News Scan for Feb 13, 2015

Polio-like illness in US kids
Listeria outbreak over
TB DNA test cleared

Another child hit by puzzling polio-like illness, CDC says

The national count of children affected by an unexplained polio-like illness that causes limb weakness has increased by one, to 112 in 34 states since August, the Centers for Disease Control and Prevention (CDC) reported in an update yesterday.

The cases largely coincided with a nationwide outbreak of severe respiratory infections in children caused by enterovirus D68 (EV-D68). Some patients with the polio-like illness tested positive for the virus, but investigators have not yet determined whether EV-D68 is the cause of the neurologic illness.

The CDC calls the polio-like illness acute flaccid myelitis. About two thirds of the children have had some improvement in their symptoms, but only one has fully recovered.

The agency and its partners are continuing to investigate the outbreak.
Feb 12 CDC update


CDC declares apple-related Listeria outbreak over

The Listeria monocytogenes outbreak that has sickened 35 people since last October appears to be over, according to a CDC update yesterday.

Since its previous update on Jan 10, the CDC reported three new cases of listeriosis related to contaminated apples and commercially produced, prepackaged caramel apples.

The Listeria outbreak affected 12 states, and 34 people required hospitalization. Seven patients died, 11 illnesses occurred in pregnant women or newborns with 1 case resulting in fetal loss, and 3 cases were associated with meningitis in children, the CDC said.

The FDA confirmed that the outbreak was related to Granny Smith and Gala apples from the Bidart Bros. apple processing plant in Bakersfield, Calif., which voluntarily recalled affected apples on Jan 6. Prepackaged caramel apples sold by Happy Apples, California Snack Foods, and Merb's Candies were voluntarily recalled at the end of last year.

The CDC continues to warn retailers and consumers not to eat prepackaged caramel apples affected by the recalls.
Feb 12 CDC update
Jan 12
CIDRAP News scan on previous update and strain confirmation


FDA clears test for determining whether active TB is contagious

The US Food and Drug Administration (FDA) approved a test that can help healthcare workers determine whether patients who have active tuberculosis (TB) are contagious and require isolation, according to a press release yesterday.

The Xpert MTB/RTF Assay, manufactured by Cepheid of Sunnyvale, Calif., is a nucleic acid amplification test that can detect DNA from TB mycobacteria more efficiently than a traditional acid-fast bacilli (AFB) sputum smear culture, according to the release.

Patients with symptomatic active TB currently require three negative AFB tests 8 to 24 hours apart to show they are not contagious and can be removed from hospital airborne infection isolation. Cepheid's MTB/RTF test requires only one, or two consecutive, negative results to remove a patient from isolation.

Studies found that a single MTB/RTF test predicted a negative sputum smear 99.7% of the time, and two MTB/RTF tests predicted a negative smear 100% of the time.

The FDA cautions that the MTB/RTF assay does not replace the use of sputum smear culture for proper diagnosis of TB or as a means of identifying the appropriate antibiotics to administer. The assay also cannot detect TB in approximately 10% to 15% of patients with active pulmonary TB who generally do not require isolation but need proper diagnosis.
Feb 12 FDA press release

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