Foodborne Disease Scan for Apr 22, 2015

News brief

Botulism suspected in 24-case church outbreak in Ohio

Suspected botulism has sickened 24 people and killed 1 after a potluck lunch at a Lancaster, Ohio, church, Reuters reported today.

Fifty to 60 people attended the lunch on April 19 at Cross Pointe Free Will Baptist Church, and outbreak patients started getting sick on Apr 21, said Jennifer Valentine, a spokeswoman for the Fairfield (County) Department of Health.

She said health officials are still testing to confirm botulism and are trying to determine what food might have caused the outbreak. Botulism, which is caused by the botulinum toxin produced by Clostridium bacteria, can result from low-acid home-canned foods such as beans that have not been canned properly. On average, 145 US cases are reported each year, and 15% are foodborne, according to the Centers for Disease Control and Prevention (CDC). The disease is not contagious.

The CDC sent a "large quantity" of botulism antitoxin overnight, and health officials were giving it to people showing symptoms, the story said.
Apr 22 Reuters story

California notes multistate Salmonella outbreak possibly tied to sushi

California health officials are tracking a Salmonella Paratyphi outbreak possibly linked to sushi that involves 25 confirmed cases.

Eighteen of the patients live in California and seven live elsewhere, Ventura County Public Health said Apr 20 in a news release. Seven of the California cases are in Los Angeles County, 4 in Orange County, 4 in Ventura County, 2 in Riverside County, and 1 in Santa Barbara County. Most of the seven out-of-state patients had traveled to Southern California, the release said.

Twenty percent of patients required hospitalization. As of Apr 17, all 10 patients who completed a detailed food questionnaire said they had recently eaten sushi, most of them eating raw tuna. The news release did not specify when patients first got sick.

The California Department of Public Health (CDHP) first notified Ventura County of the outbreak on Apr 9. The outbreak strain "had never been seen in animals or humans before March 2015," the release said, but the CDPH noted that a closely related strain was responsible for a salmonellosis outbreak in California and Hawaii in 2010. That outbreak was linked to raw tuna imported from Indonesia.
Apr 20 Ventura County Public Health news release

Airborne norovirus genomes detected in hospitals during outbreaks

Infective aerosolized human norovirus genomes can remain suspended in the air of healthcare facilities both inside and outside of infected patients' rooms, say the findings of a study published yesterday in Clinical Infectious Diseases.

The evidence lends credence to earlier suggestions that the disease may be transmissible not only through direct contact with infected patients, their fecal matter, their vomitus, or contaminated surfaces, but also through inhalation of aerosolized virus.

During norovirus outbreaks in eight Quebec City–area healthcare facilities, the Canadian researchers took air samples from patient rooms (1 meter from the patient), just outside patient rooms, and at corresponding nurses' stations. In addition, they tested murine norovirus MNV-1, used as a surrogate for norovirus GII in an aerosol chamber to determine whether the stress of aerosolization compromised the virus's infectivity.

Norovirus genomes were found in 23 of 48 air samples from 6 of the 8 healthcare facilities; the breakdown of locations was 14 positive samples of 26 (54%) in patient rooms, 6 of 16 (38%) in hallways, and 3 of 6 (50%) at nurses' stations.

In addition, the infectivity and integrity of norovirus MNV-1 was found to be preserved in the in vitro aerosol studies.

The authors conclude, "Although norovirus is an intestinal pathogen, noroviruses could be transmitted through the airborne route and subsequently could, if inhaled, settle in the pharynx and later be swallowed." They point out that several processes could lead to aerosolization, including toilet flushing and vomiting, and that healthcare workers could act as vectors for the aerosolized droplets.
Apr 21 Clin Infect Dis abstract

News Scan for Apr 22, 2015

News brief

Yet another study finds no link between MMR vaccine, autism

The alleged vaccine-autism connection has yet again been debunked. In a large retrospective cohort study of children with older siblings, the measles-mumps-rubella (MMR) vaccine was shown to not be associated with autism, even in kids with an older sibling with autism spectrum disorders (ASD).

Writing in the Journal of the American Medical Association (JAMA) yesterday, US researchers said they analyzed data from 95,727 children, 994 of whom (1%) were diagnosed as having ASD and 1,929 of whom (2%) had an older sibling with ASD.

The investigators found that the receipt of MMR vaccine was not associated with an increased risk of ASD at any age and regardless of sibling ASD.

In a related editorial, Bryan H. King, MD, MBA, of the University of Washington in Seattle, wrote, "Taken together, some dozen studies have now shown that the age of onset of ASD does not differ between vaccinated and unvaccinated children, the severity or course of ASD does not differ between vaccinated and unvaccinated children, and now the risk of ASD recurrence in families does not differ between vaccinated and unvaccinated children."

"Although the evidence is already abundant" of no MMR vaccine–autism link, "immunization rates remain low in certain populations and countries because of this inappropriate belief."
Apr 21 JAMA study
Apr 21 JAMA editorial

WHO calls global vaccination efforts off-track

Only one of six global immunization targets is on track to be met this year, and one in five kids misses out on routine life-saving vaccines, the World Health Organization (WHO) said today.

In a news release commemorating World Immunization Week next week, the WHO called for renewed efforts toward better progress. The agency said 1.5 million deaths could be prevented each year with adequate vaccinations.

In 2012, all 194 WHO member states at the World Health Assembly endorsed the Global Vaccine Action Plan (GVAP). The release noted, however, that a recent independent assessment warned that vaccines are not being delivered equitably or reliably and that the only target on track to be met in 2015 is the introduction of underused vaccines.

In 2013 nearly 22 million infants missed out on the required three doses of diphtheria-tetanus-pertussis vaccines, many of them in the world's poorest countries, the WHO said. And many nations have experienced large measles outbreak in the past year, threatening efforts to achieve the GVAP target of eliminating that disease in three WHO regions this year.

"It is critical that the global community now makes a collective and cohesive effort to put progress towards our six targets back on track," said Flavia Bustreo, MD, MPH, WHO assistant director-general of family, women's and children's health.

The WHO recommends three steps to help close vaccination gaps: (1) integrating immunization with other health services, such as postnatal care, (2) strengthening health systems so that vaccines continue to be given even in times of crisis, and (3) ensuring that everyone can access vaccines and afford to pay for them.
Apr 22 WHO news release