.

Meanwhile, the CDC said the patient in Wisconsin is also younger than 18 and that the investigation is still ongoing.

The two infections push the nation's number of variant flu infections this season to seven in five states. Five have been linked to H1N2v, and two were due to H3N2v. Last month, the CDC issued a health advisory that asked providers to monitor for variant flu illnesses and warned that it expected more cases during agricultural fair season.
Sep 16 CDC FluView update
Sep 13 CIDRAP News scan

High-path avian flu strikes Tennessee flock, poultry in other states

The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) recently reported a highly pathogenic avian flu outbreak in a backyard flock in Tennessee, the state's first in the current wave of outbreaks in poultry and wild birds.

The outbreak occurred in Obion County, located in Tennessee's northwest corner. The confirmation brings the number of states affected by poultry outbreaks to 40.

In related developments, three states reported more outbreaks in poultry: Michigan, Minnesota, and Ohio. In Michigan, the virus struck a backyard flock of 20 birds in Ingham County. In Ohio, two outbreaks were reported, both in backyard birds, one in Allen County and the other in Williams County.

Meanwhile, Minnesota reported three more outbreaks, two at commercial turkey farms. One was at a facility in Meeker County that houses 63,600 birds, and the other was at a farm in Otter Tail County that has 8,500 birds. The state's third outbreak occurred in a backyard flock in Isanti County.

So far, the outbreaks involving the Eurasian H5N1 strain has led to the loss of 44.12 million poultry.
Sep 16 USDA APHIS statement on avian flu in Tennessee poultry
USDA APHIS poultry avian flu updates

News Scan for Sep 19, 2022

News brief

High rates of fatigue, brain fog 9 months after nonsevere COVID-19

About 9 months after COVID-19 infection, 19% of nonhospitalized adult patients in a German cohort had fatigue, 26% had mild cognitive impairment ("brain fog"), and 1% had moderate cognitive dysfunction, according to a multicenter study.

The study, published late last week in EClinicalMedicine, also showed that the incidence and risk factors for fatigue and cognitive impairment differed by age-group.

The researchers administered the FACIT-Fatigue scale and Montreal Cognitive Assessment to 969 participants who had tested positive for COVID-19 at least 6 months earlier at three German hospitals from Nov 15, 2020, to Sep 29, 2021. A total of 55% of patients were women. The patients' results were compared with those of 969 matched controls from a prepandemic, population-wide survey.

A median of 9 months after COVID-19 infection, 19% had clinically relevant fatigue, compared with 8% of controls. Risk factors included female sex, younger age, history of depression, and altered consciousness, dizziness, and muscle pain—but not illness severity—during acute infection. "This suggests that the affected organ systems, especially central and peripheral nervous system involvement, are more relevant for the development of fatigue than overall illness severity," the authors wrote.

A total of 26% of patients had mild cognitive impairment—roughly twice the expected proportion—and 1% had moderate dysfunction. Risk factors for impaired cognition included older age, male sex, lower educational attainment, and a history of neuropsychiatric disease.

The link between fatigue and cognitive impairment was insignificant, and only 5% of patients had both conditions, while 14% had only fatigue, and 22% had only cognitive dysfunction. While fatigue tended to improve with time, the onset of cognitive impairment appeared to be delayed by several months.

"Fatigue and cognitive impairment are two common, but distinct sequelae of COVID-19 with potentially separate pathophysiological pathways," the researchers wrote.

The team added that these persistent conditions may place a considerable burden on the health system. "Patients with post-COVID fatigue will require professional help, e.g. through specialized interdisciplinary outpatient clinics and rehabilitation programs," they wrote.
Sep 17 EClinicalMedicine study

Diabetics' excess weight, not blood sugar, tied to COVID-19, long COVID

Adults with diabetes and a high body mass index (BMI), not high blood sugar levels, are at greater risks of COVID-19 infection and long COVID, according to a meta-analysis involving more than 30,000 UK adults from nine cohort studies presented at the European Association for the Study of Diabetes (EASD) Annual Meeting taking place this week in Stockholm, Sweden.

"Our early findings support the idea that obesity-related mechanisms may be responsible for the excess risks of COVID-19 associated with diabetes, rather than high blood sugar per se," said Anika Knuppel, PhD, a lead researcher on the study from the University College London, in an EASD news release.

To conduct the study, researchers combed nine major studies from the United Kingdom to look at self-reported COVID-19 infections and long COVID among adults and associations with HbA1c levels (average blood sugar level), self-reported or medication-based diabetes, BMI, and waist-to-hip ratio.

The 31,252 participants were aged 19 to 75 years old, and 57% were women.

The researchers found that people whose BMIs in the overweight (25 TO 29.9 kg/m²) or obese (30 kg/m²or greater) category had 10% and 16% greater odds of COVID-19 infection, respectively, compared to healthy weight individuals. For long COVID, the association was even greater, with overweight people having 20% greater odds, and obese people having 36% greater odds.

Average blood sugar level and diabetes status revealed no association with COVID-19 or long COVID.
Sep 16 EASD press release