Case Report: Paucisymptomatic College-Age Population as a Reservoir for Potentially Neutralization-Resistant Severe Acute Respiratory Syndrome Coronavirus 2 Variants

To better understand the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant lineage distribution in a college campus population, we carried out viral genome surveillance over a 7-week period from January to March 2021. Among the sequences were three novel viral variants: BV-1 with a B.1.1.7/20I genetic background and an additional spike mutation Q493R, associated with a mild but longer-than-usual COVID-19 case in a college-age person, BV-2 with a T478K mutation on a 20B genetic background, and BV-3, an apparent recombinant lineage. This work highlights the potential of an undervaccinated younger population as a reservoir for the spread and generation of novel variants. This also demonstrates the value of whole genome sequencing as a routine disease surveillance tool.

SARS-CoV-2 Infections and Viral Isolations among Serially Tested Cats and Dogs in Households with Infected Owners in Texas, USA

Understanding the ecological and epidemiological roles of pets in the transmission of SARS-CoV-2 is critical for animal and human health, identifying household reservoirs, and predicting the potential enzootic maintenance of the virus. We conducted a longitudinal household transmission study of 76 dogs and cats living with at least one SARS-CoV-2-infected human in Texas and found that 17 pets from 25.6% of 39 households met the national case definition for SARS-CoV-2 infections in animals. This includes three out of seventeen (17.6%) cats and one out of fifty-nine (1.7%) dogs that were positive by RT-PCR and sequencing, with the virus successfully isolated from the respiratory swabs of one cat and one dog. Whole-genome sequences of SARS-CoV-2 obtained from all four PCR-positive animals were unique variants grouping with genomes circulating among people with COVID-19 in Texas. Re-sampling showed persistence of viral RNA for at least 25 d-post initial test. Additionally, seven out of sixteen (43.8%) cats and seven out of fifty-nine (11.9%) dogs harbored SARS-CoV-2 neutralizing antibodies upon initial sampling, with relatively stable or increasing titers over the 2–3 months of follow-up and no evidence of seroreversion. The majority (82.4%) of infected pets were asymptomatic. ‘Reverse zoonotic’ transmission of SARS-CoV-2 from infected people to animals may occur more frequently than recognized.

SARS-CoV-2 B.1.1.7 variant of concern detected in a pet dog and cat after exposure to a person with COVID-19, USA

As part of a longitudinal household transmission study of pets living with persons with COVID‐19 in Texas, two pets were confirmed to be infected with the SARS‐CoV‐2 B.1.1.7 variant of concern (VOC). The pets were a dog and a cat from the same household, sampled two days after their owner tested positive for COVID‐19. The oral, nasal and fur swabs for both pets tested positive for SARS‐CoV‐2 by qRT‐PCR and consensus whole‐genome sequences from the dog and cat were 100% identical and matched the B.1.1.7 VOC. Virus was isolated from the cat's nasal swab. One month after initial detection of infection, the pets were re‐tested twice at which time only the fur swabs (both pets) and oral swab (dog only) remained positive, and neutralizing antibodies for SARS‐CoV‐2 were present in both animals. Sneezing by both pets was noted by the owner in the weeks between initial and follow‐up testing. This study documents the first detection of B.1.1.7. in companion animals in the United States, and the first genome recovery and isolation of B.1.1.7 variant of concern globally in any animal.

Natural SARS-CoV-2 infections, including virus isolation, among serially tested cats and dogs in households with confirmed human COVID-19 cases in Texas, USA

The natural infections and epidemiological roles of household pets in SARS-CoV-2 transmission are not understood. We conducted a longitudinal study of dogs and cats living with at least one SARS-CoV-2 infected human in Texas and found 47.1% of 17 cats and 15.3% of 59 dogs from 25.6% of 39 households were positive for SARS-CoV-2 via RT-PCR and genome sequencing or neutralizing antibodies. Virus was isolated from one cat. The majority (82.4%) of infected pets were asymptomatic. Re-sampling of one infected cat showed persistence of viral RNA at least 32 d-post human diagnosis (25 d-post initial test). Across 15 antibody-positive animals, titers increased (33.3%), decreased (33.3%) or were stable (33.3%) over time. A One Health approach is informative for prevention and control of SARS-CoV-2 transmission.

Association between health insurance coverage and uptake of seasonal influenza vaccine in Brazos County, Texas

BACKGROUND

Lack of health insurance may limit access to influenza vaccination, resulting in higher risk of infection.

METHODS

The Brazos County Health Department obtained medical records summarizing vaccination and health insurance status of all influenza cases occurring in December 2017 (n = 417). The odds of influenza vaccination were estimated for those with public or private health insurance as compared to uninsured individuals using multivariate logistic regression analysis adjusted for age and race.

RESULTS

Health insurance coverage among Brazos County residents with influenza was 62.4%. Public and private health insurance was associated with higher odds of influenza vaccination compared to no insurance (aOR: 2.05; 95% CI: 1.00-4.21 and aOR: 1.77; 95% CI: 1.07-2.92, respectively), particularly among adults 18-64 years of age.

CONCLUSIONS

Influenza vaccination is strongly associated with health insurance. Expansion of programs that facilitate access to health services or provide free influenza vaccines may improve influenza prevention among the uninsured.

Demographic Determinants of Influenza Vaccination and Infection, Brazos County, Texas, 2017

BACKGROUND

Seasonal influenza constitutes an enormous public health burden. The 2017-2018 influenza season was the most severe since the 2009 novel Influenza A (H1N1) pandemic. The State of Texas, like other states, experienced unusually high and persistent influenza activity.

METHODS

Data on confirmed cases of influenza and influenza-like illness (ILI) in Brazos County during December 2017 were collected by the Brazos County Health Department (BCHD) from medical records. Records of vaccine administered between January 1 and December 31, 2017 were collected from vaccination providers. The total number of influenza cases for 2017 was compiled from regular weekly influenza counts reported to BCHD by healthcare providers.

RESULTS

A total of 1651 cases of laboratory-confirmed influenza were reported in Brazos County residents in December 2017, 10 times more than that reported in December 2016. The highest rates of infection were in 2 ZIP codes where vaccination rates were also high. A total of 16 027 influenza vaccinations were given to individuals reporting a residential address in Brazos County in 2017. Vaccination coverage was lowest among adults aged 18 to 49, whereas those aged 65 or older and Hispanics were most likely to be hospitalized.

DISCUSSION

Overall, vaccination coverage in Brazos County, Texas is low, less than half of the Healthy People 2020 target. The development of health education materials and an increased use of social media, local television and radio, and communication methods that can reach parents, younger adults, and Hispanic residents are needed.

Use of the Community Assessment for Public Health Response (CASPER) method to assess influenza vaccination and activity in Brazos County, Texas

OBJECTIVES

Based on an increase in influenza cases in Brazos County, Texas, a Community Assessment for Public Health Emergency Response (CASPER) was conducted by the Brazos County Health Department (BCHD) and the Texas A&M School of Public Health's EpiAssist program. The goal of the CASPER was to supplement other data sources to assess vaccination rates and influenza prevalence in the community during a period of high influenza activity nationwide.

METHODS

Using the Centers for Disease Control and Prevention's (CDC) CASPER toolkit, 30 census blocks in Brazos County were selected probability proportionate to population size. Seven interviews were attempted in each selected census block by an interview team. The survey contained 21 questions in 5 domains, including demographics, general infection control knowledge, prior infection with influenza, prior experience with influenza vaccine, and attitudes towards influenza vaccination. Survey results were entered into a database for the calculation of frequencies, crude odds ratios (OR), and 95% confidence intervals (CI).

RESULTS

Two-hundred and seven households completed the survey. Estimated vaccination rates in Brazos County adults were higher than Texas adults overall, but rates did not differ among children. Forty-two (20.4%) of respondents reported having influenza illness during the month of December 2017. Overall, respondents were knowledgeable of influenza transmission and prevention and reported few barriers and objections to the vaccine; however, some responses suggest misinformation that could be addressed through communication from local health departments exists. African American/Black respondents were less likely to receive a vaccine than respondents of other races, while individuals age 65 and over as well as those who believed the vaccine to be effective were more likely to be vaccinated.

CONCLUSION

CASPER should be considered a tool for assessing influenza vaccine and disease status of communities and has potential for providing information useful in the development of public health initiatives.