News Scan for Sep 23, 2014

EV-D68 cases in 28 states
FDA seeks food safety breakthrough
Gut microbes in ICU patients

EV-D68 cases exceed 180, with 28 states affected

The US tally of enterovirus D68 cases has reached at least 181, and six more states have identified cases, raising the number of affected states to 28, according to the latest federal and state reports.

In an update late yesterday, the Centers for Disease Control and Prevention (CDC) reported 175 cases in 27 states, signaling increases of 15 cases and five states since the agency's Sep 19 report.

In addition, six cases have been identified in North Carolina, according to a story yesterday in the Raleigh (N.C.) News-Observer. North Carolina is not on the CDC's list of affected states.

The virus, which was fairly rare until now, causes cold-like symptoms but can lead to serious breathing difficulty, especially in children who have asthma. Infants, children, and teenagers are most at risk for symptomatic infections.

The states with confirmed cases are concentrated in the middle of the country, but a few states on the coasts and in the Southeast have also been affected. No deaths have been reported.

In North Carolina, the News-Observer said the confirmed cases were all in children under age 10 and occurred in various parts of the state.

In West Virginia, one of the latest states affected, the Department of Health and Human Resources said the CDC confirmed four cases yesterday, according to a story in the Huntington (W.Va.) Herald-Dispatch. It said the four were among 32 specimens sent to the CDC for testing.

The CDC is predicting that more cases will be found in more states, as a number of clusters of severe respiratory illnesses are still being investigated.
CDC update on affected states
Sep 22 News-Observer story
Sep 22 Herald-Dispatch story
CDC enterovirus page


FDA offers prize money for new ways to find Salmonella in produce

The US Food and Drug Administration (FDA) is offering $500,000 in prize money for anyone who can come up with breakthrough ideas for detecting Salmonella in fresh produce.

In an announcement today, the agency said its "2014 FDA Food Safety Challenge" was developed under the America COMPETES Reauthorization Act of 2010, which grants all federal agencies authority to offer prizes to spur innovation, solve tough problems, and advance their missions.

"Concepts must be able specifically to address the detection of Salmonella in minimally processed fresh produce, but the ability of a solution to address testing for other microbial pathogens and in other foods is encouraged," the FDA statement said.

The agency said participants should submit concepts to the FDA by Nov. 9. Up to five submitters will be selected to advance as finalists. The finalists will be awarded $20,000 and have the opportunity to be coached by FDA experts who will help them develop their ideas before they present them to the judges.

A group of food safety and pathogen-detection experts from the FDA, the CDC, and the US Department of Agriculture will judge the submissions, the FDA said.

The agency noted that an estimated 1 in 6 Americans is sickened by foodborne illness annually, resulting in about 3,000 deaths. Salmonella is the leading cause of deaths and hospitalizations due to foodborne illness, it said, with an estimated 380 deaths and 19,000 hospitalizations each year.
Sep 23 FDA announcement


Study: Long ICU stay can disrupt gut microflora, posing risk of sepsis

A long stay in an intensive care unit (ICU) is likely to nearly eliminate a patient's normal gut microflora and leave behind multidrug-resistant pathogens that can become lethal under the conditions of severe illness, rendering the patient prone to life-threatening sepsis, say results of a small trial described today in mBio, a publication of the American Society of Microbiology (ASM).

The authors cultured microbes from fecal samples of 14 patients with prolonged (more than a month) ICU stays and tested their ability to cause harm through a laboratory model of virulence.

They found that 30% of patients had only 1 to 4 types of intestinal microbes by the end of their stay, compared with about 40 in healthy volunteers. The few pathogens remaining can exist in a harmless state, they found, but that can easily be disrupted by, for example, the presence of opioids, which mimic stress signals released in seriously sick patients. The result can be a highly pathogenic state.

"They've got a lot of bad guys in there, but the presence of bad guys alone doesn't tell you who's going to live or die. . . . It's not only which microbes are there, but how they behave when provoked by the harsh and hostile conditions of critical illness," explained lead author John Alverdy of the University of Chicago in an ASM press release.

The bacteria remaining were found to have a high degree of resistance to antibiotics, induced by exposure to prolonged antibiotic treatment.

The researchers say that in critically ill patients the intestinal microbiome can be considered a "damaged organ" and that "more calibrated use of antibiotics or, alternatively, the development of novel strategies to preserve the core intestinal microbiome" may be avenues to avoiding late-onset sepsis in ICU patients.
Sep 23 mBio study
Sep 23 ASM press release

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