Salmonella outbreak linked to backyard chicken hatchery in Michigan. Since 2000, human contact with live chickens has resulted in nearly 5,000 cases of Salmonella enterica but the origin of the outbreak is rarely identified, according to the US Centers for Disease Control and Prevention (CDC). In June 2018, following 24 clinical cases of S. Enteritidis, the Michigan Department of Health and Human Services along with the CDC conducted environmental sampling at a backyard chicken hatchery and identified S. Typhimurium in 3 of 45 collected samples and S. Enteritidis in 1 sample. Genomic analysis confirmed that the outbreak strain was present at the hatchery. Researchers suggested that environmental sampling at backyard hatcheries be included in outbreak responses. [CDC MMWR]

Vietnam, Taiwan, and India report highly pathogenic avian flu outbreaks. Vietnam, Taiwan, and India have reported recent and ongoing outbreaks of highly pathogenic avian flu serotypes H5N1 or H5N2 in poultry and birds, according to the World Organization for Animal Health (OIE). In India, an ongoing outbreak in Bihar resulted in 117 bird deaths while two flu-related deaths in two peacocks forced closure of the Patna Zoo. In Taiwan, ongoing outbreaks are occurring in Taoyuan City, Chiayi County, and Yunlin County and have resulted in 33, 16, and 424 deaths, respectively. An outbreak was also reported in Dak Lak, Vietnam and resulted in 50 bird deaths. In India and Taiwan, the apparent case fatality rate is 100 percent, and in Vietnam it is 50 percent. [Avian Flu Diary, OIE India, OIE Taiwan, OIE Vietnam]

Sphingomonas koreensis infections at the NIH. In 2016, six patients at the US National Institutes of Health (NIH) Clinical Center contracted infections caused by Sphingomonas species, four of which were caused by multidrug-resistant S. koreensis. The infections triggered an epidemiologic investigation in which researchers analyzed samples collected from 37 NIH patients who also presented with infections caused by Sphingomonas species from 2001 to 2016. Researchers collected samples from potable water sources, sink faucets, ice machines, and other plumbing infrastructure. Genomic analysis showed clinical isolates and those collected from aqueous environments to be similar. Likely, a single S. koreensis strain was introduced into the facility’s plumbing system in 2004 which acted as a reservoir for subsequent infections. [NEJM]

Risk factors for C. diff infection in the hospital setting. Researchers assessed risk factors for hospital-acquired Clostridium difficile infection (CDI) among 5,209 patients who were hospitalized at the University of New Mexico Hospital between May 2011 and August 2016. Overall, there were 1,092 CDI cases among the study population. Compared to those who stayed in intensive care units, patients in the emergency department had nearly twice the odds of contracting a CDI. Prior exposure to a statin, probiotic, or high-risk antibiotic, which included cephalosporins, quinolones, or clindamycin, also increased the risk of CDI. [American Journal of Infection Control]

Measles outbreak in southern Thailand. In the southern provinces of Thailand, health officials have recorded an estimated 1,500 measles cases including 12 deaths. The majority of cases have occurred among infants and children, according to several media outlets. The outbreak is occurring in a low vaccination coverage area where there is a lack of health education and high levels of poverty, child malnourishment, and security challenges. [The ASEAN Post, Al Jazeera]

Progress and challenges for universal health coverage in Indonesia. Between 1960 and 2001, Indonesia’s centralized health system improved access to primary health services, extended life expectancy from 48 to 69 years, and reduced infant mortality from 76 deaths per 1,000 livebirths to 23. Despite progress, significant health inequities remained due mainly to the country’s diverse population, geographic dispersion across thousands of islands, and decentralized government. In 2014, a new universal health coverage system was introduced and became the world’s largest single-payer health system covering over 200 million people. The new universal health system has been widely successful, but ongoing challenges include low coverage for middle-class citizens and rising costs due to the increase in noncommunicable diseases. [The Lancet]

Attitude toward infection control associated with compliance among nurses. Positive attitudes towards infection control were associated with increased reported levels of infection control compliance among home health nurses, according to a survey of 359 nurses working in the northeastern US.  Knowledge of infection control practices was not significantly associated with increased compliance. Older and non-Hispanic black nurses also reported higher compliance with infection control practices compared to younger and non-Hispanic white nurses. [American Journal of Infection Control]

Enterovirus-D68-associated acute flaccid myelitis cases in Europe. In 2016, there were 29 Enterovirus-D68-associated acute flaccid myelitis (AFM) cases in 12 European countries including France, Scotland, Sweden, Norway, and Spain, according to questionnaire data. Twenty-six cases occurred among children. Common clinical symptoms included fever, muscle and limb weakness, cranial nerve deficits, and decreased or absent reflexes. Neuroimaging with MRI was reported to be abnormal in 25 cases, and 19 patients required ventilator support. Two patients – a 55-year old woman and 3.5-year old child – died and only three patients made a full recovery. [The Pediatric Infectious Disease Journal]

Strain causing Yemen’s cholera outbreak originated from south Asia. Genomic analysis of 46 Vibrio cholerae isolates collected from three governorates in Yemen between October 5, 2016 and August 31, 2017 revealed that the strain causing the largest cholera outbreak in recent history originated in south Asia and caused outbreaks in Kenya, Tanzania, and Uganda between 2015 and 2016. The strain likely spread through human migration. The isolates were susceptible to polymyxin antibiotics but shared decreased susceptibility to ciprofloxacin and resistance to nitrofurantoin and nalidixic acid. [Nature]

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