Top 5 Infectious Disease News of the Week—March 18, 2018

#5: Fighting Flu: Managing and Preventing Influenza with Antivirals

With the United States having experienced its most severe flu season since the 2009 influenza A (H1N1) pandemic, prompting the Centers for Disease Control (CDC)’s Acting Director, Anne Schuchat, MD, RADM, USPHS, to call the season a wake-up call, it is important for health care providers to understand and choose the best treatment option for each patient that they see.

The CDC currently recommends treating the flu with a neuriminidase inhibitor (NAI), such as oral oseltamivir (Tamiflu), inhaled zanamivir (Relenza), or IV peramivir (Rapivab). They recommend against the use of adamantanes, such as amantadine and rimantidine, due to their high level of resistance in the past few years. The NAIs work by preventing NA formation, which leads to a reduction in viral replication by inhibition of releasing the virus from infected cells.

Read more about flu.

#4: Salmonella Outbreak Linked to Dried Coconut Infects Individuals In 8 States

Soon after the Centers for Disease Control and Prevention (CDC) issued a final update for a recent multistate Salmonella outbreak linked to frozen shredded coconut, they announced yet another investigation into a new multistate Salmonella outbreak which has been linked with dried coconut.

The CDC reports that a total of 13 individuals have already fallen ill across 8 different states; 3 of the individuals have required hospitalization.

On March 16, 2018, International Harvest, Inc. of Mount Vernon, New York, announced a recall of over 14,000 pounds of bulk and more than 24,000 bags of Organic Go Smile! Raw Coconut product, due to its potential to be contaminated with Salmonella, a bacteria that is estimated to cause upwards of 1.2 million illnesses, 23,000 hospitalizations, and 450 deaths on an annual basis in the United States alone.

Read more about the multistate Salmonella outbreak linked to dried coconut.

To stay on top of the most recent case counts, be sure to visit our Outbreak Monitor.

#3: Addressing High-Concern Pathogens and Familiar Threats

In recent years, it has become clear that facilities across the spectrum of care need to take stock of their existing infection prevention and control protocols and consider where there might be knowledge gaps, areas for improvement or need for changes—not only in the context of familiar threats, like Clostridium difficile (C. difficile) and influenza, but also as they apply to emergency preparedness and response plans for high-consequence pathogens and emerging infection risks.

Most health care facilities understand what is at stake if their chosen surface disinfectant does not effectively kill C. difficile, which can not only have serious implications for patient safety, but also carry significant financial consequences for facilities. A study of 170,000 discharges from 477 hospitals from 2009 to 2011 calculated that a single case of C. difficile-associated diarrhea can increase a hospital stay by 4.7 days and add $7,286 to hospital costs. However, as health care facilities work to reduce C. difficile, which remains a leading cause of health care-associated infections (HAIs), they also need to be prepared for emerging threats.

Read more about high-concern pathogens and threats.

#2: As Flu Season Winds Down, New Study Highlights Inflight Transmission Risks

This flu season in the United States peaked in early February during week 5, according to a new flu situation update released by the Centers for Disease Control and Prevention (CDC). Despite steady declines in flu season indicators around the country since then, influenza activity remained high during week 10 ending March 10, 2018. Puerto Rico and 26 states continue to report widespread flu, according to the most recent FluView report, and hospitalization rates rose slightly from 86.3 laboratory-confirmed influenza-associated hospitalizations per 100,000 population during the previous week to a cumulative rate of 89.9 per 100,000. For Americans aged 65 and over, the hospitalization rate rose from 370.6 per 100,000 during week 9 to 386.2 per 100,000.

Although the CDC has reported that the proportion of influenza A and B viruses are nearly equal, influenza A viruses continue to cause the majority of hospitalizations. During week 10, 79% of hospitalizations were associated with influenza A viruses, and H3N2 was identified in more than 85% of hospitalized patients. Throughout the 2017-2018 flu season, the CDC has continued to recommend the flu vaccine for all individuals 6 months of age and older and prompt treatment with influenza antiviral medications such as Tamiflu for individuals who are severely ill with flu symptoms or at high risk for developing serious flu complications.

Read the rest of this week’s flu update.

#1: South Africa Hit With Largest-Ever Listeria Outbreak

South Africa has been struggling with a deadly listeria outbreak that has been hitting the country hard for over a year now.

Recently, the Minister of Health of South Africa, Dr. Aaron Motsoaledi, provided an update on the situation, reporting that as of March 2, 2018, the number of laboratory-confirmed cases of listeriosis has risen to 948 since January 2017—the cases are up by 221 since January 2018 alone. A total of 659 patients out of the 948 have been traced; 180 individuals have died. This equates to a 27% case fatality rate.

Since the outbreak began, health officials have been working doggedly to identify a potential source of the outbreak. In an effort to do this, officials from the National Institute for Communicable Diseases (NICD) interviewed 109 of the infected individuals to glean information pertaining to the foods that they consumed in the month prior to falling ill, according to Dr. Motsoaledi’s statement. They found that the majority of those interviewed (85%) consumed ready-to-eat processed meat products—polony, viennas/sausages, and other cold meats.

This, perhaps, is not surprising as many Listeria outbreaks that sprung up in the 1990s were linked primarily with deli meats and hot dogs. However, most recent outbreaks have been traced back to various dairy products and produce. For example, one of the most recent Listeria outbreaks was linked with soft raw milk cheese made by Vulto Creamery.

The outbreak occurring in South Africa is believed to be the largest-ever outbreak to have occurred to date, according to the United Nations. Previous to this, the second largest outbreak of listeriosis sprung up in 2011, and was linked with whole cantaloupes from Jensen Farms, Colorado—this outbreak had 147 confirmed cases across 28 states; 33 individuals died.

Read the rest of the top infectious disease article of the week.