Listeria risk prompts Meijer to recall produce in six U.S. states

Listeria risk prompts Meijer to recall produce in six U.S. states

NEW YORK (Reuters) – Retailer Meijer Inc said it was recalling packaged vegetables in six U.S. states because of possible contamination from Listeria monocytogenes bacteria, which can cause fatal food poisoning in young children, pregnant women and elderly or frail people.

Meijer, based in Grand Rapids, Michigan, said there were no illnesses reported as of Sunday.

The recall affects 35 products and includes vegetables such as broccoli, cauliflower and asparagus as well as party trays sold in Meijer-branded plastic or foam packaging in Michigan, Ohio, Indiana, Illinois, Kentucky and Wisconsin between Sept. 27 and Oct. 20, the company said on Saturday.

In February, Meijer recalled its Meijer-branded Colby and Colby Jack cheese sold through its deli counters because of potential contamination with Listeria monocytogenes.

The U.S. Centers for Disease Control and Prevention estimated that 1,600 people develop a serious form of infection known as listeriosis each year, and 260 die from the disease, making it the third most deadly form of food poisoning in the United States.

“The infection is most likely to sicken pregnant women and their newborns, adults aged 65 or older and people with weakened immune systems,” the CDC said on its website. Symptoms include fever and diarrhea and can start the same day of exposure or as much as 70 days later.

(Reporting by Alwyn Scott; Editing by Lisa Von Ahn and Peter Cooney)

Puerto Rico declares Zika outbreak over, CDC maintains travel warning

Aedes aegypti mosquitoes are seen at the Laboratory of Entomology and Ecology of the Dengue Branch of the U.S. Centers for Disease Control and Prevention in San Juan, Puerto Rico, March 6, 2016. REUTERS/Alvin Baez/File Photo

By Julie Steenhuysen

(Reuters) – Puerto Rico on Monday declared that the 2016 Zika epidemic is over, saying transmission of the virus that can cause birth defects when pregnant women are exposed has fallen significantly.

About 10 cases of the mosquito-borne disease have been reported in each four-week period since April 2017, down from more than 8,000 cases reported in a four-week period at the peak of the epidemic in August 2016, the Puerto Rico Health Department said in a statement.

The U.S. Centers for Disease Control and Prevention, however, has not changed its travel advice, noting that pregnant women should not travel to Puerto Rico.

The CDC said its travel notice for Puerto Rico remains in place and that it expects the virus will continue to “circulate indefinitely” in most regions where it has been introduced.

The Department of Health and Human Services declaration of a public health emergency in Puerto Rico relating to pregnant women and children born to women with the virus remains in effect, the CDC said in an emailed statement on Tuesday.

On its website, the CDC cites public health reports saying that “mosquitoes in Puerto Rico are infected with Zika virus and are spreading it to people.”

CDC acting Director Dr. Anne Schuchat said in a statement that she is “pleased that the peak of the Zika outbreak in Puerto Rico has come to a close.” However, she said, “We cannot let our guard down.”

Schuchat said CDC will continue to focus on protecting pregnant women and work closely with the Puerto Rican health department to support Zika surveillance and prevention efforts on the island, which is a U.S. territory.

A major outbreak of Zika began in Brazil in 2015 and spread rapidly to dozens of countries. There is no treatment for Zika, but private companies and governments are working on a vaccine.

In addition to Puerto Rico, the CDC has warned of a risk of Zika infection for travelers going to Mexico, Cuba, most of the Caribbean and South America, as well as parts of Africa and Southeast Asia. http://bit.ly/2m50Lf7

Locally transmitted Zika cases have also been reported in Texas and Florida.

(Reporting by Julie Steenhuysen in Chicago; Editing by Lisa Shumaker and Jonathan Oatis)

U.S. hepatitis C cases soar on spike in heroin use

FILE PHOTO - A man injects himself with heroin using a needle obtained from the People's Harm Reduction Alliance, the nation's largest needle-exchange program, in Seattle, Washington April 30, 2015. REUTERS/David Ryder/File Photo

(Reuters) – U.S. health officials said new cases of hepatitis C rose nearly 300 percent from 2010 to 2015, despite the availability of cures for the liver disease, fueled by a spike in the use of heroin and other injection drugs, according to a report released on Thursday.

In 2015, the national reported rate of hepatitis C was 0.8 per 100,000 persons with nearly 34,000 new infections, according to the report by the Centers for Disease Control and Prevention.

Access to clean syringes and a limit on Medicaid barriers to curative treatments for hepatitis C can reduce rates of death from the disease and transmission of the virus to others, the CDC said.

New treatments for hepatitis C with a cure rate of over 95 percent from Gilead Sciences <GILD.O>, AbbVie <ABBV.N> and other drugmakers have the ability to virtually wipe out the disease, which can lead to cirrhosis, cancer, the need for a liver transplant or death.

But the opioid addiction epidemic appears to be creating tens of thousands of new cases, with unclean needles the leading cause of infections. Some experts say that one reason heroin use has soared is because the illegal drug has become much cheaper than prescription opioid painkillers and due to new limits on dispensing of the addictive legal pain medicines.

The CDC conducted a state-by-state analysis of reported cases of the hepatitis C virus (HCV), as well as a review of laws related to access to clean needles for individuals who inject drugs, and levels of restriction on Medicaid access to treatments.

In 2015, it found HCV rates in 17 states exceeded the national average.

The analysis found only Massachusetts, New Mexico and Washington had both a comprehensive set of laws and a permissive Medicaid treatment policy that could help prevent the spread of HCV and provide treatment services for those who inject drugs.

Twenty-four states had policies that require some period of sobriety to receive HCV treatment through Medicaid, potentially limiting access to cures, compared with 16 states without such restrictions.

Among the best ways of preventing spread of the virus are public health laws that allow access to clean syringes for drug users, such as needle exchange programs, decriminalization of the possession of syringes, and allowing the retail sale of syringes without a prescription.

Eighteen states had no such programs, the report found, while Maine, Nevada and Utah had the most comprehensive laws related to prevention, including syringe exchange without limitations.

(Reporting by Bill Berkrot; Editing by Leslie Adler)

Exclusive: CDC considers lowering threshold level for lead exposure

CDC building

By Joshua Schneyer and M.B. Pell

NEW YORK (Reuters) – The U.S. Centers for Disease Control and Prevention is considering lowering its threshold for elevated childhood blood lead levels by 30 percent, a shift that could help health practitioners identify more children afflicted by the heavy metal.

Since 2012, the CDC, which sets public health standards for exposure to lead, has used a blood lead threshold of 5 micrograms per deciliter for children under age 6. While no level of lead exposure is safe for children, those who test at or above that level warrant a public health response, the agency says.

Based on new data from a national health survey, the CDC may lower its reference level to 3.5 micrograms per deciliter in the coming months, according to six people briefed by the agency. The measure will come up for discussion at a CDC meeting January 17 in Atlanta.

But the step, which has been under consideration for months, could prove controversial. One concern: Lowering the threshold could drain sparse resources from the public health response to children who need the most help ā€“ those with far higher lead levels.

The CDC did not respond to a request for comment.

Exposure to lead – typically in peeling old paint, tainted water or contaminated soil – can cause cognitive impairment and other irreversible health impacts.

The CDC adjusts its threshold periodically as nationwide average levels drop. The threshold value is meant to identify children whose blood lead levels put them among the 2.5 percent of those with the heaviest exposure.

ā€œLead has no biological function in the body, and so the less there is of it in the body the better,ā€ Bernard M Y Cheung, a University of Hong Kong professor who studies lead data, told Reuters. ā€œThe revision in the blood lead reference level is to push local governments to tighten the regulations on lead in the environment.ā€

The federal agency is talking with state health officials, laboratory operators, medical device makers and public housing authorities about how and when to implement a new threshold.

Since lead was banned in paint and phased out of gasoline nearly 40 years ago, average childhood blood lead levels have fallen more than 90 percent. The average is now around 1 microgram per deciliter.

Yet progress has been uneven, and lead poisoning remains an urgent problem in many U.S. communities.

AĀ Reuters investigationĀ published this month found nearly 3,000 areas with recently recorded lead poisoning rates of at least 10 percent, or double those in Flint, Michigan, during that cityā€™s water crisis. More than 1,100 of these communities had a rate of elevated blood tests at least four times higher than in Flint.

In the worst-affected urban areas, up to 50 percent of children tested in recent years had elevated lead levels.

The CDC has estimated that as many as 500,000 U.S. children have lead levels at or above the current threshold. The agency encourages ā€œcase managementā€ for these children, which is often carried out by state or local health departments and can involve educating families about lead safety, ordering more blood tests, home inspections or remediation.

Any change in the threshold level carries financial implications. The CDC budget for assisting states with lead safety programs this year was just $17 million, and many state or local health departments are understaffed to treat children who test high.

Another concern: Many lead testing devices or labs currently have trouble identifying blood lead levels in the 3 micrograms per deciliter range. Test results can have margins of error.

ā€œYou could get false positives and false negatives,ā€ said Rad Cunningham, an epidemiologist with theĀ Washington State Department of Health. ā€œItā€™s just not very sensitive in that range.ā€

The CDC doesnā€™t hold regulatory power, leaving states to make their own decisions on how to proceed. Many have yet to adapt their lead poisoning prevention programs to the last reference change, implemented four years ago, when the level dropped from 10 to 5 micrograms per deciliter. Other states, including Virginia and Maine, made changes this year.

The U.S. Department of Housing and Urban Development isĀ close to adoptingĀ a ruleĀ requiring an environmental inspection ā€“ and lead cleanup if hazards are found ā€“ in any public housing units where a young child tests at or above the CDC threshold.

If the CDC urges public health action under a new threshold, HUD said it will follow through. ā€œThe only thing that will affect our policy is the CDC recommendation for environmental intervention,ā€ said Dr. Warren Friedman, with HUDā€™s Office of Lead Hazard Control and Healthy Homes.

To set the reference value, the CDC relies upon data from the National Health and Nutrition Survey. The latest data suggests that a small child with a blood lead level of 3.5 micrograms per deciliter has higher exposure than 97.5 percent of others in the age group, 1 to 5 years.

But in lead-poisoning hotspots, a far greater portion of children have higher lead levels. Wisconsin data, for instance, shows that around 10 percent of children tested in Milwaukeeā€™s most poisoned census tracts had levels double the current CDC standard.

Some worry a lower threshold could produce the opposite effect sought, by diverting money and attention away from children with the worst exposure.

ā€œA lower reference level may actually do harm by masking reality ā€“ that significant levels of lead exposure are still a problem throughout the country,ā€ said Amy Winslow, chief executive of Magellan Diagnostics, whose blood lead testing machines are used in thousands of U.S. clinics.

(Edited by Ronnie Greene)

Texas reports four more cases of Zika spread by local mosquitoes

A woman looks at a Center for Disease Control (CDC) health advisory sign about the dangers of the Zika virus as she lines up for a security screening at Miami International Airport in Miami, Florida,

(Reuters) – Texas health officials said they had identified four additional cases of Zika likely spread by local mosquitoes, two weeks after the first case was reported in the state.

The four patients live in very close proximity to the first case, the Texas Department of State Health Services and Cameron County Department of Health and Human Services said in a statement on Friday.

The first case involved a woman living in Cameron County near the Mexico border, who is not pregnant.

The U.S. Centers for Disease Control and Prevention and the Florida Department of Health said earlier on Friday the Miami Beach area was no longer considered an active Zika transmission zone.

The CDC said there had been no new cases of local Zika virus transmission identified in South Miami Beach for more than 45 days, suggesting that the risk of infection was no longer greater than in the rest of Miami-Dade County.

“Florida no longer has any identified areas with active Zika transmission,” Governor Rick Scott said in a statement.

(Reporting by Subrat Patnaik and Akankshita Mukhopadhyay in Bengaluru; Editing by Ted Kerr and Shounak Dasgupta)

CDC to provide $16 million more to fight Zika locally

Warning of mosquitoes carrying disease by CDC

(Reuters) – The U.S. Centers for Disease Control and Prevention (CDC) is making available more than $16 million to states and territories in their fight against the Zika virus, in addition to the $25 million it had sanctioned in July.

The current Zika outbreak was first detected last year in Brazil, where it has been linked to more than 1,700 cases of the birth defect microcephaly, and has since spread rapidly through the Americas.

U.S. health officials on Monday warned pregnant women to avoid traveling to a neighborhood in Miami after the Florida government said it had identified 10 more cases of Zika caused by the bite of local mosquitoes, bringing the total to 14.

The new funding – for 40 states and territories – will be used to provide real-time data about the epidemic as it unfolds in the United States and help those affected by the virus, the CDC said on Tuesday.

Last month, the agency provided $25 million to 53 states, cities and territories as part of its ‘preparedness and response’ funding to areas at risk for outbreaks.

(Reporting by Natalie Grover in Bengaluru; Editing by Saumyadeb Chakrabarty)

CDC monitoring 320 U.S. pregnant women with Zika

A woman looks at a Center for Disease Control (CDC) health advisory sign about the dangers of the Zika virus as she lines up for a security screening at Miami International Airport in Miami, Florida, U.S., May 23, 2016. REUTERS/Carlo Allegri

WASHINGTON (Reuters) – The U.S. Centers for Disease Control and Prevention said on Thursday that it is monitoring 320 U.S. pregnant women with laboratory evidence of Zika virus infection, up from 287 women a week earlier.

However, the number of babies born in the United States with birth defects linked to Zika infection in mothers during pregnancy, or lost pregnancies linked to the virus, remained unchanged from last week’s report at 7 and 5, respectively, according to a CDC registry created last month.

The registry compiles poor outcomes of pregnancies with laboratory evidence of possible Zika virus infection in the 50 states and the District of Columbia. The latest figures are as of June 30.

Zika has caused concern throughout the Americas due to an alarming rise in cases of the birth defect microcephaly and other severe fetal brain abnormalities linked to the mosquito-borne virus reported in Brazil, the country hardest hit by the outbreak. Infants with microcephaly are born with abnormally small heads and may experience potentially disabling developmental problems.

Brazil has confirmed more than 1,600 cases of microcephaly linked to Zika.

All reported U.S. cases of Zika have so far involved people who traveled to areas with a current outbreak, but health experts have warned that local transmission cases are likely to occur in the coming weeks during summer mosquito season. Gulf Coast states, such as Florida and Texas, are seen as particularly vulnerable.

The virus can also be transmitted via unprotected sex with an infected man.

(Reporting by David Morgan in Washington and Bill Berkrot in New York)

Health agency reports U.S. babies with Zika-related birth defects

Mosquito under microscope, studying Zika

By Bill Berkrot

(Reuters) – Three babies have been born in the United States with birth defects linked to likely Zika virus infections in the mothers during pregnancy, along with three cases of lost pregnancies linked to Zika, federal health officials said on Thursday.

The six cases reported as of June 9 were included in a new U.S. Zika pregnancy registry created by the Centers for Disease Control and Prevention. The agency said it will begin regular reporting of poor outcomes of pregnancies with laboratory evidence of possible Zika virus infection in the 50 states and the District of Columbia.

Zika has caused alarm throughout the Americas since numerous cases of the birth defect microcephaly linked to the mosquito-borne virus were reported in Brazil, the country hardest hit by the current outbreak. The rare birth defect is marked by unusually small head size and potentially severe developmental problems.

The U.S. cases so far involve women who contracted the virus outside the United States in areas with active Zika outbreaks, or were infected through unprotected sex with an infected partner. There have not yet been any cases reported of local transmission of the virus in the United States. Health experts expect local transmission to occur as mosquito season gets underway with warmer weather, especially in Gulf Coast states, such as Florida and Texas.

The CDC declined to provide details of the three cases it reported on Thursday, but said all had brain abnormalities consistent with congenital Zika virus infection. Two U.S. cases of babies with microcephaly previously were reported in Hawaii and New Jersey.

The poor birth outcomes reported include those known to be caused by Zika, such as microcephaly and other severe fetal defects, including calcium deposits in the brain indicating possible brain damage, excess fluid in the brain cavities and surrounding the brain, absent or poorly formed brain structures and abnormal eye development, the CDC said.

“The pattern that we’re seeing here in the U.S. among travelers is very similar to what we’re seeing in other places like Colombia and Brazil,” Dr. Denise Jamieson, co-leader of the CDC Zika pregnancy task force, said in a telephone interview.

Authorities in Brazil have confirmed more than 1,400 cases of microcephaly in babies whose mothers were exposed to Zika during pregnancy.

Lost pregnancies include miscarriage, stillbirths and terminations with evidence of the birth defects. The CDC did not specify the nature of the three reported lost pregnancies, citing privacy concerns about pregnancy outcomes.

The CDC established its registry to monitor pregnancies for a broad range of poor outcomes linked to Zika. It said it plans to issue updated reports every Thursday intended to ensure that information about pregnancy outcomes linked with the Zika virus is publicly available.

The CDC said the information is essential for planning for clinical, public health and other services needed to support pregnant women and families affected by Zika.

“We’re hoping this underscores the importance of pregnant women not traveling to areas of ongoing Zika virus transmission if possible, and if they do need to travel to ensure that they avoid mosquito bites and the risk of sexual transmission,” Jamieson said.

(Reporting by Bill Berkrot; Editing by Will Dunham)

U.S. states on Zika’s frontline see big gaps in funding

A Greater Los Angeles County Vector Control District worker pours away stagnant water as she searches for mosquitoes in a backyard

By Julie Steenhuysen

(Reuters) – In Mississippi, a small team of entomologists has begun the first survey of mosquito populations in decades. Experts do not believe the kind of mosquitoes most likely to carry the Zika virus are active in the state, but they cannot know for sure.

By contrast, the Florida Keys Mosquito Control District, has been active since the late 1920s. With an annual budget of over $15 million, it now deploys four helicopters, two airplanes and 33 inspectors covering 125 square miles.

Because they are funded by local taxpayer dollars, U.S. mosquito control programs reflect deep economic disparities between communities, leaving some at-risk locations badly unprepared for the virus that is spreading through the Americas.

First detected in Brazil last year, Zika has been linked in that country to more than 1,300 cases of microcephaly, a rare birth defect defined by unusually small heads.

The outbreak is expected to reach the continental United States in the coming weeks as temperatures rise and mosquito populations multiply. In interviews with Reuters, more than a dozen state and local health officials and disease control experts say they worry they will have neither the money nor the time to plug gaping holes in the nation’s defenses.

They say the poorest communities along the Gulf of Mexico with a history of dengue outbreaks are at the highest risk.

States in the south are “woefully under-invested,” said Dr. Thomas Dobbs, epidemiologist for the Mississippi State Department of Health. “You have these gaping holes in capacity,” he said, with many poor communities mobilizing their first mosquito control efforts in years.

Among the best-prepared is Harris County, Texas, which includes the city of Houston. It dedicates $4.5 million a year to controlling disease carriers, or vectors, such as mosquitoes, ticks or rodents.

The 50-year-old program is considered one of the best in the country. Traps have been set up in 268 areas in the county to capture and catalog mosquitoes and test them for pesticide resistance. It is adding new traps for the Aedes aegypti mosquitoes that carry Zika.

New York City plans to spend $21 million over three years to combat the virus. Aedes aegypti have never been found in the city, so its efforts will target Aedes albopictus, a mosquito believed to be capable of spreading the virus.

At the other end of the spectrum, some communities may only have a “Chuck in the truck” – someone who does spraying runs with a fogger attached to his pickup, said Stan Cope, president of theĀ American Mosquito Control Association. Many municipalities do not even have that much.

The Obama administration has asked Congress for nearly $1.9 billion to fight Zika, including $453 million to assist with emergency response, laboratory capacity and mosquito control. Lawmakers in the House of Representatives and Senate have presented their own funding proposals, which each fall far short of that sum.

STOPGAP FUNDING

To help plug some of the gaps until Congress acts, the U.S. Centers for Disease Control and Prevention is adding $38 million to an existing infectious diseases grant program to expand lab testing capacity and surveillance for Zika.

For the first time, CDC will also provide an additional $15 million to help local programs most in need, CDC entomologist Janet McAllister told Reuters.

She said states’ proposals are due by the end of May and could cover funding for trucks, equipment and chemicals, as well as hiring contractors.

The CDC has also earmarked $25 million for at-risk states and territories, though the funds would primarily go health departments to help them deal with Zika cases.

But the CDC money is not expected to reach states until August at the earliest, late in the game to do mosquito surveillance.

The agency estimates that Aedes aegypti could be present in as many as 27 U.S. states, though the chief worry will be areas with recent dengue fever cases, McAllister said. Those include South Florida, South Texas, Southern California, areas along the U.S. border with Mexico, Louisiana and Hawaii. (Graphic: http://tmsnrt.rs/1QvaMW6)

Frank Welch, medical director for the office of community preparedness for Louisiana, a state with 64 different types of mosquitoes, said his concern was that federal emergency funding might get delayed until the fall.

“That would certainly be too late for immediate Zika preparedness,” he said.

DIFFERENT ANIMAL

Even communities with established, well-funded insect-fighting programs may lack the tools to prevent an outbreak.

“We don’t feel horribly confident that anybody in the world is very good at controlling these mosquitoes,” said Susanne Kluh, Scientific-Technical Services Director for the Greater Los Angeles County Vector Control District.

One reason is that most U.S. programs are designed to deal with nuisance mosquitoes or those carrying West Nile, which are controlled by spraying at night and dropping tablets that kill mosquito larvae into catch basins.

Confronting Aedes aegypti, a daytime biter that lives in and around homes and breeds in tiny containers of water, is more expensive and inherently less efficient.

“It’s a different animal. It requires a very different method to control,” said Michael Doyle, a former CDC entomologist who directs mosquito control in the Florida Keys.

In 2009, Doyle oversaw efforts to fight dengue, also carried by Aedes aegypti. Inspectors went door to door every week, dumping containers of water in back yards that could serve as breeding sites, spraying pesticides to kill adult mosquitoes and using a liquid non-toxic bacterial formulation to kill larvae. After every rainstorm, they continue to spray 80,000 acres with the larvicide.

That has proved expensive at $16 per acre (0.4 hectare) plus helicopter costs. The efforts have only reduced the Aedes aegypti mosquito population by half since 2010, which Doyle said is not enough to prevent disease transmission.

In California, Aedes aegypti mosquitoes arrived as recently as 2013 and have spread to seven counties from south of Fresno to San Diego. “It has really changed the manpower needs,” Kluh said.

Kluh said her district traditionally treats easily accessible public areas, such as catch basins, storm drains and the occasional swimming pool.

“This battle against these mosquitoes happens in every backyard and in tiny sources as small as a bottle cap filled with sprinkler water.”

(Reporting by Julie Steenhuysen; Editing by Michele Gershberg and Tomasz Janowski)

CDC says 157 pregnant women in U.S. test positive for Zika

A pair of Aedes albopictus mosquitoes are seen during a mating ritual while the female feeds on a blood meal in a 2003 image

By Ransdell Pierson and Bill Berkrot

(Reuters) – Some 157 pregnant women in the United States and another 122 in U.S. territories, primarily Puerto Rico, have tested positive for infection with the Zika virus, the U.S. Centers for Disease Control and Prevention said on Friday.

The CDC, in a conference call, said that so far fewer than a dozen of the infected pregnant women it has tracked in the United States and Puerto Rico have had miscarriages or babies born with birth defects. This was the first time the agency had disclosed the number of Zika-infected pregnant women in the United States and its territories.

U.S. health officials have determined that the mosquito-borne virus, which can also be transmitted through unprotected sex with an infected person, can cause microcephaly, a birth defect marked by unusually small head size, and can lead to severe brain abnormalities and developmental problems in babies.

The agency told reporters on the call it has dramatically increased its testing capacity for Zika in the United States as it girds for an increase in cases during the summer mosquito season.

Virtually all the Zika cases in the continental United States so far have been in people returning from countries where Zika is prevalent, such as Brazil, or through sexual transmission by travelers.

The latest report comes at a time when U.S. health officials have been clamoring for adequate funding to support mosquito protection and eradication, development of anti-Zika vaccines and better diagnostics, and long-term studies needed to follow children born to infected mothers and to better understand the sexual transmission risk.

The Obama Administration has requested $1.9 billion in emergency Zika funding. The U.S. Senate approved $1.1 billion of that request. The U.S. House of Representatives, however, voted to allocate $622.1 million financed through cuts to existing programs, such as for Ebola, which U.S. health officials have called inadequate and shortsighted.

The World Health Organization has said there is strong scientific consensus that Zika can also cause Guillain-Barre, a rare neurological syndrome that causes temporary paralysis in adults.

The connection between Zika and microcephaly first came to light last fall in Brazil, which has now confirmed more than 1,300 cases of microcephaly that it considers to be related to Zika infections in the mothers.

(Reporting by Ransdell Pierson and Bill Berkrot; Editing by Chizu Nomiyama and James Dalgleish)