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CDC 

Abstract

In 2015, Legionnaires’ disease was diagnosed in a street cleaning worker. We found Legionella pneumophila serogroup 1 in the water and internal foam from the tanks of 2 trucks used by the worker during the incubation period. The internal foam was removed, and a Legionella prevention program was implemented.

Legionnaires’ disease (LD) is an acute pneumonia caused by inhalation or aspiration of aerosols contaminated with Legionella bacteria. Legionella spp. are ubiquitous in freshwater aquatic habitats. Multiplication of Legionella in artificial water systems is facilitated by temperatures around 35°C and factors such as lack of disinfection, water stagnation, and poor maintenance (1).

In Spain, 925 cases of LD were reported in 2014, of which 82% were sporadic cases, not related to outbreaks (2). LD outbreaks have been related to cooling towers, spa pools, and water distribution systems (2–4), which are considered by regulations in Spain to have a high probability of proliferation of Legionella (5).

The identification of exposure in sporadic cases provides a good opportunity to enhance understanding of reservoirs for Legionella in relatively rare sources (6,7). This case report summarizes the environmental study conducted to identify the possible source of exposure of a street cleaning worker who contracted LD.

Food Poisoning Bulletin 

Paragon Wholesale Foods of Pennsylvania is recalling several lots of 1.7 ounce Broccoli Florets because they were sold by Mann Packing, which recalled many types of produce on October 19, 2017 for possible Listeria monocytogenes contamination. No illnesses have been reported to date in connection with this issue.

The recalled broccoli florets were distributed to several schools in the Greater Pittsburgh and Butler, PA areas between 10/9/2017 and 10/16/2017. These customers have all been contacted and the affected products were removed on Thursday, October 19, 2017 when the firm was first notified of the recall by their supplier.

Outbreak News Today

The Detroit Health Department is investigating two separate cases of Hepatitis A. The first case is in connection with a Detroit resident who works at Firewater Bar and Grill located at 6521 John R. St. The second case involves another Detroit resident who works as a crew member at Little Caesars Pizza located at 12712 Fenkell.

The Detroit Health Department is conducting a thorough investigation of both establishments to ensure appropriate food handing and cleaning protocols are being followed. The Detroit Health Department has notified both establishments that infected employees are not to return to work until approved by their doctor. Both employees stopped working at the establishments once the diagnosis was confirmed. Both establishments have been cooperative with the investigation

GOV UK

Recent rise recorded in number of cases of Legionnaires’ disease in people who have travelled to Palmanova, in Mallorca, Spain.

Since September, 18 British travellers who stayed in the town of Palmanova in Mallorca, Spain have been diagnosed with Legionnaires’ disease; those affected travelled to Palmanova from different parts of the UK.

Legionnaires’ disease is an infection caused by bacteria acquired from sources of contaminated water in the environment. The number of people diagnosed with Legionnaires’ disease in England and Wales who required hospitalisation in 2015 was 98.7%.

GOV UK 

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In July 2014, Public Health England (PHE) South East centre received notification of two children with Haemolytic Uraemic Syndrome (HUS) in the county of Dorset. Routine local investigations were negative for Shiga-toxin producing Escherichia coli (STEC) O157. Testing at the reference laboratory identified the causative organism as STEC O55:H7. The outbreak strain carries a sub-type verocytotoxin (VT2a) and another gene (eae) associated with elevated risk of HUS. Laboratory records showed that this strain had not previously been isolated from humans or animals in England.

By November 2015 there were 31 confirmed cases of STEC O55:H7 linked to this outbreak in the Dorset area. Twenty one cases were symptomatic with 13 developing HUS (11 children and two adults).

Detailed epidemiological, microbiological and environmental investigations were carried out, including international links to the Republic of Ireland. The only epidemiological link common to all the cases was that they either lived or had close links to Dorset County. Whole Genome Sequencing (WGS) data confirmed that all the cases were infected with the same strain. Animal and pets were also tested as part of the investigation; STEC O55:H7 was isolated from two cat faecal samples.

The outbreak was managed by an Outbreak Control Team (OCT) calling on expertise from a variety of agencies including environmental health teams; Directors of Public Health; Animal and Plant Health Agency; Food Standards Agency; Environment Agency; PHE Gastrointestinal Infections Department, PHE Gastrointestinal Bacterial Reference Unit; PHE Field Epidemiology Service; PHE Food Water and Environment laboratory and Public Health England South East Centre.

Control measures included extended screening and exclusion of cases and contacts in high risk groups. Enhanced surveillance of faecal samples in Dorset laboratories and environmental sampling occurred to help determine the extent of this organism in the community.

The outbreak was initially managed at a local level. In September 2015 additional resources and expertise were committed to this incident by PHE to explore and coordinate the wide ranging investigations that were underway. Despite this, no causal link could be made and on 16 December 2015, following a period without cases, the OCT agreed to scale back the level of involvement.

Outbreak News Today 

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In an update to the multistate outbreak of multidrug-resistant Campylobacter infections linked to Petland pet store puppies, the Centers for Disease Control and Prevention (CDC) reports an additional 12 cases, bringing the total to 67.

The cases were reported from 15 states, with Ohio seeing the most cases at 24. About a quarter of the total cases required hospitalization and no deaths have been reported.

Of the 67 ill people in this outbreak, 62 (93%) have an epidemiological link to puppies at or from a Petland store–Eighteen patients were Petland employees; Forty- four people either recently purchased a puppy from Petland, visited a Petland store, or live in or visited a home with a puppy sold by Petland before their illness began and of the other five ill people, four reported contact with puppies from other sources and one had a laboratory-confirmed infection and did not report any puppy exposure.

Food Poisoning Bulletin

Pacific Coast Fruit Company is recalling various prepared vegetable products for possible Listeria monocytogenes contamination. This is part of the Mann’s Packing recall that was issued earlier this month. The products were distributed to grocery stores, restaurants, and deli chains in Oregon and Washington state. No illnesses have been reported to date in connection with this issue.

The recalled retail salads are packed in a 10 oz, 16 oz, 20 oz, 25 oz plastic clamshell style and value-added food service items are packed in 5 lbs – 20 lbs food service salad bags. You can see the list of recalled products at the FDA web site. They included Carnival Cauli Florets, Small Veg Tray, Kit Cauliflower Cake, Kit Cauliflower Tabouleh, and Stir Fry, among others. The brands are New Seasons Market and Pacific Coast Fruit.

Food Poisoning Bulletin 

A Salmonella paratyphi outbreak associated with raw tuna or salmon was reported by the Clark County Health Department in Washington state on October 26, 2017. At least 30 people in 7 states have been confirmed ill with the outbreak strain of Salmonella. All are sick with the same strain.

Outbreak News Today 

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The number of cryptosporidium cases in Lucas County, OH is up dramatically this year and health officials are finding few commonalities between the cases and have not yet located its origin, according to a Toledo Blade report Friday.

There has been 123 cases reported to date in 2017 compared to 36 during the same period last year. There were 47 cases in in all of 2016; 22 in 2015; and 17 in 2014.

Outbreak News Today

Officials with Public Health – Seattle & King County are investigating an outbreak of gastroenteritis with vomiting, nausea, and diarrhea associated with Subway restaurant located in Normandy Park.

Last week, health officials learned of eight people from two separate groups who became ill after eating food from the restaurant on October 22, 2017.

While laboratory confirmation is not available, symptoms are suggestive of norovirus. Often in norovirus outbreaks, no laboratory testing is done. The exact food item that caused the illness has not yet been identified, though this is not uncommon for norovirus outbreaks where multiple food items may be contaminated.