Foodborne Disease Scan for Jun 12, 2014

News brief

Salmonella cases from chia powder mount in US and Canada

Four more cases of Salmonella linked to sprouted chia powder have been added to the US count and five to Canada's, and a third strain of the organism has been implicated in the outbreak, according to updates from the Centers for Disease Control and Prevention (CDC) and the Public Health Agency of Canada (PHAC).

The US count stands at 21 in 12 states as of Jun 9, the CDC said in an update yesterday. The newly implicated strain, Salmonella Oranienburg, is the cause of 2 US cases. The two previously implicated strains are Salmonella Newport (13 cases) and Salmonella Hartford (6 cases).

A Jun 10 update from PHAC says that country's total is 34 cases in four provinces, 22 of which are in Ontario. The Canadian cases so far have all been linked to the Newport and Hartford strains.

The number of US hospitalizations in the outbreak remains at two, and Canada has had one. There have been no deaths.

US companies that have recalled products containing sprouted chia seed powder, which is made from ground dried chia seeds, include Navitas Naturals and Health Matters America.

The Canadian Food Inspection Agency (CFIA) has issued food recall warnings on products from Organic Traditions, Back 2 the Garden, Intuitive Path SuperFoods, Harmonic Arts Botanical Dispensary, Naturallyorganic, Pete's Gluten Free, and Nourish Superfoods. The products are sold in numerous retail stores and online.

CDC and PHAC are working together on the outbreak investigation. Consumers are urged to not eat the recalled products, which can have a long shelf life.
Jun 11 CDC update
Jun 10 PHAC update
CFIA recall warnings

Report: Food trucks, carts score better than restaurants on sanitation

Mobile food vendors like food trucks and food carts in seven US cities averaged fewer sanitation violations than restaurants over the past several years, according to a study published yesterday by the Institute for Justice.

For its "Street eats, safe eats" report, researchers from the institute analyzed more than 260,000 inspection reports from government agencies involving food trucks, food carts, and restaurants in Boston, Las Vegas, Los Angeles, Louisville, Miami, Seattle, and Washington, D.C.

The institute requested data going back to 2008 or the first year that data included mobile vendors. Data were collected through part or all of 2012 or, for Boston and Louisville, through July 2013.

Researchers found that in every city, mobile vendors did as well as or better than restaurants and that in six cities they averaged 1 to 4 violations compared with 4 to 8 for restaurants. Seattle averaged almost 14 violations per mobile unit versus almost 17 per restaurant, because the city "weights" each violation more than the other cities do, the report said.

The difference was statistically significant in all cities but Seattle.

The report concludes, "The results suggest that the notion that street food is unsafe is a myth. They also suggest that the recipe for clean and safe food trucks is simple—inspections."
Jun 11 Institute for Justice executive summary
Report home page

 

Study shows more campylobacteriosis in wealthier neighborhoods

People of higher socioeconomic status (SES) in Connecticut are more likely to contract a Campylobacter infection than those of lower SES, according to a report today in Emerging Infectious Diseases.

Yale researchers geocoded 5,708 (96%) of the 5,950 campylobacteriosis cases reported in the state from 1999 through 2009 to census data. They found an average annual incidence of 15.9 cases per 100,000 population.

The investigators also found a strong correlation between higher campylobacteriosis incidence and higher neighborhood SES. The average annual age-adjusted incidence was 10.1 for the lowest SES group (20% or more below poverty), 11.9 for the 10%–<20% group, 14.8 for the 5%–<10% group, and 16.9 for the highest SES group (0–<5% below poverty).

The trend, which was statistically significant, followed in all age-groups except those younger than 10 years, a group that showed the opposite correlation.

The authors said the difference in higher-SES neighborhoods might be explained by surveillance artifacts but is more likely tied to risk factors such as dining out more and international travel. They confirmed that such factors were associated with higher SES in Connecticut by using FoodNet population surveys.
Jun 12 Emerg Infect Dis study

News Scan for Jun 12, 2014

News brief

Early results from chikungunya vaccine trial called promising

An Austrian pharmaceutical company today reported promising findings from a phase 1 study of its candidate chikungunya vaccine. The vaccine, which uses a standard measles vaccine vector, induced a significant neutralizing immune response and appeared to be safe, according to a press release from the Vienna-based company, Themis Bioscience.

The results are based on a study of 42 people that was conducted at Vienna General Hospital. Themis said the vaccine prompted the required immune response, even at the lowest dose, and that increasing dosages led to even stronger immune responses.

Currently, there are no vaccines to protect against chikungunya illness, a mosquito-borne disease that has been triggering outbreaks for the first time in Caribbean nations and territories.
Jun 12 Themis Bioscience press release

In other developments, the US Virgin Islands yesterday reported its first locally acquired chikungunya case and North Carolina reported its first imported infection, according to media reports.

Public health officials in the US Virgin Islands have confirmed the first locally transmitted case but did not detail any information about the patient, the Associated Press (AP) reported yesterday. Earlier this month the territory reported its first imported case, a traveler who returned to St Thomas after a Caribbean cruise.

Elsewhere, the North Carolina Department of Health and Humans Services said today that the first imported case has been detected in the state, in a resident who had recently traveled to the Caribbean, according to report today from the AP.

An increasing number of US states have reported imported chikungunya cases, with many of them in Florida. The US Centers for Disease Control and Prevention (CDC) has warned that more cases are likely to be reported in the wake of the Caribbean outbreak. The nation's number of imported cases so far this year appears to have passed the average number of cases reported in a typical year, which is about 27.
Jun 11 AP story
Jun 4 US Virgin Islands health department press release
Jun 12 AP story

 

Encouraging results for another prion blood assay

French researchers today described a test that can detect prions in humans infected with variant Creutzfeldt-Jakob disease (vCJD) and in animals that are in the early asymptomatic phase of the disease. The team reports its findings in PLoS Pathogens.

They developed their assay after optimizing a method that mimics the method that misfolded toxic prions use to propagate.

In exposed sheep and macaques, the test accurately identified the infections and detected vCJD prions in infected macaques shortly after initial infection. In blinded testing of the blood of four infected humans and 141 noninfected controls, the assay identified vCJD in three of the four infected patients and had no false-positives in the controls.

The team said the findings show progress toward a vCJD blood test that might someday be used to identify infected asymptomatic people or for screening donated blood.

Earlier this year, another research team reported results from a large trial of another test to detect abnormal prion protein associated with vCJD. The group said the test performed well enough for use in screening populations for the disease. Their findings appeared in the Mar 3 issue of the Journal of the American Medical Association (JAMA) Neurology.
Jun 12 PLoS Pathog abstract
Jun 12 Ecole Nationale Veterinaire de Toulouse press release
Mar 5 CIDRAP News scan "Study: vCJD blood test accurate enough for large-scale screening"

 

Surprising number of viruses found in critically ill septic patients

Reactivation of latent viruses is extremely common in patients with prolonged late-stage sepsis and may justify the use of immune-adjuvant drugs along with antibiotics, according to the results of a study published yesterday in PLoS One.

The researchers used polymerase chain reaction to test for viruses in the blood and urine of 560 critically ill hospitalized patients with sepsis and compared results with those from 101 critically ill hospitalized patients without sepsis and 164 healthy controls who were having outpatient surgery.

They found more viruses than expected in the septic patients: Overall, 42.7% had two or more viruses detected. The authors note that this number may underestimate viruses because not all patients were tested for all viruses. In a subgroup of 209 patients tested for all viruses, 54% showed two or more.

The virus detection rate increased with the duration of stay in the intensive care unit (ICU). In addition, the number of viruses detected correlated with the severity of illness, the frequency of secondary fungal and bacterial infections, and longer stays in the ICU.

Research has suggested that when sepsis is prolonged, the initial, hyperinflammatory phase may progress to a predominantly immunosuppressive phase. The present authors note that their research does not answer "whether the increased viral reactivation with sepsis is merely a marker of impaired immunity or contributes to sepsis morbidity/mortality" and encourage further research into this question.
Jun 11 PLoS One study
Jun 11 PLoS press release

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