Ebola Sudan infects 4 more in Uganda, 54 total
Uganda’s health ministry on Twitter today reported four more lab-confirmed Ebola Sudan cases, as well as one more death in a patient with a confirmed infection. The developments push the country’s overall total to 54 cases, 35 of them confirmed and 19 listed as probable. The latest death brings Uganda’s fatality count to 25, 7 in confirmed patients and 18 in people who had probable infections.
Officials said 427 contacts have been identified for follow up, and 16 people are currently being treated for their infections.
Jane Ruth Aceng Ocero, MBChB, MPH, Uganda’s health minister, was on hand today to mark the discharge of two Ebola patients from Mubende Regional Referral Hospital. “Unfortunately one of the recovered patients lost his wife and child to #Ebola. May their souls rest in eternal peace,” she said on Twitter.
Meanwhile, the World Health Organization (WHO) Uganda office today said construction continues on an Ebola treatment center in Madudu, where 14 cases have been confirmed, which it said will allow more timely treatment of patients.
The outbreak was first announced on Sep 20, marking Uganda’s first outbreak involving the more rare and slightly less lethal Ebola Sudan strain. The hot spots are located in the west central part of the country, and officials fear further spread of the disease, given that it could have spread undetected for 3 weeks and that most of the activity is in communities on a busy highway that runs from Kampala, the country’s capital, to the Democratic Republic of the Congo (DRC) border. So far, no cases have been reported from Kampala.
Sep 30 Uganda health ministry tweet
Sep 30 Ocero tweet
Sep 30 WHO Uganda tweet
More than 16,000 Americans died of combination cancer, COVID in 2020
In the first 10 months of the pandemic, COVID-19 was an underlying cause of 3,142 US cancer deaths, and cancer contributed to 13,419 COVID-19 deaths, according to a study published yesterday in JAMA Oncology.
Researchers from the American Cancer Society and Emory University used the Multiple Cause of Death database to identify deaths from Mar 1 to Dec 31, 2020.
A total of 3,142 US patients died of cancer, with COVID-19 as an underlying cause, and 13,419 COVID-19 deaths were related to cancer. Relative to non–COVID-related cancer deaths, those caused by both cancer and COVID-19 occurred more often in large cities in November or December among people aged 85 years or older, patients admitted to hospitals or living in long-term care facilities, and those of American Indian, Alaska Native, Black, or Hispanic race.
A higher proportion of COVID-linked cancer deaths (13.7%) and cancer-associated COVID-19 deaths (25.5%) occurred in patients with hematologic (blood) cancers, compared with non–COVID-related cancer (9.5%).
Lung cancer was the most common malignancy cited in non-COVID cancer deaths (22.5%), while prostate cancer was more common among COVID-linked cancer deaths. Cancers of the female reproductive organs and digestive organs in both sexes were less common among COVID-associated cancer deaths.
“Persons with cancer have high risks of COVID-19 infection and death, especially in 2020, when vaccines were not available,” the authors wrote. “Cancer care was disrupted, particularly among patients with socioeconomic disadvantages.”
The researchers said that the high proportion of deaths due to both COVID-19 and cancer in US medical facilities suggests sizable economic consequences that should be evaluated in future studies. “Ongoing monitoring of the mortality burden from COVID-19 variants (eg, Delta and Omicron) among patients with cancer is warranted, especially after vaccines became available,” they concluded.
Sep 29 JAMA Oncol study
Kids with shortness of breath after COVID-19 may have airway obstruction
Yesterday in the Journal of Allergy and Clinical Immunology, researchers from National Jewish Health published a study showing children who experienced shortness of breath after COVID-19 infection had evidence of peripheral airway obstruction.
The authors of the study presented a case study of a 17-year-old boy without previous respiratory symptoms who developed post-COVID dyspnea (shortness of breath). The boy was diagnosed as having COVID-19 in November 2020 (before vaccines were available), and 3 weeks following infection he developed shortness of breath, which lasted for 5 months.
The patient had no history of asthma or allergies. He had normal spirometry measurements. More testing showed, however, abnormal lung hyperinflation and peripheral airway obstruction. Doctors prescribed daily inhaled corticosteroid and bronchodilator therapy, and symptoms resolved over 3 months.
The authors said approximately 50 children have been seen at National Jewish Health over the course of the pandemic with shortness of breath as the primary symptom of long COVID. Almost all patients “report at least partial improvement of their dyspnea and improved exercise intolerance on initiation of inhaled corticosteroid therapy with, or without, long-acting β2-agonist,” the authors said. Patients also benefit from an exercise regimen.
“Through this research, we are identifying the specific diseases that long COVID may be causing, and, therefore, we can target a specific treatment for these individual issues,” said Nathan Rabinovitch, MD, MPH, lead author of the study and director of the pediatric care unit at National Jewish Health, in a press release.
Sep 29 J Allergy Clin Immunol study
Sep 29 National Jewish Health press release
Flu shows signs of rise in parts of US south
Flu levels are starting to rise in a few US locations, including Texas, Georgia, and the District of Columbia, according to the regular weekly update from the Centers for Disease Control and Prevention (CDC).
As a whole, markers are still below baselines. However, Texas, Georgia, and the District of Columbia are reporting high flu activity, which reflects clinic visits for flulike illness and can also reflect an impact from other respiratory viruses. Flu activity is unpredictable, but in some seasons, US flu activity starts first in the southern states, then expands to other parts of the country.
In Texas, the latest surveillance report from the Texas Department of Health and Human Services (TDHHS) suggests that the state’s current hot spots are in and northwest of Houston. The Georgia Department of Public Health (GDPH) said in its latest update that flulike illness levels are above the baseline, with clinic visits for flulike illness highest in the youngest children and in those ages 5 to 24. In its latest update, DC Health said flu activity remains moderately high compared to previous seasons, which could be due to combined testing at facilities due to high COVID-19 activity.
The CDC said of the respiratory samples that tested positive for flu at public health labs, 90.4% were influenza A, and of subtyped influenza A viruses, 63.6% were H3N2 and 36.4% were 2009 H1N1.
Sep 30 CDC FluView update
Sep 30 TDHHS flu surveillance report
Sep 30 GDPH flu surveillance report
Sep 30 DC Health flu surveillance report
DR Congo, Yemen, Mozambique report new polio cases
Three countries reported a total of 22 new polio cases this week, with the Democratic Republic of the Congo (DRC) and Yemen noting circulating vaccine-derived poliovirus type 2 (cVDPV2) cases and Mozambique recording circulating vaccine-derived poliovirus type 1 (cVDPV1) infections, according to the latest update from the Global Polio Eradication Initiative (GPEI).
The DRC logged 9 new cVDPV2 cases, 8 in Tanganyika province and 1 in Haut Katanga, bringing the number of such cases reported in 2022 to 120. That compares with just 28 in 2021.
Yemen has 12 new cVDPV2 cases, 4 in Sanaa City, 2 each in Ibb and Dhamar governorates, and 1 each in Amran, Al Mahwit, Hajjah, and Sana’a governorates. Yemen has reached 139 cVDPV2 cases so far in 2022, compared with 66 cVDPV2 cases and 3 cVDPV1 cases in all of 2021.
Mozambique reported 1 cVDPV1 case in Zambezia province, bringing the country’s cVDPV1 total so far this year to 4. Officials have also confirmed 4 cVDPV2 cases this year and 6 wild poliovirus type 1 cases.
Sep 29 GPEI update