News Scan for Feb 27, 2020

MERS case in Saudi Arabia
E coli sproutbreak
Ebola vaccine for US health workers
Flu vaccine for kids with asthma

One new MERS case reported in Saudi Arabia in Hail

Saudi Arabia's Ministry of Health (MOH) reported a new MERS-CoV case today. This raises the number of MERS cases recorded this month to 12.

The case involves an 80-year-old man from Hail whose exposure to MERS-CoV (Middle East respiratory syndrome coronavirus) is listed as primary, meaning it is unlikely he contracted the virus from another person. The MOH said the man was not a healthcare worker and had unknown camel contact, a known risk factor for MERS.

The World Health Organization said that, since 2012, it has received reports of 2,519 laboratory-confirmed MERS-CoV infection cases, with 866 associated deaths. The vast majority of these cases have been in Saudi Arabia.
Feb 27 Saudi MOH report


CDC says 14 ill in 5 states from E coli traced to Jimmy John's sprouts

The Centers for Disease Control and Prevention (CDC) yesterday says at least 14 people are ill in a multistate outbreak linked to eating Escherichia coli-tainted clover sprouts on Jimmy John's sandwiches.

"The CDC is concerned that people who recently ate clover sprouts on a sandwich from a Jimmy John's restaurant before February 24th could develop an E coli O103 infection," said officials in a Food Safety Alert.

Officials have confirmed that 14 people in five states were infected with the outbreak strain, with illnesses beginning from Jan 6 to Feb 11. No hospitalizations or deaths have been reported, according to the CDC. Patients range in age from 1 to 79 years, with a median age of 28. Illinois reported 6 cases, following by Iowa (3), Utah (3), and Missouri and Texas with 1 each.

On Feb 21, the Food and Drug Administration (FDA) sent a warning letter to Jimmy John's President, James North, demanding a list of steps the chain has or will take to prevent the situation from happening again.

Consumers are advised to talk to their healthcare provider, report their illness to their local health department, cooperate with public health investigators, dispose of any leftovers of their sandwich, and wash their hands after using the toilet and before and after preparing food. Symptoms usually begin 2 to 8 days after ingesting the bacteria.

The outbreak strain of E coli can cause severe stomach cramps, bloody diarrhea, vomiting, fever, and a type of sometimes fatal kidney failure called hemolytic uremic syndrome (HUS). Antibiotics are not recommended for patients with E coli because their efficacy is unproven, and they may increase the risk of HUS.

Jimmy John's reported that all of its restaurants stopped offering clover sprouts on Feb 24. The investigation into whether the tainted sprouts were served at other restaurants or retailers is ongoing, according to the CDC.
Feb 26 CDC Food Safety Alert
Feb 26 CIDRAP News scan "FDA warns Jimmy John's after recent E coli, Salmonella outbreaks"


ACIP recommends Ebola vaccinations for at-risk healthcare workers

Healthcare and laboratory workers at risk of exposure to Ebola should be vaccinated against the virus, the CDC's Advisory Committee on Immunization Practices voted yesterday, according to MedPage Today.

Committee members voted 14-0 for vaccination against Ebola for healthcare workers at risk of exposure, including those responding to an outbreak, working at federally designated US Ebola treatment centers, and laboratory workers and other staff at US biosafety-level 4 facilities.

The FDA approved Merck's Ervebo single-dose, live, attenuated vaccine (rVSV-EBOV) for adults in December 2019.

The ACIP's Ebola working group said that the vaccine is optional; organizations must decide whether to recommend the vaccine, and pregnant women must decide whether the benefits outweigh the risks of a live vaccine. "We would give a lot of guidance about how the decision was to be made," said ACIP member Sharon Frey, MD, of Saint Louis University School of Medicine in St. Louis.

ACIP recommendations are considered final only when published in the CDC's Morbidity and Mortality Weekly Report.
Feb 26 MedPage Today meeting coverage


Study reports improved flu vaccination rates in kids with asthma

Modifying the electronic health record (EHR), using a vaccination tracking tool, and educating healthcare providers and families was associated with a more than quadrupling of flu vaccinations in children hospitalized with asthma, according to a study today in Pediatrics.

Led by scientists at Baylor University in Waco, Texas, the observational study measured an increase in flu vaccination coverage from 13% to 57% over 4 years. A successful pilot project also led to the creation of a hospital-wide vaccination tracking system and a nurse-driven vaccine protocol.

The researchers used serial "plan-do-study-act" cycles to implement the changes, which consisted of documenting flu vaccination status and using the EHR asthma order set and history and physical exam template. The changes were linked to an increase in documentation of flu vaccination status from 51% to 96% and increased the use of the order set and template.

Half of all eligible patients received flu vaccinations after the interventions were implemented, with rates increasing with each year. No adverse reactions to the vaccine were documented.

Children with asthma carry an increased burden of complications from influenza. Hospitalization is considered an ideal time to immunize them against flu, according to the researchers.
Feb 27 Pediatrics abstract

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