Oman confirms MERS in 60-year-old man

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Camel racing
Omar Chatriwala / Flickr cc

Oman has reported a Middle East respiratory syndrome coronavirus (MERS-CoV) infection in a 60-year-old man who didn't have direct contact with camels, though camel racing exercises were held near his house before he got sick.

In a notification today, the World Health Organization (WHO) said the man's symptoms—including chest discomfort, shortness of breath, and fever—began on Dec 28, 2022, and he sought care at two healthcare facilities before he was hospitalized on Jan 2.

He was tested for MERS-CoV the next day, which revealed his infection with the virus. His condition improved, and he was discharged from the hospital on Jan 16. No other illnesses were found in the man's contacts, which included 51 healthcare workers. Seven of the man's 76 contacts had mild respiratory symptoms, but all tested negative for MERS-CoV.

Investigators found that the man, who worked as a driving instructor, had no history of contact with camels, goats, or sheep, and did not have any exposure to camel products, milk, or urine. However, camel racing exercises had taken place near his house in North Batinah governorate, which is in the far northwestern part of the country.

MERS case-fatality rate 36%

Oman reported its last case in May 2022, which involved a farmer from Al Dhahira governorate, also in the northwest, who had direct contact with camels.

The case marks the 26th in Oman and lifts the global total to 2,603, of which 935 were fatal, for a 36% case-fatality rate. The virus was first detected in humans in 2012, and the vast majority of cases have been reported in Saudi Arabia

Study: 60% of COVID-infected cancer patients report viral symptoms 6 months later

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A study published yesterday in eLife shows that 60% of cancer patients still have COVID-19 symptoms for 7 months after infection, similar to the general population.

University of Texas researchers identified 312 patients at MD Anderson Cancer Center who tested positive for COVID-19 from Mar 1 to Sep 1, 2020, and followed up with them until May 2021. Participants completed daily questionnaires on viral symptoms for 14 days after infection, then weekly for 3 months, and then monthly thereafter.

The researchers also reviewed patients' electronic health records to identify the persistence or emergence of new COVID-related symptoms documented at any clinic or hospital visit in the 30 days before infection and up to 14 months later.

Women much more likely to report symptoms

Median patient age was 57 years, 75% of patients had solid tumors, and 60% reported lingering COVID-19 symptoms for a median of 7 months and up to 14 months. 

The most common symptoms were fatigue (82%), disturbed sleep (78%), muscle pain (67%), and gastrointestinal symptoms (61%). Less common symptoms were headache, impaired taste or smell, shortness of breath (47%), and cough (46%).

Women reported long-COVID symptoms much more often than men (63% vs 37%). Of the 188 patients with persistent symptoms, 8.5% were readmitted for COVID-related indications. Rates of risk factors for long COVID (eg, depleted white blood cells, need for extra oxygen, hospitalization, multiorgan failure) were similar in both sexes.

We also found no underlying condition or severity of illness during acute COVID-19 that would predict long COVID-19.

Of note, patients diagnosed as having high blood pressure (BP) were less likely than others to develop long COVID. Although high BP is a risk factor for severe infection, it appears t beo less important for the development of long COVID, the authors said.

"Even in this high-risk patient population, long COVID-19 was not associated with a high rate of hospital admissions," senior author Issam Raad, MD, said in an eLife news release. "We also found no underlying condition or severity of illness during acute COVID-19 that would predict long COVID-19."

Downed spy balloon may muddy US-China medical supply chains

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Pill bottle on assembly lineA planned early-February visit between US Secretary of State Antony Blinken and Chinese President Xi Jinping in Beijing had buoyed hopes for smoothing a cratered relationship between the world powers.

Then a suspected Chinese surveillance balloon hovering over a sensitive US nuclear site at Montana's Malmstrom Air Force Base on Feb 2 led Blinken to cancel his trip. Two days later, the United States shot down the balloon off the coast of South Carolina, outraging China.

As the US Navy examines the balloon and searches for its cargo, experts fear the incident's effects on the US-China medical supply chain, according to an article yesterday in Scrip. The United States relies on overseas manufacturing for 18 of 21 critical antibiotics and 72% of its active pharmaceutical ingredients.

The incident shows there is still a long way for Washington and Beijing to return to the table.

"From upending the US Food and Drug Administration's [FDA's] regulatory inspections in China … to lucrative cross-border funding and deal-making, the incident shows there is still a long way for Washington and Beijing to return to the table," Scrip reported.

China may be at disadvantage

One urgent issue is the resumption of FDA inspections of Chinese drug manufacturing plants. For example, BeiGene, Ltd., which has interests in both China and the United States, is still awaiting approval of its cancer antibody tislelizumab, which was postponed in July 2022 because the United States couldn't conduct inspections in China amid its now-scrapped zero-COVID policy.

Geopolitical strain is expected to rise following the incident, putting the healthcare industry on alert. Scrip quoted Chinese blogger Zheng Zhen, who said the United States will likely increase pressure on China.

"That could mean more delays and cancellations of other upcoming trips by US officials to China, including US FDA inspectors, which could cast a long shadow over any hope of improving bilateral cooperation in the health area," Zhen wrote.

But after 3 years of strict lockdowns, China may have more invested in the relationship than the United States, Zhen said: "China has more to gain from a stable relationship with the US as it greatly hopes to recover its economy post-pandemic."

Meningitis outbreak reported in southeast Niger

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Niger is experiencing a spike in meningitis cases, and though the country has seasonal outbreaks every year, activity is tracking higher than in previous seasons, the World Health Organization (WHO) said today in an outbreak announcement.

The epicenter is Zinder region in southeastern Niger. Since Nov 1, 2022, and through Jan 27, a total of 559 cases have been reported, 18 of them fatal, for a case-fatality rate of 2.3%. For comparison, Niger reported 231 cases over the same period the previous year.

The vast majority (93.7%) of the 111 lab-confirmed cases in this season's outbreak involve Neisseria meningitidis serogroup C. More than half of the cases involve males, and people younger than 20 are the hardest-hit group (96.3% of cases).

Health officials have launched campaigns using the trivalent ACW meningococcal vaccine.

The WHO said Zinder region borders Nigeria's Jigawa state, where a similar meningitis outbreak is occurring. Population displacement and other humanitarian issues in the region pose a risk of meningitis spread to other West African countries, the agency added. It assessed the risk to Niger as high, to the region as moderate, and to the rest of the world as low.

Part of Niger is in Africa's meningitis belt, and epidemics typically follow a season that runs from January through June. A large meningitis outbreak in 2015, which also involved serogroup C, resulted in about 10,000 cases.

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