News Scan for Sep 23, 2022

Post-COVID neurologic conditions
SARS-CoV-2-like sarbecovirus in bats
H1N2v flu in Georgia
Southern Hemisphere flu vaccine picks
Polio in 6 countries

Risk of neurologic disorders in US veterans rose in year after COVID

The risk of a range of neurologic conditions rose significantly in the year after COVID-19 infection among a group of US veterans—regardless of whether they had required hospitalization, according to a study published yesterday in Nature Medicine.

Researchers at the Veterans Affairs St. Louis Healthcare System and Washington University used federal data to estimate the risk and incidence of new neurologic disorders in 154,068 COVID-19 survivors, 5,638,795 contemporary controls, and 5,859,621 prepandemic controls.

Most participants were White men, with an average age of 62 years. Most were unvaccinated because the study period, March 2020 to January 2021, predated wide vaccine availability. It also preceded the emergence of SARS-CoV-2 variants.

The researchers found a 42% increased risk of any neurologic condition, such as ischemic and hemorrhagic stroke (50% increase), cognitive and memory disorders (77%), epilepsy (80%), headache (35%), movement disorders (42%), and mental illness (43%).

COVID-19 patients also had 2 more cases Alzheimer's disease per 1,000 people than controls. "It's unlikely that someone who has had COVID-19 will just get Alzheimer's out of the blue," senior author Ziyad Al-Aly, MD, said in a Washington University press release. "But what we suspect is happening is that people who have a predisposition to Alzheimer's may be pushed over the edge by COVID, meaning they're on a faster track to develop the disease. It's rare but concerning."

Al-Aly said neurologic problems are developing in previously healthy COVID-19 patients and those with mild infections. "It doesn't matter if you are young or old, female or male, or what your race is," he said. "It doesn't matter if you smoked or not, or if you had other unhealthy habits or conditions."

Some neurologic conditions persist, while others resolve, in unknown proportions, Al-Aly noted. "Given the colossal scale of the pandemic, meeting these challenges requires urgent and coordinated—but, so far, absent—global, national and regional response strategies," he said.
Sep 22 Nat Med study
Sep 22 Washington University
press release


COVID-like virus in bats resistant to SARS-CoV-2 antibodies

A sarbecovirus found in Russian bats evades SARS-CoV-2 antibodies in people who have been vaccinated against COVID-19, according to a study yesterday in PLOS Pathogens.

The virus, Khosta-2, belongs to the same category of coronaviruses as the virus that causes COVID-19. It was identified in bats sampled near Sochi National Park in October 2020.

Researchers at the University of Washington, who conducted the study, said Khosta-2 would likely be able to infect humans, based on experiments using human cells from people vaccinated against SARS-CoV-2.

To conduct the study, the authors used sera from six vaccinated people (three Pfizer and three Moderna), four uninfected donors, and three vaccinated individuals with breakthrough infections through January of 2022. The authors infected the sera with Khosta-2 cells, and the virus was able to evade all antibodies to SARS-CoV-2. The virus was also able to evade monoclonal antibodies to SARS-CoV-2.

The primary mechanism of evasion was Khosta-2's spike protein, which attached to a receptor protein, called angiotensin converting enzyme 2 (ACE2.) The authors of the study said this should compel vaccine developers to consider making broader vaccines.

"Our research further demonstrates that sarbecoviruses circulating in wildlife outside of Asia—seven in places like western Russia where the Khosta-2 virus was found—also pose a threat to global health and ongoing vaccine campaigns against SARS-CoV-2," said Michael Letko, PhD a virologist and corresponding author of the study, in a University of Washington press release.
Sep 22 PLoS Pathog study
Sep 22 University of Washington press release


H1N2v flu infects Georgia swine handler and fairgoer

The US Centers for Disease Control and Prevention (CDC) today reported another variant H1N2 (H1N2v) flu infection, this time in a Georgia child. Like most of the other similar cases, the child had contact with pigs and had attended agricultural fairs before symptoms began.

Investigators found that the patient was not hospitalized and has since recovered. No respiratory illnesses had occurred in any household contacts, and no person-to-person H1N2v transmission was reported.

The illness raises the season's number of variant flu infections to eight from six states. Six involved H1N2v, and two were linked to H3N2v. In August, the CDC issued a health advisory that urged healthcare providers to monitor for variant flu infections and it said it expected more cases to surface during the ongoing agricultural fair season.
Sep 23 CDC FluView report


WHO experts advise 1 switch for next Southern Hemisphere flu vaccine

The World Health Organization (WHO) flu strain selection advisory group today announced the recommended strains for the Southern Hemisphere's 2023 flu season, which swaps out the H1N1 strain for both the egg- and cell-based vaccine versions.

For the upcoming year, the group recommended switching a virus similar to influenza A/Sydney/5/2021. The strain is different than the H1N1 strains included in the current Northern Hemisphere vaccines, which are A/Victoria/2570/2019 for egg-based vaccines and A/Wisconsin/588/2019 for cell-culture or recombinant vaccines.

In an accompanying Q and A, the WHO said flu virus detections, except for the influenza B Yamagata lineage, this year have returned to pre-COVID levels in many countries in the Southern Hemisphere, which provided the advisory group with enough viruses to support updated vaccine strain recommendations.
Sep 23 WHO recommendations
Sep 23 WHO Q and A


Six countries report new polio cases this week

According to the latest update from the Global Polio Eradication Initiative (GPEI), six countries have new polio cases this week.

Afghanistan, Pakistan, and Mozambique all have new wild poliovirus type 1 cases. This is Afghanistan's second case in 2022; last year the country reported 4 cases. In Pakistan, 2 polio cases were recorded, bringing the 2022 total to 19. In Mozambique, intensified surveillance has tracked 1 new polio case, bringing the yearly total to 6 in that country.

Benin and the Democratic Republic of the Congo reported cases of circulating vaccine-derived poliovirus type 2 (cVDPV2). Benin has 2 cases, with 6 total reported this year. The DRC has 1 case, but its 2022 total is 111, up from 28 cases in 2021.

Malawi has two circulating vaccine-derived poliovirus type 1 (cVDPV1) cases. These are the first reported in the country; last year one wild-type case was reported.
Sep 21 GPEI update

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