NEWS SCAN: Fungal, E coli outbreaks grow; school lunch inspections; peanut Salmonella update

Oct 15, 2012

Steroid-linked fungal outbreak expands; FDA eyes other drugs
The number of patients sickened in a fungal infection outbreak linked to contaminated steroid injections rose to 214 in 15 states, the US Centers for Disease Control and Prevention (CDC) said today. The total is 29 cases more than in the CDC's report on Oct 12, with three additional states affected: Illinois, New Hampshire, and Pennsylvania. Two of the cases are peripheral joint infections and 212 are meningitis cases. The CDC reported one more death, pushing that total to 15. In another development, investigators are looking into possible meningitis in patients who received two other types of medications from New England Compounding Center (NECC), the company that produced the three lots of methylprednisolone acetate injections that have been linked to the outbreak, the US Food and Drug Administration (FDA) said today. The two additional products are triamcinolone acetonide, another injectable steroid, and a cardioplegic solution used to induce cardiac muscle paralysis during open heart surgery to avoid injury to the heart. One patient with possible meningitis received the company's triamcinolone acetonide. Two transplant patients with Aspergillus fumigatus infections who received the NECC cardioplegic solution during surgery have been reported. The FDA said it hasn't confirmed that the three infections were caused by NECC products, but it voiced concern about the sterility of any of the NECC injectable drugs. Also today the CDC updated some of its guidance documents for treating patients with joint and central nervous system infections.
Oct 15 CDC outbreak update
Oct 15 FDA statement

Fair-linked North Carolina E coli outbreak grows to 21 cases, 1 death
An Escherichia coli outbreak traced to a North Carolina county fair has reached 21 cases and killed a 2-year-old boy, state health officials said yesterday. Two thirds of the cases are in children, with 10 cases from Cleveland County, 5 from Gaston County (including the fatal case), 5 from Lincoln County, and 1 from South Carolina, Charlotte-based WSOC-TV reported yesterday. All case-patients had attended the Cleveland County Fair, which was held Sep 27 through Oct 7, the Charlotte Observer noted. Gaston County Health Director Chris Dobbins said three patients are on dialysis and four have developed hemolytic uremic syndrome, a potentially life-threatening complication of toxigenic E coli infection. State and county officials are trying to determine the exact source of the outbreak, state epidemiologist Megan Davies, MD, said, adding that nothing has yet stood out. "The only common thread is that they went to the county fair."
Oct 14 WSOC report

USDA: A quarter of US schools miss required food safety inspections
About one fourth of schools in the National School Lunch Program (NSLP) have missed at least one of their two required annual food safety inspections in recent years, adding up to about 73,000 missed inspections from 2008 through 2011, Food Safety News (FSN) reported today. According to annual reports from the Food and Nutrition Service of the US Department of Agriculture (USDA), for the 2010-11 school year, 21,963 schools of the more than 100,000 in the NSLP reported being inspected just once or not at all. That compares with 22,915 schools with inadequate inspection in 2009-10 and 28,113 in 2008-09. Among the reasons the USDA has received for lack of inspections are that state and local health departments are strapped for cash and staff, that schools are considered low-risk and are therefore a low priority for inspection agencies, and that small towns and rural areas lack local inspectors.
Oct 15 FSN article

Salmonella plant findings lead to expanded peanut recall
The company involved in a large recall of nut products linked to a multistate salmonellosis outbreak has expanded the recall to include raw and roasted peanuts after Food and Drug Administration (FDA) inspectors found Salmonella in raw peanuts and environmental samples at its plant. Sunland Inc. is expanding its recall to include in-shell and shelled raw and roasted peanuts that were processed in its plant in Portales, N.M., and are within their expiration date or have no expiration date. In an Oct 13 update, the FDA said testing identified Salmonella in raw peanuts and environmental samples from the plant. It also said Salmonella in the environmental samples, which are taken from various processing surfaces in the plant, matched the DNA fingerprint of the outbreak strain of Salmonella Bredeney. Sunland has ceased production and distribution from the plant and has recalled hundreds of its products. The outbreak involves 35 cases from 19 states.
Oct 12 FDA expanded recall notice

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