topic Re: ••••• Drug-Resistant Food Poisoning Is Now In The US ••••• in Wellness

••••• Drug-Resistant Food Poisoning Is Now In The US •••••

newziesuzie — Sun, 05 Apr 2015 01:01:38 GMT

More results of over using antibiotics?

Drug-resistant food poisoning is now in the US

http://www.aol.com/article/2015/04/03/drug-resistant-food-poisoning-is-now-in-the-us/21161156/?ModPagespeed=noscript

AOL.com: A new bug sneaking into homes across the country and wreaking havoc on residents.

Shigella is causing major problems for people across the country because, according to the Centers for Disease Control and Prevention, Shigella is a new multi-drug resistant strain of food poisoning.

The new strain packs the usual wallop of hellish symptoms like stomach cramps, vomiting and diarrhea.

Researchers at the CDC narrowed down the source of the bug to travelers coming back to the US from India, the Dominican Republic and Morocco.

Doctors usually prescribe an antibiotic called ciprofloxacin, but this particular strain is resistant to the drug.

"If rates of resistance become this high, in more places, we'll have very few options left for treating Shigella with antibiotics by mouth," the epidemiologist who conducted the study told NPR. Doctors will then have to resort to IV antibiotics.

The CDC released recommendations for travelers:

Tips for travelers:

1... Observe food, water, and hand-hygiene precautions while traveling;

2.... Use over-the-counter medications like Pepto-Bismol or Immodium if they wish to

3.... treat mild or moderate travelers' diarrhea;

4....Reserve antimicrobial medications for severe cases of travelers' diarrhea;

5....Seek health care if they are experiencing diarrhea upon return to the United States or develop diarrhea shortly thereafter;

6... Remain vigilant regarding hygiene practices while ill.

"Something important that was omitted from the article above is the incubation period, which depends on the strain.

It varies from twelve hours to seven days but is usually one to three days.

Also, it can be fatal, unlike most cases of food poisoning and is incredibly contagious.

Around the world, about 100 million people get infected with Shigella each year, and about 600,000 die from it."

(thank you SuiGeneris from another thread)

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

Jersey Born — Sun, 05 Apr 2015 02:37:28 GMT

On a positive note, there are some natural things that can help fight shigella food poisoning:

Red wine:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2539099/pdf/bmj00624-0011.pdf

Green Tea:

http://www.ncbi.nlm.nih.gov/pubmed/2677434

http://www.arjournals.org/index.php/ijpm/article/view/764

Black Tea:

http://link.springer.com/article/10.1007/s00217-010-1328-1

Fennel seed extract:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736926/

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

betteb — Sun, 05 Apr 2015 02:44:05 GMT

It might be a new strain of Shigella, but Shigella is not new to the US. I had it 35 years ago and I've never been out of the US. It was not fun

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

Mindy D — Sun, 05 Apr 2015 03:35:19 GMT

Importation and Domestic Transmission of Shigella sonnei Resistant to Ciprofloxacin — United States, May 2014–February 2015 Weekly April 3, 2015 / 64(12);318-320 Anna Bowen, MD1, Jacqueline Hurd, MPH1, Cora Hoover, MD2, Yvette Khachadourian, MPH3, Elizabeth Traphagen, MPH4, Emily Harvey4, Tanya Libby, MPH5, Sara Ehlers, MPH2, Melissa Ongpin, MPH2, J. Corbin Norton1, Amelia Bicknese1, Akiko Kimura, MD6 (Author affiliations at end of text) In December 2014, PulseNet, the national molecular subtyping network for foodborne disease, detected a multistate cluster of Shigella sonnei infections with an uncommon pulsed-field gel electrophoresis (PFGE) pattern. CDC's National Antimicrobial Resistance Monitoring System (NARMS) laboratory determined that isolates from this cluster were resistant to ciprofloxacin, the antimicrobial medication recommended to treat adults with shigellosis. To understand the scope of the outbreak and to try to identify its source, CDC and state and local health departments conducted epidemiologic and laboratory investigations. During May 2014–February 2015, PulseNet identified 157 cases in 32 states and Puerto Rico; approximately half were associated with international travel. Nine of the cases identified by PulseNet, and another 86 cases without PFGE data, were part of a related outbreak of ciprofloxacin-resistant shigellosis in San Francisco, California. Of 126 total isolates with antimicrobial susceptibility information, 109 (87%) were nonsusceptible to ciprofloxacin (108 were resistant, and one had intermediate susceptibility). Travelers need to be aware of the risks of acquiring multidrug-resistant pathogens, carefully wash their hands, and adhere to food and water precautions during international travel. Clinicians should request stool cultures and antimicrobial susceptibilities when they suspect shigellosis, and counsel shigellosis patients to follow meticulous hygiene regimens while ill. Shigella causes an estimated 500,000 cases of diarrhea in the United States annually (1) and is transmitted easily from person to person and through contaminated food and recreational water. Outbreaks of shigellosis frequently are large and protracted. Although diarrhea caused by S. sonnei typically resolves without treatment, patients with mild illness often are treated with antimicrobial medications because they can reduce the duration of symptoms and shedding of shigellae in feces (2). However, resistance to the oral antimicrobial medications ampicillin and trimethoprim/sulfamethoxazole is common among shigellae in the United States, and resistance to fluorquinolones is increasing among shigellae globally (3). Because only about 2% of shigellae isolated in the United States are resistant to fluoroquinolones (4), ciprofloxacin is the first-line treatment for adults with shigellosis and is recommended as an empiric treatment for adult international travelers with diarrhea (5). Between May 24, 2014 and February 28, 2015, PulseNet detected 157 cases of illness caused by S. sonnei with closely related pulsed-field gel electrophoresis (PFGE) patterns in 32 U.S. states and Puerto Rico. Most cases were reported in Massachusetts (45 cases), California (25) and Pennsylvania (18). In addition, public health officials in the San Francisco Department of Public Health (SFDPH) identified an outbreak of 95 cases of ciprofloxacin-resistant shigellosis, nine of which were tested using PFGE and have been included in the PulseNet cluster, for a total of 243 cases (Figure). The San Francisco outbreak cases are included in the antimicrobial susceptibility summary but are excluded from other analyses. State and federal public health officials reported ciprofloxacin nonsusceptibility in 109 (87%) of 126 isolates tested (108 isolates were resistant and 1 had intermediate susceptibility). Of the 126 isolates, NARMS tested 19. All were resistant to nalidixic acid, and six (32%) were resistant to ciprofloxacin; isolates also exhibited resistance to ampicillin (5%), streptomycin (84%), sulfisoxazole (84%), tetracycline (87%), and trimethoprim/sulfamethoxazole (84%). One isolate displayed an azithromycin minimum inhibitory concentration of >256 µg/ml and harbored macrolide resistance genes mphA and ermB. Median age of the patients was 34 years (interquartile range =20–51 years). Among the patients, 48% (74 of 153) were female. Among 41 patients with such information, median duration of illness was 7 days (interquartile range = 6–12 days). Nineteen (22%) of 88 patients with such information were hospitalized. Treatment information was not available for most patients. Forty (53%) of 75 patients with such information had traveled internationally during their incubation period; destinations included Hispaniola (the Dominican Republic, 22 cases, and Haiti, four); India (eight); Morocco (three); and other destinations in Asia and Europe. No common airline or airport exposures were identified. Most travelers to the Dominican Republic stayed at resorts in Punta Cana; however, no common hotel, resort, restaurant, or event was reported. NARMS detected ciprofloxacin resistance in isolates obtained from travelers to the Dominican Republic (one of five isolates tested) and India (one of one isolate tested), and among nontravelers (four of seven isolates tested). Travel information was available for 23 of 37 children; 10 (43%) had recently traveled abroad. None of the five children who were enrolled in group child care settings had traveled internationally. One pediatric case occurred as part of a child care–associated outbreak of five culture-confirmed and 11 suspected cases of shigellosis. None of the other four isolates from this cluster were tested using PFGE; however, a single isolate was tested and found to be resistant to ciprofloxacin. Twelve patients self-identified as men who have se with men (MSM). Eleven (79%) of 14 men without recent international travel were MSM, compared with one of six men with recent international travel (Fisher's exact p = 0.02). SFDPH identified 95 ciprofloxacin-resistant S. sonnei infections in residents of or travelers to San Francisco during November 1, 2014–January 15, 2015. Nine isolates underwent PFGE and yielded patterns that were indistinguishable from or closely related to others in the PulseNet cluster. Sixty-seven patients (53% of those with such information) were hospitalized. Seventy-four cases (47% of those with such information) occurred among persons who were homeless or living in single-room occupancy hotels. Although the investigation is ongoing, no point source or common exposures such as shelters, soup kitchens, or restaurants have been identified. No patients reported international travel. Discussion International travelers are at elevated risk for colonization with multidrug-resistant Enterobacteriaceae (6). This investigation suggests that ciprofloxacin-resistant S. sonnei is being repeatedly introduced into the United States by travelers from various countries and can lead to large outbreaks domestically. The result has been a greater proportion of Shigella infections in the United States that are resistant to ciprofloxacin than in the past (National Antimicrobial Resistance Monitoring System; Division of Foodborne, Waterborne and Environmental Diseases; National Center for Emerging and Zoonotic Infectious Diseases, CDC, unpublished data, 2015). Travelers should be encouraged to 1) observe food, water, and hand-hygiene precautions while traveling; 2) use over-the-counter medications like bismuth subsalicylate (e.g., Pepto-Bismol) or loperamide (e.g., Immodium) if they wish to treat mild or moderate travelers' diarrhea; 3) reserve antimicrobial medications for severe cases of travelers' diarrhea; 4) seek health care if they are experiencing diarrhea upon return to the United States or develop diarrhea shortly thereafter; and 5) remain vigilant regarding hygiene practices while ill. Additional studies are needed to clarify the roles of antimicrobial medications, antidiarrheal medications, and other factors in acquiring multidrug-resistant enteric pathogens during international travel. Although this Shigella strain is strongly associated with international travel, it is now circulating domestically. If introduced to populations of homeless persons, MSM, or children in child care settings, Shigella can spread rapidly and cause large, protracted outbreaks, as has occurred in the homeless population in San Francisco. Hygiene promotion and increased access to hygiene and sanitation infrastructure among vulnerable populations such as the homeless might help prevent transmission. MSM can reduce their risk for acquiring this and other Shigella strains by washing their hands meticulously and by preventing fecal-oral exposures during se (7). Health care providers should culture the stool specimens of patients with symptoms consistent with shigellosis, reculture the stool of patients who fail to improve after antimicrobial therapy, and test bacterial pathogens for antimicrobial susceptibility. Reserving antimicrobial treatment for immunocompromised patients and patients with severe shigellosis and using antimicrobial susceptibility data strategically to guide therapy might help preserve the utility of such medications. Clinical guidelines for the testing and interpretation of azithromycin susceptibility among Shigella spp. are needed to improve detection and management of cases of azithromycin-nonsusceptible shigellosis. Acknowledgments Julian Grass, MPH, Davina Campbell, MS, Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging, Zoonotic, and Infectious Diseases, CDC. 1Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging, Zoonotic, and Infectious Diseases, CDC; 2San Francisco Department of Public Health; 3Philadelphia Department of Public Health Division of Disease Control; 4Massachusetts Department of Public Health; 5California Emerging Infections Program; 6California Department of Public Health (Corresponding author: Anna Bowen, abowen@cdc.gov, 404-639-4636) References Scallan E, Hoekstra RM, Angulo FJ, et al. Foodborne illness acquired in the United States—major pathogens. Emerg Infect Dis 2011;17:7–15. Christopher PR, David KV, John SM, Sankarapandian V. Antibiotic therapy for Shigella dysentery. Cochrane Database Syst Rev 2009;(4):CD006784. Gu B, Cao Y, Pan S, et al. Comparison of the prevalence and changing resistance to nalidixic acid and ciprofloxacin of Shigella between Europe-America and Asia-Africa from 1998 to 2009. Int J Antimicrob Agents 2012;40:9–17. CDC. National Antimicrobial Resistance Monitoring System: enteric bacteria human isolates final report 2012. Atlanta, GA: US Department of Health and Human Sevices, CDC; 2014. Available at http://www.cdc.gov/narms/pdf/2012-annual-report-narms-508c.pdf . CDC. Health information for international travel 2014. New York, NY: Oxford University Press; 2014. Available at http://wwwnc.cdc.gov/travel/page/2014-yellow-book-about. Kantele A, Lääveri T, Mero S, et al. Antimicrobials increase travelers' risk of colonization by extended-spectrum beta-lactamase–producing Enterobacteriaceae. Clin Infect Dis 2015;60:837–46. Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. Atlanta, GA: US Department of Health and Human Services. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf . What is already known on this topic? Approximately 500,000 cases of shigellosis occur in the United States annually. High rates of resistance to oral antimicrobial medications complicate management of patients with shigellosis; however, ciprofloxacin has remained the recommended antimicrobial treatment for adults who acquire shigellosis within the United States or while traveling internationally. What is added by this report? During May 2014–February 2015, a cluster of 243 cases of shigellosis in 32 states and Puerto Rico was identified; 109 (87%) of 126 isolates tested were nonsusceptible to ciprofloxacin. Ninety-five cases were part of an outbreak of ciprofloxacin-resistant shigellosis associated with the homeless population in San Francisco, California; approximately half of the remaining cases were associated with international travel. Ciprofloxacin-resistant Shigella sonnei is being repeatedly introduced into the United States via travelers from various countries and is circulating domestically at rates that are higher than in the past. What are the implications for public health practice? International travelers should be aware of the risks for acquiring multidrug-resistant pathogens, wash their hands meticulously, adhere to food and water precautions, and try to reserve antimicrobial medications for severe cases of travelers' diarrhea. Clinicians should request stool specimen cultures and antimicrobial susceptibilities when they suspect shigellosis, carefully consider whether antibiotic treatment is necessary, and counsel shigellosis patients to follow meticulous hygiene regimens while ill. Hygiene promotion and increased access to hygiene and sanitation infrastructure might help prevent transmission among vulnerable populations. FIGURE. Shigella sonnei infections (n = 239*) suspected resistant to ciprofloxacin, by isolation date and patient international travel history — United States, May 2014–February 2015 * Isolation date was not available for four isolates. Alternate Text: The figure above is a histogram showing Shigella sonnei infections (n = 239) suspected resistant to ciprofloxacin, by isolation date and patient international travel history in the United States during May 2014-February 2015. HERE 'S MORE FROM THE CDC

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

Mindy D — Sun, 05 Apr 2015 03:44:35 GMT

Notice that the resistant strain can be caught in recreational water, when vacationing. There is some additional advice for those that are interested. International travelers are given additional advice from the CDC.

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

Crisso — Sun, 05 Apr 2015 03:50:14 GMT

Overuse and over-prescription of antibiotics. We were warned a long time ago.

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

betteb — Sun, 05 Apr 2015 03:51:47 GMT

On 4/4/2015 Mindy D said:
Notice that the resistant strain can be caught in recreational water, when vacationing. There is some additional advice for those that are interested. International travelers are given additional advice from the CDC.

That's how I got it, going to the lake. We had quite the outbreak of it here back then. They closed the lake for the rest of the season.

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

hckynut — Sun, 05 Apr 2015 05:29:54 GMT

I ain't buying it. I keep hearing "over use of antibiotics", but seems like a majority when sick, what do they want from their doctors? Way too many do the:copy/paste of pages and pages of medical and scientific explanations, and I have a feeling there are many here, like myself, that understand little of what is: COPY/PASTE.

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

fourpaws56 — Sun, 05 Apr 2015 07:12:42 GMT

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

Campion — Sun, 05 Apr 2015 12:21:56 GMT

No, shigella isn't new, but resistant shigella is--meaning if some old person gets food contaminated by dirty hands, and they need antibiotics to help fight it because they are old and the infection is hurting them, they could get very ill and the antibiotic is useless.

Most people don't need anything after a shigella infection, but some people who are immune compromised need help, and resistant bugs can kill them.

Must.Wash.Hands.

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

Jersey Born — Sun, 05 Apr 2015 12:35:34 GMT

I think people need to try the natural approaches before resorting to the antibiotics which they may not need. That way, the antibiotics may actually work when needed in an emergency situation. Also, we should stop feeding antibiotics to the animals being raised for consumption, as that is not helping us, either.

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

Campion — Sun, 05 Apr 2015 13:15:45 GMT

On 4/5/2015 Jersey Born said:
I think people need to try the natural approaches before resorting to the antibiotics which they may not need. That way, the antibiotics may actually work when needed in an emergency situation. Also, we should stop feeding antibiotics to the animals being raised for consumption, as that is not helping us, either.

Well, I agree. I try NEVER to have antibiotics; I've become allergic to almost all of them.

HOWEVER, an old person who is in extremis from food poisoning needs help, and that is the case I mentioned. I have had food poisoning several times and I never needed any antibiotic but that doesn't apply for an 80 yr old person or an immune-compromised transplant patient.

I buy meats now (if I eat meat--which is rare) where there is no antibiotic used, due to allergies. And I wonder if that is why I HAVE allergies because I haven't used Doxycyline ever, and when I had Lyme last summer, I got a terrible reaction to it. Because I'd eaten poultry treated with it over the years?

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

newziesuzie — Sun, 05 Apr 2015 14:47:02 GMT

On 4/4/2015 hckynut said: I ain't buying it. I keep hearing "over use of antibiotics", but seems like a majority when sick, what do they want from their doctors? Way too many do the:copy/paste of pages and pages of medical and scientific explanations, and I have a feeling there are many here, like myself, that understand little of what is: COPY/PASTE.

You "don't buy" the facts of over use of antibiotics and resulting life threatening antibiotic resistant bacteria? It's real, it's not a matter of belief. As for cut and paste that's how we share news and info.

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

newziesuzie — Sun, 05 Apr 2015 14:49:09 GMT

On 4/4/2015 betteb said:
It might be a new strain of Shigella, but Shigella is not new to the US. I had it 35 years ago and I've never been out of the US. It was not fun

Yes it's a new strain.

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

hckynut — Sun, 05 Apr 2015 15:57:37 GMT

Hey Suzie! Last I heard you aren' force fed any antibiotic, so!!! If you don't want 'em, don't take 'em. Sounds simple enough to me. At this point in my life I am knowledgable enough to research/fact check COPY/PASTES, and make my own decisions on what goes into my mouth/ arm via injection, or my blood stream via IV. Wome want to believe everything someone researches? That is up to them.

E.T.A. How many words did you have to look up in the COPY/PASTE in Post #3?

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

millieshops — Sun, 05 Apr 2015 16:13:23 GMT

Yes, we probably use more antibiotics than are absolutely necessary, but, the other side of the story is that those same antibiotics are one of the top few reasons why our life span as increased so much over the past 50-60 years,

All kinds of things that are helpful/ pleasurable/etc. have their own risks. I've definitely benefitted from the various medical advances that have occurred in my life; I've already outlived in years plenty of my relatives, so even though I know there are risks, I'm not panicking. Hysteria is also life-shortening - imo.

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

Gooday — Sun, 05 Apr 2015 18:59:10 GMT

On 4/5/2015 Campion said:
No, shigella isn't new, but resistant shigella is--meaning if some old person gets food contaminated by dirty hands, and they need antibiotics to help fight it because they are old and the infection is hurting them, they could get very ill and the antibiotic is useless.

Most people don't need anything after a shigella infection, but some people who are immune compromised need help, and resistant bugs can kill them.

Must.Wash.Hands.

THANK YOU! My 86 year old dad and his brother live in an Senior Independent Living Facility. Approximately 3 weeks ago, many of the people came down with this. They have a communal dining room for their evening meals. There is also a deli on site. They closed down both, canceled Bingo and all activities. They had pre-packaged meals delivered to their rooms and told that if at all possible to stay in their apartments. This lasted for 9 days and then the dining room/deli reopened. However, the activities did not until 2 weeks later.

A week ago, my uncle was so ill, he had to go to the E.R. and while there, my cousin and uncle were told by the doctor that he was the 3rd person in the E.R. in 2 days. He was given IV fluids and I'm not sure what else.

SOMETHING really bad is going around and many seniors are getting the brunt of it.

I told my dad to wash, wash, wash his hands and he said that he was. I also told him to try and use his elbows to push the elevator buttons or turn door knobs.

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

Amazinggrace2 — Sun, 05 Apr 2015 19:20:58 GMT

It's difficult to control and contain bacterial outbreaks and the elder population has considerable risk factors due to (often) compromised immune systems.

As a former long time public school teacher, I saw very young children (K-1) become quite ill as well. There is the perception that children are resilient, but this is not always the case. In recent years we've seen school epidemics across the nation, as we're having a challenging task to address resilient bacterial infections. Some schools have actually closed down for a week to have the buildings professionally cleaned during an outbreak.

It is absolutely true that we are experiencing the fallout from meats and poultry sources given antibiotics; and equally true that the medical community has been reaching for more powerful antibiotics to treat even common infections (ear infections, for example).

The solutions are complex. There are myriad prophylactic/preventative actions we can take against illness, but it's the treatment challenges that cause alarm.

New strains are the insidious result of bacteria's uncanny ability to recreate itself to survive.

Spoiler alert--this is a bit gross---

A good analogy is the insect extermination industry's constant battle to develop new toxins as insects develop immunities over time. And yes, the argument surrounding these toxins are another whole thread!

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

febe1 — Sun, 05 Apr 2015 20:04:15 GMT

Not only to travelers. Read your labels. The FDA has stopped imported fish from China. There have been carcigenics found in their farmed fish. Also, don't buy Star Kist from China or Hormel hams from their. Foods that you take for granted are produced in USA, are many times from China and other countries. 62% of our fish comes from foreign countries.. When you buy fresh fish, you really don't know what you're getting.

Re: ••••• Drug-Resistant Food Poisoning Is Now In The US •••••

chrystaltree — Sun, 05 Apr 2015 20:09:04 GMT

....It's a holiday, take a day off. You can go back to scaremongering tomorrow.