NEWS SCAN: E coli in Canada, Campylobacter in plant workers, inactivated polio vaccine, polio attack arrests

Jan 9, 2013

E coli outbreak sickens patients in three Canadian provinces
Canadian health officials are investigating an Escherichia coli O157:H7 outbreak that has sickened 15 people in three provinces, according to a statement yesterday from the Public Health Agency of Canada (PHAC). Six of the patients are from New Brunswick, 5 are from Nova Scotia, and 4 are from Ontario. Authorities suspect a common food source, but one has yet to be identified. Patients started getting sick on Dec 22, according to an epidemiologic report on the outbreak. Five patients have been hospitalized, one of them with hemolytic uremic syndrome, a potentially fatal kidney complication. Ten of the patients are male, and patient ages range from 4 to 83 years old.
Jan 8 PHAC statement
Jan 8 PHAC epidemiologic information

Report profiles Campylobacter cases in poultry plant workers
A health hazard investigation identified 29 lab-confirmed Campylobacter cases in poultry workers from January 2008 through March 2011 at a Virginia processing plant, with most infected employees being new workers, working as live-hangers, and living at a state-operated corrections center, according to a study in Emerging Infectious Diseases yesterday. The median age of patients was 29 years (range, 19 to 52), 28 (97%) were men, and 26 (90%) were residents of a corrections center. Twenty-four had worked at the plant for less than 1 month before illness onset. Of the 29 patients, 27 (93%) worked in first-processing areas, including the live-hang (18), evisceration (8), and kill (1) rooms, and 2 worked in second-processing areas, including the rehang (1) and cut-up (1) rooms. Only one patient required hospitalization, and there were no deaths. The authors said the high prevalence among live-hangers is not surprising, "because the feathers, skin, crop, cloaca, and feces of birds brought to slaughter are often highly contaminated with Campylobacter." They also say that corrections workers are often assigned to the live-hang room. They surmise that longer-term workers likely build up immunity to Campylobacter. The authors recommended "improved sanitation, ventilation system modifications, and installation of hands-free soap dispensers and waste receptacles," especially in the live-hang areas, and employee education.
Jan 8 Emerg Infect Dis study

WHO experts endorse inactivated polio vaccine as part of eradication effort
The World Health Organization's (WHO's) panel of experts on immunization has recommended that all countries use at least one dose of inactivated polio vaccine (IPV) to guard against the risk of infection with vaccine-derived poliovirus type 2. The recommendation is noted in a report on the November meeting of the Strategic Group of Experts (SAGE) on immunization, published in the WHO's Jan 4 Weekly Epidemiological Record. The global polio eradication effort relies on oral polio vaccine (OPV) containing live attenuated polioviruses types 1, 2, and 3. When polio immunization coverage is low, oral polio vaccine virus can reproduce in the gut, spread, and in rare cases cause illness. Wild poliovirus type 2 has been nearly eliminated, but the continued use of trivalent oral vaccine creates a persistent risk of vaccine-derived type 2 infections. The draft 5-year plan of the Global Polio Eradication Initiative (GPEI) calls for withdrawing the type 2 component of the oral vaccine and switching to a bivalent vaccine, the WHO report says. SAGE advised that all countries start using IPV in their routine immunization programs to reduce the risks associated with withdrawal of type 2 OPV, the report states. The panel cited evidence that IPV vaccination will help prevent polio in persons exposed to either vaccine-derived or wild poliovirus type 2 and yield other benefits, including boosting immunity to wild poliovirus types 1 and 3. The WHO has said it is studying ways to reduce the cost of IPV, which is much more expensive than OPV.
Jan 4 WHO Weekly Epi Record
Related Jan 3 CIDRAP News story

Arrests made in Karachi polio worker attack
Police in Karachi, Pakistan, have arrested five Taliban militants who were reportedly involved in the killing of five polio immunization workers in an attack in mid December, Kuwait News Agency (KUNA) reported today. A police inspector announced at a news conference that the five terrorists have also been linked to a blast in a Karachi neighborhood that killed 10 people and injured 30 more. The arrests took place in two different raids, where police confiscated explosive material, suicide jackets, and other weapons. Pakistan has experienced a string of recent violent attacks against polio and other aid workers. Militant groups have used threats against polio campaign activity to retaliate against US drone strikes, and some groups in Pakistan believe the immunizations are a front for spy activities or plot to sterilize Muslims. Many of the attacks have taken place in the politically unstable northwestern part of Pakistan, but attacks have occurred in Karachi, as well. In July gunmen opened fire in that city on a doctor from Ghana working on a polio campaign and his Pakistani driver.
Jan 9 KUNA report

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