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."

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.

The Wisconsin Department of Natural Resources (DNR) yesterday reported the first positive result for chronic wasting disease (CWD) in a wild deer in Jackson County, located in the west central part of the state. Earlier this fall, the DNR reported the first detection in neighboring Trempealeau County, as well as in Polk County in the northwestern part of the state.

The deer was a 2-year-old hunter-harvested buck. It was harvested in the town of Garfield, which is 10-miles from the borders of Eau Claire and Trempealeau counties. The detection in Jackson County triggers a renewal of a baiting and feeding ban, which has been in place in Eau Claire and Trempealeau counties due to earlier CWD detections.

The DNR said it and the Jackson County Deer Advisory Council will hold a meeting to provide information on CWD in Wisconsin and testing for CWD in Jackson County. Wisconsin has now reported CWD in 64 of its 72 counties, after confirming its first case in 2002.

Found in deer and other cervids, CWD is a fatal neurological disease caused by prions and is similar to bovine spongiform encephalopathy (mad cow disease). Though no human cases have been found, health officials urge people to avoid eating the meat of infected animals and to take precautions when field dressing or butchering cervids.

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.