News Scan for Aug 15, 2013

Israel polio risk
H5N1 emergency in Nepal
FDA's FSMA request denied
Dengue cases in Florida
Compounding pharmacy alert

WHO declares polio risk in Israel in wake of sewage, stool findings

The World Health Organization (WHO) said today that, because of "increasing geographic extent of circulation over a prolonged period of time," the risk of international spread of wild poliovirus type 1 (WPV1) from Israel is moderate to high.

The agency made this statement after WPV1 was detected in 67 sewage samples from 24 sampling sites in Israel from Feb 3 to Aug 4, up from 30 positive samples at 10 sites a month ago. The area of detected virus has also expanded, from initially only in the south to now in the central district as well.

In addition, WPV1 has been isolated in stool samples from 27 healthy children under 9 years old, but no cases of paralytic polio have been reported.

"In addition to routine acute flaccid paralysis, public health authorities have expanded the surveillance to all age groups and have increased enterovirus surveillance and are screening aseptic meningitis cases for polio," the WHO said in today's alert.

Officials began supplemental immunization in parts of southern Israel last week and are planning a nationwide campaign starting Aug 18, the agency added.
Aug 15 WHO alert


Nepal's Kathmandu district declared H5N1 emergency zone

The government of Nepal, site of numerous outbreaks of H5N1 avian flu recently, has declared the Bhaktapur district of the Kathmandu Valley as an emergency zone, a story from Bernama, the national news agency of Malaysia, reported today.

As a result, all chickens, ducks, and pigeons in the area as well as their eggs and feed are to be destroyed. Poultry farms will also be cleaned and disinfected, and sales of poultry meat will be banned.

The story says a rapid response team has been formed by the Ministry of Agriculture to cull 500,000 birds. A story in the Himalayan Times reports that as many as 10 rapid response teams have been deployed to destroy poultry and poultry products and that security forces have been mobilized to settle any disputes.

Nepal first saw H5N1 in 2009 and has seen more than 40 outbreaks around Kathmandu, the capital, in just the past month, the Bernama story states.
Aug 15 Bernama story
Aug 15 story in the Himalayan Times


Federal judge to FDA: FSMA deadlines stand

A July request from the US Food and Drug Administration (FDA) for a second postponement of deadlines for implementation of the 2011 Food Safety Modernization Act (FSMA) has been denied by Judge Phyllis Hamilton of US District Court of Northern California, according to a press release this week.

The FDA had originally been mandated by Congress to complete the writing of rules for FSMA implementation by July 2012 but failed to do so. This resulted in a lawsuit against the agency by the Washington, DC–based Center for Food Safety (CFS) last August.

This April Judge Hamilton ruled that the FDA had violated the law and issued an injunction remedy with new deadlines: posting the proposed regulations by Nov 30, closing the comment period no later than Mar 31, 2015, and publishing the final regulations in the Federal Register by Jun 30, 2015.

The FDA in July asked for reconsideration or a stay of the injunction for two of the seven key rules that remain outstanding—food transport and intentional adulteration, but on Aug 13 Judge Hamilton denied its request and said the dates laid out in April stand.

Implementation of FSMA, the first large-scale overhaul of food safety laws in the United States in more than 70 years, is hoped to provide a long-awaited avenue toward controlling foodborne disease. The CFS's senior attorney, George Kimbrell, is quoted in the organization's press release as saying, "This ruling is clear; FDA must step up and protect public health as it has been directed by Congress. Postponing these rules unnecessarily only endangers more lives."
Aug 13 CFS press release
FDA Web page on FSMA


Florida reports 3 cases of locally acquired dengue

Florida health officials have confirmed three cases of dengue fever in central Florida, according to a CBSMiami/AP report.

The patients are residents of Martin and St. Lucie counties, and they acquired the disease from mosquito bites near Jensen Beach, Fla. None of the three had traveled out of the country recently.

St. Lucie County has not had a dengue case before, officials said, and Martin County has not had one since 2011.
Aug 15 CBS Miami/AP report


CDC reports 2 deaths possibly linked to recalled mineral supplement

The US Centers for Disease Control and Prevention (CDC), in an alert yesterday, said that 2 of the 15 patients with bacterial bloodstream infections possibly linked to mineral supplements from a Texas compounding pharmacy have died, and bacteria resembling the outbreak strain were found in an intact sample of the supplement.

The CDC's Health Alert Network (HAN) advisory was intended to inform healthcare providers and patients of a nationwide voluntary recall of all products produced and distributed for sterile use by Specialty Compounding, LLC, Cedar Park, Tex., as announced by the FDA on Aug 11.

In the notice, the CDC said that it "does not have information that the deaths are related to recalled product." The FDA hadn't mentioned the two deaths in its Aug 11 statement on the recall.

"According to Texas state officials, most infections were caused by Rhodococcus equi and are thought to be related to the infusions," the CDC said in its advisory.

The agency added, "Also, according to Texas state officials, cultures from an intact sample of calcium gluconate compounded by Specialty Compounding show growth of bacteria that are consistent with Rhodococcus species. Isolates are being evaluated by CDC to confirm the identification."
Aug 14 CDC HAN advisory
Aug 12 CIDRAP News scan on recall
Aug 11 FDA statement

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