News Scan for Jan 15, 2014

Salmonella chicken outbreak
Fungal eye infections
Sublingual flu vaccine tested
New paramyxovirus

Chicken-linked prison Salmonella cases grow to 9

A Salmonella Heidelberg outbreak at a Tennessee prison has grown to nine cases, and investigators are probing 19 infections caused by the same strain in 12 other states to see if they are linked to the outbreak, which has been tied to chicken products from Tyson Foods.

As of Jan 13, two of the nine cases have required hospitalization, the Centers for Disease Control and Prevention (CDC) said in an update yesterday. The outbreak total is two more than reported by the US Department of Agriculture (USDA) on Jan 10. At that time the agency announced that Tyson had voluntarily recalled almost 34,000 pounds of mechanically separated chicken linked to the outbreak.

"Epidemiologic and traceback investigations conducted by Tennessee and federal officials indicate that consumption of Tyson brand mechanically separated chicken is the likely source of the outbreak of Salmonella Heidelberg infections at the Tennessee correctional facility," the CDC said in its update.

The recalled products were sold to institutions but not to consumers, the CDC said. The affected Tennessee prisoners became ill either Nov 28 or 29, the agency added.

The strain involved in the outbreak is commonly reported to PulseNet, the national molecular subtyping network for identifying foodborne bacteria. The CDC is investigating whether the 19 cases from other states match the outbreak strain.
Jan 14 CDC update
Jan 13 CIDRAP News scan on USDA notice


Fungal eye infections in 2012 traced to compounded products

In 2012, 47 people in nine states developed fungal eye infections from two contaminated ophthalmic products after invasive eye procedures, resulting in at least some vision loss in almost all patients, according to a report today in Emerging Infectious Diseases (EID).

CDC, state, and local public health professionals identified 47 cases of endophthalmitis, a rare, serious eye infection, beginning in March 2012. Of them, 21 had been exposed to the intraocular dye Brilliant Blue G (BBG) during retinal surgery, and 26 had received an injection containing triamcinolone acetonide. Both products were produced by Franck's Compounding Lab in Ocala, Fla.

The team identified Fusarium incarnatum-equiseti mold in specimens from BBG-exposed patients and an unopened BBG vial. They confirmed Bipolaris hawaiiensis mold in specimens from triamcinolone-exposed patients.

They said that exposure to either product was the only factor associated with the outbreak. Of 40 patients for whom data were available, 39 (98%) lost vision to at least some degree.

Franck's recalled its BBG on Mar 9, 2012, and triamcinolone on Mar 31, 2012. On May 25 of that year, the company suspended all compounding services and announced a recall of all sterile compounded products distributed from Nov 21, 2011, to May 21, 2012, in response to an investigation by the Food and Drug Administration (FDA) that revealed fungal growth in Franck's clean room.

The EID authors noted that the FDA had investigated Franck's twice before.
Jan 15 EID report


Novartis tests sublingual flu vaccine in mice

Novartis researchers reported this week that a sublingual (under the tongue) influenza vaccine compared well with a conventional intramuscular flu vaccine in generating immune responses in mice.

Writing in Vaccine, the researchers said they assessed the mucosal and systemic immune responses of mice to a sublingual flu vaccine formulated with or without a mucosal adjuvant called LTK63. They compared the sublingual vaccine with both intramuscular and intranasal vaccines.

"Sublingual administration of adjuvanted influenza vaccine elicited comparable antibody titers to those elicited by intramuscular immunization with conventional influenza vaccine," they wrote.

In addition, the sublingual vaccine elicited antigen-specific immunoglobulin A with neutralizing activity, contributing to protection against flu, they said. Also, the adjuvanted form of the vaccine generated certain CD4+ T cells that may play a role in fighting influenza.

"Sublingual delivery of an adjuvanted subunit influenza vaccine could be an effective alternative to conventional intramuscular vaccines," the report says.
Jan 13 Vaccine abstract


Novel paramyxovirus found in field biologist returning from Africa

A wildlife biologist who became severely sick after returning from a 6-week African field expedition that included handling rodents and bats and collecting their blood and tissues was found to have been infected with a novel paramyxovirus related to rubula-like viruses isolated from fruit bats, according to a separate EID report.

The 25-year-old experienced a fever, malaise, headache, generalized myalgia and arthralgia, neck stiffness, and a sore throat 5 days after returning to the United States. She was hospitalized and during her stay developed a maculopapular rash on her back and arms.

While on her trip to South Sudan and Uganda she had handled animals in traps and mist nets, performed dissections, collected blood and tissues, and visited caves with large populations of bats. She said she sometimes used respiratory protection when working with animals and specimens and wore a respirator while in caves.

After health workers ruled out several suspect conditions such as hematophagocytic syndrome and viral hemorrhagic fever, deep sequencing and metagenomic analysis revealed a novel paramyxovirus related to rubula-like viruses that had been previously isolated from fruit bats. The genus Rubulavirus contains both mumps and parainfluenza viruses.

The authors named the new virus Sosuga (a combination of South Sudan and Uganda) and said it most likely originated in bats; they said efforts to detect it in African bats are under way.
Jan 15 EID case report

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