Category Archives: CDC

Research Campylobacter Updates

Eurosurveillance

Differentiation between travel-related and domestic cases of infectious disease is important in managing risk. Incubation periods of cases from several outbreaks of campylobacteriosis in Canada, Europe, and the United States with defined exposure time of less than 24 hours were collated to provide information on the incubation period distribution. This distribution was consistent across the varied outbreaks considered, with 84% (702/832) of cases having an incubation period of four days or less and 1% having an incubation period of eight days or more. The incubation period distribution was incorporated into a model for the number of travel-related cases presenting with symptom onset at given dates after return to their country of residence. Using New Zealand notification data between 2006 and 2010 for cases who had undertaken foreign travel within 10 days prior to symptom onset, we found that 29.6% (67/227 cases; 95% confidence interval (CI): 28.3–30.8%) of these cases were likely to have been domestic cases. When cases with symptom onset prior to arrival were included, the probable domestic cases represented 11.8% (67/571; 95% CI: 11.2–12.3%). Consideration of incubation time distributions and consistent collection of travel start/end dates with symptom onset dates would assist attribution of cases to foreign travel.

Clincal Infectious Diseases

Campylobacteriosis in humans, caused by Campylobacter jejuni and C. coli, is the most common recognized bacterial zoonosis in the EU and US. The acute phase is characterized by gastro intestinal  symptoms. The long-term sequelae (Guillain-Barré Syndrome, reactive arthritis and post-infectious irritable bowel syndrome)  contribute considerably to the disease burden. Attribution studies identified poultry as the reservoir responsible for up         to 80% of the human Campylobacter infections. In the EU, an estimated 30% of the human infections is associated with consumption and preparation of poultry  meat. Until now, interventions in the poultry meat production chain have not been effectively introduced except for targeted  interventions in Iceland and New Zealand. Intervention measures (e.g. biosecurity) have limited effect or are hampered by  economic aspects or consumer acceptance. In the future a multi-level approach should be followed, aiming at reducing the level of contamination of consumer products rather than complete absence of Campylobacter.

CDC  – UK Duck Liver Campylobacter Outbreak

Campylobacter­ spp.–related gastroenteritis in diners at a catering college restaurant was associated with consumption of duck liver pâté. Population genetic analysis indicated that isolates from duck samples were typical of isolates from farmed poultry. Campylobacter spp. contamination of duck liver may present a hazard similar to the increasingly recognized contamination of chicken liver.

 

 

Research – Norovirus Updates

Science DirectNorovirus

Human norovirus (NoV) contaminated hands are important routes for transmission. Quantitative data on transfer during contact with surfaces and food are scarce but necessary for a quantitative risk assessment. Therefore, transfer of MNV1 and human NoVs GI.4 and GII.4 was studied by artificially contaminating human finger pads, followed by pressing on stainless steel and Trespa® surfaces and also on whole tomatoes and cucumber slices. In addition, clean finger pads were pressed on artificially contaminated stainless steel and Trespa® surfaces. The transfers were performed at a pressure of 0.8–1.9 kg/cm2 for approximately 2 s up to 7 sequential transfers either to carriers or to food products. MNV1 infectivity transfer from finger pads to stainless steel ranged from 13 ± 16% on the first to 0.003 ± 0.009% on the sixth transfer on immediate transfer. After 10 min of drying, transfer was reduced to 0.1 ± 0.2% on the first transfer to 0.013 ± 0.023% on the fifth transfer. MNV1 infectivity transfer from stainless steel and Trespa® to finger pads after 40 min of drying was 2.0 ± 2.0% and 4.0 ± 5.0% respectively. MNV1 infectivity was transferred 7 ± 8% to cucumber slices and 0.3 ± 0.5% to tomatoes after 10 min of drying, where the higher transfer to cucumber was probably due to the higher moisture content of the cucumber slices. Similar results were found for NoVs GI.4 and GII.4 transfers measured in PCR units. The results indicate that transfer of the virus is possible even after the virus is dried on the surface of hands or carriers. Furthermore, the role of fingers in transmission of NoVs was quantified and these data can be useful in risk assessment models and to establish target levels for efficacy of transmission intervention methods.

CDC

The duration of immunity to norovirus (NoV) gastroenteritis has been believed to be from 6 months to 2 years. However, several observations are inconsistent with this short period. To gain better estimates of the duration of immunity to NoV, we developed a mathematical model of community NoV transmission. The model was parameterized from the literature and also fit to age-specific incidence data from England and Wales by using maximum likelihood. We developed several scenarios to determine the effect of unknowns regarding transmission and immunity on estimates of the duration of immunity. In the various models, duration of immunity to NoV gastroenteritis was estimated at 4.1 (95% CI 3.2–5.1) to 8.7 (95% CI 6.8–11.3) years. Moreover, we calculated that children (<5 years) are much more infectious than older children and adults. If a vaccine can achieve protection for duration of natural immunity indicated by our results, its potential health and economic benefits could be substantial.

CDC

We report an increase in the proportion of genotype GI.6 norovirus outbreaks in the United States from 1.4% in 2010 to 7.7% in 2012 (p<0.001). Compared with non-GI.6 outbreaks, GI.6 outbreaks were characterized by summer seasonality, foodborne transmission, and non–health care settings.

CDC

After the substantial decrease in acute gastroenteritis (AGE) in children caused by rotavirus after introduction of 2 rotavirus vaccines (1), norovirus has become the leading cause of medically attended AGE in US children <5 years of age (2). We describe the clinical characteristics of norovirus disease and assessed whether rotavirus vaccine protected against norovirus AGE.

 

 

USA – Outbreak Updates – Cyclospora – Foster Farms – Hepatitis

CDC Final Report Hepatitis A  – Townsend Farmscdc

This  particular outbreak appears to be over. However, Viral Hepatitis is still an  important cause of human illness in the United States. More information about Viral Hepatitis,  and steps people can take to reduce their risk of infection, can be found on the CDC Viral Hepatitis website.

CDC Final Report Cyclospora

These outbreaks appear to be over. More information about Cyclospora can be found on CDC’s Cyclospora pages.

CDC Report on More Foster Farms Salmonella Cases

As of October 29,  2013, a total of 362 persons infected with seven outbreak strains of Salmonella Heidelberg have been reported from 21 states and Puerto Rico.

38% of ill persons have been hospitalized, and no deaths have been reported.

Most ill persons (74%) have been reported from California.

USA – Cyclospora Outbreak Update

Food Poisoning Journal

As of September 20, 2013 (5pm EDT), CDC has been notified of 643 ill persons with of Cyclospora infection from 25 states: Arkansas, California, Connecticut, Florida, Georgia, Illinois, Iowa, Kansas, Louisiana, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, New York (including New York City), Ohio, Pennsylvania, South Dakota, Tennessee, Texas, Virginia, Wisconsin, and Wyoming.

Most of the illness onset dates have ranged from mid-June through mid-July.

Public health officials in Iowa and Nebraska performed investigations within their states and concluded that restaurant-associated cases of cyclosporiasis in their states were linked to a salad mix produced by Taylor Farms de Mexico.

Epidemiologic and traceback investigations conducted in Texas by state and local public health and regulatory officials, the FDA, and CDC indicated that some illnesses among Texas residents were linked to fresh cilantro from Puebla, Mexico.

Research – Increasing Vibrio Prevalence

Food Safety NewsVibrio

With a nearly 50-percent mortality rate, Vibrio vulnificus is the most deadly foodborne pathogen in the world, according to University of North Carolina at Charlotte Biology Professor Jim Oliver. And instances of infection in the U.S., however rare, are rapidly rising.

Fifteen years ago, there were 21 confirmed cases of Vibrio vulnificus and parahaemolyticus infections in the U.S. Last year, there were 193.

While infections from either of the pathogens are still rare compared with, say, Salmonella and Campylobacter, the incidence rate grew faster than any of the other five microbes tracked in the Centers for Disease Control’s 2012 Food Safety Progress Report. The vulnificus strain is responsible for 95 percent of seafood-related illness fatalities in the U.S., according to a 2013 study by Oliver and Joanna Nowakowska. Another Vibrio strain, parahaemolyticus, is milder, causing diarrhea, nausea, fever and chills, according to CDC.

USA – Cyclospora Outbreak Still Continues

Food Safety News

At least 646 people have now fallen ill with Cyclospora infections in connection with an outbreak that hit 24 states between June and August, according to the latest update from the U.S. Centers for Disease Control and Prevention.

At least 44 of those individuals have been hospitalized. Those ill range in age from less than one year to 92 years old, with a median age of 52.

USA – Listeria Outbreak in Cheese Updates

Food Poisoning Bulletin

The Minnesota Department of Health has released information about the multistate Listeria outbreak linked to recalled Crave Brothers soft cheeses. Two people in Minnesota have been sickened in this outbreak. Both were older adults who became ill in early June; one of them has died.

Food Poisoning Bulletin

Two Illinois restaurants served the Crave Brothers soft French cheeses that have been linked to a multistate Listeria outbreak. Girl & The Goat in Chicago, and the Hilton Hotel in Chicago sold the recalled cheese. Anyone who ate Les Frères, Petit Frère, or Petit Frère with Truffles at those restaurants may be at risk for developing listeriosis, a serious disease.

Food Poisoning Bulletin

To date, two Minnesota residents have contracted Listeria food poisoning (listeriosis) after eating Les Freres cheese produced by Crave Brothers Farmstead Cheese Company. One of Minnesota victim died. Prompted by this outbreak, Crave Brothers issued a recall of some of its cheese products, including Les Freres (LF225 2/2.5#), Petit Frère (PF88 8/8 oz) and Petit Frère with Truffles (PF88T 8/8 oz), all with a make date of 7-1-13 or earlier.

Food Poisoning Bulletin

A premier Minnesota restaurant, Butcher & The Boar, is the only restaurant in the state named by Crave Brothers Farmstead Cheese Company as a recipient of soft cheese associated with a deadly outbreak of listeriosis. Whole Foods Markets, Lunds, Byerlys, Rainbow, Kowalski’s and other grocery retailers also sold the cheese, as did restaurants in Wisconsin and Illinois. The recalled gourmet cheese has been associated with a Listeria death in Minnesota, a second Minnesota illness and individual cases of listeriosis in Illinois, Indiana and Ohio. All five people were hospitalized and one infection in a pregnant woman resulted in miscarriage.

Food Posioning Bulletin

The Centers for Disease Control and Prevention has joined the investigation by the Minnesota Department of Health into the Listeria outbreak linked to Crave Brothers Farmstead Cheeses. The company recalled three types of its cheeses on July 3, 2013 after an outbreak was announced. At least five people have been sickened in four states; one person in Minnesota has died and a woman has suffered a miscarriage.

 

USA – Townsend Farms – Berry -Hepatitis A

Food Poisoning JournalClose up 3d render of an influenza-like virus isolated on white

Townsend Farms, Inc. of Fairview, Oregon, out of an abundance of caution and in cooperation with the FDA is expanding its voluntary recall efforts and is now recalling Townsend Farms Organic Antioxidant Blend, 3 lb. bag with UPC 0 78414 40444 8. The recall codes are located on the back of the package with the words “BEST BY” followed by the code T122114 sequentially through T053115, followed by a letter. All letter designations are included in the voluntary recall. The voluntary recall is occurring because of a potential hepatitis A contamination. The voluntary recall efforts are based on epidemiological and trace-back evidence resulting from an ongoing outbreak investigation conducted by the FDA and the CDC. Photos of the package are attached.

Hepatitis A is a contagious liver disease that results from exposure to the hepatitis A virus, including from food. It can range from a mild illness lasting a few weeks to a serious illness lasting several months. Illness generally occurs within 15 to 50 days of exposure and includes fatigue, abdominal pain, jaundice, abnormal liver tests, dark urine and pale stool. Hepatitis A vaccination can prevent illness if given within two weeks of exposure to a contaminated food. In rare cases, particularly consumers who have a pre-existing severe illness or are immune-compromised, hepatitis A infection can progress to liver failure.

Food Safety News

The Hepatitis A outbreak linked to frozen mixed berries continues to grow. On Friday, the Centers for Disease Control and Prevention said five more illnesses have been confirmed as part of the outbreak, bringing the total to 127 ill in 8 states, and the U.S. Food and Drug Administration said it thinks it has identified a common shipment of pomegranate seeds from Turkey that may have been to blame.

According to CDC, all of the confirmed victims became ill after eating Townsend Farms Organic Anti-oxidant Blend, a frozen berry blend sold across the country in Costco stores. Harris Teeter also sold the now recalled product, but so far no illnesses have been linked to the retailer.

USA – CDC Vital Signs Website – Listeria Information

CDC Vital SignsE.coli O157

Many germs can be spread through food. Some, like Listeria, can be deadly. Listeria strikes hard at pregnant women and their newborns, older adults, and people with weakened immune systems. Listeria can cause miscarriage and meningitis. Most people found to have Listeria infection require hospital care and about 1 in 5 people with the infection die. Outbreak investigations tell us what foods make people sick and what needs to change to make food safer and save lives. We have made some progress against Listeria, which is the third leading cause of death from food poisoning. However, we can do more to protect people at higher risk for food poisoning and make food safer for everyone.

If you, or someone you make food for, are pregnant, 65 or older, or have a weakened immune system, you must be especially careful when selecting, preparing, and storing foods.

  • Know your risk of food poisoning.
  • Select, prepare, and store food safely.
  • Follow the safe food guidelines – Clean, Separate, Cook, Chill – at www.FoodSafety.gov

CDC

New CDC Vital Signs: Listeria Food Poisoning Striking Hard at Nation’s Most Vulnerable

USA – CDC Report on Listeria 2009-2011

CDCE.coli O157

This report details the epidemiology of invasive listeriosis, which often leads to bacteremia, meningitis, hospitalization, fetal loss, and death, and calls for actions that could protect the most vulnerable populations. Older adults and pregnant women, particularly pregnant Hispanic women, are at much higher risk than the population at large, as are persons with weakened immunity (2). Preventing infections in these populations can have substantial impact in averting these outcomes. Older adults and persons with weakened immunity, as well as infants and young children, are also prone to many other foodborne illnesses, including campylobacteriosis, salmonellosis, and Shiga toxin–producing E. coli infections (4). Accounting for underdiagnosis and underreporting, an estimated 1,662 cases of listeriosis occur each year (5). No progress in reducing the overall incidence of listeriosis has occurred in over a decade (3,4); renewed prevention efforts are needed from farm to table.