News Scan for Oct 07, 2015

More cucumber salmonellosis
H3N2 and flu vaccines
Meningococcal group B

Salmonella cases linked to cucumbers top 700

The multistate outbreak of salmonellosis linked to imported cucumbers has grown by 61 cases, to 732, and an additional death has been reported, the Centers for Disease Control and Prevention (CDC) said yesterday in an update.

One more state is affected, bringing that total to 35, the CDC said. The outbreak has now caused four deaths.

Among 536 people with available data, 150 (28%) have required hospitalization. Most patients are young, and half are children. Though ages of patients range from less than 1 to 99 years, the median age is 17. Illness-onset dates vary from Jul 3 to Sep 25.

Maryland reported its first case since the CDC's previous update, on Sep 29. Hardest-hit states are California (192 cases), Arizona (114), Utah (53), Wisconsin (40), and Minnesota (37). (See CDC map.)

The outbreak, caused by Salmonella Poona strains, has been linked to cucumbers imported from Mexico by Andrew & Williamson Fresh Produce of San Diego. The company announced a voluntary recall of its cucumbers on Sep 4.
Oct 6 CDC update


Conference data show low H3N2 vaccine effectiveness

The H3N2 component of influenza vaccines has been only 38% effective on average in the past decade, substantially below the vaccine effectiveness (VE) of the other components, according to research presented this week at IDWeek in San Diego.

Edward Belongia, MD, director of the Marshfield Clinic Research Foundation in Marshfield, Wis., said that VE for the H1N1 and influenza B components of the vaccine since 2005 have been 60% and 75%, respectively, the Boston Globe reported today.

The new data come after a season of low overall VE, of 19%, and low H3N2 VE, of 18%, in a year when the vaccine strain did not match well with H3N2 viruses circulating in the community. VE against "B" viruses last season was 45%; there were not enough H1N1 cases to get good VE data on that strain. Overall VE since 2004-05 against all strains has ranged from 10% that year to 60% in 2010-11, according to CDC data.

"Nobody responds all that well to H3N2 vaccine. The vaccine has some effectiveness and 30% to 40% effective is better than nothing, but it's certainly not as good as we would like to see," Belongia said.
Oct 7 Boston Globe story
CDC data on flu VE since 2004-05 (note that the 23% figure for 2014-15 reflects midseason data)


Meta-analysis finds low levels of group B meningococcal disease

Serogroup B meningococcal disease is widespread globally but at low levels, with higher incidence in some regions, according to a systematic review yesterday in The Lancet Infectious Diseases.

An international team reviewed 37 articles and data on 12 Web sites to determine a yearly incidence of fewer than 2 cases of group B meningococcal disease per 100,000 people in most countries. They noted, however, that New Zealand, Australia, and some European countries had notably higher levels.

New Zealand had a rate per 100,000 of 4.26, followed by Ireland at 2.08, the United Kingdom at 1.44, the Netherlands at 1.40, Malta at 1.33, Iceland at 1.22, and Belgium at 1.2. All other countries had levels below 1 case per 100,000, including Australia and Denmark at 0.99. By comparison, Canada had 0.3 cases per 100,000 people, and the United States had 0.16.

The authors noted that, with few exceptions, case-fatality rates for the disease ranged from 3% to 10%. High-income countries generally had lower rates of the disease. The investigators also noted that incidence rates seem to be declining.
Oct 6 Lancet Infect Dis study

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