News Scan for May 27, 2020

COVID-19–related loss of taste, smell
COVID-19 secondary attack rate
US flu vaccine demand
FDA approves malaria drug

Study shows loss of smell and taste among COVID-19 patients

A study yesterday in the Annals of Internal Medicine of more than 2,000 Europeans diagnosed as having mild to moderate COVID-19 shows that 87% reported loss of smell, and 56% reported taste dysfunction. The study suggests olfactory symptoms and taste disorders may be a common feature of COVID-19 infection.

The study was based on surveys completed by 2,013 patients diagnosed as having COVID-19 in one of 18 European hospitals from Mar 22 through Apr 23. Only 8% of participants required hospitalization for their infections, and none required intensive care.

Most patients reported a loss of smell after experiencing other general and otolaryngologic symptoms, the authors said. The patients reported smelling-related symptoms for a mean of 8.4 days, with 60.9% of patients regaining their sense of smell 5 to 14 days after the onset of smell loss.

"These findings highlight the importance of considering loss of smell and taste in the diagnosis of mild to moderate COVID-19," the authors concluded. 
May 26 Ann Intern Med study


Household, frequent contacts at highest risk of secondary COVID-19, study finds

The secondary COVID-19 attack rate in presymptomatic people in Guangdong province, China, was 16.1% among household contacts, 1.1% among social contacts, and 0 for workplace contacts, according to a study published yesterday in Emerging Infectious Diseases.

The researchers analyzed contact-tracing surveillance data gathered from Jan 28 to Mar 15 on 38 asymptomatic people and 369 of their close contacts. The secondary attack rate (SAR) is the percent of those who become infected by a primary, or index, case-patient.

The investigators determined an overall SAR of 3.3% (95% confidence interval [CI], 1.9% to 5.6%). Contacts 60 years and older had the highest SAR, at 8.0%, versus 1.4% to 5.6% in younger contacts. The SAR for asymptomatic index patients was 0.8%, rising to 3.5% in mildly symptomatic people, 5.7% in those with moderate symptoms, and 4.5% in those with severe disease.

Household contacts were at 12 times the risk of infection, while those with more than five contacts with the index patient in the 2 days before they tested positive were at 29 times the risk of infection.

The baseline reproduction number (R nought [R0)]) was 0.3 (95% CI, 0.2 to 0.5), much smaller than the previously reported overall R0 of 2.2, which could be attributed to active surveillance, centralized quarantine, and stringent social-distancing, the authors said. The R0 indicates how many people a single person will infect.

The study "underlines the need for prompt contact-based surveillance and social distancing," the authors wrote. The researchers also noted that asymptomatic people were less likely to transmit the virus than those with symptoms. "However, this finding should not discourage isolation and surveillance efforts," they said.
May 26 Emerg Infect Dis study


Poll sees increased US demand for flu vaccine

About 60% of US adults plan to be vaccinated against flu in the upcoming season, according to a new Reuters/Ipsos poll, which is above the 45.3% uptake in adults that the US Centers for Disease Control and Prevention (CDC) reported for last season.

The flu vaccine isn't expected to provide any protection against COVID-19, but experts say vaccination could prevent coinfections and lessen the burden on the healthcare system, especially during fall and winter respiratory illness season.

Researchers conducted the poll of 4,428 adults from May 13 to 19, and it has a margin of error of minus or plus 2%. Those most likely to say they would be vaccinated included Democrats, white respondents, those with higher household incomes and college degrees, and those who live in suburban or urban areas.

In a related development, US pharmacies are scaling up their plans to address a surge in demand for flu vaccine, according to a separate Reuters report. The Rite Aid chain said it has increased its order for flu shots by 40% for the upcoming season, and other chains such as CVS, Walmart, and Walgreens are also expecting more demand. Australia-based flu vaccine maker CSL Ltd said demand from its customers is up 10%, and GlaxoSmithKline said it is ready to expand production as needed.
May 26 Reuters story
CDC flu vaccine coverage for the 2018-2019 season
May 26 Reuters story on pharmacy plans


Amivas: US FDA approves injectable artesunate for severe malaria

Drug maker Amivas today announced US Food and Drug Administration (FDA) approval of injectable artesunate for the initial treatment of severe malaria in adults and children.

Injectable artesunate, an artemisinin derivative, is on the World Health Organization Model List of Essential Medicines.

Artesunate has been available in the United States since 2007 only through an expanded-access investigational new drug program managed by the Centers for Disease Control and Prevention (CDC). It was developed by the Walter Reed Army Institute of Research and the US Army Medical Materiel Development Activity.

Two clinical trials on artesunate treatment of 6,886 adults, children, and pregnant women showed that the drug reduced the death rate by 34.7% and 22.5% versus the injectable standard-of-care drug, according to Amivas' press release. Another study, involving 92 malaria patients treated with artesunate from January 2007 to December 2010, found a death rate of 6.9%.

Amivas said that the CDC will continue to offer artesunate until Amivas, headquartered in Frederick, Maryland, makes it available nationwide in the coming months.

About 2,000 people in the United States are diagnosed as having malaria each year. Untreated, the mosquito-borne disease causes severe disease in about 15% of infected people, in whom the death rate is nearly 100%.
May 27 Amivas press release

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