Vaccine Selection for the 2010–2011 Influenza Season

Vaccine Selection for the 2010–2011 Influenza Season
How are the viruses selected to make flu vaccine?

The influenza (flu) viruses selected for inclusion in the seasonal flu vaccines are updated each year based information about which influenza virus strains are identified, how they are spreading, and how well current vaccine strains protect against newly identified strains. Currently, 130 national influenza centers in 101 countries conduct year-round surveillance for influenza and study influenza disease trends. These laboratories then send influenza viruses to the four World Health Organization (WHO) Collaborating Centers for Reference and Research on Influenza located in Atlanta, Georgia, USA (Centers for Disease Control and Prevention, CDC); London, United Kingdom (National Institute for Medical Research); Melbourne, Australia (Victoria Infectious Diseases Reference Laboratory); Tokyo, Japan (National Institute for Infectious Diseases) for additional analyses. The seasonal flu vaccine is a trivalent vaccine (a three component vaccine) with each component selected to protect against one of the three main groups of influenza viruses circulating in humans. (Last year’s 2009 H1N1 vaccine was made in response to the pandemic first recognized in April 2009. Unlike seasonal flu vaccines, the pandemic vaccine protected against only one flu virus strain, the 2009 H1N1 virus.)

The three vaccine viruses are chosen to maximize the likelihood that the main circulating viruses during the upcoming flu season will be well covered by the vaccine. WHO recommends specific vaccine viruses for vaccine production, but then each individual country makes their own decision for licensing of vaccines in their country. In the United States, the US Food and Drug Administration (FDA) determines what viruses will be used in U.S.–licensed vaccines.

What flu viruses are included in the Northern Hemisphere seasonal vaccine for 2010-2011?

WHO recommended that the Northern Hemisphere’s 2010–2011 seasonal influenza vaccine contain the following three vaccine viruses:

an A/California/7/2009 (H1N1)–like virus;
an A/Perth/16/2009 (H3N2)–like virus;
and a B/Brisbane/60/2008–like virus.
The H1N1 virus recommended for inclusion in the 2010-2011 seasonal influenza vaccine is a pandemic 2009 H1N1 virus and is the same vaccine virus as was used in the 2009 H1N1 monovalent vaccine.

This recommended composition of the seasonal vaccine for the Northern Hemisphere, including the United States, is the same composition that was recommended for the Southern Hemisphere’s 2010 influenza vaccines.

What flu viruses are included in the Southern Hemisphere seasonal vaccine for 2011?

On September 29, 2010, in Geneva, Switzerland, WHO recommended that the Southern Hemisphere’s 2011 seasonal influenza vaccine contain the following three vaccine viruses:

an A/California/7/2009 (H1N1)-like virus;
an A/Perth/16/2009 (H3N2)-like virus;*
a B/Brisbane/60/2008-like virus.
*Note: A/Wisconsin/15/2009 and A/Victoria/210/2009 are A/Perth/16/2009-like viruses.

These are the same virus strains that the Food and Drug Administration (FDA) selected for inclusion in the Northern Hemisphere vaccine being used in the United States during the 2010-2011 season.

The WHO recommendation and summary report are available on the WHO website. In addition, a frequently asked questions document on the vaccine strain selection process is also available on the WHO website.

Who is included in the group that makes the vaccine virus selections at WHO?

The WHO vaccine virus decision meetings include WHO representatives from the WHO Collaborating Centers, Essential Regulatory Laboratories, and others from the Global Influenza Surveillance Network (GISN). After WHO makes its recommendations, the US FDA Vaccines and Related Biological Products Advisory Committee (VRBPAC) meets to concur with or modify WHO’s recommendation for the United States.

When and where did the WHO group meet to determine the vaccine composition for the 2010-2011 seasonal influenza vaccine for the Northern Hemisphere?

On January 14 and February 4, 2010, the WHO selection process for which viruses to include in the seasonal influenza vaccine for the Northern Hemisphere began with teleconferences discussing surveillance data. The final WHO Vaccine Composition Meeting was held February 14–19, 2010 at the WHO headquarters in Geneva, Switzerland.

When and where was it decided what the vaccine composition would be for the 2010-2011 seasonal vaccine for the United States?

After WHO made its recommendations for the Northern Hemisphere, the US FDA Vaccines and Related Biological Products Advisory Committee (VRBPAC) met in Bethesda, Maryland on February 22, 2010 and concurred with WHO’s recommendation. So the U.S. seasonal vaccine for the 2010–2011 season, includes an A/California/7/2009 (H1N1)-like virus, an A/Perth/16/2009 (H3N2)-like virus, and a B/Brisbane/60/2008-like virus.

Flu Season 2010-2011 – Frequently Asked Questions

Flu season is coming, and vaccination time is near, so we will start our flu season series today.

What sort of flu season is expected this year?

Flu seasons are unpredictable in a number of ways. Although epidemics of flu happen every year, the timing, severity, and length of the epidemic depends on many factors, including what influenza viruses are spreading and whether they match the viruses in the vaccine. Last flu season (2009-2010) saw the emergence of the 2009 H1N1 influenza virus (previously called “novel H1N1″ or “swine flu”). This virus caused the first influenza pandemic (global outbreak of disease caused by a new flu virus) in more than 40 years. While not certain, it is likely that 2009 H1N1 viruses will continue to spread along with seasonal viruses in the U.S.during the 2010-2011 flu season.

Will new strains of flu circulate this season?

Flu viruses are constantly changing so it’s not unusual for new flu virus strains to appear each year. For more information about how flu viruses change, visit “How the Flu Virus Can Change.” While not certain, it is likely that 2009 H1N1 viruses and seasonal viruses will cause illness in the U.S. during the 2010-2011 flu season.

When will flu activity begin and when will it peak?

The timing of flu is very unpredictable and can vary from season to season. Flu activity most commonly peaks in the U.S. in January or February. However, seasonal flu activity can occur as late as May.

What should I do to prepare for this flu season?

CDC recommends a yearly flu vaccine for everyone as the first and most important step in protecting against this serious disease. While there are many different flu viruses, the flu vaccine is designed to protect against the three main flu strains that research indicates will cause the most illness during the flu season. The 2010-2011 flu vaccine will protect against three different flu viruses: an H3N2 virus, an influenza B virus and the H1N1 virus that caused so much illness last season. Getting the flu vaccine soon after it becomes available each year is always a good idea, and the protection you get from vaccination will last throughout the flu season.

How effective is the flu vaccine?

The effectiveness of the vaccine can vary and depends in part on the match between the viruses in the vaccine and flu viruses that are circulating in the community. If these are closely matched, vaccine effectiveness (VE) is higher. If they are not closely matched, VE can be reduced. During well-matched years, clinical trials have shown VE between 70% and 90% among healthy adults. For more information about vaccine effectiveness, visit “How Well Does the Seasonal Flu Vaccine Work?”

Will this season’s vaccine be a good match for circulating viruses?

It’s not possible to predict with certainty which flu viruses will predominate during a given season. Flu viruses are constantly changing (called drift) – they can change from one season to the next or they can even change within the course of one flu season. Experts must pick which viruses to include in the vaccine many months in advance in order for vaccine to be produced and delivered on time. (For more information about the vaccine virus selection process visit “Selecting the Viruses in the Influenza (Flu) Vaccine.”) Because of these factors, there is always the possibility of a less than optimal match between circulating viruses and the viruses in the vaccine.

How do we know if there is a good match between the vaccine viruses and those causing illness?

Over the course of a flu season CDC studies samples of flu viruses circulating during that season to evaluate how close a match there is between viruses in the vaccine and circulating viruses. In addition, CDC conducts vaccine effectiveness studies to determine how well the vaccine protects against illness. However, it’s important to remember that even during seasons when the vaccine is not optimally matched to predominant circulating viruses, CDC and other experts continue to recommend flu vaccine as the best way to protect against the flu.

Can the vaccine provide protection even if the vaccine is not a “good” match?

Yes, antibodies made in response to vaccination with one strain of flu viruses can provide protection against different, but related strains. A less than ideal match may result in reduced vaccine effectiveness against the variant viruses, but it can still provide some protection against influenza illness. In addition, it’s important to remember that the flu vaccine contains three virus strains so that even when there is a less than ideal match or lower effectiveness against one strain, the vaccine may protect against the other two viruses. For these reasons, even during seasons when there is a less than ideal match, CDC continues to recommend flu vaccination. This is particularly important for people at high risk for serious flu complications, and their close contacts.

In what years was there a good match between the vaccine and the circulating viruses?

In recent years the match between the vaccine viruses and those identified during the flu season has usually been good. In 16 of the last 20 U.S. influenza seasons the viruses in the influenza vaccine have been well matched to the predominant circulating viruses. Since 1990, there has only been one season (1997-98) when there was very low cross-reaction between the viruses in the vaccine and the predominate circulating virus, and three seasons (1992-93, 2003-04, and 2007-08) when there was low cross-reaction. In response to the emergence of the 2009 H1N1 virus last season (2009-2010), a new flu vaccine was developed which was a good match to the new virus.

What is CDC doing to monitor vaccine effectiveness for the 2010-2011 season?

CDC carries out and collaborates with other partners within and outside CDC to assess the effectiveness of flu vaccines. During the 2010-2011 season, CDC is planning multiple studies on the effectiveness of influenza vaccine. These studies will measure vaccine effectiveness in preventing laboratory confirmed influenza in older people and in children.

What actions can I take to protect myself and my family against the flu this season?

CDC recommends a yearly flu vaccine as the first and most important step in protecting against this serious disease. While there are many different flu viruses, the flu vaccine protects against the three main flu strains that research indicates will cause the most illness during the flu season. In addition, you can take everyday preventive steps like staying away from sick people and washing your hands to reduce the spread of germs. If you are sick with flu, stay home from work or school to prevent spreading influenza to others.

Is there treatment for the flu?

Yes. If you get sick, there are drugs that can treat flu illness. They are called antiviral drugs and they can make your illness milder and make you feel better faster.

What is antiviral resistance?

Antiviral resistance means that a virus has changed in such a way that the antiviral drug is less effective in treating or preventing illness. Samples of viruses collected from around the United States and worldwide are studied to determine if they are resistant to any of the four FDA-approved influenza antiviral drugs.

What is CDC doing to monitor antiviral resistance in the United States during the 2010-11 season?

CDC routinely collects viruses through a domestic and global surveillance system to monitor for changes in influenza viruses. CDC will continue ongoing surveillance and testing of influenza viruses. Additionally, CDC is working with the state public health departments and the World Health Organization to collect additional information on antiviral resistance in the United States and worldwide. The information collected will assist in making informed public health policy recommendations.

Food Safety Tips for the Budget-Conscious

Food Safety Tips for the Budget-Conscious

Daniel Rosenbaum for The New York Times

. It seems as if every time we turn around there is another outbreak of a scary foodborne illness.

More Articles in This SeriesThis summer’s huge egg recall was the latest reminder that we do battle against dangerous pathogens like E. coli and salmonella in our kitchens every day.

That battle can be expensive. After a recall makes headlines, it is not unusual for consumers to flock to higher-priced organic and locally grown meats, poultry, eggs and produce that can cost two or three times as much as conventional food. And expensive antibacterial soaps and washes, cutting boards and meat thermometers are promoted as tools of the trade for a germ-free kitchen.

Kathleen McCleary of Falls Church, Va., revamped her shopping and cooking routines after she became ill with E. coli that she and her doctors thought she got from bagged lettuce. The 50-year-old novelist described her new routine: “I buy almost all my meat and produce from the local farmers’ market, I cook everything thoroughly, my cutting board is clearly labeled on either side for meats and vegetables and I keep a little hydrogen peroxide on my sink to wash down surfaces where any dangerous germs could lurk.”

Ms. McCleary estimates that her grocery bill is 20 to 30 percent higher than it used to be. “I’m still a careful shopper and watch my budget, but the extra expense is worth it to me,” she said. “I just never want to get that sick again, and I never want to put my kids at risk.”

There is good reason to be scared into action. Every year, 76 million cases of foodborne illness occur, leading to about 300,000 hospitalizations and 5,000 deaths. Young children, pregnant women, the elderly and anyone with a compromised immune system are most at risk for getting a severe or life-threatening case of food poisoning, but anyone can get hit hard. Survivors of serious cases can have long-lasting health issues like kidney problems.

As more outbreaks occur, the costs to society are skyrocketing. As of this year, the nation spent an estimated $152 billion annually on medical and lost productivity costs because of illnesses from tainted food, according to a recent study by the Produce Safety Project at Georgetown University. And that doesn’t begin to count the millions of dollars companies spend each year on recalls.

Some relief may come from Congress this fall, when the Senate is expected to take up a bill that passed the House in July. The new legislation would require food companies to adopt stricter standards and undergo more frequent inspections. The bill would also give the government the authority to order recalls of tainted food.

“This is a good bill because it changes the Food and Drug Administration’s whole approach. The F.D.A. can be more preventive to better ensure the food that arrives in our kitchens is safe to begin with,” said Christopher A. Waldrop, director of the Food Policy Institute at the Consumer Federation of America, an advocacy group.

Until that time, safe food buying, handling and preparation is the best defense — and some juggling may be needed to avoid breaking the budget. Here, food safety experts offer advice on the most important, but still cost-conscious, ways to germ-proof your kitchen.

USE PASTEURIZED EGGS If you are not willing to give up soft-boiled eggs or unbaked cookie dough, or you are using a recipe that calls for raw or partly cooked eggs, “pasteurized eggs are the easiest way to deal with the risk” said Dr. Michael Doyle with the Center for Food Safety at the University of Georgia.

Pasteurized eggs are heated in the shell to kill harmful bacteria and viruses but still taste and look like regular eggs. They are sold in most grocery stores and come with a red “P” stamped on the carton or on the eggs themselves.

PREPARE FOR STICKER SHOCK Pasteurized eggs can cost almost $5 a dozen, compared with about $4 for organic eggs and $3 for regular. You can soften the budget blow by using pasteurized eggs only when the eggs will be raw or partly cooked in the finished dish, like classic Caesar salad, especially since eggs keep in the refrigerator for three to five weeks.

“I buy farmer’s market eggs for hard-boiled and omelets, but I always have some pasteurized eggs on hand for baking because we all love to nibble the cookie dough,” Ms. McCleary said.

WASH ALL PRODUCE Even if you are going to peel a cucumber or melon, give it a good scrub so you don’t transfer bacteria from the knife or peeler to the part you are going to eat.

Most important, wash all lettuce, even if it comes in a bag that says triple washed. Better yet, skip the expensive bag and buy whole head lettuce, which is cheaper and less likely to be contaminated inside. Dr. Doyle recommends removing and discarding the outer leaves. After washing your hands, rinse the inner leaves thoroughly.

Invest in a salad spinner to make the job easier. There are lots of fancy models that cost $30 or more, but you can buy a basic plastic model that will get the job done for about $10.

LEARN TO LOVE WELL DONE Cooking thoroughly is the best way to eliminate harmful bacteria from meats and poultry. For a list of temperatures for various foods, check the Web site Foodsafety.gov, and don’t rely on your eye alone. Pick up an inexpensive meat thermometer (no need for a digital model) next time you are in the grocery store.

THE RIGHT CUTTING BOARDS Always prepare raw meats and poultry on one cutting board, using another for vegetables. Clean both with warm soapy water after each use. Every few days sanitize your cutting boards with a solution of one tablespoon bleach in one gallon of water. Allow the cutting board to stand in the solution for several minutes, then rinse with clear water. More tips are available at the Department of Agriculture’s Web site.

There is conflicting scientific evidence whether wood or plastic cutting boards are safer, said Nancy Donley, board president at Safe Tables Our Priority, a nonprofit advocacy group working to prevent foodborne illness. So use whichever you prefer or is on sale. The important thing is to keep boards clean and replace them when they become scored because pathogens can hide in the grooves.

UNDERSTAND ‘ORGANIC’ “Organic doesn’t necessarily mean safer,” Ms. Donley said. “The organic label means grown without pesticides, it has nothing to do with bacteria and other pathogens.” This became especially apparent in 2006, when some organic growers were involved in the recall of E. coli-tainted spinach.

On the other hand, there is something reassuring about buying from a small organic farmer at a local stand or farmers’ market, even if it does cost more. Like Ms. McCleary, most people can’t help but feel that food grown and raised on a small farm is a lower risk.

Even so, remember that you need to handle anything organic — meat, poultry, produce — the same as nonorganic, said Shelley Feist, executive director of the Partnership for Food Safety Education, a coalition of industry and advocacy groups. You should still keep meats and vegetables separate to avoid cross-contamination, wash all produce thoroughly and wash platters and other surfaces that come into contact with raw meat and poultry. Thoroughly cook meats, poultry and eggs. For more safe handling and cooking tips, go to the partnership’s Web site at www.fightbac.org.

BE SMART ABOUT LEFTOVERS Nothing suits a tight budget better than leftovers. But keeping food too long can pose a risk. “There’s a myth out there that if leftovers smell O.K., they’re O.K. to eat,” Ms. Feist said. “But you can’t smell, see or taste the bacteria that causes illness.”

Keep in mind this advice from the Center for Science in the Public Interest: Don’t leave food out longer than two hours, and use or freeze all leftovers within four days.

To avoid throwing out food (and wasting money), try to plan your week’s menu and shopping list with leftovers in mind — roast chicken one day, chicken salad sandwiches the next — to make sure leftovers get used quickly.

Finally, keep an eye on an elderly relative’s refrigerator. “The elderly are often likely to keep food too long,” Ms. Feist said. “But they are more at risk of getting seriously ill from tainted food.”

Finland Suspends H1N1 Vaccine

Finland Suspends H1N1 Vaccine
H1N1 vaccine suspended due to suspected links to increased narcolepsy in children and adolescents
By Stephanie Lam & Chowa Choo

The Finnish National Institute for Health (THL) proposed suspending vaccinations for H1N1 swine flu, due to suspected links to increased narcolepsy in children and adolescents, the body announced this week.

Six cases of narcolepsy, a chronic disorder causing excessive daytime sleepiness and extreme fatigue, have been reported after patients had been receiving the Pandemrix vaccine.

Six cases of narcolepsy is consistent with annual averages, reports THL, but all of these patients were affected after being vaccinated, and there are nine additional cases that have not yet been confirmed.

The precautionary measure will take effect until the actual cause of the current health issue can be established. Preliminary results of the investigation will take several months to be known, says the THL.

“A number of different reasons may be behind the observed rise in the incidence of narcolepsy: A(H1N1) infection, vaccination, a compound effect of infection and vaccination, or some other factor entirely. Infections in general are known to cause narcolepsy,” said a THL press release.

In Sweden, the Medical Products Agency started a similar investigation on Aug. 19 for the same reason. Sweden has bought 18 million doses of the vaccine, sufficient for everyone in the country to have two injections. In Europe, about 30 million people have been vaccinated, and worldwide at least 90 million.

Last winter, 29 million children in the United States were given a seasonal influenza shot that incorporates the swine flu vaccine, but according to Tom Skinner, press officer of Centers for Disease Control and Prevention, narcolepsy associated with the vaccine has not been reported.

According to Marjo Renko, chairwoman of Finland’s national group of experts on vaccines, a substance was identified as possibly cause narcolepsy, but later denied it.

“There is no proof that the increase in narcolepsy would be linked with the vaccines. We do not suspect anything. This is mere speculation,” she said, according to Helsingin Sanomat.

Nationwide meat recall

Nationwide meat recall announcedBy the CNN Wire Staff
August 24, 2010 9:33 a.m. EDT
NEW: Wal-Mart says products immediately were pulled from shelves
The recalled meat products were sold at Wal-Marts nationwide
The meat products were produced from mid-June through early July
Listeriosis is an uncommon, but potentially fatal disease

(CNN) — Zemco Industries in Buffalo, New York, has recalled approximately 380,000 pounds of deli meat that may be contaminated with bacteria that can cause a potentially fatal disease, the U.S. Department of Agriculture announced Monday.

The products were distributed to Wal-Marts nationwide, according to the USDA’s website.

The meats may be contaminated with Listeria monocytogenes, which was discovered in a retail sample collected by inspectors in Georgia. The USDA has received no reports of illnesses associated with the meats.

Upon learning of the voluntary recall, Wal-Mart immediately told its stores to remove the meat from their shelves, the company said in a statement.

“Consumption of food contaminated with Listeria monocytogenes can cause listeriosis, an uncommon but potentially fatal disease,” according to the USDA. “Healthy people rarely contract listeriosis. However, listeriosis can cause high fever, severe headache, neck stiffness and nausea.

“Listeriosis can also cause miscarriages and stillbirths, as well as serious and sometimes fatal infections in those with weakened immune systems, such as infants, the elderly and persons with HIV infection or undergoing chemotherapy,” the USDA said.

The products subject to recall are:

– 25.5-pound cases of “Marketside Grab and Go Sandwiches BLACK FOREST HAM With Natural Juices Coated with Caramel Color” with the number 17800 1300.

– 28.49-pound cases of “Marketside Grab and Go Sandwiches HOT HAM, HARD SALAMI, PEPPERONI, SANDWICH PEPPERS” with the number 17803 1300.

– 32.67-pound cases of “Marketside Grab and Go Sandwiches VIRGINIA BRAND HAM With Natural Juices, MADE IN NEW YORK, FULLY COOKED BACON, SANDWICH PICKLES, SANDWICH PEPPERS” with the number 17804 1300.

– 25.5-pound cases of “Marketside Grab and Go Sandwiches ANGUS ROAST BEEF Coated with Caramel Color” with the number 17805 1300.

The meats were produced on dates ranging from June 18 to July 2, 2010. The “Use By” dates range from August 20 to September 10, 2010.

Wal-Mart noted the recall involves Marketside Grab and Go sandwiches, but not individual packages of deli meat. “We encourage customers who recently purchased this item to return it for a full refund,” the company statement said.

CNN’s Ashley Hayes contributed to this report.

Egg recall tied to salmonella grows to 380 million


Egg recall tied to salmonella grows to 380 million
Aug 18, 9:16 PM (ET)

By MIKE STOBBE and MARY CLARE JALONICK

ATLANTA (AP) – Hundreds of people have been sickened in a salmonella outbreak linked to eggs in four states and possibly more, health officials said Wednesday as a company dramatically expanded a recall to 380 million eggs.

The Centers for Disease Control and Prevention is working with state health departments to investigate the illnesses. No deaths have been reported, said Dr. Christopher Braden, a CDC epidemiologist involved in the investigation.

Initially, 228 million eggs, or the equivalent of 19 million dozen-egg cartons, were recalled by the company Wright County Egg of Galt, Iowa. But that number was increased to nearly 32 million dozen-egg cartons.

Minnesota, a state with some of the best food-borne illness investigators in the country, has tied at least seven salmonella illnesses to the eggs.

Other states have seen a jump in reports of the type of salmonella. For example, California has reported 266 illnesses since June and believes many are related to the eggs. Colorado saw 28 cases in June and July, about four times the usual number. Spikes or clusters of suspicious cases have also been reported in Arizona, Illinois, Nevada, North Carolina, Texas and Wisconsin.

Salmonella is the most common bacterial form of food poisoning. And the strain involved in the outbreak is the most common strain of salmonella, accounting for roughly 20 percent of all salmonella food poisonings.

Unfortunately, current lab tests do not allow health officials to fingerprint this form of salmonella as precisely as other kinds of food-borne illness. So determining the size of a salmonella enteritidis outbreak is a little more challenging, Braden said.

The Food and Drug Administration also is investigating.

Much of the investigation so far has been centered on restaurants in California, Colorado, Minnesota and North Carolina. They are not necessarily breakfast places – it’s possible some got sick from eating a salad dressing that had a raw egg in it, or eating soup with an undercooked egg dropped in, Braden said.

In North Carolina, a cluster of about 80 illnesses in April were linked to meringue-containing chocolate pie and banana pudding served at a Durham barbecue restaurant, health officials said.

Eggs from Wright County Egg were linked to illnesses in the four states. The eggs were distributed around the country and packaged under the names Lucerne, Albertson, Mountain Dairy, Ralph’s, Boomsma’s, Sunshine, Hillandale, Trafficanda, Farm Fresh, Shoreland, Lund, Dutch Farms and Kemp. It wasn’t immediately clear when the eggs were produced and distributed.

The initial recall was issued last week. Eggs affected by the expanded recall were distributed to food wholesalers, distribution centers and food service companies in California, Colorado, Minnesota, Arkansas, Arizona, Georgia, Illinois, Iowa, Oklahoma, Oregon, Missouri, Nebraska, Nevada, Texas, Utah, Washington and Wisconsin.

“We are undertaking this additional recall to further protect the safety of consumers – this voluntary measure is consistent with our commitment to egg safety, and it is our responsibility,” Wright County Egg officials said in a statement Wednesday evening.

In an earlier statement, company officials said the FDA is “on-site to review records and inspect our barns.” The officials said they began the recall Aug. 13.

The most common symptoms of salmonella are diarrhea, abdominal cramps and fever within eight hours to 72 hours of eating a contaminated product. It can be life-threatening, especially to those with weakened immune systems.

This form of salmonella can be passed from chickens that appear healthy. And it grows inside eggs, not just on the shell, Braden noted.

Thoroughly cooking eggs can kill the bacteria. But health officials are recommending people throw away or return the recalled eggs.

—_

Salmonella & Eggs, Summer 2010

Salmonella & Eggs, Summer 2010
At a Glance: The CDC is working with state and local health departments in numerous jurisdictions investigating a nation-wide outbreak of Salmonella Enteriditis. Several brands and sizes of in-shell eggs have already been recalled; more are expected.
The CDC report can be found at http://www.cdc.gov/salmonella/enteritidis/.
The FDA report can be found at http://www.fda.gov/Food/NewsEvents/WhatsNewinFood/ucm222684.htm.
The Issue: The strain of Salmonella identified is the most common found. It is often found in eggs. Four times the normal number of Salmonella Enteriditis-positive samples are being submitted to CDC this summer. Clusters of illnesses have been attributed to egg consumption in California, Colorado, and Minnesota. State and local partners are also investigating human Salmonella infections in Arizona, Connecticut, Massachusetts, Maryland, North Carolina, Nevada, Oregon, Pennsylvania, Tennessee and Texas.
Am I Impacted? This outbreak is not confined to one or two distributors, restaurants, or retail stores. Some of the largest egg producers in the country are scrambling to ensure the safety of the egg supply. Three major plants have been required to divert all egg production into pasteurized product. Those plants produce eggs for foodservice, institutions, and retail. Thus far, only a small number of our customers have been impacted by a recall or recovery action; they have all been notified. We continue to talk to our suppliers and public health, and will keep you informed of the situation. Check the web sites above for retail egg recalls.
.
What You Can Do:
• Don’t eat recalled eggs or products containing recalled eggs. Recalled eggs might still be in grocery stores, restaurants, and consumers’ homes. Consumers who have recalled eggs should discard them for a refund.
• Individuals who think they have become ill from eating recalled eggs should consult their health care providers.
• Keep shell eggs refrigerated at ≤45° F (≤7° C) at all times.
• Discard cracked or dirty eggs.
• Wash hands, cooking utensils, and food preparation surfaces with soap and water after contact with raw eggs.
• Eggs should be cooked until both the white and the yolk are firm and eaten promptly after cooking.
• Do not keep eggs warm or at room temperature for more than 2 hours.
• Refrigerate unused or leftover egg- containing foods promptly.
• Avoid eating raw eggs.
• Avoid restaurant dishes made with raw or undercooked, unpasteurized eggs. Restaurants should use pasteurized eggs in any recipe (such as Hollandaise sauce or Caesar salad dressing) that calls for raw eggs.
• Consumption of raw or undercooked eggs should be avoided, especially by young children, elderly persons, and person with weakened immune systems or debilitating illness.

Superbug video

Alarm over ‘unbeatable’ enzyme that could make all bacterial diseases resistant to antibiotics

Alarm over ‘unbeatable’ enzyme that could make all bacterial diseases resistant to antibiotics
By Jenny Hope

Gene makes bacteria resistant to almost all antibiotics
Patients brought enzyme back from India and Pakistan

The NHS is on red alert to detect a ‘superbug’ resistant to the most powerful antibiotics which has been imported from India by health tourists.
There are fears that without vigilance a new gene that allows any bacteria to become a superbug could become widespread in NHS hospitals.
It has infected around 50 Britons so far, many of whom returned to the UK after undergoing surgery in India or Pakistan.

Vulnerable: Young and elderly patients will be particularly susceptible to the ‘superbugs’, which have emerged recently and are immune to almost all antibiotics (picture posed by model)
The Health Protection Agency (HPA) yesterday stepped up its warnings about the new gene called NDM-1, or New Delhi metallo-beta-lactamose after the place where it was first identified.
Dr David Livermore, director of antibiotic resistance monitoring at HPA, said resistance to one of the major groups of antibiotics, the carbapenems, is found throughout India.
‘This is important because carbapenems were often the last ‘good’ antibiotics active against bacteria that already were more resistant to more standard drugs,’ he said.

‘We have now also identified bacteria with this type of resistance – NDM – in around 50 patients in the UK.
‘Most not all, had previously travelled to the Indian subcontinent and many had received hospital treatment there.
‘International travel gives a great potential for spread of resistant bacteria between countries.’

Dr Livermore added: ‘Few antibiotics remain active against these bacteria.Their spread underscores the need for good infection control in hospitals both in the UK and overseas, and the need for new antibiotic development.’
The spread of the enzyme that makes any bug ‘super’
Rising levels of antibiotic resistance are a threat because there are few new drugs in the pipeline.

Infection experts are alarmed about the spread of multi-drug resistance facilitated by the gene NDM-1 that can easily jump from one strain of bacteria to another.

If it ends up in a bacterium which is already resistant to many other antibiotics then it could produce infections that are almost impossible to treat.

NDM-1-producing bacteria are resistant to many existing antibiotics including carbapenems – a class of drugs often reserved for emergency use and ‘last resort’ treatment.

So far two types of bacteria have been host to NDM-1 – the gut bug E.coli and another that can invade the lungs called Klebsiella pneumonia.

Both can lead to urinary tract infections and blood poisoning.

E.coli is among a group of ‘gram-negative’ bugs, and the proportion of antibiotic-resistant cases of E.coli infection has trebled since the turn of the century.

There are about 20,000 E.coli bloodstream infections each year in England, Wales and Northern Ireland, of which more than one in ten is resistant to antibiotics.

There are just two antibiotics in the pipeline against this group of infections.
This compares with several new medications for gram-positive infections like MRSA.

Figures suggest it costs between
£500 million to £1 billion to bring new drugs to market.

GSK, one of a handful of giant pharmaceutial firms actively investing in antibiotic research, said: ‘New antibiotics that work in different ways to existing medicines are desperately needed to tackle the rising incidence of antibiotics resistance.’
The HPA flagged up the problem last year but renewed its warnings after a study in journal The Lancet Infectious Diseases tracked the emergence of the ‘superbug’ gene in different countries.
The researchers found NDM-1 is becoming more common in Bangladesh, India and Pakistan and is starting to be imported back to Britain in patients returning from these countries.
Several of the British NDM-1 positive patients had recently travelled to the Indian subcontinent for hospital treatment including cosmetic surgery.
Timothy Walsh, professor of medical microbiology and antimicrobial resistance at Cardiff University, who led the study, said it was a ‘real concern’.
‘Because of medical tourism and international travel in general, resistance to these types of bacteria has the potential to tavel around the world very, very quickly.’
He said there are few drugs in development that can potentially combat the threat.
The resistant gene has also been detected in Australia, Canada, the US, the Netherlands and Sweden.
The NDM-1 gene alters bacteria, making them resistant to nearly all known antibiotics.
It has been largely found in E. coli bacteria, the most common cause of urinary tract infections, and on DNA structures that can be easily copied and passed onto other types of bacteria.
The researchers said the superbug gene appeared to be already circulating widely in India, where the health system is much less likely to identify its presence or have adequate antibiotics to treat patients.
Christopher Thomas, professor of molecular genetics at the University of Birmingham who was not linked to the study, said ‘We are potentially at the beginning of another wave of antibiotic resistance, though we still have the power to stop it.’
Prof Thomas said better surveillance and infection control procedures might halt the gene’s spread.
Although patients in British hospitals are unlikely to encounter the superbug gene, they should remain vigilant about standard hygiene measures like properly washing their hands, he added.
Enlarge ‘The spread of these multi-resistant bacteria merits very close monitoring’ wrote Johann Pitout of the division of microbiology at the University of Calgary, Canada, in an accompanying Lancet commentary.
He called for international surveillance of the bacteria, particularly in countries that actively promote medical tourism.
‘The consequences will be serious if family doctors have to treat infections caused by these multi-resistant bacteria on a daily basis’ he added.
The Department of Health spokesman said ‘We are working with the Health Protection Agency. The HPA alerted the NHS in January and July lst year to be vigilant about these bacteria and take appropriate action where necessary.
‘Hospitals need to ensure they continue to provide good infection control to prevent any spread, consider whether patients have recently been treated abroad and send samples to the HPA for testing.’
Superbug: New Dehli-Metallo-1, seen under the microscope could be untreatable for as long 10 years while scientists devise the right kind of antibiotics

Novartis Vaccines launches Fluvirin vaccine in US market

Novartis Vaccines launches Fluvirin vaccine in US market
Healthcare solutions supplier Novartis Vaccines (NYSE:NVS) stated on Thursday that the company has commenced the shipment of approximately 40m doses of Fluvirin vaccine to the US to support the seasonal influenza vaccination for the 2010-2011 flu season.

This initiation allows health care professionals in the US to protect their patients well in advance of this year’s flu season.

The Fluvirin influenza virus vaccine has been approved by the US Food and Drug Administration (FDA) and recommended for patients four years of age and older, claimed the company.

Fluvirin will be available to health care professionals in both pre-filled syringes and multi-dose vials, added the company