Monitoring and Characteristics of Mpox Contacts, Virginia, USA, May-November 2022.

During 2022, a global outbreak of mpox resulted primarily from human-to-human contact. The Virginia Department of Health (Richmond, VA, USA) implemented a contact tracing and symptom monitoring system for residents exposed to monkeypox virus, assessed their risk for infection, and offered interventions as needed. Among 991 contacts identified during May 1-November 1, 2022, import records were complete for 943 (95.2%), but 99 (10.0%) were not available for follow-up during symptom monitoring. Mpox developed in 28 (2.8%) persons; none were healthcare workers exposed at work (n = 275). Exposure risk category and likelihood of developing mpox were strongly associated. A total of 333 persons received >1 dose of JYENNOS (Bavarian Nordic, https://www.bavarian-nordic.com) vaccine, most (n = 295) administered after virus exposure. Median time from exposure to vaccination was 8 days. Those data tools provided crucial real-time information for public health responses and can be used as a framework for other emerging diseases.

One Health Investigation into Mpox and Pets, United States.

Monkeypox virus (MPXV) is zoonotic and capable of infecting many mammal species. However, whether common companion animals are susceptible to MPXV infection is unclear. During July 2022-March 2023, we collected animal and environmental swab samples within homes of confirmed human mpox case-patients and tested for MPXV and human DNA by PCR. We also used ELISA for orthopoxvirus antibody detection. Overall, 12% (22/191) of animal and 25% (14/56) of environmental swab samples from 4 households, including samples from 4 dogs and 1 cat, were positive for MPXV DNA, but we did not detect viable MPXV or orthopoxvirus antibodies. Among MPXV PCR-positive swab samples, 82% from animals and 93% from environment amplified human DNA with a statistically significant correlation in observed cycle threshold values. Our findings demonstrate likely DNA contamination from the human mpox cases. Despite the high likelihood for exposure, we found no indications that companion animals were infected with MPXV.

Coronavirus Disease among Workers in Food Processing, Food Manufacturing, and Agriculture Workplaces.

We describe coronavirus disease (COVID-19) among US food manufacturing and agriculture workers and provide updated information on meat and poultry processing workers. Among 742 food and agriculture workplaces in 30 states, 8,978 workers had confirmed COVID-19; 55 workers died. Racial and ethnic minority workers could be disproportionately affected by COVID-19.

Update: COVID-19 Among Workers in Meat and Poultry Processing Facilities - United States, April-May 2020.

Meat and poultry processing facilities face distinctive challenges in the control of infectious diseases, including coronavirus disease 2019 (COVID-19) (1). COVID-19 outbreaks among meat and poultry processing facility workers can rapidly affect large numbers of persons. Assessment of COVID-19 cases among workers in 115 meat and poultry processing facilities through April 27, 2020, documented 4,913 cases and 20 deaths reported by 19 states (1). This report provides updated aggregate data from states regarding the number of meat and poultry processing facilities affected by COVID-19, the number and demographic characteristics of affected workers, and the number of COVID-19-associated deaths among workers, as well as descriptions of interventions and prevention efforts at these facilities. Aggregate data on confirmed COVID-19 cases and deaths among workers identified and reported through May 31, 2020, were obtained from 239 affected facilities (those with a laboratory-confirmed COVID-19 case in one or more workers) in 23 states.* COVID-19 was confirmed in 16,233 workers, including 86 COVID-19-related deaths. Among 14 states reporting the total number of workers in affected meat and poultry processing facilities (112,616), COVID-19 was diagnosed in 9.1% of workers. Among 9,919 (61%) cases in 21 states with reported race/ethnicity, 87% occurred among racial and ethnic minority workers. Commonly reported interventions and prevention efforts at facilities included implementing worker temperature or symptom screening and COVID-19 education, mandating face coverings, adding hand hygiene stations, and adding physical barriers between workers. Targeted workplace interventions and prevention efforts that are appropriately tailored to the groups most affected by COVID-19 are critical to reducing both COVID-19-associated occupational risk and health disparities among vulnerable populations. Implementation of these interventions and prevention efforts† across meat and poultry processing facilities nationally could help protect workers in this critical infrastructure industry.

SARS-CoV-2 vaccine breakthrough infections in Virginia, January 17, 2021 - June 30, 2021.

As COVID-19 vaccines moved from the controlled environment of clinical trials to use in real-world settings, it has been important to evaluate vaccine effectiveness. A retrospective cohort study was designed to identify cases of SARS-CoV-2 infection that occurred between January 17-June 30, 2021 in fully vaccinated Virginia residents. Of the fully vaccinated population of Virginia at the end of the study period (N = 4,271,505), 2445 (0.057 %) were reported to have experienced a vaccine breakthrough infection. Of those, 183 (7.5 %) were reported to have been hospitalized for COVID-19 and 53 (2.2 %) died from COVID-19. There were significant differences in vaccine effectiveness over time between both mRNA vaccines and the Janssen vaccine. Increasing age, pre-existing medical conditions, and male sex were associated with severe outcomes (hospitalization or death). Persons at greater risk for severe outcomes should continue to take precautions to prevent SARS-CoV-2 infection, even if fully vaccinated.

Career stage differences in mental health symptom burden and help seeking among veterinarians during COVID-19.

OBJECTIVE: To explore veterinarians' mental health symptom burden during COVID-19 and identify differences in symptom burden, social support, help seeking, and incentives and barriers associated with receiving help across career stages. SAMPLE: Online survey responses from 266 veterinarians between June 4 and September 8, 2021. PROCEDURES: Respondents were grouped by career stage (early [< 5 years of experience], middle [5 to 19 years of experience], or late [≥ 20 years of experience]), and results were compared across groups. RESULTS: Of the 262 respondents who reported years of experience, 26 (9.9%) were early career, 130 (49.6%) were midcareer, and 106 (40.4%) were late career. The overall mean anxiety and depression symptom burden score was 3.85 ± 3.47 (0 to 2 = normal; 3 to 5 = mild; 6 to 8 = moderate; and 9 to 12 = severe), with 62 of 220 (28.1%) respondents reporting moderate to severe symptom burden. Most (164/206 [79.6%]) reported not accessing behavioral health providers, and of these, 53.6% (88/164) reported at least mild symptom burden. There were significant differences in both symptom burden and mental health help-seeking intentions across career stages, with early- and midcareer (vs late-career) veterinarians reporting higher symptom burden (P = .002) and midcareer (vs late-career) veterinarians reporting higher help-seeking intentions (P = .006). Barriers and incentives for seeking mental health care were identified. CLINICAL RELEVANCE: Findings revealed differences in symptom burden and intentions to seek mental health care across veterinary career stages. Incentives and barriers identified serve to explain these career stage differences.

Veterinarians show resilience during COVID-19: challenges faced and successful coping strategies.

OBJECTIVE: To identify challenges veterinarians faced during the COVID-19 pandemic, explore how they coped, identify coping strategies associated with greater resilience, and determine incentives and barriers to performing healthy coping behaviors. SAMPLES: 266 surveys completed by veterinarians in the Potomac region. PROCEDURES: A cross-sectional survey was distributed electronically through veterinary medical boards and professional associations between June and September 2021. RESULTS: Most survey responses came from veterinarians working in Maryland (128/266 [48%]) and Virginia (63/266 [24%]) who were predominantly white (186/266 [70%]), female (162/266 [61%]), and working in small-animal clinical practice (185/266 [70%]). The greatest workplace challenges experienced were increased workloads (195/266 [73%]) and reevaluating existing workflows (189/266 [71%]). Separation from loved ones (161/266 [61%]) was the greatest personal challenge. Of the veterinarians who completed the 10-point Connor-Davidson Resilience Scale (n = 219), which measures resilience on a scale from 0 (no resilience) to 40 (greatest resilience), the mean score was 29.6 (SD, 6.9), with a median of 30 (IQR = 10). Intrinsic factors most strongly associated with greater resilience were increasing age (P = .01) and later career stage (P = .002). Job satisfaction, autonomy, good work-life balance, and approach-focused coping strategies were positively associated with resilience. Overwhelmingly, the primary reported barrier to performing healthy coping behaviors was limited time to devote to self-care (177/266 [67%]). CLINICAL RELEVANCE: A combination of individual approach-focused coping strategies and organizational interventions are crucial to support a resilient veterinary workforce.

Cryptosporidium parvum outbreak associated with Raccoons at a Wildlife Facility-Virginia, May-June 2019.

Cryptosporidium parvum is a parasitic zoonotic pathogen responsible for diarrheal illness in humans and animals worldwide. We report an investigation of a cryptosporidiosis outbreak in raccoons and wildlife rehabilitation workers at a Virginia facility. Fifteen (31%) of 49 facility personnel experienced symptoms meeting the case definition, including four laboratory-confirmed cases. Seven juvenile raccoons were reported to have diarrhoea; six had laboratory-confirmed cryptosporidiosis. Cryptosporidium parvum of the same molecular subtype (IIaA16G3R2) was identified in two human cases and six raccoons. Raccoon illness preceded human illness by 11 days, suggesting possible zoonotic transmission from raccoons to humans. This appears to be the first report of a human cryptosporidiosis outbreak associated with exposure to raccoons infected with C. parvum. Raccoons might be an under-recognized reservoir for human C. parvum infections. Further study is needed to explore the prevalence of cryptosporidial species in raccoons and their role as a wildlife reservoir.

Caribbean small ruminant importation requirements in an era of widespread anthelmintic resistance.

Resistance of small ruminant gastrointestinal parasites to available classes of anthelmintic drugs is a widespread problem. As such, use of these drugs needs to be applied in a judicious manner in order to protect animal health. Herein, a case of drug-resistant gastrointestinal nematodes imported to the Cayman Islands is outlined. In order to explore the potential for similar occurrences within the region, a survey was undertaken in March 2017 to assess the importation requirements for small ruminants to English-speaking Caribbean countries. The survey showed that universal administration of anthelmintics to small ruminants is a common pre-requisite for importation to the Caribbean region, though very few countries require any proof of drug efficacy. Such requirements are discordant with current recommendations for judicious anthelmintic use in domestic animal species and promote the continued development of anthelmintic resistance. While this survey focused on small ruminants, similar policies are often in place for the importation of a variety of animal species, including cattle, horses, and companion animals. Given that anthelmintic resistance is also recognized in parasite populations that impact these species, it may be time for the international community to revisit live animal importation requirements in the age of anthelmintic resistance. Some recommendations and considerations are put forward to help preserve animal health, animal welfare, and developing animal agricultural industries.

Prevalence of heartworm infection in the feral cat population of Grand Cayman.

OBJECTIVES: The aim of this study was to determine the presence and prevalence of heartworm infection in the feral cat population of Grand Cayman. METHODS: During the study period, feral cats were routinely trapped and euthanized for population control by the municipal animal shelter. Cats older than 6 months of age were obtained for post-mortem examination shortly after euthanasia. The heart, lungs, pulmonary vasculature, thoracic and abdominal cavities were examined for the presence, location and number of mature heartworms. Sections of caudal lung were evaluated histologically and serologic tests were performed to screen for additional evidence of heartworm exposure. RESULTS: Mature heartworms were identified in the pulmonary vasculature of 4/36 cats (11.1%). An additional nine cats showed histopathologic changes in the lungs consistent with heartworm exposure, and one cat had a positive antibody test. CONCLUSIONS AND RELEVANCE: The results indicate a minimum heartworm prevalence of 11.1% within this population of feral cats, consistent with published necropsy reports from other endemic localities. Considering the histopathologic changes observed in this group, the true prevalence is likely higher and underscores the importance of heartworm prevention for the companion cat population of the island.