Saudi Arabia reports 3 more MERS cases in Riyadh

Saudi Arabia's Minister of Health (MOH) today confirmed three new MERS-CoV cases in elderly Riyadh residents, which means the city has had seven cases in 5 days.

All three patients with MERS-CoV (Middle East respiratory syndrome coronavirus) are in critical condition, the MOH said in an update. They are an 84-year-old woman and two men, 80 and 77. None are healthcare workers or had preexisting disease.

None of the patients reported recent contact with animals or with MERS patients in the community. Potential contact with MERS patients in a healthcare setting is under investigation for the 80-year-old, while the other two patients did not have such exposure.

Today's cases bring the country's MERS-CoV total to 842 cases, including 363 deaths.
Jan 22 MOH update

USDA announces new Salmo, Campy standards for poultry

The US Department of Agriculture's (USDA's) Food Safety and Inspection Service (FSIS) proposed changes to its Salmonella and Campylobacter Verification Testing Program to reduce the pathogens in ground chicken and turkey products and in raw chicken breasts, legs, and wings, the USDA said in a news release yesterday.

The update is part of the FSIS's Salmonella Action Plan, launched in December 2013 to reduce Salmonella in meat and poultry products.

A pathogen reduction performance standard is the measure that FSIS uses to assess food safety performance of meat and poultry facilities. The agency hopes to reduce pathogens by making the standards for ground poultry tougher to meet.

FSIS implemented performance standards for whole chickens in 1996, but it has since learned that Salmonella levels increase as chicken is further processed into parts, the agency said in the release. Poultry parts represent 80% of the chicken available to US consumers. By creating a standard for chicken parts, and by performing regulatory testing at a point closer to the final product, FSIS hopes to lower illnesses caused by Salmonella and Campylobacter by 50,000 cases a year.

"These new standards, as well as improved testing patterns, will have a major impact on public health," said USDA Deputy Under Secretary for Food Safety Al Almanza. "The proposed changes are another way we're working to meet the ever-changing food safety landscape and better protect Americans from foodborne illness."

FSIS intends to evaluate comments for 60 days and announce final standards and an implementation date this spring, according to the release. The Federal Register notice is available on FSIS Web site here.
Jan 21 USDA news release

Study: One fifth of international travelers may contract 'superbugs'

About 21% of international travelers—and 37% of travelers with diarrhea who had taken antibiotics—may be colonized with drug-resistant bacteria, according to a study yesterday in Clinical Infectious Diseases.

Researchers collected stool samples from 430 Finns before and after they traveled outside of Scandinavia. They tested for extended-spectrum beta-lactamase–producing Enterobacteriaceae (ESBL-PE) and carbapenemase-producing Enterobacteriaceae (CPE), two drug-resistant "superbugs."

They found that 90 of the travelers, or 21%, became colonized by ESBL-PE after traveling, but none by CPE. For travelers to South Asia, the prevalence rose to 46%.

The rate of ESBL-PE was 11% in those without traveler's diarrhea (TD) or antimicrobial use, 21% for those with TD and no antimicrobial use, and 37% in those with both TD and antimicrobial use.

Those numbers climbed to 14%, 37%, and 69%, respectively, in travelers to Southeast Asia, and to 23%, 47%, and 80% in travelers to South Asia.

"More than 300 million people visit these high-risk regions every year," said lead author Anu Kantele, MD, PhD, according to a press release from the Infectious Diseases Society of America (IDSA), which publishes the journal. "If approximately 20% of them are colonized with the bugs, these are really huge numbers. This is a serious thing. The only positive thing is that the colonization is usually transient, lasting for around half a year."

An accompanying editorial called the paper "an excellent prospective study that provides very compelling evidence that antimicrobials increase a traveler's risk of colonization by ESBL-PE."

The authors conclude, "In modern pre-travel counseling for those visiting high-risk regions, travelers should be advised against taking antibiotics for mild or moderate TD."
Jan 21 Clin Infect Dis abstract
Jan 22 IDSA news release
Jan 21 Clin Infect Dis editorial