News Scan for Dec 27, 2021

News brief

COVID-19 linked to increased risk of poor pregnancy outcomes

A retrospective study of a large cohort of US pregnancies during the COVID-19 pandemic found that infection with SARS-CoV-2 was associated with increased risks for poor pregnancy outcomes, an international team of researchers reported today in the Journal of Infectious Diseases.

Using de-identified administrative claims and electronic health record data for 78,283 US pregnancies with estimated conception before Apr 30, 2020, and pregnancy end after Mar 11, 2020, the researchers measured the incidence of COVID-19 among pregnant women. They then compared the risk of adverse pregnancy outcomes in infected versus non-infected women using Cox proportional hazard models that adjusted for confounding factors.

Overall, 2,655 (3.4%) of pregnancies had a documented SARS-CoV-2 infection, and 3.4% of pregnant women with COVID-19 required admission to intensive care, invasive mechanical ventilation, or ECMO treatment. In adjusted hazard models, COVID-19 during pregnancy was not associated with risk of miscarriage, antepartum hemorrhage, or stillbirth, but was associated with a 2-3 fold higher risk of induced abortion (adjusted hazard ratio [aHR], 2.60; 95% confidence interval [CI], 1.17 to 5.78), cesarean section (aHR, 1.99; 95% CI, 1.71 to 2.31), clinician initiated preterm birth (aHR, 2.88; 95% CI, 1.93 to 4.30), spontaneous preterm birth (aHR, 1.79; 95% CI, 1.37 to 2.34), fetal growth restriction (aHR, 2.04; 95% CI, 1.72 to 2.43), and postpartum hemorrhage (aHR, 2.03; 95% CI, 1.60 to 2.63).

The study supports previous research suggesting increased risk of fetal harm following maternal SARS-CoV-2 infection.

"These findings suggest prevention of SARS-CoV-2 infection during pregnancy may confer maternal and fetal health benefits," the authors write. "In addition to handwashing and social distancing measures, with the availability of highly efficacious vaccines, guidelines encouraging vaccination of pregnant individuals, and early results suggesting mRNA vaccine safety in pregnancy, effective prevention of maternal SARS-CoV-2 infection is possible."
Dec 27 J Infect Dis study


Two salad-linked Listeria outbreaks tied to 26 illnesses, 3 deaths

State and federal health officials are tracking two separate Listeria outbreaks linked to prepackaged salads, one related to Fresh Express products and the other to Dole products, the Centers for Disease Control and Prevention (CDC) said on Dec 23.

In the Fresh Express outbreak, 10 illnesses have been reported from 8 states. All 10 people were hospitalized, and one death was reported. Interviews with sick people and lab data suggest that Fresh Express prepackaged salads may be contaminated with Listeria monocytogenes. On Dec 20, Fresh Express recalled several brands of its prepackaged salads made in Streamwood, Ill., which include Bowl & Basket, Giant Eagle, Little Salad Bar, Marketside, O Organics, Signature Farms, Simply Nature, Weis Fresh from the Field, and Wellsley Farms Organic.

Meanwhile in the Dole outbreak, 16 illnesses have been reported from 13 states. Twelve people have been hospitalized, and two deaths were reported. Investigations have turned up the outbreak strain in two of Dole's prepackaged salads. On Dec 22, Dole recalled salads covering several of its brands, including Ahold, Dole, Kroger, Lidl, Little Salad Bar, Marketside, Naturally Better, Nature's Promise, and Simply Nature. The items were produced at Dole facilities in Bessemer City, NC, and Yuma, Ariz.
Dec 23 CDC press release
Dec 22 CDC Fresh Express outbreak
Dec 22 CDC Dole outbreak


More vaccine-derived polio cases reported from African nations

Three African nations reported more polio cases, all involving circulating vaccine-derived poliovirus type 2 (cVDPV2), the Global Polio Eradication Initiative (GPEI) said in its latest weekly update.

Nigeria reported 14 cases from six different states, raising its total for the year to 321. Meanwhile, Niger reported five cases from four different locations, bringing its 2021 total to 10.

Elsewhere, Yemen reported 2 cases, one from Aden and the other from Taiz. The country has now reported seven vaccine derived polio cases this year; three involved circulating vaccine-derived poliovirus type 1 (cVDPV1) and four were linked to cVDPV2.
Dec 21 GPEI update

Flu Scan for Dec 27, 2021

News brief

US flu activity shows another jump, first two peds deaths reported

United States flu activity jumped again the week ending Dec 18, with eight states reporting high or very high activity and the first two pediatric flu deaths reported for the season, the US Centers for Disease Control and Prevention (CDC) said today in its regular update.

Most flu markers showed steady rises, with eastern and central states seeing the biggest increases, with H3N2 as the dominant strain and infections continuing to affect a wider range of adult age groups after illnesses targeted younger people earlier in the season.

States or jurisdictions reporting high or very high activity—a marker that reflects clinic visits for flulike illness—include New Mexico, Kansas, North Dakota, Indiana, Tennessee, Georgia, New Jersey, and the District of Columbia. The CDC has said that other respiratory viruses are circulating and may be influencing flulike illness patterns.

Hospitalizations are starting to rise, and 1,265 people were admitted to the hospital for lab-confirmed flu during the week that ended Dec 18. Regarding the first two pediatric flu deaths of the season, one involved H3N2 and occurred during the week that ended on Dec 11. The other occurred the following week and was linked to unsubtyped influenza A.

The CDC also provided its first genetic flu virus characterization, noting that most H3N2 viruses are closely related to the vaccine strain, but there are some antigenic differences that are emerging as H3N2 viruses continue to evolve.
Dec 27 CDC FluView


Canada, Portugal, and Taiwan report H5 outbreaks in birds.

In the latest avian influenza developments, Canada reported a highly pathogenic H5N1 outbreak in captive birds at a multispecies exhibition farm on the island portion of New Foundland and Labrador, and Portugal reported more H5N1 in poultry.

The Canadian Food Inspection Agency confirmed H5N1 after the farm experienced sudden deaths of birds over several days. The event is considered a nonpoultry event, and the facility doesn't produce birds for sale.

Portugal's outbreak began on Dec 22 at a commercial turkey farm in Leiria region, killing 1,459 of 18,100 birds, according to a notification from the World Organization for Animal Health (OIE).

Elsewhere, Taiwan reported highly pathogenic H5N2 events in poultry and wild birds, according to separate notices from the OIE. There were nine poultry outbreaks, mostly at farms, but also at a slaughterhouse and at a site where discarded chickens were found. The outbreaks occurred at different locations in November and December, and taken together, the virus killed 2,755 of 66,408 susceptible birds. Taiwan also reported separate detections of H5N2 and H5N1 in wild birds.
Dec 22 CFIA statement
Dec 24 OIE report on
H5N1 in Portugal
Dec 24 OIE report in
H5N2 in Taiwanese poultry
Dec 24 OIE report on
H5N2 in Taiwanese wild birds
Dec 23 OIE report on
H5N1 in Taiwanese wild birds

In its latest avian influenza overview, the European Centre for Disease Prevention and Control (ECDC) said between Sep 18 and Dec 8, 27 European Union countries and the UK reported 867 highly pathogenic detections in poultry, wild, and captive birds. Italy had the most events in poultry, followed by Hungary and Poland.

It said the frequent incursions in poultry flocks raised concerns about biosecurity gaps. Genetic analysis shows that viruses belong to clade Tests suggest H5N1 viruses in Sweden, Germany, Poland, and the UK have been circulating in Europe since October 2020. However, viruses from North, Central, and East Europe show a novel reassortant that was introduced in October 2021.
Also, H5N1 was found in mammals in Sweden, Estonia, and Finland, and in some instances, the viruses have an adapative marker associated with increased virulence and replication in mammals.
Dec 22 ECDC report

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