News Scan for Sep 06, 2013

News brief

FSIS head rebuts GAO report on poultry inspections

Alfred Almanza, head of the US Department of Agriculture's (USDA's) Food Safety and Inspection Service (FSIS), took issue with a Government Accountability Office (GAO) report this week that was critical of some aspects of an FSIS poultry inspection plan, saying the GAO omitted key details.

The GAO report asserted that the USDA took some shortcuts in assessing the plan, called the HACCP-Based Inspection Models Project (HIMP).

Almanza, in a Sep 4 opinion piece for Food Safety News (FSN), said that the GAO report was only slightly critical of HIMP. "GAO gave HIMP a thorough review and made just two recommendations, both of which FSIS is already working to fulfill," he wrote.

In addition, the GAO failed to mention that data show that "a system like HIMP will prevent at least 5,000 more foodborne illnesses annually," Almanza asserted. He said that FSIS asked an independent group of experts 10 years ago about the agency's approach, and the experts endorsed it.

He also took issue with the GAO's assumption that the basis for moving forward with HIMP is improved food-production efficiency and cost savings. Almanza said that the plan accomplishes both those goals, but HIMP "is first and foremost about making food safer."

He said that data in support of HIMP include:

Under HIMP, FSIS inspectors complete more tasks off the production line that verify food safety performance standards.
Fecal material appears about half as often in HIMP operations as it does in non-HIMP operations.
The average rate for Salmonella in HIMP operations is 20% lower than in non-HIMP operations.

He concluded, "If finalized and implemented broadly, this new inspection system would enable FSIS to better fulfill our food safety mission. Nothing in the GAO's report contradicts this basic fact."

FSN also reported yesterday that Elisabeth Hagen, MD, USDA's under secretary for food safety, said that the GAO report will not prevent the HIMP project from moving forward.
Sep 4 FSN Almanza opinion piece
Sep 5 FSN story on Hagen's response
Sep 4 CIDRAP News story "GAO: USDA took shortcuts in poultry inspection plan"

Pertussis cases near the 2,000 mark in Texas

With almost 2,000 confirmed cases, pertussis (whooping cough) has reached epidemic levels in Texas and could hit a 50-year high, state officials told Reuters yesterday.

The number of cases will likely surpass a recent high of 3,358 in 2009, the state health department said, and two infants who were too young to be vaccinated have died.

Lisa Cornelius, MD, MPH, Texas infectious diseases medical officer, said, "This is extremely concerning. Pertussis is highly infectious and can cause serious complications, especially in babies, so people should take it seriously."

In an alert this week, the Texas Department of State Health Services urged physicians to screen for pertussis and Texans to get vaccinated. Last year, 49 states reported an increase in pertussis, but most states have seen declines so far this year, the story said.
Sep 5 Reuters report

4 people in Massachusetts contract tularemia

Four residents of Nantucket, Mass., have contracted tularemia, the Nantucket Inquirer and Mirror reported this week.

The Nantucket Health Department confirmed the cases and advised people to wear respirators when cutting grass over 6 inches tall, which could harbor a rabbit or other small animal infected with Francisella tularensis, the bacterium that causes tularemia. Community officials are warning residents of the small island south of Cape Cod to avoid touching dead small animals or approaching any animal that appears disoriented or sluggish, the story said.

Nantucket Health Department Director Richard Ray said. "We've had a few cases over the years, but not four at one time."

He added, "If there's a dead animal near the side of the road, ignore it, do not let your animal go near it."
Sep 3 Inquirer and Mirror story

West Nile cases near 500 in US, top 100 in Europe

Cases of West Nile virus (WNV) infection in the United States have reached 497, up 201 from 2 weeks ago, and Europe has had 106 WNV illnesses, up 28 cases since last week, according to new updates.

The US Centers for Disease Control and Prevention (CDC) reported on Sep 3 that 45 states are affected, and 254 (50.5%) of the cases are the more serious neuroinvasive type. Twenty US case-patients have died.

California is the most affected state, with 100 WNV cases, including 7 deaths, followed by Colorado with 72 cases and South Dakota with 71. Both those states have had 1 WNV-related death. Last year at this time the country had 1,993 cases (on its way to 5,674 cases that year), and 1,013 of them were in Texas. To date this year, Texas has just 23 confirmed cases.

In Europe, 28 WNV cases last week and 26 the week before brought its total to 106, the European Centre for Disease Prevention and Control (ECDC) said today. That compares with 289 cases in nations bordering the European Union.
Sep 3 CDC update
Sep 6 ECDC update

Avian Flu Scan for Sep 06, 2013

News brief

Report details surveillance for H7N9 in Beijing

Surveillance for pneumonia with an unknown cause and sentinel hospital-based surveillance in Beijing helped detect four cases of novel H7N9 avian flu, health officials from the city reported yesterday in Emerging Infectious Diseases. These cases were reported previously by Chinese officials, but the report offers new details.

The team analyzed samples from 39 hospitalized Beijing patients with pneumonia from April through June, as well as patients with influenza-like illness (ILI) in 23 sentinel hospitals and collaborating labs from Apr 22 through June (3,526 pharyngeal swab samples). They also obtained pharyngeal swab specimens from close contacts of H7N9 patients and from 1,422 poultry workers in five Beijing districts from Apr 19 to 28.

At the same time the poultry workers were tested, the researchers collected environmental samples from the workers' environments and elsewhere. And to complete the thorough study, they obtained samples from wild birds in 327 parks, wetlands, and nature reserves from May 3 through May 10.

Polymerase chain reaction (PCR) tests were positive for H7N9 in one of the pneumonia patients, a 7-year-old girl, as well as in her asymptomatic mother and a 4-year-old male friend, and in one of the ILI patients detected during sentinel-hospital surveillance.

Three environmental samples were positive for H7N9, but the samples were not collected from the poultry workers' environs. No samples from the workers, close contacts of H7N9 patients, or wild birds were positive for the virus.

The authors conclude, "Surveillance of patients with pneumonia of unknown etiology is preferred for early detection of severe cases. PCR is recommended for screening in sentinel hospital and laboratory-based surveillance of influenza A(H7N9)."
Sep 5 Emerg Infect Dis study

Researchers identify H7N9 site that binds to human, bird cells

Chinese researchers have pinpointed a receptor in the H7N9 influenza virus that allows it to bind to humans yet retain its ability to bind to birds, according to their study yesterday in Science.

In exploring H7N9 isolates from patients in Shanghai and Anhui province, the team found that the receptor site known as SH on the virus's hemagglutinin (HA) protein binds only to avian cells, whereas the AH receptor binds to both bird and human cells.

In addition, they found that a mutant AH called L226Q "has dual receptor binding property, indicating that other amino acid substitutions contribute to the receptor binding switch."

The authors write, "The loss of affinity for the avian receptor appears to be an important factor for the efficient human-to-human transmission; however, to date, limited human-to-human transmission has been observed for H7N9, which might be a result of retention of high affinity for the avian receptor."

They add that their study "showed that, in contrast to H5N1 HA, the Q226L substitution is not solely responsible for the avian-to-human receptor binding switch for H7 HA."

They conclude, "We believe that surveillance of H7N9 virus isolates for detection of the new amino acid substitutions is essential for the future implementation of control strategies."
Sep 5 Science abstract