News Scan for Sep 15, 2022

Ground beef E coli outbreak
Antibiotic use in Japanese hospitals
H5N6 avian flu case
More avian flu in US farm poultry

E coli outbreak linked to ground beef in Hello Fresh meal kits

The Centers for Disease Control and Prevention (CDC) yesterday reported an Escherichia coli O157:H7 outbreak tied to Hello Fresh meal kits that contained contaminated ground beef.

So far, health officials have identified seven infections from six states. Six people were hospitalized, and none of them developed hemolytic uremic syndrome (HUS), a potentially fatal kidney complication of E coli infection. No deaths have been reported.

The meals containing the contaminated ground beef were shipped between Jul 2 and 21. The latest illness onset was Aug 17. Of six people interviewed, all reported eating ground beef from Hello Fresh meal kits before they became ill. The traceback investigation found that for multiple patients, the ground beef came from the same establishment. US Department of Agriculture (USDA) investigators are still tracking the materials used to produce the ground beef.

The CDC urged people to check their freezers to see if they have any of the affected beef from the meal kits, which would have "EST. 46841" inside the USDA inspection mark. It added that officials are also working to determine whether other ground beef products may be contaminated.
Sep 14 CDC outbreak notice


Study examines inpatient antibiotic use in Japanese hospitals

A point-prevalence study conducted at five hospitals in Japan found that fewer than 30% of patients were prescribed an antibiotic on the survey date, but more than half of the antibiotics prescribed were broad spectrum, researchers reported yesterday in Antimicrobial Stewardship & Healthcare Epidemiology.

To better understand inpatient antibiotic use and the uptake of antimicrobial stewardship programs (ASPs) in the prefecture of Okinawa, a team of Japanese and US researchers assessed the proportion of total eligible hospitalized patients who received an antibiotic at five community hospitals on Oct 1, 2020. They also categorized antibiotics according to indication, drug class, and World Health Organization AWaRE (Access, Watch and Reserve) classification. Each hospital has one physician ASP champion, and three have an infectious diseases–trained physician as ASP champion.

Across the five hospitals, 504 of 1,728 (29%) unique patients received at least one antibiotic, with 51 (10%) receiving two antibiotics and 2 (0.4%) receiving 3 antibiotics. Of the patients who received antibiotics, 114 (23%) received them for prophylaxis (prevention) and 390 (77%) received them for treatment. Of the 390 patients who received antibiotics for treatment, 385 (98.7%) had a documented infection.

Overall, 241 (43.9%) of all 559 antibiotics prescribed were categorized as Access drugs, 304 (54.4%) were Watch drugs, and 12 (2.1%) were Reserve drugs. Cephalosporins were the most prescribed antibiotic class (56%), followed by beta-lactam/beta-lactamase inhibitors (19%), and narrow-spectrum penicillins (8.2%).

The study authors say that while the proportion of patients who received an antibiotic is lower than has been reported in many international studies, the high proportion of Watch antibiotics is a concern.

"Antibiotics in this classification may be more likely to cause resistance compared to Access antibiotics," they wrote. "Focusing on antimicrobial stewardship strategies (eg, selection of antibiotics for national or institutional guideline recommendations) that consider risk of antimicrobial resistance could be effective and beneficial."
Sep 14 Antimicrob Steward Hosp Epidemiol study


H5N6 avian flu hospitalizes Chinese girl

China reported another H5N6 avian flu infection, which involves a 6-year-old girl whose symptoms began in late July and who was admitted to the hospital on Aug 3.

In a statement today, Hong Kong's Centre for Health Protection (CHP) said the girl is from Guangxi province, which is in the southern part of the country. An investigation into her illness found that she had been exposed to market poultry before she got sick. She is listed in serious condition.

The case is China's first since the end of June, which involved an individual from Jiangxi province. It marks the 16th case of the year and the 80th since the virus was first detected in humans in 2014.

H5N6 infections are often severe or fatal in humans. The virus is known to circulate in poultry in some Asian countries, but China and Laos are the only ones that have reported human cases.
Sep 15 CHP statement


Avian flu outbreaks strike more turkey farms in 2 US states

Two states—Minnesota and Utah—reported more highly pathogenic avian influenza outbreaks in poultry, affecting commercial turkey farms in both states, according to the latest updates from the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS).

In Minnesota, new outbreaks were reported at a turkey farm in Brown County that houses 44,000 birds and one in Stearns County that has 72,700 birds. The virus was also detected in a backyard flock in Freeborn County.

Utah reported an outbreak at a turkey farm in Sanpete County, which affected a flock of 5,700 birds.

Outbreaks involving the Eurasian H5N1 strain started in early February and have so far led to the loss of more than 44 million birds in 39 states. Activity in poultry slowed over the summer but has increased over the past few weeks. Virus detections in wild birds have persisted over the summer across several US regions.
USDA APHIS poultry avian flu updates

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