The Perfect Enemy | News Scan for Aug 08, 2022
September 27, 2022

News Scan for Aug 08, 2022

Climate change and pathogens
Biden winds down COVID rebound
ASP benefits at peds urgent cares
More H3N2v case details
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Study outlines climate change pathogenic impacts

A scientific literature review for empiric examples of impacts from 10 climate hazards influenced by greenhouse gas emissions found that more than 58% of human diseases caused by pathogens—such as dengue, pneumonia, and Zika virus—are made worse by the climate-related hazards. A team based at the University of Hawaii at Manoa reported the findings today in Nature Climate Change.

The greenhouse gas emission-related hazards they examined were warming, drought, heatwaves, wildfires, extreme precipitation, floods, storms, sea level rise, ocean biogeochemical change, and land cover change. Using two lists of all known infections and pathogens, the researchers reviewed more than 70,000 scientific papers for examples of each combination of climate hazard impacting each of the known diseases.

Warming, precipitation, floods, drought, storm, land cover change, ocean climate change, fires, heatwaves and sea level changes were all found to influence diseases. The diseases were primarily transmitted by vectors, but the group also found other transmission pathways, including waterborne, airborne, direct contact, and foodborne.

Though most conditions were aggravated by climate hazards, 63 of 286 diseases were diminished. And some were diminished by one hazard but made worse by others.

Other key findings were that climate hazards are bringing pathogens closer to people and people closer to pathogens. Also, climate hazards are enhancing certain pathogen aspects, such as reproduction, and lengthening the season of exposure.

The hazards are also diminishing people’s ability to cope with pathogens, such as when drought leads to poor sanitation that can facilitate diseases like cholera, Escherichia coli infection, and typhoid fever. Along with the study, the team posted an online tool that allows people to look at specific hazards and disease groups, backed by available evidence.

Camilo Mora, PhD, geography professor and the study’s lead author, said in a news release from the university, “There are just too many diseases, and pathways of transmission, for us to think that we can truly adapt to climate change. It highlights the urgent need to reduce greenhouse gas emissions globally.”
Aug 8 Nat Clim Chang abstract
Aug 8 University of Hawaii
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Disease pathway
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Biden ends isolation after negative COVID-19 tests

President Joe Biden tested negative for COVID-19 yesterday for a second day in a row, prompting his return to public engagement and travel, his doctor, Kevin O’Connor, DO, said in a statement. Biden, who experienced a week-long rebound infection after Paxlovid treatment, traveled to eastern Kentucky today to meet with residents affected by devastating flooding.

In other developments, the Centers for Disease Control and Prevention (CDC) is expected to release updated COVID-19 guidance for schools as soon as today. It would relax some measures regarding distancing and testing, according to CBS News, which has seen a draft of the document.

For example, exposed students wouldn’t need to quarantine but would be advised to mask for 10 days and test after 5 days. The new guidance, expected to streamline and simplify protocols for schools, comes as schools resume in some parts of the country, vaccination uptake among children is lukewarm, and COVID-19 levels are elevated in many communities.

In international developments, countries in Asia continue to grapple with COVID spikes. In China, an outbreak on Hainan island, a tourist destination, prompted officials to add even more restrictions, according to Reuters, and a flare-up in Tibet has prompted new measures in affected areas.
Aug 7 White House statement
Aug 8 CBS News
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Aug 8 Reuters stories on
Hainan and Tibet outbreaks

ASP improved antibiotic prescribing at pediatric urgent care centers

Implementing an antimicrobial stewardship program (ASP) at pediatric urgent care centers significantly improved appropriate antibiotic dosing and duration, researchers from Missouri reported in a recent issue of the American Journal of Infection Control.

Urgent care centers have some of the highest rates of unnecessary antibiotic prescribing in outpatient settings. For the study, the researchers examined prescribing patterns at three Kansas City, Missouri, area pediatric urgent care (PUC) clinics, plus one in a rural area.

They assessed encounters for six different conditions, with an eye toward comparing antibiotic prescribing rates before the ASP was implemented, from July 2017 to July 2018, and after it was implemented, August 2018 to December 2020. The conditions included ear infection, group A streptococcal pharyngitis, community-acquired pneumonia, urinary tract infection, and skin and soft tissue infections.

Some of the elements of the ASP program included semi-annual clinician education sessions, a handbook, and prescription folders for common diagnoses in the electronic health record.

Over the study period, there were 35,917 patient encounters. The percentage of prescriptions with the recommended agent at the recommended dose and duration increased from 32.7% to 52.4%, with the most substantial changes seen in appropriate duration and dose. Group A strep pharyngitis was the only diagnosis that didn’t improve by at least one measure, though the authors pointed out that dosing for the condition is standard.

The team saw some seasonal fluctuations reflecting higher antibiotic prescribing rates in winter. They noted that prescribing increased in the last few months of the study, raising the possibility that the pandemic may have contributed to fluctuations, including for community-acquired pneumonia.

Also, they noted that PUC clinicians often prescribed antibiotics at lower-than-recommended doses, which contributes to treatment failures and partially treated infections.

They wrote that they focused similar ASPs on improving the quality of prescribing rather than restricting use, which may have made clinicians more willing to adopt changes.
Aug 5 Am J Infect Control abstract

CDC adds details on West Virginia H3N2v case, notes swine flu outbreak rise

The US Centers for Disease Control and Prevention (CDC) added more details about the recent variant H3N2 (H3N2v) case from West Virginia and warned that numbers of similar fair-linked cases might be higher than usual this season owing to increased swine flu outbreaks in pigs.

It said West Virginia’s case occurred in a person younger than 18 at an agricultural fair who had contact with pigs. The person wasn’t hospitalized and is recovering. The H3N2v findings were confirmed by the CDC, and pigs at the fair also tested positive for swine influenza.

Respiratory illnesses were also reported in other people who attended the same fair, and specimens have been sent to the CDC for further testing.

The CDC urged people at higher risk for flu complications to avoid pigs and swine barns at fairs and that those not at high risk take precautions, including avoiding eating or drinking in pig areas, avoiding contact with sick pigs, and washing hands often before and after contact with pigs.
Aug 5 CDC notice
Aug 4 CIDRAP News
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