Covid 19 Resources Center

From Airfinity’s curated analysis of various health and media sources, the US CDC, and the ECDC (European Centre for Disease Prevention and Control) Weekly Communicable Disease Threats Report:

• H5N1-infected dairy herds continue to be reported across the US.
• Two cases of A(H5N1) infection have been reported in Cambodia in two children living under the same roof.
• In Europe, the lowest number of highly pathogenic avian influenza (HPAI) cases in poultry and wild birds has been recorded since 2019/2020 and the risk to the general public remains low.

• COVID-19:
• The disease burden in Japan has been steadily increasing, not so much in terms of hospitalization rates.
• Following a period of very low SARS-CoV-2 circulation, there is evidence of increased COVID-19 activity since May in several EU/EEA countries, especially among people aged 65 years or more.
• Vaccination continues to be protective, with stronger protection against more severe disease, although this protective effect wanes over time. Vaccine protection of individuals at high risk of severe outcomes (such as older people) remains important.
• The currently circulating and largely dominating SARS-CoV-2 variant in Europe is BA.2.86, including subvariants carrying R346T and/or F456L mutations, often referred to in the media as FLiRT. These variants are not expected to be associated with increased infection severity or to significantly reduce vaccine effectiveness.

From Airfinity’s curated analysis of various health and media sources and from the ECDC (European Centre for Disease Prevention and Control) Weekly Communicable Disease Threats Report:

• The outbreak of highly pathogenic avian influenza (HPAI) A(H5N1) in cattle is still ongoing, with 69 farms affected across nine states of the US.
• As of today, there have been three human cases of avian influenza A(H5N1) reported in workers at US dairy farms with infected cows.
• No meat from affected dairy cows has entered the food supply.
• To date, routine population-based surveillance has not detected any increase in community rates of respiratory infections.

• Hospitals in the US are no longer required to report COVID-19 hospitalisations. Meanwhile, reported COVID-19 oral antiviral uptake and COVID-19 hospitalisations correlate well with SARS-CoV-2 wastewater concentration, indicating that wastewater can provide suitable metrics.

• There has been a global post COVID-19 pandemic resurgence of pertussis, also known as whooping cough. Pertussis is caused by a highly contagious bacterium and typically has a cyclical pattern returning every 3 to 5 years, varying by country. Whooping cough is preventable with a 3-dose vaccine (which also includes diphtheria and tetanus) given to small children, but recent vaccine hesitancy has resulted in an unexpected comeback of the disease. Since vaccine coverage is lowest in Africa and Oceania, these continents could be at highest risk.

• Measles cases have been detected in at least 118 countries worldwide since the start of the year.  According to the US CDC, travellers to areas where measles has been surging  are at risk if they have not been fully vaccinated at least two weeks prior to departure or have not had measles in the past. The majority of measles cases imported into the US have occured in unvaccinated residents who became infected during international travel.

• Thirteen cases of invasive meningococcal disease (IMD) serogroup W have been reported from France, Norway, UK, and US. The cases are epidemiologically linked to religious practices in the Umrah zones in the Kingdom of Saudi Arabia (KSA). International spread of IMD associated with mass gatherings during pilgrimages in the KSA has been reported in the past. Vaccination against meningococcus is recommended for those travelling to KSA to perform Umrah and for Hajj pilgrims – this year, the annual Islamic Hajj pilgrimage will take place between 14 and 19 June.

We start with cabin air research:

- In response to the question: “Is there evidence of exposure to chemical contaminants in cabin air that could have long-term health impacts, either from acute exposures or due to long-term low level exposures including mixtures, e.g., of volatile organic compounds (VOCs)?”, the UK Committee on the Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) issued earlier in April a Statement on Aircraft Cabin Air Quality. You can read it here: https://cot.food.gov.uk/sites/default/files/2024-04/Aircraft%20Cabin%20Air%20statement%202024%20Acc%20V%20SO_0.pdf

You will also find a non-technical summary here: https://cot.food.gov.uk/Statement%20on%20Aircraft%20Cabin%20Air%20Quality%20%E2%80%93%20Non-technical%20Summary

The Committee assessed the new evidence, since their previous 2007 Statement. “Overall, the COT concluded that the concentrations of the chemical contaminants (organophosphates, VOCs including as mixtures, carbon monoxide and CO₂) reported in aircraft cabin air are unlikely to cause adverse health effects in aircrew following acute or long-term exposures. However, there is still limited information about the levels of chemicals in cabin air following smoke or fume events.”

- More specifically in relation to smoke or fume events, a team led by researchers from the Ruhr University Bochum Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, published their work – also known as the FUSE II study - on biomonitoring of VOCs and organophosphorus (OP) flame retardants in commercial aircrews after “fume and smell events“. They assessed exposure to VOCs and OPs in 375 aircrew members after self-reported “fume and smell events”, as well as in 88 persons of the general population. Twenty blood and urine parameters were analysed. They concluded that “comparative VOC and OP analyses in biological samples of a large number of aircrew members and controls suggest that exposures are similar in both groups and generally low”. You can read the article in full here: https://authors.elsevier.com/sd/article/S1438-4639(24)00062-2

- In the same field, here is a reminder of the ANSES (French Agency for Food, Environmental and Occupational Health & Safety) report published at the end of last year - an extensive review of the scientific literature, as well as of the grey literature and of health data from the French national occupational disease surveillance and prevention network. The ANSES reached the same conclusion as the US National Research Council (NRC) in 2002: “there is a low level of evidence for the existence of a syndrome specifically linked to exposure to various polluting substances or breakdown products from aircraft engine or hydraulic fluid leaks”. More research is ongoing.  Short summary in English here: https://www.anses.fr/en/content/health-flight-crew-members . If you would like to review the details, look up the Medical Contact Group email of 20-Dec-2023.

From Airfinity’s curated analysis of various health and media sources and from the ECDC (European Centre for Disease Prevention and Control) Weekly Communicable Disease Threats Report:

• All indicators point to elevated but decreasing influenza activity in Europe. SARS-CoV-2 activity has remained low in Europe as well.

• The COVID-19 burden is in decline in the US and Japan.

• RSV activity has continued to decrease to low levels in most reporting countries worldwide.
• A total of four cases of avian influenza A(H9N2) have been reported in children in mainland China in February-March. H9N2 infections are usually related to contact with poultry or their environments. They are typically mild and affect children.

• Avian influenza A(H5N1) has been detected for the first time in US mammalian livestock – in goats in a Minnesota farm. Cases of highly pathogenic avian influenza (HPAI) have been detected in dairy cows in farms in Kansas, Texas, and New Mexico. At this stage, there is no concern about the safety of the commercial milk supply.

• Measles continues to surge in parts of Europe, with the highest number of cases in the UK, Romania, and Austria. A surge of measles is also ongoing in North America, with a vaccine shortage in Canada due to increased demand. Elsewhere, DRC and Kyrgyzstan, among other countries in Africa and Asia, are also facing significant outbreaks. Cases of measles have been reported so far this year in a total of 83 countries globally.

• Over half a million cases of malaria have been reported recently in Madagascar. Risk is expected to remain very high into April.

• So far this year, approximately 70.000 cases of chikungunya have been reported worldwide, in a total of 16 countries, namely in the Americas (11), Asia (4), and Africa (1).

• Since the beginning of 2024 over two million dengue cases and over 500 dengue-related deaths have been reported globally – see the ECDC Three-month dengue virus disease case notification rate per 100.000 population (Dec 2023-Feb 2024) map below:
  
  

From Airfinity’s curated analysis of various health and media sources and from the ECDC (European Centre for Disease Prevention and Control) Weekly Communicable Disease Threats Report:

• The burden of COVID-19 has begun to decline in the US and across Europe, while increasing in Mexico as the COVID-19 winter wave continues.

• JN.1 seems to be the current dominant variant in almost all G20 nations. Notable exceptions are Japan, South Korea and China, where JN.1 is rising but EG.5.1.1 remains dominant, and Russia, where XBB.1.16 is still dominant.

• In December 2023, the WHO classified JN.1 as a Variant of Interest (VOI) due to its rapidly increasing spread. Current evidence, meanwhile, shows that the risk to public health from this strain at the global level is low. JN.1 is a sublineage of BA.2.86.1 and contains the L455S mutation in the spike protein, which is associated with very high immune escape but significantly attenuated infectivity. In vitro data suggest that vaccines are still effective against JN.1.

• In most of Europe, rates of respiratory illness in the community remained elevated and at levels above baseline. Seasonal influenza is now circulating at higher levels than SARS-CoV-2 and respiratory syncytial virus (RSV).

Here is another update carrying on from last week. In the previous update I introduced to you the French Agency for Food, Environmental and Occupational Health & Safety (ANSES) report on cabin air quality and occupational health of air crew, which you can access here https://www.anses.fr/fr/system/files/AIR2019SA0075Ra.pdf (in full, in French) and here https://www.anses.fr/en/content/health-flight-crew-members  (short summary in English).

The report concludes that there is a low level of evidence for the existence of a syndrome specifically linked to exposure to various polluting substances or breakdown products from aircraft engine or hydraulic fluid leaks, and that there is no consensus to date around whether “aerotoxic syndrome” corresponds to an actual nosological entity (i.e. a syndrome or a disease).

The ANSES report also addressed the potential effects of irregular hours and ionising radiation. Here is a sum-up of the report’s conclusions.

Published data regarding commercial airline pilots and cabin crew confirm a lower incidence of a number of malignancies than in the general population, in particular cancer of the lungs, bladder, kidney, colon, brain and mouth. The incidence of testicular, colorectal and thyroid cancer was found to be similar to that in the general population, while the small number of published studies and failure to take into account potential but relevant confounding factors do not allow for a conclusion regarding the risk of prostate or breast cancer.