Quick Update: What Bugs Are Making The Rounds (September - November 2018)
Shiga toxin-producing E. coli (STEC) O26 in ground beef, September 2018
September 19, 2018, Cargill Meat Solutions (Fort Morgan, CO) recalled ground beef products
Produced and packaged on June 21, 2018 and were shipped to retailers nationwide.
18 cases in 4 states, 6 hospitalization and 1 death
PFGE and whole-genome sequencing (WGS) suggested a common source
WGS did not find genes conferring antibiotic resistance
Leftover ground beef from home of ill persons: positive for the same bug
Appears to be over
Review on STEC bugs
O157 and non-O157 “Big Six” (O26, O45, O103, O111, O121, and O145)
May cause hemolytic-uremic syndrome (HUS)
Salmonella Newport in ground beef, October 2018
6.9 million lbs of ground beef recalled by Tolleson, Inc., of Tolleson, Arizona
Produced and packaged from July 26, 2018, to September 7, 2018 and were shipped to retailers nationwide
As of November 15: 246 cases in 25 states, 59 hospitalizations, no death
California has the most number of cases: 66
PFGE and whole-genome sequencing (WGS) suggested a common source
WGS did not find genes conferring antibiotic resistance
Unopened package of ground beef from an ill person: positive for the same bug
Ongoing
Note
In 2016: top 3 serotypes per FoodNet – Enteridis, Newport, Typhimurium
Multidrug-Resistant Salmonella Infantis Infections in Raw Chicken Products, October 2018
Seems to be associate with consumption of food prepared from raw chicken product, including ground chicken, chicken pieces, and whole chicken
Also identified in individuals that reported having pets consuming ground chicken pet food
92 people in 29 states, 21 hospitalizations, no death
PFGE and whole-genome sequencing (WGS) suggested a common source
WGS predicted resistance to some or all of the following: AMP, CRO, CHL, CIP, FOS, GEN, hygromycin, KAN, NAL, STR, SXT, TET (BOLDED = confirmed with AST)
This may be because these isolates were from chicken – probably received loads of antibiotics!
Food and environment samples: positive for the same bug
Found in both live and raw chicken
Shiga toxin-producing E. coli (STEC) O157:H7 infections linked to romaine lettuce
Another reason not to eat salad so don't make me!
CDC advices against consuming all types or uses of romaine lettuce, such as whole heads of romaine, hearts of romaine, and bags and boxes of precut lettuce and salad mixes that contain romaine, including baby romaine, spring mix, and Caesar salad
If not sure, throw it away
32 cases in 11 states, 13 hospitalizations, no death.....yet
PFGE and whole-genome sequencing (WGS): isolates among patients were closely related
Also closely related E. coli strain isolated from ill people in a 2017 outbreak linked to leafy greens in the United States and to romaine lettuce in Canada
NOT related to those from multistate outbreak of STEC O157:H7 infections linked to romaine lettuce (also STEC O157:H7 but different lineages)
MDs: Antibiotics NOT recommended until STEC O157 is ruled out
Yay more measles!
Since Jan: 220 individual cases confirmed in 26 states and DC
LA folks: LA HAN is coming out in a few days!
Active outbreak of measles in Israel among areas with low vaccination rates with over 1500 cases as of now
Per Professor Yehiel Schlesinger, director of the Wilfe Children’s Hospital at Sha’arei Tzedek: “The problem in Jerusalem is with certain population regions, such as some of the Haredi areas where there are pockets of unimmunized people, and not everyone makes sure to be vaccinated.”
Haredi are parts of Jerusalem heavily populated with ultra-orthodox jews.
Guess what. It’s here now! Cases have been reported in the Orthodox Jewish community of New York City and several surrounding communities in New York and New Jersey
Some have traveled to Israel
No cases in LA County…..yet
If suspected in LA County: call ACDC or Vaccine Preventable Disease Program IMMEDIATELY
Which specimens to collect? Details here for California
Blood for serology – should not be collected prior to 72 hours after symptom onset or may get false negative IgM
Throat swab (NP swab or wash is NOT ideal) and urine for PCR