News Scan for Sep 25, 2020

Mushroom Salmonella outbreak
;
Drop in Australian antibiotic use
;
Polio in 5 countries

Salmonella outbreak tied to dried mushrooms sickens 41 in 10 states

The US Centers for Disease Control and Prevention (CDC) yesterday announced a Salmonella Stanley outbreak linked to dried mushrooms in dishes served at ramen restaurants that has so far sickened 41 people in 10 states.

Illnesses began on Jan 21, with Aug 26 as the latest illness onset. Patient ages range from 2 to 74 years, and 62% of the patients are female. Of 32 cases with information available, 4 hospitalizations were reported. Health officials are using PulseNet, the national genetic subtyping network, to look for other cases. Tests on 26 samples from patients by the National Antimicrobial Resistance Monitoring System did not demonstrate any antibiotic resistance.

Epidemiologic and trace-back investigations suggest that wood ear mushrooms distributed by Wismettac Asian Foods, of Santa Fe Springs, California, sold only to restaurants, is the likely source of the outbreak. Interviews with 18 sick people found that 16 ate ramen at a restaurant in the weeks before their symptoms began, several from the same restaurants, a sign that they may be part of illness clusters.

Eight of the nine patients in the clusters reported eating wood ear mushrooms or ramen containing the item the week before they got sick. A review of records showed that Wismettac Asian Foods is the source of the mushrooms.

The California Department of Public Health tested the company's dried fungus from one of the restaurants and found Salmonella, and whole-genome sequencing is under way to see if the sample matches the strain that made patients sick.

Yesterday Wismettac recalled all Shirakiku imported dried fungus. It said the product was distributed to 31 states, Washington, DC, and British Columbia. The label on the package says the mushrooms are a product of China.
Sep 24 CDC outbreak notice
Sep 23 FDA
recall notice

 

Report shows decline in Australian antibiotic use

A report this week from Australian health officials shows a consistent decline in the country's antibiotic use.

The report from the Australian Commission on Safety and Quality in Health Care looked at antibiotic prescriptions dispensed in all states and territories in the country from 2013-14 through 2017-18, with additional analysis of prescriptions for amoxicillin and amoxicillin-clavulanate. The results showed a downward trend in the number of prescriptions, the rate of prescriptions dispensed, and the volume of antibiotic use (number of defined daily doses dispensed per 1,000 people per day) compared with 2013-14.

Overall, 28.2 million prescriptions for antibiotics were dispensed in 2017-18, with a rate of 122,892 prescriptions per 100,000 people. That compares with 30.3 million prescriptions, and a rate of 126,864 prescriptions per 100,000 people, in 2013-14. Those trends were also observed for amoxicillin and amoxicillin-clavulanate, the second and third most prescribed antibiotics in Australia.

However, the report also notes that the volume of antibiotic use in 2017-18 (22.7 defined daily doses of antibiotics dispensed per 1,000 people per day) is more than twice the volume reported in the Netherlands (8.9) and Sweden (10.8), two countries with similar demographic profiles and standards of healthcare. In addition, socioeconomically disadvantaged areas of the country had higher antibiotic dispensing rates.

The authors of the report say that, to further optimize antibiotic prescribing in the country, efforts to educate the public and clinicians about appropriate antibiotic use need to continue.
Sep 23 Australian antibiotic dispensing report

Also this week, an organization representing Australian pharmaceutical and biotech companies announced the creation of the Australian Antimicrobial Resistance Network (AAMRNet).

The creation of AAMRNet was among the recommendations in a new "Fighting Superbugs" report from MTPConnect that came out of a meeting of stakeholders from the health, medical research, pharmaceutical, and government sectors held in November 2019 to develop an agenda for addressing AMR. Other recommendations from the report included the development of a national AMR research agenda, adoption of AMR-specific streamlined pathways for drug development, and creation of new regulatory incentives and reimbursement models to spur antibiotic development.
Sep 24 MTPConnect Fighting Superbugs report

 

Five nations report more polio; South Sudan has first vaccine-derived cases

Five countries reported more polio cases this week, two in the Middle East and three in Africa, including the first vaccine-derived cases in South Sudan, according to the latest weekly update from the Global Polio Eradication Initiative (GPEI).

In the Middle East, Afghanistan reported 1 new wild poliovirus type 1 (WPV1) case, which involves a patient from Kandahar province, raising its total for the year to 47. It also reported 1 new circulating vaccine-derived poliovirus type 2 (cVDPV2) case in Kunar province, lifting that total for the year to 79. Pakistan reported 3 more WPV1 cases, 2 in Balochistan province and 1 in Punjab province, bringing its total for the year to 73. The country also reported 2 cVDPV2 cases in Sindh province, putting that total at 61 for 2020.

In Africa, Chad reported 3 cVDPV2 cases—2 in Logone Oriental province and 1 in Mayo Kebbi East province—raising its total so far this year to 66 from two different outbreaks. Guinea also reported 3 cVDPV2 cases, 2 in Kankan and 1 in N'zerekore, making 11 cases this year. And finally, South Sudan reported 3 cVDPV2 cases, its first such cases, 1 in Warrap province and the other 2 in Western Bahr El Ghazal province, which health officials have linked to Chad's outbreak.
Sep 24 GPEI weekly report

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