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E. Coli Outbreak Is Traced Back To Ready-To-Bake Cookie Dough

The investigation of a multistate outbreak of Shiga toxin-producing Escherichia coli O157:H7 (STEC) that sickened 77 people and hospitalized 35 was traced back to ready-to-bake cookie dough, prompting infectious disease specialists to ask for stronger pasteurization and more consumer warnings.

like smack by Robert S. Donovan via Flickr and a Creative Commons licenseA report in Clinical Infectious Diseases outlined the outbreak and the work done by national and local health officials to track down the source.

No single source could be identified for certain for the outbreak. But one brand of dough was present in 94% of cases, and three nonoutbreak STEC strains were isolated from it, leading to a recall of 3.6 million packages of the cookie dough.

The detective work began with May 19, 2009, through PulseNet, the network of public health and food regulatory agency laboratories coordinated by the CDC. It identified Read more »

*This blog post was originally published at ACP Internist*

Preventing Future Listeria Outbreaks

If you have watched any news over the past week you know there is a listeria outbreak from contaminated cantaloupes that has been traced to Jensen Farms in Colorado. The CDC has confirmed 72 illnesses, including 13 deaths linked to the melons and three other deaths may be involved.  By now most of the cantaloupes should be gone as they usually last only a couple of weeks.  The recalled cantaloupes were shipped between July 29 and Sept 10.

Listeriosis is a serious infection caused by eating food contaminated with the bacterium Listeria monocytogenes. It causes fever, muscle aching and sometimes diarrhea.  It feels like a bad flu with headache, stiff neck, confusion, loss of balance and in severe cases, convulsions.  As with many infections; babies, pregnant women, people with weakened immune systems and older adults are more likely to have severe illness.  There are about Read more »

*This blog post was originally published at EverythingHealth*

CDC Promotes Infection Prevention Guidance For Outpatient Settings

As healthcare professionals, we must recognize our responsibility to protect patients – care should not provide any avenue for the transmission of infections. By working together, we can ensure infection prevention practices are understood and followed by all, during every patient visit. Healthcare continues to transition to settings outside the hospital, and efforts to prevent infections must extend to all settings where patients receive care.

Today, CDC is pleased to present the Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care. a summary guide of infection prevention recommendations for outpatient settings. Although these recommendations are not new, this guide is a concise, one-stop resource where ambulatory care providers can quickly find evidence-based guidelines produced by the CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC).

Repeated outbreaks and notification events resulting from unsafe practices highlight the need for better infection prevention across our entire healthcare system, not just in our hospitals. Based primarily upon elements of Standard Precautions, including medical injection safety and reprocessing of reusable medical devices, this guide reminds healthcare providers of the basic infection prevention practices that must be followed to assure safe care.

I urge you to use this guidance document, and the accompanying Infection Prevention Checklist for Outpatient Settings to assess the practices in your facility to assure that patients are receiving the safe care that they expect and deserve.

I also invite you to view our CDC Expert Video Commentary on Medscape titled New Infection Prevention Guidance for Outpatient Settings to learn more about the guidance.

*This blog post was originally published at Safe Healthcare*

The FDA Lacks The Resources To Ensure The Safety Of America’s Food Supply

Tommy Thompson

The recent peanut butter/salmonella outbreak offers another opportunity to reflect on the underlying budget crisis and staff shortage at the Food and Drug Administration. I interviewed Tommy Thompson, former Secretary of Health and Human Services, about what the peanut butter debacle tells us about the FDA inspections of our food supply.

You may listen to our conversation by clicking on the play button, or read a summary below. Enjoy!

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Dr. Val: Has this recent outbreak influenced how the FDA tracks food ingredients?

Thompson: No it hasn’t. We have a serious food problem in America because the FDA is understaffed. There have been too many outbreaks of food poisoning – everything from listeria on cucumbers and onions to salmonella infections from ice cream and peanut butter. Approximately 82 million people experience an episode of food poisoning each year, 350,000 of them require treatment in a hospital and 8,000 die. People don’t seem to realize what a large problem food poisoning is until there is a new outbreak. The recent peanut butter contamination affected between 700-800 different food products.

Americans need to realize that the FDA is severely understaffed and cannot do the inspections necessary to protect all of our food. I’ve been harping about this for a long time. When I was Secretary of HHS I was able to increase the number of inspectors by 100%, but since I left the funding was decreased and the numbers of inspectors is back to the level when I started.

There are 64,000 venues that the FDA has to inspect, and there are only 700 inspectors. It is geographically and mathematically impossible to do all the inspections. The FDA is responsible for inspecting 80% of our food supply while the department of agriculture does the rest. The department of agriculture has 7000 employees and 6000 venues that they have to inspect. Just compare the resource differential between the FDA and the department of agriculture and you see the serious constraints under which the FDA operates.

The department of agriculture inspects every meat processing factory every day. But an FDA inspector may get to a food processing plant only once every 6 or 7 years.

Dr. Val: Wow, that’s enlightening and also terrifying at the same time.

Thompson: Yes, it really is. We inspect less than 1% of the food coming into America. The amount of imported food continues to increase as the number of inspectors decreases. We have some serious problems with our food supply and it’s about time that congress recognized this.

The FDA is doing the best job they can, and yet they are regularly criticized by the media. When you consider their limitations, they’re doing a heck of a good job with the resources they have.

Dr. Val: So what do we need to do to improve this situation?

Thompson: The FDA needs a larger budget, we need to get more inspectors out there, we need updated testing technology, but we also need a more modern law that would require food processing plants to file an affidavit with the FDA to ensure that their food is safe. There’s very little supervision of these companies.

Dr. Val: Is there anything the public can do to petition the government to increase funding to the FDA so they can inspect our food properly?

Thompson:  There’s a coalition to improve the quality of food inspections at FDA and I’m a part of that. There are people in congress who are working on introducing legislation to provide the FDA the resources necessary to hire more inspectors, and to require affidavits of safety from food processing plants.

Dr. Val: Do you think Dr. Joshua Sharfstein will become the new FDA commissioner?

Thompson: Sharfstein is being considered for a position at FDA, whether it’s commissioner, assistant commissioner, or chief of staff I don’t know.

Dr. Val: Do you have any advice for the new FDA commissioner, whoever it is?

Thompson: Yes. In addition to lobbying for increased funding to support more inspector positions, he or she should consider appointing a special commissioner of food that would report directly to the Secretary of Health and Human Services. The new FDA commissioner should focus on getting medicines and new drugs to market. In 2008 we had fewer new drugs get to market than any year since 1981. The entire FDA is overworked, the responsibilities are great, and congress meddles too much in their affairs, though that may change now that the democrats control both houses and the presidency.

The staff at FDA are becoming demoralized because every time they make a decision someone in congress criticizes them for it. Then they become reluctant to make decisions at all.

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