Foodborne Disease Scan for Aug 07, 2017

News brief

CDC warns of rise in Cyclospora cases

The US Centers for Disease Control and Prevention (CDC) today warned health providers about an increase in the number of Cyclospora cases in the United States, with 206 infections in 27 states reported so far in people who were sick on or after May 1.

Most US Cyclospora cases are reported in the spring and summer, and earlier outbreaks have been tied to imported fresh produce, such as basil, cilantro, raspberries, and snow peas. However, the number of cases at this point in the year is higher than for the same time in 2016 when 88 infections had been reported.

In the middle of July, Texas reported increasing numbers of Cyclospora cases, and as of Aug 1, 160 illnesses had been reported in the state, most of them from Bexar and Harris counties. The CDC said most other states have relatively few cases. Eighteen patients have been hospitalized, and no deaths have been reported. So far no specific food source has been identified, and investigations are under way to determine the possible sources of infection.

Canada has also reported a Cyclospora outbreak, with 104 cases so far in Ontario and British Columbia.

Cyclosporiasis is an intestinal illness caused by ingesting food or water contaminated with the Cyclospora cayentanensis parasite. Symptoms include watery, profuse diarrhea along with fatigue, muscle pain, and low-grade fever. The infection is treated with trimethoprim/sulfamethoxazole; without treatment, the illness can last days to more than a month, with possible relapse.

The CDC urged health providers to consider cyclosporiasis in patients who have prolonged or relapsing diarrhea, to order specific Cyclospora testing if indicated, and to report cases to local health departments.
Aug 7 CDC health alert network (HAN) notice
Jul 17 CIDRAP News scan "Texas reports rise in Cyclospora cases"

Another papaya brand recalled in Salmonella outbreak

The Food and Drug Administration (FDA) warned consumers to avoid both Caribena and Cavi brands of Maradol papayas, as well as any papayas packed and grown by Carica de Campeche in Mexico. The fruit are tied to an ongoing multistate Salmonella outbreak.

The move prompted New York distributor Agroson's LLC to stop importing papayas from Carica de Campeche. "As of today no illness has been reported from our Maradol Papaya Cavi Brand but we are doing a voluntary recall in cooperation with the FDA," the company said in an FDA press release.

Agroson said the papayas in question were distributed to wholesalers in New York, Connecticut, and New Jersey from Jul 16 to 19.

According to the FDA, papayas from the Carica de Campeche farm tested positive for Salmonella Kiambu, Salmonella Thompson, Salmonella Agona, Salmonella Senftenberg, and Salmonella Gaminara. So far, Salmonella Kiambu and Thompson have been implicated in 109 infections across the United States.
Aug 4 FDA update
Aug 4 FDA press release

News Scan for Aug 07, 2017

News brief

H5N8 strikes again in Italy, South Africa, UK

The World Organization for Animal Health (OIE) reported three new highly pathogenic H5N8 avian influenza outbreaks on turkey farms in Italy's Lombardy region.

H5N8 was detected on Aug 4 at three commercial farms in the Medole area, which is in the northwestern part of Italy. The report said 94,700 birds are slated for culling.

Late last week, the OIE said highly pathogenic H5N8 was found in samples from 10 mallards found dead in a fishing pond in Lombardy.
Aug 7 OIE report on H5N8 in Italy

Elsewhere, South Africa reported two more H5N8 outbreaks, according to a separate OIE report. The virus was detected at two commercial farms on Aug 4 in Gauteng province in the north central part of the country. The virus killed 2,010 of 107,000 susceptible birds, and the survivors are to be destroyed to help curb the spread of the virus.
Aug 7 OIE report on H5N8 in South Africa

And finally, the United Kingdom today reported a H5N8 detection in a mute swan found dead on Jul 27 at a nature park in the city of North Norfolk in Norfolk county in the east of the country, according to an OIE notification today.
Aug 7 OIE report on H5N8 in the UK

Study: Macrolide-resistant M pneumoniae on the decline in Japan

A new study in Emerging Infectious Diseases reports that the prevalence of macrolide-resistant Mycoplasma pneumoniae in Japan was as high 82% in 2012 but has declined in the following years.

In the study, Japanese researchers investigated 1,448 nasopharyngeal swab samples and sputum samples from children who were treated for respiratory tract infections caused by M pneumoniae from January 2008 through December 2015. In general, M pneumoniae infection is a mild illness that is most common in young adults and school-aged children; outbreaks tend to occur mostly in crowded environments, like schools. An M pneumoniae pandemic occurred in Japan during 2010-2012, especially among children, and a rise in macrolide-resistant infections has been documented during that pandemic. The purpose of the study was to investigate macrolide resistance after the pandemic.

The researchers found that the overall prevalence rate of the macrolide-resistant M pneumoniae during the study period was 70.2% (1,016 of 1,448 samples). When divided into three time periods (pre-pandemic, pandemic, and post-pandemic), the overall rate of macrolide-resistant M pneumoniae was substantially lower in the post-pandemic period than in the pandemic period. After a peak of 81.6% in 2012, macrolide-resistant M pneumoniae decreased to 65.8% in 2013, 59.3% in 2014, and 43.6% in 2015.

By comparison, the prevalence of macrolide-resistant M pneumoniae infections is 13.2% in the United States, 8.3% in France, and 3.1% in Germany, which could reflect differences in macrolide prescribing among countries. The authors of the study say careful, continuous monitoring of macrolide-resistant M pneumoniae infection rates in Japan and other countries is needed.
Aug 4 Emerg Infect Dis dispatch

Ivory Coast reports growing dengue outbreak

The World Health Organization (WHO) reported late last week that Ivory Coast's capital city, Abidjan, is experiencing a dengue outbreak. As of Jul 11, there have been 623 suspected cases, including 2 deaths.

The first dengue cases were reported in April, but the WHO said that the trend of suspected cases is growing. Between Jun 27 and Jul 4, there were 37 new cases; between Jul 4 and 11, 142 new suspected cases were reported. Of lab-confirmed cases, about two-thirds are dengue serotype 2 and about one-third are dengue serotype 3.

Coinfection with yellow fever has been suspected in 68 cases and confirmed in 1 case. The majority (54%) of patients are female, and 27% are between the ages of 15 and 29 years. Fifty-five percent are over the age of 30.

A long rainy season and high density of mosquito breeding sites are the main risk factors for this continuing outbreak, the WHO said.
Aug 4 WHO update

Americas countries report more chikungunya cases

Countries in the Americas reported 697 more suspected, confirmed, and imported chikungunya cases last week, most of them from Panama, which added 4 week's worth of cases, the Pan American Health Organization (PAHO) said in its latest regular update.

The weekly total of new cases is down steeply from the 51,000 reported in the region the previous week. That report reflected a major update from Brazil, which continues to be the hardest hit country in the Americas.

Besides 607 additional infections reported from Panama in the current update, a handful of other countries reported small numbers of new cases, including El Salvador, Colombia, and Peru.

The region has now reported 141,266 cases in 2017. The number of deaths held steady at 51.

Since the outbreak began in the Caribbean part of the Americas in 2013, the region has now reported 2,527,977 cases.
Aug 4 PAHO update