Day: July 1, 2024

White-tailed deer across Ohio have been infected with the virus that causes COVID-19, new research has found – and the results also show that viral variants evolve about three times faster in deer than in humans. Scientists collected 1,522 nasal swabs from free-ranging deer in 83 of the state’s 88 counties between November 2021 and March 2022. More than 10% of the samples were positive for the SARS-CoV-2 virus, and at least one positive case was found in 59% of the counties in which testing took place. Genomic analysis showed that at least 30 infections in deer had been introduced by humans – a figure that surprised the research team. “We generally talk about interspecies transmission as a rare event, but this wasn’t a huge sampling, and we’re able to document 30 spillovers. It seems to be moving between people and animals quite easily,” said Andrew Bowman, associate professor of veterinary preventive medicine at The Ohio State University and co-senior author of the study. “And the evidence is growing that humans can get it from deer – which isn’t radically surprising. It’s probably not a one-way pipeline.” The combined findings suggest that the white-tailed deer species is a reservoir for SARS-CoV-2 that enables continuing mutation, and that the virus’s circulation in deer could lead to its spread to other wildlife and livestock. The study is published today in Nature Communications. Bowman and colleagues previously reported detection of SARS-CoV-2 infections in white-tailed deer in nine Ohio locations in December 2021, and are continuing to monitor deer for infection by more recent variants. “We expanded across Ohio to see if this was a localized problem – and we find it in lots of places, so it’s not just a localized event,” Bowman said. “Some of the thought back then was that maybe it’s just in urban deer because they’re in closer contact with people. But in rural parts of the state, we’re finding plenty of positive deer.” Beyond the detection of active infections, researchers also found through blood samples containing antibodies – indicating previous exposure to the virus – that an estimated 23.5% of deer in Ohio had been infected at one time or another. The 80 whole-genome sequences obtained from the collected samples were represented groups of viral variants: the highly contagious delta variant, the predominant human strain in the United States in the early fall of 2021 that accounted for almost 90% of the sequences, and alpha, the first named variant of concern that had circulated in humans in the spring of 2021. The analysis revealed that the genetic composition of delta variants in deer matched dominant lineages found in humans at the time, pointing to the spillover events, and that deer-to-deer transmission followed in clusters, some spanning multiple counties. “There’s probably a timing component to what we found – we were near the end of a delta peak in humans, and then we see a lot of delta in deer,” Bowman said. “But we were well past the last alpha detection in humans. So the idea that deer are holding onto lineages that have since gone extinct in humans is something we were worried about.” The study did suggest that COVID-19 vaccination is likely to help protect people against severe disease in the event of a spillover back to humans. An analysis of the effects of deer variants on Siberian hamsters, an animal model for SARS-CoV-2 studies, showed that vaccinated hamsters did not get as sick from infection as unvaccinated animals. That said, the variants circulating in deer are expected to continue to change. An investigation of the mutations found in the samples provided evidence of more rapid evolution of both alpha and delta variants in deer compared to humans. “Not only are deer getting infected with and maintaining SARS-CoV-2, but the rate of change is accelerated in deer – potentially away from what has infected humans,” Bowman said. How the virus is transmitted from humans to white-tailed deer remains a mystery. And so far, even with about 30 million free-ranging deer in the U.S., no substantial outbreaks of deer-origin strains have occurred in humans. Circulation among animals, however, remains highly likely. Bowman noted that about 70% of free-ranging deer in Ohio have not been infected or exposed to the virus, “so that’s a large body of naive animals that the virus could spread through rather uninhibited.” “Having that animal host in play creates things we need to watch out for,” he said. “If this trajectory continues for years and we have a virus that becomes deer-adapted, then does that become the pathway into other animal hosts, wildlife or domestic? We just don’t know.” This work was supported by the National Institute of Allergy and Infectious Diseases and Ohio State’s Infectious Diseases Institute. Martha Nelson of the National Library of Medicine was co-corresponding author of the study. Ohio State co-authors Dillon McBride, Steven Overend, Devra Huey, Amanda Williams, Seth Faith and Jacqueline Nolting worked on the study with co-authors from St. Jude Children’s Research Hospital; the University of California, Los Angeles; the National Research Centre in Giza, Egypt; PathAI Diagnostics; the Ohio Department of Natural Resources; the U.S. Department of Agriculture; Columbus and Franklin County Metroparks; and the Rega Institute for Medical Research in Belgium.

To show the long-term effects of severe Covid on the lungs, the Graphics desk created visual renderings based on data from CT scans. Times Insider explains who we are and what we do, and delivers behind-the-scenes insights into how our journalism comes together. Marlene Rodríguez used an inhaler to help her walk up the stairs. In his backyard, Andy Muñoz hefted his oxygen machine onto his lap to sit on a swing beside his son. Tom Kennedy brought his machine to the golf course. All of these patients were suffering from the lasting effects of severe Covid-19 infections. Signs of their lung damage — frequent breaks during previously easy activities, a clear tube tucked under the nose and behind the ears — were evident. But what was visible was only part of the story. Severe Covid cases often leave behind a hidden map of destruction, along with indications of the body’s attempts to heal. To show these effects, a recent project from the Graphics and Science desks at The New York Times looked inside the human body in a way no other Times article had before. Using data from CT scans, The Times constructed 3-D models of three patients’ lungs. The approach was inspired by a technique known as cinematic rendering, which is used by doctors to visualize organs, tissue and bones. Published in Monday’s newspaper, the renderings show the signs of limited lung function in Ms. Rodríguez, 32; Mr. Muñoz, 36; and Mr. Kennedy, 59, months after their infections. Andy Muñoz, 36, spent months in intensive care with Covid pneumonia.Meridith Kohut for The New York Times “Our job is to make things visible,” said Simone Landon, a deputy graphics editor who oversaw the project. “We knew people got really sick. We’d done a ton of reporting on the strain on hospitals and patients, and how painful and awful the disease could be. But we had not been able to show the actual damage to the body.” The project began last year when Noah Bassetti-Blum, then a Graphics editor at The Times (he left the company in January 2023), became familiar with cinematic rendering and wanted to apply the technique to a story dealing with Covid “sequelae,” or conditions that result from a previous disease or injury. The Graphics desk reached out to Pam Belluck, a health and science reporter whom Mr. Bassetti-Blum referred to as “the poet and the professional when it comes to working with patients with long-term health issues.” Ms. Belluck knew that the effects of Covid’s sequelae in the body were often frustratingly hard to see, so she suggested that the team focus on the lungs, as damage in the lungs is apparent to doctors in CT scans. But, to most people, a CT scan can feel abstract and nebulous. Cinematic renderings take those scans and make the extent of the damage painfully clear. Tom Kennedy, 59, hit golf balls with his wife, Gayle, and a friend in Houston in March.Meridith Kohut for The New York Times Ms. Belluck and the team decided that profiling a few patients and tracing their history with Covid would supplement the use of 3-D graphics. With the help of physicians at several hospitals, the team selected three patients who were hospitalized with Covid early in the pandemic and who consented to share their medical records. The patients’ lungs resembled scarred battlefields — tissue had retreated or had grown inflamed, and large cavities had opened up. But their lungs also showed signs of healing over time, appearing less shriveled and closer to normal size. The Times wanted to create two sets of models of the patients’ lungs: one from scans taken right after they were infected and a second from later scans that showed their lungs healing. Initially, the team planned to partner with an outside organization that could complete the cinematic rendering. But Jeremy White, a graphics editor, thought it could be done in-house. He used Maya, a software program, to create 3-D images from the patients’ CT scans. Marlene Rodríguez’s children love the trampoline, but she couldn’t bounce with them for long before her oxygen saturation dropped.Meridith Kohut for The New York Times In the past, 3-D representations of organs that appeared in Times articles had been based on generic stand-ins. Mr. White’s graphics are custom representations of the respiratory systems described in the article. “We’re visualizing medical data in a way we haven’t before,” he said. And while these 3-D models demonstrate a new capability in the newsroom, Ms. Belluck said they were enhanced by the experiences of the patients. She spent hours interviewing Mr. Kennedy, Mr. Muñoz, Ms. Rodríguez and their doctors. The Times assigned the photographer Meridith Kohut to visit the patients at home; her pictures show them at the dinner table and playing with their children while aided by oxygen tubes. Ms. Belluck said she hoped the article might help readers understand more about the long-term effects that can stem from Covid. “The human stories really reach people,” she said.

For hours, Noa Umbaugh and her five friends ran, crawled and dragged one another through a gritty obstacle course at the Sonoma Raceway in Sonoma, Calif. Tangles of barbed wire and rows of wooden boards forced them to submerge themselves in pits of muddy water. It was all part of the appeal of the 10-kilometer race put on by Tough Mudder, a race organizer that boasts about the grimy challenge of its obstacle courses. Umbaugh and her friends celebrated after completing the course on Aug. 20. They washed off the mud and went home. But the next morning, Umbaugh woke up and discovered a rash of painful red bumps covering her legs and stomach. They were sore and hot to the touch. Her friends had them, too. Her concerns grew when she found more stories on social media of other Tough Mudder participants coming down with similar symptoms. “It was just disgusting,” Umbaugh, 26, told The Washington Post. A doctor diagnosed Umbaugh with folliculitis, a skin infection sometimes caused by bacteria, and prescribed antibiotics. An announcement from the Sonoma County Department of Health Services later that week said she wasn’t alone: Multiple participants had reported rashes accompanied by fevers, muscle pain and vomiting after running the Tough Mudder race, it warned in a public health advisory. Tough Mudder, the Sonoma Raceway and the Sonoma County Department of Health Services did not immediately respond to requests for comment Sunday evening. Umbaugh was running her second Tough Mudder race after first completing a course the previous year, also at the Sonoma Raceway. The event, which featured several obstacle courses of different lengths over the weekend, felt like a fun challenge to her and her group of friends, an outdoorsy hiking group. Nothing seemed amiss until the day after, when Umbaugh woke up with a rash. She feared that small cuts she had gotten on her knees while climbing around rocks on the obstacle course may have contributed to the infection. Share this articleShare “I looked in the mirror, and my entire knees were covered, my legs were covered, my stomach, too,” Umbaugh said. “It was like something I’ve never seen before.” She quickly found that she wasn’t the only one. Increasingly alarmed posts on the Tough Mudder subreddit, a forum for the race’s participants, described runners visiting the emergency room and receiving diagnoses for bacterial infections. Umbaugh was prescribed antibiotics but did not get her condition tested to identify the bacteria responsible for her infection, she said. A Sonoma County official said they have confirmed at least 15 cases of people experiencing symptoms after the race, the Santa Rosa Press Democrat reported Wednesday. Some participants exhibited symptoms consistent with a bacterial infection, and one patient tested positive for Aeromonas, a waterborne bacteria. Tough Mudder acknowledged the reports of infections and said in a message to participants sent after the Sonoma County health alert that it was investigating the incident, Umbaugh said, but the company did not respond to her request for a refund for the race’s $150 entrance fee. Umbaugh is concerned about whether organizers tested the site, which she said is grazed by animals. The Sonoma Raceway uses a herd of sheep to manage its grassland, according to the raceway’s website. Sonoma Raceway did not immediately respond to an inquiry about whether animals grazed the fields where the Tough Mudder races took place. One week later, Umbaugh’s rash has lessened but not disappeared entirely, she said. She is considering checking with her doctor again. She and her friends spent the week nervously updating each other on their symptoms. They will opt for a hike instead of a mud-soaked obstacle course the next time they get together. “I wanted to try it out,” Umbaugh said. “But I’ll never do it again.”

Crossed renal ectopy (CRE) is a very rare congenital kidney anomaly. CRE is usually asymptomatic and is most often discovered incidentally, but the patient may sometimes develop various renal manifestations.We report a case of a girl who was symptomatic of several episodes of urinary tract infections and whose investigations including ultrasound, uroscan, renal scan and voiding cystourethrogram concluded that she had a crossed left renal ectopy without vesico-ureteral reflux. A regular Follow-up revealed no further symptoms or complications, with partial resolution of the hydronephrosis, and no recurrence of urinary tract infections after hygienic rules. This case didn’t require surgical intervention.CRE is an infrequently occurring congenital malformation. Uroscan is an excellent tool to describe the full anatomical details of this pathology; and the information provided is crucial for surgeons, nephrologists, and radiologists to aid in the proper handling of this pathology.CRE is a rare disease that can be diagnosed incidentally. Treatment is only indicated if complications occur or if there is other associated renal disease. Patients require continuous follow-up and need to be examined for potential complications.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.