Clinical outcomes in cancer patients with COVID-19 in Sweden.

BACKGROUND: The results of studies on the relationship between cancer and COVID-19 have been conflicting and therefore further studies are needed. We aimed to examine the incidence of COVID-19 among patients at one of the largest oncology departments in Sweden, and to evaluate and identify risk factors for poor outcomes, hospital care and death, associated with COVID-19 among cancer patients. MATERIAL AND METHODS: This retrospective study included cancer patients at a single center who tested positive for SARS-CoV-2 by PCR either in hospital, primary health care center or commercial laboratory between 1 March and 14 August 2020. Clinical and demographic data were collected from the medical records. Logistic regression analysis was used to identify variables that associated the primary outcomes of need for hospital care and death within 30 days of positive test. RESULTS: Of 10,774 patients from the Department of Oncology at Sahlgrenska University Hospital, 135 tested positive for SARS-CoV-2 (1.3%). Twenty-eight patients were excluded from further the data collection since they did not meet the inclusion criteria. Altogether, 107 cancer patients were included and the case fatality rate (CFR) was 12% (13) within 30 days of confirmed SARS-CoV-2 infection by PCR. Increasing years of age (OR 1.10; CI 95% 1.03-1.18), palliative treatment intent (OR 15.7; CI 95% 1.8-135.8), and transition to end-of-life care (OR 52.0; CI 95% 3.7-735.6) were associated with increased odds of death within 30 days. Male sex was associated with needing hospital care (OR 3.7; CI 95% 1.50-9.1). CONCLUSION: As in the general population, male sex was found to be at greater risk of needing hospital care for COVID-19, with terminal cancer disease, and older age increasing the odds of fatality. Compared to the general population, slightly more cancer patients had COVID-19. The CFR was within the lower range of others reported in cancer patients.

An outbreak of hepatitis A among primary and secondary contacts of an international adoptee.

The Advisory Committee on Immunization Practices recommends that susceptible people traveling to developing countries receive hepatitis A vaccine or immune globulin prior to departure. Until 2009, the recommendations did not address non-traveling family members or other close contacts of international adoptees. We report an outbreak of hepatitis A in 2008 that occurred in Maine. Eight members of an extended family developed hepatitis A following the arrival of an asymptomatic infant from Ethiopia who was brought to the United States by an adoption agency. Two children in the family attended an elementary school where five additional cases of hepatitis A were subsequently identified. Only three (1%) of 208 students at the school had previously been immunized against hepatitis A. This outbreak highlights the need to immunize household members and other close contacts of families adopting children from countries where hepatitis A is endemic, as well as all children at one year of age.

Assessment of measures to prevent disease associated with animals in agricultural fairs--Maine, 2008.

BACKGROUND: Outbreaks of enteric disease associated with animal exhibits have been reported with increasing frequency. Visitors at venues that permit contact with animals can become exposed by direct animal contact or by contact with environmental surfaces. The Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, issued by the National Association of State Public Health Veterinarians (NASPHV), provides recommendations to minimize risks associated with animals in public settings. METHODS: An observational study of Maine agricultural fairs was conducted to determine whether the recommendations provided by the NASPHV were being utilized. RESULTS: Visitors had direct contact with animals that are potential sources of enteric pathogens. Eating and drinking were permitted while interacting with animals and, with the exception of strollers, there were no exclusions on items being brought into the exhibits. Few exhibits provided visitors with educational messages regarding disease risk and prevention measures (3%). There were insufficient handwashing signs (18%) and handwashing stations available at animal exhibits (38%) and midways (20%). None of the venues were designed with 1-way visitor flow. CONCLUSION: The results from this survey suggest that the recommendations provided by the NASPHV are not being fully implemented at agricultural fairs in Maine.