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Wall Street Sticks with Back to Office Plans as Delta Variant Sparks Fears … – Latest Tweet by Reuters – LatestLY

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Unexplained hepatitis cases rise to 429 across 22 countries, WHO says – The Irish Times

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Cases of unexplained hepatitis have risen to at least 429 in 22 countries, according to the World Health Organisation (WHO).

The number of countries reporting at least five cases has doubled since the last WHO briefing in April, from six to 12. Nine of these countries are in Europe.

A further 40 possible cases of acute liver disease are awaiting classification, officials told a press conference in Geneva on Tuesday.

Six children have died and 26 have required transplants, according to Prof Philippa Easterbrook of the WHO’s global hepatitis programme. About 75 per cent of cases are in children aged under five years.

Although the cause remains unclear, scientists are still investigating whether the cases were caused by an adenovirus activating an inflammatory response, possibly after a previous Covid-19 infection.

In Ireland, one child has died after being treated for the disease, and a second has received a liver transplant, the Health Service Executive reported last week.

Six probable cases of children with hepatitis of unknown cause have been detected in Ireland since the UK issued an alert in April.

The six children were aged between one and 12 years of age. All were hospitalised.

Covid-19 cases

Meanwhile, Covid-19 cases rose in four out of six regions of the world last week, according to WHO secretary general Dr Tedros Ghebreyesus. With testing and sequencing programmes being reduced in many countries, he said it was increasingly difficult to know “where the virus is and how it’s mutating”.

Officials expressed concern about virus outbreaks in North Korea, where state media has said there are about 1.4 million suspected cases, and Eritrea, which has yet to start vaccinating its population.

High levels of transmission of the coronavirus among unvaccinated people, such as in North Korea, creates a higher risk of new variant, a WHO official said.

“Certainly it’s worrying if countries . . . are not using the tools that are now available,” said WHO emergencies director Mike Ryan in response to a question about the outbreak in North Korea.

“WHO has repeatedly said that where you have unchecked transmission there is always a higher risk of new variants emerging,” he said.

Maria Van Kerkhove, WHO technical lead on Covid-19, said the notion that the Omicron variant of Covid-19 is mild was false and this narrative needed to be corrected. Omicron, in all its sublineages, can cause anything from asymptomatic infection to death, she pointed out, though vaccination provides protection. – Additional reporting: Reuters

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The Characteristics of Patients Who Develop Long-COVID Symptoms – Neurology Advisor

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Nearly one-third of patients with symptomatic COVID-19 developed symptoms of postacute sequelae of SARS-CoV-2 (PASC), according to a study published in the Journal of General Internal Medicine.

Patients who have recovered from COVID-19 frequently report PASC symptoms such as fatigue, dyspnea, and anosmia. Prior studies describing PASC have focused on hospitalized adult patients or patients with mild COVID-19 treated in outpatient settings up to 9 months following infection. Cohorts of patients with PASC have included small proportions of individuals of minority groups. This is the first study to examine the association of ethnicity, social vulnerability, and insurance status with developing PASC, according to the researchers.

They analyzed data of 1038 participants (aged 60 years; interquartile range [IQR], 37 to 83 years; 42% Latino, 30% White) in the University of California Los Angeles (UCLA) Health COVID Ambulatory Monitory Program. The patients completed follow-up surveys at 30, 60, or 90 days after hospital discharge or outpatient diagnosis. Eighty percent of patients followed up after their illness.


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PASC were reported by 29.8% of patients at least 60 days after acute illness (30.8% of patients treated in hospitals, 26.5% of high-risk outpatients).

At 30 days, the most commonly reported symptoms were fatigue (73.2%), shortness of breath (63.6%), fevers and chills (51.5%), and muscle aches (50.6%). At 60 days, fatigue (31.4%), shortness of breath (13.9%), and loss of taste or smell (9.8%).

Fatigue was the most common symptom among both hospitalized and outpatient patients. About 15% of hospitalized patients experienced shortness of breath, and about 16% of outpatients experienced loss of taste or smell.

PASC patients in outpatient care were more likely to be younger, White, women, and commercially insured. Hospitalized patients were more likely to report PASC symptoms if they were women. Patients with history of organ transplant were less likely to develop PASC.

Hospitalization for COVID-19 (OR, 1.49 95% CI 1.04-2.14), having diabetes (odds ratio [OR], 1.39; 95% CI, 1.02-1.88), and higher body mass index (OR, 1.02; 95% CI, 1.0002–1.04), were linked with developing PASC. Patients with Medicaid (OR, 0.49; 95% CI, 0.31-0.77) or history of organ transplant (OR, 0.44; 95% CI, 0.26-9.76) were less likely to develop PASC.

The researchers said the lack of association between age or race with developing PASC may be influenced by access to the same health system with standardized follow-up, importance of risk factors for contracting COVID-19 compared with recovering from COVID-19, or variance in symptoms and expectations across demographic groups and ability of tools detecting PASC to realize those differences. Variation in symptoms between hospitalized patients and outpatient treated patients is likely due to differences in clinical phenotypes, according to the researchers.

Study limitations included potential self-report bias, referral bias, survivorship bias, evaluation of a limited number of PASC symptoms, no control group of patients with persistent symptoms following hospital admissions unrelated to COVID, and limited knowledge of pre-existing conditions.

“Understanding the effects of long COVID will allow for more effective education among patients and providers, and allow for appropriate healthcare resource utilization in the evaluation and treatment of PASC,” the researchers concluded.

Reference

Yoo SM, Liu TC, Motwani Y, et al. Factors associated with post-acute sequelaeof SARS-CoV-2 (PASC) after diagnosis of symptomatic COVID-19 in the inpatient and outpatient setting in a diverse cohort. J Gen Intern Med. Published online April 7, 2022. doi: 10.1007/s11606-022-07523-3

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Monkeypox outbreak spreads in Europe as U.K., Portugal confirm cases – CBC News

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Portuguese authorities said on Wednesday they had identified five cases of rare monkeypox infection and Spain’s health services are testing eight potential cases after Britain put Europe on alert for the virus.

The five Portuguese patients, out of 20 suspected cases, are all stable. They are all men and they all live in the region of Lisbon and the Tagus Valley, the Portuguese health authorities said.

European Health authorities are monitoring any outbreak of the disease since Britain has reported its first case of monkeypox on May 7 and found six more in the country since then.

None of the eight suspected cases in Spain has been confirmed yet, the Spanish Health Ministry said in a statement on Wednesday.

Monkeypox is a rare viral infection similar to human smallpox, though milder, first recorded in the Democratic Republic of Congo in the 1970s. The number of cases in West Africa has increased in the last decade.

During an outbreak of monkeypox in the Democratic Republic of the Congo, a young man shows his hands, which have the characteristic rash of monkeypox during the recuperative stage. (CDC)

Symptoms include fever, headaches and skin rashes starting on the face and spreading to the rest of the body.

It is not particularly infectious between people, Spanish health authorities said, and most people infected recover within a few weeks, though severe cases have been reported.

Disease may spread via sexual contact: officials

Four of the cases detected in Britain self-identified as gay, bi-sexual or other men who have sex with men, the U.K. Health Security Agency said, adding evidence suggested there may be a transmission in the community.

The agency in Britain urged men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay.

The Spanish Health Ministry and Portugal’s DGS health authority Spanish did not release any information on the sexual orientation of the monkeypox patients or suspected patients.

The two countries sent out alerts to health professionals in order to identify more possible cases.

Dr. Ibrahim Soce Fall, the World Health Organization’s assistant director-general for emergency response, said the spread of monkeypox in the U.K. needed to be investigated to understand how the disease was being transmitted among men who have sex with other men.

Fall said that health officials still need a better understanding of how monkeypox spreads in general, even in the countries where it is endemic.

He noted that while there were more than 6,000 reported cases in Congo and about 3,000 cases in Nigeria last year, there are still “so many unknowns in terms of the dynamics of transmission.”

Britain previously reported three earlier cases of monkeypox, two involving people who lived in the same household and the third someone who had traveled to Nigeria, where the disease occurs frequently in animals.

The virus has typically spread to people from infected animals like rodents, although human-to-human transmission has been known to occur.

Among people, the disease is spread when there is very close contact with lesions, body fluids, respiratory droplets or contaminated materials, like bedsheets.

Some British experts said it was too soon to conclude that monkeypox had spread through sexual contact, although the outbreak there suggested that possibility.

Vaccine approved, anti-virals appear effective

“The recent cases suggest a potentially novel means of spread,” Neil Mabbott, a disease expert at the University of Edinburgh, said, adding that related viruses were known to spread via sex.

Keith Neal, an infectious diseases expert at the University of Nottingham, said the transmission might not have occurred through sexual activity but just “the close contact associated with sexual intercourse.”

Monkeypox typically causes fever, chills, a rash and lesions on the face or genitals resembling those caused by smallpox.

A vaccine developed against smallpox has been approved for monkeypox, and several anti-virals also appear to be effective.

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