NEWS SCAN: E coli and UTIs, NBA norovirus outbreak, flu in Europe, evidence-based vaccine recommendations

Oct 31, 2011

Study: E coli causing urinary tract infections may come from meat
Escherichia coli causing urinary tract infections (UTIs) was found to be closely related to E coli strains in meat, according to Danish and Canadian scientists. They studied 22 geographically and temporally matched B2 strains for E coli isolated from UTI patients, Danes living in the community, broiler chicken meat, pork, and live chickens and pigs for clonal relatedness using pulsed-field gel electrophoresis. They found E coli strains from UTI patients and in the community were both closely clonally related to the meat strains, and several human strains were also clonally interrelated. They also found that nine isolates regardless of origin were virulent in mice. The authors conclude, "The close relationship between community-dwelling human and UTI isolates may indicate a point source spread, eg, through contaminated meat."
Oct 28 Eur J Clin Microbiol Infect Dis abstract

Report: NBA teams passed around norovirus in 2010
In the first known report of a norovirus outbreak on a professional sports team, researchers from the US Centers for Disease Control and Prevention (CDC) and the National Basketball Association (NBA) yesterday described an epidemic in December 2010 that sickened 24 players and staff members from 13 different NBA teams. The CDC and state or local health departments surveyed team physicians to identify the number of cases and infection patterns. Those who were sick at the time of the survey were asked to provide stool samples for norovirus testing. Based on the survey, 21 players and 3 staff members met the norovirus case definition. Of five stool specimens, four were positive for norovirus genogroup 2. Players reported vomiting near other team members, traveling and interacting with them while they were sick, and playing in games while they were probably still infectious. Evidence suggested person-to-person transmission on at least one team and raised the possibility of team-to-team transmission. The researchers said that medical staffs should consider restricting player activities while players are sick and shortly after recovery and reinforcing personal hygiene practices, such as washing hands with soap and water.
Oct 30 Clin Infect Dis abstract

Europe reports low flu activity
Europe is seeing low influenza activity thus far, with only France, Poland, and Scotland showing sporadic activity, according to an Oct 28 report from the European Centre for Disease Prevention and Control (ECDC). During the week that ended Oct 23, the vast majority of countries reported no geographic flu spread, but Hungary, Poland, and Slovakia reported increasing trends. Of the 32 influenza detections in sentinel and non-sentinel isolates over the past 3 weeks, 20 (63%) were influenza A and 12 (37%) influenza B. Of 13 influenza A viruses subtyped, 3 (23%) were pandemic 2009 H1N1, and 10 (77%) were H3 strains. No flu-related hospitalizations were reported for the week.
Oct 28 ECDC update

ACIP to use GRADE approach to evidence-based recommendations
The CDC's Advisory Committee on Immunization Practices (ACIP) voted last October to adopt a new framework for developing evidence-based recommendations in line with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, according to a report in the Nov 15 issue of Vaccine. With this approach, category A recommendations will be made for all people in an age- or risk-based group, and category B recommendations will call for individual clinical decision makingfor members of a given groups. Also, evidence tables will be used to summarize the body of evidence. The ACIP said in the report, "The new evidence framework will enhance the ACIP's decision-making process by making it more transparent, consistent and systematic." It added, "Key factors considered in the development of recommendations include the balance of benefits and harms, type of evidence, values and preferences of the people affected, and health economic analyses."
Nov 15 Vaccine abstract

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