News Scan for Oct 04, 2022

News brief

Antibiotic eye drops linked to shorter symptom duration for conjunctivitis

A randomized clinical trial and meta-analysis of previous trials found that topical antibiotics were associated with significantly shorter symptom duration in children with acute infective conjunctivitis, researchers reported today in JAMA Network Open.

The trial, conducted from October 2014 to February 2020, enrolled children ages 6 months to 7 years of age who had acute infective conjunctivitis, which is typically caused by bacteria, and randomized them to receive either moxifloxacin eye drops, placebo eye drops, or no intervention. The primary outcome of the trial was time to clinical cure. The trial also included a subsequent meta-analysis that included the results of the present trial, along with three previously conducted trials, and looked at the proportion of participants with conjunctival symptoms on days 3 to 6.

Of the 88 participants in the present trial, 30 received moxifloxacin eye drops, 27 received placebo eye drops, and 31 received no intervention. The time to clinical cure was significantly shorter in the children who received moxifloxacin eye drops compared with those in the no-intervention group (3.8 days vs 5.7 days; difference, –1.9 days; 95% confidence interval [CI], –3.7 to –0.1 days), but there was no difference between children who received moxifloxacin eye drops and those who received placebo drops (3.8 vs 4.0 days; difference, 0.2 days; 95% CI, –2.2 to 1.6 days). In the Kaplan-Meier survival analysis, both moxifloxacin and placebo eye drops significantly shortened the time to cure compared with no intervention.

In the meta-analysis, which compared 300 children who received topical antibiotics to 284 who received placebo, topical antibiotics were associated with a 41% reduction in conjunctival symptoms on day 3 and day 6 (odds ratio [OR], 0.59; 95% CI, 0.39 to 0.91).

"These findings suggest that topical antibiotic therapy should be considered for acute infective conjunctivitis in children because antibiotics were associated with significantly shorter recovery times," the investigators wrote. They add that the results of the present trial also suggest that lubricating eye drops may have some benefits for the management of acute infective conjunctivitis.
Oct 4 JAMA Netw Open study

WHO reports few flu hot spots for the first part of September

In an update that roughly covers the first half of September, flu activity continued to drop in the Southern Hemisphere except for South Africa, the World Health Organization (WHO) said yesterday.

South Africa has seen a rise in influenza B activity, which involves the Victoria lineage, based on findings from subtyped samples. Flu activity was low in tropical Africa, with no detections in northern Africa.

Flu activity rose slightly in some Arabian Peninsula countries, and in Europe flu remained at interseasonal levels, though a few countries reported rising detections of the H3N2 strain. North America's flu activity also remained at inter-seasonal levels.

H3N2 is still the dominant strain. Of respiratory samples that were positive for flu in the early weeks of September, 88.5% were influenza A. And of the subtyped influenza A samples, 87% were H3N2.
Oct 3 WHO global flu update

Avian flu strikes more poultry in 5 states, including turkey farms

Five states reported more highly pathogenic avian flu outbreaks in poultry, three of them with events at commercial farms, according to the latest updates from the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS).

Regarding outbreaks in commercial poultry, California reported an outbreak at a turkey farm in Stanislaus County that houses 51,000 birds. Similar outbreaks were reported in Pennsylvania's York County at a turkey farm that has 25,200 birds and in Wisconsin's Dunn County at a turkey farm with 79,600 birds.

More detections in backyard poultry were reported from North Dakota (Nelson County), California (Calaveras County), Colorado (Mesa County), and Pennsylvania (Lancaster County).

Since the Eurasian H5N1 strain was first detected in US poultry in February, outbreaks have led to the loss of 46.9 million birds in 40 states.
USDA APHIS poultry avian flu updates

In European developments, Germany reported a new H5N1 event that began on Sep 30 at a backyard location in North Rhine-Westphalia state that has laying hens, geese, broiler chickens, breeding ducks, and breeding turkeys. The virus killed 11 of 240 birds, according to a notice from the World Organization for Animal Health (WOAH).
Oct 3 WOAH notice on H5N1 in Germany

BARDA funds $1 billion for monoclonal antibody for flu, other threats

Vir Biotechnology, based in San Francisco, today announced that it has received a contract worth up to $1 billion from the US Department of Health and Human Services (HHS) Biomedical Advanced Research and Development Authority (BARDA) to develop monoclonal antibodies against flu and other infectious disease threats.

The first part of a multiyear contract provides $55 million to speed the development of a monoclonal antibody to protect against seasonal and pandemic flu. A phase 2 clinical trial is slated to begin in the second half of 2022. In a statement, Vir Biotechnology said the rest of the award will cover up to 12 options to support the development of other preexposure prophylactic antibodies for preventing flu or other pathogens that have pandemic potential.

Rajesh Gupta, MD, MPH, the company's vice president, said the company developed sotrovimab in the fight against COVID-19 and is working on an Ebola countermeasure.

"We now look forward to applying our scientific and executional expertise to this BARDA collaboration focused on advancing innovative solutions to influenza, as well as other infectious diseases with future pandemic potential," he said.

Vir said its agreement with BARDA outlines support for the development of other future pandemic flu monoclonal antibodies, as well as for development of up to 10 emerging infectious disease or chemical, biological, radiological, and nuclear medical countermeasure candidates.
Oct 4 Vir Biotechnology statement

COVID-19 Scan for Oct 04, 2022

News brief

Ohio and Florida data show more Republican excess COVID-19 deaths

New statistics from Ohio and Florida published by the National Bureau of Economic Research (NBER) show that Republicans have suffered more COVID-related excess deaths than Democrats, adding to the literature that demonstrates the link between political party affiliation, vaccination uptake, and COVID-19 mortality.

To conduct the study, researchers linked voter registration data in Ohio and Florida to mortality data to assess the individual-level association between political party affiliation and excess mortality.

The data show that the excess COVID-19 death rate for Republicans was 5.4 percentage points, or 76%, higher than the excess death rate for Democrats, and it increased after vaccines became widely available. After the introduction of vaccines, the excess death rate gap between Republicans and Democrats widened from 1.6 percentage points (22% of the Democrat excess death rate) to 10.4 percentage points (153% of the Democrat excess death rate).

Previous studies have shown Republican-leaning, or "red "counties have had higher COVID-19 mortality rates than Democratic-leaning counties, but this is the first attempt to understand the excess death risk at the individual level.

"Registered Republicans in Florida and Ohio had higher excess death rates than registered Democrats, driven by a large mortality gap in the period after all adults were eligible for vaccines," the authors concluded. "These results adjust for county-by-age differences in excess deaths during the pandemic, suggesting that there were within-age-by-county differences in excess death associated with political party affiliation."
Sep 30 NBER working paper

Study: mRNA boosters extend protection for 4 to 5 months

A new nationwide US study based on data collected from the Centers for Disease Control and Prevention's (CDC's) VISION Network shows mRNA boosters extend protection against moderate and severe disease for 4 to 5 months.

The study, published yesterday in BMJ, is based on more than 893,000 adults in 10 states followed for 18 months. The authors used hospital admission as the metric for severe disease, comparing positive COVID-19 hospitalized patients to case controls who tested negative for the virus. Hospital admissions from Jan 17, 2021 to Jul 12, 2022 were included in the study.

During the Omicron period, vaccine effectiveness against COVID-19 requiring admission to hospital was 89% (95% confidence interval 88% to 90%) within 2 months after dose 3 but waned to 66% (63% to 68%) by 4 to 5 months. Vaccine effectiveness of three doses against emergency department or urgent care visits was 83% (82% to 84%) initially but waned to 46% (44% to 49%) by 4 to 5 months.

Waning was most evident in immunosuppressed individuals. "During the omicron period, vaccine effectiveness waned within six months of the third dose by about 20 percentage points among those without immunocompromising conditions and by more than 40 percentage points among those with immunocompromising conditions," the authors wrote.

In a Regenstrief Institute press release, the authors of the study wrote that the data should compel Americans to get a booster if they have not done so yet.

"If it has been four months or longer since your last COVID booster, or if you had the initial two shots and have never received a booster, you should strongly consider a bivalent booster, which targets ancestral strains of the COVID virus plus subvariants Omicron BA.4 and BA.5," said study co-author Shaun Grannis, MD, Regenstrief Institute vice president for data and analytics.

"The evidence that boosters can keep you healthy is compelling. Combining a COVID booster with an annual flu shot will help you make it through the respiratory disease season."
Oct 3 BMJ study
Oct 3 Regenstrief Institute press release

Kids from low-income areas at triple risk of COVID hospital care: study

A study of more than 688,000 children and adolescents in Germany finds that those living in low-income areas were three times more likely as those in less-deprived areas to be hospitalized for COVID-19.

In the study, published yesterday in JAMA Network Open, a team led by University of Dusseldorf researchers assessed COVID-19 hospitalizations among 688,705 children aged 0 to 18 years enrolled in a statutory health insurance plan from Jan 1, 2020, to Jul 13, 2021. Average age was 8.3 years, and 48.9% were female.

COVID-19 hospitalization was rare, at 0.2%, but was 3.02 more likely in children living in low-income areas than among those in more well-resourced areas and 36% more likely in children whose parents were unemployed long term than those with working parents.

Participants whose parents had low-paying jobs had 29% higher odds of hospitalization than those whose parents earned more.

"This finding suggests that attention must be paid to children with SARS-CoV-2 from vulnerable families, and closer monitoring should be considered," the authors wrote. "A number of explanatory factors, including comorbidities, were taken into account, but their analysis yielded no clear picture about underlying processes," according to a summary of the key findings.

In a related commentary, Thomas Dobbs, MD, MPH, and April Carson, PhD, both of the University of Mississippi, noted that children living in areas with greater inequality in income generally have worse health outcomes.

"This is particularly stark in the United States, a country that ironically has one of the highest per capita incomes but some of the worst health measures when compared with other developed nations," they wrote.

Dobbs and Carson called for community-based interventions to address food and housing insecurity, improve access to healthcare, and reduce barriers to upward social mobility, such as zoning ordinances restricting multifamily housing to high-poverty areas. "Policies and legislation are needed that foster equitable environments, devoid of the societal ills of income inequality, poverty, and racism, if we want to achieve maximal health for all," they concluded.
Oct 3 JAMA Netw Open study and commentary