May 31, 2012
93 people in 23 states infected with Salmonella from live poultry
At least 93 people in 23 states have been infected with Salmonella Infantis, Salmonella Newport, or Salmonella Lille in an outbreak linked to live chicks and ducklings from a mail-order hatchery in Ohio that was also responsible for a Salmonella outbreak last year, the US Centers for Disease Control and Prevention (CDC) said yesterday. Of the 93 patients, 18 have been hospitalized and 34 (37%) are 10 years old or younger. The CDC also said it is investigating a death as possibly linked to the outbreak. States with more than one case are Ohio (26), New York (13), North Carolina (9), Pennsylvania (9), Virginia (6), Kentucky (4), Alabama (3), Georgia (3), Indiana (2), and Maine (2). The CDC said, "Findings of multiple traceback investigations of live chicks and ducklings from homes of ill persons have identified a single mail-order hatchery in Ohio as the source of these chicks and ducklings. This is the same mail-order hatchery that was associated with the 2011 outbreak of Salmonella Altona and Salmonella Johannesburg infections. In May 2012, veterinarians from the Ohio Department of Agriculture inspected the mail-order hatchery and made recommendations for improvement." The 2011 outbreak sickened at least 68 people in 20 states, 19 of whom were hospitalized. The CDC did not name the hatchery, but an MSNBC story today said it is Mount Healthy Hatchery near Cincinnati. The agency warned about the risk of contracting salmonellosis from live poultry.
May 30 CDC report
May 31 MSNBC story
Monitoring systems slow to change in wake of Europe's 2011 E coli outbreak
A year after Europe's deadliest Escherichia coli outbreak, governments have not yet done very much to improve the surveillance and reporting practices that allowed the outbreak to grind on for weeks, according to a Nature news report yesterday. Caused by contaminated fenugreek sprouts, the outbreak in May and June 2011 involved thousands of illnesses, most of them in Germany, and killed 53 people. Proposals to improve disease monitoring and reporting have been mired in political debate. In Germany, where it can take up to 18 days for local and state health departments to pass case reports to the central disease-surveillance agency, a law to speed reporting has passed the federal parliament but is stuck in negotiations at the legislative council that represents the country's 16 states. In addition, microbiologic testing in cases of bloody diarrhea is still inconsistent in Germany, because insurance companies don't cover the cost. Meanwhile, European Union members are still discussing a proposal from the European Food Safety Authority to develop a standardized test for sprouts and adopt it throughout the EU. On the brighter side, a World Health Organization expert said European physicians are at least more likely to recognize and report foodborne infections than they were before the outbreak.
May 30 Nature story
Additional Salmonella strain found at Missouri dog food plant
Federal officials have detected a non-outbreak strain of Salmonella in an additional product sample at a plant owned by Diamond Pet Foods, which has been implicated in a multistate outbreak linked to its dog foods. A Food and Drug Administration (FDA) update yesterday said a sample of Diamond Naturals Small Breed Adult Lamb and Rice collected by Ohio officials from the Diamond Meta plant in Missouri tested positive for Salmonella Liverpool, and the company has recalled that product, the FDA said. The outbreak strain is Salmonella Infantis, and it has caused at least 15 illnesses in nine states, according to CDC data. Last month officials detected the outbreak strain in an unopened retail sample of Diamond Puppy Formula dry dog food collected at Diamond's Gaston, S.C., plant. Environmental and ingredient samples at the facility have not tested positive for the outbreak strain, the FDA said.
May 30 FDA update
Gaps complicate response to air-travel measles cluster
Delays in reporting fever and rash in a refugee traveling from Malaysia to Los Angeles in August 2011 led to a large-scale investigation of nearly 300 contacts and precluded the use of measles, mumps, and rubella vaccine to limit the spread of disease, according to a report from California health officials today in Morbidity and Mortality Weekly Report (MMWR). The index patient was a 15-year-old Myanmar refugee from Malaysia who got sick with a fever and rash a few days before emigrating to the United States with his family, but he did not report his symptoms to migration medical officials in Malaysia or on the flight. The day after the boy arrived in Los Angeles, his ongoing symptoms required a visit to an emergency department (ED), where dengue infection was first suspected. Later that evening he was taken to another ED where measles was suspected, then a day later reported to Los Angeles County Department of Public Health, which launched an investigation with state health officials. Contact tracing found two other measles cases on passengers on the same flight, one a 12-month-old US-born girl who had not yet been vaccinated and the other an unvaccinated 19-month-old girl from Indonesia. While symptomatic and despite home isolation instructions, the 19-month-old and her family traveled by bus to Las Vegas, which expanded the investigation. The probe found another measles case, a 25-year-old customs officer who had processed the index patient at the airport. Tests found that the worker was not vaccinated or had an inadequate immune response. In total, the episode required 50 health officials to interview 298 contacts. The authors wrote that the experience reveals gaps in refugee immunization policies and immunization requirements for workers who handle incoming refugees.
Jun 1 MMWR report