NEWS SCAN: Listeria death toll at 23, non-O157 E coli request, H1N1 vaccine events, resistant hospital infections, global TB drop

Oct 12, 2011

CDC reports 116 cases and 23 deaths in Listeria outbreak
Seven more illnesses and two additional deaths have been reported since Oct 6 in the outbreak of Listeria infections linked to cantaloupe, for a total of 116 cases and 23 deaths, the Centers for Disease Control and Prevention (CDC) said in an update today. The number of affected states increased from 24 to 25 with the addition of Louisiana, which had both of the latest deaths, the report shows. Almost all the patients for whom information was available—109 of 111—were hospitalized. Four of the cases were related to pregnancy, one more than listed previously; the four included three in pregnant women and one in a newborn baby. As noted previously, one of the cases in pregnant women resulted in a miscarriage. The outbreak has been tied to Rocky Ford-brand cantaloupe from Jensen Farms in Colorado.
Oct 12 CDC update

Industry groups ask for delay on non-O157 E coli rule
Eight meat industry groups asked the federal government to delay the implementation—now scheduled for next March—of a proposed ban on six leading non-O157 strains of Shiga toxin–producing Escherichia coli in raw beef, according to a press release today from the American Meat Institute, one of the organizations. In the AMI-prepared letter, which was sent to the US Department of Agriculture's Food Safety and Inspection Service (FSIS), the groups also asked for a 60-day extension of the public comment period, which is now set to end Nov 21. "Many members of the undersigned organizations will be directly subject to the new policy set forth in the Final Determination and Request for Comments (FDRC) and all will be affected. For that reason, the undersigned organizations need additional time to prepare comments that will help guide the agency as it prepares for and implements the new policy," the letter states. The groups spell out eight topics on which the FSIS has asked for comment, including the FSIS's regulatory sampling plan, suggestions for baseline sampling, and whether a technical meeting on methods for controlling the six strains should be held during the comment period. The letter adds, "This list of issues is extensive and suggests there remains much to be done by the agency and the industry to prepare for this significant new policy."
Oct 12 AMI news release
Oct 11 meat industry group letter
Sep 13 CIDRAP News story about USDA testing plans

Study: Pandemrix in Sweden linked to some neurologic conditions
Those in Sweden immunized with the Pandemrix H1N1 vaccine in 2009 had a significantly increased risk for Bell's palsy, paresthesia, and inflammatory bowel disease but not for Guillain-Barre syndrome (GBS), multiple sclerosis (MS), type 1 diabetes, or rheumatoid arthritis, according to a BMJ study today. The retrospective cohort study of 1,024,019 residents of Stockholm county linked individualized data on H1N1 vaccinations to a database on healthcare use in the county and compared them over 8 to 10 months with data for unvaccinated people. They found no increased post-vaccine risk for GBS, MS, type 1 diabetes, or rheumatoid arthritis. They found a low risk for Bell's palsy (hazard ratio, 1.25; 95% confidence interval, 1.06 to 1.48) and paresthesia (1.11, 1.00 to 1.23) after adjusting for age, sex, socioeconomic status, and healthcare use. They also found significantly increased risks of paresthesia and inflammatory bowel disease among those vaccinated in the early phase f the vaccination campaign. They also write, "Small numbers of children and adolescents with narcolepsy precluded any meaningful conclusions." Pandemrix, produced by GlaxoSmithKline, has been linked to narcolepsy in Nordic children.
Oct 12 BMJ abstract

Resistant hospital infections in Europe cost $85 million, 8,000 lives
Hospital-acquired bloodstream infections (BSIs) caused by methicillin-resistant Staphylococcus aureus (MRSA) and third-generation cephalosporin-resistant E coli in Europe each year cause more than 8,000 deaths and 375,000 extra hospitalization days, according to a study in Public Library of Sciences (PLoS) Medicine. Researchers looked at 2007 data from 1,293 hospitals in 31 countries that participated in the European Antimicrobial Resistance Surveillance System. They estimated that 5,303 excess deaths were associated with MRSA-related BSIs, compared with 2,712 attributed to drug-resistant E coli. MRSA contributed to 255,683 extra bed-days, compared with 120,065 for drug-resistant E coli. They estimated the two pathogens increased annual medical costs by 62 million Euros (US $85.6 million), including 44 million Euros for MRSA and 18 million Euros for drug-resistant E coli. Trend analyses showed a possible 97,000 drug-resistant BSIs and 17,000 deaths in 2015. The authors conclude, "Forecasts about changes in the coming years are disturbing; despite anticipated gains in the control of MRSA, the persistently increasing number of infections caused by third-generation cephalosporin-resistant Gram-negative pathogens is likely to outweigh this achievement soon."
Oct 11 PLoS Med study
Oct 11 PLoS press release

WHO says global TB cases declining
The World Health Organization (WHO) says that new cases of tuberculosis (TB) declined last year for the first time and that TB death rates are the lowest in a decade. In a report yesterday, the UN agency said annual TB cases dropped to 8.8 million in 2010 after peaking at 9 million in 2005. Deaths fell to 1.4 million, after reaching 1.8 million in 2003. The report said annual deaths dropped 40% from 1990 to 2010, and all regions except Africa are on track to achieve a 50% decline by 2015. "This is major progress," said UN Secretary-General Ban Ki-moon in a WHO press release. "But it is no cause for complacency. Too many millions still develop TB each year, and too many die. I urge serious and sustained support for TB prevention and care." WHO Director-General Dr Margaret Chan added, "In many countries, strong leadership and domestic financing, with robust donor support, has started to make a real difference in the fight against TB. The challenge now is to build on that commitment, to increase the global effort—and to pay particular attention to the growing threat of multidrug-resistant TB." The report says that treating multidrug-resistant TB remains one of the most underfunded areas.
Oct 11 WHO news release

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