Hep A Spreads in Europe; Prevention includes Good Hand Hygiene

Key Points:

COVID

1. In today’s Recommendation for Industry, we discuss the current Hepatitis A spread in Europe. Read more below.
2. Universal masking no longer recommended in health care facilities, CDC says. The CDC no longer recommends universal masking in health care settings unless the facilities are in areas of high COVID-19 transmission. Per the new recommendations, facilities in areas without high transmission can “choose not to require” all doctors, patients and visitors to wear masks. Regardless of the new guidance, the CDC still recommends masking in health care settings for people who have suspected or confirmed COVID-19 or other respiratory infections, people who have had close contact or a higher risk exposure with someone with COVID-19 and people who reside or work on a unit or area of the facility experiencing an outbreak, regardless of universal requirements and transmission rates.
3. COVID-19 continues upward trend in Europe. Europe’s COVID cases showed more signs of rising last week, marking the first regionwide spike since the most recent BA.5 wave. Cases in people ages 65 and older rose 9% compared to the previous week, which the ECDC said was led by recent increases in 14 of 26 countries in the European Union that reported data. In a weekly update, the Centers for Disease Control and Prevention (CDC) said the 7-day average for new daily cases decreased 13.1% compared to the week before, with the 7-day average for new COVID deaths down 6.7%. In other updates, the CDC said more than 7.5 million people have gotten their updated booster doses, up from 4.4 million last week. However, it also noted that 49.9% of the eligible population has yet to receive any booster dose.

Monkeypox

1. First monkeypox case in UK likely seen in March. The World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC) released a new report on the monkeypox outbreak in Europe and noted that the first specimen identified through retrospective testing in the United Kingdom was on Mar 7, and the earliest date of symptom onset was reported on Apr 17.

Food Safety & Public Health

1. As of September 29th, 50 suspected cases of Ebola have been reported in Uganda including 31 confirmed and 19 probable cases. 24 deaths have been reported. Cumulatively, 414 contacts have been reported. Discussions continue about the possible benefits of a vaccine trial against the causative strain. It does not appear that cases have spread outside of Uganda so far, and other African countries have implemented health screenings at border crossings. Over the past 4 days, Uganda’s health ministry has reported 8 more Ebola Sudan cases, along with 2 more deaths, with officials also announcing that a doctor is among the fatal cases.
2. Measles: Since the start of an outbreak this past April, 698 children have died from measles in Zimbabwe, according to the country’s health ministry, and there has been a total of 6,291 cases recorded as of 4 September 2022. The deaths have been attributed to unvaccinated children who did not receive a vaccine because of religious beliefs. While the outbreak was originally reported in the Manicaland province, in the eastern part of Zimbabwe, measles cases have since been reported in all regions of the country.
   • The Minnesota Department of Health (MDH) said Monday that the state has a measles outbreak. The department said it has identified 12 cases of international travel-related measles in unvaccinated children since June. As a result, vaccinations are encouraged.
3. Rise in Hepatitis A cases in EU and UK could partly be foodborne. Data suggests human-to-human transmission and contaminated food are the sources of an increase of Hepatitis A infections throughout EU and UK. More than 300 cases with identical or closely related HAV strains have been identified in Austria, Germany, Hungary, the Netherlands, Slovenia, Sweden, and the UK. Good hand hygiene, including thoroughly washing hands with soap after using the bathroom and before preparing or eating food, plays an important role in preventing the spread of hepatitis A.
4. FDA links Listeria outbreak to cheeses sold at Whole Foods, Safeway and other retailers. The FDA is investigating an outbreak of infections caused by Listeria monocytogenes that are linked to certain Brie and Camembert cheeses that were sold nationwide. Old Europe Cheese, Inc. of Benton Harbor, MI, recalled multiple cheese products in relation to the outbreak. A list of those products along with retailers who sold the cheeses is at this link. The firm has stopped production and distribution of their Brie and Camembert products from the Michigan facility and is working with FDA on corrective actions. Consumers, restaurants, and retailers should not eat, sell, or serve recalled products and should throw them away; this includes Best By Dates ranging from September 28, 2022, to December 14, 2022, and all flavors and quantities.
5. FDA Reminds Human and Animal Food Facilities to Register or Renew Registration between October 1 and December 31, 2022. Owners, operators, or agents in charge of a domestic or foreign facility engaged in manufacturing/processing, packing, or holding food for consumption by humans or animals in the U.S., are required to register the facility with the FDA. The registration and renewal period is open between October 1 and December 31, 2022. The FDA will consider the registration of a food facility to be expired if a facility’s registration is not renewed by December 31, 2022. There is no fee associated with registration or renewal.

Recommendations for Industry

Hep A Spreads in Europe; Prevention includes Good Hand Hygiene

With reports surfacing of Hepatitis A spreading in the UK and EU through both person-to-person and foodborne transmission, there is potential for similar outbreaks to arise in the U.S. As such, it is particularly critical that food businesses stress the importance of personal hygiene, including robust handwashing, with workers.

Currently, the primary route of transmission in the U.S. is person to person, with certain groups at highest risk, including those who use drugs, are homeless, are men who have sex with men, are in jail or have chronic liver disease. But there is a risk that workers could be among, or exposed to, members of such groups or others in contact with them.

As noted by both CDC and the ECDC, good hand hygiene plays an important role in preventing spread. This includes thoroughly washing hands with soap after using the bathroom and before preparing or eating food. CDC also recommends hepatitis A vaccines to prevent spread, with the vaccine recommended for all children at age 1 year.

In TAG’s October 13 Weekly Insights newsletter, we will further discuss the potential and prevention of foodborne transmission. Click here to subscribe.

In case you missed it:

COVID

1. In last Thursday’s Recommendation for Industry, we discussed the overall positive trajectory of COVID cases, even with variants continuing to emerge. Read more here.
2. WHO: COVID-19 cases, deaths drop globally. The World Health Organization (WHO) said global COVID-19 cases were down 11% in the week ending on Sep 25, and deaths were down 18% compared to the previous week. Omicron is still the main variant of concern, representing 99.9% of cases reported globally in the past week. The global COVID totals are 616,275,830 cases and 6,540,285 deaths. Japan’s Shionogi & Co has proved a successful trial with its antiviral protease inhibitor known as ensitrelvir. The drug performed well compared with a placebo in phase 3 trials and was able to reduce symptoms from Omicron-caused infections.
3. Report: COVID-19 has lowered lifespan across the Americas. A report from the Pan American Health Organization (PAHO) shows that COVID-19 reduced life expectancy across the Americas while amplifying economic inequities and existing health disparities. Health expectancy across the region fell to levels not seen since 2004. Life expectancy in Latin America and the Caribbean decreased from 75.1 years in 2019 to 72.2 in 2021, a decline of 2.9 years. In North America, expected lifespan dropped from 79.5 years in 2019 to 77.7 in 2021, or by 1.8 years. In addition to declining life expectancy, both routine childhood immunization levels and mental health diagnoses have suffered under the veil of COVID-19. In other COVID-19 news, child COVID-19 cases declined for the fourth consecutive week in the United States, with 55,000 reported for the week ending Sep 22, according to the latest update from the American Academy of Pediatrics.

Monkeypox

1. Unvaccinated individuals 14 times more likely to get monkeypox than vaccinated, new US data shows. That figure reflects the first wave of authoritative data collected by the Biden administration on the efficacy of the monkeypox vaccine that is currently being administered across the United States. There is still ongoing research being performed on the Jynneos vaccine.

Food Safety & Public Health

1. Activities for the Safety of Imported Produce. There are four goals this activity document outlines, from the 2019 import strategy, in which the agency will be working to enhance the safety of fresh fruits and vegetables:
   • Food Offered for Import Meets U.S. Food Safety Requirements
   • FDA Border Surveillance Prevents Entry of Unsafe Foods
   • Rapid and Effective Responses to Unsafe Imported Food
   • Effective and Efficient Food Import Program
2. Food safety tips for those in Hurricane Ian’s path. Within this source, authors point out numerous tips for individuals who find themselves affected during and after the hurricane and what correct food safety steps they should take. Read more here.
3. FDA Proposes to Update Definition for “Healthy” Claim on Food Labels. The “healthy” claim can act as a quick signal on food package labels to help empower consumers, including those with lower nutrition knowledge, with information to identify foods that will help them build healthy eating patterns. The proposed changes to the definition of “healthy” are aligned with current nutrition science, the Dietary Guidelines for Americans, 2020-2025 and the updated Nutrition Facts label. The FDA’s approach focuses on ensuring that nutrient-dense foods that help consumers build a diet consistent with current dietary recommendations can qualify to bear the claim. The FDA is also researching a symbol that manufacturers could use on the front of the pack to show that their product meets the definition of the “healthy” claim.