News Scan for Mar 22, 2022

News brief

Project will analyze hospital wastewater for antibiotics, resistant bacteria

The Partnership for European Environmental Research (PEER) yesterday reported the launch of a new project that will use hospital wastewater to assess how antimicrobial stewardship programs are affecting levels of antibiotics and resistant bacteria released into the environment.

The £1.25 million ($1.65 million US) STRESST project (Antimicrobial Stewardship in Hospitals, Resistance Selection and Transfer in One Health context) will use a novel wastewater sampling technique developed by the UK Centre for Hydrology & Ecology (UKCHE) in response to the COVID-19 pandemic to collect and analyze wastewater from a hospital in Malawi. Investigators from UKCHE, the Liverpool School of Tropical Medicine, the University of Bergen, and Wageningen Bioveterinary Research will analyze the water for levels of antibiotics, susceptible and resistant bacteria, and rates of transfer of resistance genes.

The project will ultimately aim to determine if antibiotics present in the hospital wastewater promote selection and sharing of resistance genes among bacteria, how the release of this water into the environment affects microbial communities in the animals that drink it, and whether antimicrobial stewardship programs can reduce the flow of antibiotics and resistant bacteria into the environment.

"We are really excited to be field-testing several next-generation wastewater sampling kits in Malawi to understand the impact of different antibiotic management programmes on the presence of antimicrobial resistance (AMR) in the hospital population," principal investigator Andrew Singer of UKCHE said in a PEER news release.
Mar 21 PEER news release

High-path avian flu outbreaks strike more commercial poultry in 2 states

South Dakota and Maryland reported more highly pathogenic avian flu outbreaks on commercial farms, and Maine reported two more outbreaks in backyard flocks, according to the latest update from the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS).

In South Dakota, the virus struck three more commercial turkey farms in three previously unaffected counties, raising the state's number of outbreaks to six. The latest outbreaks were confirmed in Hanson, Kingsbury, and Hutchinson counties. Hanson and Hutchinson counties are in the southeast corner of the state, not far from Charles Mix County, where the state's first two outbreaks were reported. Kingsbury County is in east central South Dakota. The three newly affected farms house about 108,000 turkeys.

Maryland reported a second outbreak in Cecil County, which involved a large pullet operation housing 315,000 birds. Cecil County is part of the Delmarva Peninsula poultry production area that also includes farms in Delaware and Virginia's eastern shore.

Maine reported two more outbreaks in backyard flocks, raising its total to seven in that setting. The latest events, which involved 46 birds, occurred in Knox and York counties, both of which had reported earlier outbreaks.

The ongoing outbreak activity involves the Eurasian H5N1 strain, which has now led to the loss of about 13.2 million poultry from 17 states since January.
USDA APHIS poultry outbreak page

In global developments, Albania reported highly pathogenic H5N8 avian flu at a poultry farm in Durres County in the west, according to a notification from the World Organisation for Animal Health (OIE). The outbreak started on Mar 17, killing 2,905 of 132,600 susceptible birds.
Mar 20 OIE report on H5N8 in Albania

Kenya yellow fever outbreak sickens 15 people, 4 fatally

A yellow fever outbreak declared by Kenya earlier this month has led to 15 suspected cases and 4 deaths, the World Health Organization (WHO) African regional office said in its latest outbreaks and health emergencies update.

The outbreak is centered in Isiolo County, Kenya's most sparely populated county, located in its central region about 168 miles north of Nairobi. So far, eight villages are affected, and the WHO said the spread of the mosquito-borne virus is concerning, because population immunity is low in the outbreak area. It added that the area has no history of vaccine campaigns or routine immunization.

Lab tests have so far confirmed 2 yellow fever infections among the 15 suspected cases. Further confirmation is under way.

The WHO said though yellow fever is endemic in Kenya, it hadn't been documented before in Isiolo County. It warned that the risk of further spread is high owing to the lack of population immunity. The government is developing a response plan and is planning an immunization campaign to target the affected area.
Mar 22 WHO African regional office weekly report

COVID-19 Scan for Mar 22, 2022

News brief

Study shows efficient deer-to-deer SARS-CoV-2 transmission

A US study shows that white-tailed deer (WTD) inoculated with COVID-19–causing SARS-CoV-2 shed infectious virus for up to 5 days, resulting in efficient deer-to-deer transmission on day 3, findings the authors say highlight the potential for deer to become a reservoir for the virus.

Cornell University and US Department of Agriculture (USDA) researchers conducted the study, published yesterday in PLOS Pathogens. The team intranasally inoculated fawns about 8 months old with SARS-CoV-2 virus.

The fawns, which had high viral loads in their nasal and oral secretions, shed infectious virus for up to 5 days. Efficient transmission to other deer occurred on day 3, but no spread was detected to additional deer introduced to the infected deer on days 6 and 9.

In investigating SARS-CoV-2 viral replication in WTD aged 3 or 4 years, the researchers detected infectious virus up to day 6 in nasal secretions and from respiratory, lymphoid, and central nervous system tissues.

"The study provides important insights on the infection and transmission dynamics of SARS-CoV-2 in WTD, a wild animal species that is highly susceptible to infection and with the potential to become a reservoir for the virus in the field," they wrote.

The study authors noted that SARS-CoV-2 can infect both domestic and wild animal species and that WTD, the most widely distributed cervid species in the Americas, have been shown to be highly vulnerable to the virus, with reported natural infection rates of up to 40% in wild deer in Michigan, Pennsylvania, Illinois, New York, and Texas. Examples of other cervids are moose and elk.

"Understanding the infection and transmission dynamics of SARS-CoV-2 in WTD is critical to prevent future zoonotic transmission to humans, (at the human-WTD interface during hunting or venison farming), and for implementation of effective disease control measures."
Mar 21 PLOS Pathog study

Study: Referrals for partner violence increased during pandemic

A study today in Pediatrics from researchers at Boston Children's Hospital suggests that, even during a shift away from face-to-face care, there was an increase in referrals for intimate partner violence (IPV) after the start of the pandemic.

Face-to-face consults dropped from 28% to 2% when referrals were compared from the 11 months prior to the start of the pandemic to April 2020 through February 2021. But during that period, there was a significant jump in consults (240 to 295; P < .001), primarily for emotional abuse (195 to 264; P = .007).

Psychoeducation referrals also increased significantly (199 to 273; P < .001), while referrals to community resources decreased significantly (111 to 95; P < .001), the authors said.

The authors said the increased isolation, school closures, and compounding economic inequities seen during the early month of the pandemic led to more instances of parent and caregiver IPV, and more referrals to the Advocacy for Women and Kids in Emergencies (AWAKE program) embedded at Boston Children's. Children who witness IPV are at greater risk for a number of worse outcomes, the authors said.

In a commentary on the study, Maya Ragavan, MD, MPH, and Elizabeth Miller, MD, PhD, write that the lessons of the pandemic should not be forgotten: "Healthcare settings must recognize that IPV agencies are integral to the pediatric medical home and essential collaborators in the provision of healing-centered care for IPV survivors and their children."
Mar 22 Pediatrics study and commentary