Defending Against Infectious Disease

Key Points:

• In today’s Recommendation for Industry, we discuss defending against infectious disease. Read more below.
• COVID-19 vaccine during pregnancy may protect infants. The COVID-19 vaccination has shown through a study performed by JAMA Internal Medicine that it can protect babies for their first 4 months of life. Protection for infants was 33% during the Omicron surge.
• US and other nations track shifts in COVID-19 activity, reported by CIDRAP. The overall pace of COVID-19 activity in the United States has showed some signs of leveling off, with the disease burden indicating a shift from east to west. Today the FDA is meeting to discuss emergency use of the Novavax COVID vaccine. Uganda’s and France’s cases are rising while China’s seem to be on a downward trend.
• The U.S. has wasted over 82 million COVID vaccine doses. This number has increased from 65 million doses in February that was reported by the CDC. Two retail pharmacy chains, CVS and Walmart, were responsible for over a quarter of the doses thrown away in the United States in that time period. The millions of wasted vaccine doses included some that expired on pharmacy shelves before they could be used, others that were spoiled by the thousands when power went out or freezers broke, and still others that were tossed at the end of the day when no one wanted the last few doses in an opened vial.
• Why boosted Americans seem to be getting more COVID-19 infections. For the week of April 23, the rate of COVID-19 infections among boosted Americans was 119 cases per 100,000 people. That was more than double the rate of infections in those who were vaccinated but unboosted, but a fraction of the levels among unvaccinated Americans. That could be because there is a “higher prevalence of previous infection” right now among those who are unvaccinated and unboosted, the CDC said. More boosted Americans may now have abandoned “prevention behaviors” like wearing masks, leading to an uptick. Some boosted Americans might be more likely to seek out a lab test for COVID-19, as opposed to relying on over-the-counter rapid tests that go largely unreported to health authorities.
• Pfizer Portage, MI facility to produce oral COVID-19 treatment, create hundreds of jobs. Pfizer will make history as the first U.S based manufacturing facility to support the production of the oral COVID-19 treatment, Paxlovid. Paxlovid is used to treat mild-to-moderate COVID-19 in adults and kids 12 years old and older, who are at high risk for progression to severe COVID-19, including hospitalization or death. Paxlovid has not been approved by the U.S Food and Drug Administration, however it was authorized for emergency use.

Influenza:

• Reported by HealthMap.org: The flu season is getting off to an early start in Australia and New Zealand, with numbers of cases being reported that are higher than what’s been seen in recent years. Calls to encourage vaccination are going out.
• The CDC reports this week that 1 jurisdiction experienced moderate activity and 4 jurisdictions experienced high or very high activity. Seasonal influenza viruses continue to circulate, and activity is increasing in parts of the country. The percentage of outpatient visits due to respiratory illness decreased slightly over the past two weeks. Influenza is contributing to levels of respiratory illness, but other respiratory viruses are also circulating.

Public Health & Food Safety:

• Hepatitis update provided by HealthMap.org: In the ongoing hepatitis outbreak of unknown origin, as of May 27, 33 countries and regions around the world have reported 650 suspected cases of acute hepatitis in children of unknown etiology to WHO, of which at least 38 require liver transplantation. There have been nine deaths.
• Experts highlight sexual aspect of monkeypox spread. Researchers today at a World Health Organization (WHO) meeting spelled out the sexual transmission component  of a monkeypox outbreak that has affected hundreds of people—mostly men who have sex with men—in at least 27 countries outside of Africa. The Centers for Disease Control and Prevention (CDC) today confirmed another case in the United States, bringing the total to 19, but news reports in both Atlanta and Los Angeles suggest officials in those cities have suspected the virus in residents. Globally, the monkeypox outbreak in nonendemic countries continues to grow, with more than 780 cases reported in the last 3 weeks. So far, 27 countries have reported cases.
•  Abbott resumes production of infant formula under strict eye of FDA. Abbott Nutrition has resumed operations at its baby formula plant which was shut down by the FDA in mid-February because of dirty conditions and a link to a cronobacter outbreak that saw two babies die. Product won’t be available for 6 weeks. The plant in Sturgis, MI, had to meet “hundreds” of requirements before reopening according to Food and Drug Administration Commissioner Robert Califf who testified before a congressional panel in late mid-May.
• Project looks at how to modernize meat inspection. Meat inspection in the United Kingdom can be changing in the future. A project assessed the feasibility of using sensor technologies and advanced data analytics for poultry inspection. It focused on post-mortem inspection and included technologies such as visual, near-infrared, infrared and hyperspectral, X-ray and ultrasonic as well as IT-enabled benefits. Despite technology, a meat inspector would be needed to identify other conditions or to remove birds from the line and place them in the correct category bin. 
• Study assesses link between inspection results and outbreaks. Institutional catering services that had significantly poorer inspection results detected outbreaks more likely. Restaurants didn’t tend to have a correlation between inspection results and outbreaks.

Recommendations for Industry

Defending Against Infectious Disease

An employee arrives at work looking a bit pale, then begins feeling feverish and complaining of nausea. As they prepare to head back home, you ask about other symptoms to determine the cause and any potential spread to other employees. Since they mention only fatigue and no appetite, you still can only wonder – is it flu, a new COVID variant, norovirus, hepatitis or even just a hangover? And what should you do?

Sending the employee home was your first – and best – defense. It also can be helpful to check with others who worked near them to determine if they have any symptoms, keep a close eye on your employees especially over the next few days for similar signs, and ask any other employee who calls in sick to detail their symptoms. Cleaning and disinfecting surfaces that may have become contaminated, particularly if anyone did vomit or have diarrhea at work, also is important.

Determining the cause can be difficult, especially if no other employee begins to show symptoms, but stopping a workplace infectious disease as soon as possible is important for both your employees and your customers. To assist businesses in the identification of disease – and what to do about it, TAG developed 15 Infectious Disease Fact Sheets providing detailed information on each. We also developed a video on How to Be Prepared against Infectious Disease, and have public health experts who can provide expertise, guidance, and assistance in the ever-continuing battle against communicable disease. Give us a call today to talk with an expert and learn about TAG’s Foresight 20-20 Program.

In Case You Missed It:

• In last Thursday’s Recommendation for Industry, we discussed how cases seem to be improving and moving across the country, as shown through the CDC community levels map and our weekly matrix. Read more here.
• Global COVID-19 cases fall 11%, deaths drop 3%. Since January, cases have steadily fallen over the world. Some areas of the Americas continue to rise according to WHO. Pediatric cases have doubled in the past 4 weeks in the US. National officials reported more than 3.3 million cases in the week ending May 29, with more than 9,600 deaths. COVID-19 killed older Americans at vastly higher rates during this winter’s Omicron surge than it did last year.
• COVID severely disrupted global cardiac care, increasing deaths. There are severe disruptions in cardiovascular related hospitalizations, diagnostic and interventional procedures, and outpatient visits during the first two years of COVID. Across all countries, there was a 22% decline in hospitalizations for severe ST-segment elevation myocardial infarction (STEMI) and a 34% drop in less serious non-STEMI heart attacks. 
• According to data collected from New York Times, during the Omicron wave, death rates soared for older people. Almost as many Americans 65 and older died in four months of the Omicron surge as did in six months of the Delta wave, even though the Delta variant, for any one person, tended to cause more severe illness. Deaths have fallen from the heights of the winter wave in part because of growing levels of immunity from past infections.

Pfizer asks the FDA again to authorize COVID vaccine for youngest kids. The age group in question is 6 months to 4 years old. The FDA is looking into this request and if approved they could grant emergency use authorization for those ages later this month. Pfizer’s request also included a clinical trial that found 3 doses of the vaccine for the youngest children were safe and generated a strong immune response.

Public Health & Food Safety:

• There’s still no HIV vaccine. The science behind coronavirus shots may help. Scientists are thinking since the mRNA vaccines can be created and tested in shorter than a year, maybe it is better to pursue that direction of research rather than traditional technologies. HIV vaccine will be a series of shots that will nudge the immune system at specific times. Recent vaccinations have been focusing on T cells and other types of antibodies.
• Avian flu in 35 states requires a costly response, says Food Safety News. The Secretary of Agriculture is currently ready to pour money into the fight against the avian flu. In the month since the last fund transfer, avian flu was discovered in 151 additional flocks in nine states, affecting more than 10.8 million commercial and backyard birds. APHIS has mobilized 1,125 employees both physically and virtually to respond to the outbreak. In March, Vilsak approved the first $130 million in emergency funding for APHIS to address the problem. The Secretary added $263 million to the HPIA work in late April. And just this past week, Vilsack transferred another $400 million.
• Grower says organic strawberries linked to hepatitis A outbreak were from Mexico. As of May 31, there were 17 confirmed illnesses — 15 in California and one each in Minnesota and North Dakota — and 12 hospitalizations in the United States, according to the Food and Drug Administration. In Canada, 10 patients have been identified with four of them requiring hospitalization. Since the strawberries are past their shelf life, the FDA is now recommending that anyone who purchased them to throw them away. The product labels should say either “Product of Mexico” or “Distributed by Meridien Foods.”
• Legislation introduced to improve food safety and hold FDA accountable. A bill that was introduced in the U.S. Senate is calling for stricter regulation of “Generally Recognized as Safe” substances and the creation of a new FDA office to assess the safety of chemicals in America’s food supply. This bill is introduced as Ensuring Safe and Toxic-Free Foods Act and makes sure Department of Health and Human Services (HHS) fulfills its responsibilityto promote the health and well-being of American families by directing the Food and Drug Administration to strengthen the Substances Generally Recognized as Safe (GRAS) Rule, which exempts companies from seeking pre-market approval for some food additives. This bill also discusses if bisphenols and PFAS are safe for families to consume. Legislation copy is here.