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MMWR – Morbidity and Mortality Weekly Report

1. Update on Cholera — Haiti, Dominican Republic, and Florida, 2010

CDC Division of News and Electronic Media
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This report describes cases of cholera identified in the Dominican Republic and United States and provides recommendations to physicians regarding management of travel-related cases. On October 21, 2010, a cholera outbreak was confirmed by the Haitian National Public Health Laboratory (1). By November 19, the outbreak had reached every department of the country, and by December 14, a total of 114,497 cases of cholera resulting in 58,190 hospitalizations and 2,535 deaths had been reported. By November 16, additional cases of cholera had been confirmed in the neighboring Dominican Republic and in Florida. Travelers who develop watery diarrhea within 5 days after returning from cholera-affected areas should seek health care and report their travel histories. Clinicians should enquire about travel history when evaluating patients with diarrhea. When cholera is suspected, rehydration should be initiated immediately, a stool specimen should be collected for culture of Vibrio cholerae, and the appropriate public health authorities should be notified.

2. Transmission of Multidrug-Resistant Escherichia coli Through Kidney Transplant — Texas and California, 2009

CDC Division of News and Electronic Media
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This report describes transmission of multidrug-resistant Escherichia coli from a donor to two transplant recipients, resulting in the loss of both transplanted kidneys. Critical gaps were identified in communicating information regarding the donor's E. coli infection. Transplant-transmitted bacterial infection is a serious concern, and may lead to catastrophic consequences in an organ recipient. Although transplantation of organs from donors with bacterial infection can be managed, transplant teams need to be aware of all donor test results so that appropriate antimicrobials can be used to treat the recipient and avoid complications of an infected organ. To improve organ transplant safety, each organ procurement organization (OPO) should have standard procedures to ensure timely and accurate communication of donor-related information between OPOs and transplant centers, including donor information that becomes available after organs are procured.

3. Salmonella Montevideo Infections Associated with Salami Products Made with Contaminated Imported Black and Red Pepper — United States, July 2009–April 2010

CDC Division of News and Electronic Media
(404) 639-3286

In November 2009, CDC began coordinating a multistate investigation of Salmonella Montevideo infections. In a case-control study, consumption of salami was associated with illness. Purchase information from warehouse store membership card records helped determine the brand of salami products associated with cases. An investigation conducted by the United States Department of Agriculture Food Safety and Inspection Service, Food and Drug Administration and Rhode Island Department of Health revealed that the black and red pepper applied post-processing to this brand of salami products was contaminated. This finding led to a recall of approximately 1.3 million pounds of salami products and over 100,000 pounds of black red pepper. As of April 30, 2010, 272 people from 44 states and the District of Columbia became sick with the outbreak strain of Salmonella Montevideo. Twenty-six percent (52 of 203) were hospitalized; no deaths were reported. Spices should be considered as possible sources for any foodborne Salmonella outbreak in the United States, especially for widespread outbreaks.

4. Update: Influenza Activity — United States, October 3–December 11, 2010

CDC Division of News and Electronic Media
(404) 639-3286

Influenza activity in the United States during October 3–December 11 was low overall, with cocirculation of influenza A (H3N2), 2009 A (H1N1) and B viruses. Regional differences in influenza activity have been noted, with the highest levels seen in the southeastern states, where influenza B viruses have predominated. Influenza activity likely will continue to increase in the weeks ahead. During the 2009–10 season, as a result of pandemic 2009 influenza A (H1N1) circulation, influenza activity peaked unusually early (late October); however, during 22 of the 27 influenza seasons before the 2009–10 season, influenza activity peaked in January or later. Healthcare providers should offer influenza vaccination throughout the influenza season to protect as many persons as possible from influenza virus infection and its complications.



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