Nine more cases reported in romaine-linked E coli outbreak, 52 total
In new romaine-linked Escherichia coli O157:H7 outbreak developments, federal health officials yesterday reported nine more illnesses and said trace-back investigations are focusing on 12 growers.
The Centers for Disease Control and Prevention (CDC) said the 9 new illnesses lift the outbreak total to 52 cases in 15 states. The most recent illness onset was Nov 18. Nineteen people have been hospitalized, 2 of them with hemolytic uremic syndrome (HUS), a potentially fatal kidney complications. No deaths have been reported.
Since the last CDC update on Nov 26, three states—Florida, Louisiana, and Pennsylvania—have each reported their first case.
Also, the CDC said it has collected water samples from farms and cooling facilities to test for E coli, and results are pending.
Meanwhile, the Food and Drug Administration (FDA) said yesterday that its trace-back investigation continues and that the focus is still on the same six counties in California's Central Coast growing region. Information from four restaurants in three states has pointed to 10 different distributors, 12 different growers, and 11 different farms as the potential source of the contamination. So far, however, no single source has been identified.
On Nov 23, investigators began on-site investigations on farms and cooling facilities. So far tests on lettuce, soil, and scat samples have been negative for E coli.
Dec 6 CDC outbreak update
Dec 6 FDA outbreak update
Costco commits to responsible antibiotic use in meat, poultry supply chain
Costco today updated its animal welfare standards to include a policy on the responsible use of antibiotics in its meat and poultry supply chains, according to shareholder advocacy group As You Sow.
The policy commits Costco to limiting the application of medically important antibiotics to therapeutic use for the prevention, control, and treatment of disease, but not for growth promotion or feed efficiency, and only under the supervision of a licensed veterinarian. The company says it will set a target for compliance with this policy on or before December 2020.
While the policy does not commit Costco to eliminating the routine use of medically important antibiotics for disease prevention among supplier farms, it does say the company will assess the feasibility of doing so on or before December 2020.
On Sep 29, As You Sow filed a shareholder proposal that requested Costco develop an enterprise-wide policy to phase out the use of medically important antibiotics in its meat and poultry, with the exception of treatment and non-routine control of diagnosed illnesses.
"We are particularly encouraged by the company's plans to create mechanisms through which they will be able to verify supplier compliance with their antibiotics policy," Christy Spees, environmental health program manager at As You Sow, said in a press release. "This is a significant undertaking, and one that we hope will cause a ripple of change in the meat industry and set a standard for other retail chains."
Dec 7 As You Sow press release
December 2018 Costco animal welfare standards
More polio cases recorded in Afghanistan, DRC, Nigeria
According to an update today from the Global Polio Eradication Initiative (GPEI), three countries have reported seven new polio cases total in the past week: Afghanistan, the Democratic Republic of the Congo (DRC), and Nigeria.
Officials in Afghanistan recorded one new wild poliovirus type 1 infection in Uruzgan province, Shahid-e-Hassas district. The patient experienced an onset of paralysis on Oct 9 and is the 20th person to contract wild poliovirus in Afghanistan this year.
In the DRC, two cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were reported in Mufunga-Sampwe district in Haut Katanga province, with paralysis onset on Oct 6 and 7. The cases represent the fourth strain of cVDPV2 currently detected in the DRC. There have been 21 cases of cVDPV in the DRC this year.
In Nigeria four new cases of cVDPV2 involved onset of paralysis from Oct 22 to Nov 6. All cases are part of two ongoing cVDPV2 outbreaks in that country and raise Nigeria's cVDPV that include 31 cases so far this year.
Pakistan Today, meanwhile, reported three new polio cases in Balochistan, which have yet to be reflected in GPEI's recording. Two of the cases occurred in toddler girls who had had some oral polio vaccine, the newspaper said and were protected from extensive paralysis. If confirmed, these cases will raise Pakistan's total in 2018 to 11.
Afghanistan, Pakistan, and Nigeria are the only three countries in the world with endemic polio transmission. All three have reported more polio cases in 2018 than in 2017.
Dec 7 GPEI update
Dec 6 Pakistan Today article
Imported malaria not dropping in UK, and most travelers not protected
A new study in Clinical Infectious Diseases shows that rates of imported malaria in the United Kingdom have plateaued in recent years, and 60% of travelers still refuse to take chemoprophylaxis to prevent the disease. Of those who took anti-malaria treatments before traveling, none finished their medication regime.
The study was conducted by examining the medical records of malaria patients at Addenbrooke hospital in Cambridge from 2002 through 2016. Of the 225 case-patients, 27.8% contracted malaria while visiting family in their country of origin, and 42.6% of patients contracted the disease while traveling for work or vacation. The Plasmodium falciparum parasite caused 66.7% of cases, followed by P vivax (15.1%) and P ovale (6.7%).
Each year the United Kingdom sees about 1,500 cases of malaria, making it the most commonly imported tropical disease in that country. Rates of the disease decreased 31.2% from 1996 to 2003 but have held steady since, the authors said.
"Lack of chemoprophylaxis use and lack of adherence to chemoprophylaxis regimen likely contribute to lack of continued significant decline in malaria cases after 2003," the authors concluded.
Dec 7 Clin Infect Dis study