News Scan for Apr 22, 2022

COVID vs flu death rate
Avian flu outbreaks expand
US flu still rising
Wild poliovirus in Pakistan

Study reveals COVID-19 death rate 3 times higher than for flu in adults

Adults hospitalized early in the pandemic with COVID-19 were at more than triple the risk of death than those with influenza, despite the flu patients being older and having more chronic illnesses, according to new data from Spain to be presented at this year's European Congress of Clinical Microbiology & Infectious Diseases (ECCMID), which starts tomorrow.

The researchers also found that COVID-19 is associated with longer hospital and intensive care unit (ICU) stays, and its treatment costs nearly twice as much as flu treatment.

The team examined medical records of 187 flu patients (average age 76 years, 55% male) hospitalized from 2017 to 2019, and compared their data with 187 COVID-19 patients (average age 67 years, 49% male) hospitalized from March to May 2020. All the COVID patients required oxygen therapy at admission.

The 30-day COVID-19 mortality rate was 15% compared with 5% for flu. The 90-day mortality rate was 19% in the COVID-19 group and 6% in flu patients. After the investigators adjusted for confounders, they found COVID-19 to raise the risk of 30-day mortality more than four times (hazard ratio [HR] 4.04; 95% confidence interval [CI], 1.86 to 8.77) and 90-day mortality more than three times (HR 3.68; 95% CI, 1.75 to 7.74) compared with flu.

Median hospital stay was 17 versus 11 days, and median ICU stay was 15 versus 10 days, with costs for critical care almost twice as high for COVID-19 patients (€21,350 vs €12,082, or $27,400 vs $15,506).

Flu patients tended to have more existing chronic illnesses and problems performing activities of daily living than COVID-19 patients, but they were less likely to be overweight or obese.

"Our findings suggest COVID-19 is far more lethal than influenza," said lead author Inmaculada Lopez Montesinos, MD. from the Hospital del Mar in Barcelona, in an ECCMID news release. "Even for those people who are lucky enough to survive COVID-19 and make it out of the hospital, they will be forever scarred by the consequences. It is vital that people get fully vaccinated and boosted against both viruses."
Apr 21 ECCMID press release
Apr 21 ECCMID study abstract


Six states report more highly pathogenic avian flu outbreaks

Six states reported more highly pathogenic avian flu outbreaks in poultry flocks, including Iowa, which reported its first after a 2-week lull.

Iowa's outbreak involved a commercial turkey farm in Bremer County in the north central region, the Iowa Department of Agriculture and Land Stewardship (IDALS) said yesterday. The state has now reported 17 outbreaks, mostly involving layer and turkey farms.

Elsewhere in the Midwest, Minnesota reported four more outbreaks—all involving turkey farms—raising its total to 50. In its update, the Minnesota Board of Animal Health (MBAH) said the outbreaks have now led to the loss of nearly 2.3 million birds.

Outbreaks in four other states are reflected in updates from the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS). They include three outbreaks in backyard birds in Colorado (La Plata County), Idaho (Madison County), and Montana (Glacier County), as well as two more outbreaks on layer farms in Pennsylvania's Lancaster County, which affected more than 2 million birds.

The outbreaks are related to the spread of the Eurasian H5N1 strain, which has now led to the loss of nearly 31 million poultry across 29 states, according to APHIS.
Apr 21 IDALS statement
MBAH avian flu outbreak page
USDA APHIS poultry avian flu outbreak page


Flu rise continues, with bigger impact in certain regions

Flu activity in the United States, as measured by outpatient visits for flulike illness, continues a steady rise that began in the middle of February, with activity highest in the northeast, south central, and mountain regions of the country, the US Centers for Disease Control and Prevention (CDC) said in its latest update today.

The CDC included the caveats that other respiratory viruses are circulating at various levels in different regions, and though some ares are above their baselines for outpatient visits, as a whole the nation's level is at 2.1%—below the baseline of 2.5%. Of respiratory samples that tested positive for flu at public health labs, 99.8% were influenza A, and of the subtyped influenza A viruses, all were the H3N2 strain.

Hospital admissions have been rising for 11 weeks in a row, but the impact is still less than the most recent pre-COVID-pandemic flu seasons.

Three more pediatric flu deaths were reported, bringing the season's total to 22. One was from an unsubtyped influenza A virus in January, and two were linked to H3N2 and occurred in February and March.
Apr 22 CDC FluView update


Pakistan reports first wild poliovirus case in over a year

Pakistan reported its first wild poliovirus type 1 (WPV) case in more than a year, a disappointing development amid a steep downturn in WPV 1 cases over the past few years.

In other developments, three countries—the Democratic Republic of the Congo (DRC), Nigeria, and Yemen—reported more circulating vaccine-derived poliovirus type 2 (cVDPV2), the Global Polio Eradication Initiative (GPEI) said in its latest weekly update.

Pakistani health officials said the WPV1 case involved a 15-month-old boy from North Waziristan whose paralysis began on Apr 9, according to the Express Tribune, an English-language newspaper based in Pakistan. The illness was confirmed as WPV1 on Apr 22 by the country's polio lab, which also confirmed a closely related virus in an environmental sample from the same region. Pakistan reported its last WPV1 case in January 2021.

The case marks the third WPV1 case of the year, following detections in Afghanistan and Malawi.

In vaccine-derived poliovirus developments, the DRC reported 6 more cases, five in Maniema province and one in North Kivu province, lifting its total for the year to 22. Nigeria reported 1 more case, which affected a patient from Katsina, bringing its 2022 total to 16.

In the Middle East, Yemen reported 34 new cases, some of which are counted in its 2021 total. So far, its 2022 total is 5 cases, with 61 registered in 2021. The latest cases are from 11 different governorates.
Apr 22 Express Tribune story
Apr 21 GPEI update

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