News Scan for Mar 21, 2017

More nut butter E coli cases
Zika in Florida
Global flu declines
Drug resistance in eye samples

Nut butter E coli outbreak grows to 23 cases; strain found in products

Seven more Escherichia coli O157:H7 illnesses have been reported in a multistate outbreak linked to soy nut butter from an Illinois company, raising the total so far to 23, the US Centers for Disease Control and Prevention (CDC) said today.

Two of the newly reported cases involve patients who have hemolytic uremic syndrome (HUS), a potentially fatal kidney complication. Ten people have been hospitalized, and seven people now have HUS, the CDC said in an update. No deaths have been reported.

The sick people are from nine states, with western states the most affected: Oregon (6 cases), California (5), Arizona (4), and Washington (2). Virginia has also confirmed 2 cases. Children are the hardest-hit group, accounting for 20 of the 23 cases.

Epidemiologic investigations had pointed to I.M. Healthy SoyNut Butter as the illness source, and the CDC said today that lab tests have identified the E coli outbreak strains in product samples collected from the homes of sick people and from retail locations.

The CDC recommends that people do not eat and that childcare centers or other institutions avoid serving any variety or size of I.M. Health SoyNut Butter, I.M. Healthy brand granola, or Dixie Diner's Club brand Carb Not Beanit Butter, regardless of purchase date on the container. The SoyNut Butter Company, based in Glenview, Ill., had previously recalled its soynut butter and granola products.
Mar 21 CDC outbreak update


New case of local Zika in Florida, new smartphone technology for testing

Yesterday the Florida Department of Health (Florida Health) confirmed a new case of locally acquired Zika, likely picked up in Miami-Dade County. This is the second case of non-travel–related Zika found in Florida this year.

The patient was asymptomatic and found through a screening conducted in February. Florida Health said the patient likely contracted the disease in 2016, and the new detection does not mean that Florida has any ongoing sites of active transmission.

In other Zika developments, researchers at Sandia National Laboratories in Livermore, Calif., have published a new paper in Scientific Reports describing how smartphone technology could streamline testing for mosquito-borne diseases, including Zika, dengue, and chikungunya.

Sandia scientists recently developed the unincorporated amplification signal reporters (QUASR) technique, which conducts test reactions in a portable "LAMP box." The box is smartphone-controlled and battery operated and can detect diseases within 30 minutes.

Instead of using traditional polymerase chain reaction (PCR) machines to test the DNA material of a sample, the LAMP box “reads" DNA/RNA without a PCR's heating and cooling cycle, making it useful for testing in the field.

"We've demonstrated that the chemistry we're using can amplify viral RNA directly from raw, unprocessed samples," said Sandia chemical engineer and project lead Robert Meagher, PhD, in a press release. "That is the ideal for a point-of-care testing scenario because you don't want to have extra equipment for isolating DNA or RNA."
Mar 20 Florida Health update
Mar 20 Sci Rep article
Mar 20 Sandia press release


Flu declines in Northern Hemisphere

The World Health Organization (WHO) said yesterday in a global flu update that influenza cases were on the decline overall and in the Northern Hemisphere but rising in parts of the Southern Asia, where 2009 H1N1 is increasing in circulation.

In East Asia and Europe, the flu season has peaked. The H3N2 strain of influenza A was the most widely circulating strain. In North America, flu was decreasing in Canada and the United States, with a slight rise in Mexico. Flu activity in Central America and the Caribbean remained low.

Temperate regions of the Southern Hemisphere are at interseasonal levels. Of the flu samples recently tested by WHO laboratories in 94 countries across the globe, 77.3% were typed as influenza A and 22.7% as influenza B. Of the subtyped "A" samples, 91.9% were H3N2 and 8.1% 2009 H1N1.

To date, all flu samples proved to be susceptible to antivirals, and the circulating strains of influenza A and B had not antigenically drifted from the strains used in the 2016-17 flu vaccine.
Mar 21 WHO update


Ocular specimens show little antimicrobial resistance

A new retrospective study from Mount Sinai Hospital showed low levels of antibiotic resistance and decreasing rates of methicillin-resistant Staphylococcus aureas (MRSA) rates in S aureus isolates taken from ocular samples.

This is one of the first studies to track antimicrobial resistance in the ophthalmology setting, where broad-spectrum antibiotics are often used to treat infections and prescribed before and after surgical procedures, the authors wrote in Antimicrobial Resistance and Infection Control. To conduct the study, the researchers tested ocular cultures collected between January of 2010 and December of 2015 at 25 inpatient and outpatient clinics within the Mount Sinai system.

A total of 540 bacterial organisms were gathered from 1,664 cultures, and 358 isolates underwent susceptibility testing. About 51% of isolates (182) were gram-positive, and S aureus was the most common gram-positive bacteria (62.1%). MRSAdecreased during the study period, from 31% to 14% overall, but the drop was not consistent over the years nor statistically significant. Compared with methicillin-susceptible S aureus isolates, MRSA samples were much more resistant to fluoroquinolones, erythromycin, and trimethoprim/sulfamethoxazole (TMP/SMZ).

Streptococcus pneumoniae isolates showed reduced susceptibility to erythromycin. The most common gram-negative bacteria isolated were Haemophilus influenzae (26.1%) and Pseudomonas aeruginosa (23.9%); H influenzae isolates showed resistance to ampicillin and TMP/SMZ.

"Overall, antimicrobial resistance was infrequent for the Gram-negative and Gram-positive bacteria analyzed. While the MRSA isolates demonstrated increased resistance to multiple antimicrobial classes, this is expected for this pathogen," the authors concluded.
Mar 20 Antimicrob Resist Infect Control study

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