FDA unveils plan to improve foodborne outbreak response
The US Food and Drug Administration (FDA) last week released its Foodborne Outbreak Response Improvement Plan, which is designed to boost the speed, effectiveness, coordination, and communication of events for both the FDA and its investigation partners.
The plan included input from the US Department of Agriculture, the US Centers for Disease Control and Prevention, state health officials, and other stakeholders.
In crafting the new plan, the FDA also used input from an independent assessment on its current performance that it sought from the University of Minnesota School of Public Health. The FDA published the University of Minnesota's assessment, which the FDA had contracted. Led by Craig Hedberg, PhD, professor and co-director of the Minnesota Integrated Food Safety Center of Excellence, the team interviewed stakeholders, analyzed the FDA's current approach, and made a set of recommendations.
The FDA said the new plan has four priority areas, which it said will have the most impact. They include employing tech-enabled product trace-back, focusing on root-cause investigations, strengthening analysis and sharing of outbreak data, and making operational improvements.
Dec 9 FDA announcement
Dec 9 University of Minnesota independent report
10% of Chinese COVID patients may have had incubations of 14+ days
A modeling study of COVID-19 patients in China in 2020 published late last week in BMC Public Health estimates that 10% had incubation periods longer than 14 days. The incubation period is the time between infection and symptom onset or diagnosis.
A team led by researchers at Fudan University in Shanghai determined that, of 11,425 patients who tested positive from COVID-19 from January to August 2020, 268 (10.2%) had incubation periods longer than 14 days.
These patients were at lower risk for severe disease (adjusted odds ratio [aOR], 0.39) and were less likely to transmit the virus to others (aOR, 50.4) than those with shorter incubation periods.
Most patients with prolonged incubation times were older than 60 years and were exposed to the virus in public places (median, 7.1 days) or workplaces (6.7 days) than at home (5.5 days). Imported COVID-19 cases also had longer incubation times than local cases (6.9 vs 6.4 days).
Patients 60 years and older and those diagnosed as having diabetes, however, were at greater risk for severe illness, and the former group was also more likely than those 45 and younger to spread the virus.
Patients whose time from symptom onset to hospital release was longer than 3 weeks had a shorter incubation than those with an interval of less than 3 weeks (median incubation, 5.6 vs 7.3 days).
The study authors noted that most previous studies had estimated COVID-19 incubation periods at 2 to 12 days. In December 2020, the US Centers for Disease Control and Prevention shortened the recommended quarantine after COVID-19 exposure from 14 to 7 to 10 days.
"Isolation and medical quarantine policies of 2 weeks currently in place may miss the patients with longer incubation period," the authors wrote.
Dec 9 BMC Public Health study
H5N6 avian flu sickens 1 more person in China
China reported another human H5N6 avian flu infection, marking its 28th case of the year, according to a Dec 11 statement from Hong Kong's Centre for Health Protection (CHP).
The patient is a 68-year-old man from the city of Huizhou in Guangdong province in southern China. He kept poultry at his home. His symptoms began on Dec 3, and he was admitted to the hospital on Dec 7, where he is in critical condition.
Since 2014, China has reported 53 human H5N6 cases, which includes 10 deaths. Though H5N6 cases are rare, the country has reported an uptick this year. The virus has been detected in birds in four Asian countries, though China and Laos are the only nations that have reported human infections.
Dec 11 CHP statement