• In today’s Recommendations for Industry, we look at the increasing cases of non-COVID workplace communicable diseases, including Legionella and norovirus. Read more below.

• Global COVID deaths rise sharply, led by surging Delta. Global COVID deaths last week were up more than 20.6%, with about 69,000 people across the world having died; cases increased by 6.5%. Southeast Asia is currently the epicenter, and a handful of countries in that region reported more record daily highs for cases, including Malaysia with 15,902, Thailand with 15,335, and Vietnam with 7,968. The global total topped 194 million cases, climbing to 194,139,772, with at least 4,158,700 deaths

• No anaphylaxis after second dose of mRNA COVID vaccine, study finds. People who had a severe allergic reaction to their first dose of mRNA COVID-19 vaccine had no issues after their second dose. Allergic reactions are estimated to occur in up to 2% of people after their first mRNA COVID-19 vaccine dose, with anaphylaxis reported in as many as 2.5 per 10,000 vaccinees. The most common first-dose allergic reactions were flushing or redness (28%), dizziness (26%), tingling (24%), throat tightness (22%), hives (21%), and shortness of breath or wheezing (21%). Thirty-two patients (17%) experienced anaphylaxis. Of the patients with first-dose reactions, 130 (69%) were to the Moderna vaccine, and 59 (31%) were to Pfizer.

• The US could see 200,000 Covid-19 cases a day within the next six weeks, former CDC director says. The US could see about four times the current rate of Covid-19 cases in the next four to six weeks as the Delta variant spreads and the population hits a wall on vaccinations. The last time there were more than 200,000 new US cases in one day was in January, according to Johns Hopkins University data. In August, California will require all state employees and health care workers to provide proof of vaccination status or get regular tests, Gov. Gavin Newsom said Monday. A similar requirement will be implemented in New York City, where all of the workforce for the city’s agencies, including schools, fire and police, will be given the choice between vaccination or regular testing.

• A new model suggests that the current surge of COVID-19 activity will continue to gain momentum and peak in October, with around 60,000 cases and 850 deaths each day. Amid the dire predictions, the American Medical Association, American Nurses Association, and 55 other medical groups have written a joint statement calling for mandatory vaccination of all US healthcare personnel against the coronavirus

• ‘We are now in crisis mode’: Mayor of Florida county home to Disney World sounds alarm on surging Covid cases. The mayor of the Florida county that’s home to Disney World and Universal Studios is sounding the alarm on a spike of Covid-19 cases in the area, saying the county is now in “crisis mode” as it grapples with its worsening infection rate. Over the past week, Florida accounted for nearly a quarter of all new cases in the United States – more than any other state.

• Thousands protest amid global anger against COVID restrictions. Tens of thousands of people across several countries, including France and Italy, have protested anti-COVID measures, with the French police using tear gas and water cannon to disperse protesters in the capital Paris. In France, an estimated 160,000 took to the streets. Thousands of people have also protested in London, against what they describe as an erosion of their civil liberties.

Public Health & Food Safety:

• WHO seeking data on heavy metals in food. The World Health Organization (WHO) has called for data on two heavy metals in a range of food types. The first covers methylmercury and total mercury in orange roughy, pink cusk-eel and all toothfish and the second is on lead in cereal-based foods and ready-to-eat meals for infants and young children; dried spices and culinary herbs; eggs; sugars and sugar-based candies. Both have a deadline of Oct. 15, 2021.

• Salmonella dominates outbreaks in Australia. More than 450 foodborne outbreaks were reported over a three-year period in Australia, according to a new study. There were 213 outbreaks attributed to a single food with 124 linked to consumption of eggs and egg-based dishes. Ten outbreaks affected more than 100 people. Six were due to Salmonella Typhimurium, three because of norovirus, and one with 125 patients was suspected to have been caused by a bacterial toxin in curried prawns. The largest Salmonella outbreak sickened 350 people due to potato salad with raw egg mayonnaise.

• Company initiates nationwide recall of cheese in Canada because of Listeria risk. Tree of Life Canada ULC is recalling Cahill’s brand “Original Irish Porter Cheese” because of possible Listeria monocytogenes contamination. The company distributed the cheese in the provinces of New Brunswick, Newfoundland and Labrador, Nova Scotia, Ontario, Prince Edward Island, and Quebec.

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Legionella and Norovirus Cases Increase as Employees Return to Work

As businesses gradually bring employees back to work, with many slated for fall returns, some are seeing a new increase in workplace communicable diseases including legionellosis and norovirus.

In last week’s newsletter article, we discussed the Oregon and Minnesota legionella outbreaks, and we are now seeing an increase in cases in Michigan as well with 107 cases reported in 25 counties between July 1 and 14. As stated by the Michigan Department of Health, “While increases in cases are often related to environmental factors, including heat and rainfall, this represents a 569% increase from referrals from the same period in 2020 (16 cases) and a 161% increase from referrals from the same period in 2019 (41 cases).” (Please see the TAG Public Health article for information on symptoms and recommendations.)

In addition to legionellosis, TAG has been receiving client questions about norovirus. The virus is of particular concern with more than 150 outbreaks already documented in the UK since May – about triple the number normally seen during this period. The UK increase is occurring primarily in UK settings, but is frequently passed in food settings. 

Norovirus causes vomiting and diarrhea, typically within 24 hours of exposure to viral particles from an infectious person. It is the #1 cause of foodborne illness but is not always associated with food. It occurs commonly in long-term care settings and in other situations where people gather. The virus is persistent and requires aggressive techniques to be inactivated.

Its spread could indicate that control practices are lax as the workforce returns to these settings, newly hired staff may not be as familiar with symptoms or the controls needed to keep transmission down – or all of the above.  It may also be that children (and others) are immunologically naive to some of the more “common” GI viruses that they would have been otherwise exposed to if schools and daycares remained in session.  Either way, there's a risk of these outbreaks spilling out into the broader population as cases increase.

With the US seeming to follow the UK in many things COVID and return to work, TAG advises businesses to retrain employees on sanitation practices and viral infection protections. We also recommend continuing to enforce COVID-19 protection practices that can help protect your workforce against other communicable diseases, such as norovirus.

For more information on norovirus, and what your business, and employees, can do about it, visit TAG’s Public Health webpage for a downloadable Fact Sheet with information and recommendations.

• In last Thursday’s Recommendations for Industry, we looked at TAG’s COVID-19 Risk Matrix to better understand what is happening around the country. Read more here.
• As global COVID-19 cases have risen by 12% in the last week (CIDRAP), the WHO chief is sounding the alarm that we may be going into the “early stages of another wave” (CNBC). Indonesia has become the epicenter of the new wave of COVID-19 in Asia (AP News). In fact, the Delta variant has now been detected in 124 countries!
• The Delta variant of COVID-19 now accounts for 83% of all U.S. COVID-19 cases. This is a huge increase, up 50% since the week of July 3.
• The S. Government Accountability Office released a new statement providing 15 recommendations around topics such as program integrity and preparedness for future public health emergencies. As part of this, the GAO also encouraged “the CDC work with stakeholders to have a plan for dealing with surges in laboratory testing. Second, it recommends that CDC analyze its needs for manufacturing and deploying diagnostic test kits during public health emergencies, which could result in establishing pre-emptive contracts with test kit manufacturers” (CIDRAP).
• India’s death toll is likely much higher than its current reported; instead, estimates put the death toll at 10 times higher than the official count – perhaps up to 3 or 4 million dead.