News Scan for Aug 03, 2020

New DRC Ebola case
Salmonella and onions
Pediatric antibiotic stewardship
Longhorned tick in Ohio
H7N7 avian flu in Australia

One more sick in DRC Ebola outbreak, 73 total, with 31 deaths

Ebola has sickened one more person in the Democratic Republic of the Congo (DRC) Equateur province outbreak, upping the total to 73 cases, the World Health Organization (WHO) African regional office said today on Twitter.

No new deaths were reported, keeping the fatality count at 31.

The outbreak was first detected in early June and marks the DRC's 11th Ebola outbreak. It is occurring in the same area as the country's ninth outbreak in 2018, which ended in only a few months with 54 cases, 33 of them fatal.
Aug 3 WHO African regional office tweet


CDC: Onions likely source of Salmonella in almost 400-case outbreak

Almost 400 people in 34 states have been sickened with Salmonella Newport, likely tied to onions sold by Thomson International Inc., the Centers for Disease Control and Prevention (CDC) said late last week.

The multistate outbreak includes 396 cases, with 59 people requiring hospitalization. So far there have been no deaths. Oregon has the most cases, with 71, followed by Utah (61) and California (49). Illnesses started on dates ranging from Jun 19 to Jul 12.

"The traceback information collected identified Thomson International, Inc. of Bakersfield, CA as a likely source of red onions in this outbreak," the CDC said in an update. "Due to the way onions are grown and harvested, other types of onions, such as white, yellow, or sweet, may also be contaminated."

The Public Health Agency of Canada (PHAC) is also investigating a 120-case outbreak of Salmonella illnesses genetically linked to the US outbreak. On Jul 30, PHAC said red onions grown in the United States were the likely source of that outbreak.
Jul 31 CDC
Jul 31 CIDRAP News scan on PHAC update


Online program tied to less inappropriate antibiotic use for pediatric ARTIs

As many as one third of outpatient antibiotic prescriptions written for pediatric acute respiratory tract infections (ARTIs) are inappropriate, but a distance learning course consisting of three program modules aimed at family clinicians was associated with a 7% drop in overall antibiotic prescribing rates for all ARTI visits, according to a study published today in Pediatrics.

The study took place in 19 pediatric practices in 2015 to 2019, and visits for acute otitis media, bronchitis, pharyngitis, sinusitis, and upper respiratory infection for children 6 months to 11 years without recent antibiotic use were included.

Clinicians were assigned to use the Dialogue Around Respiratory Illness Treatment (DART) Quality Improvement Program—an evidence-based online communication skills and antibiotic prescribing education training program developed by the authors. The program focuses on how clinicians can communicate their decision not to prescribe antibiotics to a patient's family, as well as more generally on antibiotic overuse.

A total of 72,723 ARTI visits by 29,762 patients were included in the study. Antibiotic prescribing declined by 7% 2 to 8 months after physicians completed DART. The program resulted in sustained reductions in antibiotic prescribing during viral ARTI visits and sustained decreases in second-line antibiotic prescribing during streptococcal pharyngitis and sinusitis visits, but it did not result in sustained reductions in antibiotic prescribing during all pharyngitis visits, the authors said.

In an accompanying commentary, US experts not involved in the study said the DART program tackles one of the biggest hurdles in pediatric antibiotic overuse: parents. "The reasons for inappropriate antibiotic prescribing in ambulatory pediatrics are multifactorial, including patient pressures and demand, actual or perceived parental satisfaction, provider knowledge, and provider time constraints," they said. "An effective approach to decreasing inappropriate antibiotic prescribing must therefore address each of these contributing factors."
Aug 3 Pediatrics study
Aug 3 Pediatrics commentary


Longhorned tick identified in Ohio

The Ohio Department of Agriculture (ODA) late last week announced that the Asian longhorned tick, a rapidly spreading invasive species, has been found on a stray dog from Gallia County.

In a statement, the ODA said the tick was identified on May 28 by The Ohio State University, with findings confirmed by the US Department of Agriculture National Veterinary Services Laboratory in Ames, Iowa.

The tick was first identified in New Jersey in 2017. A ProMED Mail post on the Ohio detection said the number of states that have identified longhorned ticks has now reached 13. All but Arkansas are in the eastern United States.

Longhorned ticks haven't been known to sicken people yet in the United States, but they are aggressive biters that are known to carry pathogens that sicken humans and livestock. Researchers last summer described the first known human to have been bitten by a longhorn tick, a man from New York who was likely exposed in his yard and did not become ill.

Female Haemaphysalis longicornis ticks produce massive offspring without mating. In Australia and New Zealand, infestations from the species have been reported to decrease production in dairy cattle by 25%.
Jul 31 ODA press release
Aug 2 ProMED Mail post
Jun 3, 2019, CIDRAP News story "First US human bite from worrying longhorned tick noted"


H7N7 avian flu strikes layer farm in Australia

Agriculture officials in Australia recently reported a highly pathogenic H7N7 avian flu outbreak at a free-range layer farm in Victoria state, according to a Jul 31 notification from the World Organization for Animal Health (OIE).

The outbreak began on Juy 24 in Lethbridge, affecting birds in one of two sheds at the farm. The virus killed 1,669 of 43,500 susceptible birds, and the rest were culled to curb the spread of the virus. So far, the source hasn't been identified, but it may involve contact with wild species, according to the report.

Australia's most recent previous outbreak involving the strain occurred in 2014.
Jul 31 OIE report on H7N7 in Australia

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