Angola, Nigeria, Somalia record new polio cases

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Oral polio vaccine — ©UNICEF Ethiopia, Demissew Bizuwerk / Flickr cc

Three African nations—Angola, Nigeria, and Somalia—confirmed circulating vaccine-derived poliovirus type 2 (cVDPV2) cases, according to a weekly update from the Global Polio Eradication Initiative (GPEI).

Angola and Nigeria each reported one cVDPV2 case. The patient in Angola, who is from Benguela, had an onset of paralysis on December 12, 2024, raising the country's case total for 2024 to eight. The case in Nigeria is in Jigawa state and involved paralysis onset on January 23, raising the country's 2025 cVDPV2 case count to seven. Nigeria confirmed 98 cases last year.

Somalia confirmed four new cases, all in Bari province. Paralysis symptoms began in December 2024 for all of the patients, bringing the 2024 cVDPV2 total in the country to seven.

Recap of WHO SAGE meeting

The GPEI also provided highlights of last week's meeting of the World Health Organization's Strategic Advisory Group of Experts (SAGE) on Immunization.

The GPEI said, "SAGE expressed concern that despite the increase in wild poliovirus in the endemic areas [Afghanistan and Pakistan], there are no visible efforts towards transformative change in the eradication strategy; expressed concern at circulating variant polioviruses (cVDPVs) and their expansion into new areas, including in European countries; and stressed the need for increased efforts to improve routine immunization and reach zero-dose children."

SAGE reiterated its support for safe sunsetting of the bivalent (two-strain) oral polio vaccine and agreed with already established plans for pre-cessation vaccination campaigns.

The GPEI also noted that a polio vaccination in Gaza begun last month has reached more than 600,000 children under the age of 10 years.

Flu in US continues to decline but still packs a punch

News brief

Lisa Schnirring

US flu activity declined last week for the fifth week in a row, but the Centers for Disease Control and Prevention (CDC) said today it is still seeing substantial activity, with 17 more pediatric flu deaths reported.

sick woman with hot tea — *sezer66 / iStock*

As the nation grappled with a high-severity season, test positivity in the first months of the year reached as high as 31.6%, but that figure is now at 13.3%. The percentage of outpatient visits for flulike illness has declined to 3.9%, but it has been above the baseline of 3% for 16 straight weeks. Most of the state reporting high activity are roughly in the northeastern quadrant of the country.

Of viruses tested at public health labs, 93.7% were influenza A and 6.3% were influenza B. Of subtyped influenza A viruses, 57% were the 2009 H1N1 strain and 43% were H3N2.

Flu hospitalizations this season reached their highest level since the 2010-11 flu season and have been dropping since the middle of February, with declines last week seen in all US regions.

The 17 additional pediatric flu deaths reported last week push the national total to 151. Of the latest deaths, 15 were due to influenza A and 2 from influenza B, and of 10 subtyped influenza A viruses, half were H1N1 and half were H3N2. The previous two flu seasons saw 187 and 207 pediatric flu-related deaths, respectively, for the full season.

In its respiratory virus snapshot, the CDC said it expects flu activity to last several more weeks.

COVID, already at low levels, continues to ebb

The CDC said peak hospitalizations from COVID-19 in the winter respiratory virus season were lower than previous seasons and half that of last season. Deaths from COVID last week made up 1% of all deaths, with the level still trending higher this season for flu, at 1.9%.

Wastewater SARS-CoV-2 detections are at the moderate level and highest in the South, followed by the Midwest.

Study links beta-lactam allergy labels to 'array' of adverse effects

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Chris Dall, MA

A systematic review and meta-analysis found that beta-lactam allergy labels (BALs) are associated with increased rates of surgical-site infection and other adverse outcomes, researchers reported yesterday in The Lancet Infectious Diseases.

The review, led by researchers from the University of Peking, included 63 observational and interventional studies that compared clinical outcomes related to the presence or absence of a BAL.

While an estimated 10% to 15% of adults worldwide carry a BAL, the label is often unverified, and as many as 90% of people with a BAL may actually be beta-lactam tolerant. The concern is that patients with BALs may receive inappropriate treatment with alternative broad-spectrum antibiotics, which can result in unintended adverse effects.

Of the 63 studies reviewed, 60 were from high-income countries. The studies were conducted in the Americas (41), Europe (15), and the Western Pacific region (7).

Overall, BALs were associated with increased rates of surgical site infection (odds ration [OR], 1.60; 95% confidence interval [CI], 1.27 to 2.01), rates of infection or colonization with both multidrug-resistant organisms (MDROs) (OR, 1.42; 95% CI, 1.22 to 1.64) and Clostridioides difficile (OR, 1.26; 95% CI, 1.16 to 1.37), and length of hospital stay (standardized mean difference, 0.06 days; 95% CI, 0.05 to 0.08), although the study authors say the latter finding may not be clinically meaningful.

BALs were also associated with death at or after 180 days but not with overall, in-hospital, or 30-day mortality.

Countries should prioritize management of antibiotic allergy labels

"Given the high prevalence and potential negative consequences of BALs, it is imperative for all countries to prioritise and make proactive efforts to manage antibiotic allergy labels via their national antimicrobial stewardship regulations and clinical guidelines," the authors wrote. "Such efforts include avoiding unnecessary new labels and systematic removal of existing inaccurate labels documented in people's health records (ie, delabelling) by verifying allergy risks and categorising patients' risk levels."

The authors add that while the review is the most comprehensive evaluation of the global burden of BALs to date, further research is needed in low-income countries and children.