Top 5 Contagion&reg News Articles for the Week of April 9, 2017

The Top 5 articles of the past week highlighted new research that proposed a connection between chronic hepatitis B and C infections and Parkinson’s disease. In addition, we provided additional coverage from the Society for Healthcare Epidemiology of America (SHEA) 2017 Conference, where Laura Conway, RN, PhD, CIC, provided conference attendees with advice on how to ‘pick their battles’ when it comes to choosing infection surveillance targets. In light of the recent spring holidays, we provided the latest on a beef recall ahead of making Passover brisket, as well as the latest on the newest surge in influenza B cases across the United States. Finally, we provided coverage of a recent Centers for Disease Control and Prevention (CDC) report which showed that almost one quarter of the US population is infected with some form of high-risk human papillomavirus.

#5: Hepatitis & Gut Microbiome May Provide Potential Links to Parkinson's Disease

After reviewing the medical records of “patients with a first case of hepatitis B (~22,000 patients), hepatitis C (~48,000 patients), autoimmune hepatitis (~6,000 patients), chronic active hepatitis (~4,000 patients), and HIV (~20,000 patients) between 1999 and 2011” from a British database,” researchers determined that individuals infected with chronic hepatitis B and C infections may be at increased risk of developing Parkinson’s disease. In fact, according to the study results, “those patients with hepatitis B infection were 76% more likely to develop Parkinson’s disease than those falling in the ‘relatively minor conditions’ category, while those with hepatitis C infection were 51% more likely to develop the disease.” More research is needed to suggest a correlation.

In related news on Parkinson’s, researchers studying the disease have proposed that the disease may not start in the brain; rather, it may start in the gut and then travel to the brain. In their study, the researchers studied alpha-synuclein molecules which “tend to clump together and form fibers that damage the nerves in the brain.” The researchers used genetically-modified mice that overproduced the fibers, and placed them in environments of different levels of sterility. According to the research findings, those mice that were placed in non-sterile cages went on to develop Parkinson’s disease. When treated with antibiotics, the disease symptoms in the mice were reduced, suggesting that, “something in the microbiome” was enhancing the symptoms and that the “gut microbiota might ‘regulate’ the associated symptoms of the disease.

To read more about chronic hepatitis and the gut’s association with Parkinson’s, click here.

#4: Pick Your Battles: Conducting Efficient & Effective Targeted Surveillance in Your Facility

At the recent Society for Healthcare Epidemiology of American (SHEA) Spring 2017 Conference in St. Louis, Missouri, Laurie Conway, RN, PhD, CIC, proposed that when it comes to surveillance targets, “infection preventionists (IPs) need to ‘pick their battles,'” because surveillance takes up about 44% of their time and only about one-third of hospitals have electronic surveillance systems; this means that IPs need to choose wisely when it comes to how best to spend their time.

According to Dr. Conway, the two ways to choose surveillance targets are: regulatory mandates and formal risk assessments. In addition to these federal mandates, there are also state mandates that are updated regularly. To know which local / state mandates to target, IPs need to perform formal risk assessments, otherwise known as, infection control risk assessments (ICRAs). These should be completed annually, taking into account “the community that you serve, the services you provide, what services are building, what [ones] are winding down as well as the case mix that provides.” Existing healthcare-associated infection rates should also be considered and any trends should be noted. IPs should also take into account the antibiogram, as well as the infrastructure of the facility he or she serves.

Dr. Conway went on to identify two tools that can be used to complete the risk assessments, and then four ways to effectively and efficiently conduct targeted surveillance at a facility.

To learn more about how to effectively “pick your battles” when choosing surveillance targets, go here.

#3: Does an 80,000-Pound Brisket Recall Affect Your Passover Dinner?

The spring holiday season is upon us, and last week individuals celebrated Passover. The holiday is traditionally celebrated with a healthy serving of brisket, but a recent recall of 80,000 pounds of boneless beef products in late March may have put a damper on some celebrations.

According to the recall, the H&B Packing Company, in Waco, Texas, issued the recall as a result of potential contamination with Escherichia coli. Although the strain of the bacteria, a non-O157 Shiga toxin-producing strain, is known to cause food-borne illness if consumed, at the time of the recall, no cases had been reported. Perhaps more worrisome, however, is that the incubation period for the strains can take up to 8 days, and therefore, it can sometimes be difficult to trace back the source of illness.

A similar outbreak of this strain of bacteria in beef products was last seen in the United States back in the Fall of 2016. During this outbreak, seven individuals in four states were diagnosed with infection and five of those individuals were hospitalized.

Because brisket can be host to bacteria as it is known to sit out for long hours at holiday buffets and celebrations, those preparing the food should take extra care to ensure they are cooking, storing, and serving the meat properly to reduce risk of food-borne illness.

Read more about the brisket recall here.

#2: Spring Surge in Flu Activity Hits New England

A move into Spring usually means the end of the flu season and the beginning of baseball, but this year the flu seems to be lingering, and baseball players are feeling the effects, particularly in New England.

As infections with this season’s dominant strain of influenza A (H3N2) have been winding down, the country has seen a surge in infections with influenza B. Indeed, according to the Centers for Disease Control and Prevention's latest FluView report, “56% of the cases that public health laboratories reported in the thirteenth week of the year,” where influenza B cases.

Flu activity continues to decline across the United States; however, New England states have seen a new surge in cases of influenza B, particularly in the outer metropolitan Boston area. As a result, “several members of the Boston Red Sox, as well as the team’s play-by-play announcer, have also been affected by the uptick in flu activity, to the dismay of many baseball fans.”

In addition, residents of Maine have seen an uptick in the number of cases. For the week ending April 8, a total of 4693 laboratory-confirmed cases were reported in the state so far for the season; this total is nearly double the number the state had during the 2015-2016 influenza season.

More about the recent surge in flu activity is here.

#1: Nearly One-Quarter of US Adults Have High-Risk HPV

New research recently released by the Centers for Disease Control and Prevention (CDC) is showing that “more than 25% of adults in the United States have some form of high-risk, cancer-causing human papillomavirus (HPV).”

The virus, which can be transmitted through sexual or intimate skin-to-skin contact, has many different strains. The lowest-risk strains are responsible for causing genital warts; however, high-risk strains can lead to cancer of not only the sexual organs, but also oral and throat cancers. Perhaps more troubling is the fact that infections with these strains can be asymptomatic and individuals who do not know they are infected are able to transmit the virus to their partners.

The CDC has identified two strains of the virus, HPV 16 and 18, as being cancer-causing. Although these infections can and do typically clear within one to two years, “long-term infections can progress to cancer if left untreated.”

According to the results of the new CDC study, between 2013 and 2014, a total of 42.5% of the adult population (ages 18 to 59 years) were infected with some form of genital HPV. In addition, the “overall rate of high-risk HPV in that age group was 22.7%, with 25.1% of men and 20.4% of women having some cancer-causing genital form of the virus.” Between 2011 to 2014, oral HPV rates among adults aged 18 to 69 years of age was 7.3%, with the rate of high-risk oral HPV at 4.0%. The population with the lowest prevalence of high-risk oral and genital HPV infections was non-Hispanic Asian adults, while the population with the highest prevalence was non-Hispanic black adults.

To read more about high-risk HPV infections in the US population, click here.