Meta-analysis suggests 14% hospitalization rate for monkeypox patients
A new study published in eClinicalMedicine analyzed 19 studies on monkeypox, which included 7,553 reported cases, among which there were 555 hospitalizations. The meta-analysis suggests monkeypox patients have a 14.1% hospitalization rate.
The authors included studies on monkeypox outbreaks from 1950 through 2022. In all 19 studies, 15 recorded deaths were noted — all in Africa. The median age of cases was 35 years (interquartile range 28 to 38, n = 2010) and 98% of case-patients were male. The case-hospitalization rate (CHR) was 14.1% (95% credible interval, 7.5% to 25.0%). The case-fatality rate (CFR) was calculated to be 0.3%.
"The results from pooled estimates suggest that there has been an attenuation of the case hospitalization rate from nearly 50% during pre-2017 outbreaks to 3.2–9.4% during the 2020 outbreak," the authors wrote.
Until the global outbreak of 2022, most studies on monkeypox have been small, and establishing CHRs and CFRs has been difficult. Researchers have known the Congo Basin clade of the virus, found mostly in Africa, is associated with a CFR of 10%, while the West African clade—the cause of the current outbreak—has a CFR of 3% to 6%.
The authors said the current outbreak will yield significantly lower CFRs, because cases are occurring in upper middle- to high-income countries, among young and middle-aged men who have sex with men who are most often otherwise healthy.
"As sustained human-to-human transmission has been observed and the number of cases grow, it will be important to quantify the morbidity and mortality of MPX infections and the potential for CHR and CFR to evolve," the authors concluded.
Oct 31 EClincalMedicine study
Chronic wasting disease confirmed in Wyoming elk
Chronic wasting disease (CWD)—which most often has affected deer in the United States but can cause disease in other members of the deer family—has been confirmed in two elk in Wyoming, state officials reported earlier this week.
In an Oct 31 news release, the Wyoming Game and Fish Department confirmed the presence of CWD in Elk Hunt Areas 47 and 49. The disease was detected in two bull elk that were harvested by hunters in those areas on Oct 12 and Oct 15.
Those two hunt areas are near Cody and are bordered by areas previously affected by CWD in elk. The disease was confirmed in Hunt Areas 34 in 2015 and 48 in 2017, both of which are to the east. In 2018 CWD was detected in Hunt Area 66 to the northwest, and in 2020 it was found in Hunt Area 45 to the north.
Wyoming Game and Fish officials said that last year they tested 6,947 CWD lymph node samples from deer and elk, mostly submitted by hunters, and continue to monitor for the disease.
At least 30 states have reported CWD cases to date. The disease is always fatal to animals. No human cases have been detected yet, but the Centers for Disease Control and Prevention warn people not to eat meat from CWD-infected animals.
Oct 31 Wyoming Game and Fish news release
Avian flu strikes more poultry in US, Europe
The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) reported more highly pathogenic avian flu outbreaks in poultry in six states over the past few days, including on a commercial turkey farm in Minnesota.
Also, Iowa agriculture officials reported an outbreak at a layer farm, the state's first on a commercial farm since April.
Minnesota's outbreak occurred at a turkey farm in Swift County that houses 45,600 birds. Meanwhile, the Iowa Department of Agriculture and Land Stewardship (IDALS) reported an outbreak at a layer farm in Wright County in the north, which followed a recent detection in backyard birds in Dallas County in central Iowa.
Also, APHIS reported more backyard poultry outbreaks in Montana, New York, Oregon, Tennessee, and Florida.
In wild-bird developments, Louisiana wildlife officials reported H5N1 for the first time in wild birds, which involved a hunter-harvested blue-winged teal in the southwestern part of the state. At the national level, APHIS reported 251 more detections in wild birds, raising the total to 3,375. Most of the new detections were from hunter-harvested birds or live bird surveillance.
APHIS is now tracking H5N1 detections in mammals. So far, 78 detections have been reported, with the most recent samples reported from September involving red foxes in New York. The highest proportion of detections are in the upper Midwest in the Mississippi flyway area.
USDA APHIS poultry avian flu update page
Oct 31 IDALS statement
Oct 31 Louisiana Department of Wildlife and Fisheries statement
USDA APHIS wild bird avian flu update page
USDA APHIS mammal avian flu update page
In international developments, ongoing H5N1 outbreaks in the United Kingdom prompted a recent announcement from the Department for Environment, Food, and Rural Affairs (DEFRA) that poultry must be kept indoors starting on Nov 7. Also, Russia reported a new H5N1 outbreak, according to notifications from the World Organization for Animal Health (WOAH). Russia's outbreak occurred at a commercial farm housing 523,000 birds in Khabarovsk Krai in the far eastern region.
Oct 31 DEFRA announcement
Nov 2 WOAH report on H5N1 in Russia