Monkeypox Takes Headlines as COVID Turns a Corner

Key Points:

• In today’s Recommendation for Industry, we discuss the ongoing monkeypox headlines. Read more below.
• US COVID cases show hints of decline. The 7-day average for new daily cases has dipped slightly to the 120,000 range over the past 3 days, according to an analysis by the Washington Post. Meanwhile, the 7-day average for new daily deaths has risen some, reaching 496. According to the Centers for Disease Control and Prevention (CDC), 41.7% of US counties have high COVID community levels, and 38.9% are at the medium level.

• Study: In-class college COVID spread rare amid public health mandates. At Boston University (BU), which mandated COVID-19 vaccination and face coverings for students, faculty, and staff in fall 2021, only nine cases of SARS-CoV-2 transmission were identified among more than 140,000 full-occupancy, in-person class meetings, accounting for 0.0045% of all class sessions. The findings were published late last week in JAMA Network Open. Possible in-class viral transmission was considered after two or more positive polymerase chain reaction (PCR) COVID-19 tests from students or faculty in the same class who did not identify each other as close contacts outside the classroom. BU was fully open and required completion of a COVID-19 vaccination regimen, isolation of infected students, enhanced air filtration, and use of face coverings indoors—but not physical distancing—during that time. Vaccination rates for faculty, staff, and students were 98.5%, 93.5%, and 98.7%, respectively. Average class size was 31 students.
• Ontario’s 7th wave of COVID-19 has peaked, says top doctor. Public Health Ontario says COVID-19 case rates decreased in 22 of Ontario’s 34 health units for the week ending July 30, with percent positivity down slightly week over week, and hospital admissions decreasing to 306 compared to 463 the previous week. Based on the newest data released by the province Thursday, however, there were 80 deaths linked to COVID-19 over the week, making it the second deadliest of the seventh wave so far. Ontarians aged 18 and older have been eligible for a fourth dose of a COVID-19 vaccine for three weeks — previously it was only available to people 60 and older, as well as immunocompromised or Indigenous adults. Just under 16 percent of Ontario adults have received four doses. In the particularly vulnerable population of people aged 80 and older, about 61 percent have received a fourth dose.

Public Health & Food Safety:

• Monkeypox:
  • US declares monkeypox a public health emergency. On August 4^th officials from the Department of Health and Human Services (HHS) and the Food and Drug Administration (FDA) declared the ongoing monkeypox outbreak in the United States a public health emergency. HHS has previously said the federal government has ordered 6.9 million doses of Jynneos, but the bulk of the vaccines will not be available until 2023. This led the FDA to consider authorizing fractional dosing of the Jynneos vaccine to stretch the supply. In other news, an editorial in the New England Journal of Medicine today asks officials to consider clinical trials of tecovirimat (Tpoxx)—an antiviral drug approved for treating smallpox—to test for efficacy against monkeypox.
  • Monkeypox reported in Illinois daycare worker, US cases top 7,000. Adding another element to quickly evolving monkeypox developments, Illinois health officials today announced that they are investigating a case in an adult who has links to a daycare. The Food and Drug Administration (FDA) is allowing vaccination for those younger than 18 who may have been exposed to the virus and that anyone with guardian approval will be vaccinated today, according to NBC News. The national case count has reached 7,102 cases with Washington DC having the most cases per capita in the country. Globally, there are more than 26,800 cases from 88 countries. The outbreak is growing most quickly in the United States and Europe, where Spain has the most cases, with 4,942.
• Virginia Tech researchers testing potential vaccine for norovirus. Virginia Tech researchers are testing a potential live oral vaccine for norovirus. The vaccine that the team is testing is in development by Indiana University researchers and uses the Rotarix rotavirus vaccine as a platform. On average in the United States, norovirus causes 900 deaths, 109,000 hospitalizations, 465,000 emergency department visits and 19 to 21 million cases of vomiting and diarrhea illnesses. Yuan, who is the leader of testing the vaccine, and her lab study gnotobiotic pig models of human intestinal virus infection and disease, including how probiotics affect immunity and the evaluation of rotavirus and norovirus vaccines and anti-norovirus biologicals.
• Canadian Blood Services urges donors to keep appointments as blood supplies reach new low. Canadian Blood Services is urging donors to keep their appointments because it predicts it will fall short of supplies of certain types of blood products next week. Currently, spokesmen are encouraging new and returning blood, platelet, and plasma donors to book and keep appointments. Blood donation is crucial for many different scenarios including individuals with cancer, accident/trauma victims, people undergoing surgery and people with blood disorders. There are 57,000 open appointments that must be filled before the end of August for the organization to be able to provide patients across Canada with the essential blood products they need on time. The call for donors to keep appointments comes after the organization suspended its mandatory masks and physical distancing policy in its buildings, vehicles, and donation events on July 25. The organization says masks are still available and welcome.
• USDA wants to reinstate organic welfare standards; could benefit food safety. The United States Department of Agriculture’s Agricultural Marketing Service (AMS) proposes to amend the organic livestock and poultry production requirements by adding new provisions for livestock handling and transport for slaughter and avian living conditions; and expanding and clarifying existing requirements covering livestock care and production practices and mammalian living conditions. This would also include crucial updates that require organic chickens to have adequate space indoors and access to the outdoors, thus eliminating “porches” that have allowed some factory-farm chicken operations to market their poultry and eggs as organic. Improvements in animal welfare have the potential to reduce on-farm risks to food safety, principally through reduced stress-induced immunosuppression, reduced incidence of infectious disease on farms and reduced shedding of human pathogens by farm animals, and through reduced antibiotic use and antibiotic resistance.
• National Chicken Council objects to USDA plan to name Salmonella as adulterant in some chicken products. USDA’s Food Safety and Inspection Service (FSIS) decision to declare Salmonella as an adulterant in breaded and stuffed raw chicken products is not welcomed by the regulated industry. NCC (National Chicken Council) is concerned about the precedent set by this abrupt shift in longstanding policy, made without supporting data, for a product category that has only been associated with one outbreak since 2015. It has the potential to shutter processing plants, cost jobs, and take safe food and convenient products off shelves. The FSIS reported that since 1998, breaded and stuffed raw chicken products have been associated with up to 14 outbreaks and approximately 200 illnesses. The FSIS will be proposing to set the limit at 1 colony forming unit (CFU) of Salmonella per gram for these products, a level that the agency believes will significantly reduce the risk of illness from consuming these products.

Recommendations for Industry

Monkeypox Takes Headlines as COVID Turns a Corner

As COVID continues to show indications of decline and monkeypox takes over headlines, we appear to be turning a corner on one infectious disease while another takes hold in some populations.

As with COVID, there has been no evidence that the Monkeypox virus can be spread through food, but there is transmission risk in the workplace if an actively infected employee with uncovered lesions comes into skin-to-skin contact with another employee.

Because of the transmission risk, current CDC guidance recommends isolation while symptoms persist, that is, until the monkeypox rash has fully resolved, the scabs have fallen off, and a fresh layer of intact skin has formed – which can take 3 to 4 weeks. Monkeypox symptoms also include respiratory symptoms similar to COVID.  So, it is recommended that COVID testing be conducted to determine the viral source.

To further assist businesses in their monkeypox prevention and control efforts, TAG has developed a Monkeypox Virus Planning and Response Toolkit, as a part of our ongoing Infectious Disease Risk Management service.

If you would like a copy of TAG’s Monkeypox Virus Planning and Response Toolkit or would like to discuss TAG support on your prevention and control programs for monkeypox or other infectious diseases, please contact Desiree Kramer ([email protected]).

In case you missed it:

• In last Thursday’s Recommendation for Industry, we discussed CDC’s reduction in COVID guidelines. Read more here.
• New York Times reports updates about COVID: Hospitalizations continue to increase, as they have through the summer, but they remain well below the peaks reached in previous surges. Nationwide, around 43,000 people are hospitalized with the coronavirus on an average day. The number of virus deaths announced each day is higher now than it was in early July, but it has held steady in recent weeks at around 440 fatalities per day. There is an average of roughly 130,000 new cases reported each day.
• Global COVID cases trend down, with rises in Japan, Korea: Global COVID-19 cases dropped again last week, as the BA.5-fueled disease burden shifts to some Asian nations, including Japan and South Korea. COVID activity appears to be declining, with a 9% drop last week compared to the week before, the WHO said. In the Western Pacific region, the highest jumps were in Japan, which reported a 42% increase, and South Korea, which reported a 25% rise compared to the week before. BA.5 prevalence rose from 63.8% to 69.6%, and BA.4 levels rose slightly, from 10.9% to 11.8%. HHS estimates that 7.7 million to 23 million Americans are experiencing long COVID, and that about 1 million are out of the workforce at any given time, amounting to $50 billion in lost earnings each year.
• U.S. CDC expected to ease COVID-19 guidelines for schools this week. The U.S. Centers for Disease Control and Prevention (CDC) is expected to ease its guidelines to control the spread of COVID-19, including in schools as soon as this week. The updated guidelines are expected to ease quarantine requirements for people exposed to the virus and would no longer recommend maintaining a six-foot distance at schools, according to the report. Currently, the agency requires people exposed to COVID and those not up to date on their vaccinations to stay at home and quarantine for at least five full days. The new guidelines would not require them to stay at home but instead to wear a mask and test at least five days after exposure.

Public Health & Food Safety:

• Monkeypox:
  • California and Illinois join New York State, New York City, and San Francisco in declaring public health emergencies over monkeypox. Both states said the declaration will allow them to expand testing and vaccine access. The CDC has reported 662 more monkeypox cases, raising the nation’s total to 5,811 cases in 50 jurisdictions. There are now 11 deaths from monkeypox recorded in the global outbreak, as Peru confirmed a death from the virus. Health authorities said the death occurred in a 45-year-old with a weakened immune system due to an untreated HIV infection. Globally there are now 24,406 cases reported from 80 countries. The United Kingdom has 2,672 confirmed cases.
  • WHO: US has biggest jump in monkeypox cases. In the last week of July, the United States saw the largest spike in cases, the WHO said. Of all case-patients with available data globally, 98.8% are men, and the median age is 37. Men 18 to 44 years old represent 76.7% of cases in the global outbreak. Sexual contact is the likely transmission event for 91.5% of patients.
  • White House names new monkeypox response team. A FEMA administrator and a Centers for Disease Control and Prevention (CDC) director of HIV prevention now serve as the heads of the federal monkeypox response team. Robert Fenton, Jr., the current Federal Emergency Management Agency (FEMA) regional administrator for the American West, will be the response coordinator, and Demetre Daskalakis, MD, of the CDC, will serve as the deputy coordinator.
• 450 sick in Ferrero chocolate Salmonella outbreak. There have been more than 450 people sickened from a Salmonella outbreak linked to Kinder chocolate. The first reported patient was on January 7 in the UK, but still cases are continuing to be counted related to this outbreak. The outbreak hospitalized many people, mostly consisting of children younger than 10 years old. Of those hospitalized some were reported to have severe clinical symptoms including bloody diarrhea. Operations at Ferrero’s Arlon factory were suspended in April, which led to the recall of products made there. Potentially implicated chocolate was distributed to at least 113 countries. In May, Ferrero asked to be allowed to produce again and in June, the Federal Agency for the Safety of the Food Chain (FASFC) gave conditional approval for the plant in Belgium to restart. This approval lasts for three months. Raw materials and each batch of foodstuffs will be analyzed and only released if results are compliant.
• How predictive maintenance is changing the face of food manufacturing. Predictive maintenance is a proactive approach to maintenance management, and as its name suggests, the aim is to help predict when maintenance should be performed. It is a data-driven form of maintenance designed to analyze the current condition of equipment and machinery in order to plan for needed interventions. It has been estimated that predictive maintenance can reduce the mean time to repair (MTTR) by 60%. There are many benefits to predictive maintenance:
  • Enabling early fault detection, i.e. halting impending failures
    • Reduced risk of disruptions to production and downtime
    • Improved performance of production-related assets
    • Optimizing the lifespan of machinery and equipment
    • Overall savings in production costs due to greater asset efficiencies
  • Industry 4.0 is the next level of industrialization, one based on cloud computing, automation, connectivity, and large amounts of digital data. When Industry 4.0 is combined with the connected worker, they form the ‘smart factory.’