Hepatitis C infection during pregnancy rose sharply during opioid epidemic

News brief

The prevalence of hepatitis C virus (HCV) infection during pregnancy increased 16-fold between 1998 and 2018, fueled by the opioid epidemic, which has increased the odds of poor fetal outcomes, researchers from Johns Hopkins University recently reported in JAMA Network Open.

The group's goal was to gauge how common HCV infections in pregnancy are and flesh out maternal and fetal outcomes to help with health policy decisions against the backdrop of rising opioid use, including in younger women of childbearing age.

For the analysis, researchers used the nation's largest publicly available database of all-payer inpatient care, which included more than 70 million births or spontaneous abortions.

Along with increased prevalence over the two decades, the team found that 0.20% of the births involved mothers who had HCV infections. The level reached 5.3 per 1,000 pregnancies in 2018. Mothers with HCV infections were more likely to be White and low income, with the group more likely to have a history of tobacco, alcohol, and opioid use.

Prevalence varied by age, with a threefold increase in women ages 41 to 50 years old and a 31-fold increase in women ages 21 to 30 years.

Women who tested positive for HCV during pregnancy had higher odds of cesarean delivery, preterm labor, poor fetal growth, and fetal distress. However, researchers didn't find any significant differences in gestational diabetes, preeclampsia, eclampsia, or stillbirth.

pregnant in hospital bed

Researchers concluded that the findings support proposed recommendations for universal HCV screening during pregnancy and that pregnancy care may be the initial healthcare exposure for many women. "These touchpoints represent an opportunity for health care professionals to identify HCV infection and link women and their children to appropriate specialist care," they wrote.

UAE reports MERS case

News brief

The United Arab Emirates (UAE) reported a MERS-CoV infection in a 28-year-old man from outside the country who is living in Al Ain, a city near the border with Oman, but it's not clear how he contracted the virus, the World Health Organization (WHO) said in a statement today.

In the first week of July, the man sought care at a private medical center multiple times for vomiting and right flank pain. On July 8, he was hospitalized for gastrointestinal symptoms and was initially diagnosed with acute pancreatitis, acute kidney injury, and sepsis.

NIAID/Flickr cc

When his condition worsened, he was admitted on July 13 to an intensive care unit at a government specialty hospital, where he was placed on mechanical ventilation. His conditioned deteriorated, and a nasopharyngeal swab collected on July 21 was positive for Middle East respiratory syndrome coronavirus (MERS-CoV).

So far, it's not known how he contacted the virus. The man has no underlying health conditions, is not a healthcare worker, and had no contact with camels or camel products. Monitoring of 108 contacts for a 14-day period revealed no related infections.

The UAE reported its last case in November 2021 and has now reported 94 cases. Globally, 2,604 cases have been reported, at least 936 of them fatal, since 2012.

The WHO said since the source of the patient's virus is unclear, genetic sequencing of the sample is under way to help assess if there is any unusual pattern and assist health officials in making a risk assessment.

H5N6 avian flu hospitalizes man in China

News brief

China has reported another human infection from H5N6 avian influenza, a 64-year-old man from Guangxi province who raises domestic poultry, Hong Kong's Centre for Health Protection (CHP) said today.

backyard poultry
Chris GoldNY/Flickr cc

The man's symptoms began on July 3, and he was admitted to the hospital for treatment the next day, where he is listed in serious condition. His illness marks China's fourth H5N6 infection this year and the world's 86th since the first illnesses were detected in humans in 2014.

Though H5N6 is known to circulate in poultry in a handful of Asian countries, only China and Laos have reported human illnesses, which are often severe or fatal.

CDC weighs in on H5N1 avian flu in Polish cats

News brief

The US Centers for Disease Control and Prevention (CDC) on July 21 issued its assessment of an unusual report of H5N1 avian flu deaths in cats in Poland across a wide geographic region, including some that were kept indoors.

Cat on balcony

It said the source of the virus is still unclear. Some cats had access to the outdoors, while others were kept indoors. Some were fed raw poultry or poultry parts.

No H5N1 infections were found in humans who had contact with the cats. Early genetic sequencing reveals that the virus hasn't changed to more easily bind to the cells in the upper airways of humans or to more easily spread to people.

Also, sequencing suggests that the virus that infected the cats is a good match with a candidate vaccine virus against H5N1 that the CDC developed in 2022.

The CDC said the H5N1 risk to human health from cats is low and that H5N1 continues to mainly be an animal health issue. And though human infections from contact with domestic pets is unlikely, it is possible. It urged people to closely monitor the health of their pets for symptoms such as fever, cough, and beathing difficulty.

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