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Compared with reverse-transcription polymerase chain reaction (RT-PCR) testing, dogs can detect COVID-19 infections via scent with high sensitivity (97%)—though lower specificity (91%)—even when patients are asymptomatic, according to a study in PLOS One yesterday.

Scientists in Paris collected nasopharyngeal, saliva, and sweat samples (from participants' armpits) from 335 outpatients, 143 of whom had COVID-like symptoms and 192 of whom did not. Of the 335, 109 patients tested positive for COVID-19 via RT-PCR and 226 tested negative. Of the 109 volunteers with lab-confirmed COVID-19, 78 had symptoms and 31 did not.

Trained dogs correctly identified 106 of the 109 COVID-positive patients and 206 of the 226 COVID-negative patients. That translates to an overall sensitivity of 97% (95% confidence interval [CI], 92% to 99%), which reached 100% (95% CI, 89% to 100%) in asymptomatic patients compared with RT-PCR from nasopharyngeal swabs. The dogs' specificity was 91% (95% CI, 72% to 91%), reaching 94% (95% CI, 90% to 97%) in asymptomatic patients. That compares with 84% sensitivity and 97% specificity for nasopharyngeal antigen testing.

The study authors conclude, "Our results show the excellent sensitivity of SARS-CoV-2 detection by dogs using nasopharyngeal RT-PCR as the reference for comparison. These results are consistent with the results obtained previously in proof of concepts studies using sweat in hospitalized patients."

The authors cite four studies conducted in 2020 and 2021, but an additional study published just last month demonstrated how trained dogs can detect COVID-19 in airline travelers. Jun 1 PLOS One study

In its weekly update yesterday, the US Centers for Disease Control and Prevention (CDC) reported that investigations are under way into 30 more unexplained hepatitis cases in children, raising the nation's total to 246. The number of affected states and jurisdictions remained the same, at 38.

The CDC has said that many of the recently reported cases are retrospective, with the probe covering illnesses experienced since October 2021.

More than 650 potential cases have been reported in 33 countries, the World Health Organization (WHO) said last week in its latest update. So far, a definitive cause hasn't been established, but a possible role for adenovirus is a strong lead. The CDC and other groups are also examining other infections, such as COVID-19, as well as other types of exposures, including toxins. Jun 1 CDC update

The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) today reported the first highly pathogenic avian flu outbreak in Georgia of the year, which affected a backyard flock and brought the number of states reporting the virus in poultry to 36.

Georgia's outbreak occurred at a location housing 409 birds in Toombs County, about 90 miles west of Savannah. The state had previously reported the virus in wild birds, but not since the end of March.

In other avian flu developments, the APHIS reported two more outbreaks, both in backyard birds. One occurred in Minnesota's Becker County and the other struck a flock in Washington's Snohomish County. Jun 2 USDA APHIS announcement USDA APHIS poultry avian flu outbreak page

China reported two more H9N2 avian flu cases, both in people who had been exposed to live-poultry markets, according to a statement from Macao's Health Service that was translated and posted by Avian Flu Diary (AFD), an infectious disease news blog.

Both patients are children who had mild infections. One is a 5-year-old boy from Hunan province whose symptoms began on Apr 26, and the other is a 2-year-old boy from Guizhou province who got sick on May 8.

H9N2 is known to circulate in poultry in some Asian countries. Most of the human cases have been reported from China. The infections are most common in children, who typically experience mild illnesses. The country had reported four H9N2 cases earlier this year. Jun 2 AFD post

Iraq is experiencing a spike in Crimean Congo hemorrhagic fever (CCHF) activity this year, with cases reported across several governorates, the WHO said yesterday.

Though CCHF, a viral disease usually passed by ticks, is endemic in Iraq, the number of cases reported in the first 5 months of the year is much higher than reported in 2021. So far, 212 cases have been reported, 97 of them lab-confirmed. There have been 27 deaths, 13 of them among patients with lab-confirmed infections.

For comparison, the country reported 33 lab-confirmed cases in 2021.

Most of the patients had contact with animals and were livestock breeders or butchers. Half of the cases were in Thiquar governorate in the southeast. Besides transmission from ticks, the virus can be transmitted through contact with blood or tissues from infected people or livestock.

The WHO said there is a risk of further spread in Iraq because of an upcoming religious holiday, when more animals will be slaughtered. It added that the situation poses a cross-border risk due to holiday travel. Iraq's cases increased in March and April in connection with Ramadan observances. Jun 1 WHO announcement

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