1.6 million US COVID survivors may still have impaired sense of smell
Upwards of 700,000—perhaps as many as 1.6 million—US COVID-19 survivors haven't recovered their sense of smell after more than 6 months, according to a research letter yesterday in JAMA Otolaryngology-Head & Neck Surgery.
In the first study of its kind, a researcher from Washington University and two editors from the journal estimated the number of new daily COVID-19 cases from Jan 13, 2020, to Mar 7, 2021, using data from the COVID Tracking Project. They also analyzed data from two studies estimating the incidence of olfactory dysfunction (OD) as 52.7% (95% confidence interval [CI], 29.6% to 75.2%) and the OD recovery rate of 95.3% (95% CI, 92.6% to 98.0%).
Six months after the emergence of SARS-CoV-2, the first cases of chronic OD (COD) were identified and increased steadily through April 2021. In May 2021, the analysis predicted a near-exponential rise in the slope of cumulative COD cases through August, to 712,268. The estimated number of Americans expected to develop COD is 170,238 to 1,600,241.
For reference, the authors said that before the pandemic, the National Institute on Deafness and Other Communication Disorders estimated that as many as 13.3 million Americans 40 years and older had measurable OD. The prevalence of OD is 4.2% for Americans 40 to 49 years and 39.4% for those 80 and older.
"The addition of 0.7 to 1.6 million new cases of COD represents a 5.3% to 12% relative increase," the researchers wrote. "COVID-19 affects a younger demographic group than other causes of OD. Thus, the lifelong burden of OD will be much greater for the COVID-19 cohort than for patients in the older age groups."
The authors said that the true prevalence of COD may be much higher than estimated because the number of COVID-19 cases is likely greater than reported by states, and the estimated incidence of OD was derived from relatively healthier outpatients. "The incidence of OD may be higher among patients who were hospitalized with SARS-CoV-2," they added. "These data suggest an emerging public health concern of OD and the urgent need for research that focuses on treating COVID-19 COD."
Nov 18 JAMA Otolaryngol Head Neck Surg research letter
Poorer nations got fewer doses of the COVID vaccines they helped test
High-income countries have received disproportionately more COVID-19 vaccine doses than low- and middle-income countries, allowing them to vaccinate much more of their populations, finds a study yesterday in JAMA Network Open.
Yale University researchers identified COVID-19 vaccines listed by the World Health Organization for emergency use and all vaccine trials completed by Sep 7, 2021.
Six COVID-19 vaccines were listed for emergency use and tested in 25 countries. Of 11 high-income countries hosting completed clinical trials, 10 (90.9%) authorized the tested vaccine and received enough doses to vaccinate a median of 51.7% of residents 15 years and older.
In contrast, low-middle- and upper-middle-income countries had 100% and 90.9% rates of vaccine authorization, respectively, but median vaccination rates were only 31% and 14.9%, respectively. Rates of ongoing and completed vaccine trials were higher in high-income countries than in their lower-income counterparts.
Moderna completed clinical trials in two countries, while AstraZeneca and Janssen (Johnson & Johnson) completed trials in 14 and 10 countries, receiving authorization for their vaccines in 85.7% and 80.0% of them, respectively.
High-income countries received more vaccine doses and thus were able to vaccinate larger median shares of their residents 15 years and older, regardless of manufacturer. Through the COVAX initiative, a median of 15.4%, 48.8%, and 78.8% of doses of vaccines were sent to low-, lower-middle-, and upper-middle-income countries that hosted completed trials.
"Including low- and middle-income countries in research can be an important goal; however, inclusion should correspond with fair access to research benefits, to help avoid exploitation," the authors wrote. "These wealth-based access inequities among countries hosting trials parallel general disparities in COVID-19 vaccine access, as high-income countries have successfully procured and administered doses ahead of low- and middle-income countries."
In a related commentary, Gavin Yamey, MD, of Duke University, and Richard Gordon, PhD, and Glenda Gray, MBBCH, both of the South African Medical Research Council, said that low- and middle-income countries would do well to conduct their own vaccine trials to "ensure that they test product candidates in their own populations, use locally generated data, and ensure local access to the products."
Nov 18 JAMA Netw Open research letter and commentary
CDC says no smallpox detected in vials found in Pennsylvania lab freezer
After conducting tests on vials marked "smallpox" found in a commercial Pennsylvania lab, the Centers for Disease Control and Prevention (CDC) said they do not contain the virus that causes smallpox, the agency said late yesterday in a news release.
Testing showed the vials contain vaccinia, a related poxvirus used in smallpox vaccine, not variola, the virus that causes smallpox. "CDC is in close contact with state and local health officials, law enforcement, and the World Health Organization about these findings," the agency said.
The lab had notified federal authorities on Nov 15 that a lab worker discovered the vials while cleaning out a freezer in a lab that conducts vaccine research. The facility was immediately secured and staff followed standard protocols for notifying the CDC of the discovery. The vials were sent securely to CDC for testing yesterday, and no one was exposed to the contents of the vials, the CDC said.
In 2014, National Institutes of Health employees found decades-old vials that appeared to contain smallpox in an unused lab storage area on its Bethesda, Maryland, campus. Two vials contained viable virus, but no human infections were related to the discovery.
Smallpox was eradicated in the 1970s, but health officials remain concerned that remaining samples could pose a bioterror threat if terrorists obtain them. The last known remaining stockpiles are kept in approved labs in the United States and Russia.
Nov 18 CDC news release
Nov 17 CIDRAP news scan on the vial discovery
CDC closes Salmonella backyard poultry outbreak probe after 1,135 cases
The CDC yesterday added 272 cases to an ongoing Salmonella outbreak tied to backyard poultry, with 1,135 now confirmed sick in 48 states, the District of Columbia, and Puerto Rico. The CDC also said it has closed its investigation into the outbreak.
Two people died from Salmonella infections during this outbreak, and 273 required hospitalization. Illnesses started on dates ranging from Dec 15, 2020, to Oct 10, 2021. Twenty-four percent of those sick were under 5 years, and 12% were under 1 year. Of 1,107 people with sex information available, 646 (58%) were female.
Of 293 people who reported contact with backyard poultry and provided more information, 212 (72%) reported that they bought backyard poultry this year, the CDC said.
In related news, earlier this week the CDC said the Salmonella outbreak linked to onions has grown by 84 cases, to 894, and 1 more state is affected, bringing the total to 38 states plus Puerto Rico. Texas continues to have the most cases, with 207, followed by Oklahoma, with 114 cases.
Twenty-six more people have required hospitalization, bringing that total to 183. No deaths have been reported. Illness onset dates range from May 31 to Oct 25.
"Multiple companies have recalled onions," the CDC said. "All recalled onions were supplied by ProSource Produce LLC and Keeler Family Farms and imported from the State of Chihuahua, Mexico, between July 1, 2021, and August 31, 2021."
Nov 18 CDC backyard poultry report
Nov 18 CDC onion report
US flu levels show another slight rise; biggest burden in younger people
Though flu levels remained below their seasonal baselines, the number of positive respiratory samples and doctor's visits for flulike illness continued to rise in the past week, mainly due to H3N2 in children and young adults, the CDC said today in its latest weekly flu season update.
Both public health and clinical labs reported increasing numbers of flu viruses, mostly H3N2, with 90% of the detections in people ages 5 to 24 years old. Earlier this week, the CDC said it was assisting with an investigation into a large outbreak at the University of Michigan and had received anecdotal reports of outbreaks on other college campuses.
Nationally, clinic visits for flu were at 2.1%, a number that's rising but is still below the baseline of 2.5%.
New Mexico was the only state that reported high or very high activity, based on clinic visits for flulike illness, and Georgia reported moderate activity.
China reports fatal H9N2 avian flu case
China recently reported another H9N2 avian influenza case, which involved a 39-year-old man who died from his infection, according to the latest weekly communicable disease threat report from the European Centre for Disease Prevention and Control (ECDC).
The man from Guizhou prefecture, located in southwest China, became sick on Oct 29 and was hospitalized the same day with a severe illness. He died on Nov 1. The ECDC said no other related cases were detected.
Before the man's illness, China had reported five other H9N2 cases over the past 6 months, including another from Guizhou, according to an avian flu update from Hong Kong's Centre for Health Protection (CHP). The ECDC notes that 94 cases from 8 countries have been reported since 1998, most of them from China.
H9N2 is common in Asian poultry, and sporadic infections are known to occur in people who have contact with poultry or their environments. Infections are usually mild and typically reported in children.
Nov 19 ECDC weekly communicable disease threat report
Nov 16 CHP avian flu update
Nigeria reports another spurt of vaccine-derived polio cases
Only one country—Nigeria—reported new polio cases this week, with more circulating vaccine-derived poliovirus type 2 (cVDPV2) infections, according to the latest weekly update from the Global Polio Eradication Initiative (GPEI).
Nigeria has six new cases, three from Bauchi state, plus one each from Gombe, Katsina, and Yobe states. So far, the country has reported 280 cases this year, up sharply from 8 reported in 2020.
Also, Nigeria reported 26 more environmental cVDPV2 positive, which were from the same three states reporting cases this week, as well as Borno, Kano, Katsina, and Taraba states.
Nov 18 GPEI update