News scan for October 26, 2022

Uganda’s escalating Ebola outbreak tops 100 cases; more deaths reported

Uganda’s Health Ministry today reported 14 more laboratory-confirmed Ebola cases, bringing the outbreak’s total to 109. Health officials also reported 2 more deaths, bringing the total to 30. At the start of the outbreak, before the first cases were confirmed, the ministry reported 20 suspected cases, all fatal.

At a press conference today, Uganda Health Minister Jane Ruth Aceng Ocero, MBChB, MPH said 45 people are being treated for their infections.

The Africa Regional Office of the World Health Organization (WHO) said in its latest weekly health emergency update that the outbreak in Uganda has spread to two more districts, Kampala and Wakiso, bringing the number of affected locations to seven. It has warned that further expansion of the outbreak is possible, as high-risk contacts have been identified for follow-up in five unaffected districts.

Uganda is making progress in case management but needs more isolation units, ambulances, staff and funding to fight the outbreak, the WHO said.

Meanwhile, Doctors Without Borders (MSF) said yesterday that they are stepping up their response. It said its teams are expanding to help with the response, including medical supplies, in Kampala.

MSF is currently supporting the treatment of sick people in Mubende, the epicenter of the outbreak. A 40-bed treatment facility has been completed there, and another 40-bed unit capable of providing intensive care units is under construction in the same area. An 8 bed unit in Madudu is operational. MSF also said it stands ready to help with clinical trials of vaccines and treatments for the less common Sudan Ebola virus, which is fueling the country’s outbreak.
26 Oct Update from Uganda Ministry of Health
26.10. Ministry of Health of Uganda tweet
25 Oct WHO Regional Office for Africa weekly report on health emergencies
MSF update of October 25th

Alpha, Delta and Omicron patients can exhale more virus

A study conducted today by University of Maryland researchers found that patients infected with COVID-19 variants Alpha, Delta and Omicron — including those fully vaccinated and boosted — shed significantly more viral RNA copies into exhaled breath aerosols than patients , infected with ancestral strains and other variants.

The study appears in Clinical infectious diseases and contributes to evidence of increased portability of the Alpha, Delta and Omicron variants. The study used 30-minute airway samples collected via a Health II expiratory aerosol sampler from 93 participants with confirmed COVID-19 infection. Of these, 32 were fully vaccinated and 20 boosted. Participants were tested from June 2020 to March 2022.

According to the authors, 4 alpha, 3 delta, and 29 omicron patients shed significantly more viral RNA copies into exhaled breath aerosols than the 57 individuals infected with ancestral strains and variants.

The increase in virus shedding may be due, at least in part, to the behavior of participants in the health machine. The authors said that Delta and Omicron patients coughed more often than those infected with Alpha, ancestral strains, and other variants. Omicron patients also generally reported more upper and lower airway symptoms than the other volunteers.

“These data indicate that a characteristic of highly transmissible variants is high virus shedding in aerosols,” the authors concluded. “This evidence for a convergent evolution of increased viral aerosol release is consistent with a dominant role of airborne transmission (inhalation of viral aerosols, regardless of distance traveled by the aerosol) in the spread of COVID-19.”
26 Oct Clin Infect Dis
to learn

The subvariant Omicron BA.2 appears to be less severe than other strains

A study yesterday in JAMA network open suggests that the SARS-CoV-2 Omicron BA.2 subvariant carries a significantly lower risk of death than that of Delta and the original Omicron strain B.1.1.529.

Led by researchers from Massachusetts General Hospital and Harvard Medical School, the study included 102,315 COVID-19 cases in New England adults and children diagnosed from March 3, 2020 to June 20, 2022. The mean age of the patients was 44.2 years, 62% were female, 76.4% were White and 20.3% of the cases were Delta, 51.4% were Omicron and 28.3% were BA.2.

Amid Delta, 48.5% of patients had received a primary COVID-19 vaccine series and 44.7% were unvaccinated, while during Omicron dominance 65.9% had received a booster shot. Also, fewer people had prior infections during the Delta wave (1.8%) than during the Omicron (6.4%) and BA.2 (5.3%) waves.

The 30-day fatality rates from COVID-19 were 0.7% for Delta, 0.4% for Omicron, and 0.3% for Omicron BA.2. The adjusted odds ratio (aOR) of death from Delta compared to BA.2 was 2.07 (95% confidence interval [CI]1.04 to 4.10) and for Omicron 2.20 (95% CI, 1.56 to 3.11).

The risk of hospitalization was significantly greater with Delta than with BA.2 (aOR, 3.84; 95% CI, 2.93 to 5.02). Omicron was also more likely to result in hospitalization than BA.2 (OR, 2.71; 95% CI, 2.42 to 3.02).

Likewise, ICU admission for Delta infection was six times higher than BA.2 (OR, 6.12; 95% CI, 2.57 to 14.5) and three times higher for Omicron (OR, 3 .06; 95% CI, 2.28 to 4.10). The relative risk of invasive ventilation was more than quadrupled and tripled.

“After accounting for a variety of confounding factors associated with SARS-CoV-2 results, subvariant Omicron BA.2 was found to be inherently less severe than variants Delta and Omicron,” the study authors wrote.
Oct 25 JAMA network open to learn



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