A study shows that detections of mild E. coli infections are increasing in Australia, leading to a review of how clinical testing is performed, which could lead to changes in the public health response.
In Queensland, 31 of 96 Shiga toxin-producing E. coli (STEC) cases were reported by specialist pathology laboratories for alternative health practitioners between 2020 and 2022.
In Australia, STEC is a notifiable disease when it is confirmed in a laboratory based on isolation by culture or detection of the Shiga toxin gene by nucleic acid testing of faeces. The national notification rate in 2022 was 3.2 cases per 100,000 people in Australia and 0.6 cases per 100,000 people in Queensland. All reported STEC cases are investigated to determine the source of infection.
The frequency of asymptomatic STEC cases in Queensland increased from 2% in 2018-2019 to 29% in 2022. Asymptomatic means no symptoms.
Scientists have found an increase in the number of cases being reported by Victoria’s Specialist Pathology Laboratories (SPL), which serves health care providers including alternative health practitioners such as naturopaths and nutritionists. discovered.
STEC case data were extracted from the Queensland Health Notifiable Conditions System database and case report forms from January 2020 to December 2022. The findings were published in the journal emerging infectious diseases.
STEC case management
SPL diagnosed STEC by performing multiplex PCR for enteric pathogens on patient fecal samples. His STEC confirmation and characterization of culture-positive isolates was subsequently performed by the University of Melbourne’s Microbial Diagnostics Division Public Health Laboratory.
The 31 patients reported to SPL were more likely to be female compared to other pathology laboratories. Of the 27 cases diagnosed with SPL, 23 out of 27 underwent stool testing at the request of an alternative health practitioner, naturopath, or nutritionist, and 4 were requested by a health care professional.
The remaining 65 cases were from other pathology laboratories that serve only healthcare professionals. Patients diagnosed at these laboratories were more likely to have symptoms, experience bloody diarrhea, and be hospitalized than patients diagnosed with SPL.
Hemolytic uremic syndrome (HUS) has also been reported in other pathology laboratory cases in children and the elderly from <1 year of age to 85 years of age. Serotypes O111, O157, O26, O145 and genes known to cause severe disease were higher in patients diagnosed by other pathology laboratories. Pathology laboratory.
This study provided insight into increased detection of mild STEC infections and changes in testing practices, including testing requests by alternative health practitioners.
“Management of STEC cases requires resources for tracing and testing of both symptomatic and asymptomatic patients and their contacts. As this study shows, reporting and testing of asymptomatic cases “Changes in practice suggest the need to revise existing guidelines for the management of STEC cases based on clinical symptoms, laboratory tests, risk group identification, and available resources,” the scientists say. I did.
Food irradiation consultation
Meanwhile, Food Standards Australia and New Zealand (FSANZ) is seeking comment on the food irradiation proposals.
The application by Steritech would limit the maximum energy level for machines producing X-rays used to irradiate food to 5 megaelectron volts ( We aim to increase the energy consumption from 7.5 MeV to 7.5 MeV.
According to Steritech, there is no change in the absorbed dose of radiation in food.
FSANZ believes that there are no safety concerns in irradiating currently permitted items to already approved absorbed doses. Existing requirements regarding mandatory labeling of irradiated foods continue to apply.
Regulations in the United States, Canada, and South Korea allow increasing the energy of electron beams to 7.5 MeV to produce X-rays and the use of tantalum or gold as X-ray target materials to irradiate food. .
The deadline for responses is March 15th. For more information, follow this link.
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