Tag Archives: Disease outbreaks

Health

Eye drops linked to US drug-resistant bacteria outbreak

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NEW YORK — U.S. health officials are advising people to stop using over-the-counter eye drops that have been linked to an outbreak of drug-resistant infections.

The Centers for Disease Control and Prevention on Wednesday night sent a health alert to physicians, saying the outbreak includes at least 55 people in 12 states. One died.

Disease investigators have linked the infections, including some found in blood, urine and lungs, to EzriCare Artificial Tears. Many of the patients said they had used the product, which is a lubricant used to treat irritation and dryness.

The infections were all caused by a bacteria called Pseudomonas aeruginosa. Investigators detected that kind of bacteria in open EzriCare bottles, but further testing was underway to see if the strains matched.

EzriCare said it is not aware of any evidence definitively linking the outbreak to the product, but that it has stopped distributing the eye drops. It also has a notice on its website urging consumers to stop using the drops.

“To the greatest extent possible, we have been contacting customers to advise them against continued use of the product. We also immediately reached out to both CDC and FDA and indicated our willingness to cooperate with any requests they may have of us,” the company said.

Two weeks ago, the CDC warned medical professional societies about the possible connection between the drops and the infections. The Wednesday alert was a broader, more public warning.

Infections were diagnosed in patients in California, Colorado, Connecticut, Florida, New Jersey, New Mexico, New York, Nevada, Texas, Utah, Washington and Wisconsin. One patient — in Washington — died with a blood infection. At least five others suffered permanent vision loss.

The outbreak is considered particularly worrisome because the bacteria driving it are resistant to standard antibiotics.

Investigators found the bacteria were not susceptible to any antibiotics routinely tested at public health laboratories. However, a newer antibiotic named cefiderocol did seem to work.

How could eye drops cause infections in the blood or lungs? The eye connects to the nasal cavity through the tear ducts. Bacteria can move from the nasal cavity into the lungs. Also, bacteria in these parts of the body can seed infections at other sites such as in the blood or wounds, CDC officials said.

The product is manufactured in India by Global Pharma Healthcare Pvt Ltd., EzriCare said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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Health

What we know about the Ohio measles outbreak

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A measles outbreak in Ohio is raising concerns about the spread of the disease and how a decline in vaccination rates among children might be leading to additional outbreaks.

Eighty-five cases have been reported in Ohio as of Friday, mainly in Columbus and other parts of Franklin County, according to Columbus Public Health. Most of these cases were in unvaccinated children. Hospitalization was required for 34 of those who were infected.

It’s not the only recent measles outbreak in the country. 

Minnesota experienced 22 cases last year in the Twin Cities area. 

The outbreaks, which come amid a rise in anti-vaccine sentiment, are raising worries among health experts about whether lower vaccination rates will lead to further spread of diseases that can be safeguarded against by vaccines. 

“With any of the vaccine preventable illnesses, we always worry about when there’s not enough herd immunity,” says physician Susan Koletar, director of the Division of Infectious Diseases at The Ohio State Wexner Medical Center.

Herd immunity occurs when enough people are immune through vaccination or natural infection to stop an illness from spreading. Measles is so contagious that immunization rates need to be at least 95 percent to eliminate the disease.

The Ohio outbreak began in October 2022, with the bulk of cases occurring in mid-November to early December. These community cases are thought to be linked to one of four travel-related measles cases, says physician Mysheika W. Roberts, who is the health commissioner for Columbus. 

Although most of the cases are in unvaccinated children, six of the children had received their first of two doses of the combined measles, mumps and rubella (MMR) vaccine. Another twenty-four of the children were too young for any doses, according to the agency’s website.

The U.S. was declared measles-free in 2000, but travelers periodically bring in infections. People who visit countries where measles is endemic, meaning there is regular transmission in the population, can return to their home communities and seed a local outbreak.

“The mere fact that individuals who were not vaccinated, traveled to a measles endemic country and then were allowed to come back into the United States, where they likely instigated this outbreak is concerning to me as a public health professional,” says Roberts.  

One of the potential reasons these measles outbreaks may be happening is that vaccine coverage rates fell during the pandemic. 

The Centers for Disease Control and Prevention (CDC) report that vaccination rates among kindergarteners are high, but coverage for the 2021-2022 school year dropped to 93 percent compared to 95 percent for the 2019-2020 school year. 

The risk of contracting vaccine preventable diseases has been particularly heightened for children who are in low-income households or live in rural areas, as vaccine coverage decreased for those groups by 4 to 5 percent during the pandemic, according to the CDC. 

That drop in childhood vaccinations in part stems from disruptions during the pandemic, as well as financial and logistical hurdles, the CDC reported. But rising vaccine hesitancy and the anti-vaccine movement have also contributed, and are a major factor driving recent measles outbreaks.

The U.S. saw its highest annual number of measles cases in recent history in 2019 with 1,274, most of which occurred in eight underimmunized communities, according to the CDC. 

“We are living in a generation where most of the people who have hesitancy about the vaccines never experienced any of those diseases,” says Koletar. “And they never experienced any of those diseases because of widespread immunization practices.”

“I think many parents feel like since they don’t see measles in our community, that it is safe for them to not get their child vaccinated,” says Roberts. 

She attributes some of the vaccine hesitancy to the circulation of misinformation. A debunked theory linking the MMR vaccine to autism is one example. Baseless concern driven by that theory may lead some parents to delay MMR vaccination until right before their child enters school, which could mean the child gets their first dose when they are about 4 years old instead of 12 months old. 

The MMR vaccine has been around since the 1960s and is very, very effective, notes Roberts. “We didn’t get to eliminate measles without the MMR vaccine.”

The politicization of vaccines during the COVID-19 pandemic has also fueled anti-vaccine attitudes, she says.

“The anti-vaxx [and] the vaccine hesitant community has probably grown as a result of this pandemic and spilled over from the COVID-19 hesitancy to all vaccine hesitancy,” Roberts notes.

Each family may be weighing their own personal risk and making decisions that way, says vaccine safety researcher Elyse Kharbanda. Willingness to get vaccinated may increase when transmission is high or there is recent memory of an outbreak, but once that goes away, vaccine acceptance may subside, she continues.  

Amid the dropping vaccination rates, Koletar is concerned that there could be an uptick in other vaccine preventable diseases, like tetanus, rubella and chickenpox. Rubella can be harder to diagnose than measles and may go undetected at times, according to Koletar. 

People in their late teens and adults who have neither had chickenpox nor been vaccinated against it can get really sick if they get chickenpox, she adds. “As a physician, those are frightening times, particularly if you have a young pregnant woman who gets chickenpox.”

For now, the situation looks positive in Ohio. The most recent measles case was detected on Dec. 24, which means if there are no new cases through Feb. 4 the outbreak may be declared officially over.

Looking ahead, there’s a need for more research into what interventions would help get more people in vaccine resistant communities to accept vaccines, according to Kharbanda.

Interventions like alerts and letters are “effective at promoting vaccination to families who intend to vaccinate their children and just got busy and forgot,” Kharbanda tells The Hill.

But “those types of simple interventions really don’t work with families and communities that are fearful and vaccine resistant,” she says. It takes time and good relationships with communities to understand what beliefs are perpetuating vaccine hesitancy and to gain trust, she adds.

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250,000 kindergartners are vulnerable due to drop in vaccination rate

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Nearly a quarter of a million kindergartners are vulnerable to measles due to a dip in vaccination coverage during the pandemic, according to the Centers for Disease Control and Prevention.

The CDC, in a report published Thursday, found that 93% of kindergartners were up to date with state-required vaccines during the 2021-22 school year, a decline of 2% from 2019-20.

“While this might not sound significant, it means nearly 250,000 kindergartners are potentially not protected against measles,” Dr. Georgina Peacock, head of the CDC’s immunization services division, said during a call with reporters Thursday.

“And we know that measles, mumps and rubella vaccination coverage for kindergartners is the lowest it has been in over a decade,” Peacock said.

Kindergartners are required to be vaccinated against measles, mumps and rubella; chickenpox; polio; and diphtheria, tetanus and pertussis. The vaccination rate for measles, mumps and rubella was 93.5% during the 2021-22 school year, below the target coverage of 95% to prevent outbreaks.

An ongoing measles outbreak in Columbus, Ohio, has spread to 83 children, 33 of whom were hospitalized. None of the children have died. The overwhelming majority of the kids, 78, were not vaccinated.

“These outbreaks harm children and cause significant disruptions in their opportunities to learn and grow and thrive,” said Dr. Sean O’Leary, who heads the American Academy of Pediatrics committee on infectious disease. “This is alarming and it should be a call to action for all of us.”

The CDC report looked at whether the kindergartners had received the second dose of their measles, mumps and rubella vaccine. Two doses are 97% effective at preventing disease and one dose is about 93% effective, according to the CDC.

Measles is a highly contagious virus that spreads when someone coughs or sneezes and contaminates the air, where the virus can linger for up to two hours. It can also spread when a person touches a contaminated surface and then touches their eyes, nose or mouth.

The virus is so contagious that a single person can spread the virus to 90% of people close to them who do not have immunity through vaccination or a previous infection, according to the CDC.

Measles can be dangerous for children younger than 5, adults older than 20, pregnant women, and people with compromised immune systems.

About 1 in 5 unvaccinated people who catch it are hospitalized. About 1 in 20 kids get pneumonia, and one in 1,000 have brain swelling that can cause disabilities. Symptoms begin with a high fever, cough, runny nose and red eyes. White spots appear in the mouth two to three days later, and a rash breaks out on the body.

CDC officials said disruptions to schools and the health-care system during the Covid pandemic are largely responsible for the decline in vaccination rates.

“We know that the pandemic really had a disruption to health-care systems,” Peacock said. “Part of it is that well-child visits maybe were missed and people are still trying to catch up on those well-child visits.”

“We know that the schools had a lot of things to focus on and in some cases maybe they were not able to gather all that documentation on the vaccinations,” Peacock said. “Or because children were at home for a lot of the pandemic, that may have not been the emphasis while they were focused on testing and doing all those other things related to the pandemic.”

In a separate report published Thursday, the CDC found that coverage for what’s known as the combined seven-vaccine series actually increased slightly among children born in 2018-19 by the time they turned two, compared with kids born in 2016-17.

This seven-vaccine series includes shots against measles, chickenpox, polio, hepatitis B, streptococcus pneumoniae, haemophilus influenzae or Hib, and diphtheria, tetanus and pertussis.

However, the CDC found that there were major income and racial disparities. Vaccination coverage declined by up to 5% during the pandemic for those living below the poverty level or in rural areas. Black and Hispanic children had lower vaccination rates than white children.

O’Leary said that while misinformation about vaccines is a problem, the vast majority of parents are still getting their kids vaccinated. He said inequality is the bigger issue.

“The things we really need to focus on are addressing access and child poverty,” O’Leary said.

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omicron XBB.1.5 is immune evasive, binds better to cells

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The Covid omicron XBB.1.5 variant is rapidly becoming dominant in the U.S. because it is highly immune evasive and appears more effective at binding to cells than related subvariants, scientists say.

XBB.1.5 now represents about 41% of new cases nationwide in the U.S., nearly doubling in prevalence over the past week, according to the data published Friday by the Centers for Disease Control and Prevention. The subvariant more than doubled as a share of cases every week through Dec. 24. In the past week, it nearly doubled from 21.7% prevalence.

Scientists and public health officials have been closely monitoring the XBB subvariant family for months because the strains have many mutations that could render the Covid-19 vaccines, including the omicron boosters, less effective and cause even more breakthrough infections.

XBB was first identified in India in August. It quickly become dominant there, as well as in Singapore. It has since evolved into a family of subvariants including XBB.1 and XBB.1.5.

Andrew Pekosz, a virologist at Johns Hopkins University, said XBB.1.5 is different from its family members because it has an additional mutation that makes it bind better to cells.

“The virus needs to bind tightly to cells to be more efficient at getting in and that could help the virus be a little bit more efficient at infecting people,” Pekosz said.

Yunlong Richard Cao, a scientist and assistant professor at Peking University, published data on Twitter Tuesday that indicated XBB.1.5 not only evades protective antibodies as effectively as the XBB.1 variant, which was highly immune evasive, but also is better at binding to cells through a key receptor.

Scientists at Columbia University, in a study published earlier this month in the journal Cell, warned that the rise of subvariants such as XBB could “further compromise the efficacy of current COVID-19 vaccines and result in a surge of breakthrough infections as well as re-infections.”

The XBB subvariants are also resistant to Evusheld, an antibody cocktail that many people with weak immune systems rely on for protection against Covid infection because they don’t mount a strong response to the vaccines.

The scientists described the resistance of the XBB subvariants to antibodies from vaccination and infection as “alarming.” The XBB subvariants were even more effective at dodging protection from the omicron boosters than the BQ subvariants, which are also highly immune evasive, the scientists found.

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Dr. David Ho, an author on the Columbia study, agreed with the other scientists that XBB.1.5 probably has a growth advantage because it binds better to cells than its XBB relatives. Ho also said XBB.1.5 is about as immune evasive as XBB and XBB.1, which were two of the subvariants most resistant to protective antibodies from infection and vaccination so far.

Dr. Anthony Fauci, who is leaving his role as White House chief medical advisor, has previously said that the XBB subvariants reduce the protection the boosters provide against infection “multifold.”

“You could expect some protection, but not the optimal protection,” Fauci told reporters during a White House briefing in November.

Fauci said he was encouraged by the case of Singapore, which had a major surge of infections from XBB but did not see hospitalizations rise at the same rate. Pekosz said XBB.1.5, in combination with holiday travel, could cause cases to rise in the U.S. But he said the boosters appear to be preventing severe disease.

“It does look like the vaccine, the bivalent booster is providing continued protection against hospitalization with these variants,” Pekosz said. “It really emphasizes the need to get a booster particularly into vulnerable populations to provide continued protection from severe disease with these new variants.”

Health officials in the U.S. have repeatedly called on the elderly in particular to make sure they are up to date on their vaccines and get treated with the antiviral Paxlovid if they have a breakthrough infection.

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Health

CDC expands BMI charts for severely overweight kids

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The Centers for Disease Control and Prevention on Thursday released new body mass index charts for children in response to the growing obesity crisis in the U.S.

The previous BMI chart for children ages 2 to 19, published in 2000, is based on data from 1963 to 1980, but obesity and severe obesity in children has increased significantly since the ’80s. More than 4.5 million children and teenagers had severe obesity in 2018, according to the CDC.

BMI is calculated using a mathematical formula that measures body fat, generally by dividing an individual’s height by their weight. For adults, a healthy BMI runs from 18.5 to 24.9, or 111 lbs. to about 150 lbs. for someone who is 5’5″. At 5’10”, a healthy BMI runs between 129 lbs. and 175 lbs. For adults ages 20 and older, a BMI of 30 and above is considered obese.

The previous charts for children did not go beyond a BMI of 37. The new charts extend to a BMI of 60 and measure whether it falls within healthy parameters based on a percentile measured against other children of the same age and gender.

“Prior to today’s release, the growth charts did not extend high enough to plot BMI for the increasing number of children with severe obesity,” said Dr. Karen Hacker, director of the CDC’s National Center for Chronic Disease Prevention and Health Promotion.

BMI for kids up to 20-year-olds runs along a sliding range, depending on age and gender. Under the new guidelines, healthy BMI for kids can range from as low as around 13 to about 17 for a 6-year-old girl or boy to a range of as much as roughly 18 to around 26 for a 20-year-old young woman.

The extended charts will help health-care providers work with families to treat children who are suffering from obesity, Hacker said. The BMI charts from 2000 will still be used for children who are not obese, according to the CDC.

Obesity has increased significantly among children over the past 40 years. During the four-year period ended in 1980, 5.5% of children ages 2 to 19 were obese and 1.3% were severely obese. By 2018, 19.3% of kids were obese and 6.1% were severely obese, according to National Center for Health Statistics.

Obesity for children is defined as a BMI that is higher than 95% of kids of the same age and gender, according to the CDC. Severe obesity is a BMI that is 120% higher than the 95th percentile.

Although children’s BMI is calculated using the same formula as adults, a healthy weight is measured in relation to other kids of the same age and gender. This is because children’s height and weight can vary significantly as they grow.

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Health

BQ, XBB omicron subvariants pose serious threat to boosters

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Evusheld injection, a new COVID treatment that people can take before becoming symptomatic, in Chicago on Friday, Feb. 4, 2022.

Chris Sweda | Tribune News Service | Getty Images

The omicron subvariants that have become dominant in recent months present a serious threat to the effectiveness of the new boosters, render antibody treatments ineffective and could cause a surge of breakthrough infections, according to a new study.

The BQ.1, BQ.1.1, XBB and XBB.1 omicron subvariants are the most immune evasive variants of Covid-19 to date, according to scientists affiliated with Columbia University and the University of Michigan. These variants, taken together, are causing 72% of new infections in the U.S. right now, according to data from the Centers for Disease Control and Prevention.

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The scientists, in a study published online Tuesday in the peer-reviewed journal Cell, found that these subvariants are “barely susceptible to neutralization” by the vaccines, including the new omicron boosters. The immune response of people who were vaccinated and had breakthrough infections with prior omicron variants was also weaker against the subvariants.

“Together, our findings indicate that BQ and XBB subvariants present serious threats to current COVID-19 vaccines, render inactive all authorized antibodies, and may have gained dominance in the population because of their advantage in evading antibodies,” the scientists wrote.

Although these subvariants are more likely to cause breakthrough infections, the vaccines have been shown to remain effective at preventing hospitalization and severe disease from omicron, the scientists wrote.

The study examined blood samples from people who received three or four shots of the original vaccines, those who received the new omicron boosters after three shots of the original vaccines, and individuals vaccinated with the original shots who also had breakthrough infections from the BA.2 or BA.5 subvariants.

For people who received the omicron boosters, antibodies that block infection were 24 times lower against BQ.1, 41 times lower against BQ.1.1, 66 times lower against XBB and 85 times lower against XBB.1 compared to their performance against the ancestral strain that emerged in Wuhan, China in 2019.

However, people who received the omicron boosters had modestly higher antibody levels against all of these subvariants compared with people who received three or four shots of the original vaccines, according to the study.

People who were vaccinated and had breakthrough infections had the highest antibody levels of any group in the study, though neutralization was also much lower against the subvariants than the ancestral strain.

The subvariants have evolved away from previous versions of omicron in dramatic fashion. BQ.1.1, for example, is about as different from omicron BA.5 as the latter subvariant is from ancestral Covid strain, according to the study.

“Therefore, it is alarming that these newly emerged subvariants could further compromise the efficacy of current COVID-19 vaccines and result in a surge of breakthrough infections, as well as re-infections,” the scientists wrote.

XBB.1, however, presents the biggest challenge. It is about 49 times more resistant to antibody neutralization than the BA.5 subvariant, according to the study. XBB.1, fortunately, is currently causing no more than 1% of infections in the U.S., according to CDC data.

BQ.1.1 and BQ.1 represent 37% and 31% of new infections respectively, while XBB is causing 4.7% of new infections, according to CDC data.

Antibodies ineffective

Key antibody drugs, Evusheld and bebtelovimab, were “completely inactive” against the new subvariants, according to the study. These antibodies are used primarily by people with weak immune systems.

Evusheld is an antibody cocktail used to prevent Covid in people with weak immune systems who don’t respond strongly to the vaccines. Bebtelovimab is used to prevent Covid from progressing to severe disease in organ transplant patients and other individuals who cannot take other treatments.

“This poses a serious problem for millions of immunocompromised individuals who do not respond robustly to COVID-19 vaccines,” the scientists wrote. “The urgent need to develop active monoclonal antibodies for clinical use is obvious.”

The FDA has already pulled its authorization of bebtelovimab nationwide because it is no longer effective against the dominant omicron variants in the U.S. Evusheld remains authorized as the only option for pre-exposure prophylaxis.

New Covid infections increased by about 50% to 459,000 for the week ending Dec. 7, according to CDC data. Covid deaths increased 61% to nearly 3,000 during the same week. Hospital admissions have plateaued at 4,700 per day on average after rising in November, according to the data.

White House chief medical advisor Dr. Anthony Fauci, in a press briefing last month, said U.S. health officials are hoping there’s enough immunity in the population from vaccination, infection or both to prevent the massive surge of infections and hospitalizations the U.S. suffered last winter when omicron first arrived.

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Health

CDC encourages people to wear masks to prevent spread of Covid, flu, RSV

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The Centers for Disease Control Prevention on Monday encouraged people to wear masks to help reduce the spread of respiratory illnesses this season as Covid, flu and RSV circulate at the same time.

CDC Director Dr. Rochelle Walensky, in a call with reporters, said wearing a mask is one of several everyday precautions that people can take to reduce their chances of catching or spreading a respiratory virus during the busy holiday season.

“We also encourage you to wear a high-quality, well-fitting mask to prevent the spread of respiratory illnesses,” said Walensky, adding that people living in areas with high levels of Covid transmission should especially consider masking.

The CDC director said the agency is considering expanding its system of Covid community levels to take into account other respiratory viruses such as the flu. The system is the basis for when CDC advises the public to wear masks. But Walensky encouraged people to take proactive action.

“One need not wait on CDC action in order to put a mask on,” Walensky said. “We would encourage all of those preventive measures — hand washing, staying home when you’re sick, masking, increased ventilation — during respiratory virus season, but especially in areas of high Covid-19 community levels.”

About 5% of the U.S. population lives in counties where the CDC is officially recommending masks due to high Covid levels. The CDC continues to recommend masking for anyone travelling by plane, train, bus or other forms of public transportation, Walensky said.

People with weak immune systems and those who otherwise face a heightened risk of severe disease should also consider wearing a mask, the CDC director said.

Walensky strongly encouraged everyone eligible to receive their flu shot and Covid booster. Flu vaccination coverage is lagging for at-risk groups — children under age 5, pregnant women, and at-risk seniors — compared with last year, the CDC director said. There is no vaccine for RSV.

“I want to emphasize that the flu vaccine can be life saving and importantly, there’s still time to get vaccinated to be protected against flu this season and its potential serious consequences,” Walensky said.

The flu has arrived early and hit the U.S. hard with hospitalizations at a decade high for this time of year. More than 8.7 million people have fallen ill, 78,000 have been hospitalized, and 4,500 people have died from the flu this season, according to CDC data. Fourteen children have died from the flu so far this season.

More than 19,000 people were hospitalized with the flu during the week ending Nov. 26, nearly double the previous week, according to CDC data.

People hospitalized with Covid also increased 27% during the week ending Dec. 2, according to CDC data. And respiratory syncytial virus, or RSV, has been hospitalizing children at higher rate than in previous years. Walensky said RSV appears to have peaked in the Southeast and may be leveling off in the Mid-Atlantic, though circulation of the virus remains high in much of the nation.

“We now face yet another surge of illness. Another moment of overstretched capacity and really one of tragic and often preventable death,” Walensky said, as she thanked health-care workers for their service during the repeated surges of illness they have confronted since the Covid pandemic began.

Dr. Sandra Fryhofer, board chair of the American Medical Association, said the circulation of Covid, flu and RSV at the same is a “a perfect storm for a terrible holiday season.” Fryhofer said she understands many people are tired of receiving repeated Covid shots, but getting vaccinated is the best way to avoiding falling ill over the holidays.

“You could get really, really sick this year and ruin your holiday celebrations if you don’t get vaccinated,” Fryhofer said during Monday’s call.

The Children’s Hospital Association and the American Academy of Pediatrics last month asked the Biden administration to declare a public health emergency in response to the surge of pediatric hospitalizations from RSV and the flu.

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Health

Biden administration will end monkeypox public health emergency

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People line up to get a monkeypox vaccination at a new walk-up monkeypox vaccination site at Barnsdall Art Park on Tuesday, Aug. 9, 2022 in Hollywood, CA. 

Brian Van Der Brug | Los Angeles Times | Getty Images

The Biden administration will end the public health emergency declared in response to the monkeypox outbreak, as new infections have declined dramatically and vaccination rates have increased.

The Health and Human Services Department does not expect it will renew the emergency declaration after it expires on Jan. 31 “given the low number of cases today,” HHS Secretary Xavier Becerra said in a statement Friday.

“But we won’t take our foot off the gas — we will continue to monitor the case trends closely and encourage all at-risk individuals to get a free vaccine,” he said. “As we move into the next phase of this effort, the Biden-Harris Administration continues working closely with jurisdictions and partners to monitor trends, especially in communities that have been disproportionately affected.”

Becerra declared an emergency in August in an effort to accelerate a vaccination and education campaign as the virus was spreading swiftly in the gay community. The spread of the virus, dubbed “mpox” on Monday by the World Health Organization in order to reduce stigma associated with its name, has slowed drastically since.

Mpox has infected nearly 30,000 people and killed 15 in the U.S. since health officials confirmed the first domestic case in May, according to the Centers for Disease Control and Prevention. The U.S. outbreak is the largest in the world.

But infections have slowed dramatically since August, when new cases peaked at 638 per day on average. The U.S. is currently averaging about seven new cases a day, according to CDC data.

U.S. health officials have said the outbreak has slowed because vaccinations have increased dramatically, and people have changed their behavior in response to education campaigns about how to avoid infection.

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The vaccination campaign got off to a rocky start, with limited supplies resulting in long lines at clinics and protests in some cities. But vaccinations increased significantly after the White House created a task force and HHS declared a public health emergency.

More than 1.1 million doses of the Jynneos vaccine have been administered in the U.S. since the summer. CDC Director Dr. Rochelle Walensky has said about 1.7 million gay and bisexual people who are HIV positive or are taking medication to prevent HIV infection are at highest risk from mpox.

Mpox has spread primarily through sexual contact among men who have sex with men. The virus causes rashes resembling pimples or blisters that can develop in sensitive areas and be very painful. Though mpox is rarely fatal, people with compromised immune systems are at higher risk of severe disease.

The CDC, in a report published in late October, said it is unlikely the U.S. will eradicate mpox in the near future. The virus will probably continue to circulate at low level primarily in communities of men who have sex with men, according to CDC. Though anyone can catch mpox, there’s little evidence of the virus spreading widely in the general population so far, according to CDC.

The global mpox outbreak this year is the largest in history with more than 80,000 confirmed cases in more than 100 countries. The current outbreak is highly unusual because the virus is spreading widely between people in Europe and North America.

Historically, mpox spread at low levels in remote areas of West and Central Africa where people caught the virus from infected animals.

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Business

FDA pulls antibody bebtelovimab because not effective against omicron BQ.1

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An Eli Lilly and Company pharmaceutical manufacturing plant is pictured at 50 ImClone Drive in Branchburg, New Jersey, March 5, 2021.

Mike Segar | Reuters

A key monoclonal antibody used to treat people with weak immune systems who catch Covid is no longer authorized for use in the U.S. because it is not effective against emerging omicron subvariants.

The FDA, in a notice Wednesday, said bebtelovimab is not approved for use because it is not expected to neutralize the omicron BQ.1 and BQ.1.1 subvariants. They are causing 57% of new infections nationally and make up a majority of cases in every U.S. region except one.

The Health and Human Services Department is putting on hold pending requests for bebtelovimab, and the manufacturer Eli Lilliy has also halted commercial distribution of the antibody treatment until further notice, according to the FDA notice.

But bebtelovimab stocks should be kept on hand in the event that Covid variants which the antibody can neutralize become dominant again in the future, according to FDA.

Bebtelovimab is a single-dose injection administered to people who catch Covid and are at high risk of developing severe disease, but cannot take any other FDA-approved treatments such as the oral antiviral Paxlovid. Many people with weak immune systems, such as organ transplant patients, cannot take Paxlovid with other medications they need.

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U.S. health officials have warned that people with weak immune systems face a heightened risk from Covid this winter, because more immune evasive omicron subvariants threaten to knock out antibody treatments they rely on to stay safe from Covid.

Dr. Ashish Jha, the White House Covid coordinator, said in October that the failure of Congress to pass additional Covid funding means treatments will dwindle as new variants render them ineffective.

“We had hoped that over time as the pandemic went along, as our fight against this virus went along, we would be expanding our medicine cabinet,” Jha told reporters. “Because of lack of congressional funding that medicine cabinet has actually shrunk and that does put vulnerable people at risk.”

President Joe Biden has called on people with weak immune systems to consult with their physicians about what extra precautions they should take this winter to stay safe.

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Health

Drug overdose deaths among seniors have more than tripled in 2 decades

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Deaths from drug and alcohol use are rising among America’s seniors.

Drug overdose deaths more than tripled among people age 65 and older during the past two decades while deaths from alcohol abuse increased more than 18% from 2019 to 2020, according to data published Wednesday by the National Center for Health Statistics.

More than 800,000 seniors suffered from drug addiction and 2.7 million suffered from alcohol addiction in 2020, according to separate data from the Health and Human Services Department.

In total, more than 5,000 seniors died of drug overdoses in 2020 and more than 11,600 succumbed to alcohol, according to the NCHS data. Though drug overdose death rates are lower for seniors than other age groups, they have increased substantially from 2.4 per 100,000 in 2000 to 8.8 per 100,000 in 2020.

“We’ve got a public health problem coming at our door — these trends have been increasing for a long time now,” said Alexis Kuerbis, a professor at the Silberman School of Social Work and an expert on substance use among older adults.

Seniors today are baby boomers, a generation that had a much more open attitude toward drugs and alcohol than their parents, Kuerbis said. Some baby boomers have carried alcohol and drug habits from their youth and middle age into their later years when their bodies are no longer able to tolerate them, she said.

“Baby boomers obviously are very different generation than the silent generation or the World War II generation,” Kuerbis said. “Baby boomers were far more open to using alcohol and drugs during their younger years but also through their middle-aged years and now they are older adults,” she said.

Deaths from fentanyl and other synthetic opioids increased 53% among seniors from 2019 to 2020, according to the data. Kuerbis said there’s some evidence to suggest people who were prescribed opioids in their middle age for an injury later switched to fentanyl once it became harder to get a prescription.

If you are having suicidal thoughts or are in distress, contact the Suicide & Crisis Lifeline at 988 for support and assistance from a trained counselor.

While some drug deaths among seniors are from accidental misuse of drugs, many are suicides from overdosing on opioids, Kuerbis said. Although seniors tend to be happier than younger adults, they also have a higher prevalence of chronic pain, terminal illness and dementia, she said.

Some older adults also use drugs or alcohol to cope with major life changes such as retirement, grief and loss, or a change in their living situation, according to the National Institute of Drug Abuse.

Drug overdose deaths were highest among Black seniors. The death rate from drugs among Black men ages 65 to 74 was more than four times higher than Hispanic or white men in that age group, according to the data. Black women ages 65 to 74 died more often from drug overdoses than white and Hispanic women. White women older than 75 had a higher death rate from drugs than Black and Hispanic women.

Alcohol deaths were highest among American Indian seniors followed by Hispanics, white Americans, Black Americans and Asian Americans, according to the data.

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