The global burden of crypto in children under 5

Posted on June 17, 2018 by Douglas Powell

The protozoan Cryptosporidium is a leading cause of diarrhoea morbidity and mortality in children younger than 5 years. However, the true global burden of Cryptosporidium infection in children younger than 5 years might have been underestimated in previous quantifications because it only took account of the acute effects of diarrhoea. We aimed to demonstrate whether there is a causal relation between Cryptosporidium and childhood growth and, if so, to quantify the associated additional burden.

Methods

The Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2016 was a systematic and scientific effort to quantify the morbidity and mortality associated with more than 300 causes of death and disability, including diarrhoea caused by Cryptosporidium infection. We supplemented estimates on the burden of Cryptosporidium in GBD 2016 with findings from a systematic review of published and unpublished cohort studies and a meta-analysis of the effect of childhood diarrhoea caused by Cryptosporidium infection on physical growth.

Findings

In 2016, Cryptosporidium infection was the fifth leading diarrhoeal aetiology in children younger than 5 years, and acute infection caused more than 48 000 deaths (95% uncertainty interval [UI] 24 600–81 900) and more than 4·2 million disability-adjusted life-years lost (95% UI 2·2 million–7·2 million). We identified seven data sources from the scientific literature and six individual-level data sources describing the relation between Cryptosporidium and childhood growth. Each episode of diarrhoea caused by Cryptosporidium infection was associated with a decrease in height-for-age Z score (0·049, 95% CI 0·014–0·080), weight-for-age Z score (0·095, 0·055–0·134), and weight-for-height Z score (0·126, 0·057–0·194). We estimated that diarrhoea from Cryptosporidium infection caused an additional 7·85 million disability-adjusted life-years (95% UI 5·42 million–10·11 million) after we accounted for its effect on growth faltering—153% more than that estimated from acute effects alone.

Interpretation

Our findings show that the substantial short-term burden of diarrhoea from Cryptosporidium infection on childhood growth and wellbeing is an underestimate of the true burden. Interventions designed to prevent and effectively treat infection in children younger than 5 years will have enormous public health and social development impacts.

Morbidity, mortality, and long-term consequences associated with diarrhoea from cryptosporidium infection in children younger than 5 years: A meta-analyses study

The Lancet Global Health, DOI: https://doi.org/10.1016/S2214-109X(18)30283-3

Ibrahim A Khalil, Christopher Troeger, Puja C Rao…

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30283-3/abstract#.WyQRPA3swGY.twitter

Funding

The Bill & Melinda Gates Foundation.

3 sickened: E. coli in Conwy county over

Posted on September 30, 2015 by Douglas Powell

An E. coli O157 outbreak in the Conwy area of the UK, which affected three children has been declared over, health officials said.

A total of 83 other people were screened for E. coli O157 as part of the investigation by Public Health Wales and Conwy council but were given the all clear.

A childcare provider shut voluntarily during the outbreak but has reopened and is not believed to be the source.

Three affected children are recovering at home.

It’s the kids that suffer; from the duh files: Pet reptiles pose Salmonella risk for infants

Posted on December 26, 2014 by Douglas Powell

Owning exotic reptiles such as snakes, chameleons, iguanas and geckos could place infants at risk of salmonella infection, according to a British study.

Researchers in the southwestern English county of Cornwall found that out of 175 cases of salmonella in children under five over a three-year period, 27% occurred in homes which had reptile pets.

If the pet is allowed to run free in the home, this poses a risk, especially if the child is at an exploratory stage of crawling or licking surfaces.

The average age of children who fell ill with “reptile-associated salmonellosis” (RAS) was just six months, said the study, led by Dan Murphy of the Royal Cornwall Hospital in Truro.

The investigation is published in a specialised British journal, Archives of Disease in Childhood.

A U.S. study in 2004 estimated that RAS was behind 21% of all of laboratory-confirmed cases of Salmonella among people aged under 21.

Don’t eat dog poop, and don’t run around with sharp objects in your ear

Posted on August 17, 2014 by Douglas Powell

Oh, the Brits.

Their science-based food safety agency won’t say, use a thermometer, but a local council tells kids not to eat dog poop.

Upon seeing this image, you tell yourself that this park can’t possibly be warning kids not to eat dog feces. As if it could ever possibly be a real issue. But then upon reading the sign, you find out you are wrong: the park is warning kids not to eat turds left by dogs because dog turds cause blindness.

Elementary students served dog treats in Pennsylvania

Posted on June 10, 2014 by Douglas Powell

There was this one time, at Kansas State University, and me and student Katie were walking back from the lab with our dogs, on a Sunday afternoon, and president Wefald drove by, recognized me, and stopped for a chat.

Jon told us about his physical therapy, and how he was biking around campus every day for exercise, and how he loved dogs.

I told him about the salmonella-in-dog-food-outbreak-du-jour and how a bunch of people had gotten sick.

He recoiled and said, how would people get sick?

I explained cross-contamination and that some people eat pet food because it can be less expensive. Or maybe they like it. How the hell was I supposed to know?

During recess last Thursday afternoon, students at an elementary school in New Hanov, Penn., thought they were being handed a cookie, but it turned out to be dog treats served by a part-time aide.

An email was sent home to parents of students at New Hanover Upper Fredrick Elementary saying that their children were served dog treats that came from a pet store.

“I thought ‘wow, did I really eat dog treats? Something my own dog eats’?” one student said, who wished remain anonymous.

The aide who handed out to treats to students has been placed on administrative leave and was acting alone, school officials said in a statement.

“Our research on the product indicates that the treat ingredients would not be harmful to people, with exception for those individuals with specific food allergies,” the statement continued.

There are numerous on-going outbreaks of dangerous microorganisms in pet food because of a lack of microbial safety validation or sloppiness. And sometimes humans get sick too.

Norovirus common in children

Posted on March 22, 2013 by Douglas Powell

Norovirus infection has become the leading cause of acute gastroenteritis in children under 5 in the U.S.

Payne et al. report in The New England Journal of Medicine that norovirus infection leads to an estimated 14,000 hospitalizations, 281,000 emergency room visits, and 627,000 outpatient visits a year.

The virus causes severe stomach pain, nausea, diarrhea and vomiting. According to the Centers for Disease Control and Prevention, it leads to 800 deaths a year, but the vast majority of people infected recover completely.

For the new study, the researchers counted laboratory-confirmed cases in three United States counties in 2009 and 2010, so the sample may not be representative of the entire country. During that period, norovirus was confirmed in about 20 percent of cases of acute gastroenteritis in children. Infection with another virus, rotavirus, has become less common since the introduction of a rotavirus vaccine.

There is no vaccine and no cure for norovirus infection, and it is highly contagious. There are various strains of the virus, and some may be more potent than others.

Abstract below:

Background

Cases of rotavirus-associated acute gastroenteritis have declined since the introduction of rotavirus vaccines, but the burden of norovirus-associated acute gastroenteritis in children remains to be assessed.

Methods

We conducted active surveillance for laboratory-confirmed cases of norovirus among children younger than 5 years of age with acute gastroenteritis in hospitals, emergency departments, and outpatient clinical settings. The children resided in one of three U.S. counties during the years 2009 and 2010. Fecal specimens were tested for norovirus and rotavirus. We calculated population-based rates of norovirus-associated acute gastroenteritis and reviewed billing records to determine medical costs; these data were extrapolated to the U.S. population of children younger than 5 years of age.

Results

Norovirus was detected in 21% of young children (278 of 1295) seeking medical attention for acute gastroenteritis in 2009 and 2010, with norovirus detected in 22% (165 of 742) in 2009 and 20% (113 of 553) in 2010 (P=0.43). The virus was also detected in 4% of healthy controls (19 of 493) in 2009. Rotavirus was identified in 12% of children with acute gastroenteritis (152 of 1295) in 2009 and 2010. The respective rates of hospitalization, emergency department visits, and outpatient visits for the norovirus were 8.6, 146.7, and 367.7 per 10,000 children younger than 5 years of age in 2009 and 5.8, 134.3, and 260.1 per 10,000 in 2010, with an estimated cost per episode of $3,918, $435, and $151, respectively, in 2009. Nationally, we estimate that the average numbers of annual hospitalizations, emergency department visits, and outpatient visits due to norovirus infection in 2009 and 2010 among U.S. children in this age group exceeded 14,000, 281,000, and 627,000, respectively, with more than $273 million in treatment costs each year.

Conclusions

Since the introduction of rotavirus vaccines, norovirus has become the leading cause of medically attended acute gastroenteritis in U.S. children and is associated with nearly 1 million health care visits annually. (Funded by the Centers for Disease Control and Prevention.)

2 dead, 195 sick from Salmonella outbreak linked to mail-order chicks

Posted on October 30, 2012 by Douglas Powell

The pic, left, is from Sorenne’s pre-school yesterday.

The teachers-that-be decided at some point it was a good idea to get a chicken coup for the pre-school; I said it may be a bad idea, sent them a bunch of info about outbreaks, and left it at, you have to be a lot more careful than you thought.

There were some chickens in there for two weeks during spring break, and they came
from the grade 3 class across the road.

These are ducks; they came from one of the teachers, who fancies herself a bit of a foodie, but at least isn’t snobbish about it.

I asked if the ducks had pooped, because kids can’t be watched all the time in a 6-kid-1-teacher ratio.

Sorenne has taken to putting all sorts of things in her mouth and on the table when eating. I try to explain the be-the-bug concept; like today, Sorenne and I had lunch with a friend and his two pre-school daughters. They were putting flip-flops on the table; Sorenne was eating the menu. These are things kids do. The microbiological explanation didn’t go very far. The communal fries came with aioli dipping sauce, so I had to ask the café staff, how was the aioli made?

Raw eggs, but whole eggs.

Pasteurized or cooked?

No, raw.

I didn’t have any. Neither did Sorenne.

Kids will do all sorts of things, so platitudes about handwashing stations at petting zoos and washing hands when dealing with potentially risky things is nice but never enough.

The U.S. Centers for Disease Control reports a total of 195 persons infected with the outbreak strains of Salmonella Infantis, Salmonella Newport, and Salmonella Lille were reported from 27 states.

• 34% of ill persons were hospitalized;

• two deaths were reported; and,

• 33% of ill persons were children 10 years of age or younger.

Epidemiologic, laboratory, and traceback findings linked this outbreak of human Salmonella infections to contact with live poultry from Mt. Healthy Hatchery in Ohio.

Mail-order hatcheries, agricultural feed stores, and others that sell or display chicks, ducklings, and other live poultry should provide health-related information to owners and potential purchasers of these birds prior to the point of purchase. This should include information about the risk of acquiring a Salmonella infection from contact with live poultry.

8400 kids now sick in German outbreak; probably norovirus from single food source

Posted on September 29, 2012 by Douglas Powell

Last year it was sprouts that sickened some 4,400 and killed 53 in an outbreak centered in Germany; now the number of children that have fallen ill with vomiting and diarrhea after eating food from school cafeterias and daycare centers has risen from about 4,500 to 8,400.

Authorities in Berlin and the surrounding eastern German states reported the new gastroenteritis cases Saturday, while laboratory investigations to determine the exact cause of the outbreak were still under way.

Berlin’s health department says the sicknesses are moderate and most children recover within two days without requiring to be hospitalized.

That’s nice.

In Saxony state, at least 16 cases of norovirus, a mostly food- or water-borne illness, were proven, according to German news agency dapd.

The government-affiliated Robert Koch Institute said Friday that all facilities where the illness occurred likely received food from a single supplier.

196 sick with Salmonella; kids, step away from the turtle

Posted on September 21, 2012 by Douglas Powell

Kissing turtles remains a bad idea.

The U.S. Centers for Disease Control reports 196 people are infected with outbreak strains of Salmonella Sandiego, Salmonella Pomona, and Salmonella Poona in 31 states.

• 36 ill persons have been hospitalized, and no deaths have been reported;

• 63% of ill persons are children 10 years of age or younger, and 29% of ill persons are children 1 year of age or younger; and,

55% of ill persons are of Hispanic ethnicity. Information about the association between reptiles and Salmonella is now available in Spanish.

Results of the epidemiologic and environmental investigations indicate exposure to turtles or their environments (e.g., water from a turtle habitat) is the cause of these outbreaks.

Rate of dangerous E. coli in Irish children triples

Posted on July 28, 2012 by Douglas Powell

Irish Health reports 13 children in Ireland have been hit with hemolytic uremic syndrome, a life-threatening complication of shiga-toxin producing E. coli that affects the kidneys, so far this year.

Provisional figures show a 200% increase in the number of STEC cases in the first half of 2012 compared with the same period last year, according to Dr Kevin Kelleher, head of health protection in the Health Service Executive (HSE).

There have been 212 reports of people being infected by strains of E. coli O157 in the first six months of this year, compared to 69 for the same period in 2011.

Part of the increase is thought to be due to heavy rainfall contaminating private water supplies, others largely in child-care centers.

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