The Further Adventures of Germ Girl

Statement: “The Alabama Department of Public Health today is announcing an ongoing investigation of an outbreak of Serratia marcescens bacteremia in six Alabama hospitals.

On March 16, ADPH was notified that an outbreak had occurred in two of these hospitals among patients receiving TPN (total parenteral nutrition).

TPN is liquid nutrition fed through an IV using a catheter.

Use of contaminated products may lead to bacterial infection of the blood.

ADPH requested assistance from the Centers for Disease Control and Prevention. CDC’s initial investigation identified TPN produced by a single pharmacy, Meds IV, as a potential common source and has determined that these hospitals received TPN from this pharmacy.

Affected hospitals are Baptist Princeton, Baptist Shelby, Baptist Prattville, Medical West, Cooper Green Mercy and Select Specialty Hospital in Birmingham.

Meds IV was notified and informed its customers of the possibility of contamination. ADPH has been informed that impacted hospitals immediately stopped using TPN received from this pharmacy and that the pharmacy discontinued all production.

On March 24, Meds IV recalled all of its IV compounded products.

The U.S. Food and Drug Administration is aware of the voluntary recall. The pharmacy and the hospitals are cooperating with the investigation.

At this time, ADPH is aware of 19 cases in these six hospitals of Serratia marcescens bacteremia related to this outbreak.

ADPH will provide updates as more information becomes available.”

(from Alabama Dept of Public Health. Contact: Mary McIntyre, M.D., M.P.H. (334) 206-53255)

© Copyright Agri-Pulse Communications, Inc.

WASHINGTON, March 18 – The U.S. Department of Agriculture issued a clarification on Friday to recent statements made about livestock producers overusing antibiotics and about that overuse leading to antibiotic resistance in humans.

The statements were wrongly interpreted in a March 16 story in the Wall Street Journal. In testimony Wednesday before the House Appropriations Committee’s Agriculture Subcommittee, USDA Agricultural Research Service Administrator Dr. Edward Knipling, in response to a question from Rep. Tom Latham, R-Iowa, said his department is conducting research on antibiotic use in livestock and antibiotic resistance. Knipling said that, while data suggest “in some cases, there are problems and concerns,” they also show “this is not as severe an issue as it might be otherwise portrayed.”

Despite those statements, the Wall Street Journal reported that “hog farmers are overusing antibiotics on their herds and that may be creating antibiotic-resistant bacteria that pose a threat to human health.” The headline on the story said government data supports that contention.

In its clarification statement, USDA said: “Dr. Knipling never said that swine producers were overusing antibiotics in the herds.” He also pointed out, the statement said, that “some of that data and trends show that the resistance is not developing to the extent as otherwise might be portrayed.”…

A man is in hospital with the potentially fatal legionnaires’ disease after using the leisure centre at a four-star hotel in Dundee. Some 66 staff and visitors at the Landmark Dundee have also experienced flu-like sickness, NHS (National Health Service) Tayside confirmed last night.

NHS Tayside said that before the single confirmed case, there was no evidence of legionella infection in any samples taken.

Consultant in public health medicine for the health authority Dr Christopher McGuigan said: “…We are not recommending that people should stay away from the hotel as the investigations are focusing on the leisure club, which has been closed since the evening of Thursday, March 17. We have been working closely with the hotel since the investigation started late last week and we are systematically carrying out all appropriate health and environmental tests.”

NHS Tayside has asked anyone who has visited the hotel over the last two weeks, and who has been unwell with a flu-like illness – for example, high temperature, chills, cough, headache or shortness of breath – to seek advice…

Quiet and unassuming, Ruth Adams preferred to let her accordion do the talking. Leading a tiny combo that someone once christened the World’s Most Dangerous Polka Band, that accordion landed her on the Jon Stewart show and ABC’s “Good Morning America,” while helping to establish Nye’s in northeast Minneapolis as what Esquire magazine rightfully dubbed the best bar in America.

Adams died Friday at Hennepin County Medical Center at age 79 after a battle with cancer…

(H/t @nyculla. @tomphilpott has also written several stories on the risks of antibiotics in distillers’ grains.)

There are two major concerns with the use of antibiotics in ethanol. The first concern is the potential for bacteria to develop resistance, rendering antibiotics useless against them. The second concern is the potential for antibiotic residues to end up in animal feeds and potentially animal tissues used for human consumption.

Antibiotic resistance develops in bacteria during ethanol production due to the misuse of antibiotics. This includes antibiotic overdosing when no effect is observed and underdosing when efficient control is observed.

Overdosing can lead to an increased chance that antibiotics will not be inactivated during the distillation process. This would result in their presence in distillers grains.

Consumption of distillers grains containing antibiotic residue by animals could result in humans consuming those animals and in turn acquire resistance to the antibiotics used in ethanol production.

In addition, overdosing affects the rate of fermentation. Underdosing, on the other hand, leads to a lack of effectiveness of antibiotics. It also carries a greater risk of causing resistance, as bacteria can become accustomed to the antibiotic in low doses and thus develop resistance mechanisms.

It is the responsibility of the FDA Center for Veterinary Medicine (FDA/CVM) to approve the use of drugs in animal feeds, as well as monitor and establish limits for feed contaminants. The use of antibiotics in ethanol production could result in antibiotic residues in the distillers grains by-product. Thus, antibiotic residues in distillers grains used as feed or feed ingredients are considered feed additives and regulated by the FDA.

Currently the FDA has several concerns with the use of antibiotics in the fuel ethanol industry. Their primary concern is that antibiotic residues may be present in distillers grains and that those residues could be transferred to animal tissue upon ingestion.

However, it is unlikely that antibiotic residues in distillers grains would transfer into animal tissue due to the low levels present in distillers grains, as well the pharmacology of the antibiotics used in ethanol production.

The second concern expressed by the FDA is the potential harm to humans who eat tissues containing antibiotic residues. The FDA is specifically concerned with the probability that consumption of contaminated animal tissues could result in antibiotic resistance in humans. Many countries currently place maximum residue limits in foodstuffs of animal origin to combat this problem. Finally, the FDA expressed concern for the health of animals fed distillers grains containing antibiotic residues.

The only antibiotic currently approved for use in ethanol production is virginiamycin. The FDA/CVM issued a letter of no objection for the use of virginiamycin in the fermentation phase of alcohol production at 2 to 6 ppm. In addition, the CVM did not object to potential residues of 0.2 to 0.5 ppm in distillers by-products. This statement was based on an animal diet containing no more than 20 percent distillers grains. Moreover, it was stated that the FDA/CVM is unlikely to take regulatory action against dried distillers grains-containing feed with residual levels of virginiamycin below 0.5 ppm. Levels below 0.5 ppm pose no concern to broilers, turkeys, swine, or cattle consuming the feed, nor to the humans consuming food derived from those animals.

Although antibiotic residues have been confirmed in distillers grains by the FDA, the activity level of those residues has never been tested. It is possible that the residues present have been inactivated by the ethanol production process, as the antibiotics are exposed to high and low temperatures and a wide pH range.

Further studies will help to confirm the potential implications of feeding distillers grains with antibiotic residues.

Hog farmers are overusing antibiotics on their herds and that may be creating antibiotic-resistant bacteria that pose a threat to human health, Edward Knipling, head of the U.S. Department of Agriculture’s research branch, said Wednesday.

Data collected by the USDA and the Centers for Disease Control and Prevention show there is a problem that could be exposing Americans to bacteria like Escherichia coli and Campylobacter that have become resistant to antibiotics, Mr. Knipling told a panel of House lawmakers. …

The Food and Drug Administration warned hog, cattle and chicken producers last year in a draft guidance letter to stop the widespread practice of feeding antibiotics to livestock, which is commonly done to accelerate animal growth. The document did not mandate the farmers change their behavior, though.

Mr. Knipling focused on hogs in his remarks before a House Appropriations subcommittee, but the FDA has warned antibiotic overuse is also a problem on the cattle and chicken operations.

Mr. Knipling said that the government’s antibiotic monitoring program has already produced significant results and now the USDA is proposing to conduct new research into ways it can help wean hog farmers off use of the drugs…

… the highest rates of type 2 diabetes in the U.S. are in a “diabetes belt” in 15 mostly Southern states.

Researchers say the diabetes belt is similar to a “stroke belt” identified in earlier studies.

The diabetes belt includes 644 counties in portions of Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and West Virginia…

(Byline: B. Hendrick)

…News sources are reporting the deaths of four guests who stayed at a hotel in Muang district. A 47-year-old local woman was allegedly found dead in her room on February 3. A tourist from New Zealand, age 23, fell ill on the next day and died in hospital on February 6. It is unclear what her symptoms were, however some sources report she had vomiting, which was attributed to food poisoning. Two of her traveling companions apparently became sick too but have since recovered and returned home.

Two British tourists, aged in their 70’s, were allegedly found dead in their hotel room on February 19. Local authorities, including the police, public health authorities and the Communicable Disease Control Department are conducting an investigation. No official information is available yet….

At this stage it is unclear whether the causes of these deaths are related. Possible causes include infectious disease, including severe gastroenteritis due to contaminated food or water, or perhaps chemical poisoning…

(Two people, a German tourist and a Croatian resident, become infected with dengue while in Croatia. They are the first known cases of dengue passed by mosquitoes in Croatia, rather than infections acquired elsewhere and brought home. When the country’s health ministry investigates, they find that 9 others were infected also but recovered - m.)

…the Epidemiology Service of the CNIPH was notified on 30 September by the Robert Koch Institute (RKI) in Germany of a German citizen, who fell ill with symptoms of dengue fever immediately after returning to Germany from a 15-day stay on the Pelješac peninsula in Croatia. Virological investigation revealed the presence of DENV-specific IgM, a rise in DENV-specific IgG and the presence of NENV NS1 antigen in the patient’s blood.

As this was the first case of dengue fever probably acquired in Croatia, an epidemiological investigation was conducted and outbreak control measures implemented. We present here the first results of the epidemiological investigation.

According to information received by the RKI, the German citizen travelled from Germany via Austria and Slovenia along the Croatian coast in August 2010 and stayed on the Pelješac peninsula and the island of Korčula for 15 days. The disease onset was on the day after he returned to Germany. …

On 22 October 2010, a possible case of dengue fever was reported in a resident of the same village where the German patient had stayed. The Croatian patient, a woman in her fifties, who had not travelled outside her place of residence, developed symptoms compatible with dengue fever on 17 October, including temperature up to 39°C, skin rash, chill, headache and joint and muscle pain, and was admitted to the infectology ward at Dubrovnik hospital on day 6 after onset of disease.

… We collected 14 blood samples from healthy inhabitants living near the case’s place of residence. The samples were analysed by ELISA for the presence of DENV and WNV IgM/IgG antibodies. Nine of those were found positive for DENV infection (IgG) and seven had positive or borderline results for DENV-specific IgM.

Taking photographs from the roadside of a sunrise over hay bales near the Suwannee River, horses grazing near Ocala or sunset over citrus groves along the Indian River could land you in jail under a Senate bill filed Monday.

SB 1246 by Sen. Jim Norman, R-Tampa, would make it a first-degree felony to photograph a farm without first obtaining written permission from the owner. A farm is defined as any land “cultivated for the purpose of agricultural production, the raising and breeding of domestic animals or the storage of a commodity.”

Media law experts say the ban would violate freedoms protected in the U. S. Constitution. But Wilton Simpson, a farmer who lives in Norman’s district, said the bill is needed to protect the property rights of farmers and the “intellectual property” involving farm operations.

Simpson, president of Simpson Farms near Dade City, said the law would prevent people from posing as farmworkers so that they can secretly film agricultural operations.

He said he could not name an instance in which that happened.

But animal rights groups such as People for the Ethical Treatment of Animals and Animal Freedom display undercover videos on their web sites to make their case that livestock farming and meat consumption are cruel.

Jeff Kerr, general counsel for PETA, said the state should be ashamed that such a bill would be introduced.

“Mr. Norman should be filing bills to throw the doors of animal producers wide open to show the public where their food comes from rather than criminalizing those who would show animal cruelty,” he said.

Simpson agreed the bill would make it illegal to photograph a farm from a roadside without written permission. Norman could not be reached for comment.

Judy Dalglish, executive director for the Reporters Committee for Freedom of the Press, said shooting property from a roadside or from the air is legal. The bill “is just flat-out unconstitutional not to mention stupid,” she said…

(Byline: Bruce Ritchie. h/t @tlaskawy)

Eliminating nearly all the money for poison control centers would save $27 million — not even a rounding error when it comes to the deficit. Yet it is so foolish that it perfectly illustrates the thoughtlessness of the House Republican bill to cut $61 billion from the budget over the next seven months. The nation’s network of 57 poison control centers takes four million calls a year about people who may have been exposed to a toxic substance. In three-quarters of all cases, the centers are able to provide treatment advice that does not require a visit to a hospital or a doctor, saving tens of millions of dollars in medical costs. While a single visit to an emergency room can cost hundreds or thousands of dollars (often paid for by the government), a call to a poison center costs the government only $30 or $40. A study in the Journal of Medical Toxicology estimated that the poison centers saved the State of Arizona alone $33 million a year. Louisiana eliminated its centers in the 1980s but restored them when it realized how much money they saved. The centers, which collect poison reports, can also act as an early warning system for pandemics or large toxic exposures, allowing a quick response. The federal government pays about 20 percent of the cost of the centers, with states, cities and philanthropy picking up the rest. Many strapped state and local governments have cut back their financing, and experts say that the virtual elimination of federal money would force many centers to close and sharply damage the effectiveness of the national network. Could savings be achieved by consolidating centers? Possibly. House Republicans didn’t bother to examine that or how much the cuts would actually increase spending on emergency care. If they get their way, lines at emergency rooms will be longer.

(J. Michael Lane and Gregory Poland)

…Ethically we find it hard to justify maintaining an eradicated virus. An accidental release, no matter how small the risk, is an unacceptable risk; given the lack of any possible utility in keeping the virus. Maintenance of such stocks is expensive and places a burden on the Centers for Disease Control and Prevention that is unnecessary and scientifically without merit, and for which resources could be better used in protecting mankind from infectious diseases.

It is a twist of irony that the United States and Russia, the two nations that jointly sponsored the WHO resolution to eradicate smallpox, are now the main proponents of maintaining live stocks of the virus.

The advocates of retention of the virus have research goals that are only remotely accomplishable and, we believe, unnecessary given our current scientific understandings.

One of us (JML) has seen first hand the heartbreaking devastation of human smallpox.

The simple fact is that smallpox can now be reconstituted from published sequences if needed from a scientific point of view. Why keep the existing stocks? We risk the opprobrium of the rest of the world by keeping virus strains that have little utility, result in unnecessary risk and expense, and which may be seen by others as symbolic of a bioweapon arsenal.

It is time to destroy our remaining smallpox virus stocks, call upon the rest of the world to do the same, and make possession of the virus an international crime against humanity. We find no evidence to compel us to do otherwise.

(full document is linked behind post title above. distributed by Animal Welfare Approved. - m.)

“…Unique Physical Properties

This previously unknown organism is only visible under an electron microscope (36,000X), with an approximate size range equal to a medium size virus. It is able to reproduce and appears to be a micro-fungal-like organism. If so, it would be the first such micro-fungus ever identified. There is strong evidence that this infectious agent promotes diseases of both plants and mammals, which is very rare.

Pathogen Location and Concentration

It is found in high concentrations in Roundup Ready soybean meal and corn, distillers meal, fermentation feed products, pig stomach contents, and pig and cattle placentas.

Linked with Outbreaks of Plant Disease

The organism is prolific in plants infected with two pervasive diseases that are driving down yields and farmer income—sudden death syndrome (SDS) in soy, and Goss’ wilt in corn. The pathogen is also found in the fungal causative agent of SDS (Fusarium solani fsp glycines).

Implicated in Animal Reproductive Failure

Laboratory tests have confirmed the presence of this organism in a wide variety of livestock that have experienced spontaneous abortions and infertility. Preliminary results from ongoing research have also been able to reproduce abortions in a clinical setting.

The pathogen may explain the escalating frequency of infertility and spontaneous abortions over the past few years in US cattle, dairy, swine, and horse operations. These include recent reports of infertility rates in dairy heifers of over 20%, and spontaneous abortions in cattle as high as 45%.

For example, 450 of 1,000 pregnant heifers fed wheatlage experienced spontaneous abortions. Over the same period, another 1,000 heifers from the same herd that were raised on hay had no abortions. High concentrations of the pathogen were confirmed on the wheatlage, which likely had been under weed management using glyphosate…”

(A list of all-stars — among which I am humbled to be numbered. m.)

madregale:

Earlier today, I posted a query to Twitter: “If you could hire any three journalists working primarily online right now, who would they be?” I later clarified by query, “I think the word ‘journalist’ confused things. Think of your favorite three people who write online (whatever you call them)….