TIME Infectious Disease

There Might Be Poop on Your Cilantro

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The FDA has banned some Mexican imports

Guacamole fans, beware: the FDA has banned the import of some fresh cilantro from Mexico after evidence showed the crop could be tainted with human feces.

Several farms in Puebla were linked to outbreaks of stomach illness in 2013 and 2014 in the U.S., the Associated Press reports. The FDA believes they may also have caused more recent outbreaks due to the presence of the cyclospora parasite.

Investigators found that some farms had no toilets for employees, and discovered feces and toilet paper in the fields. The resulting ban will impact shipments from April through August in the coming years unless farms in the region can show that conditions have improved.

TIME Infectious Disease

There’s Another Drug-Resistant Bacteria In Meat

A new study suggests meat sold in grocery stores could be carrying an overlooked pathogen

We’ve heard about listeria in ice cream and E. coli in spinach, but new research suggests there’s another bacterial strain that may be infecting consumers who handle or consume meat sold in grocery stores.

A new study published in the journal Clinical Infectious Diseases shows turkey, chicken and pork sold in grocery stores can contain a bacteria called Klebsiella pneumoniae, which can cause illness in some people, and some strains of which are resistant to antibiotics. According to researchers, the new study is the first to suggest that meat may be a source of K. pneumoniae exposure for Americans. Currently the U.S. government does not routinely test food for that bacteria.

In the study published Thursday, researchers from the Milken Institute School of Public Health and elsewhere compared isolated samples of K. pneumoniae from meat products sold in Flagstaff, Arizona, and compared those to urine and blood samples from people with K. pneumoniae infections during the same time period. The samples were sequenced and the researchers found that 47% of the meat products tested had the bacteria, and some of the sequenced samples from the meat and samples from the humans were almost identical.

The findings underline the need for judicious use of antibiotics in livestock, since some of the strains of K. pneumoniae were discovered to be drug resistant.

The study cannot confirm for certain that the people in the study with Klebsiella pneumoniae got the infection from meat at a grocery store. “What we can say is that there are strains that were isolated from people and from meat that were nearly indistinguishable,” said lead study author Lance B. Price, a professor of environmental and occupational health at Milken Institute School of Public Health in an email.

The authors add that the findings are not necessarily reserved to Arizona where the study was conducted. Price says most of the products were produced outside of the state, which means contaminated meat could be in a variety of places country-wide.

TIME Infectious Disease

‘We Are Not Prepared For Another Epidemic': World Bank Survey

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Getty Images A woman, suspected of carrying ebola, looks on while under quarantine in the red zone of the Elwa clinic, an ebola treatment center in Monrovia on July 20, 2015. AFP PHOTO / ZOOM DOSSO (Photo credit should read ZOOM DOSSO/AFP/Getty Images)

A new World Bank poll reveals many countries are fearful of epidemics like Ebola and do not think the world is prepared to handle them

Correction appended, July 23

Many people living in developed countries do not think the world is prepared to appropriately respond to another infectious disease epidemic like the ongoing Ebola outbreak, a new World Bank survey shows.

The new data comes from a World Bank Foundation survey released Thursday morning. Researchers polled 4,000 people in the general public living in the regions as well as what the organization classified as opinion elites (defined as people with a university diploma who closely follow global news) and discovered that people around the world are highly concerned about global disease outbreaks, are not convinced the global community is well equipped to handle such outbreaks, and are in support of more funding for protections.

When asked to rank which global issues are most concerning, the people polled collectively ranked global health and epidemics third, after climate change and terrorism. Concern over epidemics was higher than that for global poverty and human rights abuses. When asked specifically about which global health problems concerned people most, global infectious diseases beat out other issues including HIV/AIDS, obesity and hunger.

Not only is concern over epidemics high, but twice as many people think there will be another epidemic like Ebola than people who do not. In addition, a high proportion of the people surveyed expect there could be an epidemic in their own country. That’s especially interesting, the researchers pointed out in a press conference, given that most of the countries had very few people with Ebola if any at all.

People living in the United States, France and the United Kingdom were especially unconvinced that the world is prepared to handle another outbreak. The Ebola outbreak has infected over 27,700 people and killed over 11,260. It’s been widely acknowledged that the world did not react fast enough, and a recent report cited major cultural problems at the World Health Organization (WHO) that interfered with the agency’s leadership during the outbreak and contributed to its failures to adequately respond.

The poll highlights the fact that members of the general public recognize the risk epidemics pose and support investment to prevent them. Nearly 60% of those surveyed said they support funding and policy changes in developing countries that will help protect their own country from risk, and about 70% say strengthening the health systems in developing countries will save money.

Pledges from countries to aid in the Ebola outbreak as well as vows from global agencies to reform their processes to better respond in the future have been made throughout the last year. Whether these translate to real changes and increased capacities to prevent and respond to the next outbreak remains to be seen, but it’s clear from the new poll that it’s what the people want.

Correction: The original version of this story misstated group that conducted the poll. It’s the World Bank Group.

TIME medicine

There’s Yet Another Downside To Overusing Antibiotics

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Scientists have found yet another reason not to overuse the drugs—they’re turning bacteria into better infectious agents

Scientists have been warning for decades that we use too many antibiotics, both in people to treat relatively mild infections and in agriculture to bulk up farm animals and keep them free of disease. The consequences, they caution, are dire—and already emerging in hospitals with bacteria that can’t be treated with any of our existing antibiotic medications.

But the thinking went that to become resistant to the drugs we use on them, bacteria have to pay a price. They may be able to survive the pharmaceutical onslaught, but they’re less fit and therefore less able to reproduce, less likely to remain for long in their host of choice and otherwise sapped of the energy needed to really wreak havoc on human or animal immune systems.

MORE: Study Links Widely Used Pesticides to Antibiotic Resistance

At least, that was the theory (and perhaps the hope) until now. In a study published in Science Translational Medicine, however, researchers show how misguided that belief is. Delving into the genetic code of certain common bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii — both of which are resistant to multiple antibiotics— and Vibrio cholerae, the researchers identified genes that change in the presence of these drugs. In animal models, they observed how these changes affected the different bacteria’s ability to infect and populate in hosts.

To their surprise, rather than being compromised, the antibiotic-resistant bacterial strains seemed to be stronger, more robust and better able to infect cells than less resistant strains.

MORE: Why Reducing Antibiotic Resistance Is Harder Than It Seems

“With all the possible mutations in the bacteria, there is a battle royale, a competition among all the mutants, and we see that the most fit, the most virulent were the ones that were resistant to the antibiotics,” says Dr. David Skurnik, senior author of the paper and assistant professor of medicine at Brigham and Women’s Hospital and Harvard Medical School. In the case of P. aeruginosa, he says, “the acquisition of antibiotic resistance was associated with the most increased fitness in all the possible mutations in P. aeruginosa.”

That means that the problem of antibiotic-resistant bugs just got more complicated. Overuse of antibiotics increases the number of bacterial strains that have mutations which make them better able to withstand the drugs, and this latest research shows that these strains may also be more adept at infecting hosts and causing disease. “We’ve gotten a double whammy with the acquisition of antibiotic resistance,” says Gerald Pier, a co-author of the paper and professor of medicine, microbiology and immunobiology at Brigham and Harvard Medical School. “Not only does antibiotic resistance make it more difficult to treat infections because we have fewer drugs they will respond to, but it makes the organism better able to cause infection.”

While still important, the conventional solution of cutting back on antibiotic use may not be enough, he says. Using antibiotics more appropriately will certainly reduce the appearance of new drug-resistant strains, but it won’t be enough to tamp down the emergence of these fitter, more virulent bacteria that also happen to be adept at evading the effects of antibiotics. For that, he says, other infection-fighting strategies, including boosting the immune system with vaccines or antibody treatments, may be needed.

That’s what Pier and Skurnik are working on currently, and so far, they’ve developed encouraging options for treating infections that may keep the more robust bacteria at bay. They’re targeting parts of bacteria that many strains have in common and developing new says to recognize these targets and neutralize the bacteria so they can’t cause serious infections and disease. “These results show that, yes, the problem of multi-drug resistant bacteria is more complex than we thought, but there are solutions,” says Skurnik.

TIME global health

Here’s How Much More Money Is Needed to Improve Global Health

Outbreaks like Ebola highlight the gaps in the way money is raised and used for protecting people’s health, a new study finds

In a report published in the journal Lancet, researchers point out large gaps in the money raised and dispatched for public health purposes and the medical needs of countries, particularly in the developing world, to keep their populations healthy.

Despite recurrent outbreaks of pandemic infections such as SARS and, most recently, Ebola, donors have committed less than a third of the estimated $3.4 billion that is needed to maintain a strong pandemic preparedness system, according to the World Bank. Overall, donor countries have spent only half of the $6 billion that the World Health Organization says is needed to maintain global public health.

What’s lacking, the study authors say, is a more focused system for investing in global health that emphasizes programs designed to achieve certain public health functions, such as vaccinating a particular population or corralling antibiotic resistance or the spread of multi-drug resistant tuberculosis. It’s an approach championed by philanthropic organizations such as the Bill & Melinda Gates Foundation, the organization that funded the study. Part of the funding conditions of its programs include specifying outcomes and a timeframe for achieving them.

“For example, countries like China and India would substantially benefit from market shaping to lower drug prices and increased international efforts to control multi-drug resistant tuberculosis,” Dr. Marco Schaferhoff, association director of SEEK Development in Germany and one of the co-authors of the report, said in a statement. “At the same time…donor countries should also ensure that vulnerable and marginalized populations in middle-income countries, such as ethnic minorities who suffer discrimination, refugees, and people who inject drugs, receive sufficient support.”

TIME Infectious Disease

Blue Bell Ice Cream to Resume Production After Contamination

All of the company's products were recalled in March

The Texas-based ice cream company Blue Bell Creameries said this week that it would resume testing production later this month, nearly four months after all its products were pulled from shelves amid a listeria contamination.

“Yes it’s true… our Alabama facility will begin test production in the next several weeks!” the company said on Facebook. “Thanks again for your support.”

The ice cream producer was forced to halt production in March after some of its product was discovered to be contaminated with listeria, a dangerous bacteria. Those contaminations were subsequently linked to three deaths and several other cases. Blue Bell has only been able to resume manufacturing activities after reaching an agreement with the Alabama State Health Department (and entering into similar ones with the appropriate bureaus in Texas and Oklahoma).

There is still no timetable for when Blue Bell products will return to store shelves, CBS Dallas Fort-Worth reports.

TIME Health Care

8 in 10 Doctors Admit to Treating Patients While Sick

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Elizabeth Renstrom for TIME

Even while acknowledging that it can put patients at risk, according to a new survey.

A vast majority of healthcare workers acknowledged that they show up to work while feeling sick, even if they know it poses a risk to their patients, according to a new survey.

Medical professionals including physicians, registered nurse practitioners, physician assistants and midwives will work while they are under the weather, according to results from a small survey published Monday in the journal JAMA Pediatrics. Researchers surveyed over 530 attending physicians and advanced practice clinicians at a hospital and found that while 95.3% said they believed working while sick puts patients at risk, 83.1% had done it at least one time in the past year.

Most respondents said they would work while sick because they didn’t want to let their coworkers down. Others cited staffing concerns, not wanting to let down their patients or fear of being “ostracized” by their peers in the hospital.

The results come from one single hospital, so the findings may not apply to other medical offices. Still, the study authors conclude that the findings show an area of improvement for medical venues to both better protect patients and prevent health care worker burnout.

“Creating a safer and more equitable system of sick leave for health care workers requires a culture change in many institutions to decrease stigma—internal and external—associated with health care works illness,” reads a corresponding editorial. “Identifying solutions to prioritize patient safety must factor in workforce demands and variability in patient census to emphasize flexibility.”

TIME Infectious Disease

California Lawmakers Pass Strict School Vaccine Bill

The bill ends vaccine exemptions for personal beliefs

The California senate has passed a bill that requires most children in public schools to get vaccinations and ends exemptions from vaccinations for personal beliefs.

The bill only allows for kids with serious health problems to not get vaccinated.

The bill is now heading to California Governor Jerry Brown, who has not said whether he will sign the bill. It would be one of the strictest vaccination laws in the country.

California recently experienced an outbreak of measles that was tied to a Disneyland amusement park. Many of the people infected were not vaccinated.

TIME Infectious Disease

California Lawmakers to Vote on Tougher Vaccine Measures

The bill would end exemptions from vaccinations for personal beliefs

California lawmakers are expected to vote Monday on a measure that would require most children in public schools to get vaccinations.

The bill, which is headed for a final vote in the California state Senate, would end exemptions from vaccinations for personal belief, and would excuse only children with serious health issues from vaccines, reports the Associated Press. Other unvaccinated children would need to be homeschooled.

An outbreak of measles at Disneyland in December infected over 100 people in the U.S. and Mexico, largely due to pockets of unvaccinated Californians.

Gov. Jerry Brown has not said whether he would sign the bill. If it becomes law, California, Mississippi and West Virginia would be the only states with such strict vaccination requirements.

[AP]

TIME public health

California Moves Toward Stricter Vaccination Rules for Schoolchildren

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Months after a measles outbreak infected dozens

Lawmakers in California’s Assembly approved a bill Thursday that would make vaccinations required for schoolchildren, regardless of any parental or religious objection.

The measure, if signed by Governor Jerry Brown following Senate approval of several minor amendments, would be among the strictest mandatory vaccination laws in the U.S., the Los Angeles Times reported. The only way for children starting school to avoid a vaccination against whooping cough and measles would be for a doctor to sign off on an exemption due to a medical condition, like an immune system deficiency or an allergy.

The move comes in the months after a measles outbreak that sickened some 130 people, including visitors to Disneyland in Anaheim, Calif. If the bill becomes law, California would become the country’s 32nd state to mandate vaccinations regardless of personal beliefs, but only the third to block religious exemptions.

Read more at the Los Angeles Times.

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