Food Outbreak Scan for Feb 01, 2016

News brief

CDC declares 2 Chipotle-linked E coli outbreaks over after 60 cases

Two outbreaks of Escherichia coli O26 infections linked to Chipotle restaurants are now over after causing 60 total cases in 14 states, the Centers for Disease Control and Prevention (CDC) said in a statement today.

The total is 2 cases more than an update on Dec 21. The larger outbreak involved 55 people in 11 states, 21 of whom required hospitalization. The vast majority were in Washington (27 cases) and Oregon (13). Patients reported their first symptoms from Oct 19 to Dec 1, 2015.

The smaller outbreak involves 5 patients in Oklahoma (3 cases), Kansas (1), and North Dakota (1). One of the patients was hospitalized. Illness-onset dates range from Nov 18 to Nov 26, 2015.

The CDC said, "The epidemiologic evidence collected during these investigations suggested that a common meal item or ingredient served at Chipotle Mexican Grill restaurants was a likely source of both outbreaks. The investigations did not identify a specific food or ingredient linked to illness in either outbreak."

The restaurant chain has also been plagued by local outbreaks of Salmonella and norovirus.
Feb 1 CDC update
Dec 21 CIDRAP News scan on previous update

Nutritional powder recalled over Salmonella cases in several states

Garden of Life, LLC, has voluntarily recalled 30 lots of its RAW Organic Shake & Meal because of cases of Salmonella Virchow linked to the product, the Minnesota Department of Health (MDH) said late last week.

Two instances of the same Salmonella DNA strain were found in Garden of Life's nutrition supplement from two different Minnesota stores since Jan 11, the MDH said in a Jan 29 news release. Both people who were infected, a child and a man in his 30s, have recovered without need for hospitalization. Other cases linked to the product have been reported in six other states—Wisconsin, Tennessee, Oregon, New Jersey, New Mexico, and Utah, the MDH, without specifying the number of cases in each state.

During pre-distribution testing, however, no Garden of Life product tested positive for Salmonella, the US Food and Drug Administration (FDA) said in a Jan 29 recall notice.

Infection from Salmonella usually resolves itself within 5 to 7 days, and many cases of salmonellosis end up going unidentified and untreated. Still, the MDH urges those who may be at risk and who display symptoms such as fever, abdominal pain, and diarrhea to consult with their healthcare provider. In some cases of salmonellosis, symptoms do not show up until a week after infection.

RAW Organic Shake & Meal products with the expiration date of September 2017 or later should not be consumed and can be returned to the store they were purchased at for a full refund, the FDA said.
Jan 29 MDH press release
Jan 29 FDA press release

News Scan for Feb 01, 2016

News brief

Saudi Arabia reports MERS case in Riyadh

Saudi Arabia today reported a new MERS-CoV case after a 5-day lull, and a new study shows effectiveness of a monoclonal antibody treatment in monkeys.

The new MERS-CoV (Middle East respiratory syndrome coronavirus) case involves 43-year-old foreign man in Riyadh who is not a healthcare worker, the Saudi Ministry of Health (MOH) reported. He is in stable condition, and probable sources of infection are under investigation.

The country had reported 5 cases in under a week before going 5 days without a case till today. The new case brings the country's total to 1,289, of which 551 proved fatal, the MOH said.

In the monoclonal antibody study, US researchers, including those from the National Institutes of Health and the Centers for Disease Control and Prevention (CDC), used the treatment on three rhesus monkeys before MERS-CoV infection and compared them to six monkeys that were experimentally infected with MERS-CoV in various ways and three monkeys that received an HIV antibody treatment as a control group.

The team found that the MERS antibody treatment reduced lung pathology in infected monkeys, as determined by computed tomography.
Feb 1 Saudi MOH update
Jan 30 Virology study

CDC releases alert on seasonal flu, warns of severe cases

The CDC today issued a Health Alert Network (HAN) advisory that warns of severe flu cases and recommends how to prevent unnecessary outbreaks.

Although the pneumonia and influenza mortality rate of week 3 (ending Jan 23, as the CDC noted on Jan 30) was below the epidemic thresholds in both the 122 Cities Mortality Reporting System and the NCHS Mortality Surveillance System, the rate of flu reports is increasing, particularly those caused by 2009 H1N1.

According to the CDC, 2009 H1N1, which is now a seasonal strain, has caused severe respiratory illness leading to hospitalization and some fatalities in patients.

The f CDC recommends that anyone 6 months or older should still receive the flu vaccine as soon as possible for protection yet this season. All US flu vaccines protect against H1N1, H3N2, and influenza B viruses.

In addition, antiviral drugs are strongly recommended for high-risk patients, such as those who are hospitalized, under the age of 2, over the age of 65, and have other factors that put them at risk, the agency said. Antiviral treatment should also be given to high-risk patients even if they are just suspected of having influenza, preferably within 48 hours of symptom onset, the CDC added.

The advisory also cautions clinicians that rapid influenza diagnostic tests may yield false-negatives, so antiviral therapy should not be withheld based on results from these tests.

This is the first time since December 2014 that the CDC has issued a HAN over flu. At that point a drifted H3N2 strain was circulating and was eventually associated with decreased vaccine effectiveness and a more severe flu season.
Feb 1 CDC HAN Advisory
Jan 30 CDC Weekly FluView report

Oxfam analysis finds gaps in Ebola fund transparency

Of the almost $6 billion pledged toward Ebola relief efforts in West Africa, at least $1.9 billion never materialized, but information for the remaining $3.9 billion is scarce, the humanitarian group Oxfam reported on Jan 30.

Aboubacry Tall, Oxfam's regional director for West Africa, said, "We know that $1.9 billion of the promised funds have not even been committed to a specific country but we can't say for sure how much of the remaining committed money has been effectively delivered.

"A lack of transparency throughout the whole process, from donors to implementing organizations to programs on the ground means we're finding it hard to understand which donors have given what money, to whom and for what purpose."

Tall added, "In order for the countries to quickly build the health systems they require, governments and communities need to know what aid they are getting, when it is coming, where it is going and they need to have a say in how it is used. We urge donors to 'put their money where their mouths are' and demonstrate what transparency really means by, at a minimum, publishing information in accordance with International Aid Transparency Initiative standards."

Oxfam also strongly recommended that the three hardest-hit countries—Sierra Leone, Liberia, and Guinea—should empower local communities to take a leading role in healthcare and public health.
Jan 30 Oxfam press release