Coronavirus Tidbits #231 2/5/23

Could a popular COVID-19 antiviral supercharge the pandemic?

Merck & Co.’s molnupiravir appears to be speeding evolution of SARS-CoV-2

Science

A widely used COVID-19 drug may be driving the appearance of new SARS-CoV-2 variants, sparking concerns it could prolong and even reinvigorate the pandemic. The drug, molnupiravir, produced by Merck & Co., is designed to kill the virus by inducing mutations in the viral genome. A survey of viral genomes reported in a new preprint, however, suggests some people treated with the drug generate novel viruses that not only remain viable, but spread.

“It’s very clear that viable mutant viruses can survive [molnupiravir treatment] and compete [with existing variants],” says virologist William Haseltine, chair of ACCESS Health International, who has repeatedly raised concerns about the drug. “I think we are courting disaster.” But a Merck spokesperson disputes that the drug has led to the emergence of widely circulating variants, and some researchers downplayed the significance of molnupiravir-caused mutations. “Right now, it’s much ado about nothing,” says Raymond Schinazi, a medicinal chemist at the Emory University School of Medicine, noting that with SARS-CoV-2 infecting millions of people worldwide, the virus is naturally mutating at a fast clip.

Authorized in the United Kingdom and the United States in late 2021, molnupiravir was the first oral antiviral approved anywhere to fight COVID-19. It has since been authorized in dozens of other countries. In 2022, Merck estimated global sales of the compound at more than $5 billion. Though that is well below the $18.9 billion in 2022 sales for Paxlovid, another oral SARS-CoV-2 antiviral, molnupiravir remains widely popular in certain countries.

https://www.science.org/content/article/could-popular-covid-19-antiviral-supercharge-pandemic

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Deer harbor out-of-circulation SARS-CoV-2 strains, study finds

Scientists analyzing samples collected from white-tailed deer in New York state have identified the Alpha, Gamma, and Delta SARS-CoV-2 variants well after they caused widespread COVID-19 in people, representing a reservoir for the strains and a potential future risk to humans.

The Cornell University researchers who conducted the study, published yesterday in Proceedings of the National Academy of Sciences, say it represents one of the most comprehensive approaches to date to assess the prevalence, genetic diversity, and evolution of SARS-CoV-2 in white-tailed deer.

A March 2022 study by some of the same investigators and their colleagues found SARS-CoV-2 in up to 40% of deer populations across five states. And a December 2021 study led by Ohio State researchers found a 36% incidence in Ohio. The United States is home to an estimated 30 million white-tailed deer, the most abundant large animal in the country.

https://www.cidrap.umn.edu/covid-19/deer-harbor-out-circulation-sars-cov-2-strains-study-finds

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COVID vaccine-boosted nursing home residents at 30% to 50% lower risk of infection

A study today in Morbidity and Mortality Weekly Report finds that US nursing home residents who weren't up to date on recommended COVID-19 vaccines were at a 30% to 50% higher risk for infection than those who were current.

https://www.cidrap.umn.edu/covid-19/covid-vaccine-boosted-nursing-home-residents-30-50-lower-risk-infection

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Excellent overview from KFF on impact of ending the #Covid pandemic emergency plans will have:

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Long Covid:

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Other infections:

9 diseases that keep epidemiologists up at night

https://www.npr.org/sections/goatsandsoda/2023/01/29/1151039454/9-diseases-virus-epidemiologists-pandemic-potential-who?

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UK reports more H5N1 avian flu in mammals

Tests on mammal species in the United Kingdom have found H5N1 avian influenza in red foxes and otters, according to notifications from UK animal health officials, part of a growing number of detections in mammals in Europe and the Americas.

The UK detections range from animals collected in 2021 through the early weeks of 2023. The animals that tested positive—five foxes and four otters—were from England, Scotland, and Wales.

Spanish officials recently reported H5N1 in farmed minks, and veterinary authorities in Canada and the United States have reported several H5N1 detections in wild mammals, including seals, raccoon, skunks, and bears.

The H5N1 clade circulating on multiple continents has a mutation that makes it more recognizable by human airway cells. So far only seven human infections have been reported, all in people who had close contact with sick poultry. Some were asymptomatic, but some were severe or fatal.

More avian flu also detected in poultry and wild birds

https://www.cidrap.umn.edu/avian-influenza-bird-flu/uk-reports-more-h5n1-avian-flu-mammals

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Bobcat tests positive for avian influenza in Washington

https://outbreaknewstoday.com/bobcat-tests-positive-for-avian-influenza-in-washington-84647/

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WHO continues global polio emergency-- and breach noted at Dutch vaccine facility

1 employee with an asymptomatic infection.

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Hogs are running wild in the U.S.—and spreading disease

National Geographic

Today, around six million feral swine run hog wild in at least 35 U.S. states, where they can grow more than five feet long and weigh more than 500 pounds. They’re adaptable creatures, capable of thriving in nearly any environment. For instance, the animals are also increasingly widespread on myriad Caribbean Islands and in Mexico, from the Baja to the Yucatán Peninsula, as well as Canada, where even deep snow and bitter cold can't slow them down. (Read how feral hogs are moving into Canada and building “pigloos.”)

 According to the USDA, feral swine can carry a litany of pathogens that could potentially spread to people such as leptospirosis, toxoplasmosis, brucellosis, swine influenza, salmonella, hepatitis, and pathogenic E. coli.

But there’s another concern—new diseases we don’t even know about yet.

“Swine, in general, are considered a mixing vessel species, because they’re susceptible to human viruses, like influenza viruses,” says Vienna Brown, a USDA staff biologist with the agency’s National Feral Swine Damage Management Program. “And when those get into swine,” she says, they could “create a novel influenza virus.”

By far, U.S. health officials are most worried about African swine fever, a virus that first originated in 1921 but has since reemerged in various countries worldwide. Though not transmissible to people, the disease is always fatal to pigs, either wild or farmed, says Brown.

https://www.nationalgeographic.com/animals/article/wild-hogs-swine-pigs-feral-us-disease-crops

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CDC investigating deadly outbreak of multidrug-resistant Pseudomonas tied to eye drops

The Centers for Disease Control and Prevention (CDC) is investigating a multistate outbreak of carbapenem-resistant Pseudomonas aeruginosa linked to eye drops and one death.

In a Jan 20 statement, the CDC said it identified 56 isolates of Verona integron-mediated metallo beta-lactamase and Guiana extended-spectrum beta-lactamase­–producing carbapenem-resistant P aeruginosa (VIM-GES-CRPA) from 50 case patients in 11 states from May 17, 2022, to Jan 19. Thirty-eight cases are part of four facility clusters. Whole-genome sequencing data indicate that all isolates are closely related.

The isolates were collected in outpatient and inpatient healthcare settings in California, Colorado, Connecticut, Florida, New Jersey, New Mexico, New York, Nevada, Texas, Utah, and Washington. The isolates were associated with multiple different infection types, including eye infections, and colonization. Patient outcomes include permanent vision loss and one death from a bloodstream infection.

Review of common exposure among patients revealed that most patients used artificial tears prior to the identification of VIM-GES-CRPA infection or colonization, with EzriCare Artificial Tears the most commonly used brand. Lab testing of the product by the CDC identified the presence of VIM-CRPA in opened bottles.

https://emergency.cdc.gov/han/2023/pdf/CDC_HAN_485.pdf?