News Scan for Jul 18, 2013

TB in Wisconsin
Salmonella in tree nuts
Two more hepatitis outbreak cases

Wisconsin town battles costly TB outbreak

Sheboygan, Wis., has spent millions battling a nine-case tuberculosis (TB) outbreak this spring and summer that may still be growing, at a time when states are cutting their TB-control budgets, NPR reported today.

The index patient, who was identified in April, is still recovering in isolation with multidrug-resistant TB (MDR-TB). Epidemiologists say the city of 50,000 people could end up with about 15 symptomatic MDR-TB cases before the outbreak runs its course, and many dozens more who don't show symptoms.

Five households have been confirmed affected, but none of the other eight cases have been as drug resistant as the first. Sheboygan received $5 million in state aid to combat the outbreak.

A recent national survey found that 60% of states have cut their TB-control budgets, the story said, which reminds one researcher of what happened in the 1990s. Then, funding cuts led to a TB resurgence.

"We corrected that mistake, and we've had great results," said Richard Chaisson, MD, who directs TB research at Johns Hopkins University. "Now we're making that same mistake all over again, which is declaring victory and withdrawing from the fight before the disease is controlled."
Jul 18 NPR story


FDA seeks comments on Salmonella risk from tree nuts

In a nutshell, the US Food and Drug Administration (FDA) wants the public's help in assessing the risk of Salmonella infection from eating tree nuts.

The risk assessment decision was prompted by salmonellosis outbreaks linked to tree nuts over the past decade, by product recalls, and by detection of Salmonella in tree-nut surveys, the FDA said in an announcement yesterday. In recent years the bacterium has been found in almonds, cashews, pistachios, pine nuts, Brazil nuts, macadamia nuts, and walnuts.

The FDA said it aims to measure the public health risk associated with eating tree nuts potentially contaminated with Salmonella and to evaluate interventions to prevent or reduce such contamination.

The risk assessment will influence FDA policy and may be useful for owners and operators of nut processing plants and other post-harvest facilities, among other stakeholders, the agency said.

The FDA said it will present a webinar on the assessment plan and related data needs on Monday, Jul 22, from noon to 1 pm ET. Information on how to participate is included in the FDA statement linked below. A recording of the webinar will be posted on the FDA's risk and safety assessment Web page after the event.

Anyone wishing to submit comments, scientific data, or other information for use in the risk assessment should visit the same risk and safety assessment Web page, the FDA said.
Jul 17 FDA announcement


Berry-linked hepatitis outbreak grows to 149 cases

The Centers for Disease Control and Prevention (CDC) today confirmed two more cases of hepatitis A in a multistate outbreak tied to a frozen berry mix containing pomegranate seeds from Turkey, bringing the outbreak total to 149.

Patients' ages range from 1 to 84 years, but 85 (57%) are between 40 and 64. Sixty-five patients have been hospitalized, but none have died, the CDC said.

The latest illness onset in the outbreak was Jul 5. The affected states, with case numbers, are California, 73; Colorado, 27; Arizona, 22; Hawaii and New Mexico, 8 each; Nevada, 6; Utah, 3; and Wisconsin, 2. The Wisconsin cases resulted from product exposure in California, the CDC said.

All patients in the outbreak reported eating Townsend Farms Organic Antioxidant Blend bought at Costco stores, though the same product was sold at Harris Teeter stores. Investigators said the most likely source of contamination was pomegranate seeds from Goknur Foodstuffs of Turkey.
Jul 18 CDC update

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