News Scan for Jun 13, 2014

News brief

California declares pertussis epidemic

California health officials today upgraded pertussis activity in the state to epidemic status, with more than 800 cases reported over the past 2 weeks, according to a statement from the California Department of Public Health (CDPH)

As of Jun 10, 3,458 cases had been reported, passing the number of cases reported for all of 2013. The CDPH said pertussis activity is cyclical and peaks every 3 to 5 years, and because the last peak occurred in 2010, it's likely that another peak is under way.

Ron Chapman, MD, MPH, CDPH director and state health officer, said in the statement that preventing disease in infants is the state's highest priority. "We urge all pregnant women to get vaccinated. We also urge parents to vaccinate infants as soon as possible," he said.

Infants who are too young to be fully vaccinated are at highest risk for severe and fatal pertussis infections, the agency said. So far two infant deaths have been reported and two thirds of hospitalizations for the disease have been in children age 4 months or younger.

The CDPH also said older children, preadolescents, and adults should be vaccinated based on current recommendations. "Unlike some other vaccine-preventable diseases, like measles, neither vaccination nor illness from pertussis offers lifetime immunity," Chapman said. "However, vaccination is still the best defense against this potentially fatal disease."

In a Jun 10 update, the CDPH said that although pertussis is cyclical, incidence has increased since 1990 because of the transition to acellular vaccines, which come with fewer side effects but offer a shorter window of protection.

The CDPH said school outbreaks have been reported from across the state, with the highest incidence in Sonoma, Napa, and Marin counties.

Nationally, the number of pertussis infections reported as of Apr 14 was up 24% compared with the same time last year, according to the US Centers for Disease Control and Prevention (CDC). It said 4,838 cases had been reported by 48 states and Washington, DC.
Jun 13 CDPH press release
Jun 10 CDPH pertussis update
CDC pertussis background

Measles cases triple in Eastern Mediterranean region

Measles cases in the World Health Organization's Eastern Mediterranean Region (EMR) tripled from 2008 to 2012, the CDC said today in Morbidity and Mortality Weekly Report (MMWR).

Cases in the 23-nation region increased from 12,186 to 36,456 in that span, putting a serious crimp in plans to eliminate the disease from the EMR by 2015. That amounts to an increased incidence from 21.4 to 59.5 cases per million population.

Nations with conflict and insecurity or with a high incidence of measles saw large outbreaks, with the largest in Iraq (35,822 cases, 2008-09), Somalia (27,281 cases, 2011-12), Pakistan (16,753 cases, 2010-12), and Sudan (14,139 cases, 2011-12).

Achieving measles elimination in the region requires two doses of vaccine, the CDC said. In 2012, 10 countries had measles vaccination coverage of 95% or higher, 2 had coverage from 90% to 94%, 10 had coverage under 90% (ranging from 46% to 85%), and 1 had no coverage data available.
Jun 13 MMWR report

Food Outbreak Scan for Jun 13, 2014

News brief

Salmonella cases linked to bearded dragons climb to 150 in 35 states

Eighteen more illnesses, including five from a second subtype, have been reported in a multistate Salmonella outbreak linked to contact with pet bearded dragons, and four more states are reporting cases, the US Centers for Disease Control and Prevention (CDC) said yesterday in an update.

The new cases push the outbreak total to 150 and the number of affected states to 35.

Though most of the infections involve Salmonella Cotham, a sample from a sick person's home yielded that strain as well as Salmonella Kisarawe, a second, rarely reported strain. The CDC's search of PulseNet, the national subtyping network, identified five sick people infected with the same strain of Salmonella Kisarawe, along with five samples collected from bearded dragons.

The latest illness onset is May 19, and, of 83 patients with available information, 36 (43%) were hospitalized for their infections. No deaths have been reported.

Antibiotic resistance testing on 12 isolates from patients has identified 1 that is multidrug resistant.

The CDC first announced the outbreak in late April. In late May Canada reported nine Salmonella Cotham infections from at least two provinces that also have links to contact with pet bearded dragons.
Jun 12 CDC outbreak update

CDC warns consumers over chia power products

In other Salmonella outbreak developments, the CDC today warned consumers about an ongoing outbreak linked to products containing chia powder, which is made from small chia seeds that are sprouted, ground into powder, and added for nutritional value to health foods such as smoothies.

The agency said several recalls of different product brands have been issued in both the United States and Canada. In the United States as of Jun 9, 21 illnesses had been reported from 12 states. In a Jun 10 update, the Public Health Agency of Canada (PHAC) said it had received reports of 34 cases in 4 provinces.

The recalled products have a long shelf life and may still be in people's homes, the CDC warned. It provided a link to a list of recalled products and their photos to allow people to see if the chia powder items they have are on the recall list.
Jun 13 CDC media advisory
CDC chia powder recall list

Multistate E coli outbreak tied to clover sprouts grows to 17 cases

A multistate outbreak of Escherichia coli O121 infections linked to raw clover sprouts has increased by 10 cases and 3 states, to 17 cases and 5 affected states, the CDC said in a Jun 10 update.

Illness-onset dates range from May 1 to May 20, and patients range in age from 11 years to 45 years, with a median age of 27. Thirteen of the patients are female.

Among the 15 people with available information, 7 (47%) have been hospitalized. No case-patients have developed hemolytic uremic syndrome, a potentially fatal kidney complication, and no deaths have been reported.

The number cases per state are: Idaho, 3; Michigan, 1; Montana, 2; Utah, 1; and Washington, 10. The initial CDC outbreak report on May 22 listed only the 3 cases in Idaho, plus 7 in Washington state.

Twelve of 14 people interviewed reported eating raw clover sprouts in the week before they became ill. The CDC said, "Epidemiology and traceback investigations conducted by local, state, and federal officials indicated that contaminated raw clover sprouts produced by Evergreen Fresh Sprouts, LLC of Idaho are the likely source of this outbreak" but added that the company had not recalled its clover sprouts.
Jun 10 CDC update