Latest US data show increased detections of foodborne pathogens

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raw meat
nito100 / iStock

A new report of foodborne illness surveillance in the United States shows the country is not meeting disease-reduction goals. That may be, however, because of increased use of culture-independent diagnostic tests (CIDTs), which allow for diagnoses of infections that previously would not have been reported. 

A summary of the 2023 Foodborne Diseases Active Surveillance Network report was recently published in Morbidity and Mortality Weekly Report, and the authors said continued surveillance is needed to monitor the impact of changing diagnostic practices on disease trend.

The report is meant to compare 2023 incidences of foodborne illnesses with an annual baseline in 2016 through 2018 as part of the Healthy People 2030 initiative, which outlines disease reduction goals for Campylobacter, Listeria, Salmonella, and Shiga toxin–producing Escherichia coli (STEC) infections.

Testing increased in past decade

In 2023, FoodNet identified 29,607 infections, 7,234 hospitalizations, and 177 deaths overall related to foodborne pathogens. 

During 2023, the incidence of domestically acquired campylobacteriosis, STEC infection, yersiniosis, vibriosis, and cyclosporiasis increased, whereas those of listeriosis, salmonellosis, and shigellosis remained stable.

"Increased use of CIDTs facilitates prompt clinical diagnosis and treatment but also complicates the interpretation of surveillance data and trends because CIDT adoption has varied over time, among clinical labs, and by pathogen," the authors wrote. 

STD cases rose 5% from 2020 to 2023, with biggest jumps among older adults, data show

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Gonorrhea bacteria
NIAID

A new Fair Health study shows that sexually transmitted disease (STD) diagnoses in the United States climbed 4.8% from 2020 to 2023, with a 23.8% surge in people aged 65 and older.

Fair Health researchers analyzed data from the nonprofit's repository of more than 47 billion commercial health insurance claims over the 3-year period. The results, released as an infographic, also describe a rise of 16.2% among Americans aged 55 to 64, 8.6% among 35- to 44-year-olds, 7.6% for those aged 45 to 54, and decreases of 6.6% for 19- to 24-year-olds and 3.8% for the 18-and-younger group.

Syphilis, gonorrhea, HIV, and HPV

The fastest-growing STD diagnoses were syphilis (29.4%), gonorrhea (16.8%), and HIV/AIDS (14.1%). Among people aged 65 and older and 55 to 64, the largest increases (32.2% and 21.9%, respectively) were for human papillomavirus (HPV). Diagnoses of HPV also rose for those 45 to 54 (11.3%) and 35 to 44 (3.6%) but declined for those aged 19 to 24 (18.2%) and 25 to 34 (0.9%).

Syphilis diagnoses rose among both sexes (22.9% among males and 46.5% among females).

Diagnoses of gonorrhea grew 59.2% among male patients and fell 19.3% among females. Syphilis diagnoses rose among both sexes (22.9% among males and 46.5% among females).

"It is central to Fair Health’s mission to use our vast repository of claims data to provide data on public health concerns and support research by others," Robin Gelburd, JD, Fair Health president, said in a news release from the New York-based organization. "We hope this information brings greater clarity to the incidence of STDs."

Meningococcal vaccines shown to be moderately effective against gonorrhea

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Meningococcal vaccination
Albert Gonzalez Farran - UNAMID / Flickr cc

A systematic review and meta-analysis of 12 studies suggests meningococcal vaccines show moderate effectiveness against gonorrhea infection, researchers reported yesterday in the Journal of Infection.

Of the 12 studies included in the review, conducted by a team of researchers from Australia, nine evaluated the evidence of vaccine effectiveness (VE) of meningococcal B (MenB) outer membrane vesicle (OMV) vaccines against gonorrhea, and one evaluated VE of a non-OMV-based vaccine (MenB-FHbp) 

While previous studies have indicated that the four-component serogroup B meningococcal vaccine (4CMenB) and other OMV-based MenB vaccines, which target Neisseria meningitides, may provide some cross-protection against Neisseria gonorrhoeae, none have synthesized and examined the evidence of the effects of all meningococcal vaccines on gonococcal infections.

Most of the included studies targeted people aged 15 to 30 years in 8 countries: Australia, Canada, Cuba, France, Italy, New Zealand, Norway, and the United States. Six of the studies evaluated the VE of the 4CMenB vaccine. The adjusted VE for OMV-based vaccines against gonorrhea ranged from 22% to 46%. The pooled VE estimates of OMV vaccines against any gonorrhea infection following the full vaccine series were 33% to 34%. The observed vaccine impact (VI) ranged from a 30% reduction in gonorrhea incidence in South Australia to a 59% reduction in Quebec, Canada.

The MenB-FHbp vaccine showed no protection against gonorrhea.

A potential strategy for reducing gonorrhea incidence

The study authors say that while the variation in VE and VI could be attributed to differences in vaccination programs, target age-groups, and the regional epidemiology of gonococcal infections, the findings "provide reassurance regarding the cross-protection provided by MenB vaccines." And with the prevalence of N gonorrhoeae strains with resistance to most commonly used antibiotics on the rise worldwide, and no highly effective, gonorrhea-specific vaccine on the horizon, they suggest vaccines like 4CMenB are "the most favorable approach" to combat the increasing incidence of gonorrhea.

These findings emphasise the potential value of incorporating meningococcal vaccination into strategies aimed at controlling gonococcal infections.

"These findings emphasise the potential value of incorporating meningococcal vaccination into strategies aimed at controlling gonococcal infections, particularly in regions with high incidence rates and limited treatment options due to antibiotic resistance," they wrote. 

Study: Long-term post-COVID altered sense of smell in healthcare workers common

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smell
NataBene / iStock

A new study based on 2,149 healthcare workers (HCWs) employed at Danderyd Hospital in Stockholm, Sweden, shows that a significant proportion of those who contracted COVID-19 experienced lasting changes to taste and smell, with 45% reporting olfactory disorders 15 months after infection, and 24% still experiencing symptoms 2.5 years after infection.

The study began in April 2020 and involved testing the HCWs for SARS-CoV-2 antibodies every 4 months. HCWs infected during the first wave of the pandemic were compared to healthy controls. All participants were asked "How has your sense of smell been during the last three days?" and to respond "always," "often," or "rarely" to the statement, "The biggest problem is not that I do not or weakly perceive odors, but that they smell different than they should," which assesses for the presence of parosmia, or altered sense of smell.

One-fourth still had loss of smell 2 years later

The authors found that 37% of the COVID-positive group suffered quantitative olfactory dysfunction, with 4 people exhibiting anosmia (loss of sense of smell), and 32 people exhibiting hyposmia, or decreased sense of smell. In the COVID-negative group, 20% showed quantitative olfactory dysfunction, all of whom had hyposmia.

Overall, first-wave infections nearly doubled the prevalence of olfactory dysfunction in the study population, from 20% to 36%, and increased the prevalence of any form of olfactory dysfunction by a full 41 percentage points compared to those without COVID.

Perhaps even more striking, 24% of all tested COVID-19 survivors still experience parosmia 2.6 years after COVID-19 diagnosis.

"Perhaps even more striking, 24% of all tested COVID-19 survivors still experience parosmia 2.6 years after COVID-19 diagnosis, nearly half of which experience medium to severe symptoms," the authors concluded. "Given the length of time, it is possible that these olfactory problems may not be fully reversible in a plurality of individuals."

Quick takes: South Africa mpox spike, New Hampshire measles cluster, walnut E coli probe over

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  • The World Health Organization (WHO) today posted an outbreak notice about a spike in mpox cases in South Africa, which since early May has resulted in 20 confirmed illnesses, 3 of them fatal. The cases were reported in three of the country's nine provinces: Gauteng, Western Cape, and KwaZulu-Natal. The mpox cases are South Africa's first since 2022, when it reported five cases, none of them fatal. All of the 2024 cases are in men ages 17 to 43, and 11 are men who have sex with men. At least 15 of the patients have HIV. Exposures are related to sexual contact. The sudden appearance of the cases in people without international travel, the high HIV prevalence, and the high case-fatality rate suggest only a small portion of cases have been confirmed and that community transmission of the global clade 2 strain in South Africa is ongoing, the WHO said. 
  • New Hampshire's Department of Health and Human Services today announced a confirmed measles infection in an unvaccinated resident who was likely exposed to an international traveler who had measles and was in Hanover in late June. Officials said a measles infection in Vermont has also been linked to the international traveler, bringing the measles cluster to three. The New Hampshire resident visited several public places while infectious, including a restaurant, stores, and medical facilities. 
  • An Escherichia coli O157 outbreak linked to bulk organic walnuts, first announced in April, appears to be over, the Centers for Disease Control and Prevention (CDC) said today, noting that it has ended its investigation. Thirteen illnesses were reported in California and Washington. Epidemiologic and trace-back investigations showed that the organic walnuts were distributed by Gibson Farms, which recalled two lots of its products that were sold in bulk bins in natural foods and co-op stores in 19 states, mostly in the West. Seven patients were hospitalized, including two who had hemolytic uremic syndrome, a potentially fatal kidney condition.

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