NEWS SCAN: Ricin letter found, hedgehog Salmonella, Haiti's cholera strain, animal antibiotics in Europe, hepatitis A outbreak, US Lyme up 80%

Apr 16, 2013

Reports: Ricin found in mail addressed to US senator
The deadly poison ricin was found today in an envelope that was addressed to a US senator but was intercepted at the US Capitol's off-site mail processing facility, according to media reports. The envelope tested positive in a routine test, and then came up positive on two follow-up tests, according to a CNN story that cited law enforcement sources. The story said the package was then sent to a lab in Maryland for further testing. CNN said sources would not reveal which senator the envelope was addressed to, but a report from Politico identified the intended recipient as Sen. Roger Wicker, R-Miss.
Apr 16 CNN report
Apr 16 Politico report

Salmonella outbreak tied to hedgehogs expands to 23 cases
With the addition of two Ohio cases and one in Idaho, an outbreak of Salmonella Typhimurium infections linked to pet hedgehogs has increased to 23 cases in nine states, the US Centers for Disease Control and Prevention (CDC) reported today. States with cases are Alabama, Idaho, Illinois, Indiana, and Oregon, 1 each; Michigan and Minnesota, 3 each; Ohio, 5; and Washington, 7. The CDC first announced the outbreak in September 2012 and gave its last previous update on Jan 31. Among 20 patients with available information, 7 were hospitalized, and 1 death was reported in Washington, the CDC said. Illness-onset dates ranged from Dec 26, 2011, to Mar 5, 2013. Nineteen of 22 case-patients (86%) who were interviewed reported contact with pet hedgehogs or their environments before they got sick. They reported buying the pets from multiple breeders in several states. Investigators found the outbreak strain of Salmonella in environmental samples and/or feces from hedgehogs in Illinois and Ohio. For prevention, CDC officials stress the importance of thorough hand washing after touching hedgehogs or things in their environments.
Apr 16 CDC update

Toxin mutations may help explain virulence of Haiti's cholera strain
The Vibrio cholerae strain that invaded Haiti in 2010 has a combination of toxin-gene mutations that may help explain the severity of disease and render it more like a strain that was prevalent in the 1800s, according to a study published today in mBio. The strain, called altered El Tor, emerged in about 2000 and is more virulent than strains that had been circulating since the 1960s, according to a press release from Northwestern University Feinberg School of Medicine, where the study was done. Karla J. F. Satchell, PhD, and a colleague analyzed genomic sequences for the new strain and found that the gene for the main cholera toxin had converted to a form similar to that produced in strains prevalent during cholera epidemics in the 1800s. In addition, the new strain had acquired a mutation that inactivated the MARTX toxin, previously recognized as important for evading the immune system. Also, the strain had a third, as yet uncharacterized mutation, perhaps to compensate for the loss of MARTX, according to the release. The findings also further confirm that the strain in Haiti probably originated in Nepal, which is consistent with previous findings from whole-genome analysis and public health studies, according to the release.
Apr 16 mBio abstract
Apr 16 Northwestern University press release
Related Dec 10, 2010, CIDRAP News story

European drug regulators develop animal antibiotic recommendations
The European Medicines Agency (EMA) announced today that it will study the impact of animal antibiotics on human and animal health and make recommendations to reduce the threat to human health, based on a request from the European Commission. In a statement today the EMA said the commission made its request as part of its action plan against the rising antimicrobial resistance threat. It said two of its committees—one that evaluates human drugs and another that looks at animal drugs—will work together on the report and will include experts from the European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority. The group will seek stakeholder input during its analysis and expects to deliver an initial report by June 2013, with a final version expected by the end of 2014.
Apr 16 EMA statement

Scandinavian countries report hepatitis A outbreak
Denmark, Finland, Norway, and Sweden have reported 66 cases of hepatitis A over the past 6 months possibly linked to frozen berries, the European Centre for Disease Prevention and Control (ECDC) said today. Of the cases, 16 were due to genotype 1b hepatitis A with identical RNA sequences, while sequence data for the other 50 cases are unknown, the agency said. None of the 66 patients had traveled outside their countries, but all of them had eaten berries, particularly frozen berries in smoothies. Strawberries had the strongest association with the disease. No hepatitis A virus has been isolated from food samples so far, the ECDC said.
Apr 16 ECDC report

Study: US Lyme disease incidence up 80% from 1993 to 2007
The US incidence of Lyme disease increased about 80% from 1993 to 2007, with the greatest increases seen in northern states while southern states experienced stable or declining rates, a phenomenon that may in part be attributable to climate change, according to a study in CMAJ Open today. Canadian researchers estimated state-level Lyme incidence rates and. using Poisson regression methods on data from the US Centers for Disease Control and Prevention, year-on-year incidence rate ratios (IRRs) from 1993 to 2007. They found an overall increase of 80% during that period, with an IRR per year of 1.049. The national average incidence was 6.2 case per 100,000 person-years, but the rate varied from 0.008 in Colorado to 75 in Connecticut. The team also determined that state latitude and population density explained 27% of the significant between-state variation in IRRs. The authors conclude, "Our findings are consistent with the hypothesis that increases in Lyme disease incidence in recent decades are attributable at least in part to the effects of climate change, with increasing rates of change observed at more northerly latitudes, and declines in disease incidence in the southernmost states. . . . [T]his association could also be described as an apparent decrease in Lyme disease incidence in warmer states and increase in cooler states."
Apr 16 CMAJ Open study

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