News Scan for Oct 25, 2018

Four more DRC Ebola cases
FSMA produce guidance
Antibiotic overuse with RSV

DRC Ebola total grows by 4 cases as college students support response

In its daily update today the Democratic Republic of the Congo (DRC) health ministry reported four more lab-confirmed cases, three in the current outbreak epicenter in Beni and one in the city of Butembo.

Also, three more deaths were reported in confirmed patients, including two in Beni, one of which involved a death in the community rather than a healthcare center, an occurrence known to raise the risk of virus transmission to others. The third fatality involved a person from Butembo.

The new developments raise the outbreak total to 251 cases, 216 of them confirmed and 35 probable. The latest fatalities lift the death count to 162.

Meanwhile, about 1,000 students from universities and colleges in Beni peacefully marched through the city today to show support for the Ebola response. The ministry said students spent about 2 hours crisscrossing areas of the city where pockets of resistance have been reported to convince residents to collaborate with responders. The health ministry said the event marks the launch of the "Ebola Pas Chez Moi" (Ebola not at my house) campaign, designed to enlist the support of citizens in observing recommended steps for stopping the spread of the virus.

In vaccination developments, the ministry said that, because of large numbers of people being vaccinated, more immunization teams are being trained in Kinshasa and Butembo. Since immunization began in early August, 22,326 people have been vaccinated, nearly half of those in Beni.
Oct 25 DRC update


FDA publishes new drafts of produce guidance

As part of the Food Safety and Modernization Act (FSMA), the Food and Drug Administration (FDA) published its latest draft guidance documents on safe produce handling.

The first document, "Standards for the Growing, Harvesting, Packing, and Holding of Produce for Human Consumption: Guidance for Industry," is meant to help farms comply with the requirements of the Produce Safety Rule, which, according to the FDA, establishes minimum standards for the safe growing, harvesting, packing, and holding of produce. The guidance suggests schedules for cleaning and maintaining farm equipment, steps to keep pests out of buildings, requirements for hand-washing facilities in the produce supply chain, and many other measures.

The second guidance document is titled, "Guide to Minimize Food Safety Hazards of Fresh-Cut Produce." When finalized, the guidance will update and supersede the current guidance on the topic, which was written in 2008.

The FDA is seeking public comments on the draft guidance documents, and requests both electronic and written comments by Apr 22, 2019. The agency will also hold four public hearings in Oregon, California, New York, and Georgia in the coming months.
Oct 22 FDA Guidance "
Standards for the Growing…"
Oct 22 FDA Guidance "
Guide to Minimize…"


Dutch, Israeli study finds antibiotic overuse in children with viral infections

A team of Dutch and Israeli researchers report in The Pediatric Infectious Disease Journal that nearly a third of children hospitalized with a lower respiratory tract infection (LRTI) caused by a virus were treated unnecessarily with antibiotics.

The patient population in the prospective study included children 1 month of age and over with an LRTI or fever without source from hospitals in the Netherlands and Israel. The researchers were looking to determine the incidence of bacterial coinfections and the amount of antibiotic overuse in children with respiratory syncytial virus (RSV), a common viral LRTI that is a risk factor for bacterial coinfection. In winter seasons, 20% of hospitalizations and 18% of emergency department visits for acute respiratory infections in young children are associated with RSV.

A total of 784 children were recruited from October 2013 through May 2016, and 188 children (24%) were positive for RSV. Of the 188 RSV-positive children, 92 (49%) were treated with antibiotics, including 27 (14%) who had bacterial coinfections and were treated appropriately and 8 in whom an expert panel could not distinguish simple viral infection from bacterial coinfection. That left 57 children (30%) treated unnecessarily with antibiotics. Antibiotic overuse was similar among Dutch and Israeli children.

"In conclusion, our data show that although bacterial coinfections in children with RSV infections are relatively rare, high percentages of antibiotic prescriptions are common," the authors of the study wrote. "Further research is need to develop accurate and practical tools to help physicians recognizing bacterial coinfections in children infected with RSV."
Nov 2018 Pediatr Infect Dis J abstract

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