News Scan for Mar 28, 2017

New NIH cuts
Yellow fever from Suriname
Measles in Europe
C diff in surgical patients
New chikungunya cases
Food safety in cookbooks

Research grants target of Trump's new $1.2 billion NIH budget cuts

More details emerged today on President Donald Trump's proposed budget, including plans to drastically cut research grant funding to the National Institutes of Health (NIH) in the current fiscal year, which ends in October.

According to a summary obtained by Stat News, $1.2 billion of Trump's proposed $18 billion cut in federal funding will go to directly reducing the money available for scientific and medical research. The amount is in addition to the $6 billion cut in NIH funding in Trump's original budget proposal announced 2 weeks ago. The latest cuts would take $50 million from funding for IDeA grants, which support biomedical research across the country.

The White House also proposed a $314 million cut for the Centers for Disease Control and Prevention (CDC), which would reduce occupational safety and public health preparedness grants and HIV/AIDS programs. Another $100 million in grants for mental health would be taken away from the Substance Abuse and Mental Health Services Administration.

The cuts are made at the expense of expanding defense spending, a move that leaves the country vulnerable to multiple disease threats, according to many biomedical and health groups.
Mar 28 Stat story


Details emerge on Dutch yellow fever patient

The World Health Organization (WHO) today released updated information on a Dutch traveler who contracted yellow fever while visiting Suriname. The WHO says the case highlights the importance of getting the yellow fever vaccine prior to travel to at-risk countries.

The patient, a Dutch woman, had not been vaccinated against the mosquito-borne disease before traveling to Suriname in mid-February. She began having symptoms (headache and high fever) on Feb 28 and was admitted to a Dutch intensive care unit on Mar 3 with liver failure. Yellow fever was confirmed through laboratory testing on Mar 9. She remains hospitalized in critical condition.

The woman traveled throughout Suriname, but the WHO said she most likely contracted the virus in Brokopondo. Currently, Suriname requires a yellow fever vaccination certificate for all visitors over the age of 1 year.

"This case report illustrates the importance of yellow fever vaccination for travellers to countries with risk of yellow fever virus transmission, even for countries that have not reported cases for decades," the WHO statement said. "WHO, therefore, urges Members States to comply with the requirement for yellow fever vaccination for travellers to certain countries and the recommendation for all travellers to countries or areas with risk of yellow fever transmission."
Mar 28 WHO update


Measles outbreaks in Europe top 500 cases

The WHO's European Region office said today that more than 500 new cases of measles were diagnosed in the region in January. The outbreaks, which are concentrated in Romania and Italy, threaten the region’s measles elimination goals.

"With steady progress towards elimination over the past 2 years, it is of particular concern that measles cases are climbing in Europe," says Zsuzsanna Jakab, MD, the WHO Regional Director for Europe, in a news release. "Today's travel patterns put no person or country beyond the reach of the measles virus. Outbreaks will continue in Europe, as elsewhere, until every country reaches the level of immunization needed to fully protect their populations."

Ninety-five percent or more of a population needs to be immunized to prevent measles outbreaks. In Europe, measles remains endemic in 14 countries, and 474 of January's cases were reported in 7 of the 14 endemic countries (France, Germany, Italy, Poland, Romania, Switzerland and Ukraine).

According to the WHO, the current major outbreaks are in Romania, which has had more than 3,400 cases since January of 2016. Italy saw a spike of new cases in the first weeks of January, when it reported 238 cases. Preliminary reports suggest similar case counts for February and March.

The WHO's elimination goals are for interrupted transmission for all of Europe by 2020.
Mar 28 WHO press release


Antibiotic use, ICU admission seen as factors for C diff in surgical patients

A study yesterday in Antimicrobial Resistance and Infection Control describes the incidence rate and risk factors for Clostridium difficile infection (CDI) among surgical patients in Serbia.

In the case-control study, investigators with the Military Medical Academy, a 1,200-bed hospital in Belgrade, Serbia, prospectively identified all patients who had new healthcare-associated (HA), lab-confirmed postoperative CDI from January 2011 through December 2012. The incidence rate was defined as the number HA CDIs per 10,000 patient-days and per 1,000 patients. To determine risk factors, the investigators compared every surgical patient with HA CDI with two control patients without CDI.

Of the 29,033 surgical patients treated during the study period, 67 were diagnosed with CDI, for an incidence rate of 2.6 per 10,000 patient-days and 2.3 per 1,000 patients. The investigators identified three independent risk factors associated with CDI in surgical patients: previous administration of carbapenems, use of third-generation cephalosporins, and admission to the intensive care unit. In-hospital morality was nine times higher in the CDI patients compared with control patients.

"CDI is an important HA infection in population of surgical patients, and this study emphasizes the importance of the wise use of antibiotics and other infection control strategies to prevent HA CDI, decrease incidence and in-hospital mortality rate," the authors conclude.
Mar 27 Antimicrob Resist Infect Control study


PAHO reports more than 200 new chikungunya cases

The total number of chikungunya cases in the Americas grew by 207 after leaping by more than 7,000 cases the week before, the Pan American Health Organization (PAHO) noted in an update late last week. The case count for 2017 has now reached 12,451, PAHO said in its Mar 24 update.

Most of the new cases were in Paraguay, which noted 124 new cases and 632 total for the year. Peru had 32 new cases and 307 total, and Colombia reported 29 new cases and 328 total. In the previous week's report, PAHO had added 7,091 cases, largely because of catch-up reporting by Brazil, which has been by far the hardest-hit country last year and this year.

The chikungunya outbreak began in late 2013 on the Caribbean island of St. Martin and has now sickened at least 2,399,478 people.
Mar 24 PAHO update


Study finds accurate food safety advice sorely lacking in cookbooks

The lack of food safety steps on TV gourmet food shows has been widely noted. Now cookbooks join the list, as a new study found that only 6% of recipes in bestselling cookbooks accurately advise readers to safely cook dishes containing meat, poultry, seafood, or eggs to a certain temperature—results that haven't changed in 25 years.

In the study, published in the British Food Journal by US researchers, the experts dissected 1,497 recipes from 29 cookbooks that appeared on the New York Times best-sellers list. All recipes involved handling raw animal ingredients.

They found that only 123 recipes (8%) mentioned cooking the dishes to a certain internal temperature. But the temperature cited in 34 of those recipes was inadequate to kill pathogens according to US government standards, so in fact only 89 recipes (6%) contained sound food safety advice on internal temperature.

In addition, 99.7% of recipes gave readers unreliable subjective indicators to determine when a dish was done cooking. The most common, in 44% of recipes, was cooking time. Others were color or texture of meat, as well as vague language such as "cook until done."

"Cookbooks aren't widely viewed as a primary source of food-safety information, but cookbook sales are strong and they're intended to be instructional," said senior author Ben Chapman, PhD, in a North Carolina State University (NCSU) news release. He added that a similar study conducted 25 year ago produced similar results.
March Br Food J study
Mar 27 NCSU news release

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