NEWS SCAN: Ricotta Listeria outbreak over, fungal meningitis toll grows, yellow fever in Sudan

Nov 26, 2012

CDC says ricotta Listeria outbreak is over
A multistate outbreak of Listeria monocytogenes infections linked to imported Italian ricotta cheese appears to be over, according a final update posted by the US Centers for Disease Control and Prevention (CDC) on Nov 21. No new illnesses, deaths, or affected states were reported since the CDC's last update on Oct 26. The number of patients sickened in the outbreak remained at 22, and the number of deaths remained at 4, including 2 that officials linked to listeriosis and 1 fetal loss. The CDC first announced the outbreak on Sep 11, a day after Forever Cheese, Inc., announced a voluntary recall of its imported Frescolina Marte brand ricotta salata cheese. Three days later the company expanded its recall to include all lots and production codes of the cheese and withdrew all cheeses it received from the Italian exporter Fattorie Chiarappa. The Food and Drug Administration (FDA) has placed an import alert on the company, which bars its products unless the importer can show they're not contaminated with Listeria. The FDA said the investigation has been transferred to its Coordinated Outbreak Response and Evaluation (CORE) Network post-response team for follow-up.
Nov 21 CDC final outbreak update
Nov 21 FDA statement

CDC: Fungal meningitis cases, complications still rising
The CDC today confirmed 20 new reports of fungal meningitis in patients who received contaminated steroid injections, raising the total to 510. Two more deaths were reported, pushing that total to 36, as well as 2 more peripheral joint infections, raising that total to 14. The tainted methylprednisolone acetate injections, produced by New England Compounding Center (NECC), were used to treat joint problems as well as back pain.

In a related development, the CDC issued a Health Alert Network (HAN) advisory to clinicians on Nov 20 warning about other infections and complications that are cropping up in new patients and those who are already undergoing treatment for fungal meningitis. The CDC said that although new fungal meningitis cases are still being reported in those exposed to the tainted drug, it has seen in increase in the number of patients with other types of fungal infections, including epidural abscess, phlegmon, discitis, vertebral osteomyelitis, or arachnoiditis at or near the infection site. Of 91 cases reported since Nov 4, 26 were meningitis, 61 had abscess or myelitis, 2 had peripheral joint infections, and 2 had more than one condition. The agency said the localized complications can occur alone or in patients already diagnosed as having fungal meningitis and can be difficult to distinguish from the patient's baseline chronic pain. It urged clinicians to obtain an injection-site MRI.
Nov 20 CDC HAN advisory

Yellow fever outbreak in Sudan grows as vaccine campaign begins
Sudan's yellow fever outbreak has grown to 459 suspected cases, including 116 deaths, the World Health Organization (WHO) reported last week. Those numbers are up from 329 suspected cases and 97 deaths in the last WHO update, on Nov 13, although earlier last week China's Xinhua news agency reported 400 cases and as many as 150 deaths. The WHO said the country launched a 10-day mass vaccination campaign on Nov 20 in an effort to reach 2.2 million people in the hardest-hit region, Darfur. The outbreak has affected 26 localities, the WHO said.
Nov 22 WHO update
Nov 19 CIDRAP News item on the outbreak

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