Safer food saves lives

From 2010 to 2014, multistate outbreaks caused 56% of deaths in all reported foodborne outbreaks despite accounting for just 3% of outbreaks. Foods involved in multistate outbreaks are contaminated before they reach a restaurant or home kitchen. Investigating these outbreaks often reveals problems on the farm, during processing or in distribution that resulted in contaminated food. To help improve detection of and response to these outbreaks, the report outlines specific actions such as the following: food industries should keep detailed records to allow faster tracing of foods from source to destination; state and local agencies should interview sick people promptly about what they ate; healthcare providers should rapidly submit specimens from sick people to public health laboratories for advanced testing; and consumers should check for information about food recalls and safe food handling and preparation.

Two recent E. coli outbreaks traced to food from retailers are multistate outbreaks. CDC, FDA, and several states have been investigating amultistate outbreak of Shiga toxin-producing E. coli O26 (STEC O26) infections linked to eating at multiple locations of Chipotle Mexican Grill. As of December 4, a total of 52 ill people have been reported from 9 states. Twenty have been hospitalized, and there have been no reports of hemolytic uremic syndrome or deaths.

The outbreak was initially detected by public health officials in Washington and Oregon through local foodborne disease surveillance. Officials in Washington and Oregon detected an increase in STEC infections in their states and after interviews with ill people they determined illness was likely linked to eating at multiple Chipotle locations. Once DNA fingerprinting had been completed, CDC determined that several illnesses in states other than Washington and Oregon had occurred during the same period. Whole genome sequencing also provided genetic information linking cases in multiple states. The epidemiologic evidence available at this time suggests that a common meal item or ingredient served at the restaurants is a likely source of the outbreak; the ongoing investigation has not identified the specific food linked to illness. Chipotle is assisting public health officials with understanding the distribution of food items served at locations where ill people ate.

Just before Thanksgiving, CDC, FDA, USDA’s Food Safety and Inspection Service (FSIS), and state and local health officials in several states collaborated to investigate yet another multistate foodborne disease outbreak , this one involving E. coli O157:H7 infections in people who had eaten rotisserie chicken salad purchased from Costco stores. As of December 8, a total of 19 people have been sickened in 7 states, and 5 have been hospitalized. Preliminary laboratory results indicated the presence of E. coli O157:H7 in a celery and onion diced blend used in the chicken salad and supplied by Taylor Farms Pacific, Inc. As a result, the company voluntarily recalled multiple products containing celery because they may be contaminated. According to FDA, additional laboratory analysis of a sample of celery/onion blend did not confirm the presence of E. coliO157:H7 in the sample, and the investigation is working which specific ingredient in the chicken salad is linked to illness. The celery and onion diced blend has not been ruled out as a source of the outbreak. No additional illnesses linked to this outbreak have been reported to CDC since November 23.

Dengue outbreak in Hawaii

CDC is assisting the Hawaii Department of Health (DOH) in the response to an outbreak of dengue on the Big Island. As of December 9, there have been 145 confirmed cases of dengue.  Dengue is not endemic to the island, but it is intermittently imported from disease-endemic areas by infected travelers. This is the first outbreak of locally acquired dengue in the state since 2011. CDC is providing diagnostic assistance to the Hawaii DOH in confirming dengue cases. At the request of Hawaii’s governor, CDC staff traveled to Hawaii to assist with the investigation and outbreak response.

Get Smart about Antibiotics Week

Backed for the first time by a Presidential Proclamation , Get Smart About Antibiotics Week (November 16-22) aimed to raise awareness about the threat of antibiotic resistance and promote appropriate antibiotic prescribing and use. This year’s rollout involved science, communications, and CDC policy experts. With 130 partners in 2015, this year’s Get Smart Week included:

• New CDC data maps about antibiotic prescribing rates in US health provider offices and antibiotic stewardship programs by state
• Stewardship activities from partners like Walmart, Consumer Reports, and the Hospital Corporation of America

Ebola update

Status in West Africa

The situation in West Africa continues to evolve. On November 7, Sierra Leone reached a major milestone in its fight against Ebola – after more than 14,000 reported cases and nearly 4,000 deaths, WHO declared the country free of Ebola virus transmission. Additionally, as of December 7 Guinea had not reported a confirmed case of Ebola since October 29. The last known patient with Ebola tested negative on November 16, and the country’s 42-day countdown to being declared free of transmission began on November 17.

Despite the progress, it’s clear that we cannot let our guard down. On November 19, Liberia identified three new confirmed cases of Ebola. We also know that Ebola virus sometimes persists in certain parts of the body after someone recovers from the disease – and we continue to learn more about this phenomenon. As we look toward 2016, we need to make sure each of these countries is equipped to prevent, detect, and rapidly respond to any new cases. This means educating and supporting survivors, as well as maintaining and strengthening the health infrastructure.

New Ebola assays deployed

Two new tests—the CDC Ebola virus NP real-time RT-PCR assay and CDC Ebola virus VP40 real-time RT-PCR assay—have just been deployed to Ebola testing laboratories in the Laboratory Response Network (LRN). The assays have been authorized for emergency use by the US Food and Drug Administration (FDA). Use of these two assays in conjunction with the algorithm in the LRN Guidance for Definitive Identification of Ebola Virus in Patient Specimens will help speed case confirmation and reduce the risk of false-positive results in vaccinated individuals.