According to data released October 6 from the U.S. Centers for Disease Control and Prevention (CDC), 199 persons have been infected to-date with E. coli O157:H7 from fresh spinach. There have been two confirmed fatalities from the infection. One additional death is suspected to have been caused by the tainted spinach.

The CDC report, "Update on Multi-State Outbreak of E. coli O157:H7 Infections from Fresh Spinach" confirms that 26 states have reported incidents of infection.

Among those confirmed ill, ninety-eight (51%) were hospitalized and thirty (16%) developed hemolytic-uremic syndrome (HUS), a type of kidney failure. Additionally, CDC data shows that one hundred thirty-six (71%) of the total roster of victims were female and 20 (11%) were children under 5 years old.

CDC investigators report they have taken 188 environmental samples, including water, products and sediment from the Central California cultivated fields targeted as the source of the contamination. In recent developments, federal law enforcement officials have also opened a criminal case into the outbreak, raiding the offices of Natural Selection Foods LLC in San Juan Bautista and Growers Express in Salinas. They are reportedly seeking evidence that food safety policies may have been intentionally disregarded.

For resources and the latest information on the outbreak from the CDC, please go to:
http://www.cdc.gov/foodborne/ecolispinach/

An international group of public health experts designated to advise the World Health Organization (WHO) on avian and pandemic influenza issues met in Geneva, Switzerland for the first time last week. The Influenza Pandemic Task Force (IPTF) will advise the global health community on the critical questions including:

1) when to raise the pandemic alert level,
2) when to declare a pandemic, and
3) how to handle the international response

The task force is considered a temporary body that will continue to advise WHO until the new International Health Regulations take effect in June 2007. The new regulations were approved by the World Health Assembly in May 2005 and are designed to prevent the international spread of diseases.

According to WHO, the IPTF will also serve as an expert advisory group to WHO's Global Influenza Program until the June 2007.

In the wake of a Cryptosporidium outbreak that sickened at least seven people who came into contact with the water at a popular San Jose, California public fountain during the summer, health officials in the San Francisco Bay Area have acknowledged that public fountains are not inspected for the illness-causing parasite. With the recent closure of the water feature, health officials confirmed that dozens of fountains in at least four Bay Area counties are also falling through the regulatory cracks.

The California Conference of Directors of Environmental Health released public health safety guidelines for fountains in 2001. However, the agency admitted that they have not been widely implemented. Bay Area health officials report that they will begin consideration of restructured guidelines and rules for ornamental water features, including required health safety warning signs and meeting with operators to improve maintenance procedures. Additional changes could include stricter rules on allowing infants in or near public fountain water and a more stringent policing to prevent animals from contaminating the water.

Fecal contamination is the main source of Cryptosporidium. Contact with the pathogen can lead to severe gastrointestinal illness. According to the Centers for Disease Control and Prevention (CDC), cases of Cryptosporidiosis can become a serious and potential life-threatening illness for your children, the elderly and those with weakened immune systems.

Much like swimming pools, water in ornamental fountains is constantly recirculated. Once the source water is contaminated with "Crypto" from human or animal feces, the pathogen remains in the fountain, leading to additional exposure possibilities.

For more on Cryptosporidium from the CDC, please go to:
http://www.cdc.gov/Ncidod/dpd/parasites/cryptosporidiosis/factsht_cryptosporidiosis.htm#1

According to a new report from the World Health Organization (WHO) and UNICEF, the world is in danger of missing established targets for providing clean water and sanitation unless there is a dramatic increase in the pace of work and investment. Based on recent evaluations, the Millennium Development Goals (MDGs) promising to cut in half the number of those who exist without clean water and proper sanitation by 2015 stands to miss that goal by more than half a billion people.

Global health officials estimate that more than 1.1 billion people currently lack access to a safe source of drinking water and 2.6 billion are without basic sanitation. To achieve targets under the Millennium Development Goals, nations must reduce by half the proportion of people without access to clean water and proper sanitation by 2015. The recently completed WHO-UNICEF evaluation suggests the world may miss that goal by more than half a billion people.

According to the new report, "Meeting the MDG Drinking Water and Sanitation Target - The Urban and Rural Challenge of the Decade," Sub-Saharan Africa is the main focus of concern. Due to population growth over the period from 1990-2004, the number of people without access to drinking water in the region increased by 23 percent during that time period. Report data from 2004 also shows that only 56 percent of the population has access to an improved water supply and just 37 percent have access to basic sanitation.

Currently, 95% of city dwellers globally have access to an improved source of drinking water and 80% have access to sanitation services. However with urban populations on the rising, the pressure to maintain these systems is becoming more acute, raising a distinct threat to achieving the global health goals.

WHO estimates that in 2005 alone, 1.6 million children under the age of 5 (an average of 4,500 a day) died from the consequences of unsafe water and inadequate hygiene.

To read the full WHO/UNICEF report, please go to:
http://www.who.int/water_sanitation_health/monitoring/jmpfinal.pdf

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