NEWS SCAN: Botulism outbreak lessons, more meningitis cases, UK pertussis, Tdap in pregnant women, Mexico ousts H7N3

Oct 25, 2012

Report fills in details of 2007 botulism outbreak
Federal and state officials who were part of a 2007 investigation into a botulism outbreak linked to hot dog chili sauce yesterday described the details of the probe in Clinical Infectious Diseases, including the deficiencies they found at the Georgia cannery that produced the sauce. The event was the first botulism outbreak linked to a commercial cannery in the United States in more than 30 years. Eight patients were sickened in the outbreak, including two from Indiana, three from Texas, and three from Ohio. After epidemiologic investigations and lab testing connected the infections to Castleberry hot dog chili sauce, an investigation at the plant found violations of federal canned-food regulations that could have allowed spores of Clostridium botulinum to survive, along with evidence that system maintenance may not have been performed during cooking. The event triggered a recall of about 111 million cans of the company's chili sauce and other canned products, along with a federal warning to other manufacturers about the need to comply with canned-food regulations. The authors wrote that the low number of cases in the outbreak was surprising and could have resulted from only a few cans being underprocessed or from clinicians not identifying all cases.
Oct 24 Clin Infect Dis abstract

Fungal meningitis cases reach 328
Cases of fungal meningitis linked to contaminated steroid injections rose by 11 today to 328, the US Centers for Disease Control and Prevention (CDC) said in an update. The number of deaths remained the same as in yesterday's update, at 24, but the number of affected states grew by 1 to 18, as South Carolina recorded its first case. Of the cases, 323 involved meningitis, stroke presumably due to meningitis, or another infection related to the central nervous system, and 5 were peripheral joint infections, a number that hasn't changed from yesterday. The cases stem from injected methylprednisolone acetate distributed by New England Compounding Center in Framingham, Mass., which is under investigation by federal and state officials. Of the affected states, four had by far the most cases: Michigan (80), Tennessee (70), Indiana (43), and Virginia (43). The state with the next-highest case load is Florida, with 19.
Oct 25 CDC update

UK pertussis surge prompts HPA vaccine push for pregnant women
A continuing surge of pertussis infections in England and Wales has prompted the UK Health Protection Agency (HPA) to launch a program to offer pertussis vaccine to pregnant women to protect newborns, who aren't usually vaccinated until ages 2 to 4 months, according to an HPA press release today. In September, 1,322 pertussis cases were reported in England and Wales, pushing the year's total to 6,121, which is five times higher than in 2011 and seven times higher than the previous peak year of 2008. One death of an infant younger than 3 months old was reported in September, bringing the year's total for pertussis deaths in that age-group to 10. The HPA said that at the end of September the Department of Health announced a program to offer women the pertussis vaccine between 28 and 38 weeks of pregnancy. In the United States, the Advisory Committee for Immunization Practices (ACIP), which advises the Centers for Disease Control and Prevention (CDC) on vaccination policies, yesterday recommended that all pregnant women receive the tetanus, diphtheria, and pertussis (Tdap) vaccine during each pregnancy.
Oct 25 HPA press release
Oct 24 CIDRAP News story "ACIP makes recommendations for Tdap, meningococcal vaccines"

Study: Pre-pregnancy Tdap vaccination won't protect newborns
In related news, women who received the Tdap vaccine either before conception or early in pregnancy did not develop antibodies deemed sufficient to protect their newborns against pertussis (whooping cough), a study in Clinical Infectious Diseases revealed. Researchers from Baylor College of Medicine in Houston analyzed data from 105 mothers (average age, 25) who received the Tdap vaccine within 2 years before giving birth. They found no difference in geometric mean concentrations of pertussis-specific immunoglobulin G in maternal-delivery or infant-cord serum samples between the 86 women immunized before conception and the 19 immunized during early pregnancy—and in both groups the immune response was determined to be insufficient to protect newborns from pertussis. The authors concluded, "Maternal immunization during the third trimester, immunization of other infant contacts, and reimmunization during subsequent pregnancies may be necessary."
Oct 24 Clin Infect Dis abstract
Oct 24 CIDRAP News story on ACIP Tdap recommendations

Mexico's H7N3 avian flu crisis is over, says president
The H7N3 avian flu crisis in Mexico is over after 68 days without any new cases, Mexican President Felipe Calderon announced yesterday, according to the Associated Press (AP). Since the disease surfaced in western Mexico in June, 22 million chickens have been sacrificed in the fight to stop it, Calderon said. The outbreaks increased chicken and egg prices in Mexico and importation of eggs from the United States, the story noted. The outbreaks began on Jun 13 on commercial farms in Jalisco state and were Mexico's first highly pathogenic avian flu event since the mid 1990s, according to earlier reports.

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