News Scan for Jul 06, 2018

Polio in Afghanistan, Somalia
Pregnancy and flu
CDC reports more Cyclospora illnesses
Frozen veggie Listeria outbreak in Europe

More polio cases reported from Afghanistan, Somalia

In its weekly report, the Global Polio Eradication Initiative (GPEI) announced two advance notices of polio cases, one each in Afghanistan and Somalia.

The case in Afghanistan involves wild poliovirus type 1 (WPV1) in Nad-e-Ali district, Helmand province. The patient suffered an onset of paralysis on Jun 1. The case raises the total number of WPV1cases in Afghanistan in 2018 to 9.

In Somalia, a case of circulating vaccine-derived poliovirus type 2 was recorded for the first time in Dolo district, Gedo province on May 29. Somalia is currently in the midst of an outbreak response vaccination campaign.

With these cases, there are now 12 wild poliovirus cases and 13 vaccine-derived cases reported globally in 2018.
Jul 9 GPEI report


Study of pregnant women shows increased hospitalization risk for flu

A new study based on pregnant Spanish women showed that women in their second trimester were more likely to seek outpatient care for influenza, while women in their third trimester were more likely to be hospitalized for flu complications. The study was published in the Journal of Infection.

Researchers in Catalonia tracked outpatient and hospital visits due to cardiopulmonary illness attributable to influenza from 2008 to 2013 in a cohort of 200,667 pregnant women from Catalonia, Spain. Throughout the study, a total of 25,325 outpatient visits and 209 hospitalizations due to respiratory or cardiovascular illness were observed.

Women in their second trimester had the highest rates of outpatient visits (153 per 10,000 women-months) during flu seasons. Women in the third trimester had the highest rates of hospitalizations (1.60 per 10,000 women-months). They also had an increased risk of hospitalization (adjusted rate ratio [aRR], 1.85; 95% CI, 1.01-3.39) compared to women in other trimesters.

Pregnant women with comorbidities were the most at risk for flu complications, including hospitalization, the authors said.

"According to our results, pregnant women with any comorbidity had higher rates of ambulatory visits than healthy pregnant women in all study seasons. During the influenza epidemic seasons having a high-risk condition was associated with higher rates of outpatient visits (aRR=1.28; 95% CI, 1.21-1.36) and these high-risk women had almost twice the hospitalization rates than healthy women (aRR=1.93; 95% CI, 1.10-3.38)," the authors wrote.

The authors also noted that during the 2009 influenza pandemic, pregnant women with any comorbidity were three times more likely to be hospitalized than during inter-pandemic influenza seasons.
Jul 5 J Infect study


CDC: 27 more sickened in veggie tray Cyclospora outbreak

In an update yesterday, the US Centers for Disease Control and Prevention (CDC) said 27 more people have been sickened in a Cyclospora outbreak linked to Del Monte raw vegetable trays, raising the total number to 212.

So far, only four states in the Upper Midwest have reported cases: Iowa, Minnesota, Michigan, and Wisconsin. The latest illness onset was Jun 6. The number of hospitalized patients remains at 7, and no deaths have been reported.

Most of the sick people reported eating and buying prepacked trays from Kwik Trip convenience stores. Recalled veggie trays contained broccoli, cauliflower, carrots, celery sticks, and dill dip.

The Food and Drug Administration (FDA) said it has not identified which ingredient is the source of the outbreak and that it is looking at each component of the vegetable trays and reviewing related distribution and supplier information.

Cyclosporiasis is caused by the Cyclospora cayetanensis parasite. Symptoms of infection include watery diarrhea, appetite loss, cramping, bloating, and fatigue.

Texas said on Jul 2 that is investigating 56 Cyclospora illnesses reported since early May, but it's not clear if they are related to the infections in other states.
Jul 5 CDC outbreak update


Listeria outbreak linked to frozen vegetables in Europe grows to 47 cases, 9 fatal

A Listeria monocytogenes outbreak in Europe linked to frozen corn and possibly other frozen vegetables has sickened 47 people in five countries since 2015, including 9 deaths, according to a Jul 3 joint statement from the European Center for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA). Affected countries include Austria, Denmark, Finland, Sweden, and the United Kingdom.

The investigation has traced the products to vegetables produced in 2016, 2017, and 2018 at a plant in Hungary, and whole-genome sequencing suggests that L monocytogenes serogroup IVb sequence type 6 (ST6) from the human cases matches isolates found in corn and other frozen vegetables. The report said the findings point to a common source, possibly related to frozen corn, persisting in the food chain and that the strain could be persisting in the processing plant despite standard cleaning and disinfection procedures. The use of contaminated production lines to produce several food products may pose a cross-contamination risk, the groups added.

Food companies in four countries have recalled their frozen vegetable products, and said no frozen foods have come from the Hungarian since March.

The ECDC said the outbreak is still continuing, and that the long shelf-lives of the frozen corn and other potentially contaminated products persists, because they may still be on consumer's freezers.
Jul 3 ECDC-EFSA outbreak update

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