NEWS SCAN: Treatment for EHEC neuropathy, GI infections in UK, more Colorado listeriosis, Korea dumps smallpox vaccine, RSV season

Sep 8, 2011

Rescue therapy found helpful for EHEC neurological complications
German doctors who treated patients who had serious neurological complications from Escherichia coli O104:H4 infections linked to contaminated fenugreek sprouts had success using immunoglobulin G (IgG) immunoadsorption as a rescue therapy, the group reported in The Lancet. While treating patients hospitalized with severe infections along with hemolytic uremic syndrome (HUS), they observed that neurologic complications usually arose about a week after diarrhea onset, which led them suspect an immune-related mechanism. They also noticed that patients with neurologic complications did not respond to therapeutic plasma exchange or the complement-blocking antibody eculizumab. Their prospective, noncontrolled trial of immunoadsorption therapy involved 12 patients whose symptoms included delirium, myoclonus, aphasia, altered consciousness, and seizure. Ten of the patients had neurologic symptoms despite repeated treatment with plasma exchange. Eight had received eculizumab. Doctors performed 38 immunoadsorption procedures. Though doctors saw rapid improvement, some patients needed more than one treatment after their symptoms recurred. After the second of two applications, the doctors administered intravenous IgG to prevent hypogammaglobulinemia. Patients tolerated the treatment well, though one patient's pneumonia infection worsened.
Sep 5 Lancet abstract

Study estimates intestinal infections in UK at 17 million per year
British scientists estimate that nearly 17 million intestinal infections occur in the United Kingdom each year, with norovirus as the leading culprit, the UK Food Standards Agency (FSA) reported this week. The agency said the total represents about one case for every four people. About half of those who get sick take time off from work or school, leading to an estimated 19 million days lost, including 11 million work days. The study, led by the University of Manchester, looked at all infectious intestinal illnesses, not just those linked to food, and other studies suggest that the majority of such cases are not foodborne, officials said. In noting that norovirus was the most common cause of intestinal infections, the FSA said noroviruses spread both directly from person to person and via food. The researchers also found that Campylobacter was the most common bacterial cause of intestinal infections, numbering about 500,000 a year. A recent FSA survey found that about two thirds of retail poultry samples in the UK were contaminated with Campylobacter, the agency said. In comparison with a similar study in the mid 1990s, the new study suggests that the rate of intestinal infections is about 43% higher now, the statement said.
Sep 6 FSA press release

Colorado Listeria cases reach 13
Colorado officials today confirmed that 4 more listeriosis cases have occurred in the state over the past several days, raising the total to 13, including 2 deaths, but the outbreak source remains unknown and no link between cases has been established, according to the Denver Post. Cases have been reported since Aug 1 in Adams, Arapahoe, Boulder, Denver, Douglas, El Paso, Jefferson, Larimer, and Weld counties. Colorado typically sees about 10 cases of foodborne Listeria infection over an entire year, according to the state health department. Public health workers are conducting trace-back investigations to identify whether there is a common source of infection, although it is still "way too early to identify a cause," said Bernadette Albanese, medical director for El Paso County Public Health in Colorado Springs. One of the deaths occurred in that county, but the location of the other death has not been released.
Sep 8 Denver Post article

Toxicity tests prompt South Korea to destroy smallpox vaccine doses
South Korea is destroying 1 million doses of smallpox vaccine in its national stockpile after tests on guinea pigs this summer found high toxicity, making them unfit for human use, Chosun Ilbo, a newspaper based in Seoul, reported yesterday. The doses, part of a 7 million dose stockpile the country keeps in the event of a biological weapons attack from North Korea, were produced in 2009 by a domestic producer and had not reached their expiration date, according to the report. The information came from data from the Korea Food and Drug Administration that was released by Lee Jae-sun, a Liberty Forward Party lawmaker.  Another 4.95 million doses of smallpox vaccine that South Korea's government bought between 2003 and 2008 have expired, according to the newspaper report.
Sep 7 Chosun Ilbo story

RSV season varies among US regions, according to CDC data
The US respiratory syncytial virus (RSV) season last winter lasted from late November to early April nationwide, but it varied widely by region in both 2010-11 and over the past 4 years, according to a Centers for Disease Control and Prevention (CDC) report today. The report, compiled from data collected by the National Respiratory and Enteric Virus Surveillance System (NREVSS), appears in the CDC's Morbidity and Mortality Weekly Report (MMWR). RSV is the leading cause of pneumonia and bronchiolitis in infants but causes less serious disease in older populations. After excluding data from Florida, which experiences a markedly earlier and more prolonged season, the authors found that the national RSV season onset in 2010-11 was the week ending Nov 27, 2010, the season concluded during the week ending Apr 9, 2011, and the peak week ended Feb 5. That compares with a 4-year median of mid November, late March, and late January, respectively. Onset for the 10 US regions ranged from mid November to early January, and the season's end ranged from mid March to late April. The 4-year medians among regions excluding Florida were as early as mid October for onset and as late as early May for season's end. The report said the NREVSS data can be used to guide local vaccination timing.
Sep 9 MMWR report

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