News Scan for Dec 08, 2021

News brief

Anorexia cases, hospitalizations rose in Canadian youth during COVID-19

A study of 1,883 Canadian children and teens with newly diagnosed or atypical anorexia nervosa shows that rates of the disease rose 66%, and hospitalizations climbed 267%, per month during the first 9 months of the COVID-19 pandemic.

The study, published yesterday in JAMA Network Open, also showed that in the same period, illness onset was faster, and the disease was more severe by the time patients sought care than before the pandemic.

Researchers at Montreal Children's Hospital analyzed eating disorder assessments conducted with patients 9 to 18 years old within 7 days of a new or atypical anorexia diagnosis at six pediatric hospitals in Canada from Mar 1 to Nov 30, 2020. They compared anorexia rates from that period with those from Jan 1, 2015, to Feb 28, 2020, before the pandemic. Median patient age was 15.9 years, and 91% were girls.

Before the pandemic, new or atypical anorexia case rates were stable, at an average of 24.5 cases per month. During the pandemic, new anorexia diagnoses increased to, on average, 40.6 cases per month, and hospitalizations rose from an average of 7.5 to 20.0 per month.

Trends were most pronounced in provinces with higher COVID-19 rates and thus more stringent lockdowns and healthcare closures.

Markers of disease severity were worse among patients diagnosed as having anorexia during the pandemic than before, with faster disease progression (7.0 vs 9.8 months), greater average weight loss (19.2% vs 17.5%), and worse bradycardia (abnormally slow heartbeat) (average, 57 vs 63 beats per minute).

The researchers said that the cause for the uptick in anorexia cases and hospitalizations is likely multifaceted, citing school closures, lack of structures that normalize eating, social isolation, lack of physical activity, and increased social media use. "These findings highlight the need for expanded eating disorder and mental health programs during and after the COVID-19 pandemic," they wrote.

In a commentary in the same journal, Youngjung Kim, MD, PhD, of Massachusetts General Hospital, called for research into a possible connection between anorexia symptom severity and previous COVID-19 infection. "It is unknown whether any viral contributions can be found in the pathogenesis of anorexia nervosa, and future investigations could enhance the understanding of the biological processes of anorexia nervosa," she wrote.
Dec 7 JAMA Netw Open study and commentary


Rhode Island confirms its first Jamestown Canyon virus case in 8 years

Rhode Island has confirmed its first case of Jamestown Canyon virus infection since 2013, according to a Dec 6 news release.

The Rhode Island Department of Health (RIDOH) said a person from Kent County in his or her 50s tested positive for the mosquito-borne disease. Symptoms first developed in September and led to hospitalization.

Because of symptom progression, the medical team submitted samples to the Centers for Disease Control and Prevention (CDC) in mid-October, and the CDC confirmed Jamestown Canyon virus. The patient has since been discharged from the hospital and is recovering, the RIDOH said.

Jamestown Canyon virus circulates widely in North America, primarily between deer and mosquitoes, but it can also infect people. Human cases can occur from late spring through mid-fall, according to the news release. People can be infected and develop no or only mild symptoms. Early symptoms can include fever, muscle aches, headaches, and fatigue. Rarely, more serious central nervous system disease, including meningitis or encephalitis, can occur.

The RIDOH also reported its second West Nile virus case of the year. Connecticut has confirmed 6 West Nile cases in people this year, and Massachusetts has reported 10.
Dec 6 RIDOH news release

Flu Scan for Dec 08, 2021

News brief

Flu vaccine uptake low among those with no regular doctor, minorities

A new study presented at an American Society of Health-System Pharmacists (ASHP) meeting finds that influenza vaccination rates are low for people without a regular healthcare provider, at just 20.5%, as well as among minority groups.

Vaccine coverage among American adults with a regular provider was 44.5%, according to the research, which was presented yesterday at the society's midyear conference.

To determine flu vaccination uptake, researchers looked at 2.5 million health survey records from the 2015, 2017, and 2019 Behavior Risk Factor Surveillance System databases of the Centers of Disease Control and Prevention for adults ages 18 and older.

White Americans were more likely to be vaccinated than Black peers (41%, compared with 32%). Latinos had the lowest coverage, at 31%. Almost 60% of older Americans were vaccinated, while only approximately 30% of adults ages 18 to 25 reported receiving the flu vaccine.

"This research reminds us that under-vaccination and vaccine hesitancy are not limited to COVID-19," said Sinmileoluwa Okegbile, a PharmD candidate at Midwestern University in Arizona and researcher on the study, in an ASHP press release. "Low vaccination rates for the flu persist among those living in the United States even though vaccines can prevent severe illnesses, hospitalization and death.

"Our study suggests a need for a fresh approach to counteract hesitancy."
Dec 7 ASHP
press release


China reports fatal H5N6 avian flu infection

China has reported another human H5N6 avian flu infection, which occurred in a 54-year-old woman from Sichuan province who died from her illness, Hong Kong's Centre for Health Protection (CHP) said today in a statement. Following a spike in infections this year, the new case is China's first in more than a month.

The woman's symptoms began on Nov 17, and she was admitted to the hospital on Nov 21, where she died 2 days later. Investigators found that she had been exposed to dead backyard poultry before she got sick.

Since 2014, China has reported 52 human H5N6 cases, 27 of which were reported this year, 10 of them fatal. H5N6 cases, though rare, are often severe or fatal. The H5N6 strain that causes human illness has been reported in birds in four Asian nations. Laos is the only country outside of China to report an H5N6 infection.
Dec 8 CHP statement


Global flu activity rises, but at lower levels than in previous seasons

In an update that covers the middle 2 weeks of November, global flu activity increased but is still below levels seen in previous seasons, the World Health Organization (WHO) said this week.

In the Northern Hemisphere, flu is still at interseasonal levels, but some Southern Hemisphere locations are experiencing rises, including South Africa. In tropical parts of South America, Brazil reported detections of the H3N2 strain.

Meanwhile, Caribbean and Central American countries reported sporadic cases of influenza A and B, while cases declined in Southern Asia. Central Asian countries, including Kyrgyzstan and Uzbekistan, reported H3N2 activity, with Middle Eastern countries reporting increasing numbers of flu detections, mainly from H3N2. Though activity in East Asia was low, influenza B activity rose in China, especially in the north.

Several parts of the world are reporting elevated respiratory syncytial virus (RSV) activity, though some countries such as the United States and parts of Europe reported decreasing cases.

Globally, of respiratory specimens that tested positive for flu in the middle of November, 56.9% were influenza B and 43.1% were influenza A. Of subtyped influenza A viruses, 89.3% were H3N2, with the rest being the H1N1 strain.

The WHO included its usual caveats that flu data should be interpreted with caution, due to potential impacts from COVID-19 measures and surveillance.
Dec 6 WHO global flu update

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