More than half of US states reporting ‘very high’ COVID activity levels: CDC
SONGPHOL THESAKIT/Getty Images
(NEW YORK) — More than half of U.S. states are reporting “very high” levels of COVID activity as the virus continues to spread and increase in many parts of the country, according to the latest wastewater data from the Centers for Disease Control and Prevention.
At least 27 states are reporting “very high” levels and 17 states are reporting “high” levels of wastewater viral activity.
The western region continues to see the highest levels followed by the South, Midwest and Northeast, respectively.
Current levels are nearing but remain lower than what they were in the winter months, when there tends to be increased spread of respiratory illnesses.
Wastewater data comes with limitations in how well it represents spread in a community, but it may be the best data available, experts say.
“While wastewater is not a perfect measure, it’s increasingly vital in filling the gaps left by the absence of comprehensive case reporting and hospitalization data,” said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital and an ABC News contributor.
Many national surveillance systems have diminished in scope since the national public health emergency ended, leaving authorities with limited resources to monitor how the virus is spreading.
“As traditional surveillance systems have dwindled, wastewater analysis has emerged as one of the most reliable tools we have to monitor COVID-19 activity in communities,” Brownstein added.
Other limited COVID surveillance systems such as emergency department visits and test positivity are also on the rise, according to CDC data. Deaths from the virus remain relatively flat, especially compared to previous years.
Updated COVID vaccines are set to be available this fall, according to federal health authorities. The U.S. Food and Drug Administration recommended that vaccine manufacturers formulate shots based on the KP.2 strain, an offshoot of the omicron variant that is currently estimated to make up about 6% of cases.
Genetically similar variants, known as KP.3.1.1 and KP.3, currently make up almost half of estimated cases, CDC data shows.
The CDC has already recommended that everyone over the age of 6 months get an updated COVID vaccine this season. The recommendation will take effect as soon as the vaccines are made available, pending FDA authorization.
An expected delivery date for the updated COVID vaccines has not been shared yet, but in previous years the shot was made available in late August or September. Vaccine manufacturers have told ABC News they are ready to ship doses as soon as they receive the green light from the FDA.
(NEW YORK) — As mosquito season continues, public health officials in the U.S. have been tracking several different illnesses caused by the pesky flying insect.
Health officials are reporting at least eighteen deaths from West Nile virus in the U.S. this year, with three recent deaths recorded in Wisconsin and Illinois. There have been six cases of eastern equine encephalitis (EEE), including one person who died after testing positive for the virus, as well as dengue cases recorded in several states. The viruses that cause all three illnesses are transmitted to humans via mosquito bite.
“What we’ve seen is a rapid uptake in certain viruses that haven’t been in the limelight in recent years. Both West Nile virus and ‘triple E,’ which is eastern equine encephalitis, have had an uptick, particularly post-COVID,” Dr. Larry Han, an assistant professor of public health and health sciences at Northeastern University in Boston, told ABC News.
“There’s also been a rise in dengue relative to what we’ve seen in recent years. And so, these ‘triple threats,’ you might say, have led to more attention and more worry among the general populace.”
Experts who spoke with ABC News said some of the uptick is due to the “randomness” regarding which seasons have a greater number of cases than others, coupled with the general rise in mosquito-borne viruses during the summer and early fall months.
Here are some ways to tell the difference between West Nile, EEE, and dengue. However, if you’re concerned you might have contracted any of these viruses, you should contact your doctor immediately.
How common are West Nile, EEE and dengue?
West Nile virus is the leading cause of mosquito-borne disease in the contiguous United States, according to the Centers for Disease Control and Prevention (CDC). It was first identified in the Western Hemisphere in August 1999 after people were diagnosed in New York City.
Dengue viruses are spread through bites from infected Aedes species mosquitoes, mostly found in tropical and subtropical regions of the world, according to the CDC. These mosquitoes are also responsible for spreading Zika and chikungunya viruses.
“It would be very rare to see dengue cases unless you lived in more tropical climates, so you might see this in Florida, some Southern states along the East Coast, but, for example, you would nearly never see this in Massachusetts or in the Midwest or West,” Han said.
Comparatively, EEE is quite rare, with only a few cases reported in the U.S. every year. However, similar to dengue, most cases occur in the Eastern or Gulf Coast states, according to the CDC.
What are the symptoms?
The majority of people with West Nile virus do not present with symptoms, but about one in five will experience fever along with headaches, body aches, joint pain, diarrhea, vomiting, or a rash. Symptoms typically disappear in a week or less for most people but weakness and fatigue may last for weeks or months. For some people, however, the disease can progress to something far more concerning.
“About one out of 150 of those people that develop signs and symptoms can actually develop a more severe disease, like West Nile encephalitis, where we have the swelling of the brain that could potentially be fatal,” Dr. Thomas Duszynski, director of epidemiology education at the Indiana University Richard M. Fairbanks School of Public Health, told ABC News.
Similarly, about one in four people who contract dengue develop symptoms lasting two to seven days, but symptoms are usually mild and may include fever, rash, nausea, vomiting, muscle pain, joint pain and bone pain.
Duszynski explained that most U.S. dengue cases are typically seen among people who contract it while traveling abroad, where dengue is endemic or where cases are more common, and who then bring the virus back to the U.S. Because dengue’s symptoms are not specific to the virus, they’re often confused with other illnesses, according to the CDC.
Most people who are infected with EEE show either mild symptoms or no symptoms at all, according to the CDC. However, severe cases typically present with fever, headache, chills and vomiting.
Like West Nile virus, EEE also can progress to a more severe condition, like encephalitis or meningitis, the latter of which is swelling of the membranes that surround the brain and spinal cord. Many survivors can experience ongoing neurologic problems, including convulsions, paralysis and intellectual disability. About 30% of encephalitis cases caused by EEE result in death.
“I think the mortality risk if one were to contract dengue or West Nile virus would be very low. For EEE, it’s the opposite; it’s very high,” Han said.
Treatments and vaccines
There are no disease-specific treatments for any of the viruses. The CDC recommends rest, fluids, and over-the-counter medications to relieve symptoms. Patients with severe illness often need to be hospitalized and receive additional supportive treatments, such as intravenous fluids.
There also are no vaccines available for West Nile or EEE. However, a dengue vaccine is available in the U.S. and is FDA approved for children between ages 9 and 16 who have a laboratory-confirmed previous dengue virus infection and who live in areas where dengue is endemic.
The vaccine also is available in Puerto Rico and is part of the territory’s routine childhood immunization schedule, the CDC said.
Dengue can be caused by dengue virus strains 1, 2, 3 or 4, with a person being infected multiple times over the course of their life, Duszynski told ABC News, so a vaccine may be able to help prevent infection from a different strain.
“If I got infected with one strain, if I get bit by this mosquito with the same strain, I’m probably going to be okay,’ he said. “But it’s those three other strains that are out there that … I could get infected with even though I had strain 1.”
How to best protect yourself from infection
There are no differences when it comes to protecting yourself from dengue, EEE or West Nile virus, the experts told ABC News. Prevention methods include using effective mosquito repellents, wearing long-sleeve shirts and long pants when outside, and staying in places with air conditioning, when possible. The CDC also recommends emptying containers of still or stagnant water, to eliminate places where mosquitos can breed.
“The single deadliest [animal] to the human species has been the mosquito,” Han said. “So, while we might think of sharks or we might think of lions or tigers, it’s really the mosquito that has led to the devastation of the human population multiple times throughout history.”
“I’m not saying that we should kill off all mosquitoes, because they play an important role in ecology, but there are various new techniques and strategies people are thinking about to combat mosquito-borne viruses and illnesses,” Han continued. “I’m hopeful that we can make mosquito borne viruses less of a threat to humanity.”
An Eli Lilly & Co. Zepbound injection pen arranged in the Brooklyn borough of New York, US, on Thursday, March 28, 2024. (Shelby Knowles/Bloomberg via Getty Images)
(NEW YORK) — People who are in need of weight loss medications but do not have insurance coverage will soon have a new way to access one of the popular medications, Zepbound.
Eli Lilly, the maker of Zepbound, announced Tuesday it will begin selling the weight loss drug directly to consumers through the company’s direct pharmacy, LillyDirect.
With a doctors’ prescription, consumers will be able to purchase Zepbound in vial forms that are about half the price of the auto-injector pre-filled pens sold in pharmacies, according to Eli Lilly CEO Dave Ricks.
A one-month supply of Zepbound at a 2.5-milligram dose will cost $349, while a one-month supply at a 5-milligram dose will cost $549, according to Ricks.
Medical professionals can start filling prescriptions for the Zepbound vials on Tuesday via LillyDirect and the vials will start shipping in the days ahead.
Ricks noted that the new option will be self-pay only and will not participate in insurance.
With insurance coverage, Zepbound can cost as low as $25 per month, but without coverage, the medication can cost more than $1,000 per month.
Consumers who purchase Zepbound through LillyDirect will have access to educational resources on how to administer the medication, according to Ricks.
Zepbound is approved by the U.S. Food and Drug Administration as a weight loss management treatment for people with obesity or those who are overweight with at least one related underlying condition such as high blood pressure.
However, many private insurers and Medicare do not cover weight loss drugs used for obesity.
Zepbound contains the same active ingredient, tirzepatide, as another medication, Mounjaro, which is also made by Lilly and is FDA-approved to treat Type 2 diabetes.
Tirzepatide works by helping the pancreas increase the production of insulin to move sugar from the blood into body tissues.
It also slows down the movement of food through the stomach and curbs appetite, thereby causing weight loss.
Past clinical studies have shown users of medications used for weight loss like Zepbound and Mounjaro can lose between 5% and 20% of their body weight on the medications over time.
Medical specialists point out that using medication to lose weight also requires cardio and strength training and changing your diet to one that includes proteins and less processed foods with added sugars.
The most commonly reported side effects of medications used for weight loss are nausea and constipation, but gallbladder and pancreatic disease are also reported.
Makers of these drugs recommend having a conversation about the side effect profile and personalized risks with a health care professional before starting.
(NEW YORK) — Infant mortality rates in the United States increased by 3% in 2022, according to a new federal report published early Thursday morning.
Researchers from the Center for Disease Control and Prevention’s (CDC) National Center for Health Statistics looked at linked birth and death data sets — information from the death certificate linked to the information from the birth certificate — from the National Vital Statistics System.
Data showed the rate increased from 5.44 infant deaths per 1,000 live births in 2021 to 5.61 deaths per 1,000 live births in 2022. This equates to a total of 20,577 infant deaths reported in 2022, up 3% from 2021.
Although the rate is lower than the 7.57 per 1,000 recorded in 1995 — the first year the linked birth/infant death file was available — it marks the second straight year of increases.
“It is concerning that the rate bumped up by 3% compared to ’21,” Dr. James Greenberg, co-director of the Perinatal Institute at Cincinnati Children’s and co-founder of Cradle Cincinnati — a non-profit working to improve infant mortality rates in Hamilton County, Ohio — told ABC News.
“The overall trend for the last many decades has been, in general, a downward trend, but the United States infant mortality rate is still much higher than almost every other developed country in the world,” he continued. “So, when we see an uptick like this, it’s certainly a cause for additional concern.”
The report found that the overall mortality rate increased for infants born to American Indian/Alaska Native women, white women and Dominican women in 2022 while other racial and ethnic groups did not see significant increases from 2021 to 2022.
Meanwhile, infants of Black women had the highest mortality rate at 10.90 per 1,000 live births in 2022 followed by infants of American Indian/Alaska Native women and Native Hawaiian or Other Pacific Islander women.
Greenberg, who was not involved in the report, said the data is further evidence of the racial and ethnic disparities seen in infant mortality rates when it comes to minority women.
“This has been a rather intractable problem in the United States…and the disparities between white and non-Hispanic, Black infant mortality and white and American Indian/Alaska Native infant mortality are quite striking and continue to be very, very troubling,” he said.
Greenberg called the Black infant mortality rate “extraordinary” and said it was “on par with some parts of the world that have very limited resources.”
The report also found that infant mortality rates were highest in the South and Rust Belt middle America and lowest in the Northeast, Northwest and West, which Greenberg said is in line with where rates are traditionally higher and lower.
Data from the report showed in 2022, the five leading causes of all infant deaths were the same as those in 2021 including congenital malformations, disorders related to short gestation and low birth weight, sudden infant death syndrome (SIDS), unintentional injuries and maternal complications.
Greenberg said preterm birth is the actual leading cause of infant death based on research conducted by his team, but there’s not a single code for a death certificate that covers preterm births.
“It’s a reflection of the way coding around cause of death is done. The problem is that the causes related to preterm birth are subdivided, so you have to actually add them up in order to get the whole impact of preterm birth,” he said. “It’s not congenital malformations, certainly not to denigrate that, that cause, but preterm birth is where it’s at.”
Greenberg said other factors that may have played a role in the bump in 2022 include an RSV and flu season in 2022 that began much earlier than usual after COVID-19 pandemic mitigation measures began to be lifted. Another role may have been the impact of a COVID-19 infection in pregnant women, which may have forced some to deliver early and, in turn, raised the risk of infant mortality.
Another factor contributing to the bump may be the overturning of Roe v. Wade in 2022, which led to anecdotal reports of women forced to carry to term babies that would die upon being born or shortly after birth.
He said it’s too soon to tell if any of the other three factors played a role, but anecdotal evidence suggests this may be the case.
Greenberg has actively been involved in working to reduce infant mortality rates in Hamilton County, where Cincinnati is located, as a co-founder of Cradle Cincinnati.
He said the county has seen a steep decrease in infant mortality since 2013 from being 70% above the national average to being right around the national average in 2023 by focusing on reducing infant mortality related to pre-term birth and improving Black infant mortality.
Efforts include promoting smoking cessation and getting pregnant people into early prenatal care by eliminating barriers in vulnerable communities.
“Our experience in Hamilton County suggests that it is possible to accelerate the reduction in infant mortality, and that it’s worth doing because infant mortality is really a signal for overall health and well-being of the whole country,” he said. “It’s not just babies. It’s a reflection of our health care system, and our ability to deliver health care effectively. It’s our reflection of our ability to do it in a way that people everywhere value and can embrace.”
