Hi Grain Cattle Diet Creates Need for Antibiotics

http://articles.mercola.com/sites/articles/archive/2001/06/13/cattle-drugs.aspx

Bird Flu, a Disease of Our Own Making

http://birdflubook.com/g.php?id=5

HIN1 GLOBAL UPDATE

PANDEMIC INFLUENZA (H1N1) (44): PAN AMERICAN HEALTH ORGANIZATION UPDATE
***********************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Mon 21 Jun 2010
Source: Pan American Health Organization (PAHO), Regional Update,
Pandemic (H1N1) 2009 [edited]



The information contained within this update is obtained from data
provided by Ministries of Health of Member States and National
Influenza Centers through reports sent to the Pan American Health
Organization (PAHO) or updates on their web pages.

Weekly Update:

- In North America, acute respiratory disease activity remained low.
- The Caribbean countries reported decreasing or unchanged trends in
acute respiratory disease.
- In Central America, Panama reported an unchanged trend in acute
respiratory disease.
- In South America, Bolivia, Colombia, and Venezuela reported
increasing trends of acute respiratory disease.
- From EW 1 to 23, 2010, El Salvador reported a predominance of
influenza type B, while Cuba, Jamaica, Mexico, and Panama reported
predominately influenza type A. Paraguay reported a predominance of
respiratory syncytial virus.
- 23 new confirmed deaths in 3 countries were reported; in total,
there have been 8450 cumulative confirmed deaths in 28 countries of the region.

I - Evolution of the pandemic

North America

In the United States (1), the traditional influenza season ended in
EW 20. In EW 23, the proportion of outpatient consultations for
influenza-like illness (ILI) continued to remain below the national
baseline, and all sub-national surveillance regions reported the
proportion of outpatient visits for ILI to be below their
region-specific baseline. The proportion of deaths attributed to
pneumonia and influenza was below the epidemic threshold. No
influenza-associated pediatric deaths were reported this week.

Caribbean

Jamaica reported widespread influenza activity; Cuba reported
regional influenza activity; and Dominica and Dominican Republic
reported no influenza activity. Cuba reported a decreasing trend in
acute respiratory disease, while the other 3 countries reported an
unchanged trend. All of these countries reported low/moderate
intensity of acute respiratory disease and low impact of acute
respiratory disease on health care services.

Central America

Panama reported no influenza activity, an unchanged trend in acute
respiratory disease, low/moderate intensity of acute respiratory
disease, and low impact of acute respiratory disease on health care services.

South America

Andean

Bolivia, Colombia, Peru, and Venezuela reported regional influenza
activity, while Ecuador reported no influenza activity. Bolivia
reported a new increasing trend in acute respiratory disease, while
Colombia and Venezuela have reported 2 and 3 consecutive weeks of
increasing trends in acute respiratory disease, respectively. Ecuador
and Peru reported unchanged trends in acute respiratory disease. All
countries reported low/moderate intensity of acute respiratory
disease and low impact of acute respiratory disease on health care services.

In Bolivia (2), nationally, the number of cases of acute respiratory
infection (ARI) remained within the endemic channel, however, in the
department of Pando, the number of ARI cases passed the epidemic
threshold in EW 23.

In Peru (3), in EW22, nationally, the number of pneumonia cases in
children under 5 years of age was below the epidemic threshold, while
in the southern department of Moquegua, it was above the threshold.

Southern Cone

Brazil and Chile reported regional influenza activity, unchanged
trends in acute respiratory disease, and low/moderate intensity of
acute respiratory disease.

In Chile (4), nationally, consultations for ILI remained low and
within the endemic channel. At the regional level, 10 regions
reported low ILI activity, one reported moderate ILI activity, one
reported high ILI activity, and 3 reported no ILI activity.

References:

1. US Surveillance Summary. Week 23. Centers for Disease Control and
Prevention.
2. Weekly notification of the situation of the pandemic of influenza
A (H1N1) - Bolivia, EW 23
3. Peru, EW 22,
4. Chile, Situation Report, 16 Jun 2010.

[The remaining sections of this document, "II - Description of
hospitalizations and deaths among confirmed cases of pandemic (H1N1)
2009," and "III - Viral circulation," contain maps, graphs and
tabulated data. Interested readers should access the original pdf
file via the URL at the top of this report. - Mod.CP]

--
Communicated by:
ProMED-mail Rapporteur Marianne Hopp

[see also:
Influenza pandemic (H1N1) (43): WHO update 105 20100619.2059
Influenza pandemic (H1N1) (42): reassortment, swine 20100618.2055
Influenza pandemic (H1N1) (41): New Zealand 20100618.2042
Influenza pandemic (H1N1) (40): WHO update 104 20100612.1970
Influenza pandemic (H1N1) (39): WHO update 103 20100605.1867
Influenza pandemic (H1N1) (38): WHO 20100603.1841
Influenza pandemic (H1N1) (37): Guillain-Barre syndrome risk 20100602.1837
Influenza pandemic (H1N1) (36): WHO update & seasonal 20100530.1798
Influenza pandemic (H1N1) (35): Singapore 20100530.1795
Influenza pandemic (H1N1) (34): Indian variants 20100525.1741
Influenza pandemic (H1N1) (33): WHO update, corr. 20100527.1765
Influenza pandemic (H1N1) (32): WHO update 20100501.1418
Influenza pandemic (H1N1) (31): UK (Scotland) D222G mut 20100422.1310
Influenza pandemic (H1N1) (30): WHO update 20100417.1250
Influenza pandemic (H1N1) (20): China, update 20100303.0702
Influenza pandemic (H1N1) (10): PAHO update 20100121.0240
Influenza pandemic (H1N1) (01): China, 2009 20100105.0040
2009
----
Influenza pandemic (H1N1) 2009 (126): PAHO, North Korea 20091209.4200
Influenza pandemic (H1N1) 2009 (108): PAHO update 20091118.3981
Influenza pandemic (H1N1) 2009 (88): PAHO update 20091104.3813]
..................................................cp/msp/dk

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using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
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SALMONELLOSIS, SEROTYPE HVITTINGFOSS - USA: (ILLINOIS) RESTAURANT CHAIN

************************************************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


[1]
Date: Tue 8 Jun 2010
Source: WIFR [edited]



Salmonellosis linked to Subway restaurants continues to plague the
state line with 2 cases now reported in Winnebago County. Those who
got sick ate at a Subway in Machesney Park. That now brings the total
to 60 cases of salmonellosis related to this outbreak in Illinois.
Normally this specific serotype is only seen in one or two cases a
year in the state.

Although health investigators say the bacterium has not yet been
linked to a specific product, they're narrowing it down by comparing
similar items that the infected people ate. In fact, Subway has
voluntarily replaced all its lettuce, green peppers, red onion, and
tomatoes, with fresh produce.

The illnesses are reported to have started between 11 and 25 May 2010.
Leaders with the Winnebago County Health Department say people who
choose to eat at Subway now should be safe.

"All the food products that are in question that the state has worked
with Subway, that are under question, have been pulled. Those products
are no longer in the stores. I would say that it is alright to go eat
at a Subway," says Sue Fuller, Public Information Officer with the
Winnebago County Health Department. Fuller says salmonellosis is not
typically deadly. But symptoms include diarrhea, vomiting, fever and
stomach cramps. Salmonellosis usually develops within 72 hours after
being exposed to the bacterium and can last up to a week.

[Byline: Lauren Kravets]

--
Communicated by:
ProMED-mail


******
[2]
Date: Mon 7 Jun 2010
Source: QRS Web [edited]



Certain Subway restaurants in 14 Illinois counties have been linked to
a salmonellosis outbreak involving the rare strain [serotype]
Hvittingfoss. The Illinois Department of Public Health and local
health departments throughout the state are investigating the cause of
salmonellosis among customers who ate at certain Subway restaurants in
Illinois. To date, 34 cases of salmonella have been confirmed with
this outbreak and all are recovering, of which 14 had been hospitalized.

Salmonella cases identified in this outbreak reported eating at Subway
locations in the following counties: Sangamon, Schuyler, Christian,
Bureau, LaSalle, Cass, Champaign, Peoria, Shelby, Warren, Macon, Ogle,
Fulton, and Tazewell. At this point in the investigation, no cases
have reported eating at Subway restaurants in either northeastern or
southernmost portions of Illinois. Illnesses are reported to have
started between 14 May and 25 May 2010 and cases range in age from 6
to 88 years old.

"We are aware of the investigation currently being conducted by the
State of Illinois Department of Public Health and are cooperating
fully as they attempt to pinpoint the exact product in question and
its origin," the company said. "The Subway brand will continue to work
with the Department of Health to assist in pinpointing the exact cause
of the outbreak."

[Byline: Christa Hoyland]

--
Communicated by:
ProMED-mail


[It can be difficult to pinpoint the initial vehicle of the enteric
pathogen if it is generally served in combination with others on a
sandwich or salad.

A 2005 outbreak (42 cases) of _S._ Hvittingfoss infection involving
several states in Australia was mentioned in a 2007 background
posting. The outbreak was associated with contaminated fruits or
vegetables. (Salmonellosis, eggs - Australia (QLD) (02): background
20070305.0771)

An earlier Australian outbreak of _S._ Hvittingfoss occurred in those
who had attended a private party in Brisbane in August 1997. There
were approximately 30 guests, 15 of whom allegedly became ill. The
party was a "bring-your-own-plate affair", and because of the range of
foods available and the time interval between the party and the
detection of this cluster, no further follow up was possible or
feasible. (Salmonella infections - Australia (Brisbane) 19970926.2021)
- Mod. LL]

[Illinois can be located on the HealthMap/ProMED-mail interactive map
of the US at
.
The counties mentioned can be seen on the map at
. - Sr.Tech.Ed.MJ]

[see also:
Salmonellosis, serotype Newport - USA (02): sprouts, alert, recall
20100604.1855
Salmonellosis, serotype Newport - USA: sprouts, alert, recall 20100522.1701
Salmonellosis, salami - USA (07): black & red pepper 20100313.0804
Salmonellosis, salami - USA: alert, recall 20100124.0270
2008
----
Salmonellosis, restaurant - USA: (TX), novel trans. vehicle 20081020.3323
Salmonellosis, serotype Saintpaul, tomatoes - USA (17): peppers 20080903.2759
Salmonellosis, serotype Saintpaul, tomatoes - USA: multistate 20080603.1777
2007
----
Salmonellosis, antibiotic resistant - USA: (AZ), RFI 20071213.4014
Salmonellosis, frozen poultry pie - USA (multistate) (09) 20071119.3748
Salmonellosis, frozen poultry pie - USA (multistate): alert 20071010.3319
Salmonellosis, serotype Wandsworth - N America (05): 2nd serotype
20070721.2336
Salmonellosis, serotype Tennessee, peanut butter - USA
(multistate)(17) 20070603.179620070329.1084
Salmonellosis, serotype Newport, Mexican-style cheese - USA (IL) (02)
20070329.1084
Salmonellosis, serotype Newport, Mexican-style cheese - USA (IL) 20070324.1027
Salmonellosis, serotype Oranienburg - USA (AZ) 20070305.0779
Salmonellosis, serotype Tennessee, peanut butter - USA (multistate)
20070215.0563
Salmonellosis, meat slicer - USA (GA) (02): 2006 20070116.0217
Salmonellosis, meat slicer - USA (GA): 2006 20070116.0208]
........................................sb/ll/mj/jw
*##########################################################*
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ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
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WHO / H1N1 scandal exposed

Advisors received kickbacks from H1N1 vaccine manufacturers
by Mike Adams, the Health Ranger, NaturalNews Editor

(NaturalNews) A stunning new report reveals that top scientists who convinced the World Health Organization (WHO) to declare H1N1 a global pandemic held close financial ties to the drug companies that profited from the sale of those vaccines. This report, published in the British Medical Journal, exposes the hidden ties that drove WHO to declare a pandemic, resulting in billions of dollars in profits for vaccine manufacturers.

Several key advisors who urged WHO to declare a pandemic received direct financial compensation from the very same vaccine manufacturers who received a windfall of profits from the pandemic announcement. During all this, WHO refused to disclose any conflicts of interests between its top advisors and the drug companies who would financially benefit from its decisions.

All the kickbacks, in other words, were swept under the table and kept silent, and WHO somehow didn’t think it was important to let the world know that it was receiving policy advice from individuals who stood to make millions of dollars when a pandemic was declared.

WHO credibility destroyed
The report was authored by Deborah Cohen (BMJ features editor), and Philip Carter, a journalist who works for the Bureau of Investigative Journalism in London. In their report, Cohen states, “…our investigation has revealed damaging issues. If these are not addressed, H1N1 may yet claim its biggest victim — the credibility of the WHO and the trust in the global public health system.”

In response to the report, WHO secretary-general Dr Margaret Chan defended the secrecy, saying that WHO intentionally kept the financial ties a secret in order to “…protect the integrity and independence of the members while doing this critical work… [and] also to ensure transparency.”

Dr Chan apparently does not understand the meaning of the word “transparency.” Then again, WHO has always twisted reality in order to serve its corporate masters, the pharmaceutical giants who profit from disease. To say that they are keeping the financial ties a secret in order to “protect the integrity” of the members is like saying we’re all serving alcohol at tonight’s AA meeting in order to keep everybody off the bottle.

It just flat out makes no sense.

But since when did making sense have anything to do with WHO’s decision process anyway?

Even Fiona Godlee, editor of the BMJ, had harsh words for the WHO, saying, “…its credibility has been badly damaged. WHO must act now to restore its credibility.”

Yet more criticism for WHO
The BMJ isn’t the only medical publication criticizing WHO for its poor handling of conflicts of interest. Another report from the Council of Europe Parliamentary Assembly also criticized WHO, saying: “Parliamentary Assembly is alarmed about the way in which the H1N1 influenza pandemic has been handled, not only by the World Health Organization (WHO), but also by the competent health authorities at the level of the European Union and at national level.” It went on to explain that WHO’s actions led to “a waste of large sums of public money, and also unjustified scares and fears about health risks faced by the European public at large.”

The funny thing is, NaturalNews and other natural health advocates told you all the same thing a year ago, and we didn’t have to spend millions of dollars on a study to arrive at this conclusion. It was obvious to anyone who knows just how corrupt the sick-care industry really is. They’ll do practically anything to make more money, including bribing WHO scientific advisors and paying them kickbacks once the vaccine sales surge.

The vaccine industry and all its drug pushers are, of course, criticizing this investigative report. They say WHO “had no choice” but to declare a pandemic and recommend vaccines, since vaccines are the only treatment option for influenza. That’s a lie, of course: Vitamin D has been scientifically proven to be five times more effective than vaccines at preventing influenza infections, but WHO never recommended vitamin D to anyone.

The entire focus was on pushing more high-profit vaccines, not recommending the things that would actually help people the most. And now we know why: The more vulnerable people were to the pandemic, the more would be killed by H1N1, thereby “proving” the importance of vaccination programs.

People were kept ignorant of natural remedies, in other words, to make sure more people died and a more urgent call for mass vaccination programs could be carried out. (A few lives never gets in the way of Big Pharma profits, does it?)

How the scam really worked
Here’s a summary of how the WHO vaccine scam worked:

Step 1) Exaggerate the risk: WHO hypes up the pandemic risk by declaring a phase 6 pandemic even when the mortality rate of the virus was so low that it could be halted with simple vitamin D supplements.

Step 2) Urge countries to stockpile: WHO urged nations around the world to stockpile H1N1 vaccines, calling it a “public health emergency.”

Step 3) Collect the cash: Countries spend billions of dollars buying and stockpiling H1N1 vaccines while Big Pharma pockets the cash.

Step 4) Get your kickbacks: WHO advisors, meanwhile, collected their kickbacks from the vaccine manufacturers. Those kickbacks were intentionally kept secret.

Step 5) Keep people afraid: In order to keep demand for the vaccines as high as possible, WHO continued to flame the fears by warning that H1N1 was extremely dangerous and everybody should continue to get vaccinated. (The CDC echoed the same message in the USA.)

This is how WHO pulled off one of the greatest vaccine pandemic scams in the last century, and it worked like gangbusters. WHO advisors walked away with loads of cash, the drug companies stockpiled huge profits, and the taxpayers of nations around the world were left saddled with useless vaccines rotting on the shelves that will soon have to be destroyed (at additional taxpayer cost, no doubt) or dumped down the drain (where they will contaminate the waterways).

Meanwhile, nobody dared tell the public the truth about vitamin D, thereby ensuring that the next pandemic will give them another opportunity to repeat the exact same scam (for yet more profit).

The criminality of the vaccine industry
The bottom line is all this is a frightening picture of just how pathetic the vaccine industry has become and how corrupt the WHO and the CDC really are. What took place here is called corruption and bribery, folks. Kickbacks were paid, lies were told and governments were swindled out of billions of dollars. These are felony crimes being committed by our global health leaders.

The real question is: Why do governments continue to allow public health organizations to be so easily corrupted by the vaccine industry? And who will stand up to this profit conspiracy that exploits members of the public as if they were profit-generating guinea pigs?

The next time you hear the WHO say anything, just remember: Their advisors are on the take from the drug companies, and just about anything you’re likely to hear from the World Health Organization originates with a profit motive rather than a commitment to public health.

Oh, and by the way… for the record, there has never been a single scientific study ever published showing that H1N1 vaccines worked. Not only was the H1N1 pandemic a fraud to begin with, but the medicine they claimed treated it was also based on fraud. And now we know the rest of the story of why it was all done: Kickbacks from Big Pharma, paid to advisors who told WHO to declare a pandemic.

(C) 2010 Mike Adams


http://farmwars.info/?p=3062

SALMONELLOSIS, SEROTYPE 4,[5],12:i:- - EUROPEAN UNION

See First: Salmonellosis a Biological Weapon of Mass Destruction
http://www.globalsecurity.org/wmd/intro/bio-salmonella.htm

****************************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


[1]
Date: Thu 3 Jun 2010
Source: Eurosurveillance [edited]



Infections with _Salmonella enterica_ account for the 2nd largest
burden of bacterial gastrointestinal disease in the European Union
(EU) (1). The majority of _Salmonella_ infections result in mild,
self-limited illness and may not require treatment with
antimicrobials. Nevertheless, treatment with an appropriate
antimicrobial can be life-saving in immunocompromised patients and in
invasive disease, such as Salmonella bacteraemia and meningitis.

Serotyping according to the Kauffmann-White scheme is a widely used
method for the initial characterisation of Salmonella isolates and is
based on the antigenic variability of the somatic (O) and flagellar
(H) antigens present in the cell wall of the organism (2). Despite
identification of more than 2500 different serovars [serotypes -
Mod.LL], the majority of cases of human infection are caused by a
limited number of serovars. Most serovars are biphasic and express 2
distinct flagellar antigens encoded by fliC (phase-1 flagellin) and
fljB (phase-2 flagellin). However, some serovars fail to express
either the phase-1 or phase-2 flagellar antigen, therefore are
classed as monophasic.

_S. enterica_ serovar 4,[5],12:i:- is considered a monophasic variant
of serovar Typhimurium (4,[5],12:i:1,2) due to antigenic and
genotypic similarities between the 2 serovars (3,4). Serovar
Typhimurium is the 2nd most common serovar associated with human
cases of salmonellosis in the EU (1). In contrast, isolates of
serovar 4,[5],12:i:- were rarely identified before the mid-1990s but
are now among the top 10 most common serovars isolated from humans in
several countries (3-8). According to Enter-net data, this serovar
was the 4th most common serovar in confirmed cases of human
salmonellosis in the EU in 2006 (1). Cases of infection with serovar
4,[5],12:i:- have reportedly been severe, with a 70 percent
hospitalization rate during an outbreak in New York City in 1998 (9),
although a much lower rate of 21 percent was observed during an
outbreak in Luxembourg in 2006 (6). Infections have also been
particularly associated with cases of septicemia in Thailand and
Brazil (7,10). Overall, cases of infection have been linked to a
number of sources, including poultry and cattle, but particularly
pigs and pork products (4,6,10-13). Serovar 4,[5],12:i:- was among
the top 10 most common serovars isolated from both pigs and pig meat
in the EU in 2006 (1).

A marked increase in prevalence of _S. enterica_ serovar 4,[5],12:i:-
with resistance to ampicillin, streptomycin, sulphonamides and
tetracyclines (R-type ASSuT) has been noted both in food-borne
infections and in pigs/pig meat in several European countries over
the last 10 years (6,8,14,15). In the baseline study from fattening
pigs (Commission Decision 2006/668/EC), Spanish strains of _S.
enterica_ serovar 4,[5],12:i:- represented 14.3 percent of the
isolates, 52.5 percent of which were of R-type ASSuT (VISAVET
Salmonella database, unpublished data). In England and Wales cases of
serovar 4,[5],12:i:- infection have risen from 47 in 2005 to 151 in
2009 (a 321 percent increase) against a backdrop of an overall
decrease in the number of salmonellosis cases, with R-type ASSuT
accounting for approximately 30 percent of these strains (Health
Protection Agency (HPA) Salmonella database, unpublished data). In
France isolations of serovar 4,[5],12:i:- increased from 99 to 410
between 2005 and 2008 to become the 3rd most common serovar isolated
from humans, with 62 percent of strains in 2007 being of R-type ASSuT
(16). In Italy cases of serovar 4,[5],12:i:- infection have risen
from 59 in 2003 to 641 in 2009, with 75 percent of monophasic strains
isolated in 2009 belonging to R-type ASSuT (with or without
additional resistances) (Istituto Superiore di Sanita Salmonella
database, unpublished data). A recent study described emergence of a
clonal group of serovar Typhimurium and 4,[5],12:i:- R-type ASSuT
strains in Italy, Denmark and the United Kingdom (UK) (17).
Resistance genes blaTEM-1, strA-strB, sul2 and tet(B) encoding
resistance to ampicillin, streptomycin, sulphonamides and
tetracyclines were localised on the bacterial chromosome. On the
basis of resistance gene content and the lack of class 1 integrons,
these observations have suggested the existence of a new resistance
island that differs from the Salmonella Genomic Island-1 (17).

In response to the rapid increase in the frequency of _S. enterica_
serovar 4,[5],12:i:-, R-type ASSuT strains, isolates from England and
Wales, Germany, France, Italy, Poland, Spain and the Netherlands were
compared using phage typing, resistance gene characterization,
pulsed-field gel electrophoresis (PFGE) and multilocus variable
number tandem repeat (MLVA) analysis to evaluate the possibility of
clonal spread of this emerging multidrug-resistant (MDR) strain.

Methods and Materials [can be found at original URL. - Mod. LL]

Results
--------
Some 122 serovar 4,[5],12:i:- isolates were sent to the HPA
Laboratory of Gastrointestinal Pathogens, of which 116 were confirmed
as serovar 4,[5],12:i:-. These comprised 41 from England and Wales
(20 from pigs and 21 from humans, including 3 from patients with a
history of recent travel to Thailand, Greece and an undisclosed
destination), 10 isolates from France (isolated from pig meat), 19
from Germany (12 from pigs, 6 from pig meat and one from a human), 23
from Italy (from humans), 5 from Poland (from humans), 8 from Spain
(from pigs) and 10 from the Netherlands (7 from human cases of
infection; 3 from pigs). The H:1,2 phase-2 flagellar antigen could be
serologically detected in the remaining 6 isolates.

Phage typing using the Typhimurium typing phages identified 16
different PTs (Table 1 - for tables, see original URL - Mod.LL). The
most commonly identified PTs were DT193 (51 isolates), DT120 (27
isolates) and RDNC (reacts but does not conform; 11 isolates). DT193
was the most common PT identified in England and Wales, France,
Germany, Spain and the Netherlands, while DT120 predominated in Italy
and Poland. All 116 isolates were PCR-positive for the
Typhimurium-specific fragment of the malic acid dehydrogenase gene
but only 4 isolates (one belonging to DT104, two to PT U302 and one
untypable) gave a product with primers targeting the 16S to 23S
spacer region specific to DT104 and the related PT U302 (19).

Overall, 94 of 116 isolates were PCR-negative for all variants of the
fljB gene coding for the phase-2 flagellar antigen, including 48 of
51 DT193 and 17 of 27 DT120 isolates. H:1,2-specific amplicons were
detected in the remaining 22 isolates.

84 isolates (72 percent) expressed resistance to ampicillin,
streptomycin, sulphonamides and tetracyclines (R-type ASSuT), with or
without additional resistance(s) (Table 2). Six isolates were fully
sensitive to all antimicrobials in the test panel. 83 of 92
ampicillin-resistant iolates carried blaTEM, 85 of 96
streptomycin-resistant isolates carried strA-strB, 88 of 99
sulphonamide-resistant isolates carried sul2 and 93 of 105
tetracycline-resistant isolates carried tet(B) (data not shown). Of
84 R-type ASSuT strains, 68 possessed blaTEM, strA-strB, sul2 and
tet(B) resistance genes. 82 percent of RDNC isolates, 80 percent of
DT193 and 74 percent of DT120 were of R-type ASSuT (with/without
additional resistance(s)), with resistance encoded by genes blaTEM,
strA-strB, sul2 and tet(B) in 78 percent, 75 percent and 56 percent
of isolates respectively. Isolates of R-type ASSuT were negative for
both class 1 and 2 integrase genes; these were found only in strains
expressing resistance to aminoglycosides and/or trimethoprim. Among
the remaining 16 R-type ASSuT strains from the present study that did
not carry blaTEM, strA-strB, sul2 and tet(B), 11 strains lacked only
one of tet(B), blaTEM-1 or sul2, one strain each lacked blaTEM-1 and
tet(B) or strA-strB and tet(B), one strain lacked blaTEM-1, strA-strB
and sul2 and one strain lacked all 4 genes. These strains belonged to
phage types DT120 (5 strains), DT193 (4 strains), RDNC (2 strains),
and one each belonged to phage types DT104, DT18 variant, U302, U311
and UT.

PFGE analysis and MLVA typing [can be seen at the original URL - Mod.LL]

Discussion
----------
Antimicrobial resistance is a serious public health problem limiting
the therapeutic options available to clinicians treating complicated
salmonellosis. In recent years there has been an overall decline in
the level of resistance in serovar Typhimurium in several European
countries as a result of a reduction in the number of isolates of
penta-resistant DT104 (14). To some extent this reduction has been
counteracted by an increase in prevalence of serovar 4,[5],12:i:-
isolates expressing resistance to ampicillin, streptomycin,
sulphonamides and tetracyclines (8,17).

One of the 1st reports of serovar 4,[5],12:i:- in Europe was of an
isolate grown in the late 1980s from a chicken carcass in Portugal
(26). This serovar emerged in Spain in strains from humans and pork
or pork products during 1997, and subsequently became the 4th most
common Salmonella serovar identified from 1998 to 2000 (11). All
isolates belonged to phage type U302. These isolates were classed as
monophasic variants of serovar Typhimurium due to presence of an
IS2000 fragment located in a Typhimurium-specific location within the
fliB-fliA intergenic region and amplification of a Typhimurium DT104-
and U302-specific region (3). All 116 monophasic isolates in this
study harboured the Typhimurium-specific fragment of the malic acid
dehydrogenase gene, suggesting that these strains are monophasic
variants of serovar Typhimurium. However, the majority (97 percent)
were negative for the DT104- and U302-specific region, suggesting
that these monophasic isolates may not be related to the serovar
4,[5],12:i:- strain(s) that emerged in Spain. This was confirmed by
phage typing, which identified DT193 as the most common PT, followed
by DT120, thereby adding to the diversity of phage types of serovar
4,[5],12:i:- linked to serovar Typhimurium. DT193 and DT120 have
consistently fallen within the top 5 phage types of serovar
Typhimurium from cases of human infection in England and Wales in
recent years (HPA Salmonella database, unpublished data). It is
plausible that at least some of this increase may be attributed to
the emergence of serovar 4,[5],12:i:- DT193 and DT120 strains.
Putative Typhimurium isolates sent from primary diagnostic
laboratories to the HPA Salmonella Reference Unit are only
phage-typed and not routinely subjected to further serological
examination. This may result in misclassification as serovar
Typhimurium and under-reporting of this serovar in England and Wales,
and in other countries where phage typing is used in lieu of full
serotyping to identify strains as serovar Typhimurium. Serovar
4,[5],12:i: DT193 strains have previously been isolated from human
cases of infection and/or pigs in Luxembourg and Spain (6,13), while
monophasic DT120 strains were identified in Italy (8).

The Spanish PT U302 serovar 4,[5],12:i:- strains were PCR-negative
for H:1,2 (11), as were the majority (81 percent) of monophasic
isolates in this study. Previous published work has shown that the
lack of phase-2 flagellar expression may be due to different
mutations (including point mutations) and partial or complete
deletions in fljB and adjacent genes (4,27). Monophasic strains in
which the phase-2 flagellar antigen is not detected serologically but
can be detected by PCR may contain deletions in a part of fljB that
leave the H:1,2-specific PCR primer binding sites intact, or they may
represent "serotype inconsistent" strains (27). These are serovar
Typhimurium strains in which serological detection of the phase-2
flagellar antigen may be inconsistent. This may be due to problems
with flagellar phase reversal, which is a time-consuming and
technically demanding procedure that may result in misclassification
of Typhimurium strains as serovar 4,[5],12:i:-. Alternatively, the
invertible promoter controlling expression of fljB and fliC may have
become locked in one position allowing only expression of fliC in
these strains (4). The range of mechanisms that can result in
non-expression of the phase-2 flagellar antigen make definitive
identification of serovar 4,[5],12:i:- problematic. It is possible
that molecular serotyping could be used as a basis to define such
strains as serovar 4,[5],12:i:- or Typhimurium, but as yet such
methods lack standardisation, are not in place in most countries and
may not be suitable for laboratories other than reference facilities.
Given that there may be discrepancy in detection of the phase-2
flagellar antigen between classical and molecular serotyping, an
international agreement both on the definition of monophasic strains
and on detection methodology is required. Without reaching such a
consensus the true incidence of such Typhimurium-like strains is
difficult to assess; only the harmonisation and the sharing of
methods will allow accurate comparison of reported data.

In contrast to the monophasic variants isolated in Thailand and
Spain, which commonly expressed additional resistance to gentamicin
and trimethoprim-sulphamethoxazole and/or chloramphenicol (10,11) and
to serovar 4,[5],12:i:- strains isolated in Brazil and New York City,
which were infrequently MDR (7,9), the countries participating in
this study observed an increase in isolates of serovar 4,[5],12:i:-
with resistance to ampicillin, streptomycin, sulphonamides and
tetracyclines only. Characterisation of the resistance genes
responsible for this phenotype identified blaTEM, strA-strB, sul2 and
tet(B) in 81% of isolates. Such genes have also been identified in
isolates of Typhimurium DT193 R-type ASSuT obtained during 2005 in
England and Wales from raw beef and a human case of infection,
although the majority of strains tested harboured tet(A) rather than
tet(B) (unpublished data). Analysis of a 10 kb chromosomal region of
a Typhimurium DT193 revealed the presence of an
strB-strA-sul2-repC-repA region derived from plasmid RSF1010 located
upstream of blaTEM-1 and downstream of a class 1 integron [28]. The
resistance genes encoding the tetra-resistant phenotype in isolates
of serovars Typhimurium and 4,[5],12:i:- from Italy, Denmark and the
UK were also identified as blaTEM-1, strA-strB, sul2 and tet(B), but
all isolates were negative for class 1 integrons (17). Transfer
experiments were unsuccessful and probes specific for these genes
bound to a 750 kb I-CeuI digest fragment, suggesting a chromosomal
location and existence of a new resistance island. As in the present
study, strains with other R-types than ASSuT, but with related PFGE
profiles and harbouring one or more of blaTEM-1, strA-strB, sul2 and
tet(B) were identified. This suggests that rearrangements or
deletions may occur within the resistance island leading to partial
resistance patterns [17]. In contrast, resistance to ampicillin,
streptomycin, sulphonamides and tetracyclines was mediated by
plasmid-borne blaTEM-1 and tet(A), and a class 1 integron harboring
aadA2 and sul1 in the Spanish serovar 4,[5],12:i:- U302 isolates (29).

[Discussion on PFGE and MLVA typing can be found at the original URL. - Mod.LL]

The data presented here suggest that a serovar 4,[5],12:i:- DT193
R-type ASSuT clone with PFGE profile STYMXB.0131 has emerged from
serovar Typhimurium and spread within several European countries,
with pigs as a likely reservoir of infection. Isolates of serovar
4,[5],12:i:- DT120 R-type ASSuT with closely related PFGE profiles
were identified in humans and pigs from 5 of the participating
countries. The diversity of PFGE and MLVA profiles within serovar
4,[5],12:i:- DT193 and DT120 R-type ASSuT isolates, and the
differences between these isolates and those previously described in
Spain (30), suggests that serovar 4,[5],12:i:- is likely to represent
several clones or strains that have emerged independently from
serovar Typhimurium. Recent genotypic studies have shown that in
addition to the Spanish 4,[5],12:i- clone, other 4,[5],12:i:-
lineages exist (27).

In the 1st 10 months of 2009, DT193 and DT120 accounted for 18
percent and 11 percent of Typhimurium isolates in England and Wales,
respectively. In contrast, DT104 accounted for only 7 percent of
Typhimurium isolates (HPA Salmonella database, unpublished data).
Serovar 4,[5],12:i:- has already caused substantial outbreaks in
several countries, with reports of severe infections and also deaths
(6,7,9,10). In order to prevent a global epidemic of these newly
emerging clones or strains, as occurred with Typhimurium DT104,
appropriate intervention strategies need to be put in place as soon
as possible, particularly in pig husbandry throughout the EU.

[References can be found at original URL. - Mod.LL]

[Authors: Hopkins KL, Kirchner M, Guerra B, et al]

--
Communicated by:
ProMED-mail

*****
[2] France (dried sausage)
Date: Sat 5 Jun 2010
Source: eFoot Alert [edited]



An outbreak of salmonellosis due to salmonellosis (serotype 4,12:i:-)
was traced late in May 2010 to contaminated dried sausages produced
by the French sausage company Salaisons du Lignon, based in
Saint-Maurice de Lignon (Haute Loire).

The outbreak, which was still under investigation as of 28 May 2010,
has sickened at least 88 people, 18 severely enough to require
hospital treatment, in 49 departements throughout France. Illnesses
were reported between 15 Mar and 9 May 2010.

This particular Salmonella Typhimurium-like serotype 1st appeared in
Europe in the mid 1990s; it now has become the 2nd most common type
of salmonellosis reported by European Union member countries. Cases
of salmonellosis associated with this type tend to be more severe
than average, and result in a higher rate of hospitalization than is
usual.

Based on patient interviews, investigators from France's Institut de
Veille Sanitaire traced the outbreak to a single production lot of
Lou Montagnard brand La Pause Auvergnate style dried sausages
(saucisses seches droites nature La Pause Auvergnate). Salaisons du
Lignon recalled the implicated production lot (Lot No. 040020900)
distributed both in France and in Belgium on 27 May 2010.

Yesterday (4 Jun 2010), without fanfare or explanation, Salaisons du
Lignon expanded its recall in Belgium, but not yet in France, to
encompass all product expiration dates up to and including 24 Aug
2010. There have been no published reports of salmonellosis cases in
Belgium that are tied to the French outbreak.

--
Communicated by:
ProMED-mail

[This discussion is taken from Salmonellosis, frozen poultry pie -
USA (multistate)(04): recall 20071013.3355:

As readers will note from past outbreaks of salmonellosis, the
specific organism involved is usually referred to as _Salmonella
enterica_ followed by its serotype (or serovar) name such as _S.
enterica_ serotype Tennessee. Serotype Tennessee was associated with
the well-publicized USA-wide peanut butter-associated outbreak
affecting more than 600 people.

As discussed by Ana Paccagnella (supervisor of the Enteric
Bacteriology Section at the British Columbia Centre for Disease
Control),
,
_Salmonella_ as a genus has 2 species, _enterica_ and _bongori_. _S.
enterica_ is divided into 6 subspecies: _enterica_, _salamae_,
_arizonae_, _diarizonae_, _houtenae_ and _indica_. _S. enterica_
subspecies _enterica_ (or subspecies I) strains are the ones usually
isolated from humans or warm-blooded animals and represent a majority
of the salmonellas that are clinically important.

The designation _Salmonella_ I 4,[5],12:i:- means:
- the "I" reflects subspecies _enterica_;
- the "4, [5], 12" are the O (or somatic) antigens associated with
the organism; It should be noted that serotype Typhimurium carries
somatic antigens 4, 5 and 12 (the Group B antigens). Paccagnella
pointed out to me in an email that an O antigen underscored or placed
in [ ] can refer to whether the antigen is related to phage
conversion or not.
- the nomenclature after the colon, in this case i:-, reflect the
flagellar or H antigens. It is these H antigens that define the
serotype identity within an individual group of salmonellae.

Almost all of these organisms are biphasic in regard to the H
antigens, that is, they can switch from 1 flagellar antigen to
another. As an example, _S._ Typhimurium is I 4, 5, 12:i:1,2. The
outbreak organism here, however, is monophasic. Echeita and
colleagues (1) have found that this monophasic strain appears to be
such due to the absence of the _flj_B gene which is involved in the H
antigen switching mechanism. According to Paccagnella, around 1903
Smith and Reagh reported on the different behavior of the flagellar
and somatic antigens of salmonella strains. Their work was mostly
ignored until Weil and Felix, working on _Proteus_ cultures, noted 2
forms, the swarming form called the H form (_mit Hauch_, in English:
with breath) and the non-swarming form, called the O form (_ohne
Hauch_, in English: without breath). The H form contained both O and
H antigens (correctly termed the OH form). These parallels were
transposed to the salmonella antigens.

If O antiserum is added to a culture motility is preserved, whereas
if H antiserum is added the culture does not move. Therefore, H
antigen was involved with swarming in the agar plate (breathing might
have been used to imply the ability to move). (Salmonellae, of
course, do not swarm on certain agar plates like _Proteus_ bacteria
do.)

Several other foodborne outbreaks related to 4, 5, 12:i:- salmonellae
have been reported including one in New York City reported in 2002
(2). Additional information about this monophasic organism, which may
be resistant to multiple antimicrobial agents, can be found in
references 3-5.

1. Echeita MA, Herrera S, Usera M. Atypical, fljB-negative
_Salmonella enterica_ subsp. _enterica_ strain of serovar 4,5,12:i:-
appears to be a monophasic variant of serovar Typhimurium. J Clin
Microbiol 2001; 39: 2981-3.
2. Agasan A, Kornblum J, Williams G, et al. Profile of _Salmonella
enterica_ subsp. _enterica_ (subspecies I) serotype 4,5,12:i:-
strains causing food-borne infections in New York City. J Clin
Microbiol 2002; 40: 1924-9.
3. Guerra B, Laconcha I, Soto SM, et al. Molecular characterisation
of emergent multiresistant _Salmonella enterica_ serotype
[4,5,12:i:-] organisms causing human salmonellosis. FEMS Microbiol
Lett 2000; 190: 341-7.
4. de la Torre E, Zapata D, Tello M, et al. Several _Salmonella
enterica_ subsp. _enterica_ serotype 4,5,12:i:- phage types isolated
from swine samples originate from serotype Typhimurium DT U302. J
Clin Microbiol 2003; 41: 2395-400.
5. Mossong J, Marques P, Ragimbeaul C, et al. Outbreaks of monophasic
_Salmonella enterica_ serovar 4,[5],12:i:- in Luxembourg, 2006.
Eurosurveillance 2006; 12 (6).
. - Mod.LL]

[see also:
2007
----
Salmonellosis, frozen poultry pie - USA (multistate)(09) 20071119.3748
Salmonellosis, frozen poultry pie - USA (multistate)(03): CDC 20071011.3337
Salmonellosis, human, pet turtles - USA (multistate): 2006-2007 20070709.2186]
..............................................sb/ll/msp/lm
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SALMONELLOSIS, SEROTYPE NEWPORT - USA (02): SPROUTS, ALERT, RECALL

******************************************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Thu 3 Jun 2010
Source: CDC, Salmonella Outbreak Investigations [edited]
http://www.cdc.gov/salmonella/newport/


CDC is collaborating with public health officials in many states and
FDA to investigate a multistate outbreak of _Salmonella [enterica_]
serotype Newport infections linked to the consumption of raw alfalfa
sprouts. Investigators are using DNA analysis of bacteria obtained
through diagnostic testing to identify cases of illness that may be
part of this outbreak.

As of 11:00 PM EDT on 2 Jun 2010, a total of 35 individuals infected
with a matching strain of _S._ Newport have been reported from 11
states since 1 Mar 2010. The number of ill people identified in each
state with this strain is as follows: AZ (2), CA (17), CO (1), ID
(5), IL (1), MO (1), NM (1), NV (2), OR (2), PA (1), and WI (2).
Among those for whom information is available about when symptoms
started, illnesses began between 1 Mar 2010, 2010 and 16 May 2010.
Case-patients range in age from less than 1 to 75 years old, and the
median age is 36 years. 66 percent of patients are female. Among the
30 patients with available hospitalization information, 7 (23
percent) were hospitalized. No deaths have been reported.

Investigation of the outbreak
-----------------------------
Collaborative investigative efforts of many local, state, and federal
public health, agriculture, and regulatory agencies have linked this
outbreak to eating raw alfalfa sprouts. Interviews of case-patients
found that most reported eating raw alfalfa sprouts before becoming
ill. Some case-patients reported eating sprouts at restaurants;
others purchased sprouts at grocery stores. The initial investigation
traced the implicated raw alfalfa sprouts to a single sprout
processor in California. Investigations are currently ongoing at the
sprout processor.

Recall information
------------------
On 21 May 2010, JH Caldwell and Sons Inc. of Maywood, California,
recalled several brands of alfalfa sprouts distributed to wholesale
distributors, restaurants, delicatessens, and grocery stores.

--
Communicated by:
ProMED-mail


[see also:
Salmonellosis, serotype Newport - USA: sprouts, alert, recall 20100522.1701
2009
----
Salmonellosis, serotype Cubana, sprouts - Canada: alert, recall 20090819.2936
Salmonellosis, serotype Saintpaul - USA (03): sprouts, geo. spread
20090310.0992
Salmonellosis, serotype Saintpaul - USA (02): sprouts recall 20090306.0929
2008
----
Salmonellosis, serotype Enteritidis - Canada (02): (QC), cheese 20080902.2747
Salmonellosis, serotype Enteritidis - Canada: (BC) 20080730.2326
Salmonellosis, serotype Newport - USA: (SD) 20080115.0190
2007
----
Salmonellosis, serotype Newport, ground beef - USA: alert 20071221.4105
Salmonellosis, serotype Weltevreden, sprouts - Scandinavia 20071130.3870
Salmonellosis, serotype Newport, Mexican-style cheese - USA (IL) (02)
20070329.1084
Salmonellosis, serotype Newport, Mexican-style cheese - USA (IL) 20070324.1027]
...................................ll/mj/lm

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are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
Donate to ProMED-mail. Details available at:

************************************************************
Visit ProMED-mail's web site at .
Send all items for posting to: promed@promedmail.org
(NOT to an individual moderator). If you do not give your
full name and affiliation, it may not be posted. Send
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