News Scan for Sep 21, 2018

E coli ground beef outbreak
Polio in Afghanistan, DRC
Healthcare-associated infections

Ground beef recalled after 18-case deadly E coli outbreak

Cargill Meat Solutions of Fort Morgan, Colo., has recalled more than 130,000 pounds of ground beef products after they were tied to an 18-case, four-state outbreak of Escherichia coli infections that has left one person dead, federal officials said yesterday.

The Centers for Disease Control and Prevention (CDC) said that E coli O26 has hospitalized 6 people in the outbreak. The person who died was from Florida, which has recorded 15 of the cases. Colorado, Massachusetts, and Tennessee have each confirmed 1 outbreak case.

Illness-onset dates range from Jul 5 to Jul 25, and patient ages vary from 1 to 75 years old, with a median age of 16. Twelve of the patients are male. All 14 patients interviewed reported eating ground beef in the week before they fell ill. Whole-genome sequencing did not identify any antibiotic resistance in the outbreak isolates, the CDC said.

"Initial information collected from ill people in Florida indicated that the ground beef was purchased from various Publix grocery stores," the CDC said. "On August 30, 2018, Publix Super Markets, Inc. recalled ground chuck products sold in several Florida counties." That meat was later traced to the Cargill operation in Colorado, according to a Sep 19 US Department of Agriculture's Food Safety and Inspection Service (FSIS) news release. The recall totals 132,606 pounds of ground beef made from the chuck portion of the cattle.

"E. coli O26, like the more common E. coli O157:H7, is a serovar of Shiga toxin-producing E. coli (STEC)," the FSIS said. "People can become ill from STECs 2–8 days (average of 3–4 days) after exposure to the organism."
Sep 20 CDC statement
Sep 18 FSIS news release


Polio cases confirmed in Afghanistan, DR Congo

The Global Polio Eradication Initiative (GPEI) today reported one new case of wild poliovirus type 1 (WPV1) in Afghanistan and two new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) in the Democratic Republic of the Congo (DRC).

The WPV1 case in Afghanistan is in Kandahar province in the Kandahar district. The patient had onset of paralysis on Aug 11, and the case raises the 2018 total to 14, the same number the country had in all of 2017. At this point last year, Afghanistan had confirmed only 6 WPV1 cases.

Both of the DRC's cVDPV2 cases are in Mongola province, one in Yamaluka district and one in Bumba district. The Yamaluka patient experienced paralysis onset on Jul 30, and the other on Aug 5. Officials also detected the presence of cVDPV2 in a healthy community contact in the province. DCR is addressing three separate cVDPV2 outbreaks in separate provinces. The DRC has now confirmed 15 cVDPV cases this year, compared with 9 at this point last year and 22 for all of 2017.

Global totals of WPV1 now stand at 18 so far this year (Pakistan has had 4 cases), compared with 10 at this time last year. cVDPV cases number 36, compared with 49 at this point in 2017. Syria, however, accounted for 40 of the cVDPV cases year-to-date in 2017, and it has confirmed none so far this year.
Sep 21 GPEI update


Interventions found to cut healthcare-associated infections 35% to 55%

Healthcare-associated infections can be reduced 35% to 55% by systematically implementing evidence-based infection prevention and control strategies, according to a systematic review of 144 studies published yesterday in Infection Control & Hospital Epidemiology.

Swiss investigators assessed multifaceted interventions to reduce catheter-associated urinary tract infections (CAUTIs), central-line–associated bloodstream infections (CLABSIs), surgical-site infections (SSIs), ventilator-associated pneumonia (VAP), and hospital-acquired pneumonia not associated with mechanical ventilation (HAP) in acute-care or long-term care settings. Fifty-six of the studies were conducted in the United States.

They found that interventions reduced infections from around 35% to 55%. Pooled incidence rate ratios associated with multifaceted interventions were 0.54 for CAUTI, 0.46 for CLABSI, and 0.55 for VAP. The pooled rate ratio was 0.46 for interventions aiming at SSI reduction. For VAP-reduction initiatives, the pooled rate ratios were 0.61 for before-and-after studies and 0.51 for randomized controlled trials. The researchers determined that reductions in infection rates were independent of the economic status of the study country.

"Our analysis shows that even in high income countries and in institutions that supposedly have implemented the standard-of-care infection prevention and control measures, improvements may still be possible," said Peter W. Schreiber, MD, the study's lead author, in a news release from the Society for Healthcare Epidemiology of America (SHEA), which publishes the journal.
Sep 20 Infect Control Hosp Epidemiol study
Sep 20 SHEA news release

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