Category: Infection

As West Nile season approaches its peak in Colorado, the state is starting to see an increase in human cases of the virus, outpacing the five-year average. Since the first case of the virus was documented in La Plata County on July 17, the Colorado Department of Public Health and Environment has confirmed 36 human cases of the virus across 14 counties. Nineteen of the 36 were hospitalized with severe neurological symptoms and one died from the virus. Last week, Denver alone was investigating six cases of the virus in residents. “Based on the past 20 years of monitoring by municipalities, counties and the state, we have seen extremely high levels of mosquito activity in our region this summer,” said Bob McDonald, executive director Denver’s health department. “It’s extremely important to take extra precautions to protect yourself, your family, and neighbors, especially if you’re spending time outdoors in the morning or evening.” AnneMarie Harper, communications director for the state health department, said 36 statewide cases is also above the norm. On average, Colorado would normally have seen less than 10 cases by this point in the year. “These increased human cases of West Nile virus follow reports of unusually high levels of infection in the Culex mosquitoes that carry the virus,” she said in a statement to the Denver Post. “The abundance of Culex mosquitoes this season is likely due to the unusual amount of precipitation this winter and spring.” State epidemiologist Rachel Herlihy said the trends her team is seeing in their West Nile virus tracking data is unprecedented. West Nile virus has been found in mosquitoes in 10 of the 11 counties that have tested mosquitoes this season, including Adams, Arapahoe, Boulder, Delta, Denver, Jefferson, La Plata, Larimer, Mesa, Pueblo and Weld counties. “The number of West Nile virus-infected mosquitoes we’ve detected this season is the highest we’ve seen in years,” Herlihy said. “This is especially concerning now that August is here and September is just around the corner, as this is usually when human cases peak in Colorado.” Eric Aakko, a spokesperson for the Weld County health department, said they don’t usually start seeing cases until September. This year, the county has already documented seven human cases and the state’s only death from the virus. During the week of July 16, the number of mosquitoes that tested positive for West Nile in Weld County passed 2,500 — more than eight times the five-year average. “What’s interesting is that the number of mosquitoes testing positive in those traps is going back down,” Aakko said. “In the week of Aug. 6, it went back below the five-year average and there were less than 200 positive cases.” Wet weather in July, mixed with hot summer temperatures, might have accelerated the presence of Culex mosquitoes and led to the spike of infections, Aakko said. And the season is far from over, with more spikes in cases expected, state officials across departments said. According to Brian Byrd, a professor of environmental health sciences at Western Carolina University and SciLine scientist, the highest risk of infection comes from older mosquitoes — as opposed to recently hatched insects. After the adult mosquito bites an infected bird, the virus incubates for five to 10 days in the insect’s body before it can transmit the virus. So when the weather is hot and humid — the Culex’s mosquito’s favorite, according to Aakko — there’s a higher risk of contracting the disease because the insects live longer. But Byrd said August is a difficult time of year to predict West Nile cases. Between delays in reporting and confirmation of cases and unpredictable weather, there’s no way to know how the rest of the season will turn out. According to the Centers for Disease Control and Prevention, Colorado had the most West Nile cases in the country last year with 204 cases and 18 deaths from the virus. In 2021, Colorado had the second most cases of any state. Only 20% of people bitten by mosquitoes carrying the virus will develop symptoms — including fever, headaches, body aches, skin rashes and swollen lymph glands, according to the CDC. While most people infected with the virus don’t get sick, symptoms for those who do appear between two and 14 days after infection. About one in 150 people who are infected develop a severe illness or life-threatening symptoms, including high fevers, tremors and convulsions, muscle weakness, paralysis and inflammation of the brain and spinal cord. Less than 1% of people with West Nile cases die, according to the CDC. Byrd advised residents to protect themselves by draining standing water weekly, limiting outdoor activities around dusk and dawn, dressing in protective clothing and using DEET, oil of lemon eucalyptus or Picaridin-based insect repellents. Get more Colorado news by signing up for our daily Your Morning Dozen email newsletter.

Share on PinterestTick-borne illnesses are common through much of the U.S. Jerry Monkman/Aurora Photos/Getty Images According to a new report from the CDC, a novel bacterium was found in 4 U.S. patients who were suspected of being infected with tick-borne illnesses. This is just an initial report and further research is needed. Antibiotics are the first line of treatment for these infections. For safety precautions, people are advised to avoid areas that are known to be tick-infested and wear appropriate clothing to minimize risk. The CDC recently announced the presence of novel Anaplasma bovis–like infections in humans. In the report in Emerging Infectious Diseases, health officials stated they found the A. bovis-like bacterium in 4 U.S. patients who are believed to have tick-borne diseases. The CDC points out that multiple Anaplasma species are already known to lead to tick-borne illness in humans. “Three recognized species (Anaplasma phagocytophilum, Anaplasma ovis, and Anaplasma bovis) and one provisionally named species (Anaplasma capra) are associated with moderately severe to severe disease in humans,” the CDC reported. Little is known about how disease symptoms may present or how common infections with the A. bovis-like agent are in the population. “The spectrum of disease and epidemiology associated with human infections caused by this novel A. bovis–like agent remains unknown. Presumably, human infections with this agent in the United States are uncommon, because this bacterium was detected only 4 times from 29,928 residual clinical samples,” the report noted. Low number of cases For the study, researchers looked at data from patients in the central and upper midwestern United States. “This is another anaplasma that affects humans so it’s the beginning of the story that we need to learn more about,” Dr. David Walker, Executive Director at UTMB Center for Biodefense and Emerging Infectious Disease, told Healthline. “It was only 4 samples out of 30,000 samples so it’s a low percentage.” Dr. Charles Bailey, medical director for infection prevention at Providence Mission Hospital and Providence St. Joseph Hospital in Orange County, California, explained “This is an interesting observation but researchers admit there is a lot they don’t know about this class of bacteria. This is a very partial fingerprint when you don’t have a full set of fingerprints to compare it to. In the US there are approximately 15 illnesses carried by ticks that are pretty much the same. This might be the 16th, but the research is very preliminary and quite a narrow potential impact for the general public.” It’s also important to note the samples that were tested in this study were between 2015 and 2017. “It’s a new species but those samples were from years ago, so it’s not an emerging infection that is now circulating,” said Wassim Ballan, MD, Division Chief of infectious disease, Medical Director of Antimicrobial Stewardship Program and Associate Director of the Infection Prevention Program at Phoenix Children’s. What is A. bovis? A. bovis is a bacteria that primarily causes disease in mammals such as cattle, sheep and antelope. These types of mammals are called ruminants. The condition is spread from host to host by a tick bite, Catherine Troisi, PhD, infectious disease epidemiologist with UTHealth Houston, explained. It is rarely transmitted from animals to humans although this paper reports on four cases of a tick-borne illness in humans (2 in 2015 and 2 in 2017). “Technology at the time didn’t allow for specific classification of the bacteria detected but it appeared to be close to A. bovis. The current paper reports on a more detailed analysis of the bacteria found in these four cases and determined that it is similar to, but not exactly like, A. bovis strains found earlier and so there is some genetic variation,” said Troisi. Typical symptoms of tick-borne illnesses are fevers/chills, aches and pains, and rash. Due to the rarity of infections, the spectrum of disease and epidemiology associated with human infections caused by this novel A. bovis–like agent is not known, Troisi added. Who is most at risk? “The bacteria is spread by tick bites and people should take precautions to not get bit to protect themselves from Lyme Disease, babesiosis, ehrlichiosis, Rocky Mountain Spotted Fever along with other tick-borne infections,” Troisi stated. “However only four cases were found out of 29,928 samples tested so no cause to be concerned specifically about this disease.” In addition, “it’s an Anaplasma infection, so it will fit within the same picture as other Anaplasma infections. Based on the whole species of Anaplasma, people who are immunocompromised are most at risk,” Ballan stated. Treatments Antibiotics are prescribed to treat this disease since it is a bacterial infection. However, “for this new species we don’t know for sure, but looking at Anaplasma as a whole there are antibiotics to treat these infections,” Ballan explained. “Doxycycline is commonly prescribed in these cases, but there are other options available as well. It’s antibiotics because it’s a bacterial infection.” Takeaway A new report from the CDC reveals that a novel Anaplasma bovis-like bacterium was found in 4 U.S. patients who were believed to be infected with tick-borne illnesses. More research is needed to learn more about this new species. Antibiotics are the first line of treatment for tick-borne infections. To stay safe, doctors recommend avoiding places that are infested with ticks and wear proper clothing to reduce risk of infection.

A rare flesh-eating bacteria infection led to the demise of three individuals in Connecticut and New York who had consumed raw shellfish. According to CNN, officials confirmed on Wednesday (August 16) that Vibrio infection found in warm, brackish waters or raw shellfish infected three people aged between 60 and 80. Christopher Boyle, director of communications for the state’s Department of Public Health, told CNN that two people in Connecticut contracted the disease and died after swimming in two locations on Long Island Sound. The Department of Public Health articulated that the third person fell ill upon eating raw oysters from an out-of-state establishment.

The Centers for Disease Control and Prevention said it is tracking a new lineage of the virus that causes COVID-19 after it was detected in the United States. Named BA.2.86, the strain was first detected in Denmark on July 24 of this year, then Israel, followed by Michigan in August for a total of four cases, according to the open global genome sequencing database GISAID. “Today we are more prepared than ever to detect and respond to changes in the COVID-19 virus,” a CDC spokesperson told ABC News. “Scientists are working now to understand more about the newly identified lineage in these for cases and we will share more information as it becomes available.” According to lab data, BA.2.86 has more than 30 mutations in total, much more than other variants currently circulating. “Based on the available evidence, we do not yet know what risks, if any, this may pose to the public’s health beyond what has been seen with other currently circulating lineages,” the spokesperson said. A man receives a nasal swab COVID-19 test at Tom Bradley International Terminal at Los Angeles International Airport (LAX), Dec. 22, 2020, in Los Angeles. Mario Tama/Getty Images On Thursday, the World Health Organization listed BA.2.86 as a “variant under monitoring” also due to its large number of mutations. Experts told ABC News that even though the number of cases spotted in laboratories is low, the fact that the variant has been detected on three continents suggests a high level of transmissibility and that there could be more cases out there. “The reason that scientists are concerned, I think it’s the numbers of mutations plus the fact that the four sequences were found on three continents,” said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital. “So that does tell you that it has some level of fitness, to be able to spread and potentially escape the immune system to create infection, but we don’t know the extent.” Brownstein, an ABC news contributor, said the number of mutations, particularly on the spike protein, which the virus uses to enter and infect cells indicates “features of a variant that could take off.” However, he explained that because there’s been no real-world data observation done yet, there’s no cause for alarm, just for continued public surveillance. Recently, CDC data has shown COVID hospitalizations are increasing. For the week ending Aug. 5, hospitalizations rose 14.3% from 9,026 to 10,320 weekly hospitalizations. Although a double-digit percentage increase seems scary, experts said it’s important to remember hospitalizations are much lower than during other surges such as the omicron surge of winter 2021-22. Dr. Peter Chin-Hong, an infectious diseases specialist at the University of California, San Francisco, said there is a combination of immunity from vaccines, boosters, previous infection and multiple infections that would stem any potential surge from BA.2.86 or at least lessen the severity. “Many people won’t get ill because the population has been so exposed with lots of different kinds of COVID and variants and vaccines and previous infections,” he told ABC News. “So, the body’s immune system has already seen a lot of the repertoire of COVID in all different angles. So, it’s unlikely even if it takes off that it will result in a huge wave of illness.” A 3D model shows the structure of the Covid-19 virus. STOCK IMAGE/Longhua Liao/Getty Images He added, “For example, if BA.2.86 came in March of 2020, it probably would be a different story, given the lack of population immunity, the repertoire of the immune response in people, then compared to now.” Until more information is learned about BA.2.864, the CDC said its “advice on protecting yourself from COVID-19 remains the same.” ABC News’ Sony Salzman contributed to this report.

Media Advisory Friday, August 18, 2023 NIH-funded research links alterations to inflammatory protein, underscores vaccine importance. What Severe COVID-19 may cause long-lasting alterations to the innate immune system, the first line of defense against pathogens, according to a small study funded by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health. These changes may help explain why the disease can damage so many different organs and why some people with long COVID have high levels of inflammation throughout the body. The findings were published online today in the journal Cell. Researchers led by Steven Z. Josefowicz, Ph.D., of Weill Cornell Medicine in New York City examined immune cells and molecules in blood samples from 38 people recovering from severe COVID-19 and other severe illnesses, as well as from 19 healthy people. Notably, the researchers established a new technique for collecting, concentrating and characterizing very rare blood-forming stem cells that circulate in the blood, eliminating the need to extract such cells from bone marrow. In these rare stem cells—the parents of immune-system cells—taken from people recovering from COVID-19, the scientists identified changes in the instructions for which genes got turned on or off. These changes were passed down to daughter cells, leading them to boost production of immune cells called monocytes. In the monocytes from people recovering from severe COVID-19, the changes in gene expression led the cells to pump out greater amounts of molecules called inflammatory cytokines than monocytes from people who were healthy or had non-COVID-19 illnesses. The researchers observed these changes as much as a year after the participants came down with COVID-19. Due to the small number of study participants, the scientists could not establish a direct association between the cellular and molecular changes and health outcomes. The investigators suspected that an inflammatory cytokine called IL-6 might play role in establishing the changes in gene-expression instructions. They tested their hypothesis both in mice with COVID-19-like disease and in people with COVID-19. In these experiments, some of the subjects received antibodies at the early stage of illness that prevented IL-6 from binding to cells. During recovery, these mice and people had lower levels of altered stem cell gene-expression instructions, monocyte production and inflammatory cytokine production than subjects that didn’t receive the antibody. In addition, the lungs and brains of mice that received the antibodies had fewer monocyte-derived cells and less organ damage. These findings suggest that SARS-CoV-2 can cause changes in gene expression that ultimately boost the production of inflammatory cytokines, and one type of those cytokines perpetuates the process by inducing these changes in stem cells even after the illness is over. Additionally, the findings suggest that early-acting IL-6 is likely a major driver of long-term inflammation in people with severe COVID-19. These findings shed light on the pathogenesis of SARS-CoV-2 infection and may provide new leads for therapies. The results also underscore the importance of staying up to date with recommended COVID-19 vaccines, which are proven to protect against serious illness, hospitalization and death. Article JG Cheong et al. Epigenetic memory of coronavirus infection in innate immune cells and progenitors. Cell DOI: 10.1016/j.cell.2023.07.019 (2023). Who Joy Liu, M.D., a program officer in the NIAID Division of Allergy, Immunology and Transplantation, is available to discuss this research. NIAID conducts and supports research—at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID website. About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov. NIH…Turning Discovery Into Health® ###

LONG ISLAND, NY — Officials confirmed Friday that the person who died of a rare, flesh-eating bacteria on Long Island was a 55-year-old-man. Suffolk County officials said the man lived in Brookhaven Town but did not give any additional information. Health officials this week warned of a rare flesh-eating bacterium known as Vibrio vulnificus, found naturally in warm coastal waters, that has killed at least eight people along the East Coast this summer. In addition to the Long Island death, two people died in Connecticut after becoming infected, health officials in both states said this week. Five people have died in Florida so far this year, according to state health officials. Vibrio infections are commonly associated with eating raw or undercooked oysters and other seafood, but also occur when people with open wounds or cuts come in contact with seawater or brackish water where the bacteria are present, according to the U.S. Centers for Disease Control and Prevention. New York State Health Commissioner Dr. James McDonald said: “We are reminding providers to be on the lookout for cases of vibriosis, which is not often the first diagnosis that comes to mind. We are also suggesting to New Yorkers that if you have wounds, you should avoid swimming in warm seawater. And, if you have a compromised immune system, you should also avoid handling or eating raw seafood that could also carry the bacteria.” Three people in all were hospitalized in Connecticut after becoming infected. Two of the three Vibrio vulnificus infections reported in that state were wound infections not associated with seafood. The third infection was a Connecticut resident who consumed raw oysters at an out-of-state establishment. “The bacteria is extraordinarily dangerous,” New York Gov. Kathy Hochul said after the Long Island resident died as a result of the infection. Hochul said that vibriosis can cause skin breakdown and ulcers. Hochul urged New Yorkers to learn how to avoid exposure and to take appropriate precautions, as the New York State Department of Health reminded providers to consider vibriosis when diagnosing wound infections or sepsis of unknown origins. “While rare, the vibrio bacteria has unfortunately made it to this region and can be extraordinarily dangerous,” Hochul said. “As we investigate further, it is critical that all New Yorkers stay vigilant and take responsible precautions to keep themselves and their loved ones safe, including protecting open wounds from seawater and for those with compromised immune systems, avoiding raw or undercooked shellfish which may carry the bacteria.” Vibriosis is caused by several species of bacteria, including the Vibrio vulnificus bacteria, which occurs naturally in saltwater coastal environments and can be found in higher concentrations from May to October when the weather is warmer, Hochul added. Infection with vibriosis can cause a range of symptoms when ingested, including diarrhea, stomach cramps, vomiting, fever and chills. Exposure can also result in ear infections and cause sepsis and life-threatening wound infections. The death in Suffolk County is still being investigated to determine if the bacteria was encountered in New York waters or elsewhere, Hochul said. “While we continue to investigate the source of this rare infection, it is important for residents to remain aware and vigilant on precautions that can be taken,” Suffolk County Executive Steve Bellone said. While anyone can get vibriosis, those with liver disease, cancer or a weakened immune system or people taking medicine to decrease stomach acid levels may be more likely to get an infection or develop complications when infected, Hochul said. To help prevent vibriosis, people with a wound, such as a cut or scrape, a recent piercing or tattoo, should avoid exposing skin to warm seawater in coastal environments or cover the wound with a waterproof bandage. In addition, those with compromised immune systems should avoid eating raw or undercooked shellfish, such as oysters, which can carry the bacteria. Wear gloves when handling raw shellfish and thoroughly wash your hands with soap and water when finished. People infected by the Vibrio vulnificus bacteria often require intensive care or limb amputations, and about one in five die, often within a day or two of becoming ill, according to the CDC. People at greatest risk for illness from the infection are those with weakened immune systems and the elderly. Some Vibrio vulnificus infections lead to necrotizing fasciitis, a severe infection in which the flesh around an open wound dies, inspiring the “flesh-eating bacteria” moniker. The necrotizing fasciitis can be caused by more than one type of bacteria, according to the CDC. Besides occurring naturally in warm coastal waters, Vibrio vulnificus infections have also been associated with hurricanes, storm surges and coastal flooding.

Septic arthritis is a rare and severe arthritis that affects one or more of your joints. Bacteria generally cause it, but sometimes, it can develop after exposure to a virus or fungus. The infection will spread to the joints and cause inflammation. Septic arthritis is also called pyogenic arthritis or bacterial arthritis. It typically affects the large joints of the hips and knees but can affect other joints, such as the shoulder or ankle, as well. Symptoms include severe pain and swelling, limited joint range of motion, fever, and chills. Risk factors include prior joint surgery, a weakened immune system, diabetes, inflammatory arthritis, or an open wound. Septic arthritis is treated with antibiotics and can be a serious condition if left untreated. It can lead to progressive and irreversible joint damage or become a life-threatening medical emergency. This article will cover the causes and risk factors for septic arthritis, its effects on joints, symptoms, treatment, and more. prpicturesproduction / Getty Images What Causes Septic Arthritis? Septic arthritis is caused by bacteria, viruses, and fungi, with Staphylococcus aureus (staph) as the most common infectious cause. Staphylococcus aureus bacteria are linked to pneumonia, skin infections, sepsis, and bone and joint infections. Staph infections can become life-threatening if not adequately treated. Septic arthritis can develop when an infection, such as a skin infection, spreads into the bloodstream to a joint. This might be because of an open wound related to surgery or injury, which allows germs to enter the joint space. It typically affects one joint. However, it is possible to experience the condition in multiple joints depending on the bacterium that caused it. For example, Neisseria bacteria can lead to septic arthritis in multiple joints (polyarticular arthritis). With polyarticular septic arthritis, usually both knees are involved, but other joints can also be affected. Inflammation linked to septic arthritis occurs at the cartilage surface (the connective tissue that allows bones and joints to move over one another smoothly) or the synovium (joint lining). It can also invade the synovial fluid that lubricates the joints. The most common organisms that lead to pediatric septic arthritis are methicillin-resistant Staphylococcus aureus (MRSA), Streptococcus pneumoniae, group B Streptococcus, Klebsiella pneumoniae, and Gram-negative bacilli. Common pathogens for adult septic arthritis include Staphylococcus aureus, coagulase-negative Staphylococcus, Streptococcus, and Pseudomonas, and other Gram-negative bacteria. Who Is at Risk for Septic Arthritis? Septic arthritis frequently affects children, but adults get it too. Children are at a higher risk for infections that could lead to septic arthritis. Some risk factors in children and adults increase the risk for infections, including those that lead to septic arthritis. Risk factors include: Arthritis conditions, including osteoarthritis, gout, and autoimmune arthritis like rheumatoid arthritis (RA) and lupus: The medications you take to treat these conditions could also raise the risk for septic arthritis. For example, people with RA are treated with drugs that suppress the immune system and increase their risk for infection, including, disease-modifying antirheumatic drugs (DMARDs) and corticosteroids. Previous septic arthritis: If you have had septic arthritis in the past, you are more likely to get it a second time. Having a weakened immune system: People with diabetes and kidney or liver problems are at an increased risk for septic arthritis. The medications they take to treat these conditions can add to that risk. Having an artificial joint: Bacteria can enter the joint space during joint surgery, or an artificial joint can be infected after an infection from a nearby body area. Joint trauma: If you have an open wound or cut near a joint, germs from the skin can enter the joint space through the bloodstream. Skin problems: People with fragile skin might be at an increased risk for septic arthritis. This includes people with psoriasis, an autoimmune skin condition that causes overgrowth of skin cells. Injection drug use: This is a newer known risk factor often linked to non-medically administered injections that are not sterile and can introduce bacteria through the skin into the bloodstream. These bacteria might be more antibiotic-resistant or infectious, leading to disease complications and life-threatening medical situations. Two or more of the above risk factors put you at a greater risk for developing septic arthritis compared to one risk factor alone. What Joints Are More Likely to Have Septic Arthritis? In general, infections in native joints (joints you’re born with as opposed to prosthetic, or artificial, joints that are implanted) commonly occur in the knees, hips, shoulders, ankles, elbows, and wrists. However, the location may depend on the type of pathogen, underlying conditions, or exposure type. Additionally, children may experience septic arthritis in different joints than adults. Research shows that children are more likely to get septic arthritis in the hip or knee. Children can also experience elbow septic arthritis caused by a staph infection. Pathogens that cause septic arthritis in adults are typically linked to medical history, health status, orthopedic surgery, and injection drug misuse. Adults are more likely to get septic arthritis in the knee or the small joints of the interphalangeal joints (hinge joints) of the fingers. Septic arthritis causes excess fluid in and around the knee joint. “Knee joint effusion” is the medical term for this condition, and it is seen on ultrasound in 91% of people with septic arthritis. One 2021 Orthopedics report finds the joints most affected by septic arthritis caused by injection drug use include the knees, ankles, shoulders, elbows, wrists, and fingers. Additional research suggests septic arthritis linked to injection drugs may also affect the sacroiliac joints connecting the pelvis and lower spine, the facet joints in the lower spine, and the sternoclavicular joint connecting the collarbone to the breastbone. What Are the Symptoms of Septic Arthritis? The symptoms of septic arthritis will occur in the infected joints. You may also experience systemic (whole-body) symptoms. Symptoms of septic arthritis include: Severe pain and tenderness in the affected joint, especially with movement Visible swelling from increased fluid in the joint Warmth (the joint is warm to the touch) Stiffness of

FARGO — The smoldering coronavirus spread is creeping up in North Dakota but is unlikely to burst into another major conflagration of cases because many people have some level of immunity from vaccination or natural infection, experts say. Throughout the United States, COVID-19 infections have been increasing, with hospitalizations up 14.3% over the past week, according to the Centers for Disease Control and Prevention. But the trend so far is more subdued in North Dakota, which had three weekly reported COVID-19 hospital cases as of Friday, Aug. 18, and 197 weekly positive cases . The week earlier, one hospitalization and 115 positive cases were reported. Public health officials caution, however, that the spread of cases is largely invisible because few test results are reported, and cases in North Dakota have been gradually rising. “Testing is down, so reporting is down,” said Kirby Kruger, director of disease prevention at the North Dakota Department of Health and Human Services. ADVERTISEMENT “It really is trending upward,” he added. “We’ve been trending upward since the end of June. That indicates that viral activity is increasing.” Reported weekly COVID-19 infections, which do not include at-home test results, dropped to 44 on June 29, the lowest level since late March of 2020, when the pandemic started in North Dakota. Hospitalizations, a key indicator that is reliably reported, so far remain subdued. “Those hospitalizations are remaining low, and that’s encouraging,” Kruger said. North Dakota is unlikely to see another spike like the peak in late January of 2022 during the wave of cases from the Omicron variant, when reported cases reached an all-time high of 15,938 active infections, Kruger said. “We have a lot of protection in our population now that we didn’t have when this first emerged,” since many people have been vaccinated, infected or both, he said. Still, the virus continues to mutate into variants that spread more rapidly, and some people suffer severe illness, so people should not let down their guard, Kruger said. “This virus is still here and it’s still circulating now with severe illness for some,” he said. “So we don’t want to ignore this.” ADVERTISEMENT Infectious disease specialists at Essentia Health and Sanford Health in Fargo agreed the population has significant protection from prior vaccination or natural infection but caution that cases are likely to increase as people spend more time indoors in the fall and winter. “The peaks and troughs are significantly lower,” said Dr. Drubert Guerrero, an infectious disease specialist at Sanford. “At this time, there’s no reason to be alarmed.” In fall and winter, there likely will be a slight increase in COVID-19 infections, he said. Hospitalizations for COVID-19 have remained low at both Sanford and Essentia. Sanford no longer tracks COVID-19 hospital trends, and Dr. Bertha Ayi, an infectious disease specialist at Essentia, said COVID-19 hospitalizations are “remarkably down,” adding, “I haven’t seen a COVID case in months.” Generally, transmission levels are low in North Dakota, Ayi said. Looking ahead to fall and winter, “I’m optimistic that it won’t be a big issue,” she said. “But people should be sure to get vaccinated” and maintain good indoor ventilation whenever possible and take other precautions, such as wearing masks if risk levels are high. New vaccines formulated for the most prevalent strains now circulating are expected to be available in late September or early October, and people should get booster doses, Ayi, Guerrero and Kruger said. “It’s a good time to get updated this fall,” Guerrero said. “COVID is still here. It’s still causing a lot of illness, and there is some mortality associated with it.” ADVERTISEMENT Fortunately, vaccines and medicines, including antiviral medications, help reduce severe illness, he said, but people have to remain mindful that the coronavirus is circulating. “We now have to live in a post-pandemic environment,” and people must stay vigilant, Guerrero said. North Dakota health officials stopped monitoring coronavirus levels in municipal wastewater in December 2022, Kruger said. North Dakota’s health laboratory has the ability to do the analysis, and health officials are determining whether communities are interested in collecting samples. So far, no cities seem eager to participate. “There isn’t a lot of interest in COVID in general right now,” Kruger said.

The Connecticut Department of Public Health today announced that a resident has tested positive for West Nile virus infection. This is the first human case of WNV-associated illness identified in Connecticut this season. The female is a resident of New Haven County and is between 50-59 years of age. She became ill during the third week of July with West Nile fever and has since recovered. Laboratory tests confirmed the presence of antibodies to WNV. “As we approach the end of summer and continue to enjoy time outdoors with family, friends, and neighbors, it is important to prevent mosquito bites to reduce your risk of exposure to West Nile virus infection,” said DPH Commissioner Manisha Juthani. “Using insect repellent, covering bare skin, and avoiding being outdoors during the hours of dusk and dawn are effective ways to help keep you from being bitten by mosquitoes.” “The mosquitoes that carry West Nile virus are most abundant in urban and suburban areas and are most active between dusk and dawn.  We anticipate continued risk for human infection until mosquito activity subsides in October,” added Philip Armstrong, medical entomologist at the Connecticut Agricultural Experiment Station. West Nile virus has been detected in Connecticut every year since 1999 and is the most prevalent mosquito-borne disease in the US. Most people infected with WNV do not develop symptoms. About one in five people who are infected develop West Nile fever, an illness which includes a fever and other symptoms such as body aches, joint pain, headache, or a rash. About one out of 150 infected people develop a severe illness affecting the central nervous system. About one out of 10 cases of severe illness are fatal. People over the age of 60 are at highest risk of serious illness. Tips for reducing mosquitoes around homes Mosquitoes require water for reproduction. The following are measures that can help reduce mosquitoes: Eliminate standing water suitable for mosquitoes. Dispose of water-holding containers, such as ceramic pots, used tires, and tire swings. Drill holes in the bottom of containers such as those used for recycling Clean clogged roof gutters. Turn over objects that may trap water when not in use, such as wading pools and wheelbarrows. Change water in bird baths on a weekly basis. Clean and chlorinate swimming pools. When pools are not in use, use pool covers and drain when necessary. Tips for avoiding mosquito bites when outdoors Mosquitoes require a blood meal for reproduction. The following are measures that can help reduce bites from mosquitoes that feed on people: Minimize outdoor activities at dusk and dawn when mosquitoes are most active. Wear shoes, socks, long pants, and long-sleeved shirts. Clothing material should be tightly woven and loose fitting. Use mosquito netting when sleeping outdoors. Consider the use of CDC-recommended mosquito repellents, containing DEET, picaridin, oil of lemon eucalyptus, IR3535, or 2-undecanone, and apply according to directions, when it is necessary to be outdoors. When using DEET, use the lowest concentration effective for the time spent outdoors (for example, 6 percent lasts approximately two hours and 20% for four hours) and wash treated skin when returning indoors. Do not apply under clothing, to wounds or irritated skin, the hands of children, or to infants less than two months old. Be sure door and window screens are tight fitting and in good repair to avoid mosquito bites when indoors. For information on West Nile virus and how to prevent mosquito bites, visit the Connecticut Mosquito Management Program Web site at www.ct.gov/mosquito.

Here’s our weekly round-up of what illnesses are spreading the most in Metro Detroit communities, according to our local doctors and hospitals. Wayne County — Bee stings, infected bug bites, hand foot & mouth disease, seasonal allergies, asthma flare-ups, strep throat, COVID Dr. Kevin Dazy — Pediatrician, Children’s Hospital of Michigan “We continue to see kids with croup and hand-foot-mouth symptoms of rash and mouth sores. Once hand-foot-mouth starts going around, we expect the numbers of kids with the virus to grow. Right now, though, all thoughts are on back-to-school. Parents should be working on getting their kids updated on vaccines to ensure their children are protected against preventable disease. We see too many families who deal with these preventable diseases when their child is hospitalized or dealing with issues that were completely avoidable saying, ‘I wish I would have gotten those vaccinations.’ Now’s the time. “ Dr. Tiffany Widner — Pediatrician, Children’s Hospital of Michigan “We are seeing allergic reactions to bug bites, hand foot mouth, viral infections including viral URIs (cold symptoms) and contact dermatitis from environmental exposures (the name for rashes that can be associated with things like poison ivy, grasses, etc). We also are still seeing a lot of allergy and asthma complaints. In terms of back to school, I would recommend that parents turn their school forms in to their physicians as soon as possible, if they haven’t done it already. Also keep in mind that we are unable to complete forms if the child hasn’t been seen in the past year. Parents should consider the COVID19 vaccine as numbers are creeping up, and children in school will be at risk for contracting the illness. Also, remember the flu vaccine will be coming out next month. And now is the time to start putting all of the children back on a regular sleep schedule prior to the start of school.” Oakland County — Bee stings, infected bug bites, summer rashes, hand foot and mouth disease, seasonal allergies, asthma flare-ups, COVID, ear infections Dr. Steven McGraw — Chair of Emergency Medicine, Ascension Providence Hospital, Southfield Campus “I’m still seeing LOTS of bee stings. Some are rather serious and if people are allergic, make certain to have epi-pens available. Bees and wasps get aggressive during this time of year. I’m seeing some patients with COVID-19. It’s still lower than before, but coming back.” Dr. Jennifer Stevenson — Division Head, Fairlane Emergency Department Senior Staff Physician Department of Emergency Medicine Henry Ford Hospital, Fairlane “The number of strep cases continues to blow my mind! We’re also definitely seeing an uptick in COVID-19 cases. Generally speaking, those who are younger without medical problems are faring well. We have seen an increase in COVID-19 hospital admissions in those with co-morbidities. In addition, there’s been some hand-foot-mouth in the community. We’re also seeing a lot of allergic reactions. I think the bees get a little feisty this time of year. Those who are allergic should be sure to have their epi pens on hand!” Sarah Rauner — Pediatric nurse practitioner, Emergency Center, Corewell Health’s Beaumont Hospital, Troy “We are continuing to see some summer time rashes and bug bites that can become infected. Hand foot and mouth disease has made an appearance as well. Less vomiting and diarrhea lately however COVID has picked up a little bit. Keep washing your hands in preparation for the fall and school!” Dr. Susan Bork — Director of Operations, Emergency Center, Corewell Health’s Beaumont Hospital, Royal Oak “We are seeing an uptick in gastroenteritis cases with symptoms of vomiting and diarrhea, as well as sore throats and hand, foot and mouth infections. There has been a slight increase in mild COVID cases and no major changes in allergies.” Caroline Morris, PA-C — Henry Ford-GoHealth Urgent Care Centers “Presently we are seeing an increase in flu-like symptoms that are neither the flu or COVID-19, but rather a really bad cold (rhinovirus). We are still seeing an increase in COVID-19 cases currently that seem to present with fatigue cough and sore throat. We’re also seeing a lot of sporting injuries that include dislocated fingers, wrist, hand, knee and ankle injuries.” Dr. Rena Daiza — Primary Care Physician, Henry Ford Medical Center Bloomfield Twp. “With the weather changes this week, I am seeing a lot of allergies and asthma flares. Asthma can often overlap symptoms with upper respiratory illnesses, so people should be sure to test for respiratory illnesses like COVID-19. An upper respiratory illness should be suspected if usual remedies for asthma and allergies are not helping symptoms.” Emergency Department at Henry Ford West Bloomfield Hospital “I am seeing a lot of a lot of pain complaints (abdominal, flank and headache). We have had some allergic reactions from bees and peanut butter allergies. Falls and shortness of breath are also some of the top complaints.” Washtenaw County — Sore throats, COVID, infected bug bites, summer rashes Monroe County — Stomach viruses, sore throats, pink eye, swimmer’s ear Macomb County — Bee stings, infected bug bites, poison ivy, seasonal allergies, eye infections, sore throats Dr. Matthew Steck — Emergency physician at McLaren Macomb “There has been a noticeable increase in the prevalence of water incidents, including injuries and near-drowning, prompting the ER to urge extra caution when in and around water. Across all ages and patient populations, various orthopedic and soft tissue injuries continue to be the most common reason to seek care in the emergency and trauma center. Following a brief uptick in viral infections causing upper respiratory infections and a lingering cough, those cases have tapered off. Though an increase in cases has been reported on, there has not been a significant increase in the prevalence of COVID-19 diagnoses. “ Livingston County — Increase in rabies treatment due to bat exposures