Infectious disease

bird-flu-virus-from-texas-human-case-kills-100%-of-ferrets-in-cdc-study

Bird flu virus from Texas human case kills 100% of ferrets in CDC study

animal experiments, bird flu, CDC, dairy cows, Ferrets, H5N1, Infectious disease, respiratory transmission, Science, texas, Transmission / /

Animal study —

H5N1 bird flu viruses have shown to be lethal in ferret model before.

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Bird flu virus from Texas human case kills 100% of ferrets in CDC study

The strain of H5N1 bird flu isolated from a dairy worker in Texas was 100 percent fatal in ferrets used to model influenza illnesses in humans. However, the virus appeared inefficient at spreading via respiratory droplets, according to newly released study results from the Centers for Disease Control and Prevention.

The data confirms that H5N1 infections are significantly different from seasonal influenza viruses that circulate in humans. Those annual viruses make ferrets sick but are not deadly. They have also shown to be highly efficient at spreading via respiratory droplets, with 100 percent transmission rates in laboratory settings. In contrast, the strain from the Texas man (A/Texas/37/2024) appeared to have only a 33 percent transmission rate via respiratory droplets among ferrets.

“This suggests that A/Texas/37/2024-like viruses would need to undergo changes to spread efficiently by droplets through the air, such as from coughs and sneezes,” the CDC said in its data summary. The agency went on to note that “efficient respiratory droplet spread, like what is seen with seasonal influenza viruses, is needed for sustained person-to-person spread to happen.”

In the CDC’s study, researchers infected six ferrets with A/Texas/37/2024. The CDC’s data summary did not specify how the ferrets were infected in this study, but in other recent ferret H5N1 studies, the animals were infected by putting the virus in their noses. Ars has reached out to the agency for clarity on the inoculation route in the latest study and will update the story with any additional information provided.

All six of the infected ferrets developed severe disease and died. To test how well the virus could spread among the ferrets, the CDC scientists set up experiments to test transmission through direct contact and respiratory droplets. For the direct transmission test, three healthy ferrets were placed in the same enclosures with three experimentally infected ferrets. All three healthy ferrets became infected.

For the respiratory transmission test, three healthy ferrets were placed in enclosures next to enclosures containing the experimentally infected animals. The infected and uninfected ferrets shared air, but did not have direct contact with each other. Of the three healthy ferrets, only one contracted the H5N1 virus (33 percent). Additionally, that one respiratory transmission event seemed to have a one- to two-day delay compared with what’s seen in the same test with seasonal influenza viruses. This suggests further that the virus is inefficient at respiratory transmission.

The CDC called the overall results “not surprising.” Previous ferret experiments with H5N1 isolates—collected prior to the current bird flu outbreak among US dairy cows—have also found that H5N1 is often lethal to ferrets. Likewise, H5N1 isolates collected from Spain and Chile during the current global outbreak also found that the virus was inefficient at spreading via respiratory droplets among ferrets—with rates ranging from 0 percent to 37.5 percent.

For now, the findings don’t affect the CDC’s overall risk assessment for the general public, which is low. However, it does reinforce the risk to those who have contact with infected animals, particularly dairy and poultry farm workers.

To date, there have been four human cases of H5N1 in the US since the current global bird flu outbreak began in 2022—one in a poultry farm worker in 2022 and three in dairy farm workers, all reported between the beginning of April and the end of May this year. So far, the cases have been mild, the CDC noted, but given the results in ferrets, “it is possible that there will be serious illnesses among people,” the agency concluded.

As of June 9, the US Department of Agriculture has confirmed H5N1 in 85 dairy herds and one alpaca farm across 10 states.

Bird flu virus from Texas human case kills 100% of ferrets in CDC study Read More »

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After mice drink raw H5N1 milk, bird flu virus riddles their organs

avian influenza, bird flu, CDC, cows, dairy cows, fda, flu, H5N1, Infectious disease, Mice, milk, outbreak, raw milk, Science, USDA, virus / /

Deadly dairy —

No, really, drinking raw milk during the H5N1 outbreak is a bad idea.

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Fresh raw milk being poured into a container on a dairy farm on July 29, 2023, in De Lutte, Netherlands.

Enlarge / Fresh raw milk being poured into a container on a dairy farm on July 29, 2023, in De Lutte, Netherlands.

Despite the delusions of the raw milk crowd, drinking unpasteurized milk brimming with infectious avian H5N1 influenza virus is a very bad idea, according to freshly squeezed data published Friday in the New England Journal of Medicine.

Researchers at the University of Wisconsin-Madison squirted raw H5N1-containing milk from infected cows into the throats of anesthetized laboratory mice, finding that the virus caused systemic infections after the mice were observed swallowing the dose. The illnesses began quickly, with symptoms of lethargy and ruffled fur starting on day 1. On day 4, the animals were euthanized to prevent extended suffering. Subsequent analysis found that the mice had high levels of H5N1 bird flu virus in their respiratory tracts, as well their hearts, kidneys, spleens, livers, mammary glands, and brains.

“Collectively, our data indicate that HPAI [Highly Pathogenic Avian Influenza] A(H5N1) virus in untreated milk can infect susceptible animals that consume it,” the researchers concluded. The researchers also found that raw milk containing H5N1 can remain infectious for weeks when stored at refrigerator temperatures.

Bird flu has not historically been considered a foodborne pathogen, but prior to the unexpected outbreak of H5N1 in US dairy cows discovered in March, it had never been found at high levels in a food product like milk before. While experts have stepped up warnings against drinking raw milk amid the outbreak, the mouse experiment offers some of the first data on the risks of H5N1 from drinking unpasteurized dairy.

Before the mouse data, numerous reports have noted carnivores falling ill with H5N1 after eating infected wild birds. And a study from March in the journal Emerging Infectious Diseases reported that over half of the 24 or so cats on an H5N1-infected dairy farm in Texas died after drinking raw milk from the sick cows. Before their deaths, the cats displayed distressing neurological symptoms, and studies found the virus had invaded their lungs, brains, hearts, and eyes.

While the data cannot definitely determine if humans who drink H5N1-contaminated raw milk will suffer the same fate as the mice and cats, it highlights the very real risk. Still, raw milk enthusiasts have disregarded the concerns. PBS NewsHour reported last week that since March 25, when the H5N1 outbreak in US dairy cows was announced, weekly sales of raw cow’s milk have ticked up 21 percent, to as much as 65 percent compared with the same periods a year ago, according to data shared by market research firm NielsenIQ. Moreover, the founder of California-based Raw Milk Institute, Mark McAfee, told the Los Angeles Times this month that his customers baselessly believe drinking H5N1 will give them immunity to the deadly pathogen.

In normal times, the Centers for Disease Control and Prevention and the Food and Drug Administration strongly discourage drinking raw milk. Without pasteurization, it can easily be contaminated with a wide variety of pathogens, including Campylobacter, Cryptosporidium, E. coli, Listeria, Brucella, and Salmonella.

Fortunately, for the bulk of Americans who heed germ theory, pasteurization appears completely effective at deactivating the virus in milk, according to thorough testing by the FDA. Pasteurized milk is considered safe during the outbreak. The US Department of Agriculture, meanwhile, reports finding no H5N1 in retail beef so far and, in laboratory experiments, beef patties purposefully inoculated with H5N1 had no viable virus in them after the patties were cooked to 145°F (medium) or 160°F (well done).

To date, the USDA has reported that H5N1 has infected at least 58 dairy herds in nine states.

After mice drink raw H5N1 milk, bird flu virus riddles their organs Read More »

it-could-soon-be-illegal-to-publicly-wear-a-mask-for-health-reasons-in-nc

It could soon be illegal to publicly wear a mask for health reasons in NC

cancer, health, house bill, immunocompromised, Infectious disease, masks, North Carolina, pandemic, public health, Science / /

Freedumb —

Senators skeptical of legal trouble for harmless masking after moving to make it illegal.

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It could soon be illegal to publicly wear a mask for health reasons in NC

The North Carolina State Senate on Wednesday voted 30–15, along party lines, in favor of a Republican bill that would make it illegal for people in the state to wear a mask in public for health reasons. The bill is now moving to the House, where it could potentially see changes.

The proposed ban on health-based masking is part of a larger bill otherwise aimed at increasing penalties for people wearing masks to conceal their identity while committing a crime or impeding traffic. The bill was largely spurred by recent protests on university and college campuses across the country, including North Carolina-based schools, against the war in Gaza. In recent months, there have been demonstrations in Raleigh and Durham that have blocked roadways, as well as clashes on the nearby campus of the University of North Carolina at Chapel Hill. Some demonstrators were seen wearing masks in those events.

But the bill, House Bill 237, goes a step further by making it illegal to wear a mask in public for health and safety reasons, either to protect the wearer, those around them, or both. Specifically, the bill repeals a 2020 legal exemption enacted amid the COVID-19 pandemic, which allowed for public health-based masking for the first time in decades.

Prior to 2020, laws dating back to 1953 largely prohibited public masking. The prohibition was part of a crackdown on “secret societies” at the time, or more specifically, an attempt to curtail the activities of the Ku Klux Clan in the state. Exemptions only existed for things like holiday costumes, theater productions, gas masks, and members of public parades or ceremonies that had obtained permits.

On Wednesday, North Carolina residents with compromised immune systems spoke—while masked—during a public comment section. Simone Hetherington told lawmakers that masking was the only way to protect herself in public from illness and feared passage of the bill would prevent her from doing so, according to reporting by the Associated Press.

But, according to The News & Observer, Republicans were dismissive of that possibility, arguing that in the decades prior to the pandemic, when public masking was largely illegal, they couldn’t recall anyone being prosecuted for wearing a mask for health reasons.

Raleigh-based news outlet WRAL quoted Sen. Sydney Batch, a Democrat from Wake, who criticized the bill along with fellow Democratic colleagues. Batch, a cancer survivor, spoke of how her husband and children wore masks to protect her while she underwent cancer treatments that weakened her immune system. “This bill criminalizes their behavior and mine,” she said. “We talk a lot about freedoms in this chamber. I hear it all the time. I should have the freedom—my children and my husband should have the freedom—to wear masks in order to protect and save my life, without fear of being arrested and charged.”

It could soon be illegal to publicly wear a mask for health reasons in NC Read More »

we-still-don’t-understand-how-one-human-apparently-got-bird-flu-from-a-cow

We still don’t understand how one human apparently got bird flu from a cow

bird flu, cattle, CDC, cows, genetic surveillance, H5N1, human case, Infectious disease, mutations, outbreak, pandemic, Science, USDA, viral sequences, viruses / /
Holstein dairy cows in a freestall barn.

Enlarge / Holstein dairy cows in a freestall barn.

The US Department of Agriculture this week posted an unpublished version of its genetic analysis into the spillover and spread of bird flu into US dairy cattle, offering the most complete look yet at the data state and federal investigators have amassed in the unexpected and worrisome outbreak—and what it might mean.

The preprint analysis provides several significant insights into the outbreak—from when it may have actually started, just how much transmission we’re missing, stunning unknowns about the only human infection linked to the outbreak, and how much the virus continues to evolve in cows. The information is critical as flu experts fear the outbreak is heightening the ever-present risk that this wily flu virus will evolve to spread among humans and spark a pandemic.

But, the information hasn’t been easy to come by. Since March 25—when the USDA confirmed for the first time that a herd of US dairy cows had contracted the highly pathogenic avian influenza H5N1 virus—the agency has garnered international criticism for not sharing data quickly or completely. On April 21, the agency dumped over 200 genetic sequences into public databases amid pressure from outside experts. However, many of those sequences lack descriptive metadata, which normally contains basic and key bits of information, like when and where the viral sample was taken. Outside experts don’t have that crucial information, making independent analyses frustratingly limited. Thus, the new USDA analysis—which presumably includes that data—offers the best yet glimpse of the complete information on the outbreak.

Undetected spread

One of the big takeaways is that USDA researchers think the spillover of bird flu from wild birds to cattle began late last year, likely in December. Thus, the virus likely circulated undetected in dairy cows for around four months before the USDA’s March 25 confirmation of an infection in a Texas herd.

This timeline conclusion largely aligns with what outside experts previously gleaned from the limited publicly available data. So, it may not surprise those following the outbreak, but it is worrisome. Months of undetected spread raise significant concerns about the country’s ability to identify and swiftly respond to emerging infectious disease outbreaks—and whether public health responses have moved past the missteps seen in the early stages of the COVID-19 pandemic.

But another big finding from the preprint is how many gaps still exist in our current understanding of the outbreak. To date, the USDA has identified 36 herds in nine states that have been infected with H5N1. The good news from the genetic analysis is that the USDA can draw lines connecting most of them. USDA researchers reported that “direct movement of cattle based upon production practices” seems to explain how H5N1 hopped from the Texas panhandle region—where the initial spillover is thought to have occurred—to nine other states, some as far-flung as North Carolina, Michigan, and Idaho.

Bayes factors for inferred movement between different discrete traits of H5N1 clade 2.3.4.4b viruses demonstrating the frequency of movement.

Enlarge / Bayes factors for inferred movement between different discrete traits of H5N1 clade 2.3.4.4b viruses demonstrating the frequency of movement.

Putative transmission pathways of HPAI H5N1 clade 2.3.4.4b genotype B3.13 supported by epidemiological links, animal movements, and genomic analysis.

Enlarge / Putative transmission pathways of HPAI H5N1 clade 2.3.4.4b genotype B3.13 supported by epidemiological links, animal movements, and genomic analysis.

Putative transmission pathways of HPAI H5N1 clade 2.3.4.4b genotype B3.13 supported by epidemiological links, animal movements, and genomic analysis. [/ars_img]The bad news is that those lines connecting the herds aren’t solid. There are gaps in which the genetic data suggests unidentified transmission occurred, maybe in unsampled cows, maybe in other animals entirely. The genetic data is clear that once this strain of bird flu—H5N1 clade 2.3.4.4 genotype B3.13 —hopped into cattle, it could readily spread to other mammals. The genetic data links viruses from cattle moving many times into other animals: There were five cattle-to-poultry jumps, one cattle-to-raccoon transmission, two events where the virus moved from cattle to domestic cats, and three times when the virus from cattle spilled back into wild birds.

“We cannot exclude the possibility that this genotype is circulating in unsampled locations and hosts as the existing analysis suggests that data are missing and undersurveillance may obscure transmission inferred using phylogenetic methods,” the USDA researchers wrote in their preprint.

We still don’t understand how one human apparently got bird flu from a cow Read More »

20%-of-grocery-store-milk-has-traces-of-bird-flu,-suggesting-wider-outbreak

20% of grocery store milk has traces of bird flu, suggesting wider outbreak

bird flu, CDC, cows, fda, H5N1, health, Infectious disease, milk, Science, USDA, virus / /

widespread —

The milk is still considered safe, but disease experts are alarmed by the prevalence.

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20% of grocery store milk has traces of bird flu, suggesting wider outbreak

The Food and Drug Administration reported late Thursday that about 20 percent of retail milk samples from around the country tested positive for genetic fragments of the bird flu, aka highly pathogenic avian influenza (HPAI) virus H5N1. While retail milk is still considered to be safe, the finding suggests that the spread of the virus in cows is more extensive than is currently known.

The FDA used a test called quantitative polymerase chain reaction (qPCR), which can only detect the presence of genetic fragments. In pasteurized retail milk, it is highly likely that those genetic snippets are merely remnants of virus particles destroyed during pasteurization. The FDA is currently conducting additional testing using egg inoculation tests, a gold standard for detecting a live virus, to confirm the effectiveness of pasteurization. Meanwhile, the director of the National Institute of Allergy and Infectious Diseases, Jeanne Marrazzo, told reporters Wednesday that tests at the agency’s federal labs so far did not identify live virus from any of its sampling. Additionally, several previous studies have found that pasteurization of eggs—which is done at a lower temperature than it is for milk—was effective at destroying H5N1.

While experts are largely unconcerned with the safety of commercial milk, the potential for wide, unrecognized spread of bird flu in dairy herds is alarming. To date, the US Department of Agriculture has only confirmed infections in 33 herds in eight states. The FDA acknowledged that of its positive samples, “a greater proportion of positive results [are] coming from milk in areas with infected herds.” But with tens of thousands of dairy herds in the US, the finding suggests that infections are being missed. It does not necessarily suggest that 20 percent of all cows are affected, since milk is pooled for commercial distribution. But 33 herds alone are unlikely to explain the high prevalence.

Last week, The New York Times reported that the one dairy herd that tested positive for bird flu in North Carolina did not show any symptoms of the infection. The possibility of asymptomatic spread of the virus among cows will make containment and monitoring far more difficult—and could explain why infections may be easily missed. On Wednesday, the USDA issued a federal order requiring dairy cattle to have a negative H5N1 test before being moved across state lines.

For now, the risk to the public is still considered low by the Centers for Disease Control and Prevention. But the more the bird flu virus spreads among mammals—and mammals with close contact with humans—the more opportunities it has to evolve to jump to and among people, experts warn.

20% of grocery store milk has traces of bird flu, suggesting wider outbreak Read More »

three-women-contract-hiv-from-dirty-“vampire-facials”-at-unlicensed-spa

Three women contract HIV from dirty “vampire facials” at unlicensed spa

CDC, health, HIV, Infectious disease, outbreak, outbreak investigation, platelet-rich plasma, Science, spa, vampire facials / /

Yikes —

Five patients with links to the spa had viral genetic sequences that closely matched.

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Drops of the blood going onto an HIV quick test.

Enlarge / Drops of the blood going onto an HIV quick test.

Trendy, unproven “vampire facials” performed at an unlicensed spa in New Mexico left at least three women with HIV infections. This marks the first time that cosmetic procedures have been associated with an HIV outbreak, according to a detailed report of the outbreak investigation published today.

Ars reported on the cluster last year when state health officials announced they were still identifying cases linked to the spa despite it being shut down in September 2018. But today’s investigation report offers more insight into the unprecedented outbreak, which linked five people with HIV infections to the spa and spurred investigators to contact and test nearly 200 other spa clients. The report appears in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

The investigation began when a woman between the ages of 40 and 50 turned up positive on a rapid HIV test taken while she was traveling abroad in the summer of 2018. She had a stage 1 acute infection. It was a result that was as dumbfounding as it was likely distressing. The woman had no clear risk factors for acquiring the infection: no injection drug use, no blood transfusions, and her current and only recent sexual partner tested negative. But, she did report getting a vampire facial in the spring of 2018 at a spa in Albuquerque called VIP Spa.

“Vampire facial” is the common name for a platelet-rich plasma microneedling procedure. In this treatment, a patient’s blood is drawn, spun down to separate out plasma from blood cells, and the platelet-rich plasma is then injected into the face with microneedles. It’s claimed—with little evidence—that it can rejuvenate and improve the look of skin, and got notable promotions from celebrities, including Gwyneth Paltrow and Kim Kardashian.

The woman’s case led investigators to VIP Spa, which was unlicensed, had no appointment scheduling system, and did not store client contact information. In an inspection in the fall of 2018, health investigators found shocking conditions: unwrapped syringes in drawers and counters, unlabeled tubes of blood sitting out on a kitchen counter, more unlabeled blood and medical injectables alongside food in a kitchen fridge, and disposable equipment—electric desiccator tips—that were reused. The facility also did not have an autoclave—a pressurized oven—for sterilizing equipment.

A novel and challenging investigation

The spa was quickly shut down, and the owner Maria de Lourdes Ramos De Ruiz, 62, was charged with practicing medicine without a license. In 2022, she pleaded guilty to five counts and is serving a three-and-a-half-year prison sentence.

A second spa client, another woman between the ages of 40 and 50, tested positive for HIV in a screen in the fall of 2018 and received a diagnosis in early 2019. She has received a vampire facial in the summer of 2018. Her HIV infection was also at stage 1. Investigators scrambled to track down dozens of other clients, who mostly spoke Spanish as their first language. The next two identified cases weren’t diagnosed until the fall of 2021.

The two cases diagnosed in 2021 were sexual partners: a woman who received three vampire facials in the spring and summer of 2018 from the spa and her male partner. Both had a stage 3 HIV infection, which is when the infection has developed into Acquired Immunodeficiency Syndrome (AIDS). The severity of the infections suggested the two had been infected prior to the woman’s 2018 spa treatments. Health officials uncovered that the woman had tested positive in an HIV screen in 2016, though she did not report being notified of the result.

The health officials reopened their outbreak investigation in 2023 and found a fifth case that was diagnosed in the spring of 2023, which was also in a woman aged 40 to 50 who had received a vampire facial in the summer of 2018. She had a stage 3 infection and was hospitalized with an AIDS-defining illness.

Viral genetic sequencing from the five cases shows that the infections are all closely related. But, given the extent of the unsanitary and contaminated conditions at the facility, investigators were unable to determine precisely how the infections spread in the spa. In all, 198 spa clients were tested for HIV between 2018 and 2023, the investigators report.

“Incomplete spa client records posed a substantial challenge during this investigation, necessitating a large-scale outreach approach to identify potential cases,” the authors acknowledge. However, the investigation’s finding “underscores the importance of determining possible novel sources of HIV transmission among persons with no known HIV risk factors.”

Three women contract HIV from dirty “vampire facials” at unlicensed spa Read More »

fragments-of-bird-flu-virus-genome-found-in-pasteurized-milk,-fda-says

Fragments of bird flu virus genome found in pasteurized milk, FDA says

avian influenza, bird flu, CDC, cows, dairy cows, fda, flu, H5N1, Infectious disease, influenza, milk, pasteurization, Science, Uncategorized / /

Milk testing —

The test cannot tell if the virus is live. The FDA still assess milk supply as safe.

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Cows being milked

Enlarge / Cows being milked

The Food and Drug Administration on Tuesday announced that genetic fragments from the highly-pathogenic avian influenza virus H5N1 have been detected in the pasteurized, commercial milk supply. However, the testing completed so far—using quantitative polymerase chain reaction (qPCR)—only detects the presence of viral genetic material and cannot tell whether the genetic material is from live and infectious viral particles or merely remnants of dead ones killed by the pasteurization process.

Testing is now ongoing to see if viable, infectious H5N1 can be identified in milk samples.

So far, the FDA still believes that the milk supply is safe. “To date, we have seen nothing that would change our assessment that the commercial milk supply is safe,” the agency said in a lengthy explanation of the finding and ongoing testing.

H5N1 made its startling jump to US dairy cows recently, with the first ever documented cases in a Texas herd confirmed on March 25. It has spread widely since then with at least 32 herds in eight states now known to be infected. The unexpected spread to bovines has raised fears that the virus is evolving to infect mammals more efficiently, and so poses a heightened risk of spread to and among humans.

But amid the alarming outbreak among the country’s dairy herds, federal agencies have appeared confident that the virus poses little risk to no risk to the safety of the milk supply.

“At this time, there continues to be no concern that this circumstance poses a risk to consumer health, or that it affects the safety of the interstate commercial milk supply because products are pasteurized before entering the market” the FDA wrote in an FAQ published Friday. “Pasteurization has continually proven to inactivate bacteria and viruses, like influenza, in milk.”

In the announcement Tuesday, the FDA also highlighted that multiple studies have shown that the pasteurization process for eggs, which uses lower temperatures than what is used for milk, is effective at inactivating H5N1.

Nevertheless, the FDA, along with the Centers for Disease Control and Prevention and the US Department of Agriculture, have continued to investigate potential risks, including establishing whether pasteurization can inactivate this specific virus. The FDA noted in its announcement Tuesday that, while pasteurization is expected to kill the virus, pasteurization is “different than complete sterilization.”

As such, it carried out the qPCR tests, expecting it might find some genetic fragments in the pasteurized milk because virus has been detected in raw milk. “Based on available information, pasteurization is likely to inactivate the virus, however the process is not expected to remove the presence of viral particles,” the FDA explained. “Therefore, some of the samples collected have indicated the presence of HPAI [Highly Pathogenic Avian Influenza] using quantitative polymerase chain reaction (qPCR) testing.”

The FDA did not indicate how many samples it has tested, where the samples were collected from, or the level of viral genetic material the samples contained.

The agency is now working on assessing whether it can identify if any virus particles are infectious using egg inoculation tests, which are considered a gold-standard for determining viral viability. It added that it will release results from those tests and others in “the next few days to weeks.”

“[W]e take this current situation and the safety of the milk supply very seriously. We recognize the importance of releasing further, actionable information,” the FDA said.

Meanwhile, the agency reported that the CDC’s food safety group has been closely monitoring emergency department data and flu testing data for any unusual trends in flu-like illness, flu, or conjunctivitis, which could indicate spread of H5N1 to people. “To date, surveillance systems do not show any unusual trends or activity,” the FDA said.

Fragments of bird flu virus genome found in pasteurized milk, FDA says Read More »

puerto-rico-declares-public-health-emergency-as-dengue-cases-rise

Puerto Rico declares public health emergency as dengue cases rise

Aedes aegypti, dengue, health, Infectious disease, mosquitoes, Puerto Rico, Science, viral infection / /

emergency —

Cases so far are up 140 percent compared to this point last year.

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Female Aedes aegypti mosquito as she was in the process of obtaining a

Female Aedes aegypti mosquito as she was in the process of obtaining a “blood meal.”

Puerto Rico has declared a public health emergency amid an ongoing outbreak of dengue infections, a mosquito-spread viral infection that can cause fever, aches, rash, vomiting, and, in about 5 percent of cases, a severe disease marked by internal bleeding and shock.

The US territory has tallied 549 cases since the start of the year, representing a 140 percent increase compared with cases tallied at this point last year, according to the territory’s health department. The Associated Press reported that more than 340 of the 549 cases have been hospitalized.

In 2023, the island nation of more than 3.2 million people had over 1,000 cases of dengue throughout the year.

But this year’s cases are rising rapidly, leading health officials to warn residents to be vigilant and take prevention measures. That includes wearing insect repellent and draining or treating any standing water where mosquitoes can breed. The mosquitoes that transmit dengue—Aedes aegypti—seem to prefer breeding in artificial containers, such as flower pots, buckets, water drums, vases, plastic containers of any kind, the inner rings of discarded automobile tires, and trash in general. They can breed in tiny amounts of water, such as in bottle caps.

Puerto Rico’s outbreak of dengue is part of a larger regional trend, the island’s health department noted. Last year, the Americas saw the highest number of dengue cases ever recorded, totaling 4,565,911, according to the Pan American Health Organization (PAHO), a division of the World Health Organization. So far this year, the region has reported 3,578,414 cases, including 1,039 deaths. The bulk of the cases are in Brazil, which has reported over 2.9 million cases so far. Paraguay has reported over 191,000 cases, and Argentina has reported over 134,000 cases.

In a December 2023 risk assessment, the PAHO deemed the risk to human health from dengue to be “high” in the region. The report noted that the effects of climate change are driving higher rainfall, higher temperatures, and more humidity, allowing A. aegypti to expand into new areas and increase breeding. A. aegypti are already found in much of South America, Central America, and the southeastern US.

This post was updated to include additional case tallies. 

Puerto Rico declares public health emergency as dengue cases rise Read More »

gastrointestinal-disease-explodes-in-ala.-elementary-school;-773-kids-out

Gastrointestinal disease explodes in Ala. elementary school; 773 kids out

Alabama, elementary school, gastrointestinal, health, Infectious disease, Norovirus, outbreak, school, Science, students / /

no, no, no —

Highly contagious norovirus is the leading suspect; four other area schools affected.

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An electron micrograph of norovirus.

Enlarge / An electron micrograph of norovirus.

Officials in Alabama have shut down an elementary school for the rest of the week and are conducting a deep clean after 773 of the school’s 974 students were absent Wednesday amid an explosive outbreak of gastrointestinal illness.

Local media reported that only 29 students were absent from Fairhope West Elementary School on Tuesday. However, the situation escalated quickly on Wednesday as word spread of a stomach bug going around the Gulf Coast school. A spokesperson for the county school district told AL.com that 773 students and 50 staff were absent Wednesday. It’s unclear how many of the absences were due to sickness or precaution.

Health officials are now investigating the cause of the gastrointestinal outbreak, collecting specimens for testing. So far, officials are working under the assumption that it is norovirus, a highly infectious gastrointestinal bug that can survive hand sanitizer and transmit easily from surfaces, food, and water. The symptoms of the unidentified illness align with norovirus: vomiting, diarrhea, abdominal cramps, and nausea.

On Wednesday, Baldwin County Schools Superintendent Eddie Tyler sent a message to parents saying that the county had decided to shut the school down for the rest of the week. “Due to the amount of staff and students who are absent, the number who are experiencing symptoms, and in an effort to help contain the contagion, we unfortunately need to shut the building down,” Tyler wrote. “While out, we will be conducting a deep cleaning of the school so when students return next week, it will be sanitized to the fullest extent.”

But local outlet WKRG reported Thursday that the outbreak has already spread beyond Fairhope West. On Thursday, 1,231 students from four other area schools were also absent, including 721 students at Fairhope East Elementary School, 136 at a third elementary school, 170 at a middle school, and 204 at a high school. These are in addition to the 974 students at Fairhope West who are out of school while it is shut down.

Norovirus activity is high across the country, with the northeastern region seeing the largest surge, according to surveillance by the Centers for Disease Control and Prevention. The agency notes that outbreaks are commonly linked to health care settings, restaurants or catered events, cruise ships, as well as schools and childcare centers. “Close quarters, shared spaces, and high-touch surfaces make it easy for norovirus to spread in schools,” the CDC points out.

In 2022, the COVID-19 pandemic flipped the script on standard norovirus outbreaks. People who were hoping to avoid close contact and share indoor air with strangers headed to the great outdoors, which led to a large outbreak of norovirus in the Grand Canyon.

Gastrointestinal disease explodes in Ala. elementary school; 773 kids out Read More »

measles-erupts-in-florida-school-where-11%-of-kids-are-unvaccinated

Measles erupts in Florida school where 11% of kids are unvaccinated

CDC, Florida, health, Infectious disease, measles, Science, Transmission, vaccination rate, virus / /

outbreak potential —

Over 100 children at the school are susceptible to virus.

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A child with measles.

Enlarge / A child with measles.

Florida health officials on Sunday announced an investigation into a cluster of measles cases at an elementary school in the Fort Lauderdale area with a low vaccination rate, a scenario health experts fear will become more and more common amid slipping vaccination rates nationwide.

On Friday, Broward County Public School reported a confirmed case of measles in a student at Manatee Bay Elementary School in the city of Weston. A local CBS affiliate reported that the case was in a third-grade student who had not recently traveled. On Saturday, the school system announced that three additional cases at the same school had been reported, bringing the current reported total to four cases.

On Sunday, the Florida Department of Health in Broward County (DOH-Broward) released a health advisory about the cases and announced it was opening an investigation to track contacts at risk of infection.

At Manatee Bay Elementary School, the number of children at risk could be over 100 students. According to a Broward County vaccine study reported by the local CBS outlet, only 89.31 percent of students at Manatee Bay Elementary School were fully immunized in the 2023/2024 school year, which is significantly lower than the target vaccination coverage of 95 percent. The school currently has 1,067 students enrolled, suggesting that up to 114 students are vulnerable to the infection based on their vaccination status.

Measles is one of the most contagious viruses known. It spreads via respiratory and airborne transmission. The virus can linger in air space for up to two hours after an infected person has been in an area. People who are not vaccinated or have compromised immune systems are susceptible, and up to 90 percent of susceptible people exposed to the virus will become infected. Measles symptoms typically begin around eight to 14 days after exposure, but the disease can incubate for up to 21 days. The symptoms begin as a high fever, runny nose, red and watery eyes, and a cough before the telltale rash develops. Infected people can be contagious from four days before the rash develops through four days after the rash appears, according to the Centers for Disease Control and Prevention. About 1 in 5 unvaccinated people with measles is hospitalized, the CDC adds, while 1 in 20 infected children develop pneumonia and up to 3 in 1,000 children die of the infection.

Those who are not immunocompromised and are fully vaccinated against measles (who have received two doses of the Measles, Mumps, and Rubella (MMR) vaccine) are generally not considered at risk. The two doses are about 97 percent effective at preventing measles and protection is considered to be life-long.

The DOH-Broward said it is now “identifying susceptible contacts that may be candidates for post-exposure prophylaxis through MMR or immunoglobulin.”

While the risk of measles is generally low in the US—the country declared it eliminated in 2000—the threat of large outbreaks is growing as vaccination rates slip. Many cases in the US are linked to travel from countries where the virus still circulates. But, if a travel-related case lands in a pocket with low vaccination coverage, the virus can take off. Such was the case in 2019, when the country tallied 1,274 measles cases and nearly lost its elimination status.

Health officials typically consider vaccination coverage of 95 percent or greater to protect from ongoing transmission. In the years since the COVID-19 pandemic began, vaccination rates among US kindergartners have slipped to 93 percent, and vaccination exemptions reached an all-time high in the latest data from the 2022-2023 school year. There are now at least 10 states that have vaccination exemption rates above 5 percent, meaning that even if every non-exempt child is vaccinated, those states will not have enough coverage to reach the 95 percent target.

The CDC has tallied 20 measles cases in the US so far this year. But that is the tally as of February 15; it does not include any of the Florida cases reported since Friday. In 2023, there were 58 measles cases reported to the CDC.

This story was updated to include additional information about measles infection outcomes.

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Measles is “growing global threat,” CDC tells doctors in alert message

CDC, health, Infectious disease, measles, MMR vaccines, outbreak, pandemic, Science, vaccines, WHO / /

Alert —

Since December, there have been 23 measles cases in the US, including two outbreaks.

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A baby with measles.

Enlarge / A baby with measles.

The Centers for Disease Control and Prevention is putting clinicians on alert about the growing risk of measles cases and outbreaks amid a global surge in transmission.

In an outreach message sent Thursday, the CDC told clinicians to look out for patients who have a rash accompanied by a fever and other symptoms of measles, as well as patients who have recently traveled to countries with ongoing measles outbreaks.

Between December 1, 2023, and January 23, 2024, there have been 23 confirmed measles cases in the US, including seven direct importations by international travelers and two outbreaks with more than five cases each, the CDC noted. Most of the cases were in unvaccinated children and teens.

Measles outbreaks in the US are typically sparked by unvaccinated or undervaccinated US residents who pick up the infection abroad and then, when they return, transmit the disease to pockets of their communities that are also unvaccinated or undervaccinated.

Globally and in the US, vaccination rates against measles—via the measles, mumps, and rubella vaccine (MMR)—have fallen in recent years due to pandemic-related health care disruption and vaccine hesitancy fueled by misinformation.

“The increased number of measles importations seen in recent weeks is reflective of a rise in global measles cases and a growing global threat from the disease,” the CDC’s outreach message, titled “Stay Alert for Measles Cases,” read.

According to data from the World Health Organization, the European region saw an over 40-fold rise in measles cases in 2023 as compared with 2022. The region tallied over 42,200 measles cases last year, compared with just 941 in 2022.

This week, the WHO reported a rapid escalation of measles cases in Kazakhstan (which the WHO considers part of the European region). Kazakhstan has recorded the highest incidence of measles cases in the region, with 13,677 cases in 2023. That corresponds to over 639 cases per million in the population. In the news release Tuesday, Kazakhstan’s health minister reported that there are “currently 2,167 children in hospital with measles, 27 of them in a serious condition.”

The outbreak is largely spurred by unvaccinated children who missed their routine immunizations during the pandemic. Sixty-five percent of the reported measles cases are in children under age 5, the WHO noted. The country is now trying to catch children up on their vaccines to curb the outbreak.

“Measles is highly infectious, but fortunately, can be effectively prevented through vaccination,” WHO’s Regional Director for Europe, Hans Henri P. Kluge, said in the news release. “I commend Kazakhstan for the urgent measures being taken to stop the spread of this dangerous disease.”

Meanwhile, measles is flaring up in many other places. Last week, the UK Health Security Agency warned of the potential for an ongoing measles outbreak to spread. As of January 18, there were 216 confirmed cases and 103 probable cases in the West Midlands region since October 2023. Authorities warned that any areas with low MMR vaccination rates are at risk of an outbreak.

The vast majority of Americans have received their MMR vaccines on schedule. In this case, the two standard, recommended doses are considered 97 percent effective against measles, and the protection is considered for life. But anyone who is unvaccinated or undervaccinated is at high risk of infection in the event of an exposure. The virus can linger in air space for up to two hours after an infected person leaves the area, the CDC notes, and is highly infectious—up to 90 percent of unvaccinated people exposed will fall ill. Once infected, people are infectious from four days before the telltale measles rash develops to four days afterward.

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