MMWR News Synopsis

Friday, August 20, 2021


Protracted, Intermittent Outbreak of Salmonella Mbandaka Linked to a Restaurant — Michigan, 2008–2019

CDC Media Relations

The source of an intermittent and nearly 11-year outbreak of Salmonella was identified by focusing investigations on a single restaurant, retrospectively identifying older cases, testing restaurant surfaces and asymptomatic food workers for Salmonella, and performing lab testing on Salmonella isolates to confirm the outbreak strain in the restaurant, food workers, and ill patrons. Typically, Salmonella outbreaks occur through contaminated foods over a period of days to weeks and end once the food is no longer distributed. The reported outbreak was instead due to a complex relationship between the restaurant environment and food workers, which then led to patron illnesses intermittently over nearly 11 years. The outbreak was ultimately identified after focusing investigations on the restaurant rather than food items, reviewing older cases, testing restaurant surfaces and asymptomatic food workers for Salmonella, and performing Salmonella genetic sequencing lab tests to confirm the outbreak strain in the restaurant, food workers, and ill patrons. As attempts to eradicate Salmonella from the restaurant failed, the restaurant ultimately closed.

Disparities in Excess Mortality Associated with COVID-19 — United States, 2020

CDC Media Relations

A new study looked at how many more people in the United States died in 2020 than expected to better understand the effects of the COVID-19 pandemic. People from racial and ethnic minority groups had the highest excess death rates among all age groups, regardless of cause. These findings can help inform efforts to prevent deaths associated with the COVID-19 pandemic in the United States, particularly among racial and ethnic minority groups and age groups with the greatest excess death rates. Using data from the National Vital Statistics System, researchers assessed excess death rates occurring in the United States during December 29, 2019–January 2, 2021 by race and ethnicity and by age group. When more people die during a time period than were expected to die based on historical and current trends, those deaths are considered excess deaths. Racial and ethnic minority groups have higher excess deaths from all causes. Non-Hispanic Black and American Indian and Alaska Native people had the highest excess death rates among people younger than 65 years of age. Among adults aged 65 years and older, the highest excess death rate was among non-Hispanic Black and Hispanic people. Among all assessed racial and ethnic groups, excess death rates were higher among people aged 65 years or older than among those aged 25–64 years. Of the nearly 2,000 excess deaths among Black people aged 25 years or younger in 2020, more than 90% were not directly attributed to COVID-19. Injury-related causes of death are typically the leading causes of death among younger age groups. Excess deaths among younger groups and the disparities related to these excess deaths may be related to increases in homicides, drug overdoses, and unintentional injuries in 2020. Higher excess death rates from all causes among racial and ethnic groups of all ages have been driven, in part, by factors such as on-the-job risk, socioeconomic status, housing conditions, reduced access to health care, and discrimination. These findings can help inform efforts to prevent deaths from COVID-19 in the United States, particularly among people in racial and ethnic minority groups and age groups with the greatest excess death rates.

Use of Rapid Antigen Testing for SARS-CoV-2 in Remote Communities — Yukon-Kuskokwim Delta Region, Alaska, September 15, 2020–March 1, 2021

CDC Media Relations

Introducing rapid antigen testing for COVID-19 in remote Alaskan villages reduced turnaround times for test results by more than 30%. This allowed for faster diagnosis, isolation, and treatment of infected people, and it might have helped slow the spread of COVID-19. The Yukon-Kuskokwim Health Corporation introduced the rapid, point-of-care COVID-19 test, BinaxNOW, in the Yukon-Kuskokwim Delta Region of Alaska on November 9, 2020. The BinaxNOW rapid antigen test was valuable in reducing the turnaround time for COVID-19 testing in isolated Alaskan communities where local access to nucleic acid amplification testing is not readily available. The BinaxNOW test provides results in 15 minutes or less using a nasal swab. This allowed infected people to be identified and isolated during the same day. After the introduction of rapid antigen tests, the overall turnaround time for all test results in the region fell by more than 30%, from about six days to four days. The faster results also enabled public health measures to be quickly implemented to control COVID-19 outbreaks in the region. In the month after introducing rapid antigen testing, daily COVID-19 case rates decreased by 65% in the region from 342 cases per 100,000 people to 119 cases per 100,000 people.

Notes from the Field

Homemade infant formulas can cause rickets, a vitamin D deficiency that leads to hypocalcemia; bone malformation and growth delay; and other nutritional deficiencies like iodine deficiency and neonatal hypothyroidism. Infants should receive human breast milk or commercial infant formulas, both of which contain adequate amounts of vitamins and nutrients. This report describes three infants from three states who were fed a homemade “alkaline diet” formula recipe that was deficient in essential vitamins and nutrients. This led to the development of rickets, a deficiency of vitamin D that causes bone malformation and growth delay, in all three infants. One infant also developed iodine deficiency and hypothyroidism, which can cause long-term developmental delays. Commercial infant formulas and human breast milk contain adequate amounts of vitamins and nutrients, but homemade formulas may be dangerously lacking. This report emphasizes the consequences of this practice, which have also been outlined in warnings from CDC and FDA.



CDC works 24/7 protecting America’s health, safety and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.

Page last reviewed: August 18, 2021