News Scan for Aug 12, 2022 – CIDRAP

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Maine, which has confirmed only four monkeypox cases, today reported a case of the virus in a resident under the age of 18. No further details were released by the Maine Centers for Disease Control. Maine now joins California and Florida as states with pediatric cases. 
Also, researchers in Spain detail a possible human-to-dog case.
The United States now has 10,768 cases of the poxvirus disease, according to the Centers for Disease Control and Prevention (CDC). Wyoming remains the only state without a confirmed case. New York has the most cases, with 2,187, followed by California, with 1,892.
Also today, the Food and Drug Administration (FDA) confirmed that adequate safeguards are in place for blood donors, and donation centers do not need to ask additional questions or perform additional screenings for monkeypox.
“Worldwide, there have been no reports of transmission of monkeypox virus through blood transfusion and the risk of transfusion-transmission remains theoretical,” the FDA said.
“Blood establishments typically request that blood donors report illnesses or symptoms that develop after blood donation so that the blood establishment can assess if the donation is safe for transfusion. These safeguards are likely to identify individuals who present to donate who are diagnosed with monkeypox virus or who are currently at the greatest risk for infection with monkeypox virus.”
In research news, The Lancet this week published a report describing evidence of human-to-dog monkeypox transmission in France in a household with two positive cases. The likely human-to-animal spillover event stokes fears that, with widespread monkeypox transmission, new animal reservoirs of the virus could be established. Rodents are considered the primary animal hosts.
Aug 12 WMTX Maine news story
Aug 12 CDC monkeypox map
Aug 12 FDA press release
Aug 10 Lancet study
 
A retrospective analysis of US hospital data found that the use of certain inpatient antibiotics was strongly associated with influenza activity during the 2015 through 2019 viral respiratory seasons, researchers reported yesterday in Antimicrobial Stewardship & Healthcare Epidemiology.
To evaluate changes in inpatient antibiotic use (IAU) over time and possible associations between influenza rates and IAU, researchers with Becton, Dickinson & Co (BD) analyzed data on adult hospital patients from the BD Insights Research Database, which includes large and small hospitals across the United States. They looked at community influenza rates and IAU for commonly prescribed oral and intravenous antibiotics, calculated as days of therapy (DOT) per 1,000 patient-days.
Among the 239 facilities contributing data, extended-spectrum cephalosporins (ESC), specific anti–methicillin-resistant Staphylococcus aureus (MRSA) drugs, and beta-lactam inhibitor combinations (BLICs) had the highest IAU rates from 2015 through 2019 (average of 125, 95, and 94 DOT per 1,000 patient-days, respectively). Ascending trends over time were observed for ESCs, BLICs, macrolides, and tetracyclines. Seasonal changes in IAU were significant for BLICs, macrolides, tetracyclines, specified anti-MRSA drugs, and lipopeptides.
In multivariate analyses that controlled for geographic regions and hospital-level factors, influenza rates were significantly associated with IAU for ESCs, specified anti-MRSA drugs, macrolides, fluoroquinolones, tetracyclines, and lipopeptides. The researchers found no association between influenza rates and IAUd for BLICs, carbapenems, and “other” antibiotics.
The authors of the study note that while patients with influenza-like respiratory symptoms are treated empirically with antibiotics because of concerns about secondary bacterial infections, many antibiotics showing this association are often prescribed and recommended for community-acquired pneumonia (CAP), and that unsupported antibiotic use in hospitalized patients with CAP is common.
They concluded, “Information on IAU influenced by influenza activity may be useful in guiding infection prevention and control measures, including rapid diagnostic testing and vaccination campaigns for influenza and other respiratory viruses, and in determining policies, strategies, and programs for antimicrobial stewardship efforts to reduce inappropriate IAU during influenza season.”
Aug 11 Antimicrob Steward Healthc Epidemiol study
 
The CDC today reported two more variant H3N2 (H3N2v) flu infections in West Virginia, both with links to the same agricultural fair as the initially identified case.
In its weekly flu report, the CDC said the two new cases involve people ages 18 and younger. Neither was hospitalized, and both have recovered. So far, no human-to-human spread has been identified.
In an earlier update, the CDC said the first of the three cases occurred in a person who had contact with pigs and that respiratory illnesses were reported in others who attended the fair. Also, pigs at the fair tested positive for swine influenza. The agency added that numbers of variant flu cases linked to fairs might be higher than usual this year due to increased outbreaks of swine influenza in pigs.
Aug 12 CDC FluView report
Aug 8 CIDRAP News scan
 
A leptospirosis outbreak in Tanzania has sickened 20 people, 3 of them fatally, the World Health Organization (WHO) said today.
Though leptospirosis cases in Tanzania aren’t surprising, outbreaks there are rare, the WHO said. The event is centered in two districts of Lindi region, located in the southeast corner of the country. Most cases are in men and all involve farmers, hinting at occupational exposure.
In the middle of July, a cluster of deaths in people with hemorrhagic symptoms in Tanzania raised suspicions about a potential viral hemorrhagic fever outbreak. Shortly after, the health ministry said leptospirosis was identified as the cause.
No new cases have been identified since Jul 15, but investigations are under way to find any new or missed cases, the WHO said.
Aug 12 WHO statement
Jul 18 CIDRAP News scan
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