News Scan for Apr 17, 2018

News brief

New MERS cases, deaths reported in Saudi Arabia

After several days without updates, the Saudi Arabian Ministry of Health (MOH) confirmed three new cases of MERS-CoV today and one death. The MOH has issued only sporadic updates this month; this is the first update since Apr 9.

On Apr 12, officials reported that a 69-year-old Saudi woman from Hofuf has MERS-CoV (Middle East respiratory syndrome coronavirus). She is in stable condition. The source of her infection is listed as "primary," meaning it's unlikely she contracted the virus from another person. On the same day, the MOH said a 43-year-old male expatriate in Najran was in critical condition with MERS. He had direct contact with camels, a known risk factor for the virus.

Officials confirmed MERS in a 93-year-old Saudi man from Al Qunfudhah on Apr 15. He is in stable condition, and the source of his infection is listed as "primary."

On Apr 14, a male expatriate from Hofuf, age 44, whose case was confirmed earlier, died from complications of the virus. Officials also recorded the death of a male expatriate, 64, in Riyadh on Apr 10. Neither patient was a healthcare worker.

Saudi Arabia's MERS-CoV total cases since 2012 have now reached 1,834, including 741 deaths. Six people are still being treated for their infections.
Apr 10 MOH report
Apr 12 MOH report
Apr 14 MOH report
Apr 15 MOH report

Almost three fourths of Americans support increased biosecurity spending

According to a new survey, 73% of Americans said they would support congressional budget increases in developing preventive measures for biological and chemical threats. The Alliance for Biosecurity conducted the survey, which included 1,612 participants.

The survey also revealed that Americans' confidence in the government's ability to handle biosecurity threats has dropped significantly in the past 2 years. In March of 2016, 50% of those surveyed said they were confident in America's preparedness to handle biosecurity threats. Today that percentage has dropped to 31%.

"What we're seeing in these results is that people care greatly about health security threats and want their elected officials putting more resources into medical countermeasures," said Brent MacGregor, MBA, co-chair of the Alliance for Biosecurity, in a press release. "Preparedness against naturally occurring and man-made biological threats is a very real part of our national security that Americans across a wide spectrum are willing to spend the necessary money to bolster."

The survey was conducted via telephone among 2018 general election voters. A slight majority of participants, 52%, said they were more likely to support their elected representative if that representative is actively pursuing biosecurity measures.
Apr 17 Alliance for Biosecurity press release

Paper describes One Health strategy for stewardship in South Africa

A commentary yesterday in The Lancet Infectious Diseases outlines the efforts by South Africa to promote stewardship of the last-resort antibiotic colistin, an approach the authors say is pertinent to all shared-use antibiotics.

In the paper, Marc Mendelson, PhD, and colleagues describe how South Africa has responded to the threat of losing colistin as a treatment for multidrug-resistant infections in humans through a One Health platform that promotes stewardship of the drug across human, animal, and environmental health. The response was prompted by the discovery of the mobile colistin-resistance gene MCR-1 in Escherichia coli in South African poultry and the identification of MCR-1-induced colistin resistance in South African patients.

The paper highlights the work of the Colistin Working Group, which was convened by the South African Medicines Control Council and first met in April 2016. Using data on colistin consumption and resistance levels in humans and animals in South Africa, along with a report on colistin from the European Medicines Agency, the group issued detailed recommendations on steps the South African government could take to mitigate colistin resistance. Among the recommendations was that colistin no longer be used in food-producing animals.

Since issuing that recommendations, the group has expanded to include additional stakeholders from various government departments and formed a One Health Stewardship Sub-Committee to take the work further.

"We believe that our approach of convening intersectoral stakeholders across the One Health platform to develop a national strategy for the stewardship of antibiotics provides valuable lessons for future work in South Africa, and that such a method could be useful in other countries," the authors write.
Apr 16 Lancet Infect Dis personal view

Food Safety Scan for Apr 17, 2018

News brief

USDA study finds several factors fueling rise in food recalls

The average yearly number of food recalls increased from 2004 to 2013, probably because of several factors, including an increase in food volume sold and improvements in pathogen detection technology, the US Department of Agriculture (USDA) Economic Research Service reported yesterday.

Food recalls averaged 304 per year from 2004 to 2008 but rose to an average of 676 from 2009 to 2013, according to the report. Other factors that might partially explain the significant increase in food recalls include an increase in regulatory oversight and enforcement in the wake of two major food policy laws passed by Congress: the Food Allergen Labeling and Consumer Protection Act and the Food and Drug Administration Food Safety Modernization Act.

The analysis of six food categories found that, except for nut products, the most common reason that triggered recalls was failure to declare major food allergens. The most common reason for nut product recalls was possible Salmonella contamination. Though recall numbers rose for all food categories, the increase was statistically significant for just three: grain products, animal products, and prepared foods and meals.

Looking at recall by type of risk, the author of the study, Elina Tselepidakis Page, PhD, MS, an agricultural economist for the USDA, found that 41% were due to pathogen contamination, such as Shiga toxin–producing Escherichia coli and Salmonella, and 27.4% were due to undeclared allergens. Overall, over the decade studied, the number of recalls related to pathogen contamination didn't rise significantly, but recalls for allergens nearly doubled, which Page said is likely due to the passage of the federal food allergy safety law.
Apr 16 USDA Economic Research Service report summary
Apr 16 USDA Economic Research Service report

Chlorine may help foodborne pathogens evade detection

The use of chlorine for deterring foodborne pathogen growth might not only be ineffective, its use could help the pathogens avoid detection, a study today in mBio found.

Many bacteria enter a viable-but-nonculturable (VBNC) state in response to environmental stresses during which they can't be detected by standard laboratory culture testing often used to detect pathogens on produce. UK researchers assessed the effects of chlorine, a sanitizer commonly used for fresh produce, on Listeria monocytogenes and Salmonella enterica serovar Thompson, two key foodborne bacteria.

They found that L monocytogenes became VBNC at 50 parts per million (ppm) chloride, while Salmonella Thompson did so at 100 ppm. When these VBNC bacteria were ingested by roundworms called nematodes, the nematodes had statistically significant higher death rates, demonstrating the pathogenicity of the bacteria. In the case of L monocytogenes, its VBNC version was as infectious as its non-VBNC counterpart.

The authors concluded, "It was also found that chlorine is ineffective at killing total populations of the pathogens. . . . These data show that VBNC food-borne pathogens can both be generated and avoid detection by industrial practices while potentially retaining the ability to cause disease."
Apr 17 mBio study