News Scan for Jun 21, 2018

More suspected DRC Ebola
;
ACIP on flu, anthrax vaccines
;
US food outbreak review

Influx of suspected, ruled-out cases continues in DRC Ebola outbreak

In the latest development in the Democratic Republic of Congo (DRC) Ebola outbreak, the country's health ministry yesterday reported three new suspected cases in Bikoro, one of the two remote hotspots, according to a daily update.

Tests on earlier suspected cases ruled out two infections, which puts the overall total at 61 cases, including 38 confirmed, 14 probable, and 9 suspected illnesses. The fatality count held steady at 28.

A vaccination campaign in the affected area continues with the experimental VSV-EBOV vaccine, and so far 3,139 people have been immunized, the vast majority of them in Iboko and Bikoro, the two locations in the forested region where most of the illnesses have occurred.

The last confirmed case-patient became ill on Jun 2. Though the number of lab-confirmed cases has tapered off, the World Health Organization (WHO) said yesterday in an outbreak update that the trend is promising, "However, in spite of progress, there should be no room for laxity and complacency until the outbreak is controlled. The focus of operations remains on intensive surveillance and active case finding."
Jan 20 DRC health ministry update
Jun 20 WHO outbreak update

 

ACIP reviews flu vaccine protection, approves anthrax mass vaccination recs

At a meeting of the US Center for Disease Control and Prevention's (CDC's) vaccine advisory group yesterday, researchers gave an update on flu vaccine effectiveness, noting that for seniors, cell-based and high-dose vaccine were slightly more effective than the standard quadrivalent vaccine.

Also, the Advisory Committee on Immunization Practices (ACIP) approved a set of recommendations for postexposure prophylaxis for the anthrax vaccine in a mass vaccination setting.

CDC officials told the group that cell-cultured vaccines were about 10% more effective and that the high-dose vaccine was about 8% more effective, Medpage Today reported. The group voted to reiterate the flu vaccine recommendations from February, which puts FluMist back onto the list of vaccines recommended for the 2018-19 flu season.

Regarding anthrax vaccine, ACIP approved working group recommendations regarding postexposure prophylaxis, according to the report. They include intramuscular administration if the subcutaneous route poses clinical, operational, or logistical challenges that would delay or prevent immunization.

Also, if vaccine supplies are scarce, either two full doses or three half doses can be used to stretch the supply. For immunocompetent adults ages 18 to 65, antibiotics given alongside the vaccine can be discontinued at 42 days after the first vaccine dose or 2 weeks after the last vaccine dose, whichever comes later.

Anthrax vaccine adsorbed, also known as BioThrax, is the only licensed vaccine for active vaccination against disease caused by Bacillus anthracis, the bacterium that causes anthrax, and the US government keeps a supply in the Strategic National Stockpile.
Jun 20 Medpage Today story

Produce-related disease outbreaks down in recent years in US

Centers for Disease Control and Prevention (CDC) scientists yesterday noted that produce-related foodborne disease outbreaks reported to the CDC declined from 1998 through 2013, but still led to a total of 34,674 illnesses, 2,315 hospitalizations, and 72 deaths.

Writing in Epidemiology & Infection, the CDC investigators analyzed data on 972 outbreaks tied to raw produce. They note that foodborne disease outbreaks overall decreased by 38% during the study period, while those associated with fresh produce dropped 19%. This means that produce-related outbreaks made up an increasingly larger proportion of foodborne outbreaks in general, rising from 8% of all outbreaks from 1998 through 2001 to 16% of outbreaks from 2010 through 2013.

Produce outbreaks were most commonly attributed to vegetable row crops (38% of outbreaks), fruits (35%), and seeded vegetables (11%). The most common pathogens were norovirus (54%), Salmonella enterica (21%) and Shiga toxin–producing Escherichia coli (10%). Over a third of produce outbreaks (39%) involved food-handling errors.

The authors call for a re-evaluation of safety measures in light of the Food Safety Modernization Act, which was enacted in 2011 to decrease foodborne disease.
Jun 20 Epidemiol Infect abstract

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