Dec 22, 2011
Report cites understaffing, other state food safety barriers
State health departments are understaffed by more than 300 employees collectively for food safety efforts, according to the results of a survey by the Council of State and Territorial Epidemiologists (CSTE) published today in Morbidity and Mortality Weekly Report (MMWR). Health department representatives from all 50 states responded to the Web-based assessment of food safety epidemiology capacity conducted in April 2010. The survey also found that the most often-cited barriers to investigating foodborne disease outbreaks were delayed notification of the outbreak (reported by 41 states), shortage of food safety staff (29 states), low priority placed on investigations (27 states), inability to pay overtime (20 states), and inadequate epidemiology expertise (12 states). In 2010, 787 full-time-equivalent (FTE) employees were working as foodborne disease epidemiologists in state, regional, and local health departments. Of these, 616.5 (78%) had an epidemiology-related degree or had completed coursework in epidemiology. But the survey respondents reported needing 304 additional FTEs, half with master's degrees. In addition, some states reported investigating less than 25% of outbreaks caused by these pathogens: Campylobacter (16% of states), Listeria (13%), Escherichia coli (10%), norovirus (7%), and Salmonella (4%). A Centers for Disease Control and Prevention (CDC) editorial comment on the report said that even though responses may have been subjective, "Ensuring adequate epidemiology capacity in foodborne disease programs is essential for the timely detection, investigation, control, and prevention of foodborne disease outbreaks."
Dec 23 MMWR report
Report details O26:H11 E coli outbreak at a daycare
In an analysis of the largest non-O157 Shiga toxin–producing Escherichia coli outbreak reported in a US childcare center, researchers found that transmission was fueled by person-to-person spread and that cohorting helped slow the spread of the disease. Writing in the Pediatric Infectious Disease Journal, investigations found that 60% of staff and children got sick with E coli O26:H11, totaling 18 confirmed and 27 suspected cases. Four confirmed case-patients were asymptomatic. None of the patients were hospitalized. Children under age 3 were twice as likely to become ill as older children. The investigation by county health officials found 22 health violations, such as inappropriate diapering procedures, that may have contributed to the outbreak. The authors wrote that the outbreak illustrates the importance of considering non-O157 E coli among the diagnostic possibilities in childcare diarrhea outbreaks and that aggressive measures such as cohorting should be evaluated for outbreaks in other settings.
Dec 20 Pediatr Infect Dis J abstract
Kansas City man may represent cantaloupe outbreak's 31st death
A Kansas City man who had listeriosis died Dec 18, presumably becoming the 31st fatality in a Listeria outbreak linked to Jensen Farms cantaloupe from Colorado, the Kansas City Star and local TV stations KCTV and KSHB reported Dec 20. The man, Paul Schwarz, 92, became ill in September after eating cantaloupe and was moved to a nursing home in October. The CDC declared the outbreak over on Dec 8 and confirmed 146 illnesses and 30 deaths in 28 states, which makes it the deadliest US foodborne outbreak since 1911.
Dec 20 KSHB story
Dec 8 CDC update