CNN
—
US health officials may soon require states to notify them of any cases of infants with severe infections caused by Cronobacter sakazakii, a bacterium that can contaminate infant formula.
Cronobacter infections usually affect babies younger than 2 months and can be fatal or permanently disabling.
in a outbreak that the US Centers for Disease Control and Prevention investigated last year, four babies became ill, including two who died. All of the babies had been fed infant formula made at the same factory in Sturgis, Michigan, prompting an extensive investigation by the US Food and Drug Administration and ultimately halting production. on the premises for months. The lockdown worsened current supply chain problems and plunged the country into a national shortage.
Ultimately, the FDA and CDC were unable to find genetic links between the Cronobacter samples from the facility and the bacteria found in the water and dust used to mix the formula the infants had consumed.
These infections are thought to be rare, but the true burden in the US is unknown because Cronobacter is not currently part of the National Reportable Disease Surveillance System, a list of about 120 diseases They have been given special priority by the CDC because they have been considered important to public health.
The Council of State and Territorial Epidemiologists, a nonprofit organization that advocates for effective disease surveillance, identified Cronobacter as a priority area for research this year.
A working group was formed in the winter to assess conditions, risks, and surveillance processes related to bacterial infection, and will present recommendations for advancing Cronobacter surveillance in June.
Adding Cronobacter infections to the national watch list is one strategy being considered.
“When we look back at large-scale outbreaks over the course of the past year, many of those outbreaks were associated with diseases and conditions that were nationally notifiable, but not all of them.” said Janet Hamilton, executive director of the council, and Cronobacter was one of the exceptions.
“So any time we have something like that, that makes it up to the council to determine and evaluate whether we need to do more.”
Adding a disease to the national list can have a considerable impact. After E. coli O157 was added to the list of reportable diseases in 1994 and most states required physicians to report cases by the year 2000, the number of reported outbreaks triplicate.
However, it would take quite a while for the changes to take effect.
If the Council of State and Territorial Epidemiologists votes to add Cronobacter infections to the national list of notifiable diseases, the recommendation will go to CDC for approval. If the CDC deems a disease reportable, it’s up to state and local governments to adjust their reporting laws and develop processes for doctors to report cases to health departments, which then send those reports to CDC.
The earliest data collection could begin is early 2024, and most likely well into the year, depending on state legislative sessions.
Currently, only two states, Minnesota and Michigan, require doctors to report Cronobacter cases, which can be diagnosed more generically as sepsis or meningitis, conditions that can result from infection.
“Unless detailed studies are performed, the diagnosis as Cronobacter disease may be missed,” FDA Commissioner Dr. Robert Califf wrote in a statement. blog post last week. “The lack of mandatory reporting significantly hinders the ability to fully understand the public health impact of Cronobacter.”
Dr. Peter Lurie, executive director of the Center for Science in the Public Interest, applauded the potential move.
“I think it is a necessary step. It’s hard to prevent diseases that can’t be counted,” Lurie said.
In addition, Lurie says, manufacturers should be required to notify the FDA when a batch of infant formula tests positive for Cronobacter before it leaves the plant. The FDA has asked manufacturers to report positive tests, but reporting is voluntary.
Lurie says the FDA should also do more environmental sampling and testing for Cronobacter to better understand where the bacteria can appear.
“I think we have a lot to learn there,” he said.
Mitzi Baum, CEO of the Stop Foodborne Illness group, which has been defending for the change, she said she was grateful that the Council of State and Territorial Epidemiologists moved toward a vote on it.
She said that increased awareness of the infection was long overdue.
“It’s always preceded by ‘this is rare,’ but we don’t know how rare it is because it’s not reportable. And there needs to be a lot more education on this pathogen and a lot more research,” Baum said.
Baum said his group is working with the council to create an educational campaign to raise awareness of the infection among doctors. The next step, she says, is to get financing.
The council’s Hamilton notes that “just making something nationally reportable doesn’t necessarily translate to awareness and recognition on the prevention side. If people don’t have the right set of information and education, by the time we do public health surveillance, the disease or infection will already have occurred.”
According to the FDA, Cronobacter sakazakii is a common natural pathogen that can enter homes and other spaces through contaminated hands, shoes, and other surfaces. It is “especially good at surviving in dry foods,” such as powdered baby formula.
Infections are harmless to most people, but they can be life-threatening in babies, especially those born prematurely or with weakened immune systems. It’s particularly important to make sure parents of high-risk babies know how to keep them safe, Hamilton said.
“Providing good education on how to stop infections is really what leads to the level of change that we would love to see,” he said.
—————————————————-
Source link