Minnesota has reported two more highly pathogenic avian influenza outbreaks at commercial turkey farms, according to the latest updates from the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS). One is at a facility in Redwood County that houses 18,500 birds and the other is a farm in Steele County that has 48,100 birds.

Since avian influenza activity began ramping up again in early October, Minnesota has reported at least 12 outbreaks on turkey farms spanning 7 counties. Minnesota has also reported a large outbreak at a layer farm that led to the loss of nearly 1 million birds.

Elsewhere, two states reported new outbreaks in backyard poultry flocks, including Colorado, which reported an event in Montrose County, and North Dakota, where the virus hit a location in Mcintosh County. The H5N1 outbreaks, which began in February 2022, have led to the loss of a record 61.60 million birds across 47 states.

Outbreaks in the Netherlands and Hungary

Following two new outbreaks in poultry in two different provinces, the first since July, the Netherlands reinstated many of its poultry restrictions, according to an agriculture ministry statement translated and posted by Avian Flu Diary, an infectious disease news blog.

Elsewhere, Hungary also reported a second new outbreak in poultry, this time involving a farm in Bacs-Kiskun County, according to a notification from the World Organization for Animal Health.

The pace of flu detections in the last half of October rose in parts of Asia, the United States, and some tropical countries, the World Health Organization (WHO) said in its latest global flu update.

In East Asia, flu levels rose in China and South Korea, while levels remained elevated in Southeast Asia, with rises reported from Laos and Thailand. Southern Asia's activity rose, mainly fueled by increased detections in Iran.

In the WHO's European region, flu remained low or at baseline in all countries except for Slovakia and Israel. And in the Americas, flu activity rose slightly in the Caribbean, with rising levels in parts of the United States.

Elsewhere, a few other countries reported rises, including Ecuador and Ethiopia.

Of respiratory samples that were positive for flu at national labs during the last half of October, 86% were influenza A, and of subtyped influenza A samples, 67.4% were H3N2 and 32.6% were 2009 H1N1.

The TB Alliance announced yesterday that Indian pharmaceutical company Macleods will start manufacturing an essential component of the shorter, all-oral drug regimen for drug-resistant tuberculosis (DR-TB).

Under a licensing agreement with the non-profit TB Alliance, Macleods will be able to supply 135 low- and middle-income countries (LMICs) with pretomanid, which is part of the 6-month BPaL (bedaquiline, pretomanid, and linezolid) regimen used with or without moxifloxacin (BPaLM). Macleods will supply the drug to those countries through the Stop TB Partnership's Global Drug Facility. Pretomanid was developed by TB Alliance and approved by the Food and Drug Administration in 2019.

The BPaL and BPALM regimens are recommended by the World Health Organization (WHO) for treating DR-TB. Previous treatments lasted 9 to 18 months and included multiple pills and injectable drugs, many of them with toxic side effects. But accessibility remains an issue, particularly in LMICs. According to a recent WHO report, only 40% of the estimated 410,000 patients who developed DR-TB in 2022 were started on one of those regimens.

"Macleods' pretomanid product will create an additional source of pretomanid for countries, thereby making the BPaL regimen even more accessible," Sandeep Juneja, MBA, Senior Vice President of Market Access at TB Alliance, said in a press release.

"Curing drug-resistant TB faster and with fewer pills will help people overcome one of the most difficult-to-treat infections on our planet," added Macleods CEO Vijay Agarwal.

A new study published in the Proceedings of the National Academy of Sciences (PNAS) from researchers at Stockholm University shows that among Sweden’s population, disadvantaged groups suffered the most from COVID-19 disease as well as pandemic economic strain.

"Our results confirm that pandemic burdens were not shouldered equally," lead author Adam Altmejd, PhD, said in a press release. "Socially vulnerable individuals faced higher risks not just to fall seriously sick or die from COVID-19, but also to suffer from lower income, lose their job, not have a cancer diagnosed, or not get an operation.”

The study was based on the demographic risk associated with six negative outcomes during the pandemic, including positive COVID-19 test, death from COVID, hospitalization from COVID, unemployment, income loss, psychiatric care visit, and death from all causes.

Outcomes were compared to those seen in the 4 years prior to the pandemic.

Immigrants suffered most

Between 2016 and 2019, being born outside of Europe and having low education levels were associated with an increased risk of unemployment, loss of income, and all-cause mortality.

Those risks only increased during the first 2 years of the pandemic.

The relative risk of admission to hospital with COVID-19 was close to 2.2 for those born outside of Europe and about 1.4 for those born in Europe, the authors said.

What stands out the most about the 2020 relative risks are the pandemic effects among migrants from outside Europe.

"What stands out the most about the 2020 relative risks are the pandemic effects among migrants from outside Europe, who faced large relative risks of COVID-19 hospitalization and of unemployment compared to natives," the authors wrote. "Moreover, the gradients in COVID-19 morbidity and mortality are substantially steeper than the gradients for general somatic and psychiatric health."