NEWS SCAN: Toxin-linked foodborne outbreak, immunization info systems, hand hygiene 1-2 punch

Jun 28, 2012

Chemical source found in foodborne illness outbreak
An April 2010 investigation by Dallas County (Texas) health officials into acute-onset illnesses in restaurant customers suggested chemical poisoning, which eventually turned out to b e sodium azide, according to a report today in Morbidity and Mortality Weekly Report (MMWR). In the initial incident, four customers were taken from the restaurant to an emergency department after experiencing rapid-onset foodborne illness symptoms, including nausea, lightheadedness, and sweating. The patients had drunk iced tea from paper cups filled from a self-serve urn. Authorities collected iced tea samples from the restaurant and from two patients who had brought their paper cups of ice to the ED. Surveillance of similar cases in local EDs yielded one more patient. Healthcare teams suspected a chemical source, but tests in the ED and in area labs didn't identify the cause. Tea samples were sent to the FBI, which 5 months later detected hydrazoic acid, formed when sodium azide contacts water. The patients recovered, but the source of the contamination was never found. The toxic chemical, widely used in industry, has been involved in food-poisoning incidents before, but the MMWR account is the first detailed report of an event at a public venue and the resulting investigation. The authors suggest that chemical poisoning be considered as a potential cause of any rapid-onset foodborne illness and that an interdisciplinary approach is the key to pinpointing the cause.
Jun 28 MMWR report

Survey shows increasing use of immunization info systems
Wider use of immunization information systems (IIS) has been recommended as a way to increase vaccination rates, and a recent US Centers for Disease Control and Prevention (CDC) survey found that the number of provider sites participating in such systems has increased to 48,048, according to a another MMWR article today. In 2006, 34,639 public and private providers were using IIS. The survey also found that as of 2010, 82% of all US children younger than 5 have immunization records that are in IIS, which is an increase from 78% in 2009. However, the latest number is still below the Healthy People 2020 target of 95%. The survey also found that 38 of 52 grantees who responded said they intended to use IIS to interface with the Vaccine Tracking System (VtrckS), the CDC's new national ordering and inventory system for publicly purchased vaccines. The report said that challenges remain, including recruiting and training providers to participate in IIS.
Jun 28 MMWR report

Study supports hand hygiene double punch
A study of the effectiveness of different hand hygiene methods against bacterial and viral contamination found in foodservice settings showed that using a washing-plus-sanitizing regimen was more effective than washing alone. The findings appear in the July issue of the Journal of Food Protection. The microbial challenges included chicken broth contaminated with Escherichia coli, ground beef containing E coli, and murine norovirus, a surrogate for human norovirus. Researchers collected samples from soiled hands for baseline data, and then collected samples from subjects' hands after washing only or after washing plus using one of various hand sanitizers. For moderate E coli contamination, the combination method using a 70% ethanol advanced formula (EtOH AF) gel achieved a 5.22-log reduction, versus a 3.10-log reduction with hand washing alone. For heavy E coli contamination, a wash-sanitize regimen using a 0.5% chloroxylenol hand washing product and EtOH AF yielded a 4.60-log reduction, versus a 4.11-log reduction with a wash-sanitize regimen using a 62% ethanol sanitizer. Combined with hand washing, the 70% EtOH AF gel produced a 3.19-log reduction against murine norovirus. The authors say the findings suggest that hand hygiene regimens can be effective even against high organic loads and nonenveloped viruses such as norovirus. Routines including a high-efficacy formulation should be used in high-risk environments where uncooked meat is handled near ready-to-eat foods, they write.
Jul J Food Prot abstract

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