Even though Maryland wasn't in the full eclipse path, I miraculously located my eclipse glasses and enjoyed Monday's event. It easily overshadowed last week's relatively quiet collection of infections.
Newer Covid Publications
CDC gave us more reassurance that cardiac events associated with covid vaccination are mild. For the period June 2021 - December 2022, investigators looked at Oregon death certificate data in adolescents and young adults (16 - 30 year-olds). They found 40 deaths, 3 of which occurred < 100 days following receipt of covid vaccine, a time period when vaccine-associated myocarditis/pericarditis occurs. Of those 3, 2 individuals had underlying disease (one had mitral stenosis associated with chronic respiratory failure, the other congestive heart failure due to hypertension, with comorbidities of morbid obesity, type 2 diabetes, and obstructive sleep apnea). The other person died of "undetermined natural cause" 45 days after vaccination; toxicology results showed aripiprazole, ritalinic acid, and trazodone, presumably medications the individual was receiving but apparently not definitively explaining a cause for death. To most scientists this is further good news, but I'm sure anti-vaxxers will somehow spin this as a negative. Below is the big picture:
German investigators reported success of a program using pooled SARS-CoV-2 PCR testing to allow children to remain in day care versus quarantining after covid exposure, which they termed a "test-to-stay" approach.
The investigators estimated that. over a 30-week period, they avoided between 7 and 20 days of quarantine per eligible child. The study was performed from March 2021 to April 2022, at a different state of immunity and variants than we are experiencing today but still helpful to strategize when we hit the next big outbreak.
More on Bird Flu/HPAI
Highly pathogenic avian influenza news has calmed down a bit, but the viruses are still out there. We are up to 21 dairy herds with outbreaks according to USDA:
As of April 10, CDC reports widespread detections in wild birds with sporadic outbreaks in poultry flocks, sporadic infections in mammals, and still just the 2 human infections.
Measles
Not as many new cases now, with Illinois and Florida retaining the dubious distinction as leading all states this year. The national total stands at 121.
CDC reported that most US measles outbreaks from 1/1/20 through 3/28/24 were triggered by unvaccinated US residents returning from foreign travel. This is a good reminder for frontline clinicians to advise people planning foreign travel this summer to ensure their families have not only up-to-date immunizations but also early measles immunization for infants and toddlers who otherwise have not received 2 doses of MMR.
I also happened upon a link for assessing measles outbreak risk in US communities. I resisted the temptation to copy the entire page here, please check out the link. Here's a few highlights:
So, about 29% of US communities are at risk for small or medium outbreaks, with 1% at risk for a large outbreak. Even within communities with the same vaccination coverage, outbreak risk can vary if they have pockets of unvaccinated people.
And a look at outbreak modeling risks for measles outbreaks after one measles case is introduced in a school, according to vaccine coverage rates. (Note these numbers apply for situations where no post-exposure preventive measures are instituted. Risks go down if established interventions are applied.)
Here's the latest (2022-23) geographic measles vaccine coverage data.
Fingers crossed for measles to continue to slow down, though I'm predicting another blip around travel season.
See you next week!
