News Scan for Nov 22, 2013

E coli salad outbreak
Bacteria in courthouse mail
Vaccination in the Philippines
Inactivated polio vaccine

Multistate E coli outbreak linked to salads grows to 32 cases

At least 32 people have now been sickened in a four-state Escherichia coli O157:H7 outbreak tied to ready-to-eat salads sold at Trader Joe's stores, the Centers for Disease Control and Prevention (CDC) said yesterday. That number is 6 cases higher than reported in the CDC's initial notice on the outbreak on Nov 10, and Texas has confirmed its first case.

Illness-onset dates range from Oct 13 to Oct 26, and patients' ages range from 2 to 78 years, with a median of 29 years. Among 22 cases with available information, 7 (32%) involved hospitalization.

Two case-patients have developed hemolytic uremic syndrome, a serious kidney complication, but no deaths have been reported.

Cases per state are: Arizona, 1; California, 27; Texas, 1; and Washington, 3. In addition to the new case in Texas, California reported 5 new cases.

Of 22 patients interviewed, 19 (86%) reported shopping at Trader Joe's grocery stores, and 12 (80%) of 15 reported eating a ready-to-eat salad from Trader Joe's. The salads were of two types: Field Fresh Chopped Salad with Grilled Chicken and Mexicali Salad with Chili Lime Chicken. The salads were produced by Glass Onion Catering of Richmond, Calif.

On Nov 10 Glass Onion recalled numerous ready-to-eat salads and sandwich wraps that may be contaminated with the E coli O157:H7 outbreak strain.
Nov 21 CDC update


Powder in courthouse mail was bacteria but posed little threat

A mysterious white powder that was mailed to a courthouse in northeastern Minnesota earlier this week turned out to be bacteria, but it did not pose a significant danger, the Minnesota Department of Health (MDH) announced today.

Tests showed that the powder sent in six letters to the Pine County Courthouse was either Bacillus thuringiensis or Bacillus cereus, two closely related species that can be hard to tell apart, the MDH said.

Another Bacillus species—B anthracis—was mailed to senators' and media offices in 2001, leading to 22 anthrax illnesses and 5 deaths.

The MDH said, "While testing will continue to determine which kind of bacteria was present in the letters, neither is considered a significant health risk based on the facts of this situation. Studies have not found adverse health effects from Bacillus thuringiensis. People who consume food contaminated with Bacillus cereus may experience foodborne illness symptoms including diarrhea and vomiting—usually within 24-48 hours of exposure."

The MDH said initial tests ruled out bioterrorism agents under CDC protocols, and Pine County officials were told of the results. Subsequent testing pointed to the two Bacillus species. Final test results are expected in about 2 weeks.

People who were in the Pine County Courthouse on Nov 19, when the letters arrived, were advised to contact their doctor if they had any unusual symptoms and to further reduce their possible exposure by washing their clothes and showering, the statement said.
Nov 22 MDH press release


Vaccination campaign targets polio, measles following Typhoon Haiyan

A massive vaccination campaign to protect young children against measles and polio in areas of the Philippines struck by Typhoon Haiyan is under way, with healthcare volunteers deploying there this weekend to help local workers, the World Health Organization's (WHO's) Western Pacific Region office announced today.

Large numbers of people, including families with children, have been displaced by the storm and are living in congested temporary shelters, which provide a fertile environment for the spread of infectious diseases. Unvaccinated and undervaccinated children are vulnerable and can readily contract and spread disease, notes the WHO press release.

Evacuation centers in the hardest-hit areas, Tacloban and Cebu, will see vaccination teams first, with children 6 months to 5 years of age being targeted initially because they are most at risk. Vaccinations may be extended to youngsters up to 15 years of age if resources are adequate, says the release.

The WHO and the Philippines Department of Health cooperated on planning and setting up immunization stations, and 20 volunteer nurses will arrive this weekend, the WHO stated. The WHO also called on partners to acquire and deliver vaccines by refrigerated conveyances, which is necessary for vaccine safety and preservation in areas without power.

"Our system is shaken but not broken," said Enrique Ona, the Philippines Secretary of Health, as the campaign began.
Nov 22 WHO press release


GAVI Alliance supports inactivated polio vaccine in poorest nations

The GAVI Alliance will support introducing inactivated poliovirus vaccine (IPV) as part of routine immunizations in the world's 73 poorest countries, its board ruled today. 

"This decision will enable the Alliance to help countries reach more children with important vaccines, and play a complementary role supporting the efforts of the World Health Organization (WHO) and the Global Polio Eradication Initiative (GPEI) in eradicating polio as part of implementing the polio endgame strategy," the organization said in a press release.

In May the World Health Assembly endorsed the new strategic plan developed by GPEI to eradicate polio in the coming years. The plan calls on countries to introduce at least one dose of IPV and begin phasing out oral polio vaccines, GAVI said. Removing oral polio vaccines will eliminate the risk of vaccine-associated polio outbreaks, and introducing IPV is crucial to the phased removal.

Donors have committed additional resources to GAVI for the expansion of IPV use, the group said in the release. IPV costs more than 10 times as much as the oral polio vaccine does, according to a report earlier this year in Nature.
Nov 22 GAVI Alliance press release
Jan 14 Nature News report

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