NEWS SCAN: E coli developments, raw-milk illnesses, Pakistan's avian flu efforts, cowpox infection, scarlet fever in Hong Kong, food safety campaign

Jun 28, 2011

E coli infections shutter German school
German officials closed a primary school in the western town of Altenbecken today after several students got sick with the Escherichia coli strain responsible for a large ongoing outbreak, Reuters reported. Officials suspect the illnesses are related to poor hygiene among students or school cafeteria workers, rather than bean sprouts, which have been implicated in the larger outbreak. The school's illnesses involve three boys and four food workers. In another development, Swedish officials said today that they have identified the country's first E coli O104:H4 case with no direct link to Germany, according to an Associated Press (AP) report. So far it's not clear how the patient became infected. Meanwhile, the European Centre for Disease Prevention and Control (ECDC) reported 104 more E coli infections, including five with hemolytic uremic syndrome (HUS), a serious kidney complication. One new death was reported. The new cases push Europe's outbreak total to 4,023 cases, including 885 with HUS and 48 deaths. Today's total includes a cluster of French patients who got sick after attending an event where sprouts from a local French source were served, raising suspicions that contaminated sprout seeds might be the outbreak source. So far nine French patients with E coli have been hospitalized, including eight with HUS. The ECDC said four more suspected cases have been identified and are under investigation.
Jun 28 Reuters story
Jun 28 ECDC update

Campylobacter cases in Alaska tied to raw milk
Alaska officials are investigating four cases of Campylobacter infection in people who drank raw milk obtained through a cow-share program in south central Alaska, the state Department of Health and Social Services announced yesterday. Alaska regulations ban the sale of raw milk, but milk obtained through cow-share programs is not subject to that restriction or to testing requirements, the department said in a Jun 27 press release. In a Jun 27 epidemiology bulletin, state health officials said all four patients obtained milk from the same cow-share farm in the Matanuska-Susitna Valley, and their C jejuni isolates had matching DNA fingerprints. Three of the people got sick in May and one in June. Two of them reported that a total of three other family members who drank the milk also got sick but didn't seek medical care. Environmental health officials tested a sample of milk from the farm in May and found no Campylobacter but did find Listeria, according to the bulletin. The farm owner distributed a listeriosis fact sheet to shareholders on Jun 1, and on Jun 21 distributed a health advisory about the Campylobacter outbreak. State officials took another milk sample at the farm on Jun 22; results were still pending. Officials said anyone who has consumed raw milk since March and thereafter had an acute gastrointestinal illness should contact the state Section of Epidemiology at 907-269-8000.
Jun 27 epidemiology bulletin

Pakistan to decentralize avian flu efforts
Pakistan's government plans to hand over avian influenza control efforts to provinces at the end of June, the Lahore-based Daily Times newspaper reported yesterday. Currently, avian influenza surveillance, prevention, and response are handled by the National Programme for the Control and Prevention of Avian Influenza. The report said disease experts oppose the change, because provinces don't have the lab facilities to test for avian flu viruses or the resources to perform other functions. Experts have also raised concern that not having samples examined at a lab approved by the World Organization for Animal Health (OIE) may threaten Pakistan's avian flu–free status as defined by the OIE, which is important for poultry exporters. A federal planning advisor, however, denied that provinces are unable to handle avian flu control duties, according to the report.
Jun 27 Daily Times story

Contact with pet rats led to severe cowpox infection
A 27-year-old French woman suffered a severe earlobe infection with cowpox virus, a relative of the smallpox virus, as a result of contact with infected pet rats, according to an "in press" report published online by the Journal of Infection. The woman bought two pet rats, imported from the Czech Republic, which quickly got sick and died. A few days after the rats died, she sought care for an inflammatory lesion on her left earlobe. The woman was treated unsuccessfully with antibiotics, and the lesion spread to the skin of her neck and cheek. Eventually she was hospitalized and underwent surgery to excise extensive necrotic tissue at the site of the original lesion and smaller ones on one finger and her abdomen. The doctors sent specimens to the French Armed Forces Biomedical Research Institute, which, after a series of tests, identified the pathogen as cowpox virus. It was later learned that other pet rats from the same store had also fallen ill and died. The report says that wild rodents, not cows, are now considered the true reservoir for cowpox virus, and that in recent years several human cowpox infections have resulted from contact with pet rats, though humans are more commonly infected through contact with cats, which are incidental hosts. The authors say the cessation of smallpox vaccination may partly explain the reemergence of cowpox in humans, as the vaccine probably induced some immunity to other orthopoxviruses.
J Infect report title and authors

Scarlet fever surge in Hong Kong likely to persist
The current upsurge of scarlet fever cases in Hong Kong was the subject of a joint meeting today of two scientific committees of the Center for Health Protection (CHP) of the Department of Health there. The committees reported that infrequent cases have an atypical presentation and that the high activity of scarlet fever will likely persist further into the summer. Overall epidemiologic and clinical characteristics of the cases resemble those in past outbreaks, and the case-fatality rate is not significantly increased, the group said. The reasons for the current outbreak are being investigated, with attention to any association with the new Group A streptococcus clones with altered genetic characteristics. The committees also advised that antibiotics should be used judiciously to prevent the development of bacterial resistance and that patients with runny nose but no fever should not be treated with antimicrobials. Surveillance for scarlet fever has been stepped up, and radio announcements and other educational efforts are being undertaken ahead of the coming summer holidays.
Committees' statement

US launches campaign to prevent foodborne disease
A new national multimedia public-service campaign called Food Safe Families was launched today with the goal of reducing food-related illnesses in homes. The campaign, which coincides with the summer grilling and outdoor-eating season, is a joint effort of the US Department of Agriculture's Food Safety and Inspection Service, the Food and Drug Administration, the Centers for Disease Control and Prevention, and the Ad Council. Aimed at making consumers pay attention to their food-handling practices, a series of actions called "Check Your Steps" urges them to focus on four key precautions: clean, separate, cook, and chill.
Jun 28 FoodSafety.gov announcement
Check Your Steps Web page

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