Mar 14, 2012
Antibiotic use in 2011 German E coli outbreak may have cut shedding
During the large 2011 Escherichia coli outbreak linked to sprouts in Germany, use of azithromycin was associated with less frequent long-term E coli carriage and a shorter duration of bacterial shedding in stool specimens, according to a study in today's Journal of the American Medical Association (JAMA). These findings contradict recommendations against prescribing antibiotics to treat infections with Shiga toxin–producing E coli (STEC) such as the O104:H4 outbreak strain, the study authors say. The study included 65 patients with STEC illness, 37 of whom had hemolytic uremic syndrome (HUS), a potentially fatal kidney complication of STEC infection. Of those, 22 received azithromycin (on average 12 days after symptom onset), all of them HUS patients, and 43 did not, 15 of whom had HUS. They were all monitored from the day of symptom onset. Rates of STEC carriage were 31.8% in the treated group versus 83.7% in the non-treated group by day 21 of observation, 4.5% versus 81.4% by day 28, and 0% versus 74.4% by day 35.
Mar 14 JAMA abstract
Mar 13 JAMA news release
ECDC says antibiotic resistance in Europe changed little in 2010
Antimicrobial resistance in zoonotic and indicator bacteria from humans, animals, and food was common in 2010 but showed no major changes from 2009, according to an annual report from the European Food Safety Authority (EFSA) and the ECDC. The report is based on data from 26 European Union members and covers resistance in zoonotic Salmonella and Campylobacter from humans, food, and animals and in indicator Escherichia coli strains and enteroocci from animals and food. Salmonella isolates from humans showed high resistance to ampicillin, tetracyclines, and sulfonamides, but resistance to third-generation cephalosporins and fluoroquinolones remained low, the report abstract says. Salmonella and E coli isolates from poultry, pigs, and cattle were commonly resistant to tetracyclines, ampicillin, and sulfonamides, but not to third-generation cephalosporins, while Salmonella from poultry showed moderate to high resistance to ciprofloxacin, a fluoroquinolone. "In Campylobacter isolates from human cases, resistance to ampicillin, ciprofloxacin, nalidixic acid, and tetracyclines was high, while resistance to erythromycin was recorded at low to moderate levels," the report adds. Methicillin-resistant Staphylococcus aureus was found in some animal species and foods of animal origin.
Mar 14 ECDC press release
Full 233-page report
Mar 5 CIDRAP News story on US report on resistant bacteria in poultry and meat
Flu vaccine requirement for daycare children paid off in Connecticut
A requirement for flu vaccination of all Connecticut children in daycare led to a sharp increase in vaccination coverage and a decrease in flu in the age-group, according to a report presented today at the International Conference on Emerging Infectious Diseases in Atlanta (ICEID). The immunization requirement took effect Jan 1, 2012, for all children aged 6 to 59 months who were enrolled in licensed daycare centers, according to the study abstract. Researchers from the Yale School of Public Health and the Connecticut Department of Public Health compared flu data from the 2010-11 season and the most recent season dominated by H3N2 strains, 2007-08. Vaccination coverage in the age-group increased from 53.9% in the 2009-10 season to 85% in 2010-11, they reported. For the age-group, the proportion of all emergency department visits attributed to fever or flu in 2011 was lower than in 2008 (30.4% versus 33.5%, P = .01). Also, children 6 to 59 months old made up a smaller share of all patients hospitalized for flu in 2010-11 than in 2007-08 (2.3% versus 4.5%, P = .04)). Finally, daycare-age children accounted for a smaller proportion of all lab-confirmed flu cases in 2010-11 than in 2007-08 (10.3% versus 13.2%, P = .03).
ICEID abstracts (see page 176)
Ukraine, Purdue University issue measles vaccination warnings
Health officials in Ukraine say soccer fans who plan to attend the European Championship this summer should be vaccinated for measles in view of the outbreak there, the Associated Press (AP) reported yesterday. Foreigners are also advised to be immunized against tuberculosis, rubella, and other diseases if they haven't been already, officials said. In a Feb 21 notice, the European Centre for Disease Prevention and Control (ECDC) said Ukraine had had 3,000 measles cases since the start of the year. Ukraine is co-hosting the soccer championship with neighboring Poland from Jun 8 to Jul 1, the AP said.
Mar 13 AP story
Feb 21 CIDRAP News item
In other measles news, 484 Purdue University students have provided no proof of measles vaccination, which could keep them from registering for next semester's classes, the AP reported yesterday. Mar 12 was the deadline for new students to show proof of immunization. Indiana law requires students at state-funded institutions to be vaccinated against measles, mumps, rubella, tetanus, and diphtheria. Jim Westman, director of Purdue's student health center, said the requirement has drawn increased attention because of Indiana's recent measles outbreak, with 17 cases since early February. If a campus outbreak occurred, students who have not met the immunization requirement would not be allowed to attend classes or participate in activities for at least a week, Westman said.
Mar 13 AP story
Northeastern US may face its worst year for Lyme disease risk
Owing to a bumper crop of acorns in 2010, this year could be the worst yet for Lyme disease and other tickborne infections in the northeastern United States, according to Richard S. Ostfeld, PhD, a disease ecologist at the Cary Institute of Ecosystem Studies in East Millbrook, N.Y. Speaking at the ICEID, Ostfeld said yesterday that the acorn crop sparked a 2011 population boom for white-footed mice, which store acorns for winter food and begin breeding earlier when well fed, medical writer Maryn McKenna reported on her blog, Superbug. The mouse population boom intersected with the 2-year life cycle of Lyme-carrying ticks, and this summer could bring a big crop of infected tick nymphs, Ostfeld said. He explained that for several reasons white-footed mice appear to be the best reservoir for Borrelia burgdorferi, the Lyme disease bacterium. Unusually large acorn crops could serve as an early-warning signal for increased Lyme disease risk, he said.
Mar 13 Superbug entry