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COVID-19 prevention and control measures associated with decrease in influenza activity

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A recent study provides preliminary evidence of the long-term relationship between prevention and control measures and influenza transmission in China during the COVID-19 pandemic, accounting for the impact under various prevention and control levels. This study, the first of its kind, was published in Health Data Science, a Science Partner Journal.

Since December 2019, various nonpharmaceutical interventions (NPIs) and COVID-19 vaccination have been used to prevent and control the community transmission of COVID-19. However, the relationship between the changing influenza epidemic and COVID-19 prevention and control was unclear.”

Miss Zirui Guo, Department of Epidemiology and Biostatistics, Peking University School of Public Health

Caused by the influenza virus, influenza is an acute respiratory infectious disease that can impose a high burden and lead to severe seasonal epidemics or even pandemics. However, a marked decrease in influenza activity was registered in Japan and the United States, among other regions in the Northern Hemisphere, in early 2020. In addition, Australia, Chile, and other areas in the Southern Hemisphere shared this observation during their influenza season in 2020.

“The COVID-19 outbreak changed the epidemic trend and characteristics of influenza, according to our analysis.” shares Professor Min Liu, author of the article and scientist of the organization mentioned above.

A significant decrease in influenza activity in China was observed during the 2020-2022 COVID-19 pandemic, particularly in winter and spring. In addition, influenza seasonality was evident from 2010 to 2019 but absent during the 2020/2021 season across China, whether north or south.

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Reduction of influenza viral infection might be related to everyday COVID-19 public health interventions in China, concluded the authors after analyzing the epidemiology and seasonal patterns of influenza based on the timeline of COVID-19 NPIs in place in China.

Respiratory diseases frequently occur in winter and spring when COVID-19 and influenza tend to circulate easily. Meanwhile, the resurgence of other respiratory viruses once suppressed under COVID-19 NPIs in 2020-2021 was recognized worldwide. Thus, the entire population has missed the opportunity for enhanced immunity against influenza after a prolonged low flu season during 2020-2022. As a result, high-risk populations, such as young children and elderly individuals, are more vulnerable to widespread and severe illness from influenza as time goes by.

To protect these vulnerable populations, besides increasing influenza vaccine coverage, efforts should be paid to strengthen influenza surveillance and establish a comprehensive surveillance system for influenza virus and SARS-CoV-2.

“Given the limitations in our analysis, further studies should be performed to confirm our results,” comments Professor Liu. “More indicators, such as influenza-positive rate and the number of influenza report cases, might supplement and verify our study. We will also consider using different prediction methods to validate our conclusions and make appropriate supplements in the future.”

Journal reference:

Guo, Z., et al. (2022) Impact of COVID-19 Prevention and Control on the Influenza Epidemic in China: A Time Series Study. Health Data Science. doi.org/10.34133/2022/9830159.

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Deadly fungal infections a concern in patients post-COVID-19, flu | CTV News – CTV News Calgary

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While fungi are not about to start turning the human race into zombies, like in the HBO blockbuster series The Last of Us, the World Health Organization (WHO) says invasive fungal infections are an increasing threat to human health.

Aspergillosis is one fungal infection common in our environment but, in some circumstances, it can turn deadly. In an average day, most of us will inhale hundreds to thousands of Aspergillus spores with no adverse effects, but for people with weakened immune systems it can cause deadly infections. That includes people undergoing cancer treatments, or bone marrow transplants, but it is now recognized that some viral infections, like influenza (flu) and SARS-CoV-2 (COVID-19) increase the risk of deadly fungal infection even in otherwise healthy people.

“When these kinds of things happen in the ICU, it can be devastating because even advanced medicines still can’t treat these infections,” said Dr. Bryan Yipp, an intensive care physician and researcher at the University of Calgary.

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“Once many of these infections really get ingrained and take over, clearing them with medications alone, antifungal or anti microbials, can be very difficult.”

Dr.Yipp began studying Aspergillus — a type of fungus that is a common mould — and its connection to viral infections in 2019, following three deaths in intensive care units of patients initially admitted for influenza, but who subsequently died of the fungal infection.

“It was very much a surprise when people first started identifying the fungus in the lung.  There was a lot of discussion around the table of ICU doctors, infectious disease doctors, asking ‘Was Aspergillosis really the cause of death, or was this just a secondary finding?'” said Yipp. “The pathologists who looked at the samples and the autopsies, were convinced that it was Aspergillosis that was the main problem.”

UCalgary researchers have determined exposure to Aspergillus, a common fungal mould, can lead to a potentially dangerous Aspergillosis infection in people with weakened immune systems.

Working in Yipp’s lab, lead researcher Nicole Sarden, a PhD candidate, isolated the mechanism by which the immune system starts failing to prevent fungal infections.

“In healthy humans. specific immune cells, called B cells, produce molecules (antibodies) that basically tag invaders so that other cells in the immune system, called neutrophils, can recognize them, eat them, and clear the infection,” said Sarden

“But when you have infections with viruses, such as influenza, or if you get COVID, these molecules are no longer present, which means that the immune systems that are trying to eat, and clear the fungi cannot do it because they cannot see it.”

Working with both mice and human blood and tissue samples, the researchers discovered that following a viral infection, neutrophils could identify a fungal infection and surround it but did nothing to destroy it.  

“The virus kills the B cells, no messenger molecules exist, so the neutrophils that would normally attack, the fungus, are blinded. They sit there and don’t know what to do,” said Sarden.

The research team also discovered that reintroducing Aspergillosis reactive antibodies can protect infected mice, leading to hopes a similar treatment will be available in the near future for humans with Aspergillosis infections.

While Yipp and Sarden focused on Aspergillus, it is not the only fungus that can cause serious, or fatal infections. It is estimated fungal infections kill an estimated 1.5 million people worldwide every year. Most of those are due to four different fungi; Cryptococcus, Candida, Aspergillus, and Pneumocystis.  Since the advent of COVID, a previously rare infection of the fungus Mucormycosis has been increasing rapidly in India. It affects the sinuses, brains and lungs of its victims. The rise in Mucormycosis has also been seen in patients who are recovering or have recently recovered from COVID.

Yipp is hopeful the research being conducted at Calgary’s Cumming School of Medicine could lead to treatments for these infections as well.

“We have some hunches that that could be a similar mechanism to what we see here with what we have found.” said Yipp. “So we think that this could be applied to multiple different types of fungi around the world.”

The research team, led by Sarden, published their findings in the journal Science Translational Medicine.

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Barrie hospital declares COVID outbreak in transitional care unit – BarrieToday

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Royal Victoria Regional Health Centre (RVH), in collaboration with the Simcoe Muskoka District Health Unit, declared a COVID-19 outbreak in the Barrie hospital’s transitional care unit on Friday, Jan. 27.

According to RVH, eight patients have tested positive for COVID-19 and have been isolated.

“Enhanced cleaning measures are underway, as well as swabbing of patients and staff,” RVH said in a news release Monday afternoon. 

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Admissions to the unit are on hold at this time, and visitors are not permitted. However, RVH says some exceptions may apply.

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Guidance for diagnosing and managing migraine – News-Medical.Net

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Migraine is a major cause of disability, affecting about 12% of people. A 2-part series published in CMAJ (Canadian Medical Association Journal) on diagnosing and managing the condition with both acute and preventive therapy provides guidance for clinicians. https://www.cmaj.ca/lookup/doi/10.1503/cmaj.211969.

“The goal of treatment of migraine attacks is to provide rapid relief from pain and other migraine-related symptoms, to restore patient function and to prevent recurrence,” writes Dr. Tommy Chan, Department of Clinical Neurological Sciences, Western University, London, Ontario, with coauthors.

“A stratified approach to treatment that empowers patients to choose from different options, depending on attack symptoms and severity, and encourages them to combine medications from different classes (e.g., nonsteroidal anti-inflammatory drugs and triptans) for severe or prolonged attacks, is preferred.”

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Part 2 of the review, which will be published February 6, focuses on preventive treatment to reduce the frequency and severity of migraine attacks.

Journal reference:

Tzankova, V., et al. (2023) Diagnosis and acute management of migraine. Canadian Medical Association Journal. doi.org/10.1503/cmaj.211969.

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