Key Points:

• In today’s Recommendation for Industry, we discuss COVID masking and the Hepatitis A outbreak. Read more below.
• Vaccines lower risk of long COVID 15%, death by 34%, data show. The vaccines were shown to be the most effective for lung disorders and blood clots. Those who tested positive for COVID-19 after vaccination faced a higher risk of death after the first 30 days of illness. They also were at higher risk for persistent symptoms including cardiovascular, blood-clotting and hematologic, gastrointestinal, kidney, mental, metabolic, musculoskeletal, and neurologic disorders.
• Asymptomatic COVID-19 may not spread as easily as symptomatic. A study published by PLOS Medicine concluded that in 46 contact-tracing or outbreak studies, the total share of asymptomatic COVID-19 cases was 19%. Relative to symptomatic infections, the rate of viral spread from asymptomatic index patients to contacts was about two-thirds lower.
• Study finds recent influenza vaccination is associated with an appreciable reduction in the risk of SARS-CoV-2 infection and COVID-19 severity, News Medical. The protection mechanism is as yet unexplained but could be due to a general rise in immunologic responsiveness enhancing nonspecific immunity or trained specific immunity. The former does not usually last beyond some weeks, and given that even specific COVID-19 vaccines are known to wane in efficacy quite rapidly, it may not play a long-term role in protection.

Influenza:

• Flu cases are rising in Australia as the southern hemisphere flu season begins.
• CDC estimates that, so far this season, there have been at least 7.3 million flu illnesses, 74,000 hospitalizations, and 4,500 deaths from flu. The majority of influenza viruses detected are A(H3N2). H3N2 viruses identified so far this season are genetically closely related to the vaccine virus. One influenza-associated pediatric death was reported this week. There have been 25 pediatric deaths reported this season. This week, 6 jurisdictions experienced moderate activity and 2 jursidictions experienced high or very high activity.

Public Health & Food Safety:

• Hepatitis news reported by Health Map and results published by Precision Vaccinations. The World Health Organization (WHO), the U.K, Europe, Canada, the USA, and other countries have reported about 650 acute liver inflammation infections of unknown etiology among children, with 99 additional cases pending classification, in thirty-three countries. According to the WHO and European CDC on May 27, 2022, most researchers involved in these acute liver investigations have not formulated a hypothesis and continue to question causality vs. coincidence.
• WHO says monkeypox containable, but nations should be on alert. More than 20 countries have logged more than 300 confirmed cases. Massachusetts General Hospital became the first facility in the US to vaccinate health care workers exposed to monkeypox.
• Fresh organic strawberries likely spread hepatitis A in U.S. and Canada. Strawberries branded as FreshKampo and HEB, purchased between March 5, 2022- April 25, 2022 could be contaminated. These products are sold at Aldi, HEB, Kroger, Safeway, Sprouts Farmers market, Trader Joe’s, Walmart, Weis Markets, and WinCo Foods. If you are unsure about the purchase, it is recommended to throw them away. Current reports are in California, Minnesota and Canada.
• FDA efforts to result in millions of additional bottles of infant formula to further increase U.S. supply. Recent reports state that Bubs Australia is providing 1.25 million cans of several varieties of infant formula. On Tuesday and Thursday, the FDA also announced steps that will lead to tens of millions of additional bottles of infant formula, including specialty infant formula that is in short supply for infants with certain allergies or critical health conditions.

Recommendations for Industry

Virus Update: COVID Masks, Hepatitis Outbreak

Masks. As COVID cases continue to appear at a fairly stable rate, masks continue to be a discussion point from both the voluntary and the mandate aspect, such as that discussed in today’s New York Times article, Why Masks Work, but Mandates Haven’t. As the article notes, in both the U.S. and globally, areas that had mask mandates and common usage have had similar COVID rates as those without mandates or more resistance.

As TAG has explained in previous newsletters, and the article supports, masks can be useful in reducing spread, however the majority of COVID transmission occurs in household or congregant living settings; places where mask mandates don’t cover and where people are generally unmasked around members of their household.  Masking indoors does help limit transmission in those settings and may reduce the amount of community-driven transmission in places like offices and schools when community case rates are high.

Thus, the infectious nature of COVID means that population spread will happen, however the proper wearing of masks, particularly targeted towards public indoor confined spaces can reduce the risk of transmission in those settings. As workplaces think about reducing the risk of transmission, masking remains a viable tool especially as community case rates rise.

Hepatitis A. With epidemiologic and traceback data implicating fresh organic strawberries in the multistate outbreak of hepatitis A infections in the U.S. and Canada, TAG has received questions as to how this virus spreads.

Hepatitis A can contaminate produce, such as strawberries, through contaminated water or handling by infected food handlers and/or harvesters, particularly if they do not wash their hands thoroughly after using the restroom or have access to clean water. (Though it can also be spread person-to-person, casual person-to-person contact in a food establishment is unlikely to cause spread.)

To limit the spread of Hepatitis A in the food establishment, businesses should:

1. Exclude infected food handlers from handling food.
2. Ensure food handlers wash hands properly before meal preparation, particularly after toileting.
3. Ensure proper sanitation and access to safe water.
4. Clean and disinfect frequently touched surfaces in restrooms; using a product with a Hepatitis A claim may be beneficial.
5. If a bodily fluid incident occurs, respond quickly to contain it, disinfect the spill and surrounding areas, and exclude anyone from the area.

For more information, see TAG’s Hepatitis Fact Sheet.

In Case You Missed It:

• In Tuesday’s Recommendations for Industry, we discussed COVID-19 trends stabilizing and declining. Read more here.
• The CDC released research done on post-COVID conditions among adult COVID-19 survivors aged 18-64 and younger than 65, here are some results:

• Another figure shows additional areas of the body that were included in the research conducted. Independent of age group, the highest risk ratios were for acute pulmonary embolism and respiratory symptoms.
• A study in BMJ showed that the effectiveness of a fourth dose of Pfizer-BioNTech mRNA vaccine waned faster than the third dose in adults 60 and older. The study took place over 10 weeks and at the end, 106 participants had passed- 77 who had the third dose and 23 with the fourth dose.
• COVID- 19 vaccine protection lower, wanes faster in cancer patients, concludes a Lancet study. The COVID-19 vaccine offered more protection against hospitalization (83.3%) and death (93.4%) than against infection in cancer patients but also waned after 3 to 6 months. Vaccine effectiveness was much lower among patients with the blood cancers leukemia or lymphoma, a recent cancer diagnosis, or chemotherapy or radiotherapy within the past year.
• Global COVID-19 cases start to drop again. After a week of stabilization, global COVID-19 cases are declining again, with downturns in two of four regions that have seen recent upticks, according to WHO. Part of the decline came from South Africa, which had experienced a spike involving the more transmissible BA.4 and BA.5 Omicron subvariants in late April. Of more than 3.7 million cases reported to the WHO last week, the five countries with the most cases were the United States, China, Australia, Germany, and Japan. More than 9,000 people died from their infections, with the United States reporting by far the most (1,957). Omicron continues to be the dominate strain.

Public Health & Food Safety:

• The FDA provides new guidance to decrease pathogen growth in sprout seeds and their final guidance suggests that individuals become as informed as possible about food safety practices, processes, and procedures. There have been 52 outbreaks between 1996 and 2020- 2,700 people were sick because of the outbreaks. Outbreaks have consisted of Salmonella findings. Sprouts are grown in warm and moist environments which is perfect for bacterial growth inside the seed coat. The FDA deemed grower’s cleaning methods were ineffective in killing the bacteria inside the seed coat.
• People are being urged to cook frozen fruit and vegetables because of Listeria findings. There have been low findings, but the risk is greater with frequent consumption. Of 906 samples tested, 27 were positive and 21 of those were non-ready to eat frozen vegetables.
• Officials confirm 226 monkeypox cases in 21 countries. Clusters of monkeypox cases are in young men who have sex with other men. Though not sexually transmitted, monkeypox is spread through close contact. UK has 78 cases according to the European Centre for Disease Prevention and Control. Spain has 51 cases, Portugal has 37, and Canada has 15.