Foodborne Disease Scan for Jun 09, 2015

News brief

NARMS report notes some rise in resistant foodborne pathogens

Antibiotic resistance in foodborne pathogens showed some disturbing trends—including multidrug resistance in one Salmonella strain—according to the latest report from the National Antimicrobial Resistance Monitoring System (NARMS), which covered US data through 2013.

NARMS tracks antibiotic resistance in non-typhoidal Salmonella, typhoidal Salmonella, Shigella, Campylobacter, Escherichia coli O157, and Vibrio species found in ill people, retail meats, and food animals. In 2013, NARMS tested more than 5,000 isolates.

The new NARMS report on human illnesses noted that, on the bright side, multidrug resistance in Salmonella isolates remained steady, at 10% of infections, compared with 11% in 2004 through 2008.

Resistance in some types of Salmonella is increasing, however. For example, multidrug resistance (to ampicillin, streptomycin, sulfonamides, and tetracycline) in a common Salmonella serotype called I4,[5],12:i:- was 46%, up markedly from 18% in 2011.

Also, resistance in Shigella to ciprofloxacin doubled to 4% in 2013 and azithromycin nonsusceptibility appears to be on the rise, particularly among Shigella flexneri. And resistance to a quinolone drug in Salmonella Typhi—the bacterium that causes typhoid fever—was 67% in 2013, up from 53% in the baseline period of 2008 to 2012. This raises concerns that ciprofloxacin, a fluoroquinolone drug and a common treatment for typhoid fever, may not be as effective.

The NARMS report also noted that ciprofloxacin resistance in Campylobacter jejuni, the most common species isolated from humans, remains high, at 22%. And macrolide resistance in Campylobacter coli doubled, from 9% to 18%.

The Centers for Disease Control and Prevention (CDC), in a news release today, said that antibiotic-resistant infections from foodborne pathogens cause an estimated 440,000 illnesses each year in the United States.
Jun 9 NARMS report
Jun 9 CDC press release
Landing page for NARMS reports since 1997
Apr 15 CIDRAP News scan on previous 2012-13 reports

Report: States are reporting, solving fewer foodborne outbreaks

States have reported and solved fewer foodborne disease outbreaks in recent years than they did earlier, according to an analysis by the Center for Science in the Public Interest (CSPI) that covered the decade from 2003 through 2012.

From 2009 to 2012, the average number of foodborne outbreaks that states reported to the CDC dropped by about a third compared with the 6 preceding years, the CSPI, a food and nutrition watchdog group, said in a press release about the report, All Over the Map: A 10-Year Review of State Outbreak Reporting.

In addition, the share of outbreaks in which the contaminated food and the contaminant were identified decreased from 41% in 2003 to 29% in 2012, the group said.

The CSPI also found that reporting varies widely by state, with nine states reporting six or more outbreaks per million population and 19 states reporting one or fewer per million. States that did exceptionally well, with eight or more reported outbreaks, were Oregon, Wyoming, Kansas, North Dakota, Minnesota, and Hawaii.

Also, the 10 states that participated in the CDC's FoodNet surveillance program reported more outbreaks to the CDC, solved more of them, and could identify more pathogens than non-FoodNet states, the CSPI said.

"Our results suggest that many states may lack adequate funding and support for public health services," the report says.

"States that aggressively investigate outbreaks and report them to CDC can help nail down the foods that are responsible for making people sick," CSPI food safety director Caroline Smith DeWaal said in the release. Failure to detect and investigate outbreaks, she added, puts more people at risk.

Craig W. Hedberg, PhD, a food safety expert in the University of Minnesota's School of Public Health, added in the release, "The lessons learned from outbreak investigations are critical for identifying gaps in our food safety systems, and for developing more effective prevention strategies."

The report is an update of one the CSPI published in 2011 and was prepared with generally the same methodology.
Jun 8 CSPI press release
Full CSPI report
Jan 19, 2011, CIDRAP News story on earlier CSPI report

News Scan for Jun 09, 2015

News brief

Saudi Arabia reports another MERS case

Saudi Arabia reported just one MERS-CoV case today, in Mecca province, far from the eastern city of Hofuf, which has been the country's MERS hot spot the past several weeks.

The patient, who is in critical condition, is a 73-year-old Saudi man in the city of Turaba (Turubah), the country's Ministry of Health (MOH) said. He is not a healthcare worker and did not have any contact with other MERS-CoV (Middle East respiratory syndrome coronavirus) patients before he got sick.

The ministry also reported the death of a previously reported case-patient and the recovery of five others, all in Hofuf. The patient who died was a 72-year-old Saudi man, while those who recovered—4 men and 1 woman, all Saudis—ranged in age from 29 to 64.

Saudi Arabia has now had 1,028 MERS cases, with 451 deaths, the MOH said. Eight patients are still being treated, and one is in home isolation.
Jun 9 MOH update

Traveler with XDR-TB being treated at NIH hospital

A woman with extensively drug-resistant tuberculosis (XDR-TB)—which is resistant to almost all known TB drugs—is being treated at the National Institutes Health (NIH) in the Washington, D.C., area after she traveled to at least three states, NBC News reported today.

Federal and state officials are now tracking down hundreds of people who may have been in contact with the woman. No details on the woman or locations of her travel were released.

"The patient was transferred to the NIH via special air and ground ambulances," the NIH said in a statement. She is staying in an isolation room in the NIH Clinical Center designed specifically for handling patients with respiratory infections, including XDR-TB.

The woman faces months or even years of treatment, the story said. XDR-TB patients have only about a 30% to 50% cure rate, according to the Centers for Disease Control and Prevention (CDC).
Jun 9 NBC News report
CDC XDR-TB fact sheet

China's Jiangsu province reports 3 H7N9 cases

China's Jiangsu province, in its May update of reportable infectious disease, noted three cases of H7N9 avian flu that were not previously reported, according to a translation of the report posted on FluTrackers, an infectious disease news message board.

No further information was available about the three cases. China's previous H7N9 cases, which were noted in an April surveillance report with the same lack of detail, were reported on May 22.

The new cases lift the H7N9 total to 668 infections, according to a case list maintained by FluTrackers.
Jun 8 FluTrackers thread
FluTrackers H7N9 case list