During the first 3 years of the pandemic, at least 255 healthcare workers (HCWs) around the world were attacked, 18 were killed, 147 were injured, and 86 facilities were damaged, finds a report published last week in Health Security.

Led by researchers in the Netherlands, the study extracted data on global COVID-related attacks against HCWs from the Safeguarding Health in Conflict Coalition database from January 2020 to January 2023. The team included incidents related to COVID-19 public health measures or interference with COVID-19 care, including attacks related to conflict.

"During the COVID-19 pandemic, violence targeting healthcare reportedly increased," the researchers wrote. "Attacks against healthcare can severely hamper the public health response during a pandemic."

Likely an undercount

During the study period, 255 COVID-19-related attacks on HCWs were reported, with 18 killed and 147 injured, in addition to damage to 86 facilities. Attacks were most common at the beginning of the pandemic and primarily consisted of "stigma-related" attacks on HCWs. 

The findings of this study emphasize the importance of public education campaigns, improved coordination between healthcare organizations and law enforcement, and the possible need to bolster the security of medical facilities and health workers.

Incidents in 2021 included those against vaccination campaigns and conflict-related attacks that interfered with COVID-19 care. Such incidents were reported in heterogeneous contexts throughout the pandemic.

"Due to underreporting, the data presented are a minimum estimate of the actual magnitude of violence," the study authors wrote. "The findings of this study emphasize the importance of public education campaigns, improved coordination between healthcare organizations and law enforcement, and the possible need to bolster the security of medical facilities and health workers."

Southern Hemisphere flu activity is winding down, and data show that the 2024 season was similar to the region’s earlier flu seasons, a reminder that the virus can cause significant public health impact, the US Centers for Disease Control and Prevention (CDC) said in an overview yesterday.

Though it's important to consider Southern Hemisphere flu activity ahead of the upcoming US flu season, the CDC emphasized that patterns there don't always predict how the season will unfold in the United States. Differences in predominant flu viruses and population immunity can contribute to regional variations, it added.

Mix of subregional flu patterns

In the Southern Hemisphere, flu activity this season varied by virus strain, severity, and timing. In South America, H3N2 was the main strain, and Argentina, Chile, and Uruguay had an early start to their seasons. Chile's activity was very high, and Chile, Ecuador, and Uruguay had high levels of severe disease.

In contrast, H1N1 was dominant in the African region, with Zambia reporting an early start to the season and very high levels of illness and severe disease. Activity continues—now mostly from influenza B—in South Africa and Zambia.

H3N2 was predominant in the Oceania region. The timing of Australia's season was similar to pre-COVID years and similar to its 2023 flu season. Flu activity reached the moderate level and has been decreasing in recent weeks, though several areas are seeing upward trends.

The Southern Hemisphere's flu season typically runs from April through September, but it can sometimes extend into October or November, the CDC said.

"Vaccination remains the best defense against flu and even if vaccination does not prevent the risk of flu entirely, it can help reduce the severity of flu illness in people who get flu despite being vaccinated," the CDC said "In the United States, September and October are generally good times to be vaccinated against flu."

An analysis of veterinary data from Germany found that about 12% of Escherichia coli isolates from the country's dogs and cats are resistant to third-generation cephalosporins, researchers reported yesterday in PLOS One.

In the study, a team led by researchers from Germany's Institute of Veterinary Epidemiology and Biostatistics analyzed antimicrobial susceptibility test results obtained from 3,491 veterinary practices in Germany (33% of all practices nationwide) from 2019 through 2021 through GERM-Vet, Germany's monitoring system for resistant pathogenic bacteria in animals. Out of 175,171 samples, they evaluated 25,491 E coli strains for resistance to several antibiotic classes, focusing on cefovecin, the only third-generation cephalosporin approved for veterinary use. 

Third-generation cephalosporin-resistant E coli is considered a significant health threat in both people and animals, and the study authors note that cefovecin resistance can be reasonably compared to resistance to other third-generation cephalosporins. Third-generation cephalosporin-resistant E coli in companion animals is a particular concern because of the potential for transmission to owners.

"Due to the close contact between pet animals and their owners, information on resistance-carrying pathogens in companion animals is crucial for human health as well," the study authors wrote. "Knowledge about the occurrence and distribution are needed to gain further understanding and contribute to the One Health aspect of AMR [antimicrobial resistance]."

Data highlight need for integrated AMR surveillance

The proportion of E coli isolates that were resistant to cefovecin was 11.6%, with a similar proportion found in dogs (11.6%) and cats (11.7%). But there was notable local variation, with some regions showing resistance proportions around 15%. In addition, cefovecin-resistant E coli showed higher resistance levels to other antibiotics, specifically 30% for trimethoprim-sulfamethoxazole, 28% for chloramphenicol, 18% for enrofloxacin, and 14% for gentamicin.

The authors acknowledge that more research is needed to determine how often third-generation cephalosporin-resistant E coli is exchanged between pets and their owners, but they say the findings demonstrate the importance of integrated AMR surveillance.

"Accurate knowledge of antibiotic resistance in animal pathogens is crucial for the optimal use of antibiotics and benefits human and animal health," they concluded.