Flu Scan for Aug 31, 2022

News brief

CDC urges providers to watch for variant flu infections

The Centers for Disease Control and Prevention (CDC) yesterday urged health providers to ask patients with suspected flu infections outside of the regular flu season to ask about any recent exposure to pigs.

So far, five variant cases have been reported over the summer from three states, all but one of which occurred in people who were exposed to pigs or attended an agricultural fair. Three West Virginia cases involved variant H3N2 (H3N2v), and single cases from Ohio and Oregon involved variant H1N2 (H1N2v). All patients recovered, and no human-to-human spread was detected.

The CDC said fair settings allow swine influenza viruses to spread among pigs and from pigs to people, and it said it expects more cases to be reported as the agricultural fair season continues.

It recommends that clinicians who suspect flu in people with recent swine exposure obtain a nasopharyngeal swab and request testing at a state public health lab. The CDC also recommended that people at high risk for flu complications avoid exposure to pigs and swine barns this year.
Aug 30 CDC Health Alert Network notice

H5N1 detected in Canadian bear, Swedish porpoise

Animal health officials in Canada and Sweden recently reported avian influenza in two more mammal species, including a bear in Canada that tested positive for H5N1 and a porpoise in Sweden that was positive for avian flu.

In Canada, the Canadian Wildlife Health Cooperative (CWHC) said that a black female bear was tested in June after visitors to a Quebec national park noticed unusual behavior, and the bear was later found sick and unresponsive. The bear was anesthetized, and brain tissue samples were positive for highly pathogenic H5N1.

The cooperative said while several other mammals have tested positive for H5N1, the case they described is the first known fatal case in a bear. It said the bear probably contracted the virus from eating the carcasses of dead seabirds at the park.

Meanwhile, Swedish officials reported avian flu in a porpoise found stranded on a beach in June, marking the first known detection in that species, according to Agence France-Presse (AFP). Over the past few months, the virus had been detected in seals, including some in Maine.

The young male porpoise was found stranded on a beach in western Sweden in late June. Despite efforts to return it to the water, it died. Testing revealed H5N1 in tissues from several of its organs.
Aug 30 CWHC blog post
Aug 31 AFP story

In other avian flu developments, the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) today reported three more outbreaks at commercial turkey farms in California. One occurred at a facility in Sacramento County that houses 97,000 birds, and two occurred in Tuolumne County, one of them on a farm that has 7,400 birds and another that has 91,000.

Since early February, the virus has led to the loss of 40.5 million birds across 39 states.

Also, APHIS reported 73 more H5N1 detections in wild birds, raising the total to 2,189. Most of the new detections occurred in waterfowl in western states, including Oregon, Utah, Nevada, California, and Alaska. The virus has been found in wild birds in all but five states.
USDA APHIS poultry outbreak page
USDA APHIS wild bird avian flu page

News Scan for Aug 31, 2022

News brief

WHO Director: World does not need to live with monkeypox

Director-General Tedros Adhanom Ghebreyesus, PhD, of the World Health Organization (WHO) today said many European countries, including Germany and the Netherlands, were showing continued slowing of new monkeypox cases, while countries in the Americas (save for Canada) are still seeing increased case counts.

Tedros said the slowing of cases in Europe, once the epicenter of the current outbreak, is welcome news.

"There are encouraging early signs, as evidenced in France, Germany, Portugal, Spain, the United Kingdom. These signs confirm what we have said consistently since the beginning: that with the right measures, this is an outbreak that can be stopped," Tedros said. "And in regions that do not have animal-to-human transmission, this is a virus that can be eliminated."

Unlike COVID-19, which the world will have to live with for the foreseeable future, monkeypox does not have to become an accepted disease, Tedros said.

"Eliminating monkeypox needs three things: the evidence that it's possible, which we are now beginning to see; political will and commitment; and the implementation of public health measures in the communities that need them most," said Tedros.

Globally there are more than 50,000 cases of monkeypox. In the United States, the total stands at 18,417.
Aug 31 WHO remarks
Aug 31 CDC update

Limited COVID healthcare tied to excess deaths in kids, moms in poor countries

COVID-19–related healthcare disruptions in the first year of the pandemic were tied to nearly 114,000 excess deaths in children and mothers in 18 low- and middle-income countries, threatening to erase years of progress, according to an international modeling study published yesterday in PLOS Medicine.

A team led by researchers from the World Bank extracted data on health-service usage from health management information systems in 18 low- and middle-income countries in Africa, Asia, the Caribbean, and the Middle East from January 2018 to June 2021.

Across all countries, all outpatient healthcare visits declined by an estimated average of 13.1%, with drops of 2.6% for maternal services and 4.6% for child services. These decreases were associated with a projected 110,686 excess deaths in children younger than 5 years and 3,276 excess deaths in mothers, representing 3.6% and 1.5% jumps in child and maternal death rates, respectively.

Healthcare usage shortfalls varied widely among countries and health services over time. The largest healthcare disruptions, linked to 27.5% of excess deaths, occurred in spring 2020. The scope of health-service disruptions was significantly associated with the strictness of lockdowns.

The researchers said the healthcare disruptions could have resulted from limited healthcare services during COVID-19 surges; shortages of workers, space, and supplies; and differences in patient behavior because of changes in public transportation, lockdowns, and fear of infection in a healthcare setting.

"This use of facility data highlights the potential, with additional investment and validation, for these systems to play an important role in monitoring the resilience of health systems during times of shock," they wrote.

In a PLOS news release, lead author Tashrik Ahmed, PhD, MPH, of the World Bank, said the study shows how the pandemic has negated years of progress in child and maternal health in vulnerable communities. "As countries tackle multiple crises that continue to restrict service delivery and utilization, these findings can help them promote effective policies to strengthen health systems and recover with greater resilience," he said.
Aug 30 PLOS Med study and news release

Study: COVID-19 vaccine incentives do not impact uptake

Small incentives to get a COVID-19 vaccine, including amounts of $10 to $50, do not meaningfully increase COVID-19 vaccination rates amongst the vaccine hesitant according to a California study. The study is published in Vaccine.

The study was conducted in mid-to-late 2021, after vaccines were widely and easily available across California. Researchers targeted 2,701 unvaccinated members of a Medicaid managed care plan in California and randomly assigned them to different public health messages, $10 or $50 financial incentives for vaccination, a simple vaccination appointment scheduler, or control (no intervention). At the time of the study, roughly 30% of Medicaid recipients in California were unvaccinated.

None of the interventions influenced or increased vaccination rates.

"Although some public health messages increased vaccination intentions, none of the interventions meaningfully changed COVID-19 vaccination rates among the vaccine hesitant," the authors said.

Moreover, the authors found offering financial incentives had perverse effects on intention to vaccination among Trump supporters and those 40 and older.
Aug 30 Vaccine study