11/01/2024

Public Health Infection Control Weekly Update for 11.1.24

Infection Control and Public Health Weekly Meeting Summary
10.31.2024

Point of Care Rapid STI testing for students (Dr. Saker) attached PowerPoint

• GC, Chlamydia, Trichomonas ($60-80 per test)
• CLIA-waived, FDA approved (Mar 2021) with results in 30 minutes (qualitative yes/no result)
• Self or clinician collected vaginal swab (test for males pending FDA approval)
• ODH STI grant support for Title X grant for age ≥ 12

Visby Medical Sexual Health Validation Study Lancet Infectious Disease May 2021

• Chlamydia trachomatis … 97.6% sens / 98.3% spec
• Neisseria gonorrhoeae … 97.4% sens / 99.4% spec
• Trichomonas vaginalis … 99.2% sens / 96.9% spec

ACIP Update on Pneumococcal Vaccine (age ≥ 50)

• CDC updated its vaccine guidance to include pneumonia vaccination for all adults aged 50 years and older to receive either PCV20 or PCV21 (conjugate vaccines).   
• Pendulum swinging towards PCV21 (CAPVAXIVE, Merck). Covers the serotypes causing ~85% of invasive pneumococcal disease in adults (compared to ~51% by PCV20), including eight serotypes not included in other licensed vaccines.
• PCV21 does notcover serotype 4, which is an emerging cause of invasive disease in certain populations in the Western US and in individuals experiencing homelessness. 

PneumoRecs VaxAdvisor App for Vaccine Providers

• CDC PneumoRecsapp pneumococcal vaccine decisions, mobile app and web version. 
• ACIP recommended 21-valent PCV (PCV21) as an option for adults aged ≥19 years who are currently recommended to receive PCV15 or PCV20.

CDC Expectations for Virus Season

1. CDC projects COVID hospitalizations could peak in late December with fewer hospitalizations.
2. 80% chance that combined peak hospitalizations from COVID-19, respiratory syncytial virus and influenza will be similar or lower to levels seen during last year's respiratory virus season.
3. Summer COVID-19 wave peaked the week ending Aug. 10 and population immunity may now be lower with winter peak exceeding the summer peak (following trend from the past four years).

1. Vaccines are expected to impact the peak of respiratory illnesses.
2. If 17% of adults over 18 receive the COVID-19 vaccine this year, up to 98,000 hospitalizations could be prevented.  If the vaccination rate doubles from the 2023-24 season's rate, up to 227,000 hospitalizations could be avoided.
3. Giving all vaccines to eligible adults at the same visit is a CDC best practice.

Halloween historically has been a transitional period from largely outdoor activities to more indoor social gatherings and seasonal events and holidays where seasonal respiratory viruses are more easily spread from person to person.

Peak hospitalization burden for COVID-19, RSV, and Influenza

Lower than last season at a rate of around 20 per 100,000 people, risk of higher hospitalizations

1. Emergence of a new COVID variant capable of evading immunity from prior infections and vaccinations, or a new variant associated with higher disease severity.

1. Predominance of an influenza subtype linked to more severe outcomes.
2. Low vaccine uptake or effectiveness

2024 Hamilton County Daily COVID-19 Cases

Wastewater COVID-2 and average N2 Levels (last 12 months)

COVID-19 variant XEC detected in Cincinnati area Wastewater

• ODH reports wastewater analysis has detected COVID-19 variant XEC in specimens collected from Cincinnati wastewater treatment plants.
• ODH reports a significant increased in viral gene copies of SARS CoV-2 from the Little Miami Wastewater Treatment Plant samples

FDA Approves Expiration Extension for Baxter IV products

• Baxter has received FDA approval to extend the shelf life of more than 50 intravenous and irrigation products by up to 12 months.
• Allowing for a 24-month expiry from products made before September 2024.

Extension of JYNNEOS Mpox Vaccine Expiration to August 2026

• Lot expiring Oct 31 been extended to 31-Aug-2026 when stored at -25°C to -15°C.

WHO: Tuberculosis Regains Top Spot as Deadliest Infectious Disease

• Tuberculosis replaced COVID-19 to become the top cause for infectious disease-related deaths.
• In 2023 8.2 million people were newly diagnosed – highest number recorded since WHO began global TB monitoring in 1995 - up from 7.5 million reported in 2022. .
• While the number of deaths related to the disease fell to 1.25 million in 2023 from 1.32 million in 2022, the total number of people falling ill rose slightly to an estimated 10.8 million in 2023.
• The multidrug-resistant form of the disease remains a public health crisis

Large Scale Active Shooter Drill at Kings Island (Oct 16) thank you to Dr Calhoun

• Large number of “actors” with reasonable variety of wounds included.
• Good coordination between EMS/FD departments.
• Did not activate HospitalNet.
• Kings Mill Hospital activated and five patients transported
• Opportunities for hospital readiness

Public Health Tuberculosis Summit

Wednesday, Nov 20; Zoom only, 5:00 - 6:15 pm

DPIC Infectious disease hotline … 877-774-4636