Global & Disaster Medicine

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CDC: Multistate Outbreak of E. coli O157:H7 Infections Linked to Chopped Romaine Lettuce

CDC

Case Count Update

Since the last update on April 10, 2018, 18 more people from 9 states were added to this outbreak.

As of April 12, 2018, 35 people infected with the outbreak strain of E. coli O157:H7 have been reported from 11 states. A list of the states and the number of cases in each can be found on the Case Count Map page. Illnesses started on dates ranging from March 22, 2018 to March 31, 2018. Ill people range in age from 12 to 84 years, with a median age of 29. Sixty-nine percent of ill people are female. Twenty-two ill people have been hospitalized, including three people who developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

Map of United States - People infected with the outbreak strain of E. coli, by state of residence, as of April 12, 2018

Illnesses that occurred after March 27, 2018, might not yet be reported due to the time it takes between when a person becomes ill with E. coli and when the illness is reported. This takes an average of two to three weeks.

The current outbreak is not related to a recent multistate outbreak of E. coli O157:H7 infections linked to leafy greens. People in the previous outbreak were infected with a different DNA fingerprint of E. coli O157:H7 bacteria.

Investigation Update

Epidemiologic evidence collected to date indicates that chopped romaine lettuce is the likely source of this outbreak. Twenty-six (93%) of 28 people interviewed reported consuming romaine lettuce in the week before their illness started. This percentage is significantly higher than results from a survey[787 KB] of healthy people in which 46% reported eating romaine lettuce in the week before they were interviewed. Most people reported eating a salad at a restaurant, and romaine lettuce was the only common ingredient identified among the salads eaten. The restaurants reported using bagged, chopped romaine lettuce to make salads. At this time, ill people are not reporting whole heads or hearts of romaine.

Traceback investigations are ongoing to determine the source of chopped romaine lettuce supplied to restaurant locations where ill people ate. At this time, no common grower, supplier, distributor, or brand has been identified. However, preliminary information indicates that the chopped romaine lettuce was from the Yuma, Arizona growing region.

Information collected to date indicates that chopped romaine lettuce from the Yuma, Arizona growing region could be contaminated with E. coli O157:H7 and could make people sick. Read CDC’s advice to consumers, restaurants, and retailers.

This investigation is ongoing, and CDC will provide more information as it becomes available.


Indonesia: 82 Indonesians have died and many more have been hospitalized after drinking tainted bootleg liquor

Reuters


CDC has now confirmed 132 cases in 32 states tied to the use of kratom, an herbal alternative to opioids.

CDC

What’s New?

  • Forty-five more ill people from 19 states were added to this investigation since the last update on March 15, 2018.
  • Three additional states have reported ill people: Connecticut, Iowa, and Idaho.

 

Highlights

  • At this time, CDC recommends that people not consume any brand of kratom in any form because it could be contaminated with Salmonella.
    • Kratom products from several companies have been recalled because they might be contaminated with Salmonella. The list of recalled kratom products is available on the U.S. Food and Drug Administration website.
    • Kratom is also known as Thang, Kakuam, Thom, Ketom, and Biak.
    • Kratom is a plant consumed for its stimulant effects and as an opioid substitute.
  • CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Salmonella infections.
  • Epidemiologic and laboratory evidence indicates that kratom is the likely source of this multistate outbreak.
    • No common brands or suppliers of kratom products have been identified at this time.
    • Because no common source of Salmonella-contaminated kratom has been identified, CDC is recommending against consuming any kratom.
  • A total of 132 people infected with outbreak strains of Salmonella I 4,[5],12:b:- (61), Salmonella Javiana (15), Salmonella Okatie (21), or Salmonella Thompson (35) have been reported from 38 states.
    • Forty percent of ill people have been hospitalized, and no deaths have been reported.
  • This investigation is ongoing. CDC will provide updates when more information is available.

People infected with the outbreak strains of Salmonella, by state of residence, as of April 5, 2018


South Africa: The world’s largest known listeria outbreak and it was all due to tainted baloney!

NY Times

The world’s largest known listeria outbreak has spread throughout South Africa for 15 months, killing 189 people. Health officials believe they have identified the source: bologna.

Since January last year, 982 confirmed cases of listeriosis had been recorded, the National Institute for Communicable Diseases in South Africa reported on Thursday. The infection, caused by food that has been contaminated with the bacterium Listeria monocytogenes, is often lethal.

A cluster of gastroenteritis cases among toddlers in a Johannesburg hospital this January led authorities to the sandwich meat in a day care center’s refrigerator — and in turn, to a meat production facility in the northern city of Polokwane. There, officials said they detected traces of LST6, the listeria strain identified in 91 percent of the outbreak’s cases.


A multistate Salmonella outbreak linked to kratom supplements has sickened 47 more people and expanded to 8 more states, raising the total to 87 cases from 35 states,

CDC

At A Glance

  • Case Count: 87
  • States: 35
  • Deaths: 0
  • Hospitalizations: 27
  • Recall: Yes

People infected with the outbreak strain of Salmonella, by state of residence, as of March 14, 2018


14 people, including four children, were hospitalized after a mass botulism food poisoning outbreak in southern Kyrgyzstan.

Xinhua

  •  3 are in a serious condition.
  • All patients have received the anti-botulinum serum.

Jars of canned vegetables


Multistate Outbreak of Salmonella Typhimurium Linked to Chicken Salad

CDC

At A Glance

  • Case Count: 170
  • States: 7
  • Deaths: 0
  • Hospitalizations: 62
  • Recall: Yes

Persons infected with the outbreak strain of Salmonella Typhimurium, by date of illness onset as of March 7, 2018*

People infected with the outbreak strain of Salmonella Typhimurium, by state of residence, as of March 7, 2018

 


South Africa: A factory operated by Enterprise Foods in Polokwane in Limpopo is the source of a listeria outbreak that has killed 180 people in the past year

BBC

‘…..”Avoid all processed meat products that are sold as ready to eat‚” Health Minister Aaron Motsoaledi told journalists at the National Institute of Communicable Diseases (NICD) on Sunday afternoon…..’

 


Chicken Salad & The Case of the Multistate Outbreak of Salmonella Typhimurium

CDC

  • CDC recommends people do not eat recalled chicken salad sold at Fareway grocery stores. Throw it away or return it to the place of purchase.
    • On February 21, 2018, Triple T Specialty Meats, Inc. recalled all chicken salad produced from January 2, 2018 to February 7, 2018.
    • The recalled chicken salad was sold in containers of various weights from the deli at Fareway grocery stores in Illinois, Iowa, Minnesota, Nebraska, and South Dakota from January 4, 2018 to February 9, 2018.
    • Even if some of the chicken salad was eaten or served and no one got sick, throw the rest of it away. Put it in a sealed bag in the trash so that children, pets, and other animals can’t eat it.
    • Wash and sanitize countertops as well as drawers or shelves in refrigerators or freezers where recalled chicken salad was stored.
    • If you don’t remember the date when you purchased chicken salad from Fareway, don’t eat it. Throw it away or return it to the place of purchase.

Photo of chicken salad.

  • CDC, public health and regulatory officials in several states, and the U.S. Department of Agriculture’s Food Safety and Inspection Service are investigating a multistate outbreak of Salmonella Typhimurium infections.
  • Epidemiologic and laboratory evidence indicates that chicken salad produced by Triple T Specialty Meats, Inc. and sold at Fareway grocery stores is the likely source of this multistate outbreak.
  • Sixty-five people infected with the outbreak strain of Salmonella Typhimurium have been reported from five states.
    • Twenty-eight hospitalizations have been reported.
    • No deaths have been reported.
  • This investigation is ongoing. CDC will provide updates when more information is available.

People infected with the outbreak strain of Salmonella I 4,[5],12:b:-, by state of residence, as of February 16, 2018

 


Madagascar’s health service ministry says 8 children have died after suffering acute food poisoning believed to have been caused by eating sea turtle meat in northern Madagascar.

Radio VOP

Image result for sea turtle

Med Sante Trop. 2017 Feb 1;27(1):56-61. doi: 10.1684/mst.2017.0664.
Collective poisoning from sea turtle consumption in Mahajanga Madagascar, May 2014.

Abstract

Poisoning from eating sea turtles, medically known as chelonitoxism, is seen especially in coastal areas. It remains a public health problem in Madagascar, despite a ban on hunting these animals. The objective of this study was to describe its epidemiological and clinical aspects and outcome to improve knowledge and prevention of this type of poisoning. Chelonitoxism occurred in May 2014, affecting the population in Antsanitia, a fishing village in northwest Mahajanga, Madagascar. All patients came first to the CSB I basic health center in Antsanitia and were subsequently hospitalized at the Mahajanga CHU Pzaga, 51 in the adult emergency department and 25 in the pediatrics department. These 76 patients ranged in age from 3 months to 79 years. The predominant clinical signs were gastrointestinal and neurological disorders. ENT-oral signs characterized the poisoning. Ingestion of the turtle fat caused intermediate and severe disease forms in adults. Breastfeeding was a prognostic factor in children. Signs of severity appeared within 72 hours in adults. After intensive resuscitation, the signs of poisoning disappeared after 12 days. The severe form predominated in children; death was either early or delayed to the second to sixth day after consumption. It is essential to develop awareness of this danger among the entire coastal population of Madagascar to prevent this kind of poisoning.


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