News Scan for Oct 24, 2022

News brief

CDC confirms variant flu case in Michigan agricultural fair attendee

Late last week, the Centers for Disease Control and Prevention (CDC) reported a further rise in US flu activity, particularly in the southeast and south central regions, along with another variant H3N2 (H3N2v) flu case, this time in a Michigan resident who had indirect exposure to swine at an agricultural fair.

The variant flu case occurred in a child who was not hospitalized and has recovered from his or her illness. No person-to-person transmission of H3N2v associated with this patient has been identified, the CDC said.

This is the ninth variant flu case detected in the United States this year, including 4 H3N2v cases (Michigan, 1; West Virginia, 3), and 5 H1N2v infections (Georgia, Michigan, Ohio, Oregon, and Wisconsin).

As flu activity rises across the country, clinical labs are reporting a 4.4% positivity rate for the past week, and 3% of outpatient visits have been for respiratory illnesses. Nonvariant H3N2 is the dominant strain this season, representing 79.5% of all cases detected thus far. The 2009 H1N1 strain represents 20.5% of cases.
Oct 21 CDC FluView

Four countries report new polio cases

Four countries have new polio cases this week, all vaccine-derived types. Benin, the Democratic Republic of the Congo (DRC), and Yemen have more circulating vaccine-derived poliovirus type 2 (cVDPV2) cases, while the DRC and Malawi have circulating type 1 (cVDPV1) cases, according to the weekly report published by the Global Polio Eradication Initiative (GPEI).

Benin reported a single case in Donga, bringing its 2022 total to seven cases. In Yemen 5 new cVDPV2 cases bring its yearly total to 150. The country saw 66 cVDPV2 cases and 3 cVDPV1 cases in 2021.

The DRC reported 17 new cVDPV2, bringing the yearly total to 154. The DRC also reported 18 cVDPV1 cases, raising the 2022 total to 28.

Finally, Malawi reported one cVDPV1 case in Southern province.
Oct 19 GPEI report

Avian flu strikes Rhode Island flock; H5N1 detected in Mexico, Colombia

The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) on Oct 21 reported the first highly pathogenic avian flu outbreak in a Rhode Island poultry flock, raising the number of affected states to 43.

The state's agriculture department said the outbreak occurred in a backyard flock in Newport County and that its employees have euthanized the mixed-breed flock. Over the summer, officials had warned residents that avian flu had been found in shorebirds such as gulls and that it expected that the virus would spread to domestic birds. Newport County is on the Atlantic coast, just south of Providence.

In related developments, APHIS over the past few days has reported more outbreaks in 10 states, all but 1 involving backyard poultry. The other was an outbreak at an animal rehabilitation facility in New Jersey's Ocean County.

Since outbreaks involving the Eurasian H5N1 strain began in poultry in early February, the virus has led to the loss of 44.6 million birds across 43 states. In related developments, APHIS reported 142 more detections in wild birds, bringing the total since January to 3,072.
Oct 21 USDA APHIS statement
Oct 21 Rhode Island Department of Agriculture news release
USDA APHIS poultry avian flu updates
USDA APHIS wild bird avian flu updates

In international developments, Mexico last week reported its first appearance of highly pathogenic H5N1, according to an Oct 21 notification from the World Organization for Animal Health (WOAH). The detection involved a gyrfalcon found sick in a migratory bird corridor near the city of Metepec, just west of Mexico City.

Similarly, animal health officials in Colombia reported the first H5N1 detections in that nation, which involved domestic birds living together with wild birds at two locations in Choco department in the western part of the country.

Meanwhile, European countries continue to report more H5N1 outbreaks, which have picked up over the last several weeks. They include the United Kingdom (wild birds), Slovenia (wild birds), and Norway (poultry farm).
Oct 21 WOAH report on H5N1 in Mexico
Oct 24 WOAH report on H5N1 in Colombia
WOAH reports on H5N1 in the UK, Slovenia, and Norway

COVID-19 Scan for Oct 24, 2022

News brief

Symptoms after COVID vaccination tied to greater antibody response

A study published late last week in JAMA Network Open links systemic symptoms—those that affect the entire body—after receipt of two doses of mRNA COVID-19 vaccine with stronger SARS-CoV-2 antibody responses than in vaccinees with no or localized symptoms.

In February 2021, a team led by Columbia University researchers invited US adult participants in the Framingham Heart Study, which has been ongoing since 1948, to answer questions on COVID-19 vaccination and symptoms and to submit a dried-blood spot to test their antibody responses to two doses of the Pfizer/BioNTech or Moderna vaccine received at least 2 weeks earlier.

Vaccine-related symptoms were characterized as either systemic (fever, chills, muscle pain, nausea, vomiting, headache, and moderate or severe fatigue) or local (pain at the injection site or rash). Average age of the 928 respondents was 65 years, 39% were men, 96% were White, and 9% reported a previous COVID-19 infection.

After each dose, 48% of participants reported systemic symptoms, while 12% reported only local symptoms, and 40% were asymptomatic. A bivariate analysis tied the presence of symptoms to younger age, female sex, previous infection, and the Moderna vaccine.

Antibody reactivity was detected in 98% of asymptomatic participants, 99% with local-only symptoms, and 99% with systemic symptoms. Adjusted models associated systemic symptoms with a stronger antibody response, but the link weakened after adjustment for potential confounding factors. The results were similar after exclusion of previously infected patients.

The researchers said the findings concur with that of an Aug 16, 2021, study published in JAMA Internal Medicine, which found that US healthcare workers with significant symptoms after mRNA COVID-19 vaccination had higher antibody concentrations.

"In this generalizable cohort, nearly all participants exhibited a positive antibody response to complete mRNA vaccine series," they wrote. "Nonetheless, systemic symptoms remained associated with greater antibody response in multivariable-adjusted models, highlighting unexplained interpersonal variability."

They added, "These findings support reframing postvaccination symptoms as signals of vaccine effectiveness and reinforce guidelines for vaccine boosters in older adults," they concluded.
Oct 21 JAMA Netw Open research letter

Statins may reduce risk of death and COVID-19 severity

Commonly used cholesterol-lowering drugs called statins may reduce the risk of death and the severity of COVID-19 disease, according to a new study of more than 38,000 patients presented at the Anesthesiology annual meeting.

The study was based on electronic medical records from 38,000 Americans hospitalized for COVID-19 at 185 hospitals in the United States from Jan 1 to Sep 30, 2020; 30% of those patients were taking statins to manage cholesterol.

"Statins decrease inflammation, which may help reduce the severity of the disease," said Ettore Crimi, MD, MBA, lead author of the study and a professor at the University of Central Florida, Orlando, in an Academy of Anesthesiologists press release, "Results of our study clearly showed regular statin use is associated with reduced risk of death and improved outcomes in hospitalized COVID-19 patients."

Statin users had a 37% lower risk of dying from COVID-19 than patients not taking the medications, statin users were also less likely to require mechanical ventilation, be discharged to hospice, and require admission into the intensive care unit.

Of the statin users, the mean age was 70.8 years, and 47.1% were women. Of the 70% non-statin users, 48.5% were women, and the mean age was 58.4 years. Chronic statin users showed significantly lower rates of all-cause mortality (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.64 to 0.75), and mortality from COVID-19 (OR, 0.63; 95% CI, 0.58 to 0.69).

"Our results suggest statins could be an additional cost-effective solution against COVID-19 disease severity and should be studied further," said Crimi.
Oct 22 Academy of Anesthesiologists press release