WHO says it will maintain global health emergency for mpox

News brief

mpox viruses under the microscope — NIAID

The World Health Organization (WHO) said today that the mpox outbreak will remain a global health emergency.

The decision from the International Health Regulations (IHR) Emergency Committee comes amid a continued decline in reported mpox cases globally, the WHO said. But in its Feb 10 meeting—the fourth since mpox was declared a global health emergency in July 2022—the committee concluded that the sustained incidence of illness in a few countries, along with underreported detection and confirmation of reported cases, was enough to maintain Public Health Emergency of International Concern status.

As of Feb 14, there have been 85,860 confirmed mpox cases globally, with 93 deaths. Outside of countries in West and Central Africa, the outbreak has primarily affected men who have sex with men.

WHO continues to call on all countries to maintain surveillance for mpox, and to integrate services for prevention, preparedness, and response.

Members of the IHR Emergency Committee noted at their meeting that, while 43 countries in the WHO European Region have not detected any new mpox cases in the past 3 months, 18 countries in the region continue to report recent local transmission. In addition, ongoing transmission in the Americas remains a concern. The region, which has accounted for 68% of mpox infections since the outbreak began, has continued to report 200 to 250 cases per week over the past 6 weeks.

The committee also expressed concerns about the possible resurgence of cases in some countries with the resumption of LQBTQ social events and other mass gatherings, the lack of access to vaccines and testing in some regions, recurring zoonotic transmission in Africa, and insufficient evidence regarding vaccine efficacy and the duration of protection.

In introductory remarks at the WHO's weekly media briefing, Director-General Tedros Adhanom Ghebreyesus, PhD, said that he concurred with the committee's decision.

"WHO continues to call on all countries to maintain surveillance for mpox, and to integrate services for prevention, preparedness, and response into national control programs, including for HIV and other sexually transmitted infections," he said.

NARMS report shows rise in multidrug-resistant Salmonella from food animals

News brief

Chris Dall, MA

Flock of chickens A new report from the National Antimicrobial Resistance Monitoring System (NARMS) highlights some concerning antimicrobial resistance (AMR) trends in Salmonella from food-producing animals.

To evaluate trends in Salmonella serotypes and AMR in cattle, swine, chicken, turkey and related food products, scientists with the Food Safety Inspection Service, the Centers for Disease Control and Prevention, and the Food and Drug Administration analyzed 32,978 cecal (intestinal) samples from slaughter facilities and 226,741 meat and poultry product samples from 2014 through 2019.

The analysis found that 64% of Salmonella isolated from cecal samples and 45% from product samples were not resistant to any of the antibiotics tested (pan-susceptible). The proportion of Salmonella isolates that were pan-susceptible differed among slaughter classes and by sample sources (cecal/product samples, respectively): cattle (83%/71%), swine (65%/64%), chicken (35%/43%), and turkey (34%/32%).

However, multidrug-resistant (MDR) Salmonella gradually increased over time in both cecal and product samples, with a consistent increase in product samples from 2016 through 2019. Salmonella serotype Infantis was a major contributor to the increase in MDR Salmonella in chicken, which jumped by 17.7% in cecal samples and 20.3% in product samples.

NARMS data over the 6-year period also revealed that resistance to the critically important antibiotics ciprofloxacin, ceftriaxone, and trimethoprim-sulfamethoxazole increased in chicken cecal and product samples and cattle and swine product samples, while cephalosporin-resistant Salmonella increased over time in product samples from cattle and swine. Increased resistance to at least one critically important antibiotic class was observed in at least one Salmonella serotype isolated from cattle, swine, and chicken.

This information is crucial in our efforts to develop appropriate solutions to prevent and contain AMR.

Salmonella causes an estimated 1.35 million illnesses and 26,500 hospitalizations in the United States each year.

"This report shows how the analysis of both cecal and product samples provides a more complete picture of changes in Salmonella AMR and continually serves as an early indicator of emerging AMR Salmonella threats to public health," the report states. "This information is crucial in our efforts to develop appropriate solutions to prevent and contain AMR."

Asthma patients report worse asthma control after COVID-19

News brief

Jim Wappes

People with asthma in Hong Kong experienced worse control of their asthma after they had recovered from mild to moderate COVID-19, according to findings yesterday in Respiratory Research.

For the case-control study, researchers with the University of Hong Kong enrolled 111 people with asthma who had experienced mild to moderate COVID-19 from 30 to 270 days before enrollment and 110 asthma patients who hadn't had COVID.

They used the Asthma Control Test (ACT) for quantifying asthma control. An ACT score of 25 indicates complete asthma control, 20 to 24 indicates well-controlled asthma, 17 to 19 not well-controlled asthma, and 16 or less poorly controlled asthma. The investigators determined that a drop of 3 ACT points or more indicates less asthma control.

The study authors found that COVID-19 was tied to a tripling of the risk for a drop of 3 or more ACT points (adjusted odds ratio [aOR], 3.11), an almost five times higher odds of escalation of asthma therapy by at least 1 Global Initiative for Asthma step—another measure of less asthma control—(aOR, 4.73), and a more than five times higher risk of having uncontrolled asthma overall (aOR, 5.51).

The authors, conclude, "Mild-to-moderate COVID-19 among asthma patients was associated with worsening of asthma symptom, lower ACT score, a greater need for escalation of asthma maintenance therapy, and more uncontrolled asthma after recovery."

Three Iowa counties report chronic wasting disease for first time

News brief

Jim Wappes

Testing done on samples from about 5,000 deer harvested in last year's hunting seasons in Iowa revealed that 84 deer were positive for chronic wasting disease (CWD), and three counties joined the roster of CWD-affected, according to the Iowa Department of Natural Resources (DNR), Radio Iowa reports.

Plymouth County in the northwest, Grundy County in central Iowa, and Lucas County in the south-central part of the state all reported CWD for the first time.

CWD, which is caused by a misfolded protein called a prion, affects cervids such as deer, moose, and elk and is always fatal. The disease was first detected in Iowa in 2013.

DNR state deer biologist Jace Elliott, MS, said, "Our prevalence is still relatively low statewide, although there are areas in the state where it's much higher." The state's highest concentration of CWD cases has been in south-central Iowa, particularly Wayne County, and in the northeast in Winneshiek, Fayette, Allamakee, and Clayton counties.

Our prevalence is still relatively low statewide, although there are areas in the state where it's much higher.

Elliott said the DNR typically holds public meetings in newly affected counties.

CWD has not yet been detected in humans, but the Centers for Disease Control and Prevention recommends that people not eat meat from infected animals and have their wild game tested before eating the meat if the animal was taken from an area where CWD is known to exist.