Study finds boosters give good protection against Omicron hospital cases
A US study of almost 17,000 patients finds modest two-dose Pfizer COVID vaccine effectiveness (VE) against hospitalization and emergency department (ED) admission for Omicron BA.1 (the original Omicron variant) and the BA.2 subvariant, but three-dose VE was 79% and 71% for hospitalization, respectively, and 72% and 21% for ED visits.
Also, VE 3 months or more after the third dose remained high except for BA.2 ED admission.
The test-negative case-control study, by Kaiser Permanente and Pfizer scientists, was published in The Lancet Respiratory Medicine and involved 16,994 COVID-19 members of Kaiser Permanente Southern California—a US healthcare system—who were admitted for an acute respiratory infection. Of those, 7,435 (43.8%) had BA.1, 1,056 (6.2%) had BA.2, and 8,503 (50.0%) did not have SARS-CoV-2.
The researchers noted that two-dose Pfizer VE was 40% (95% confidence interval [CI], 27% to 50%) for hospitalization and 29% (95% CI, 18% to 38%) for ED admission against Omicron BA.1 and 56% (95% CI, 31% to 72%) for hospitalization and 16% (95% CI, –3% to 33%) for ED admission against BA.2.
Three-dose VE was 79% (74% to 83%) for hospitalization and 72% (67% to 77%) for ED visit against BA.1 and 71% (55% to 81%) for hospitalization and 21% (1% to 37%) for ED visit against BA.2. VE 3 months or more after the third dose was 76% (69% to 82%) against BA.1-related hospitalization and 65% (56% to 73%) against BA.1-related ED visit. Against BA.2, VE 3 or more months after the third dose was 70% (53% to 81%) for hospitalization and 5% (−21% to 25%) for ED admission.
In a related commentary, two infectious disease epidemiologists write, "Boosters restore vaccine protection to a high level for at least several months, even against the immune-evasive omicron subvariants." But they add, "Strong and durable protection from the current generation of vaccines increasingly appears to be an elusive goal."
They conclude that the newly available bivalent (two-strain) boosters that specifically target Omicron should help.
Oct 7 Lancet Respir Med study and commentary
Vaccinated COVID patients fare better on mechanical ventilation, data show
A new study in JAMA Network Open suggests vaccinated COVID-19 patients intubated for mechanical ventilation had a higher survival rate than unvaccinated or partially vaccinated patients.
The study tracked outcomes among 265 consecutive COVID patients seen in academic intensive care units (ICUs) in Greece who underwent invasive mechanical ventilation due to acute respiratory distress syndrome from Jun 7, 2021, to Feb 1, 2022.
The authors analyzed outcomes in a full vaccination group, who completed the primary COVID-19 vaccination series more than 14 days but less than 5 months prior to intubation. The other patients were either unvaccinated or partially vaccinated or had completed their full vaccination series more than 5 months earlier. The primary outcome was time from intubation to all-cause ICU mortality.
The median age of intubated patients was 66, and 64.2% were men. Twenty-six (9.8%) in the full vaccination group required ventilation. Patients in the full vaccination group were older (72.5 vs 66.0 years) and had a higher rate of significant comorbidities (92.3% vs 66.9%) than the unvaccinated group.
The authors found full vaccination status was significantly associated with lower mortality compared with controls (16 of 26 patients [61.5%] died in the full vaccination group vs 163 of 239 [68.2%] in the control group; hazard ratio, 0.55 [95% CI, 0.32 to 0.94]; P = .03).
"These findings suggest that the total benefits associated with vaccination against COVID-19 may exceed those previously estimated from the prevention of invasive mechanical ventilation alone," the authors concluded.
Oct 7 JAMA Netw Open study
More cases and deaths reported in Uganda's Ebola outbreak
Uganda's health ministry has recorded 4 more Ebola Sudan infections, raising the number of lab-confirmed cases to 48, the group said today on Twitter, marking its first official update since Oct 3. Officials also reported 7 more deaths in confirmed patients, raising that total to 17.
Earlier in the outbreak, officials reported 18 probable cases, all apparently fatal, which would presumably raise the overall totals to 66 cases and 35 deaths.
Fourteen people are currently in medical care for their infections, and 1,049 contacts are listed for follow up.
In a feature story on the outbreak today, the World Health Organization (WHO) African regional office said as of Oct 8, the case-fatality rate was 23% among confirmed cases.
With support from Doctors Without Borders and other health partners, an isolation tent with 12 beds was built in Mubende 5 days after the outbreak was declared. Another tent was added containing 24 beds and medical equipment, bringing the overall Ebola treatment capacity at the Mubende Regional Referral Hospital to 50 beds.
Seventeen health workers are staffing the treatment unit. The WHO has provided three treatment kits, each with enough to treat 100 patients. The WHO is also supporting local authorities, who have deployed health workers and a fleet of 11 ambulances.
Oct 10 Uganda health ministry tweet
Oct 10 WHO African regional office feature story
Sep 26 WHO outbreak notice
Frozen falafel tied to 20 E coli illnesses in 6 states
The US Centers for Disease Control and Prevention (CDC) on Oct 7 announced an Escherichia coli O121 outbreak that has sickened 20 people from 6 states is linked to frozen falafel sold at Aldi stores.
Of 14 people with available information, 5 were hospitalized, including 1 who developed hemolytic uremic syndrome (HUS), a potentially fatal kidney complication. Illness onsets range from Jul 13 to Sep 13. Eleven patients are from Michigan. Other states reporting cases include Wisconsin (4), Florida (2), Iowa (1), Kansas (1), and Ohio (1).
Interviews with 18 patients by state and local public health departments found that 15 had shopped at Aldi stores, and of those, 6 had eaten Earth Grown brand frozen falafel the week before they became ill. Whole genome sequencing showed that the bacteria from samples from the sick people are closely related, suggesting that they got sick from the same food.
On Oct 7, Cuisine Innovations, based in Lakewood, New Jersey, recalled Earth Grown Vegan Traditional Falafel and Garlic and Herb Falafel. Aldi said Cuisine Innovations is the only company that supplies Earth Grown falafel to Aldi stores.
The Food and Drug Administration (FDA) said in its outbreak announcement that two types of falafel from the company are sold exclusively by Aldi, which removed the products from the stores on Oct 6. In its recall notice, the company said the products were sold in Aldi stores in 37 states and in the District of Columbia.
The CDC advises people not to eat, sell, or serve the recalled frozen falafel. The FDA said the product has an 18-month shelf life and that consumers should check their freezers for the products.
Oct 7 CDC outbreak announcement
Oct 7 FDA outbreak announcement
Oct 7 FDA recall notice
H5N1 avian flu confirmed at Arkansas broiler farm
The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) on Oct 7 reported the first appearance of highly pathogenic avian flu in the current outbreak in Arkansas. The outbreak struck a broiler breeding facility in Madison County, located in northwest corner of the state.
The outbreak brings the number of states reporting poultry outbreaks since early February to 42.
In a statement, the Arkansas Department of Agriculture (ADA) said testing confirmed the finding as H5N1 after increasing mortality was noted over several days. Officials said the birds were depopulated and that the outbreak is the state's first involving a highly pathogenic strain since 2015.
In related developments, APHIS reported more poultry outbreaks in three states. Kentucky reported an outbreak in backyard poultry in Fayette County. South Dakota reported an event at a commercial gamebird farm in Brule County. And Virginia reported an outbreak at an unspecified facility in Hampton.
Oct 7 USDA APHIS statement
Oct 7 ADA statement
USDA APHIS poultry outbreak updates