News Scan for Jul 14, 2014

CDC handling of anthrax agent
More West Africa Ebola
Moral debt for Haiti cholera
Tattoo product recall

House memo reports more flaws in CDC handling of anthrax agent

A US House of Representatives committee that will host a hearing on Jul 16 to question federal officials on recent incidents involving anthrax bacteria and other pathogens at US Centers for Disease Control and Prevention (CDC) labs today unveiled some findings from its requests for documents and testimony about the agency's biosafety issues.

In a background memo, the House Energy and Commerce Committee described findings from an independent investigation into the anthrax incident by the US Department of Agriculture's Animal and Plant Health Inspection Service (APHIS), which found deficiencies related to seven regulatory requirements. APHIS regulates the domestic possession, use, and transfer of select agents and toxins that can pose a severe threat to public health or the US food supply. The memo said APHIS submitted its report to the CDC on Jul 10.

According to the memo, the APHIS report said the CDC's Bacillus anthracis inactivation protocol was faulty, because it was suitable only for organisms that don't form spores and had been modified without validation. It said the principal investigators did not oversee the lab's use of the protocol.

Other deficiencies included, for example, use of expired disinfectant to decontaminate bags and vials and gaps in decontamination training for lab workers. The report suggests that the CDC's Occupational Health Clinic wasn't prepared to handle such a large exposure incident, which it said led to examination delays for some employees. The report also found problems with leadership and several inconsistencies in post-incident reports.

According to the committee's memo, APHIS investigators also found problems with access to select agents and toxins, with anthrax allegedly stored in unlocked refrigerators in unrestricted hallways and anthrax samples reportedly kept in unregistered, unlocked labs. It's not clear from the memo if the samples involved live or inactivated B anthracis.

In a committee press release today, Rep. Tim Murphy. R-Pa., said as the investigation progresses, the committee sees more problems with CDC's pathogen management.

The hearing is at 10 am (EST) on Wednesday and will be Webcast. Witnesses will include CDC Director Tom Frieden, MD, MPH; Joseph Henderson, deputy director of the CDC's Office of Security and Emergency Preparedness; and Jere Dick, DVM, associate deputy administrator at APHIS.
Jul 14 US House committee press release
Jul 14 US House committee background memo
Jul 8 US House committee hearing notice
House hearing Webcast link


Ebola case reported in Sierra Leone capital as outbreak totals 930

Health officials in Sierra Leone have confirmed the first Ebola virus disease (EVD) case in Freetown, the country's capital, according to a Jul 12 Bloomberg News report. The patient is an Egyptian citizen who got sick after spending time in Kenema, an outbreak hot spot located in the country's Eastern province. The patient has been sent to a treatment center in Kenema.

West Africa's Ebola outbreak has been unusual, because it has affected people in both urban and rural areas, and across a wide geographic area. Earlier in the outbreak, Guinea reported a spike in infections after the disease was detected in Conakry, that country's capital.

In other developments, the World Health Organization (WHO) said more efforts are under way to track people who identify and monitor people in Sierra Leone and Liberia who may have been exposed to EVD.

In a Jul 10 statement the WHO said it, local, and global health partners have trained the last set of 300 community workers from Kailahun district. They will collaborate closely with community leaders and local officials to gain the confidence and support of the people, the WHO said.

In a report today, meanwhile, the WHO said contact tracing is one of the most important outbreak response activities and that the agency and its partners are scaling up efforts. As an example, the WHO said 107 community volunteers in Liberia are working as tracers, targeting Monrovia, the country's capital, and New Kru Town.

So far three West African nations—Guinea, Sierra Leone, and Liberia—have reported 930 EVD cases, along with 580 deaths, with new cases continuing to be reported, it said. The agency did not give details about the most recent cases. The WHO had reported 888 cases in a Jul 10 outbreak update.
Jul 12 Bloomberg News story
Jul 10 WHO statement
Jul 14 WHO report
Jul 11 CIDRAP News story on outbreak numbers


UN head cites moral imperative on Haitian cholera aid

In his strongest statement yet on the topic, United Nations Secretary General Ban Ki-moon said the UN has a "moral responsibility" to help Haiti halt a cholera outbreak that began in 2010 and has sickened more than 700,000, the Miami Herald reported yesterday.

Ban made the comments as he prepared to visit Haiti, which experienced the outbreak 10 months after a devastating earthquake on Jan 12, 2010. The waterborne disease has killed at least 8,563, the story said.

"Regardless of what the legal implication may be, as the secretary general of the United Nations and as a person, I feel very sad," Ban said. "I believe that the international community, including the United Nations, has a moral responsibility to help the Haitian people stem the further spread of this cholera epidemic."

The UN has refused to admit responsibility for the outbreak, even though scientific evidence and the agency's own investigation suggest it was introduced to Haiti by UN peacekeepers from Nepal. In three lawsuits filed in US courts, outbreak patients and their families are seeking compensation from the UN and an apology.

The UN admits that foreign donors have been slow to deliver on $2.2 billion in pledges over 10 years for a cholera-elimination campaign that Ban launched in 2012, according to the story. The agency has even struggled to raise an initial $400 million for the first 2 years to contain the epidemic and build infrastructure for clean water and sanitation.
Jul 13 Miami Herald story


Tattoo ink and needles recalled over contamination risk

The US Food and Drug Administration (FDA) late last week announced a recall of tattoo ink, needles, and kits because of bacterial contamination that led to one illness, the agency said in press release.

White & Blue Lion, Inc., of Industry, Calif., is recalling 5-milliliter bottles of all colors of tattoo ink from a certain lot and batch sold in kits and separately. The ink has a best-used-by date of Dec 16, 2016. It is also recalling various lots of tattoo needles that are included in kits and have an expiration date of June 2018.

"Use of these products may cause bacterial infection and can lead to sepsis, a potentially life-threatening complication of an infection," the FDA said in the release. It did not specify the bacterium. As of Jul 11, one person had become ill because of these products.

FDA laboratory testing found bacterial contamination in both the ink and needles, the agency said.
Jul 11 FDA press release

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