News Scan for Aug 07, 2018

Role of cattle in romaine E coli outbreak
Papua New Guinea polio
Guinea worm in South Sudan

FDA: Cattle may have contaminated romaine lettuce tied to E coli outbreak

Canal water contamination with Escherichia coli O157:H7 near a Yuma, Ariz., romaine lettuce growing region might be linked to a large cattle facility, the US Food and Drug Administration (FDA) said yesterday in an update.

The FDA said it recently met with a Leafy Greens Food Safety Task Force formed to address the E coli outbreak earlier this year, during which the task force shared preliminary hypotheses from its environmental assessment in Yuma. In late June, federal officials had said samples from canal water in the Yuma lettuce growing region had tested positive for the outbreak strain. The outbreak from earlier this year sickened at least 210 people in 36 states.

In yesterday's update, the FDA said it continues to consider that contaminated water had contact with the produce, either through direct irrigation or other means. It noted that the canal is close to a concentrated animal feeding operation (CAFO), which can hold more than 100,000 head of cattle at a time. The FDA also said the trace-back investigation revealed a clustering of romaine lettuce farms nearby.

"Our experts continue to work on examining potential links between the CAFO, adjacent water, and geologic and other factors that may explain the contamination and its relationship to the outbreak. Additional sampling activities will be conducted to further explore and narrow down hypotheses in the near future," the agency said, adding that it will detail its findings in a final environmental assessment report that will be publicly available when completed.
Aug 6 FDA update
Jun 28 CIDRAP News scan "
CDC: Canal water near romaine region contained E coli"


Polio case detected in second Papua New Guinea province

Papua New Guinea health officials and the World Health Organization (WHO) yesterday announced another polio case in a vaccine-derived poliovirus type 1 outbreak that now totals three infections.

In a WHO statement, health officials said the new case-patient is a 3-year-old boy in Enga province whose symptoms began on Jun 30, with paralysis that started on Jul 2. His vaccination status is unknown and an investigation into his travel history is under way.

Tests on samples from the boy at the US Centers for Disease Control and Prevention (CDC) confirm that the new case is genetically liked to the two earlier cases, both in Morobe province, which were confirmed in June and July.

With substantial vaccination gaps across Papua New Guinea, the country's risk of further polio spread is high, especially since the spread of the virus to Enga province has been confirmed, the WHO said.

David Mcloughlin, UNICEF representative in Papua New Guinea, said in the statement, "Any province with low routine immunization coverage or gaps in vaccination coverage during the outbreak response is vulnerable for polio virus circulation. This is highlighted by the new confirmed case in Enga."

The country's polio response emergency operations center is updating its risk assessment and enhancing response plans, which may include expanding the vaccination campaign to the whole Highlands region.
Aug 6 WHO statement


South Sudan declares Guinea worm outbreak

On Jul 23, the South Sudan Ministry of Health declared an outbreak of Guinea worm disease (dracunculiasis), after three specimens tested positive for the parasite. The cases are from Western Lakes State, in the center of the country, according to a weekly report late last week from the WHO's African regional office.

The three patients with confirmed infestation each had two to four worms, the WHO said. The patients are two females and one male, ages 14, 17, and 25. 

These are the first Guinea worm cases detected in South Sudan since December of 2016. These cases hinder the country's current 3-year surveillance phase that's required before declaring South Sudan Guinea worm–free.

"The affected communities have been engaged in communal violence over the past several years, which had hindered surveillance for the disease in the area," the WHO said. "Detailed investigations are ongoing to ascertain the source of disease, close contacts (search for additional cases) and the open water sources visited by the cases after the worms emerged."

People contract the parasite when they drink water containing water fleas infected with guinea worm larvae. The worm grows inside the body for up to 1 year before emerging from a painful blister.
Aug 3 WHO

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