Texas Cyclospora outbreaks grows to 161 cases

The Texas Department of State Health Services (TDSHS) reported 10 new Cyclospora infections yesterday, lifting the outbreak total to 161 cases.

So far 31 of the state's 254 counties have reported cases, with Travis County, which includes Austin, reporting by far the most illnesses, with 73. Dallas County is second with 14.

Cyclosporiasis is a parasitic infection caused by consuming tainted food or water. Its main symptom is watery diarrhea that can last from days to months.

A similar outbreak in Texas last summer resulted in 200 illnesses, some of which were tied to cilantro from Mexico's Puebla region.
Jul 13 TDSHS update
Jul 10 CIDRAP News scan on previous update

Study finds viruses more common cause of pneumonia than bacteria

Not surprisingly, hospitalization for community-acquired pneumonia (CAP) was highest among older adults, with no respiratory pathogen clearly dominant but viruses sidelining patients more frequently than bacteria, according to a study today from the US Centers for Disease Control and Prevention (CDC).

Writing in the New England Journal of Medicine, the CDC investigators reported on their analysis of data involving 2,320 adult patients in hospitals in Chicago and Nashville, Tenn., who had a clinical diagnosis and radiographic evidence of CAP from January 2010 through June 2012. Median patient age was 57, 498 (21%) required intensive care, and 52 (2%) died.

The overall annual incidence, calculated using US Census population estimates for the study catchment area, was 24.8 cases per 10,000 adults, which climbed to 63.0 in those 65 to 79 and 164.3 in patients who were 80 or older.

Among 2,259 patients who had specimens available for both bacterial and viral detection, a pathogen was detected in 853 (38%). One or more viruses were detected in 23% of patients, one or more bacteria in 11%, and both in 3%. One percent of patients harbored a fungal or mycobacterial pathogen. The most common pathogens were rhinovirus (9%), influenza (6%), and Streptococcus pneumoniae (5%).

In a CDC press release, Seema Jain, MD, first author of the study and a CDC medical epidemiologist, said respiratory viruses were detected more frequently in this study than in previous studies of hospitalized pneumonia patients, possibly because of improved diagnostics and the benefits of bacterial vaccines. 

"However, what’s most remarkable is that despite how hard we looked for pathogens, no discernible pathogen was detected in 62 percent of adults hospitalized with pneumonia," Jain added. "This illustrates the need for more sensitive diagnostic methods that can both help guide treatment at the individual level as well as inform public health policy for adult pneumonia at a population level."
Jul 14 N Engl J Med study