Southern Hemisphere Flu Season Bodes Ill for U.S.

Key Points:

COVID

• In today’s Recommendation for Industry, we discuss flu season in the Southern Hemisphere. Read more below.
• Serious adverse events rare after COVID-19 boosters in young kids. Data collected from two vaccine safety surveillance programs in the first 10 weeks of administration of third doses of the Pfizer/BioNTech COVID-19 to US children aged 5 to 11 years show that serious adverse events were rare. The most common adverse reactions included injection-site pain (66.7%), fatigue (28.9%), and headache (19.9%). Most reactions were reported the day after vaccine receipt and were mild. Estimated vaccine effectiveness (VE) 0 to 13 days after two doses was 75.5% among 18-year-olds, 80.4% among those aged 16 or 17, and 79.2% among those 12 to 15. Thirty to 59 days after a second dose, VE waned to 71.3% among 18-year-olds, 61.5% among those 16 or 17, and 49.6% among those 12 to 15. Thirty to 59 days after a third dose, VE fell to 55.2% among 18-year-olds.
• COVID-19 survivors still at higher risk of neurologic disorders 2 years later. Rates of “brain fog,” dementia, psychotic disorders, and epilepsy or seizures remained elevated 2 years after COVID-19 infection, according to a study of nearly 1.3 million adults and children in the United States, Australia, Europe, and Asia. The risk of common psychiatric disorders returned to baseline within 1 or 2 months (43 days for mood disorders, 58 days for anxiety disorders) and then equalized with that of controls by 1.1 years (anxiety) and 1.3 years (mood disorders).
• Pfizer files for emergency use of its BA.4/BA.5 Omicron booster. Pfizer filed an emergency use of their new bivalent booster in hopes they will ship the vaccine in September. The FDA told Pfizer it could submit clinical data for its bivalent BA.1 vaccine alongside preclinical and manufacturing data on its BA.4/BA.5 vaccine. Preclinical data in animals suggest that the BA.4/BA.5 bivalent booster prompts a strong neutralization antibody response against Omicron BA.1, BA.2, and BA.4/BA.5 variants, as well as to the original SARS-CoV-2 virus. New CDC data on COVID-19 cases and deaths show that people ages 50 and up who have had one booster dose have an 83% reduction in deaths, and those with both recommended booster shots have a 94% reduction in death.

Monkeypox

• Survey shows high intent to get the monkeypox vaccine but problems self-diagnosing. A study today in Eurosurveillance shows 70% of surveyed men who have sex with men (MSM) in the Netherlands said they intended to vaccinate against monkeypox, and 44% showed high intention for self-isolation after diagnosis. Within the survey, only 52.3% of participants could correctly identify pictures of monkeypox lesions on the face. In US news, federal officials will make 1.8 million more Jynneos vaccine doses available next week.
• Evidence of monkeypox virus found on household surfaces. A study in Morbidity and Mortality Weekly Report shows multiple surface sites testing positive for monkeypox virus genetic material in a household of two people infected with monkeypox in Utah. UDHHS sampled 30 objects in the home of the infected individual after 20 days of being isolated. Of the 30 specimens, 21 (70%) yielded positive real-time polymerase chain reaction (PCR) results. Three of the positive swabs came from porous items such as cloth furniture and blankets. Seventeen of the eighteen positives out of twenty-one came from nonporous surfaces (handles and switches) while one came from a mixed-surface type (chairs). The researchers concluded their results with the following recommendation: “Persons living in or visiting the home of someone with monkeypox should follow appropriate precautions against indirect exposure and transmission by wearing a well-fitting mask, avoiding touching possibly contaminated surfaces, maintaining appropriate hand hygiene, avoiding sharing eating utensils, clothing, bedding, or towels, and following home disinfection recommendations.”
• CDC cut down the paperwork from 3 to 4 hours to obtain Tpoxx (tecovirimat) to only four forms.
• US total case count is at 14,115 cases.

Food Safety & Public Health

• Countries face shortages of drugs, some for life-threatening conditions. Countries around the world, including the United States, are experiencing a medicine shortage to treat some conditions such as HIV and diabetes, which clinicians say could threaten patient health.
• New Ebola case in DRC likely linked to earlier outbreak. There was a confirmed finding of an individual who passed away on August 15^th in the Democratic Republic of the Congo that had Ebola. The individual was a 46-year-old woman who was initially hospitalized for different problems. Persistent virus in survivors is known to trigger flare-ups, and following the large outbreak, there were two other small events in the same area, both thought to be linked to earlier human cases in the area. One that began in February 2021 resulted in 12 cases, 6 of them fatal. And one that started that October led to 11 cases, 6 of them fatal.
• Here’s the checklist for the new FDA food traceability rule that’s coming up. This strict rule will become official on November 7^th, 2022. Some of the “high-risk” products that will be under this rule are cheeses other than hard cheese, crustaceans, cucumbers, finfish, fresh herbs, fresh cut fruits and vegetables, leafy greens, melons, mollusks, nut butters, peppers, ready-to-eat deli salads, shell eggs from domesticated hens, sprouts, tomatoes, and tropical tree fruits. The details for what is required from this rule can be found here.
• Romaine on Wendy’s sandwiches linked to multistate E. coli outbreak. Thirty-seven individuals have been deemed ill from romaine lettuce associated with Wendy’s. These people are in four different states: Michigan, Ohio, Pennsylvania, and Indiana. Investigation of this outbreak is still ongoing.

Recommendations for Industry

Southern Hemisphere Flu Season Bodes Ill for U.S.

Although the influenza season has been relatively mild in the U.S. since the start of COVID, there are signs that flu spread could go the other way this fall for the U.S. and other countries in the Northern Hemisphere. Because the flu season in the Southern Hemisphere comes earlier in the year, its spread has historically been an indicator for expectations in the North – and those indicators are rather pessimistic, with Australia and other Southern Hemisphere countries experiencing their worst flu season in five years, according to a number of sources.

According to Andy Pekosz, a virologist at Johns Hopkins, the factors contributing to a “perfect storm” of viral infections, that could be indicators for the U.S., include this year’s earlier-than-normal start and peaking of the Australian flu season, and the surge infecting those who do not have natural or vaccine-acquired immunity (e.g., such as that due to the pandemic precautions – distancing, mask usage, etc.)

Thus far, the U.S. is continuing to see low levels of flu activity, according to the CDC. But if the U.S. follows Australia’s lead – with weekly cases since mid-April exceeding the last five years’ averages and starting two months before the typical June-to-September occurrence – we could start seeing a rise in the U.S. very soon. In Australia, the highest rates of infection have occurred in those ages 5-19 and workplace sick leave in May was 50% higher than seasonally adjusted averages.  And, in all likelihood, that rise may continue above historical rates here as well.

TAG’s recommendation for businesses is to continue, or begin to increase, your wellness checks to ensure those who are sick – with any illness – stay home and help contain the spread. TAG will continue to track and report on influenza rates and provide recommendations. We encourage you to keep an eye on this space and contact us for any assistance you may need in communicable disease risk management.

In case you missed it:

COVID

• In last Thursday’s Recommendation for Industry, we discussed TAG expanding our public health offerings to include focus on other workplace communicable diseases. Read more here.
• Global COVID-19 cases down 24%. The WHO’s weekly epidemiologic update showed official worldwide reports of 5.4 million new COVID-19 cases last week, down 24% from the week before, and 15,000 deaths, down 6%.
• Updated COVID boosters could be available in 3 weeks, White House predicts. Newly updated COVID-19 booster will be available in the next three weeks or so, if the FDA and CDC work through their processes for authorization as expected. In late June, the FDA directed Moderna and Pfizer to make vaccines that targeted the more contagious BA.5 Omicron subvariant and the original COVID strain. That work has been underway, and the next step is for the FDA and CDC to receive and review data from the companies. Neither has announced a timeline.
• Study: 56% of Omicron-infected adults didn’t know they were contagious. An observational study of 210 adults in California with detectable SARS-CoV-2 antibodies during an Omicron variant wave shows that 56% didn’t know they had been infected, with some attributing symptoms to a cold or other non-COVID infection. The JAMA Network Open report finding fuels concerns about asymptomatic transmission, particularly by those with lesser general health awareness and those without daily screening protocols supported by COVID-19 sick pay policies.
• Study shows potential benefits of mix-and-match approach for COVID-19 boosters. A “mix-and-match” strategy for COVID-19 vaccine boosters may help improve the durability of antibody and T-cell responses against the Omicron variant, according to a Harvard Medical School study. The study found that people who received a booster dose of the J&J adenovirus vector vaccine after primary immunization with the Pfizer messenger RNA vaccine had durable responses for at least 4 months.

Monkeypox

• WHO: Monkeypox cases rose 20% in past week. According to the World Health Organization (WHO) monkeypox cases increased by about 20% for the second consecutive week, with most case increases seen in Europe and North America. More than 35,000 cases have been reported from 92 countries and territories, with 12 deaths. Almost all cases continue to be reported among men who have sex with men. In the U.S., CDC reported 799 more cases, raising the total to 12,689. New York has the most cases (2,620) followed by California (1,945).
• Studies heighten concerns about asymptomatic monkeypox spread. In one study, lab tests from asymptomatic French men who were sampled regularly for other purposes were positive for monkeypox. The authors said it’s not clear if viral shedding can lead to transmission. Another case study showed that a man sought care for a week-long vesicular rash he developed after a trip to the UK, where he attended a large, crowded outdoor event that involved close contact, including dancing; his sharing of an e-cigarette with a woman he met; and many attendees wearing shorts and sleeveless tops. The studies suggest that vaccination of only known contacts may not prevent spread; there may be potential for spread at large events; and fomites may be another potential transmission mode.

Food Safety & Public Health

• CDC director calls for agency changes following pandemic missteps. In an email to employees, CDC Director Dr. Rochelle Walensky said the agency must make drastic changes to respond better and faster to public health emergencies, following missteps during the COVID pandemic. With a goal of “a new, public health action-oriented culture at CDC that emphasizes accountability, collaboration, communication, and timeliness,” she wrote, the agency needs to overhaul how it analyzes, shares, and communicates data – sharing data faster and in a way that speaks to the American public in easy-to-understand language. It’s also anticipated that leadership changes and internal reorganizations will occur.
• New Online Toolkit to Help Small Processors Comply With FSMA. The Northeast Center to Advance Food Safety (NECAFS), a University of Vermont Extension program, published a new webpage that features a food safety toolkit tailored to small and very small processors that are required to comply with FSMA’s Preventive Controls Rule.
• Salmonella linked to backyard poultry sickens 312 more people. In its latest update on the Salmonella outbreak linked to backyard poultry, the CDC reported 312 more cases, raising the nation’s total to 884 in 48 states and the District of Columbia. The five states with the most cases are California (59), Minnesota (46), Texas (45), Wisconsin (41), and Missouri (36). Two more Salmonella subtypes were added to the outbreak.
• C.D.C. Investigates ‘Fast-Moving’ E. coli Outbreak. Federal health officials are investigating an E. coli outbreak that has sickened 14 people in Ohio and 15 in Michigan, with nine people hospitalized and no reported deaths. The CDC said that no food had been identified yet as the source, but laboratory tests have shown that the patients are infected with the same type of E. coli.