The shootings in Pennsylvania give all of us a chance to reflect. We should be thankful that more people weren't harmed while also keeping the families of the critically injured and the dead close to heart.
More Poultry Workers Presumptively Infected With Bird Flu
The Colorado state health department now reports 3 other presumptive H5N1 cases in poultry workers, adding to the single case in that state earlier this month. All apparently had mild illness with respiratory symptoms and conjunctivitis. We're still waiting for ongoing studies to provide better understanding of transmission modes and extent of infection in high-risk workers; such knowledge likely will lead to effective preventive measures.
Infection in animals is widespread in the US.
Olympic Wastewater
The World Health Organization has plans to monitor 6 pathogens in wastewater from the 2024 Olympics and Paralympics in Paris: poliovirus, influenza A and B viruses, mpox, SARS-CoV-2, and measles. It's an interesting read if you have the time.
More Kudos for Nirsevimab
Last week saw the publication of a report from France of a matched case-control study of nirsevimab effectiveness during the 2023-2024 RSV season and reflects real-world implementation as it occurred in that country. Results were again excellent, 83% (95% CI 73.4-89.2%) effective against hospitalization.
Returning to my broken record mode, I implore all pediatric healthcare providers to ensure families protect their infants with nirsevimab (or with maternal RSV vaccine use).
Blood Culture Bottle Shortage
Usually we worry about medication/vaccine shortages, but don't forget equipment shortages are relatively common. Now the FDA has announced a shortage of blood culture bottles likely to last a long time. This does give me an opportunity to reference again one of my favorite guidelines, recently updated, concerning effective use of the microbiology laboratory.
Many providers were surprised by the recommendations for volume of blood to be drawn for pediatric blood cultures:
Two separate cultures are usually recommended but can be drawn at the same time. Utilizing appropriate skin decontamination and proper blood volumes will increase yield of true pathogens. While one could argue that adhering to the guidelines above would actually increase the number of bottles used (since most pediatric practitioners obtain just 1 culture at a time), I'd push back against that claim by stating that fewer bottles would be used because we wouldn't be obtaining cultures in very low risk clinical settings nor chasing contaminants nearly as often. If you frequently make decisions on obtaining blood cultures, this is a good time to review the guideline section on bloodstream infection.
Remember the Children
I wrote some time ago about how the assassination of President Kennedy in 1963 affected me. I was a 5th grader when the presidential motorcade, including the limousine carrying JFK, the First Lady, and Texas Governor Connally and his wife, drove past my school the day before the assassination. I was one of a couple hundred kids on the curb waving as they went by. I remember the confused thoughts in my 10-year-old mind. Take time to discuss yesterday's event with your children, grandchildren, and with your patients and their families.