News Scan for Aug 05, 2022

Wastewater polio in second New York county factors to wider circulation

Polio in New York state is circulating extra broadly than thought, with wastewater sampling revealing traces of the virus in a second county, the New York Division of Well being (NYDH) introduced yesterday.

Constructive samples have been detected from two geographic places in June and July in Orange County, which is situated north of the New York Metropolis metro space. Additionally, samples have been detected from July in wastewater in Rockland County, which is a part of the metro space and the place a confirmed case and optimistic June wastewater samples have been reported earlier.

Sequencing accomplished by the Facilities for Illness Management and Prevention (CDC) on three wastewater samples from Rockland County and 4 wastewater samples from Rockland County present that they’re genetically linked to the virus discovered within the Rockland County resident. The affected person was reported earlier to be man who sought remedy for weak spot and paralysis. Officers have additionally mentioned that the person’s samples are linked to Sabin-like sort 2 remoted detected in environmental samples from Jerusalem and London, although the findings do not suggest that that the person had traveled to both of the places.

The well being division mentioned the findings within the two counties present proof of native transmission.

Mary Bassett, MD, New York’s well being commissioner, mentioned the one case detected is simply the tip of the iceberg. “Based mostly on earlier polio outbreaks, New Yorkers ought to know that for each one case of paralytic polio noticed, there could also be a whole lot of different folks contaminated,” she mentioned, urging adults and younger youngsters to rise up thus far with their polio immunizations.

Officers mentioned the environmental findings do not implicate the Rockland County affected person because the supply of transmission and that an investigation continues into the origin of the virus.
Aug 4 NYDH statement
Aug 1 CIDRAP Information

In different polio developments, one nation reported a polio case this week, Pakistan with one other wild poliovirus sort 1 (WPV1) case. In its weekly replace, the International Polio Eradication Initiative (GPEI) mentioned Pakistan’s case is from Khyber Pakhtunkhwa, the identical space the place different current circumstances have been reported. The nation has now reported 14 WPV1 circumstances this 12 months.
Aug 4 GPEI update


Research: Stewardship program lower antibiotic prescribing by 20 share factors

An antimicrobial stewardship program (ASP) was tied to a discount in antibiotic prescriptions for specified non–COVID-19 higher respiratory infections (URIs) from 27.6% to 7.6% over 2 years, in line with a examine revealed right this moment in Antimicrobial Stewardship & Healthcare Epidemiology (ASHE).

Researchers from Mayo Clinic Well being System-Southwest Minnesota evaluated their ASP, which was designed to cut back antibiotic prescribing for URIs in household drugs, inside drugs, pediatrics, emergency drugs, and pressing care clinics from 27.6% in 2019 to lower than 21.6% in 2021. The authors famous that antibiotic prescribing had already begun to drop in 2020, earlier than ASP implementation.

Two urgent-care clinics with greater than 300 URI visits per 12 months and an antibiotic prescribing charge better than 40% (high-priority) have been focused, whereas all household drugs, pediatric, and adolescent clinics have been thought-about reasonable priorities as a result of they’d antibiotic prescribing charges of 15% to 57% and solely 100 to 300 annual URI visits.

In 2021, an ASP liaison was recognized for every high-priority division to obtain one-on-one schooling from the ASP pharmacist and month-to-month information experiences on antibiotic prescribing for his or her space. Every moderate-priority division obtained quarterly information summaries.

From October 2020 to February 2021, all departments got at the least one presentation on ASP targets and assets, which included a slide set for supplier schooling, a poster and symptom-management suggestions for sufferers, and an order panel within the digital well being file system with syndrome-specific tips.

Consequently, antibiotic prescriptions for URIs fell from 27.6% in 2019 to 19.1% in 2020 and seven.6% in 2021.

The researchers famous that an estimated 44% of antibiotic prescriptions written for outpatients with URIs in the USA are inappropriate and that in 2020, the Joint Fee mandated that accredited establishments implement an outpatient ASP.

“Prioritization of particular departments or suppliers for ASP intervention based mostly on charge of antibiotic prescribing and whole variety of encounters of curiosity could also be advantageous in settings with restricted ASP personnel,” they wrote. “The creation of a provider-specific scoring software for prioritizing ASP interventions directed towards particular person suppliers might advantage future investigation.”
Aug 5 ASHE study


Research examine effectiveness of Pfizer COVID vaccine in teenagers, children

JAMA Community Open has revealed a brand new examine on Pfizer/BioNTech COVID-19 vaccine effectiveness in US teenagers, and the Facilities for Illness Management and Prevention (CDC) and different US investigators conclude in a Scientific Infectious Illnesses examine that the vaccine protects in opposition to multisystem inflammatory syndrome in youngsters (MIS-C) in youngsters.

The JAMA Community Open examine included 3,168 youngsters ages 12 to 17 who had obtained two doses of the Pfizer vaccine (BNT162b2). The first final result was safety in opposition to Delta- and Omicron-related emergency division and pressing care encounters.

The authors discovered that the estimated effectiveness of two doses of BNT162b2 was highest in opposition to each the Delta (89%) and Omicron (73%) variants lower than 2 months after vaccination however waned to 49% in opposition to Delta and 16% in opposition to Omicron at 6 months and past.

A 3rd dose of BNT162b2 was related to improved safety in opposition to Omicron (87% [95% confidence interval, 72% to 94%]) after a median of 19 days.

Within the Scientific Infectious Illnesses examine, researchers confirmed that youngsters ages 5 to 18 have been protected in opposition to MIS-C after two doses of the Pfizer vaccine.

The examine in contrast 304 MIS-C case-patients (280 [92%] unvaccinated) with 502 controls (346 [69%] unvaccinated). Vaccination was related to a lower within the probability of MIS-C throughout each the Delta and Omicron waves.

“Vaccination with two doses of BNT162b2 was related to decrease frequency of MIS-C in comparison with hospitalized SARS-CoV-2 unfavorable controls,” the authors concluded.
Aug 3 JAMA Netw Open study
Aug 4 Clin Infect Dis study


Spain experiences pair of acute hepatitis deaths in youngsters

Spain’s well being ministry has reported its first two deaths in youngsters who had unexplained hepatitis, in line with the Related Press (AP).

Officers mentioned 46 circumstances have been reported up to now, together with 3 children who wanted liver transplants. Of the three, two sufferers died. One was a 15-month-old child who died in June and the opposite was a 6-year-old little one who died in July.

To date, the reason for the unexplained circumstances hasn’t been decided, however scientists suspect an adenovirus hyperlink, and two research lately prompt a job for adenovirus-associated virus sort 2, a “helper virus” that is not recognized to trigger illness by itself.
Aug 5 AP story

In associated developments in the USA, the Facilities for Illness Management and Prevention in its weekly replace reported 3 extra circumstances, bringing the nation’s whole to 357 from 43 states.
CDC update on acute hepatitis in children

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