Multistate Salmonella outbreak tied to backyard poultry

News brief

The US Centers for Disease Control and Prevention (CDC) and their partners are investigatingSalmonella Mbandaka illnesses in several states that appear to be linked to contact with backyard poultry.

So far, seven illnesses involving the outbreak strain have been identified from six states, which include Florida, Illinois, Missouri, South Dakota, Utah, and Wisconsin. Illness onset dates range from February 9 to March 24. “The true number of sick people in an outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses,” the CDC said, noting that many people recover and are not tested and recent illness may not be reported yet.

Ohio lab finds clue tests on poultry shipping materials

Of seven people who were interviewed about animals they had contact with, five said they had contact with backyard poultry before they got sick. Of four people with information available, two had bought or obtained poultry from agricultural retail stores.

The CDC said the outbreak strain has been linked to two hatcheries in past outbreaks. One facility is linked to a positive poultry shipping material sample collected by Ohio health officials from the current outbreak that matches the samples from patients. “CDC is working with state partners to notify this hatchery of these links and assess any links to upstream suppliers. Additional hatcheries may be linked to the outbreak as the investigation continues,” the group said.

European survey finds gaps in infection prevention, antimicrobial stewardship in long-term care

News brief

Chris Dall, MA

A surveillance study conducted by the European Centre for Disease Prevention and Control (ECDC) found that more than 3% of long-term care facility (LTCF) residents in Europe had at least one healthcare-associated infection (HAI) in 2023 or 2024.

The point prevalence study was conducted in 1,097 LTCFs in 18 European Union/European Economic Area countries and involved 66,112 residents. Of the surveyed LCTFs, at least one staff member with infection prevention and control (IPC) training was available in 77.5%, 40.5% reported having an IPC committee, and 94.2% had a written hand-hygiene protocol. But 38.8% did not have any of the 10 specified antimicrobial stewardship elements.

Nurse with patient in nursing home — AlexRaths / iStock

The crude prevalence of residents with at least one HAI was 3.1%. The most frequently reported HAIs were urinary tract infections (34.1%), respiratory tract infections (27.3%), and skin infections (23.9%). Overall, only 20% of HAIs had positive microbiologic confirmation at the time of the study.

Among the confirmed infections, the most frequently reported microorganisms were Escherichia coli (32.6%), SARS-CoV-2 (14.1%), Klebsiella pneumoniae (9.8%), and Staphylococcus aureus (7.9%).

The crude prevalence of residents receiving at least one antimicrobial was 4.1%. Nearly one-third (29.1%) of prescriptions were given for prophylactic (preventive) purposes.

Enhanced IPC efforts needed

ECDC officials say the results indicate that national health authorities and LTCF managers need to allocate adequate resources for IPC programs, implement robust quality control and surveillance systems, and ensure core competencies for IPC professionals.

"Good data are the foundation for effective action," ECDC Chief Scientist Piotr Kramarz, MD, PhD, said in a press release. "This survey shows we need to better protect long-term care residents through evidence-based strategies, enhanced surveillance, and a firm commitment to real change."

Data link long-term COVID-related loss of smell to depression, anxiety

News brief

Mary Van Beusekom, MS

Woman smelling flower — *Jorge / Flickr cc*

COVID-19 survivors who lose their sense of smell for at least 6 months have more serious depression and anxiety than those without the dysfunction, University of Mons researchers in Belgium write in the Journal of Otolaryngology-Head and Neck Surgery.

At a single medical center, 218 patients with olfactory dysfunction (OD) and 102 asymptomatic controls completed the Olfactory Disorder Questionnaire, General Anxiety Disorder (GAD-7) questionnaire, and Patient Health Questionnaire (PHQ-9) and underwent the Sino-Nasal Outcome Test-22 and threshold, identification, and discrimination testing from August 2023 to January 2024.

The average age was 51.3 years in OD patients and 41.2 in controls. Thirteen OD patients (5.9%) and 5 (4.9%) controls reported a depression diagnosis in the last 5 years.

"The olfaction plays a crucial role in human social interactions, in transforming eating from a simple vital function to a pleasant activity, and for detecting environmental hazards," the authors noted.

Women had higher burden of both measured conditions

At enrollment, the average duration of OD was 31.1 months. OD patients had anosmia (loss of smell; 26.3%), hyposmia (reduced ability to smell; 33.7%), or parosmia (distorted sense of smell; 40.0%), respectively.

While the causality relationship remains unclear, depression and anxiety symptoms must be investigated in this subgroup of patients with long COVID-19.

The average PHQ-9 score was significantly higher in OD patients (6.12; mild depression) than in controls (4.4; minimal depression), as were average GAD-7 scores (4.6 vs 3.5; mild and minimal anxiety, respectively).

Rates of mild-to-severe depression (51.2% vs 44.1%) and mild-to-severe anxiety (39.5% vs 32.4%) were significantly higher in OD patients than in controls; OD patients had a significantly higher percentage of moderate and severe depression and anxiety than those with intact olfaction.

Relative to hyposmia and parosmia, anosmia was tied to severe anxiety. Women scored higher on the GAD-7 and PHQ-9 than men. The average PHQ-9 scores of unvaccinated patients were significantly higher than those of vaccinated participants, indicating a higher depression burden (6.9 vs 5.9). The severity of depression and anxiety increased with OD severity and nasal symptoms.

"While the causality relationship remains unclear, depression and anxiety symptoms must be investigated in this subgroup of patients with long COVID-19," the authors concluded.