News Scan for Aug 10, 2018

H1N2v in California and Michigan
Cost of antibiotic resistance
Cyclospora outbreak grows
Biosecurity leadership honors

H1N2v confirmed in California, Michigan fairgoers; CDC unveils variant flu graphic novel

The US Centers for Disease Control and Prevention (CDC) today reported four variant H1N2 (H1N2v) cases in people who had contact with swine at fairs, two first reported by California yesterday and two from Michigan, the same day the agency released a new graphic novel aimed at teaching young people about the risk of variant flu in swine exhibit settings.

The California Department of Public Health (CDPH) yesterday confirmed that two cases of flu first reported earlier this week were H1N2v.  These are California's first variant flu cases and occurred in people who attended the Mid-State Fair in Paso Robles. A pig at the fair tested positive for the flu.

In Michigan, two people who attended the Fowlerville Family Fair and had contact with swine have also tested positive for variant influenza A, according to an Aug 3 press release from the Michigan Department of Health and Human Services (MDHHS).

According to the latest FluView, the CDC said these cases are the first H1N2v cases reported in the United States in 2018. All four cases occurred in children younger than 18 who had direct contact with swine. They were not hospitalized and are recovering or have fully recovered from their infections. In June, Indiana reported the nation's first illness from H3N2v, which also involved a fairgoer who had been exposed to pigs.

Swine flu typically occurs after coming into contact with an infected animal.  Symptoms are often mild, but can be more severe in those over the age of 65, under the age of 5, or in immunocompromised persons. The CDC said it expects more cases as state and country fair season come into full swing.

In a related development, the CDC today released a graphic novel geared toward educating young people about variant flu and the disease detective work by public health and veterinary health officials. Titled, "The Junior Disease Detectives: Operation Outbreak," the publication was developed with the US Department of Agriculture and 4-H. The book was illustrated by Bob Hobbs, the same artist who illustrated the CDC's 2011 zombie pandemic graphic novel.

The CDC and teachers who participated in its Science Ambassador Fellowship developed educational activities to accompany the graphic novel that can be used in middle school and high school science classes.
Aug 10 CDC FluView
Aug 9 CDPH press release
Aug 3 MDHHS press release
CDC graphic novel page


Researchers estimate $2.9 billion in US resistance costs for 5 key pathogens

In a study yesterday in Antimicrobial Resistance & Infection Control, scientists estimate that the annual economic cost of five common antimicrobial-resistant (AMR) pathogens to be $0.5 billion in Thailand and $2.9 billion in the United States.

United Kingdom, Thai, and Vietnamese researchers assessed correlations between human antibiotic use and subsequent resistance, the economic cost of AMR for five key pathogens, and consumption data for antibiotic classes driving resistance in the organisms. They analyzed costs for Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa, using resistance rates of 0.37, 0.27, 0.35, 0.45, and 0.52, respectively.

The scientists determined that the cost of AMR associated with the consumption of one standard unit (SU) of antibiotics ranged from $0.1 for macrolides to $0.7 for quinolones, cephalosporins and broad-spectrum penicillins in Thailand. Using US data, the cost of AMR per SU of antibiotic consumed ranged from $0.1 for carbapenems to $0.6 for quinolones, cephalosporins, and broad-spectrum penicillins.

The total annual economic cost of AMR in these five pathogens was $0.5 billion and $2.9 billion in Thailand and the United States, respectively.

The authors conclude, "The economic costs of AMR per antibiotic consumed were considerable, often exceeding their purchase cost. . . . Notwithstanding their limitations, use of these estimates in economic evaluations can make better-informed policy recommendations regarding interventions that affect antimicrobial consumption and those aimed specifically at reducing the burden of AMR."
Aug 9 Antimicrob Resist Infect Control study


CDC: 41 more McDonald’s salad-linked Cyclospora cases

The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) reported 41 additional Cyclospora cases tied to McDonald's salads. As of Aug 9, the outbreak totaled 436 cases in 15 states.

So far there have been 20 hospitalizations from this outbreak, and no deaths.

The parasite was found in Fresh Express bagged salads mixes processed in Streamwood, Ill., which contained romaine and carrots. Fresh Express pulled the salad mix during the last week of July from McDonald's and said no romaine lettuce from the lot infected with Cyclospora was sold to direct retail sale consumers.

"McDonald's reports that they stopped using the Fresh Express salad mix at impacted restaurants in IL, IA, IN, WI, MI, OH, MN, NE, SD, MT, ND, KY, WV, and MO on July 13, 2018," the FDA said. "The company has since reported that it has replaced the supplier of salads in those states."

The outbreak is focused on the center of the country, with 219 cases reported in Illinois, 96 in Iowa, and 53 in Missouri.
Aug 9 CDC update
Aug 9 FDA


Group honors bipartisan Congress members for biosecurity leadership

The Alliance for Biosecurity, a coalition that supports strong public-private partnerships to protect the public against bioterrorism and infectious disease threats, yesterday honored four bipartisan lawmakers with their Congressional Biosecurity Champion awards.

In a press release, the group said the awards went to Sen Joni Ernst, R-Iowa; Sen Elizabeth Warren, D-Mass.; Rep John Moolenaar, R-Mich.; and Rep Scott Peters, D-Calif. It said the awards recognize Congress members who have shown leadership in improving the nation's capacity to prevent and address naturally emerging and human-made chemical, biological, radiological, nuclear, and pandemic biosecurity threats.

A recent survey from the Alliance for Biosecurity suggested that most Americans support increased funding to address biosecurity threats and support the efforts of elected officials who promote and support biosecurity.

Brent MacGregor, the group's cochair, said in the release, "As our nation continues to face natural and manmade threats, sustained congressional support is needed." He added that the four recipients have taken lead roles in the area, and the alliance is proud to honor their commitment to preparedness.
Aug 9 Alliance for Biosecurity press release

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