Don't eat precut cantaloupe if you don't know its source, the Centers for Disease Control and Prevention (CDC) said yesterday as it confirmed 18 more cases and outlined more recalled fruit in the ongoing Salmonella outbreak that has now topped 100 illnesses.

As of November 28, the CDC said, officials in 34 states have identified 117 people infected with one of the outbreak strains of Salmonella. Illnesses-onset dates range from October 17 to November 14. Of 103 people with information available, 61 (59%) have been hospitalized, 16 of which are newly reported cases. Two deaths in Minnesota were previously reported.

Patients range in age from less than a year to 100, 59% are male, and 85% are White. Minnesota has confirmed the most cases, 14, followed by Wisconsin (10), Missouri (9), Ohio (8), Arizona (7), and Illinois (6).

Multiple recalls

Federal officials have detailed a raft of recalls related to the outbreak, including Malichita and Rudy brand whole cantaloupes. Brands included in those recalls are Trufresh, Crown Jewels, and Pacific Trellis. Affected whole cantaloupes might have a sticker that says "Malichita" or "Rudy," with the number 4050, and "Product of Mexico/produit du Mexique."

Recalls also include precut fruit products made with recalled whole cantaloupes and sold by Kwik Trip, Freshness Guaranteed and RaceTrac, Vinyard, Kroger, Sprouts Farmers Market, Trader Joe's, Aldi, and Bix Produce.

"Do not eat pre-cut cantaloupes if you don't know whether Malichita or Rudy brand cantaloupes were used," the CDC said. "This includes cantaloupe chunks and fruit mixes with cantaloupes at restaurants and grocery stores."

Flu activity in the United States continues to climb and five new flu-related deaths in kids have been confirmed, according to the FluView weekly update released today by the Centers for the Disease Control and Prevention (CDC).

The percentage of clinical specimens testing positive for influenza rose to 6.2% for the week ending November 24, up from 4.9% the week before. Of all outpatient visits last week, 3.9% were for a respiratory illness, which is up from 3.7% the previous week.

Outpatient influenza-like illness (ILI) is above baselinenationally for the fourth straight week and is at or above baseline in 8 of 10 US regions. The south central, southeast, Mountain, and West Coast regions saw notable increases in flu activity. Eleven states, New York City, and Puerto Rico are reporting high or very high ILI levels.

Five new pediatric deaths

Of the 5 new flu-related deaths in children, 3 were caused by the 2009 H1N1 strain and 2 by influenza B. The CDC has now confirmed 8 pediatric deaths this season, compared with 182 for all of last season.

Of viruses reported by public health laboratories last week, 82.1% were influenza A and 17.9% influenza B. Of 202 influenza A viruses subtyped, 82.2% were H1N1 and 17.8% were the H3N2 strain.

The CDC estimates that so far this season flu has caused at least 1.8 million illnesses, 17,000 hospitalizations, and 1,100 deaths. "CDC recommends that everyone 6 months and older get an annual flu vaccine, as there are still vaccines available," the agency said. "Now is still a good time to get a vaccine, if you haven't already."

The findings of a study yesterday in JAMA Network Open suggest that more than a third of young US adults had anxiety or depression during the COVID-19 pandemic, and economic and social uncertainty may have played a role.

This cross-sectional study consisted of a nationally representative online survey administered from April 2020 to August 2022. Researchers from Northwestern University and the University of Florida assessed symptoms of anxiety and depression via responses to two screening tools, the Generalized Anxiety Disorder 2 (for anxiety) and the Patient Health Questionnaire-2 (for depression).

40% of young adults expressed anxiety

Their analysis included 3,028,923 respondents. The investigators found likely anxiety disorders in 40% of adults 18 to 39, compared with 31% in those 40 to 59 and 20% in people 60 and older. They noted likely depressive disorders in 33% of the young adults, 24% of those 40 to 59, and just 16% in the oldest group.

They noted, "Levels declined throughout the pandemic period for those aged 40 years and older but remained elevated for younger adults…. Younger adults' anxiety and depression increased more than older adults' after surges in COVID-19 case counts but decreased less following vaccination against the virus."

The authors attributed about a third of the age gap among adults with depression and anxiety to economic precarity, found more often in young adults.

They conclude, "Economic precarity was associated with high anxiety and depression among younger adults in the US compared with older adults in the US. These findings suggest a need for greater mental health care and economic policies targeted toward younger adults."

Younger adults' anxiety and depression increased more than older adults' after surges in COVID-19 case counts but decreased less following vaccination against the virus.

New data from the Centers for Disease Control and Prevention (CDC) show significant declines in healthcare-associated infections (HAIs) at US acute care hospitals in 2022.

According to the CDC's 2022 National and State Healthcare-Associated Infections Progress Report, which includes data from more than 38,000 US healthcare facilities, acute care hospitals saw a 19% decrease in ventilator-associated events from 2021 to 2022, a 16% decrease in hospital-onset methicillin-resistant Staphylococcus aureus bacteremia, a 12% decrease in catheter-associated urinary tract infections, a 9% decrease in central line–associated bloodstream infections, and a 3% decrease in hospital-onset Clostridioides difficile (CDI) infections.

On the state level, 31 states performed better on at least 2 infections types in 2022 compared with 2021, 17 saw improvements in at least 3 infection types, and 6 on at least 4 HAIs.

Substantial progress after pandemic-related setbacks

The declines follow 2 years in which HAIs climbed sharply at US acute care hospitals, driven primarily by the COVID-19 pandemic's impact on hospital staffing and infection prevention and control efforts. Some hospitals had to suspend infection prevention and control programs entirely,

The president of the Society for Healthcare Epidemiology of America said the decline in HAIs in 2022 is a sign that hospitals have been able to shift their focus back to HAI prevention.

"Under the leadership of healthcare epidemiologists and infection preventionists, acute care facilities have made substantial progress in shifting attention that was understandably focused on responding to the COVID-19 pandemic back to broader infection prevention initiatives that protect our patients from a wide range of infections," Deborah Yokoe, MD, MPH, said in a statement emailed to reporters.

But the CDC report showed little progress was made in reducing HAIs in other US healthcare settings, which include inpatient rehabilitation facilities (IRFs), critical access hospitals, and long-term acute care hospitals (LTACHs). While IRFs saw a 9% decline in hospital-onset CDI cases, LTACHs saw no changes in standardized infection ratios for any HAI in 2022.

"While much progress has been made, more needs to be done to prevent healthcare-associated infections in a variety of settings," the CDC said.

Acute care facilities have made substantial progress in shifting attention that was understandably focused on responding to the COVID-19 pandemic back to broader infection prevention initiatives.