Food Outbreak Scan for Jun 16, 2016

News brief

Study finds similarity in outbreak and sporadic foodborne illnesses

Foodborne illness patterns are generally similar when comparing outbreaks with sporadic infections, except in some instances for children, according to an analysis of the characteristics of four bacteria monitored by surveillance sites that are part of the US FoodNet system.

Researchers from the US Department of Agriculture (USDA), Centers for Disease Control and Prevention (CDC), and Food and Drug Administration (FDA) reported their findings yesterday in Emerging Infectious Diseases. The pathogens they explored were Campylobacter, Escherichia coli O157, Listeria, and Salmonella.

They said it's not possible to directly compare exposures for both types of illnesses, but to come up with an estimate they looked at demographic, clinical, temporal, and geographic patterns for outbreak and sporadic illnesses.

For Campylobacter, E coli, and Listeria, outbreak and sporadic illnesses were similar for severity, sex, and age. However, Salmonella illnesses for the two groups were only similar for severity and sex, with lower percentages of outbreak illnesses seen in the youngest age-group, children up to age 3 years. They also found some differences by season in reported Salmonella cases.

The researchers concluded that differences among FoodNet sites in outbreak and sporadic illnesses might reflect differences in reporting practices. They noted that the analysis is limited but still useful—similarities between the two groups wouldn't necessarily imply identical food exposures, but big differences in disease characteristics might point to different food exposures.

The information could be useful for making food safety decisions and monitoring the impact of interventions, they said.
Jun 14 Emerg Infect Dis study

Multistate Salmonella outbreaks caused by turtles increasing, CDC says

An analysis of US salmonellosis outbreaks linked to pet turtles revealed an increasing incidence, high impact on children and Hispanics, and low knowledge of the connection between small turtles and Salmonella risk, according to a report published yesterday in Emerging Infectious Diseases.

CDC researchers detailed 15 multistate outbreaks from 2006 through 2014, comprising 191 illnesses, 156 hospitalizations, and 1 death, in an infant. They ranged from 4 to 135 lab-confirmed cases, with a median of 44. In all outbreaks the median age was less than 10 years.

The year 2012 was especially bad for salmonellosis caused by turtles, the authors noted, with eight outbreaks accounting for 473 illnesses and a total cost of $2.8 million. Among 191 patients for whom information was available, 85 (45%) said they were Hispanic. Turtles with shells less than 4 inches long, which are illegal to sell in the United States, accounted for 124 (88%) of 141 cases.

In addition, only 14 of 95 patients (15%) were aware that reptiles can carry Salmonella. That compares with 20% in a 2007-08 outbreak and 27% in a 2008 outbreak.

Slowing the trend of salmonellosis caused by turtle exposure, especially in children, will take a One Health approach involving human, animal, and environmental health officials as well as the turtle industry and the retail pet industry, the authors conclude. They also underscored the importance of public health awareness campaigns in English and Spanish.
Jun 15 Emerg Infect Dis report

News Scan for Jun 16, 2016

News brief

ECDC report describes severe enterovirus outbreak in Spain

An outbreak of an especially large and severe enterovirus A71 (EV-A71) outbreak in kids younger than 10 in Spain's Catalonia region that began in the middle of April has so far sickened 87, with 22 still in the hospital, the European Centre for Disease Prevention and Control (ECDC) said today in a risk assessment.

Children sickened in the outbreak have had neurologic symptoms, the ECDC said. Most cases have resolved, with the exception of the hospitalized patients, which includes seven in intensive care units. So far no other European countries are reporting enterovirus outbreaks or any indications of the illness.

The ECDC warned that the epidemiologic pattern of EV-A71 in Europe is changing because of molecular evolution and increasing likelihood of new imported virus strains. It said the EV-A71 outbreak in Spain and earlier reported EV-D68 clusters affirm the need for vigilance of hand, foot, and mouth disease (HFMD) that manifests with more severe clinical symptoms. It urged doctors to obtain specimens for patients under assessment for neurologic conditions such as meningitis or acute flaccid paralysis as well as HFMD.

Enterovirus D68 was implicated in a large outbreak in US children in the fall of 2014, with more than 1,550 illnesses reported, 115 involving acute flaccid myelitis. Fourteen deaths were reported.
Jun 16 ECDC rapid risk assessment

India launches vaccine drive after polio strain found in sewage

India will launch an extensive immunization campaign after a non-vaccine strain of polio was found in sewer water in Hyderabad, capital of the southern state of Telangana, according to media reports yesterday.

The vaccination drive will begin Jun 20, officials said, with the aim of reaching about 300,000 children in parts of Hyderabad and in Rangareddy district in the state, the New York Times reported, citing health ministry officials.

"We have to avoid any kind of risk, even though nobody has been affected," said Rajeshwar Tiwari, the principal secretary for the Ministry of Health in Telangana. "We want to remain a polio-free nation." India was declared polio-free in 2014.

G. Srinivasa Rao, a health official in southern Telangana, said the strain of polio found in the sewage likely originated from a virus in an oral vaccine that mutated after it was administered to a child , Agence France-Presse reported. "Most likely a child released it through stool who must have been vaccinated a year ago. Such rare cases happen in children with low immunity," he said.

Vaccine is being flown in from Geneva because local supplies are inadequate, AFP noted. It will cover all polio strains, the Times story added.
Jun 15 New York Times story
Jun 15 AFP report

Novartis continues partnership to help develop malaria drug

Swiss-based drug maker Novartis said yesterday it will expand its long-standing partnership with Medicines for Malaria Venture (MMV) for developing its experimental antimalarial compound KAF156.

MMV will supply scientific and financial support in collaboration with the Bill & Melinda Gates Foundation, Novartis said in a press release.

KAF156 belongs to a novel class of antimalarial molecules and is one of the first antimalarial drug candidates to enter Phase 2b clinical development in more than 20 years, the company said. It acts against the two parasites responsible for most malaria deaths: Plasmodium falciparum and P vivax. It also might provide a more convenient dosing regimen and possibly address the multidrug resistance problem that has emerged in recent years in five Southeast Asia countries, Novartis said.

"Partnerships and collaborations like this one with MMV are essential for the development of next generation antimalarials and accelerating efforts to eradicate this deadly disease," said Novartis CEO Joseph Jimenez.
Jun 15 Novartis press release