CDC looking into TB outbreak in spinal surgery patients
The Centers for Disease Control and Prevention (CDC) said this week that it’s investigating a cluster of tuberculosis (TB) infections in patients who’ve recently undergone spinal surgery that used a single lot of a bone repair product.
The CDC said patients who underwent spinal fusions or fracture repairs using FiberCel products from a single lot (#NMDS210011) are likely to have been exposed to Mycobacterium tuberculosis. The agency is recommending that all patients who received this product lot obtain TB treatment, even if they are asymptomatic.
The manufacturer sent a voluntary recall notice for the product on Jun 2, and as of Jun 10, all unused products in the lot have been sequestered.
The CDC said it is working with the Food and Drug Administration and with health department, hospitals, and surgical centers in the affected states to prevent further patient harm.
Jun 14 CDC notice
2020 excess deaths in Switzerland were mostly older people
In 2020, Switzerland’s all-cause mortality saw a standardized mortality rate 8.8% higher than in 2019, with statistical significance only for men older than 70 and women older than 75, according to a study yesterday in PLOS One. Standardized mortality rates adjust for changes in the population, such as age and sex composition.
The researchers used official death data and found that 2020 had excess deaths in both crude and standardized mortality rates (8.8%). Prior to 2020, crude rates had looked relatively constant since 1980, and standardized mortality rates had decreased by a factor of about 2.5, they note.
The data also showed that men had a higher increase in mortality rates than women (10.6% vs 7.2%), but statistical significance occurred only for men over 70 years and women over 75. From 2020 to 2019, a 0.7% decrease in life expectancy was found, with men losing 9.7 months and women losing 5.3 months.
“There was an excess mortality in Switzerland in 2020, linked to the COVID-19 pandemic. However, as this excess only concerned the elderly, the resulting loss of life expectancy was restricted to a few months, bringing the mortality level back to 2015,” the researchers conclude.
Overall, the country’s 6.8 million population has experienced more than 650,000 COVID-19 cases and 10,500 deaths since the pandemic began, with about 7,400 of those deaths in 2020.
Jun 17 PLOS One study
Convalescent plasma linked with survival of COVID blood cancer patients
Convalescent blood plasma treatment was associated with a reduced risk of 30-day, all-cause mortality in hospitalized COVID-19 patients with blood cancers, according to a JAMA Oncology study yesterday.
The retrospective cohort consisted of 966 COVID-19 patients admitted to US hospitals between Mar 17, 2020, and Jan 21, 2021. All had blood cancers, with the most common type being lymphoid cancers, and 143 (14.8%) received plasma from COVID-19 survivors.
Plasma recipients were more likely to be treated with corticosteroids, tocilizumab, and/or remdesivir and less likely to be treated with hydroxychloroquine. Overall, a little over half were men (55.8%), and the mean age was 65 (all were adults).
Of the 845 patients who had absolute lymphocyte counts, 57.9% had lymphopenia, which increased to 79.1% among those who received anti-CD20 monoclonal antibodies.
During the 30-day follow-up, 223 people died of COVID-19, comprising 13.3% of the convalescent plasma group and 24.8% of the control group. The researchers found an adjusted hazard ratio (aHR) of 0.60 for convalescent plasma patients (95% confidence interval [CI], 0.37 to 0.97), which remained significant after propensity score matching (aHR, 0.52; 95% CI, 0.29 to 0.92). Among 338 patients in the intensive care unit (ICU) and 227 who needed mechanical ventilation, propensity-matched mortality risk was still lower in plasma recipients (aHRs, 0.40 and 0.32, respectively).
Convalescent plasma recipients were more likely to need higher levels of care (53.1% needed ICU admission and 31.5% required mechanical ventilatory support), and in propensity score matches, bleeding (11.2% vs 4.2%), sepsis (40.6% vs 22.4%), pulmonary complications (69.2% vs 46.2%), and congestive heart failure (7% vs less than 3.5%) were more common. The study did not note convalescent plasma antibody levels or regimen.
“Notably, despite superior survival in the convalescent plasma group, there were considerably more sepsis and respiratory complications in this group. This finding likely reflects a higher severity of SARS-CoV-2 infection rather than complications from the treatment, although this possibility cannot be entirely excluded,” the researchers write.
Jun 17 JAMA Oncol study
Seven countries report more vaccine-derived polio cases
Seven countries—Afghanistan and six African nations—reported more polio cases this week, all involving circulating vaccine-derived poliovirus type 2 (cVDPV2), according to the latest update from the Global Polio Eradication Initiative (GPEI).
Afghanistan’s latest case is from Ghanzi in the southeastern part of the country, putting its total for the year at 41.
In Africa, Burkina Faso reported two more cVDPV2 cases, one each from Dori and Banfora, which are counted in its 2020 total, which is now 65. Benin reported one case, which involves a patient from Couffo, marking the country’s second case of the year.
The Democratic Republic of Congo reported one case from Sud-Ubangi province, lifting its 2021 total to eight. Ethiopia reported six new cases, four from Oromiya and one each from Tigray and the Southern Nations, Nationalities, and Peoples region, the first cases reported for 2021. In 2020, the country identified 26 cases.
Elsewhere in Africa, Niger reported one more case in Zinder, which is counted with the country’s 2020 total now standing at 10. And finally, Senegal reported five cases from five different areas, bringing its 2021 total to nine.
Jun 17 GPEI update
Global flu stays low, mainly influenza B
In its latest update, which looked at data collected through the middle of May, the World Health Organization (WHO) said Northern Hemisphere flu activity remained below baseline, though influenza B detections involving the Victoria lineage increased slightly, especially in China.
In the Southern Hemisphere, flu remained at interseasonal levels. Elsewhere, a few detections were reported in parts of western and middle Africa and in India.
Globally, of the few respiratory samples that tested positive for flu in the middle of May, influenza B was dominant at 91%, mostly all involving the Victoria lineage. Of subtyped influenza viruses, 55% were H1N1 and 45% were H3N2.
The WHO urged people to interpret the flu surveillance trends with caution, given that COVID-19 priorities have influenced healthcare routines and public health measures may be playing a role in reducing flu transmission.
Jun 7 WHO global flu update