Enlarge / The director of Germany's National Reference Centre for Invasive Fungal Infections holds a petri dish containing the yeast Candida auris in a laboratory at Wuerzburg University. (credit: Getty | Nicolas Armer )

A deadly, drug-resistant fungus emerging in the US gained ground faster and picked up yet more drug resistance amid the COVID-19 pandemic, researchers at the Centers for Disease Control and Prevention reported Monday.

The yeast Candida auris has been considered an "urgent threat"—the CDC's highest level of concern—since it was first reported in the US in 2016. The yeast lurks in health care settings and preys upon vulnerable patients, causing invasive infections with a fatality rate of between 30 to 60 percent.

In 2019, before the pandemic began, 17 states and Washington, DC, reported a total of 476 clinical cases. But in 2020, eight additional states reported cases for the first time, with the national clinical case count jumping 59 percent to 756. In 2021, 28 states were affected, with the clinical case count nearly doubling to 1,471. Asymptomatic cases detected through patient screening also jumped amid the pandemic, tripling from 1,310 cases in 2020 to 4,041 cases in 2021. The data appeared Monday in the Annals of Internal Medicine.

Enlarge / A microscope image of Streptococcus pyogenes , a common type of group A strep. (credit: Getty | BSIP )

In the wake of the COVID-19 pandemic and amid a tall wave of respiratory viruses, health officials in Colorado and Minnesota documented an unusual spike in deadly, invasive infections from Streptococcus bacteria late last year, according to a study published this week by the Centers for Disease Control and Prevention .

The spike is yet another oddity of post-pandemic disease transmission, but one that points to a simple prevention strategy: flu shots.

The infections are invasive group A strep , or iGAS for short, which is caused by the same group of bacteria that cause relatively minor diseases, such as strep throat and scarlet fever. But iGAS occurs when the bacteria spread in the body and cause severe infection, such as necrotizing fasciitis (flesh-eating disease), toxic shock syndrome, or sepsis. These conditions can occur quickly and be deadly.

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Surviving a bout of COVID-19 can significantly increase the risk of developing a range of long-term gastrointestinal symptoms and conditions—from constipation and diarrhea to chronic acid reflux, pancreatitis, and inflammation of the bile ducts—according to a study published this week in Nature Communications .

The study likely confirms what many long COVID patients already know all too well. But the analysis is among the largest and most comprehensive to evaluate the boost in relative and absolute risks, drawing on medical records from more than 11,652,484 people in the Department of Veterans Affairs databases.

The study was led by clinical epidemiologist Ziyad Al-Aly at the VA Saint Louis Health Care System in Saint Louis. With colleagues, Al-Aly examined medical records of over 154,000 people who had COVID-19 between March 2020 and January 2021. The researchers then compared the COVID survivors' rates of gastrointestinal problems in the year after their infection to the rates seen in two control cohorts. One was a contemporary cohort of over 5.6 million people who went from the March 2020 to January 2021 without any evidence of a COVID-19 infection. The other was of 5.8 million people who were tracked for a year before the pandemic, which served as a control for unreported COVID-19 cases in the contemporary cohort.

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The US Centers for Disease Control and Prevention updated its pandemic guidance today, offering slightly looser recommendations that likely won't change much about how Americans handle the pandemic these days.

According to the updated guidance , people who are not up-to-date on their vaccinations —i.e., unvaccinated people or people who have not received the recommended number of boosters—no longer need to quarantine if they know they've been exposed to someone with COVID-19. Instead, if a not up-to-date person is exposed, the CDC now recommends they wear a mask for 10 days after the exposure and get tested for COVID-19 on day 5. Currently, roughly 68 percent of the US population is not up to date on their COVID-19 vaccination.

This guidance update essentially ends all COVID-19-related quarantine recommendations since the CDC had previously said that those who are up to date on their vaccines do not need to quarantine but only wear a mask for 10 days and test.

Enlarge / A negative stain electron micrograph of a monkeypox virus virion in human vesicular fluid. (credit: Getty | BSIP )

On May 7, health officials in the UK reported a case of monkeypox in a person who had recently traveled to Nigeria. The case was very rare but not necessarily alarming; a small number of travel-related cases of monkeypox pop up now and then. The UK logged seven such cases between 2018 and 2021 . But this year, the cases kept coming.

By May 16, the UK had reported six additional cases, mostly unconnected, and all unrelated to travel, suggesting domestic transmission. On May 18, Portugal reported five confirmed cases and more than 20 suspected ones. The same day, health officials in Massachusetts reported the first US case . Spain, meanwhile, issued an outbreak alert after 23 people showed signs of the unusual infection. Cases in Italy and Sweden followed .

In the past, monkeypox transmission largely fizzled out on its own. Experts did not consider the virus to be easily transmissible. Still, the cases kept coming. By May 26, the multinational outbreak had exceeded 300 cases in over 20 countries. At the time, the US had only nine cases confirmed, but the Centers for Disease Control and Prevention announced that it presumed domestic community transmission was already underway. In early June, the global tally exceeded 1,300 from 31 countries, including 45 cases in the US.

Enlarge / California Gov. Gavin Newsom talks with 7th grade students at James Denman Middle School on October 01, 2021 in San Francisco, California. (credit: Getty | Justin Sullivan )

California Governor Gavin Newsom on Friday announced that the state will add COVID-19 vaccines to the list of immunizations students are required to get to attend in-person public and private schools.

California is the first state to announce such plans. COVID-19 vaccines will join the ranks of vaccine for measles, mumps, polio, hepatitis B, pertussis, tetanus, and chicken pox, which are already required for school attendance.

The mandate isn't immediate. The requirement will not kick in until the vaccine is fully approved by the Food and Drug Administration for school aged children. As such, the requirement will be phased in by grade groups—grades 7 through 12 and K-6—and begin at the start of the school term following full FDA approval.

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Enlarge / The US Food and Drug Administration in Silver Spring, Maryland. (credit: Getty | Xinhua News Agency )

Two top vaccine regulators have resigned from the Food and Drug Administration, revealing anger, frustration, and turmoil at the federal agency as it faces intensifying pressure to authorize COVID-19 vaccine booster shots and doses for children under the age of 12.

The two regulators leaving are Marion Gruber, director of the FDA’s Office of Vaccines Research and Review (OVRR), and OVRR Deputy Director Phil Krause. Gruber has been with the FDA for more than 30 years, and Krause has been at the agency for more than a decade.

Their resignations, first reported by pharmaceutical trade publication BioCentury , were apparently sparked by frustration that the Biden administration had overstepped the FDA in announcing plans to offer COVID-19 booster shots beginning on September 20. The pair also clashed with higher-up Peter Marks, who reportedly went along with the administration's plans. Marks is the director of the FDA's Center for Biologics Evaluation and Research (CBER), which includes the OVRR.

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Enlarge / Two classrooms had to be shut down due to a series of problems with maintaining policies meant to limit the spread of the pandemic. (credit: Andrew Lichtenstein / Getty Images )

On Friday, the CDC released a report that traced the spread of the Delta variant through a California elementary school. It's tempting to make this into a story of gross irresponsibility—a teacher was unvaccinated and read to the class while unmasked. But beyond that, it provides a number of warnings about how our public health system remains under stress as we close in on two years since the start of the pandemic. It also reemphasizes how the Delta variant ensures that small errors can easily explode into big problems.

One bad apple

The school in question was a small one, with only a bit over 200 students and 24 staff. It is an elementary school, meaning that its student population is also younger than the cutoff for approved vaccine use. The school did a number of things right, though. Class sizes were kept small, and individual classes were kept in separate rooms, with doors and windows kept open and air filtration equipment installed. There was also a standing policy requiring mask use in place.

But not everything was ideal. The CDC notes that two of the 24 staff members were unvaccinated. While the vaccinated can clearly transmit the Delta variant, they are likely to be less infectious, and in a worst case they'd be infectious for a shorter period of time.

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