https://www.nature.com/article...
https://gizmodo.com/first-bird...

Florida Dolphin Dies of Bird Flu as Alarm Grows Over Species Spread
Florida scientists have reported the first known and fatal case of highly pathogenic H5N1 avian influenza in a bottlenose dolphin.
By
Ed Cara
PublishedFriday 4:50PM

A pod of bottlenose dolphins.Image: Anita Kainrath (Shutterstock)
Bird flu isn't just lurking inside cows, new research shows. Florida scientists have reported the first known case of highly pathogenic H5N1 avian influenza in a common bottlenose dolphin (Tursiops truncatus). Though the case dates back to 2022, it's the latest indication that these flu strains can potentially infect a wide variety of mammals.

The report was published Friday in the Nature journal Communications Biology. According to the paper, the flu-infected dolphin was first identified on March 29, 2022. Researchers with the University of Florida's Marine Animal Rescue Program were notified of a dolphin that appeared to be in clear distress around the waters of Horseshoe Beach in North Florida. By the time they arrived, however, the dolphin had already died. It was subsequently packed in ice and taken to the university for an autopsy the following day.

The post-mortem examination found signs of poor health and inflammation in the dolphin's brain and meninges (the membrane layers that protect the brain and spinal cord). The dolphin tested negative for other common infectious causes of brain inflammation, which prompted the researchers to expand their search. They knew that wild birds can develop neuroinflammation from highly pathogenic strains of avian influenza, that several bird die-offs tied to the flu had occurred in the area recently, and that recent outbreaks had occurred among other populations of marine mammals elsewhere, so they decided to screen for it. Testing then revealed the presence of H5N1 within the dolphin's lungs and brain.

There have been sightings of highly pathogenic avian influenza (HPAI) in other marine mammals lately, such as harbor seals and other species of dolphins. But this is the first reported case documented in a common bottlenose dolphin and the first report in any cetacean (dolphins and whales) within the waters of North America.

Strains of bird flu are classified as highly pathogenic when they cause severe illness and deaths in wild birds, so it's not necessarily a given that they will be as dangerous to other animals they infect. The current outbreaks of H5N1 bird flu in cows, for instance, have caused generally mild illness to date. But strains belonging to this particular lineage of H5N1 (2.3.4.4b) have been deadly to marine mammals.

The strain in this case did not appear to develop known genetic changes that would make it easier to infect and transmit between mammals, the authors found. But flu viruses mutate very quickly, leaving open the possibility that some strains will adapt and pick up the right changes that can make them a much bigger threat to mammals both on land and in the sea.

"Human health risk aside, the consequences of A(H5N1) viruses adapting for enhanced replication in and transmission between dolphins and other cetacea could be catastrophic for these populations," the authors wrote.

The researchers are continuing to investigate the case, hoping to pinpoint the origins of the dolphin's infection and to better understand the potential for bird flu strains to successfully jump the species barrier to these marine mammals.

With every new article I'm thinking the Avian flu is, and has been, more prevalent than anyone realized. Makes me think it may not be as hard on other life forms as it is on birds. What's most disturbing is how often flu virus mutates into something worse and more virulent. It may be that what's being observed is a huge potential threat on the horizon. Maybe that recognition will result in being more prepared to keep it from being as bad as it might have been.

needrain said: Maybe that recognition will result in being more prepared to keep it from being as bad as it might have been.

You're so funny!!!

https://www.cidrap.umn.edu/avi...

Analysis of cow, cat H5N1 avian flu samples raises concerns about spread to other animals
Lisa Schnirring Today at 4:13 p.m.
Avian Influenza (Bird Flu)

Microbiological examination of cow, milk, and cat samples early in the investigation of H5N1 avian flu in some of the first affected states found that the cats died shortly after they were fed raw colostrum from sick cows, highlighting the risk of spread from cows to other animals through contaminated milk.

A research team based at Iowa State University reported its findings on some of the earliest samples from cows and cats today in Emerging Infectious Diseases.

For the study, the scientists examined samples—milk, serum, and tissues—from cows on early affected farms in Texas and Kansas. They also analyzed samples from cats that died on the farms. The initial H5N1 highly pathogenic avian influenza (HPAI) findings prompted the initial announcement from the US Department of Agriculture (USDA) on March 25.

H5N1 in mammary gland cells
The tissue samples in cows came from a three that were euthanized and three that died naturally. The researchers also performed postmortem exams on two adult cats from one of the farms, which had about 24 cats. The cats started showing symptoms a day after clinical disease was noted in the cows, and about half of the cats died.

Microscopic examination revealed that the H5N1 virus infects epithelial cells of mammary alveoli where milk is produced, prompting acute inflammation in the udder, which could explain the drop in milk production and high virus levels that have been turning up in milk.

The authors said the case series shows that H5N1 infection has more dramatic symptoms in cows than reflected in earlier reports of influenza A viruses in the animals.

Cats showed symptoms soon after exposure
Meanwhile, they wrote that the clinical disease in cats, especially neurologic symptoms, is consistent with earlier reports of H5N1 in cats and tracks with reports of cats eating infected wild birds and poultry products.

Though wild-bird consumption can't be ruled out in the cats from the dairy farms, known consumption of unpasteurized milk and colostrum from infected cows, a fluid that contained a high viral load, makes it a likely exposure route, the team wrote.

"Therefore, our findings suggest cross-species mammal-to-mammal transmission of HPAI H5N1 virus and raise new concerns regarding the potential for virus spread within mammal populations," they said.

Ingestion of feed contaminated with feces from wild birds is the most likely initial source of infection on dairy farms, according to the authors, who said more studies are needed to clarify transmission routes and pathogenesis within infected cattle.

FDA, CDC, USDA add updates
Over the past few days, federal agencies involved in the nationwide H5N1 investigation and response updated their findings and provided policy clarifications.

Egg inoculation tests were negative for live infectious virus in retail milk samples that were positive for H5N1 fragments in earlier polymerase chain reaction (PCR) tests, the Food and Drug Administration (FDA) said in an April 26 update. It noted that the test results are preliminary but affirm its assessment that the commercial milk supply is safe.

The FDA also said it tested several samples of retail powered infant formula and powdered milk products marketed as toddler formula, and all were negative for H5N1 remnants on PCR testing.

Work is still under way on 297 retail samples from 38 states. The agency said that samples that are positive on PCR testing will go through egg inoculation testing.

Meanwhile, the Centers for Disease Control and Prevention (CDC) in an update on the same day says its ongoing susceptibility testing on commercially available antiviral drugs has found that the current H5N1 strain is susceptible to baloxavir marboxil (Xofluza).

The CDC said its earlier studies showed that the H5N1 virus from the human case in Texas was susceptible to other antivirals, including oseltamivir. However, it said one of the 200 publicly posted H5N1 samples from dairy cows found a marker with a known link to reduced susceptibility to neuraminidase inhibitors.

"The detection of this marker in one of more than 200 specimens is not surprising or concerning at this time in terms of the clinical usefulness of these drugs, but it does underscore why this kind of constant monitoring is important," the agency wrote.

Finally, the US Department of Agriculture (USDA) on April 27 clarified its recent federal order barring interstate movement of lactating dairy cows without tests to ensure that the animals aren't infected with HPAI H5N1.

It said the clarification notes that the order doesn't apply to the interstate movement of dairy cows going to sale barns, which are sometimes used to consolidate and move cattle to slaughter out of state. "We are announcing this clarification over the weekend to ensure small farms have the guidance necessary to continue to move cull cattle and limit animal welfare issues," the USDA said.

https://www.cidrap.umn.edu/cov...

X's crowdsourced tool to counter COVID untruths mainly accurate, credible, researchers say
Mary Van Beusekom, MS Today at 2:01 p.m.
COVID-19

Community Notes, a crowdsourced COVID-19 vaccine misinformation countermeasure on X (formerly Twitter), generally corrected false posts accurately and pointed readers to more credible sources, according to researchers who evaluated the posts.

The University of California at San Diego (UCSD)-led team assessed the accuracy and credibility of a random sample of 205 Community Notes on COVID-19 vaccines from the year after the tool's December 2022 launch. The reviewers included an infectious-disease doctor and a virologist. The results were published last week in JAMA.

For the open-sourced Community Notes, anonymous, ideologically diverse volunteers independently flag posts containing erroneous COVID-19 and vaccine information and suggest corrections, or "notes." Notes labeled as helpful by contributors who disagreed on previous notes are shown alongside the original posts. The process is public rather than company-controlled.

"Social media can magnify health misinformation, especially about vaccination," the study authors noted. "Platform countermeasures have included censoring, shadowbanning (limiting distribution without disclosure), and adding warning labels to problematic content. Yet, evaluating these countermeasures is challenging due to restrictive public disclosures about their inner workings."

93% cited high- or moderate-quality sources
A total of 1.4% of the 45,783 notes mentioned COVID-19 vaccines. Monthly note rates rose from 22 to 186 over the study period. Of the randomly sampled notes, there was strong agreement on note topics (90%), source credibility (87%), and accuracy (96%) before disagreements were resolved.

The most common note topic was adverse events (51%), followed by conspiracy theories (37%), vaccine recommendations (7%), and vaccine effectiveness (5%). Nearly all (97%) of the notes were accurate, 2% were partially accurate, and 0.5% were inaccurate.

Of all notes, 49% cited high-credibility sources (eg, peer-reviewed studies), while 44% were of moderate credibility (eg, news stories, fact-checking sites), and 7% were of low credibility (eg, blogs, tabloids). Views of the 189 posts with view data totaled 201 million (average, 1 million).

Alternative to censoring
"Since the World Health Organization declared an 'infodemic' of misinformation, there have been surprisingly few achievements to celebrate," senior author John Ayers, PhD, of UCSD, said in a university news release. "X's Community Notes have emerged as an innovative solution, pushing back with accurate and credible health information."

By providing context and credible sources alongside contentious posts, the platform empowers users to discern fact from fiction, a skill they will find useful as they navigate all claims.
Eric Leas, PhD, MPH

Coauthor Eric Leas, PhD, MPH, of UCSD, said that Community Notes offers an alternative to censoring. "Community Notes fosters a learning environment where users can glean insights from corrections to misinformation to prevent similar misunderstandings in the future," he said in the release. "By providing context and credible sources alongside contentious posts, the platform empowers users to discern fact from fiction, a skill they will find useful as they navigate all claims."

Coauthor Mark Dredze, PhD, of Johns Hopkins University, said the study offers practical insights into social media strategies that may promote public health. "Although we couldn't examine how these notes directly influenced people's beliefs or actions, the characteristics we analyzed have consistently been shown to predict a message's effectiveness," he said.

The researchers urged other social media platforms to open-source their misinformation countermeasures for study by independent scientists to scale the most effective strategies and foster public trust in them.

https://www.cidrap.umn.edu/cov...

WHO COVID vaccine advisers recommend switch to JN.1 strain
Lisa Schnirring Today at 1:23 p.m.
COVID-19

The World Health Organization (WHO) Technical Advisory Group on COVID-19 Vaccine Composition, which meets about every 6 months to assess if any changes are needed, has recommended that the next COVID vaccine formulations use a monovalent (single-strain) JN.1 lineage.

The group met in the middle of April to review the genetic and antigenic evolution of SARS-CoV-2, with an eye toward vaccine composition implications.

In a statement, the experts note that the XBB lineage has been displaced by JN.1 and said that, over the short-term, circulating variants will likely be derived from JN.1.

A year ago, the group recommended a switch to XBB.1.5 for COVID vaccines, but evidence from animal studies and human sera experiments suggests that XBB.1.5 and JN.1 are antigenically distinct. Animal studies and tests on human blood following exposure to XBB.1.5 from vaccination or infection suggest that neutralization titers against JN.1are two to five times lower than titers against the XBB.1.5 vaccine antigen.

Current vaccine might be less effective as JN.1 evolves
"There are further reductions in cross neutralization of JN.1 variants with F456L and/or R346T substitutions," the advisory group said. The two substitutions have been nicknamed FLiRT (F for L at position 456 and R for T at position 346), and virologists had seen them crop up in earlier SARS-CoV-2 variants.

In the United States, for example, a JN.1 spinoff called KP.2 that contains the FLiRT substitutions edged out the JN.1 parent virus as the most commonly detected variant, the Centers for Disease Control and Prevention (CDC) said in its latest variant proportion estimates.

The WHO experts said the few studies that estimate relative vaccine effectiveness (VE) for the XBB.1.5 vaccine during JN.1 circulation suggest some protection during the first 3 months after vaccination, but with a slight reduction in VE against JN.1 for protection against severe and symptomatic disease, similar to what neutralization antibody titer studies found. They added, however, that the ability for XBB.1.5 vaccination to protect against symptomatic disease may be less robust as SARS-CoV-2 evolution continues from JN.1.

Meanwhile, a single immunogenicity study in humans of a candidate monovalent JN.1 vaccine suggests that it produces higher neutralization antibodies against co-circulating JN.1 variants such as KP.2 than does the XBB.1.5 vaccine.

The advisers acknowledged several limitations of their analysis, including gaps in genetic surveillance, low numbers of viruses sequenced, and the difficulty of predicting public health impacts of mutations seen with the more recent JN.1 variants.

They urged countries to continue to use any COVID vaccines that are emergency listed or prequalified by the WHO and emphasized that COVID vaccination shouldn't be delayed while waiting for updated versions.

FDA to consider strain recommendations in mid May
The US Food and Drug Administration (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC) will meet on May 16 to discuss and make strain-selection recommendations for 2024-25 COVID vaccines.

The meeting is available online, and the group said it will post the background materials its members will use during the deliberations on its website at least 2 days before the meeting.

https://www.cidrap.umn.edu/cov...

WHO COVID vaccine advisers recommend switch to JN.1 strain
Lisa Schnirring Today at 1:23 p.m.
COVID-19
vaccine prep

The World Health Organization (WHO) Technical Advisory Group on COVID-19 Vaccine Composition, which meets about every 6 months to assess if any changes are needed, has recommended that the next COVID vaccine formulations use a monovalent (single-strain) JN.1 lineage.

The group met in the middle of April to review the genetic and antigenic evolution of SARS-CoV-2, with an eye toward vaccine composition implications.

In a statement, the experts note that the XBB lineage has been displaced by JN.1 and said that, over the short-term, circulating variants will likely be derived from JN.1.

A year ago, the group recommended a switch to XBB.1.5 for COVID vaccines, but evidence from animal studies and human sera experiments suggests that XBB.1.5 and JN.1 are antigenically distinct. Animal studies and tests on human blood following exposure to XBB.1.5 from vaccination or infection suggest that neutralization titers against JN.1are two to five times lower than titers against the XBB.1.5 vaccine antigen.

Current vaccine might be less effective as JN.1 evolves
"There are further reductions in cross neutralization of JN.1 variants with F456L and/or R346T substitutions," the advisory group said. The two substitutions have been nicknamed FLiRT (F for L at position 456 and R for T at position 346), and virologists had seen them crop up in earlier SARS-CoV-2 variants.

In the United States, for example, a JN.1 spinoff called KP.2 that contains the FLiRT substitutions edged out the JN.1 parent virus as the most commonly detected variant, the Centers for Disease Control and Prevention (CDC) said in its latest variant proportion estimates.

The WHO experts said the few studies that estimate relative vaccine effectiveness (VE) for the XBB.1.5 vaccine during JN.1 circulation suggest some protection during the first 3 months after vaccination, but with a slight reduction in VE against JN.1 for protection against severe and symptomatic disease, similar to what neutralization antibody titer studies found. They added, however, that the ability for XBB.1.5 vaccination to protect against symptomatic disease may be less robust as SARS-CoV-2 evolution continues from JN.1.

Meanwhile, a single immunogenicity study in humans of a candidate monovalent JN.1 vaccine suggests that it produces higher neutralization antibodies against co-circulating JN.1 variants such as KP.2 than does the XBB.1.5 vaccine.

The advisers acknowledged several limitations of their analysis, including gaps in genetic surveillance, low numbers of viruses sequenced, and the difficulty of predicting public health impacts of mutations seen with the more recent JN.1 variants.

They urged countries to continue to use any COVID vaccines that are emergency listed or prequalified by the WHO and emphasized that COVID vaccination shouldn't be delayed while waiting for updated versions.

FDA to consider strain recommendations in mid May
The US Food and Drug Administration (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC) will meet on May 16 to discuss and make strain-selection recommendations for 2024-25 COVID vaccines.

The meeting is available online, and the group said it will post the background materials its members will use during the deliberations on its website at least 2 days before the meeting.

https://www.cidrap.umn.edu/cov...

COVID booster linked to 25% lower odds of long COVID
News brief Today at 3:43 p.m.
Stephanie Soucheray, MA
Topics COVID-19

A new cross-sectional study published in Vaccine of US adults demonstrates that people who received the COVID-19 booster vaccine had 25% lower odds of having long COVID than their unvaccinated counterparts.

The study was based on 8,757 respondents to the 2022 National Health Interview Survey, with data from a weighted sample size of 87,509,670 Americans. Authors used self-reported COVID-19 booster vaccination status and self-reported long-COVID status (defined as having new or persistent symptoms 3 or more months after an initial COVID-19 infection) to calculate odds ratios (ORs) of developing long COVID.

1 in 5 report long COVID
Overall, 2.2% (19,396,656) had not received any COVID-19 vaccine, 17.3% (15,151,843) had received only one dose of the COVID-19 vaccine, 33.3% (29,184,366) had completed the initial series of the COVID-19 vaccine, and 27.2% (23,776,806) received the COVID-19 booster vaccine. Among all respondents, 19.5 % reported experiencing long COVID (17,102,276).

People receiving the COVID-19 booster vaccine had significantly lower adjusted odds of long COVID (OR 0.75, 95 % confidence interval 0.61 to 0.93) compared to unvaccinated people.

"Our findings suggest that ensuring individuals are up-to-date with their COVID-19 vaccinations could be an effective public health strategy for reducing the prevalence of long-COVID," the authors concluded.

https://www.cidrap.umn.edu/cov...

After COVID vaccine rollout, negativity on Twitter spiked
News brief Today at 2:35 p.m.
Stephanie Soucheray, MA
Topics COVID-19
vax protest

Negativity about vaccines surged 27% on Twitter after COVID-19 vaccines first became available, according to a new study presented this week at the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Global Congress.

In the years prior to COVID-19, there were more negative statements about vaccines than positive ones, but the introduction of vaccines and news about mandating vaccines caused negative statements to spike on Twitter, now called X.

The study used data from an open-source software (the Snscrape library in Python). The program downloaded tweets with the hashtag "vaccine" published on Twitter from January 1, 2018, to December 31, 2022.

A total of 567,915 tweets were extracted and analyzed, with 458,045 classified as negative and 109,870 as positive by a machine-learning algorithm. After the introduction of COVID-19 vaccines at the end of 2020, there was an average 10,201 more vaccine-related tweets per month.

Negative tweets peaked in April 2021
The program identified 310,508 tweets (12,420 a month on average) with negative sentiment after December 11, 2020. This represents a 27% increase in negative tweets than would be expected had the COVID-19 vaccines not been introduced (9,785 a month, 95% confidence interval, 9,282 to 10,249).

April 2021, the month the White House announced that all people aged 16 and older would be eligible for the COVID-19, had the highest number of negative tweets.

"Vaccines can prevent complications from diseases for which we have limited treatment options, such as influenza and COVID-19, but there has been growing opposition to their use in recent years," said first study author Guillermo Rodriguez-Nava, MD, of Stanford University, in an ESCMID press release.

The damage caused by negative voices is already apparent.
"The damage caused by negative voices is already apparent, with clusters of measles re-emerging in countries where it was previously considered eradicated."

https://www.cidrap.umn.edu/cov...

Undocumented Latinos vaccinated against COVID at same rate as US citizens, study suggests
News brief Today at 10:35 a.m.
Mary Van Beusekom, MS
Topics COVID-19

A University of California at Los Angeles (UCLA) study late last week in JAMA Network Open finds that, despite less access to healthcare, undocumented Latino workers who visited the emergency department (ED) received COVID-19 vaccines at the same rate as US citizens.

The researchers interviewed a sample of adult non-Latino patients, legal Latino residents or citizens, and undocumented Latino patients at two California healthcare centers from September 2021 to March 2022.

The median age of the 306 participants was 51 years, 48% were women, 68% were Latino, 14% were White, 11% were Black, and 7% were of other race. Of undocumented Latinos, 25% were uninsured, and 30% usually visited the ED for healthcare.

Undocumented workers much more likely to report infection
Among all participants, 87% said they had received one or more doses of COVID-19 vaccine, and 13% reported declining the vaccine. Concern about potential adverse effects of the vaccine was the most common reason (37%) for not getting vaccinated.

Undocumented Latino workers were much more likely to report a previous COVID-19 infection than non-Latinos and legal Latino residents.
Relative to undocumented Latinos, non-Latino patients were much less likely to believe that undocumented workers could receive the COVID-19 vaccine in the United States (odds ratio [OR], 0.09). Thirteen percent of interviewees said they knew undocumented people who didn't get vaccinated because they worried about deportation. Of those who had declined the vaccine, 22% said they were interested in receiving a dose in the ED.

Undocumented Latino workers were much more likely to report a previous COVID-19 infection than non-Latinos (OR, 3.42) and legal Latino residents (OR, 2.73).

"We would have expected Latinx patients to have lower rates of vaccination, considering higher rates of infection, hospitalizations, and death," lead author Jesus Torres, MD, MPH, said in a UCLA news release. Torres noted that EDs are one of the main healthcare access points for undocumented workers, who make up about 3% of the US population but are not often included in research.

From a public health perspective, he added, it's important to identify disadvantaged groups for research, policy work, resource allocation, and targeted vaccine campaigns.

Cats suffer H5N1 brain infections, blindness, death after drinking raw milk
Mammal-to-mammal transmission raises new concerns about the virus's ability to spread.

https://arstechnica.com/scienc...

FTC fines Razer for every cent made selling bogus "N95 grade" RGB masks
"Deceptive advertising and misinformation posed a risk to public health."

https://arstechnica.com/tech-p...

https://www.cidrap.umn.edu/cov...

Global survey shows COVID booster uptake in question
Stephanie Soucheray, MA Today at 3:31 p.m.
COVID-19

A new survey of 23,000 adults in 23 countries taken in October 2023 finds a lower intent to get a COVID-19 booster vaccine (71.6%), compared with 2022 (87.9%).

Moreover, 60.8% expressed being more willing to get vaccinated for diseases other than COVID-19 as a result of their experiences during the pandemic, while 23.1% reported being less willing.

"This study reveals that a substantial proportion of individuals express resistance to vaccination and that concerns about COVID-19 vaccination appear to have spilled over to affect other vaccine-preventable disease," the authors write.

This study reveals that a substantial proportion of individuals express resistance to vaccination and that concerns about COVID-19 vaccination appear to have spilled over to affect other vaccine-preventable disease.
The findings, published in Nature Medicine, offer a new global snapshot of COVID vaccine attitudes and show that vaccine hesitancy and trust challenges remain throughout the world today.

"The repercussions of pandemic disruptions in healthcare services, the effects of the inequitable and slow global vaccine distribution, and the prevalence of misinformation and mistrust in health authorities continue to be felt," said lead author Jeffrey V. Lazarus, PhD, CUNY professor of global health, in a press release from CUNY Graduate School of Public Health and Health Policy. "They represent major obstacles for health practitioners struggling to meet the urgent need to get people caught up on routine immunizations and ready to face the next pandemic."

While booster uptake dropped from 2022 to 2023, the number of respondents with at least one COVID vaccine dose increased to 87.8% in 2023, compared to 36.9% in 2021 and 70.4% in 2022.

Willingness to get booster drops in high-income countries
The reluctance to get a booster could spell trouble for nations now trying to handle COVID-19 as a seasonal threat best tempered by seasonal, annual vaccines.

"The SARS-CoV-2 virus continues to circulate and mutate," said Ayman El-Mohandes, PhD, a senior author of the study and dean of the CUNY School of Public Health. "Variant-adapted boosters are available, but public health statistics show that many older people and others who are at higher risk of severe disease and death have not accepted them."

This is the fourth annual survey to assess attitudes towards COVID-19 vaccines conducted by this research group. The 23 countries included were Brazil, Canada, China, Ecuador, France, Germany, Ghana, India, Italy, Kenya, Mexico, Nigeria, Peru, Poland, Russia, Singapore, South Africa, South Korea, Spain, Sweden, Turkey, the United Kingdom, and the United States.

Willingness to get a booster dose of vaccine dropped most notably in high-income countries compared to middle-income countries. In the richest countries surveyed, 85.1% of respondents in 2022 said they were willing to get a booster, compared to just 63.3% in 2023.

Across high-, middle-, and low-income countries, trust in health authorities who recommended COVID-19 vaccination was higher than trust in governments' management of the COVID-19 pandemic, at 65.4% and 56.4%, respectively.

https://www.cidrap.umn.edu/cov...

Study: COVID vaccines not linked to seizures
News brief Today at 1:40 p.m.
Stephanie Soucheray, MA
Topics COVID-19

Today a new meta-analysis of six randomized controlled trials in JAMA Neurology finds no increase in seizures in the month following COVID vaccination.

The study compared the incidence of new-onset seizures between the 63,521 vaccine and 54,919 placebo recipients involved in randomized controlled trials conducted in the last 4 years.

"The new onset seizures following vaccination, even with the different types of vaccine, we found no statistical difference," study author Churl-Su Kwon, MD, MPH, said in an interview posted online on the journal site.

In the vaccine group there were 9 seizure events reported, compared to 1 in the placebo group, resulting in an odds ratio of 2.70 (95% confidence interval [CI], 0.76 to 9.57) during the 28 days following vaccination.

When analyzing the entire study periods included in the analysis (median time 43 days), the authors reported no significant difference between the vaccine and placebo groups in terms of incident new-onset seizure (13/43,724 events [0.03%] in vaccine and 5/40 612 [0.012%] in placebo recipients; odds ratio 2.31; 95% CI, 0.86 to 3.23).

The findings suggest that there is no difference in risk of seizure incidence among vaccinated individuals vs placebo recipients
"The findings suggest that there is no difference in risk of seizure incidence among vaccinated individuals vs placebo recipients," the authors concluded. "However, the risk of seizure occurrence after SARS-CoV-2 infection seems to be relatively high."

https://www.cidrap.umn.edu/sex...

Health officials in Madison, Wisconsin, recently reported a measles case involving someone who traveled to and works in neighboring Rock County. In a statement, Public Health Madison and Dane County said it is working with the Wisconsin Department of Health Services (WDHS) and the Rock County Department of Health to identify contacts and potential exposures. The WDHS identified potential exposures at two healthcare facilities in Janesville, as well as a gas station in Milton, an electronics repair shop in Madison, and a fast food restaurant in Cottage Grove. The infection is part of a rise in global cases, including in the United States. In its latest weekly update, the Centers for Disease Control and Prevention (CDC) on April 26 reported three more cases, raising the national total to 128 from 20 jurisdictions, more than double the cases reported for 2023.

https://www.cidrap.umn.edu/avi...

FDA finds no live H5N1 avian flu virus in sour cream or cottage cheese, will assess raw milk
Lisa Schnirring 41 minutes ago.
Avian Influenza (Bird Flu)
cottage cheese

In updates today from federal agencies involved in the response to H5N1 avian flu outbreaks in dairy cows, the US Department of Agriculture (USDA) said egg inoculation tests on cottage cheese and sour cream that tested positive for traces of the virus traces showed no live virus.

Dairy product testing will extend to raw milk
At a Department of Health and Human Services (HHS) briefing, Don Prater, DVM, acting director of the Center for Food Safety and Applied Nutrition, revealed preliminary data on a second set of retail dairy samples, a group of 201 that had tested positive on polymerase chain reaction (PCR) testing, which can only identify virus fragments.

Last week, the Food and Drug Administration (FDA) announced that preliminary tests on 96 PCR-positive retail milk samples were negative for live virus on follow-up tests using egg inoculation, considered the gold standard for determining viability.

Today the agency announced egg inoculation results for 201 more PCR-positive dairy product samples, which also included cottage cheese and sour cream. None showed any evidence of live virus, which Prater said reaffirms the FDA's assessment that the nation's retail milk supply is safe. So far, the FDA has tested 297 total retail dairy samples.

Earlier this week, the FDA said PCR tests were negative on samples of powered infant formula and powdered formula marketed for toddlers. Prater said the FDA will continue to analyze and share its data, but when asked if the agency has seen a regional pattern in the PCR-positives, he said milk bought in a state doesn't mean it was processed and pasteurized there.

Prater said the FDA has plans for more testing, including raw milk, which he said will give the agency a better picture of the viral load before pasteurization. In a statement, the FDA said it will test pooled raw milk that has been routed to pasteurization and processing for commercial use.

Even before the H5N1 outbreak in dairy cows was first detected in late March, the FDA recommended against drinking raw milk due to potential contamination with pathogens.

USDA reports 2 more infected herds, details beef testing plans
Rosemary Sifford, DVM, deputy administrator veterinary services and chief veterinary officer with the USDA, said 36 outbreaks have now been reported in dairy herds from nine states. Yesterday the USDA added 2 earlier outbreaks from New Mexico to its total.

Sifford said so far the extent of the spread isn't clear and that the agency hopes to learn more, now that the federal order for sampling lactating dairy cattle before interstate movement is in effect as of April 29.

Evidence still suggests that the source of the virus is a single spillover from wild birds to dairy cattle in multiple herds in the Texas panhandle and that the virus is spreading among cows through milk, Sifford said. "We think milk is the primary vector."

She said there's still no evidence of the virus in beef herds.

The USDA's Food Safety and Inspection Service (FSIS) has three beef sampling efforts under way, one involving ground beef, Sifford said, which was announced earlier this week. Another includes muscle sampling of culled dairy cows, though she said the virus doesn't seem to spread throughout the bodies of infected cows.

Another is to examine the effects of cooking beef patties at three different temperatures to ensure that the process kills the virus. "This will enhance the scientific data and add assurance to our safety statements," she said.

More than 100 exposed people have been monitored
Demetre Daskalakis, MD, MPH, who directs the Centers for Disease Control and Prevention (CDC) National Center for Immunization and Respiratory Diseases, said flu surveillance in areas where H5N1 has been detected still shows no unusual trends. More than 100 people who were exposed to the sick cattle have been monitored, and about 25 have been tested, he said.

So far the only human case was confirmed by Texas officials on April 1.

CDC scientists continue to characterize the virus, and efforts are under way to grow the virus isolated from the Texas patient to assess its severity and transmission in ferret studies, Daskalakis said.

Two safety and efficacy studies have begun on vaccines from two different companies that are using one of the two H5N1 candidate vaccine viruses, he added.

More H5N1 positive tests in other mammals
Separately, the USDA Animal and Plant Health Inspection Service (APHIS) reported eight more H5N1 confirmations in other mammals in seven states. The samples were collected from early December 2023 to the middle of March and were confirmed in March and April.

The animals include three bobcats (New York, Washington, and Vermont), two skunks (California and Idaho), a mink (Kentucky), a raccoon (New York), and a red fox (Missouri).

https://www.cidrap.umn.edu/cov...

Peer support valuable intervention for health worker stress during COVID-19, study shows
Stephanie Soucheray, MA 43 minutes ago.
COVID-19

With healthcare worker (HCW) burnout one of the most pressing issues facing US clinicians, a new study in JAMA Network Open indicates that Stress First Aid, a peer-to-peer support intervention, improved the well-being of HCWs compared with usual care during the COVID-19 pandemic.

The study is one of the only randomized clinical trials published on provider burnout interventions, and an editorial on the study in the same journal suggests the findings "highlight that workplace interventions in health care have the potential to make meaningful reductions in burnout and potentially lead to more robust and resilient health care institutions."

The study enrolled 2,077 HCWs employed at 28 hospitals or clinics across the country from March 2021 through July 2022. Participants were divided into two groups, one that revived standard care and one that received a peer-to-peer support intervention from trained healthcare workers.

Recipients of the intervention were also taught to respond to their own and their peers' stress reactions, the authors said, using seven core actions: check, coordinate, cover, calm, connect, competence, and confidence.

Younger HCWs benefitted
For every 50 HCWs trained, one "champion" at each site was selected to then learn the training and continue training new workers. The main outcomes of the study were rates of psychological distress and posttraumatic stress disorder (PTSD).

In total, 862 participants (696 women [80.7%] and 159 men [18.4%]) were from sites randomly assigned to the intervention arm, with a baseline psychological distress score of 5.86 and a baseline PTSD score of 16.11.

A total of 1,215 study participants were not treated. That group had a baseline mean psychological distress score of 5.98 and a baseline PTSD score of 16.40.

When looking at self-reported symptoms, researchers found a 4.6-point reduction (95% confidence interval [CI], −8.1 to −1.0) on the 0- to 24-point psychological distress score and a 6.8-point reduction (95% CI, −13.2 to −0.3) on the 0- to 80-point PTSD symptom score, which were clinically meaningful effect sizes, the authors said.

But an intent-to-treat analyses revealed no overall treatment effect of the intervention. Furthermore, the treatment effect was seen most strongly in HCWs 30 years and younger.

"Given that we found a significant effect in younger HCWs," they wrote. "It could be helpful to focus future studies of this peer-to-peer support intervention on trainees (eg, residents and nursing trainees) to capture HCWs at a critical point in their early professional development, as the intervention was originally implemented in its first military setting to create culture change within a large system."

It could be helpful to focus future studies of this peer-to-peer support intervention on trainees .
In a commentary on the study, Anna O'Kelly, MD, from Harvard Medical School, and colleagues wrote that the study highlights the "…importance of collegiality and mutual support in a cataclysmic crisis. On the basis of the results of their study, this may be especially meaningful for young health care workers who have yet to develop the most personally meaningful coping strategies, clinical confidence, and workplace community and networks that a longer career in health care may afford."

https://www.cidrap.umn.edu/res...

Scant drug ingredients linked to US generic-drug shortages in first 2 COVID years
Mary Van Beusekom, MS Today at 12:56 p.m.
Resilient Drug Supply

In the first 2 years of the COVID-19 pandemic, shortages of 11% of generic active pharmaceutical ingredients (APIs) made by global manufacturers—35% of them from larger facilities in India—were tied to generic-drug unavailability in the United States, according to a research letter posted this week in JAMA.

APIs key to drug quality
Johns Hopkins University researchers analyzed US drug shortage data from the Food and Drug Administration (FDA) from January 2020 to December 2021. The team then matched each shortage to the Clarivate Analytics Cortellis Generics Intelligence (CGI) database, which has information on global generic API manufacturers, and extracted details on all generic APIs bound for the United States.

The information included the number, location, and characteristics of API manufacturing plants; year of the first US abbreviated new drug application; US-licensed generic-drug makers using the API; routes of administration; and therapeutic category.

APIs are key to the quality of prescription drugs, and generic drugs made up about 90% of US prescriptions in 2022, the researchers noted. "In 2014, 9% of drug shortages were attributed to the unavailability of APIs," they wrote. "In addition, APIs could potentially be linked to the 40% of shortages attributed to quality problems and the 30% caused by manufacturing delays and capacity issues."

Shortages lasted 2.3 years on average
The FDA documented 194 drug shortages, which lasted an average of 844.6 days and involved 162 unique generic APIs, of which 91% were also found in the CGI database. The 1,379 US-bound generic APIs in the CGI database were manufactured by 565 firms, with each API made by an average of 3.7 plants.

Relative to APIs not linked to shortages, the 147 shortage-associated APIs (10.7% of 1,379 APIs) were mainly older products (average year of new-drug approval, 1993 vs 2004), linked to more approval holders (average, 7.2 vs 4.1), more likely to be in injectable form or to have multiple routes of administration, and more likely to be neuromuscular or anti-infective.

Identifying API manufacturers linked to shortages could guide FDA inspections and help prioritize approvals of new entrants in vulnerable markets.
The number of manufacturing plants did not differ by shortage association (average, 3.6 vs 3.7). But facilities linked to at least one API in shortage (48.1%) produced more APIs (average, 13.7 vs 4.5), didn't differ by year of last FDA inspection (average, 2017 vs 2018) or receipt of an FDA warning letter (33 vs 35 facilities), and had more non-US inspectors (average, 2.1 vs 1.5) than those making APIs not tied to a shortage.

In total, 35.3% of plants making APIs in shortage were located in India, 12.1% were in Italy, 10.7% were in China, and 9.6% were in the United States.

"Identifying API manufacturers linked to shortages could guide FDA inspections and help prioritize approvals of new entrants in vulnerable markets," the study authors wrote. "Although the pandemic posed additional strain to global supply chains, highlighting the importance of strong generic drug supply chains for national security, drug shortages have continued to increase since then."

https://www.cidrap.umn.edu/e-c...

Organic walnuts tied to 2-state outbreak of E coli infections
News brief Today at 11:39 a.m.
Jim Wappes
Topics E coli Foodborne Disease
Walnut bowl

At least 12 people in California and Washington state have been sickened and 7 people hospitalized in an Escherichia coli O157 outbreak traced to Gibson Farms organic walnuts that are sold in 19 states, the Centers for Disease Control and Prevention (CDC) said in a food safety alert yesterday.

Two patients developed hemolytic uremic syndrome, a serious and potentially fatal kidney condition. The CDC said in a news release, "Almost all sick people purchased organic walnuts from bulk bins in food co-ops or natural food stores in California and Washington." Two people bought bulk walnuts from the same store.

Company recalls bulk walnuts
In a recall notice yesterday, the Food and Drug Administration (FDA) said Gibson Farms has voluntarily recalled the implicated walnuts. "Gibson Farms Organic Light Halves and Pieces shelled walnuts were sold in bulk boxes in Net Wt. 25 lbs quantities and can be identified by lot 3325-043 & 3341-501 with expiration dates 5/21/25 & 6/7/25."

The agency added, "A full investigation is currently under way to determine the potential source of the contamination."

The CDC said the nuts were distributed to natural food and co-op stores in Alaska, Arkansas, Arizona, California, Colorado, Hawaii, Idaho, Kansas, Louisiana, Montana, Nebraska, New Mexico, Nevada, Oregon, South Dakota, Texas, Utah, Washington, and West Virginia. The FDA has posted a list of stores that sold the walnuts.

Gibson Farms, Inc, is headquartered in Hollister, California.

First patient fell ill on February 1
The 12 patients—6 in California and 6 in Washington—range in age from 6 to 84 years, with a median age of 57. Eight are female. Of 10 patients who reported racial information, 9 are White and 1 is Black.

Illness-onset dates range from February 1 to April 4. No deaths have been reported.

"The true number of sick people in this outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses," the CDC said.

https://www.beckershospitalrev...

CDC: Hospitals no longer required to report COVID-19 data
Naomi Diaz - yesterday

The CDC has announced that starting May 1, hospitals are no longer required to report COVID-19 hospital admissions, hospital capacity or hospital occupancy data.

However, the CDC continues to strongly encourage hospitals to voluntarily report this data. Any voluntarily reported data after May 1 will be accessible starting May 10, according to the agency.

CDC data shows that hospitalizations due to COVID-19 reached a record low of 5,615 for the week ending April 20th.