News Scan for Jul 21, 2022

News brief

CDC reports 17 more unexplained hepatitis cases in kids

The US Centers for Disease Control and Prevention (CDC) said it has received 17 more reports of unexplained pediatric hepatitis cases that are under investigation, raising the nation's total to 355.

The number of states reporting cases remained the same, at 42.

Similar cases have been reported in several countries, and so far the strongest lead from epidemiologic investigations is a possible role for adenovirus. Scientists, however, are examining several other contributors, which they say might include prior COVID-19 infection, atypical immune response, or exposure to environmental or toxic triggers.

Globally, more than 1,000 cases have been reported, and the World Health Organization recently announced new efforts to gauge prepandemic levels of unexplained hepatitis and liver transplants in children.
Jul 20 CDC update

More avian flu confirmed in US poultry and wild birds

Sporadic highly pathogenic avian flu outbreaks continue to strike US poultry, as federal officials report three more outbreaks, including one at a commercial farm in Utah.

In its latest update, the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) said the outbreak in Utah occurred in Sanpete County, located in the central part of the state, just south of Provo. The facility houses 25,900 birds. The event marks the second recent outbreak at a turkey producer in the county.

Also, officials reported two outbreaks in backyard birds, one in Oregon's Deschutes County and the other in Washington's Snohomish County.

Since the outbreaks in poultry began in early February, the H5N1 outbreaks—which involve the Eurasian strain circulating in several parts of the world—have led to the loss of 40.1 million birds across 37 states.

In related developments, APHIS this week reported 64 more detections in wild birds, raising the total this year to 1,890. The notifications came from several parts of the country and included several vultures, along with gulls, waterfowl, raptors, and even a few ravens.
USDA APHIS poultry outbreak updates
USDA APHIS wild bird H5N1 detections

COVID-19 Scan for Jul 21, 2022

News brief

Pfizer vaccine 83% effective against hospital Omicron illness in kids 5 to 11

In 5- to 11-year-old children, two doses of the Pfizer/BioNTech COVID-19 vaccine were 36.8% effective in preventing all SARS-CoV-2 infections, 63.5% against test-confirmed cases, and 82.7% against hospitalization amid the Omicron variant surge in Singapore, finds a real-world study published yesterday in the New England Journal of Medicine (NEJM).

Researchers in Singapore analyzed data from 255,936 children aged 5 to 11 years from Jan 21 to Apr 8, 2022. In Singapore, COVID-19 vaccination of children 5 to 11 years old began Dec 27, 2021, starting with those aged 9 to 11 and extending to the younger children 2 weeks later.

By the end of the study, 67.7% children were fully vaccinated, 12.0% had one dose, and 20.3% were unvaccinated. Overall, 53,429 COVID-19 infections were reported over the 17.9 million person-days at risk, and 10% were confirmed by polymerase chain reaction (PCR).

Of the 16.4 million person-days at risk for hospitalization, 288 children were admitted for treatment, 5 were hospitalized, and 4 required intensive care; 2 were fully vaccinated, 2 were partially vaccinated, and 1 was unvaccinated.

Rates of all SARS-CoV-2 infections (positive result on PCR or rapid antigen testing), cases confirmed through PCR, and hospitalizations among unvaccinated children were 3,303.5, 473.8, and 30.0 per 1 million person-days, respectively.

Vaccine effectiveness (VE) among partially vaccinated children was 13.6% (95% confidence interval [CI], 11.7% to 15.5%) against infection, 24.3% (95% CI, 19.5% to 28.9%) against PCR-confirmed infection, and 42.3% (95% CI, 24.9% to 55.7%) against hospitalization. Among fully vaccinated children, VE was 36.8% (95% CI, 35.3% to 38.2%) against infection, 65.3% (95% CI, 62.0% to 68.3%) against PCR-confirmed cases, and 82.7% (95% CI, 74.8% to 88.2%) against hospitalization.

"The omicron variant has been reported to result in less severe disease, but the absolute number and rate of hospitalizations among unvaccinated children may still be high because of increased transmissibility," the researchers wrote. "Our results indicate that vaccines may play an important role in reducing infections and hospitalizations during the omicron wave."
Jul 20 NEJM study

COVID-19 in third trimester—but not earlier—linked to preterm birth

A new study of more than 5,000 women shows that contracting COVID-19 during the third trimester of pregnancy is linked to a more than double increased risk of preterm birth. The study was published yesterday in PLOS One.

Israeli researchers using patients in the Maccabi Healthcare Services system matched 2,753 women who were infected during pregnancy with 2,753 women without reported COVID-19 infections. The study ran from February 2020 to July 2021.

Among the women with confirmed COVID-19 infections, 17.4% got COVID-19 during the first trimester, 34.2% during the second. and 48.4% during the third trimester. No association was found between infection in the first or second trimesters with preterm birth, but infection in the third trimester was associated with a 2.76 times likelihood preterm birth (2.76, 95% confidence interval [CI], 1.63 to 4.67), while women infected after 34 weeks of gestation were over seven times more likely to experience preterm birth (7.10; 95% CI, 2.44 to 20.61).

Infection in the third trimester was not, however, associated with an increased risk of infant loss or cesarean birth.

"The results are encouraging and reassuring that COVID-19 infection during pregnancy is not associated with any type of pregnancy loss. However, it should be remembered that the research group tested the COVID pre-Delta variants, and does not refer to the dominant variant today, which is Omicron," said study coauthor Tal Patalon, MD, MBA, in a PLOS press release.
Jul 20 PLOS One study
Jul 20 PLOS press release