News Scan for Mar 14, 2019

News brief

Rare plague case in dog exposes more than 100 people to Yersinia pestis

A Colorado dog with pneumonic plague exposed at least 116 people at a veterinary hospital to Yersinia pestis because of a delay in diagnosis, according to a report in Emerging Infectious Diseases. 

In December 2017, a dog was brought into a veterinary clinic because of lethargy and fever 4 days after the 3-year-old mixed breed was found sniffing a dead prairie dog. After worsening symptoms, the dog was sent to Colorado State University Veterinary Teaching Hospital (CSU-VTH).

In the following 2 days before diagnosis, the dog was estimated to have exposed at least 46 animals and 116 people at CSU-VTH. The dog was humanely killed because of a poor prognosis.

Plague is rare in dogs, even in endemic regions, the authors said, but should be considered  in dogs that have fever and respiratory signs with potential exposure in disease-endemic areas. Pneumonic plague is the most serious form of the disease and the only one that can be spread from person to person, which occurs via infectious respiratory droplets.

"This unique case highlights the public health response challenges in a large teaching institution," the authors concluded.
Mar 13 Emerg Infect Dis
study

 

Butterball recalls 78,000 pounds of ground turkey after Salmonella cases

Yesterday the US Department of Agriculture's Food Safety and Inspection Service (FSIS) announced that Butterball was recalling 78,164 pounds of ground raw turkey products because of a possible contamination with Salmonella Schwarzengrund.

So far five people in two states have been sickened with the bacterium. Butterball ground turkey collected from the home of four patients in Wisconsin contained matching Salmonella isolates.

The meat in question was produced on Jul 7, 2018, and the recall includes 48-ounce and 16-ounce plastic-wrapped trays of "Butterball everyday fresh ground turkey with natural flavoring." All products have a sell or freeze-by date of Jul 26, 2018.

"FSIS is concerned that some product may be frozen and in consumers' freezers," the agency said. "Consumers who have purchased these products are urged not to consume them. These products should be thrown away or returned to the place of purchase."
Mar 13 FSIS
press release

 

WHO describes new details about Saudi MERS cluster

The World Health Organization (WHO) released new details about the hospital-based MERS-CoV outbreak in Wadi ad-Dawasir, Saudi Arabia.

The WHO said the outbreak of MERS-CoV (Middle East respiratory syndrome coronavirus) began at the end of January, and as of Feb 16, 42 cases, including 9 involving healthcare workers, were recorded. Five patients have died, resulting in a case-fatality rate (CFR) of 11.9%. The WHO said 7 cases were primary, and 35 were secondary cases, including household or hospital contacts.

Three samples taken from camels at primary case-patients' homes also tested positive for the virus, suggesting both animal and human transmission in the outbreak. In 2017, Wadi ad-Dawasir reported a similar but smaller outbreak, which involved 15 cases, including 3 healthcare workers.

"Frequent occurrences of small sized hospital outbreaks characterize MERS' occurrence in Saudi Arabia. A total of 24 hospital outbreaks have occurred since 2015 resulting in 351 cases and 103 associated deaths (CFR:  29.34%)," the WHO said. In these outbreaks, roughly 30% of the patients are healthcare workers.

And yesterday Emerging Infectious Diseases published new information about the clinical profiles of Saudi MERS patients. Researchers analyzed 33 clinically diverse patients admitted to a hospital in 2015 and 2016, recording both symptoms and serum antibody responses.

"Among case-patients who died, development of robust neutralizing serum antibody responses during the second and third week of illness was not sufficient for patient recovery or virus clearance," the authors said. "Fever and cough among mildly ill patients typically aligned with RNA detection in the upper respiratory tract; RNA levels peaked during the first week of illness."
Feb 17 WHO
report
Mar 13 Emerg Infect Dis
study

 

Bulgaria, Taiwan, South Africa report new high-path avian flu outbreaks

H5 strains of highly pathogenic avian flu have affected poultry in Bulgaria, Taiwan, and South Africa, the World Organization for Animal Health (OIE) reported yesterday and today.

In Bulgaria H5 avian flu sickened 20 birds among a flock of 3,200 poultry near Lovech, a city in the north-central part of the country. Officials plan to cull the flock to prevent disease spread. The outbreak began yesterday.

Taiwanese officials reported two H5N2 outbreaks on chicken farms on the west side of the island, in Yunlin and Changhua counties. Together the virus killed 82 of 53,103 susceptible birds, and officials euthanized the surviving poultry. The farms have also been placed under movement restrictions to prevent the transport of birds to other farms.

The outbreaks were first detected on Feb 25 and Mar 4. Taiwan has combatted a series of H5N2 outbreaks for months.

And in South Africa, officials confirmed H5N8 on a commercial ostrich farm in the province of Free State in an outbreak that began on Feb 1. They reported 75 H5N8 infections among 4,372 susceptible ostriches. Officials plan to cull the flock.
Mar 13 OIE Bulgaria report
Mar 14 OIE Taiwan report
Mar 14 OIE South Africa report

Stewardship / Resistance Scan for Mar 14, 2019

News brief

Iranian researchers report high MRSA rates in hospital cockroaches

Iranian investigators have discovered a high rate of methicillin-resistant Staphylococcus aureus (MRSA), a common superbug, in two types of cockroaches found in hospitals, according to a study yesterday in Antimicrobial Resistance & Infection Control.

The group collected 533 Periplanets americana and Blattella germanica cockroaches and isolated bacteria from their gut content and exoskeleton.

They found that 52.8% of P americana and 43.3% of B germanica cockroaches harbored MRSA. The prevalence was highest (59.6%) among body-surface samples of P americana. MRSA isolates from the P americana surface samples harbored 100% resistance to penicillin, ceftaroline, and tetracycline, as well as 83.3% resistance to gentamicin and 80.6% resistance to trimethoprim-sulfamethoxazole.

The authors conclude, "The present investigation is the first report of the phenotypic and genotypic evaluation of antibiotic resistance in the MRSA strains isolated from P. americana and B. germanica hospital cockroaches. Hospital cockroaches are considered as a potential mechanical vector for MRSA strains."
Mar 13 Antimicrob Resist Infect Control study

 

US company launches rapid test for antibiotic-resistant gonorrhea

Shield Diagnostics of San Jose, California, yesterday announced it has launched a rapid molecular test, called Target-NG, for diagnosing antibiotic susceptibility in Neisseria gonorrhoeae, the bacterium that causes gonorrhea.

The company said in a press release that the British Association for Sexual Health and HIV recently recommended treating N gonorrhoeae with ciprofloxacin if susceptibility results are available prior to treatment. The US Centers for Disease Control and Prevention recommends ceftriaxone in combination with azithromycin to treat uncomplicated gonorrhea.

"Rapid molecular testing for ciprofloxacin resistance allows for smarter medicine," Jeffrey D. Klausner, MD, MPH, a professor of infectious diseases at the University of California, Los Angeles, said in the news release. "Right now we're treating gonorrhea with a sledgehammer; we're treating everything with the same exact regime. And it's not a surprise that the organism will become resistant to what we're currently using."

Ciprofloxacin can be used to treat 80% of gonorrhea and is 99.8% effective when susceptibility has been determined, Shield Diagnostics said. It is administered as a single oral dose.

"Target-NG can determine if a given gonorrhea infection is susceptible to ciprofloxacin with the same turnaround time as regular gonorrhea screening tests," said Fred Turner, MS, the company's CEO.
Mar 13 Shield Diagnostics news release

 

CARB-X announces partnership with German government

CARB-X announced today that the German government has committed more than $45 million to the effort to fight drug-resistant superbugs.

Under a partnership agreement, Germany's Federal Ministry of Education and Research (BMBF) will invest €39 million over 4 years in CARB-X (the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator), a private-public partnership that funds pre-clinical development of new antibiotics, vaccines, and diagnostics for multidrug-resistant infections. BMBF will also commit an additional €1 million to a consortium of the German Center for Infection Research, the Federal Institute for Vaccines and Biomedicines, and the Federal Institute for Drugs and Medical Devices (BfArm).

"The growing number of pathogens being no longer responsive to lifesaving therapies puts the life of millions of people worldwide at risk," German Federal Research Minister Anja Karliczek said in a CARB-X news release. "Resistant pathogens spread globally. Thus, combatting them takes joint international collaborative actions, such as CARB-X."

Under the agreement, which went into effect on Jan 1, 2019, BfArM will also join CARB-X's Global Accelerator Network.
Mar 14 CARB-X news release

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