Bacterial Infection Brucella Canis Suspected in Dogs in Iceland

The Icelandic Food and Veterinary Authority (MAST) has reason to suspect that a bacterial disease called Brucella canis has been found in dogs in Iceland. RÚV reports that Bruncella canis can—in very rare instances—be transmitted from dogs to humans, with young children, pregnant, and immunocompromised people at the greatest risk of serious infection. This is the first time that Brucella canis has been detected in Iceland.

MAST veterinarian Vigdís Tryggvadóttir was quick to clarify that as yet, it is not certain that Bruncella canis actually is in Iceland, although there is a very high likeliness of this. “We have a strong suspicion, but it’s still only a suspicion,” she said. “We’ve sent samples abroad for confirmation, and hopefully, it won’t be [Brucella canis]. But [results] could take up to two weeks.”

In the meantime, MAST has enacted some protocols to curb the spread of infection. Relevant parties have been told to quarantine animals suspected of being infected with Brucella canis and a mating ban has been instated where appropriate. The agency is also collecting samples and information to trace possible spread and is urging dog breeders to observe the strictest level of infection prevention while assisting with whelping. Breeders are also encouraged to contact their veterinarian if a dog miscarries late in gestation or gives birth to stillborn puppies or puppies that die shortly after birth.

Dog breeders and vets at highest risk of exposure, minimal risk for others

Brucella canis is a zoonotic bacterial disease, which means it can be passed from animals to people. In a recent announcement, MAST said its most prominent symptoms in female dogs are miscarriages late in gestation, as well as puppies that are stillborn or die soon after birth; for male dogs, swollen testicles. The most common mode of transmission between dogs is mating.

It is rare for people to become infected with Brucella canis, but the biggest risk of infection is via fluids and tissue when helping an infected dog give birth. This puts dog breeders and veterinarians at the highest risk of infection, says Vigdís, while nearly everyone else has almost no risk of exposure.

In the very unlikely case of infection, symptoms of Brucella canis within people include fever, chills, malaise, loss of appetite, bone and/or muscle pain, and swollen lymph nodes. Symptoms may appear within several days or as much as a month after infection. The disease is not generally transmittable between people.

First time suspected in Iceland

This is the first time that Brucella canis has been suspected of being in Iceland, but it is a very common disease in nearby nations. “Brucella canis is endemic in many countries in Europe and also Asia and further afield,” said Vigdís. “It’s never been diagnosed here and it’s rare in some other European countries. We’ve never had it here and want, of course, to keep it outside our borders.”

Vigdís concluded by saying that even if a case of Brucella canis is confirmed in Iceland, that doesn’t mean an epidemic is breaking out.

Increase in COVID Admissions, But Infections Much Milder

Iceland National Hospital COVID-19

As many as 150 new cases of COVID-19 are being diagnosed every day in Iceland and the number of patients admitted to the hospital for COVID infection is also rising incrementally, RÚV reports. While there are a considerable number infections all throughout Iceland, however, Chief Epidemiologist Þórólfur Guðnason says that fortunately, these cases are much, much milder amongst those who are vaccinated.

Fortunate as well, says Þórólfur, is that the stress on Iceland’s health system is not nearly what it was at the height of the pandemic, when there were 88 patients in the COVID ward at once. There were only two people in Landspítali’s COVID ward at the start of May, which increased to nine patients on Thursday, and 16 on Friday. Admissions are mostly elderly patients and those with underlying conditions, but as the infections are not as acute, none of those currently in the hospital are on ventilators.

“There’s no doubt about it, of course we would have liked for the vaccine to prevent infection,” Þórólfur remarked. “It doesn’t do that, but what it does do, first and foremost, is prevent serious illness. If we didn’t have this widespread vaccination, particularly amongst older age groups, I think we’d have much worse infections and more people in the hospital.”

COVID-hit Iceland loses to Denmark at European Handball Championship

Handball

The Icelandic men’s national handball team suffered a defeat at the hands of Denmark last night. Six Icelandic players tested positive for COVID-19 the night before the game, the first match of the European Handball Championship’s main round. 

Rough news following a smooth start

Following a positive start to the European Handball Championship, which saw the Icelandic men’s national handball team win all three of its matches in the preliminary round, the squad suffered a four-point defeat to Denmark last night. The match was the first game of the tournament’s main round.  

On the evening before the game, news broke that three Icelandic players had tested positive for COVID-19: goalkeeper Björgvin Páll Gústavsson, centre-back Elvar Örn Jónsson, and left back Ólafur Andrés Guðmundsson. More bad news broke on the following morning when it was revealed that captain Aron Pálmarson and winger Bjarki Már Elísson had also tested positive. The final blow arrived just a few hours before the game against Denmark; centre-back Gísli Þorgeir Kristjánsson also tested positive. 

The players have little to no symptoms, according to reports.

Critical of tournament organisers

In an interview with Vísir yesterday, Bjarki Már Elísson criticised the tournament organisers for not doing enough to minimise the risk of infection:  

“We’ve been doing everything in our power to avoid infection; we’ve been holed up in our hotels since January 2,” who added that the team had been prepared for the worst after the first three players tested positive.”

“The conditions at the hotel are such that there are tourists and other guests staying alongside us, which, personally, I find absurd. But, of course, there are fans in the stadiums, and we’re doing interviews, so you’re always at some risk. Perhaps it was to be expected,” Bjarki continued. 

“I suppose what’s most disappointing, however, is that tournament organisers didn’t provide better conditions. Ensure that we were more isolated, that there aren’t other people staying at the hotels; all of the teams are eating in the same places, too. This allows infection to spread, and it was expected, but it is also extremely disappointing.”

A tough schedule ahead

Iceland will play its second match of the main round tomorrow, Saturday, January 22. The team will face off against France, the reigning Olympic Champions, with Iceland’s President Guðni Th. Jóhannesson expected to be in the stands. The following two games are against Croatia on Monday (January 24) and Montenegro on Wednesday (January 26). 

New COVID-19 Study Provides Both “Assurance and Alarm”

COVID-19

A new study published yesterday in the New England Journal of Medicine, examining the spread of the SARS-CoV-2 virus among the Icelandic populace (via targeting testing and by open-invitation and random-population screening), found that children under the age of ten had a lower incidence of SARS-CoV-2 infection than adolescents or adults and that females had a lower incidence than males. The researchers also noted that many individuals who tested positive reported having no symptoms (although symptoms almost certainly developed later among some of them). The study was a collaboration between researchers at deCODE genetics, Iceland’s Directorate of Health, and the National University Hospital.

Targeted Testing

COVID-19 was first diagnosed in Iceland on February 28. Testing, however, had begun a month earlier, on January 31, 2020, with individuals deemed to be at high risk for SARS-CoV-2 infection being targeted. These included mainly persons who were already symptomatic (cough, fever, body aches, and shortness of breath), who were returning to Iceland from regions classified as high risk by the health authorities, or who had been in contact with infected persons.

Roughly 6% of the nation tested

As of April 4, 2020, over 22,000 Icelandic residents had been tested for SARS-CoV-2 or roughly 6% of the entire populace. Of the 9,199 individuals who had been targeted for testing, 1,221 tested positive for SARS-CoV-2 (13.3%). Of the 13,080 individuals tested through population screening, 100 tested positive (0.8%): 87 of the 10,797 (0.8%) individuals who accepted an open invitation for testing and 13 of 2,283 (0.6%) individuals who were invited at random. Most individuals in the targeted-testing group who received positive tests early on in the process had recently travelled internationally, in contrast to those who tested positive later in the study.

Results

The study found that within the targeted-testing group, children under the age of ten were less likely to test positive for SARS-CoV-2 than individuals tens years of age or older (6.7% compared to 13.7%). In the population-screening group, no child under ten tested positive, compared to 0.8% of those ten years of age or older. Furthermore, a smaller percentage of females than males received positive results both in the targeted-testing group (11.0% vs. 16.7%) and in the population-screening group (0.6% vs. 0.9%).

The study suggests that as the proportion of infected individuals identified through population screening did not “change substantially during the screening period,” the containment efforts of the Icelandic authorities proved effective. These efforts include the testing of symptomatic individuals, which began one month before the first confirmed SARS-CoV-2 case in Iceland, along with various social-distancing measures that were imposed roughly two weeks after the first confirmed case. Furthermore, all participants who tested positive for SARS-CoV-2 were required to self-isolate until ten days after their fever had subsided (or until they tested negative), and all persons who were in contact with individuals who tested positive were required to self-quarantine for two weeks.

Assurance and alarm

The researchers note that the prevalence of SARS-CoV-2 infection among persons at high risk for infection and the stability of the infection rate in the general population provide “grist for both assurance and alarm,” as a large portion of those who tested positive reported no symptoms:

“Symptoms were common both in participants who tested positive and in those who tested negative for SARS-CoV-2 in the overall population-screening group. Notably, 43% of the participants who tested positive reported having no symptoms, although symptoms almost certainly developed later in some of them. During the study, the prevalence of symptoms decreased considerably in both testing groups (despite the stability of the SARS-CoV-2 infection rate), probably owing to a general decrease in other respiratory infections, which in turn may have been brought about through measures implemented to decrease the spread of SARS-CoV-2.”

Recently, CEO of DeCODE genetics Kári Stefánsson spoke to Iceland Review and shed light on the spread of the novel coronavirus in Iceland. For further information on the state of the COVID-19 epidemic in Iceland click here.

More Recovering from COVID-19 than Newly Infected

COVID-19 Press conference Þórólfur Guðnason Alma Möller V'iðir Reynisson

The number of people recovering from COVID-19 in Iceland is greater than that of people being newly diagnosed with the virus. “As things stand, I think we can say that we have reached the peak,” reported Chief Epidemiologist Þórólfur Guðnason at the daily COVID-19 press conference on Wednesday.

This means that Iceland now likely has a basic reproduction number (R0) of less than 1. R0 is used to measure the transmission potential of a disease and measures secondary transmission in a susceptible population, i.e. how many people each infected individual is infecting.

“As it stands, the epidemic is now on the decline, I think we can say,” continued Þórólfur, “but it’s absolutely clear that this is in no small part due to [our] response and this could change with a new batch of infections if people don’t take care.”

Indeed, said Director of Health Alma Möller, the news that Iceland had reached the peak with new infections is very welcome, but she also cautioned that the stress on the health care system probably wouldn’t reach its peak for another 10 days or so.

A particularly heartening finding, however, is that there has been very little community transmission in Iceland of late. Of the individuals tested on Tuesday, only .07% had the virus; that means that one out of the 1,284 samples taken was due to a community transmission.

The epidemic appears to be following the best predictions of the model produced by scientists at the University of Iceland, the National University Hospital, and the Directorate of Health, says Þórólfur. The only exception to this is with the number of hospitalized patients. Þórólfur said the model had been very helpful to health authorities.

Þórólfur also reported that a diagnostic machine in the National Hospital’s microbiology and immunology division, which had been broken, is now fixed. This means that it will possible to speed up sample analysis.

At time of writing, Iceland had 1,648 confirmed infections, with 40 individuals hospitalized and 11 in intensive care. Six hundred and eighty-eight COVID-19 patients had recovered; six have died.

Health officials project that social distancing measures and the gathering ban will start being relaxed on May 4, but nothing certain would be announced until after Easter. “We’re sticking to that date and the speed with which we relax these measures will depend on how things are progressing,” concluded Þórólfur.

Measles Vaccination Initiative Underway

landspitali national university hospital iceland

3000 doses of measles vaccination have been sent to the country to combat the measles outbreak which started recently. A substantial operation is now underway in both the Reykjavík capital area as well as East Iceland to combat the spread of measles, focusing on 6 to 18-month-old children as well as unvaccinated adults.

The vaccination operation is a preventive measure first and foremost. So far, the operation has been a success, according to Óskar Reykdalsson, head of the health centres in the capital area. Around 1000 individuals were vaccinated in the capital area today. “It went well today. We had 19 health centres open today and we received somewhere around 1000 people. It was mostly children, and some amount of unvaccinated adults, but first and foremost children between six to eighteen months old,” Óskar stated.

Public health services have called for all individuals who have not been vaccinated to head immediately to their closest health center. It is expected that the 3000 vaccination doses will all have been used by the end of the weekend. More doses will be sent to the country in the beginning of next week.

Every person who has not been vaccinated should head to a health centre as soon as possible to get vaccinated for measles. Children that are between six to eighteen months old, along with those born after 1970, will have precedence.

The fifth case of measles in the country has already been confirmed as a kindergarten worker in Egilsstaðir, East Iceland, got infected. The person has now been put into isolation.

Further information in Icelandic about the vaccination initiative can be found here. Measles information is also available by calling the phone number 1700.

London to Reykjavík Flight Passengers Exposed to Measles

Passengers flying from London to Reykjavík on February 14 and on Air Iceland Connect from Reykjavík to Egilsstaðir may have been exposed to the measles during their flights, RÚV reports. Iceland’s Chief of Epidemiology has been in touch with all the passengers who were onboard both flights, and those passengers who show any symptoms of the measles are encouraged to seek medical attention, particularly those who have never been vaccinated against it.

The affected flights were Icelandair FI455 and Air Iceland Connected NY356. Icelandair spokesperson Ásdís Ýr Pétursdóttir has confirmed that one passenger, who was travelling from the Philippines, has been infected with the measles. This discovery then initiated a standard protocol in collaboration with the Chief of Epidemiology regarding passenger notification.

People who may have been exposed to the virus are advised to be on the lookout for fever, cold symptoms, red eyes, and/or a rash. The website for the Directorate of Health advises any passengers on board either of the effected flights to be on the lookout for symptoms until March 7. The announcement also states that individuals with the measles are only contagious after symptoms begin to manifest and are then contagious for 7 – 10 days afterwards. In general, measles symptoms manifest 10 – 14 days after initial infection, but can still do so after as long as three weeks.

People who have already been vaccinated against the measles need not be vaccinated again, but those who have not, may be vaccinated within six days of infection. Measles vaccinations are available at local health clinics.

This is not the only time that a passenger has travelled through Iceland with the measles virus of late. In June, a passenger flying from Ukraine to Toronto via Berlin and Reykjavík was also found to have had the virus, triggering a similar notification from the Chief of Epidemiology and a vaccination advisory.

The Chief of Epidemiology considers it unlikely that there will be an outbreak of the measles in Iceland, as 95% of the Icelandic public is vaccinated against the virus.

Herring Infection Worsens

A considerable number of the herring catch that’s been landed in recent days has been found to be infected, RÚV reports. As such, almost all of it will be incinerated. The infection has plagued Iceland’s summer-spawning herring on and off for the last decade.

Four fishing companies have sent ships to fish in waters west of Iceland and have then landed their herring catch at Vopnafjörður and Neskaupstaður in Northeast Iceland, Hornafjörður in Southeast Iceland, as well as in the Westman Islands. At three of four locations, the majority of the herring catch had to be incinerated. At Hornafjörður, however, it was actually possible to process and freeze a good portion of the catch. The rate of infection seems then to depend on where the fish has been caught.

“Unfortunately, this is what we feared after the last expeditions that went out last winter,” remarked Þorsteinn Sigurðsson, the head of the Peleagic Division of the Marine and Freshwater Institute. “We saw how high the rate of infection was in all of the cohorts we’d tracked. So this is unfortunately consistent with the projections we had.”

At first, the infection was only in older herring cohorts, while the younger cohorts remained healthy. This gave observers the hope that the infection would eventually disappear, and for a time, it did decline. But in the last two years, the infection has been detected in younger herring cohorts and the situation is now worsening again.