News Scan for Sep 20, 2021

Rapidly growing Salmonella outbreak
;
Decline in antibiotics in UK poultry
;
COVID vaccine hesitancy in healthcare workers
;
Polio updates in cases, gender equality

Salmonella outbreak sickens 127 in 25 states; cake mix E coli probe ends

A rapidly growing Salmonella Oranienburg outbreak linked to an unknown food source has sickened 127 people, some of them part of restaurant clusters, from 25 states, the US Centers for Disease Control and Prevention (CDC) said in a Sep 17 announcement.

The number of cases reported to the CDC has grown from 20 on Sep 2, when the CDC identified the outbreak. Patient ages range from 1 to 82 years, and 59% are female. Of 49 people with available information, 18 were hospitalized. No deaths have been reported. The latest illness onset was Sep 1.

So far, interviews with sick patients have not pointed to a specific food, but several restaurant subclusters have been identified from several states. Of the 25 states reporting cases, Minnesota and Texas have the highest number, followed by Illinois, Kansas, Maryland, Massachusetts, Oklahoma, Wisconsin, and Virginia.

Whole-genome sequencing of bacteria from 98 patients didn't predict resistance to any antibiotics.

The Food and Drug Administration (FDA) is looking at records from restaurants associated with subclusters to help identify a common source.
Sep 17 CDC Salmonella outbreak announcement

In other foodborne illness outbreak developments, the CDC on Sep 16 said the investigation into an Escherichia coli O121 outbreak linked to cake mix is over, with no new cases reported since its first announcement on Jul 28.

The case count remained at 16 people from 12 states. Seven people were hospitalized, and no deaths were reported.

Though the epidemiological investigation suggested cake mix was the likely source, no common brand was identified. Of nine people interviewed, seven had tasted or eaten raw batter made with cake mix.

Whole-genome sequencing of bacteria from six patients predicted resistance to sulfisoxazole, streptomycin, and trimethoprim-sulfamethoxazole for one sample. The testing didn't predict any resistance for the other five samples.
Sep 16 CDC final E coli outbreak update

 

Antibiotic use in British poultry has declined dramatically, report shows

Antibiotic use by poultry farmers in the United Kingdom has declined by nearly 75% since 2012, according to a report last week by the British Poultry Council (BPC).

The BPC 2021 antibiotic stewardship report shows that UK farmers raising chickens, turkeys, and ducks used 21 tonnes of antibiotics in 2020, down from 81.7 tonnes in 2012, a decline of 74.2%. Use of fluoroquinolones and critically important antibiotics declined by 97.2% a 95.5%, respectively. Antibiotic use in chickens and turkeys is below the government-approved sector targets set by the Responsible Use of Medicines in Agriculture Alliance, which sets standards for food safety, animal health, and animal welfare in the British livestock industry.

The decline follows the 2011 establishment of the BPC Antibiotic Stewardship Scheme, under which the UK poultry sector has ended preventive use of antibiotics, introduced a voluntary ban on the use of third- and fourth-generation cephalosporins, committed to reducing fluoroquinolone use, and stopped using the last-resort antibiotic colistin.

"As the sector producing half the meat this country eats, our Antibiotic Stewardship plays a crucial role in delivering good bird health and welfare, ensuring responsible use of antibiotics, safeguarding the efficacy of antibiotics, and helping produce food people can trust," BPC Chief Executive Richard Griffiths said in a BPC press release.
Sep 15 BPC 2021 antibiotic stewardship report
Sep 15 BPC press release

 

COVID vaccine hesitancy found in 32% of healthcare workers, survey says

About 68% of frontline healthcare workers said they were planning on getting vaccinated against COVID-19 when asked at the end of 2020, according to survey results published today in Infection Control & Hospital Epidemiology. Nurses, females, and minorities were more likely to report vaccine hesitancy.

The researchers surveyed 5,929 healthcare workers, 49.5% of whom were nurses; 38.0%, physicians; 9.8%, nurse practitioners (NPs); and 2.7%, physician assistants (PAs) at two academic hospitals in Philadelphia. About 67.8% said they planned on getting vaccinated against COVID-19. Nurses had the highest proportion of vaccine hesitancy while physicians had the least (47.3% vs 13.1%). Regardless of position, Black healthcare workers were about 5 times more hesitant than White healthcare workers (75.3% vs 44.8%), and women were about twice as hesitant as men (53.2% vs 22.3%).

Concerns about side effects, the newness of the vaccines, and lack of knowledge were the most common reasons for hesitancy. For instance, of the 31.3% who said they would delay vaccination, 85% pointed to possible side effects, and about 4% of women said the "other" reason they were concerned was unknown effects on pregnancy.

Data showed other significant variables, including a greater likelihood to be vaccine hesitant if: the respondent was under 40 years old (51.1% vs 42.7% or lower), had less than a bachelor's degree (66.4% vs 27.4% of those with a postgraduate degree), or if they lived in rural areas (66.3% vs 49.5% or lower in more urban areas). Those who were in "excellent health" were less hesitant compared to those who said their health was worse (38.1% vs 51.8% or higher). Possible COVID risk at work or prior vaccinations were not significantly associated with vaccine hesitancy.

The researchers note that, as the survey was given prior to the authorization of any COVID-19 vaccine, the results may look different now.
Sep 20 Infect Control Hosp Epidemiol study

 

Polio found in Nigeria; GPEI commits to gender equality

Ten cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) have been identified in Nigeria, the most in the Global Polio Eradication Initiative's (GPEI's) weekly report, as of Sep 15. The organization has also newly committed to advancing gender equality around polio eradication.

The 10 cases were found in Nigeria's north and northeastern states: Gombe (2), Jigawa (2), Kano (2), Yobe (2), Katsina (1), and Plateau (1). The country has reported 151 cases this year, whereas in 2020 it recorded eight. Pakistan, on the other hand, has had less cases of cVDPV2 in 2021 compared with 2020 (8 vs 135), and the weekly report only showed three positive environmental samples in the northern province of Khyber Pakhtoon.

Mali, which is still reporting last year's cases, has identified one more cVDPV2 case, bringing its 2020 total to 52.

The GPEI also announced last week new commitments to gender equality sparked by the Generation Equality Forum in Paris this past summer. The organization now has a 5-year strategy that integrates gender perspective in programming to help remove gender-related barriers to polio vaccination, empower women's participation, and ensure boys and girls are reached equally.
Sep 15 GPEI update and commitment

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