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January 2006
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On Oct. 29, 2004, three HUS cases among children who visited one of two petting zoos at the North Carolina State Fair were reported to the health department. Approximately 800,000 visitors attended this fair between Oct. 15 and Oct. 24, 2004.
Surveillance identified 108 people who became ill after attending the fair. Eighty-two visited one of the petting zoos. Fifty-two people had bloody diarrhea, and 48 had fever. Forty-one cases were laboratory-confirmed shiga toxin-producing E. coli infections. Twenty patients were hospitalized, and 15 developed HUS.
Environmental sampling of the fairgrounds identified E. coli O157:H7 contamination at one of the petting zoos. Among children younger than 6, illness was associated with touching or stepping in manure, falling or sitting on the ground, using a pacifier or “sippy” cup or sucking on one’s thumb while in the petting zoo. Using an alcohol-based hand sanitizer did not protect against disease, although parents who knew the animals could cause disease were less likely to have a child who was ill, according to the report.
In Florida, 22 cases occurred in March 2005; seven developed HUS. Investigators determined the source was a petting zoo run by the same vendor at various fairs. After the initial reports, the state health department intensified its surveillance and found 63 patients with symptoms of E. coli O157:H7 infection within 10 days or HUS within 21 days after visiting the fairs. Most patients had visited the petting zoo and petted or fed one of the animals.
Two unrelated children hospitalized with E. coli O157:H7 infection were reported to the Arizona Department of Health Services in July 2005. Both children had visited a petting zoo. One child had direct contact with the animals, while the second child only had possible contact with exterior railings at the petting zoo. Both children had played in an area near the petting zoo facility. — Marie Rosenthal
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The FDA issued warning letters to nine companies marketing bogus flu products, eight of which were purported to be dietary supplements, that claim their products could be effective against preventing avian flu or other forms of influenza.
No scientific evidence demonstrates the safety or effectiveness of these products for treating or preventing avian flu, the FDA said.
“There are initiatives in place to deter counterfeiters and those who sell fraudulent or phony products to prevent or treat avian flu,” said Andrew von Eschenbach, MD, acting FDA commissioner. “The use of unproven flu cures and treatments increases the risk of catching and spreading the flu rather than lessening it because people assume they are protected and safe, and they aren’t.”
Examples of the unproven claims cited include “prevents avian flu,” “a natural virus shield,” “kills the virus” and “treats the avian flu.” These alternative therapies are promoted as “natural” or “safer” treatments that people can use in place of an approved treatment or preventive medical product.
The FDA considers the firms’ products to be drugs because they claim to treat or prevent disease. The letters state that the FDA considers these products to be new drugs that require FDA approval before marketing. The companies have 15 days to respond to the FDA.
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Five children were hospitalized after an outbreak of E. coli in Clark and Cowlitz counties in Washington. The outbreaks were linked to drinking raw milk. Three developed hemolytic uremic syndrome.
“Raw, unpasteurized milk carries a number of health risks,” said food safety advisor Janet Anderberg, of the Washington State Department of Health, in a statement. “There can be several dangerous bacteria in raw dairy products, any of which could cause life-threatening illness. Infants, children, pregnant women, the elderly and those with compromised immune systems are especially at risk.”
The state limits the sale of raw milk within the state to milk producers and milk processors who have been inspected and licensed by the Washington State Department of Agriculture. The milk in these cases was not acquired from a licensed dairy, health officials said.
In late December, the Department of Agriculture (USDA) changed Minnesota’s bovine tuberculosis (TB) status to Modified Accredited Advanced. The state lost its bovine TB-free status when an outbreak began in February.
It was the first outbreak of Mycobacterium bovis in the state in 34 years. Health authorities worked quickly to stop the outbreak, and destroyed thousands of cattle.
The USDA will require that all breeding cattle aged 18 months and older be tested for bovine TB within 60 days of shipment. Cattle are exempt from the testing requirement if they are moving interstate directly to slaughter, a feedlot or if the animals are from a TB-accredited herd.
Regaining TB-free status is not easy for states that have had the disease. It generally takes two years once a state finds no more TB cases to be deemed disease free.
The FDA said it was encouraged by the decision of the Japanese government to lift the temporary ban on imports of U.S. beef products. The Japanese banned the imports bovine spongiform encephalopathy (BSE) was reported in a U.S. cow.
“We believe that this decision by Japan acknowledges the effectiveness of U.S. measures adopted over the years — one of the most critical measures being FDA’s ruminant feed ban — to protect our country from BSE,” said acting FDA commissioner Andrew von Eschenbach.
The FDA prohibits mammalian tissues that may contain the BSE infective agent from use in cattle feed. The FDA and state health authorities have carried out more than 41,000 inspections of feed manufacturers, renderers and other producers of feeds for cattle and other ruminant animals to ensure that the rule is rigorously implemented to protect the public health. Over the years, the compliance rate with the FDA regulation has exceeded 99% for renderers, protein blenders and feed mills, the statement said.
