News Scan for Feb 22, 2019

Salmonella in raw chicken
Polio in Pakistan, Afghanistan
Campylobacter in water supply
Zika monoclonal antibody trial
Avian flu in China, India

CDC ends probe of Salmonella raw chicken outbreak after 129 cases

Without being able to pinpoint a specific source of contamination, the Centers for Disease Control and Prevention (CDC) yesterday declared an end to its investigation of an outbreak of antibiotic-resistant Salmonella Infantis infections after confirming 129 cases in 32 states, including 25 hospitalizations and 1 death.

The CDC first alerted the public to the outbreak on Oct 17, 2018, and since then the outbreak has grown by 37 cases, 3 states, and 4 hospitalizations. The agency had not confirmed the death, in a person from New York, until yesterday.

"Epidemiologic and laboratory evidence indicated that many types of raw chicken products from a variety of sources are contaminated with Salmonella Infantis and are making people sick," the agency said in its final statement on the outbreak. However, it said illnesses could continue, because the Salmonella strain appears to be widespread in the chicken industry.

In interviews, people reported eating different types and brands of chicken products. Officials confirmed the outbreak strain in samples taken from raw chicken products, raw chicken pet food, and live chickens, but they could not identify a single, common supplier. Therefore, no food recall was initiated because of the outbreak.

Illness-onset dates range from Jan 8, 2018, to Jan 27, 2019. Patients range in age from less than 1 year to 105, with a median age of 42, and 69% are female.

Of 69 people interviewed, 60 (87%) reported preparing or eating chicken products that were bought raw, including ground chicken, chicken pieces, and whole chicken. One person got sick after pets in the home ate raw ground chicken pet food, and two patients live with someone who works in a facility that raises or processes chickens.

The CDC said it and the US Department of Agriculture are working with the poultry industry to explore ways to reduce Salmonella Infantis in chicken products.
Feb 21 CDC update
Oct 17, 2018, CIDRAP News scan


Afghanistan, Pakistan report wild poliovirus cases

Both Afghanistan and Pakistan recorded recent wild poliovirus type 1 (WPV1) cases, according to the latest update today from the Global Polio Eradication Initiative (GPEI).

In Afghanistan, a patient from Kandahar province experienced symptom onset on Jan 12. This is the second WPV1 case recorded in 2019 in Afghanistan. The country recorded 21 cases in 2018.

In neighboring Pakistan, two cases were recorded, both with onset of paralysis on Jan 20. The cases originated in Khyber Pakhtunkhwa and Punjab provinces. These cases raise Pakistan's 2019 total number of WPV1 cases to 4, compared with 12 last year.

The GPEI also noted the Feb 20 meeting of the World Health Organization's International Health Regulations and Emergency Committee, which unanimously agreed that the risk of polio spread continues to be a Public Health Emergency of International Concern.
Feb 22 GPEI


Officials detail how contaminated water supply caused campylobacteriosis

Municipal water supply contaminated with livestock waste runoff was the cause of a campylobacteriosis outbreak in Nebraska in 2017, according to a study today in Morbidity and Mortality Weekly Reports (MMWR).

The Nebraska Department of Health and Human Services was notified of 39 cases of illness caused by Campylobacter jejuni in March 2017, and the only shared exposure associated with illness (odds ratio, 7.84; 95% confidence interval, 1.69 to 36.36) was to city tap water.

"A collaborative on-site investigation revealed that during the pumping of a large volume of livestock wastewater from a concentrated animal feeding operation through a center pivot irrigation system, the system malfunctioned at an undetermined time," the study authors said. The malfunction allowed wastewater to collect near two wells that served the city.

Campylobacter infection is one of the most common causes of diarrheal illness in the United States, affecting an estimated 1.3 million people each year. It is often associated with eating raw or undercooked poultry.

"This investigation demonstrates the importance of considering exposure to untreated water sources as a potential cause for Campylobacter outbreaks. Including this risk factor in initial questioning could help to expedite outbreak investigations," the authors concluded.
Feb 22 MMWR study


Inovio targets Zika in first human trial of DNA monoclonal antibody

Inovio this week announced the launch of a trial of a DNA-encoded monoclonal antibody (dMAb) treatment, which will test its ability to prevent and treat Zika infection, the company said in a Feb 20 press release.

Inovio is collaborating with The Wistar Institute and the University of Pennsylvania, and the Bill and Melinda Gates Foundation is funding the trial.

The open-label, single-center dose-escalation trial will involve 24 healthy volunteers who will receive up to four doses of the dMAb, which is called INO-A002. According to the press release, the genetic codes provided by the synthetic dMAb trigger the body to make the therapeutic antibodies, meaning production of the monoclonal antibodies doesn't rely on manufacturing in bioreactors, a fact that can speed development and cut costs.

J. Joseph Kim, PhD, Inovio's president and chief executive officer, said the first human study of INO-A002 could provide important information about the platform, which could lead to production of other dMAbs targeting other infectious diseases, cancers, inflammation, and cardiovascular disease.
Feb 20 Inovio press release


H5 avian flu outbreaks strike birds in China and India

In the latest highly pathogenic avian flu outbreak developments, China reported an H5N6 event in poultry and India reported more H5N1 detections in house crows.

China's H5N6 outbreak occurred at a poultry farm in Yunnan province, which killed 463 birds and led to the culling of 55,917, Reuters reported today, citing a report from China's agriculture ministry. H5N6 has been implicated in outbreaks in China and a few other Asian nations, and though the virus is known to infect people, China is the only country that has reported human cases.

India's agriculture ministry, meanwhile, reported three more H5N1 outbreaks involving house crows, two in different cities in Jharkhand state and one in Bihar state, according to separate notifications from the World Organization for Animal Health (OIE).

The outbreaks in Jharkhand state began on Jan 28, resulting in the deaths of 37 birds. The event in Bihar state began on Feb 1 in the city of Jehanabad, with the virus linked to 18 bird deaths. India has reported sporadic H5N1 detections in wild birds and poultry this year, including one reported last week in backyard poultry in Jharkhand.
Feb 22 Reuters story
Feb 22 OIE report on H5N1 in India's Jharkhand state
Feb 21 OIE report on H5N1 in India's Bihar state

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