Tortilla chips blamed for GI illness outbreak at Wyoming prison
In today's Morbidity and Mortality Weekly Report, the Centers for Disease Control and Prevention (CDC) and local health officials said rancid tortilla chips were to blame for an outbreak of gastrointestinal illness that sickened 79 workers and inmates at a correctional facility in Wyoming a year ago.
The patients fell ill 1 to 3 hours after eating lunch on Oct 11, 2015, and reported gas, bloating, and diarrhea (70% of patients) and vomiting (21%). Within 3 weeks of the outbreak, the Wyoming Department of Health and county health department conducted a case-control study to identify the outbreak source.
Epidemiologic investigation pointed to tortilla chips as the only food associated with the illness, and markers for rancidity (hexanal and peroxide) were found in the chips through composite food samples. There was no evidence of an infectious source or chemical agent. Very few case-control studies exist that prove that rancidity, caused by the decomposition of oils and fats, can lead to gastrointestinal illness.
"This outbreak serves as a reminder to consider alternative food testing methods during outbreaks of unusual gastrointestinal illness when typical foodborne pathogens are not identified," the authors said.
Oct 27 MMWR study
WHO: 1 million successfully treated for hepatitis C with new drugs
The World Health Organization (WHO) in a report today titled, Global Report on Access to Hepatitis C Treatment: Focus on Overcoming Barriers, said 1 million people in low and middle-income countries have been successfully treated for hepatitis C with a new class of drugs, direct-acting antivirals (DAAs).
When the drugs were introduced in 2013, many critics feared DAAs were too expensive for poorer countries, and would fail to reach the 80 million people who have chronic hepatitis C worldwide. Through cost-lowering strategies, such as competition from generic medicines through licensing agreements, local production, and price negotiations, the WHO said some member states were able to offer wider access to the drug.
Costs for the drug vary greatly: Some countries, such as Romania, price a 3-month course of DAAs at almost $80,000. But other countries, such as Egypt, used local production and dropped their cost from $900 in 2014 to less than $200 in 2016, the report said.
Hepatic C kills 700,000 people each year. DAAs have a cure rate of 95%, but their high costs have led to restricted use in even high-income countries. Earlier this year, the World Health Assembly said that its goal for viral hepatitis was to treat 80% of infected people by 2030.
Oct 27 WHO press release
C Diff DNA found on hospital surfaces during outbreak
In a study today in the American Journal of Infection Control, the authors found Clostridium difficile DNA on 71% of hospital surfaces during a C difficile outbreak, and on 28% of the surfaces 2 years after the outbreak ended.
The disease is easily spread in hospitals because its spores are resistant to most disinfectants. The bacteria can also live on inert surfaces and is one of the leading causes of diarrhea in elderly hospital patients.
From January through July 2009, a C difficile outbreak linked to a mortality rate of 11% occurred in a Costa Rican general hospital. Twenty-four surface samples were collected during the outbreak, with another 54 surface samples collected 2 years later. Overall, C difficile DNAwas detected in 40% of the 75 environmental samples, with a 2.5-fold increase during the outbreak.
About 67% of bedrails and walls were C difficile–positive during the outbreak.
"These results reinforce the relevance of strict hygiene procedures and cleaning measures in the control of C difficile infections in hospitals, even in the absence of outbreaks," the authors concluded.
Oct 27 Am J Infect Control study