Five cases of Legionnaires' disease reported in Lexington, prompting health officials to urge caution around pools, hot tubs

Centers for Disease Control and Prevention graphic

By Melissa Patrick

Kentucky Health News

The Lexington-Fayette County Health Department announced Thursday that it has seen an increase in Legionnaires' disease this year and is warning people to take caution around outdoor pools and hot tubs, since the disease is spread when people breathe in small droplets of water that contain the bacteria that causes it. 

"The increase of use of outdoor pools and hot tubs during the summer, combined with recent rainfall and the potential for stagnant water, creates a need for reminders about Legionnaires’ disease," the department said in a news release. 

Kevin Hall, spokesperson for the department, told Kentucky Health News that five cases of the disease have been reported and that they typically don't have any. He added that they were still investigating the sources of the infections and that it is still unknown whether the cases ae related. 

Legionnaires' disease is a very serious type of pneumonia caused by Legionella pneumophil bacteria. The bacteria can also cause a less serious illness called Pontiac fever.

"Legionella occurs naturally in freshwater environments, like lakes and streams. It can become a health concern when it grows and spreads in human-made building water systems," the release says. 

For example, the Centers for Disease Control and Prevention says it can grow in shower heads and sink faucets, cooling towers, hot tubs, decorative fountains and water features, hot-water tanks and heaters and large, complex plumbing systems like those found in hospitals, hotels and cruise ships. (It was discoveerd after an outbreak at a Philadelphia hotel durign an American Legion convention.)

The health department adds that swimming pools become a concern when the temperature sits within the danger zone for the growth of the bacteria: "Legionella are unlikely to grow in typical swimming pools because water temperatures are usually too cold. However, you should sample pools if they are associated with a possible exposure or temperatures are within the permissive range (i77 to 113°F )." 

Health officials say the disease is generally not spread from person to person, but that is possible under rare circumstances. 

People at higher risk of getting Legionnaires' disease are those 50 and older, those with chronic lung disease, current or former smokers, those who take drugs that suppress their immune system, and people with cancer or underlying illnesses like diabetes, kidney failure or liver failure. 

The CDC urges people to talk to their doctor or local health department right away if they think they have been exposed to Legionella or if you develop pneumonia symptoms, such as fever, cough, chills or muscle aches. And, to be sure to mention if you have spent any nights away from home in the last 14 days. 

The health department says public-health agencies reported nearly 10,000 cases of Legionnaires’ disease in the U.S. in 2018, but thie actual number was likely much higher because the disease often goes undiagnosed: "A recent study estimated that the true number of Legionnaires’ disease cases may be 1.8–2.7 times higher than what is reported."

In Kentucky, 606 cases of  Legionnaires' disease (both confirmed and probable) have been reported since 2018, with an average of 114 cases a year between 2018 and 2021. In 2022, the state reported 107 cases, which are still being reconciled, and so far, 43 cases have been reported in 2023.  

While the disease is uncommon and most people make a full recovery, it can be deadly. According to the CDC, most people who get Legionnaires' disease need  hospital care, and about one out of every 10 people who get the disease die from complications of the illness.

Salmonella outbreaks in backyard poultry sicken Kentuckians

Centers for Disease Control and Prevention chart, adapted by Kentucky Health News

Chickens are common in Kentucky backyards.
(Getty Images photo via CDC)

At least 17 people in Kentucky have become sick in an outbreak of Salmonella bacteria linked to backyard poultry, according to the Centers for Disease Control and Prevention.

"One in three sick people is a child younger than 5 years," the CDC warned Thursday. "Don’t let young children touch chicks, ducklings, or other backyard poultry."

The outbreaks have affected almost 500 people and caused more than 100 hospitalizations in 46 states; Kentucky's case numbers are higher than average for the nation.

Poultry can carry salmonella "even if they look healthy and clean," the CDC said. "These germs can easily spread to anything in the areas where the poultry live and roam. You can get sick from touching your backyard poultry or anything in their environment and then touching your mouth or food."

The CDC said owners of backyard poultry should:

• Wash your hands
  • Always wash your hands with soap and water immediately after touching backyard poultry, their eggs, or anything in the area where they live and roam.
  • Use hand sanitizer if soap and water are not readily available. Consider having hand sanitizer at your coop.
• Be safe around backyard flocks
  • Don’t kiss or snuggle backyard poultry, and don’t eat or drink around them. This can spread Salmonella germs to your mouth and make you sick.
  • Keep your backyard flock and supplies you use to care for them (like feed containers and shoes you wear in the coop) outside of the house. You should also clean the supplies outside the house.
• Supervise kids around flocks
  • Always supervise children around backyard poultry and make sure they wash their hands properly afterward.
  • Don’t let children younger than 5 years touch chicks, ducklings, or other backyard poultry. Young children are more likely to get sick from germs like Salmonella.
• Handle eggs safely
  • Collect eggs often. Eggs that sit in the nest can become dirty or break.
  • Throw away cracked eggs. Germs on the shell can more easily enter the egg through a cracked shell.
  • Rub off dirt on eggs with fine sandpaper, a brush, or a cloth. Don’t wash them because colder water can pull germs into the egg.
  • Refrigerate eggs to keep them fresh and slow the growth of germs.
  • Cook eggs until both the yolk and white are firm, and cook egg dishes to an internal temperature of 160°F to kill all germs.

Call your health-care provider right away if you have any of these severe symptoms:

• Diarrhea and a fever higher than 102°F
• Diarrhea for more than three days that is not improving
• Bloody diarrhea
• So much vomiting that you cannot keep liquids down
• Signs of dehydration, such as:
  • Not urinating much
  • Dry mouth and throat
  • Feeling dizzy when standing up

Former Kentuckian recovering from serious health challenges offers hope and advice for others in similar situations

Written as "an open letter to friends and colleagues," this essay offers hope and insight for people and families facing serious health challenges.

By Wes Irvin

Over the last seven years, I have been on a medical journey that has unfortunately taken me away from many folks who I still miss working with on a daily basis in Washington, D.C.

I’m sure many of you have wondered if I just fell off the face of the earth. Well, I have fallen along the way many times, and this journey has been a rollercoaster in every sense of the word, but I remain thankful to still be here every day.

Wes Irvin

Here’s my story: In September 2012, my life took an unexpected turn. Since then, I have undergone 60 surgeries and survived abdominal flesh-eating bacteria, five septic episodes, and multiple pulmonary embolisms. I also lost my spleen and gallbladder. I’ve been treated (and my life saved, more than once) in hospitals in Baltimore, Cleveland, Houston, and Rochester. I could go on, but you get the picture. It’s an understatement to say that there is no playbook for what my family and I have undergone. Thankfully, my underlying health was strong and it’s a big part of my story of survival.

I write not to seek sympathy, but to share some reflections born from this journey of compounded trauma, emotional healing and wellness, patience, perseverance, faith, and forgiveness—and also to thank some of the people closest to me who have been so supportive.

1. Yes, it is the journey, not the destination. As Robert Hastings writes in The Station, life really is about the journey. If you look out over the horizon, and try to figure out everything in your life, you’ll simply outrun yourself and miss living the gift of today. We exhaust ourselves by overreaching for the future—becoming less and less aware of what’s directly in front of us.

2. Today is the real deal. We all get excited about opening a Christmas present, a wedding present, or a birthday present. Right? There is so much anticipation and enthusiasm around a new gift. I have learned after losing hundreds of days since 2012—and from coming in and out of the woods—that I needed to open my “daily present” a bit more mindfully. I’ve realized that yesterday is in the rear-view mirror, tomorrow is uncertain, but today is for real: it’s a gift; it’s here. We should open today with excitement, surprise, and thanksgiving. Grab on and enjoy! As Eleanor Roosevelt wisely said, Tomorrow is a mystery. Today is a gift. That is why it is called the present.

3. Find the pony in the pile. It sounds crass, but I’ll say it anyway: Find the pony in whatever pile of crap you unexpectedly wander into—and work tirelessly to find it. When horrible things happen to us, believe it or not, there is good we can find. I encourage you to hone in on that. If you can approach adversity with this mindset—and it isn’t easy—then you can ride that pony to the finish line. What I’m saying is find the positive, that morsel of goodness inside what may seem the deepest, darkest place in the issue you are facing.

4. Love is not just for “loved ones.” It is so important not only to love yourself, and your family, but to love people from all walks of life, every day, because I assure you that one day it may take all walks of life to save yours. Since day one of my ordeal, I have reminded the very kind folks who cleaned my rooms from the ICU to the ER in every hospital where I’ve stayed, how critical their jobs are. They, too, are busy with the work of saving lives. I hope you will look around for individuals working to ensure we can open the gift of today and tomorrow—folks working tirelessly to keep us safe, get us where we’re going, to ensure we get food. The list is endless. . . .

5. Forget politics—we’re all people. The America in 2012 when I fell sick is not the America I recognize today, in terms of the rhetoric. As politicized and divided as the country is today, I have seen up close the incredible professionalism, courage and skill of medical teams whose only concern is the care of their patients. My caregivers have been from all walks and stations of life and from countries around the world. I have been blessed that they call America their home. It’s because of the microsurgeon from Turkey, the nurse from India, and so many others who treated and helped me, that I am here. All of them worked and continue to work to find ways to put Humpty Dumpty back together. And I remain grateful to all of them.

6. Giving thanks, with gratitude. Finally, I want to thank the people who have accompanied me on this journey: First, my wife Tricia and our children, Ashby, Jack, and Mary Rose. Trish has navigated the unimaginable with grace and forgiveness—and our children have done so as well. I also want to add that Trish did all this while serving our community in multiple roles over the years. They have all been a blessing and extremely understanding during rough times and managed to pick themselves up—and often me as well—every day while moving forward.

I also want to thank my former bosses who helped me along the way. They have either sat by my bedside or helped to keep my focus balanced and strong. And speaking of bedsides, Secretary Norman Mineta was also an inspiration to me as I watched him, too, bravely navigate a serious illness while managing his leadership duties from a hospital bed. So thank you: Secretary Mineta, Ernie Fletcher, Frank Wolf, Jay Timmons and the National Association of Manufacturers, Jim Simpson, Mike DeWine, Bill Schubert, and Dave Camp. You were there for me, and it has meant the world.

I have been enveloped by a spiritual guiding light and have felt all the prayers and positive thoughts over the years from so many of you reading this. My heartfelt thanks to you all. As I like to say, “Thankful is simply every day.” The S.S. Irvin remains afloat, and we are working hard to mindfully navigate it every single day. Our family, knowing we are all survivors from this journey, has so much to celebrate and to continue to be thankful for.

Wes Irvin is a former Lexington resident who was congressional, campaign and gubernatorial press secretary for Ernie Fletcher. He lives in Annapolis, Md., and says he is an evolving survivor who advocates for the disabled and focuses his volunteer time on emotional wellness issues, due to a multi-year health journey.

Health officials warn outbreak of drug-resistant bacteria is likely coming from petting puppies in pet stores; 3 of 30 cases are in Ky.

By Melissa Patrick
Kentucky Health News

Getting a puppy for Christmas? Keep clean and take it to a vet. At least 30 people in 13 states have been sickened by a drug-resistant bacteria that federal health officials say was likely picked up from puppies in pet stores, three of them in Kentucky.

Getty Images photo, via WJW-TV, Fox 8 Cleveland

The infection is from a multi-drug-resistant strain of the bacterium Campylobacter jejuni. The outbreak has caused four hospitalizations, the federal Centers for Disease Control and Prevention said in a news release.

The CDC noted that the hospitalized ranged in age from 8 months to 70 years old.

Among 24 people with infections who were interviewed, 21 said they had recently touched a puppy and 15 of those said they did so in a pet store. All of the cases were reported between January and November.

"Campylobacter bacteria can spread to people through contact with poop of infected animals and contaminated food or water," says the release.

Infection from the Campylobacter bacteria is one of the most common causes of diarrheal illness in the United States, infecting more than 1.5 million people every year, says the CDC. Most cases are not part of a recognized outbreak.

The release notes that a single, common supplier of puppies has not been identified. However, 12 of those who had contact with a puppy did so at a Petland store, and five of the 12 were Petland employees. Petland has two locations in Kentucky, in Florence and Ashland.

The CDC adds that the strain of Campylobacter in this outbreak appears to be related to a strain that caused a similar outbreak of puppy-related human illness in 2016.

In a statement, Petland said that just like a 2016 outbreak, this specific Campylobacter strain has not originated at any specific Petland store. The company said it implemented all recommended protocols from federal and state officials to prevent human and dog illness after that outbreak.

Campylobacter jejuni oubreak as of Dec. 11, 2019

"For perspective, more than 12 million guests visit our stores annually, and during this specific time period, Petland estimates more than 2.4 million customer socializations of Petland puppies," says the statement.

Illnesses have been reported in Connecticut, Florida, Georgia, Illinois, Kentucky, Maryland, Minnesota, Nevada, Ohio, South Carolina, Tennessee, Utah and Wyoming.

Symptoms of Campylobacter infection include diarrhea, fever and stomach cramps that begin two to five days after being exposed to the bacteria. The illness usually lasts about a week and most people recover without antibiotics. Antibiotics are needed for patients who are very ill or those with severely weakened immune systems.

The CDC encourages people to make sure they take a new puppy or dog to a veterinarian for a checkup within a few days after getting it because puppies and dogs can carry the Campylobacter germs even while appearing healthy and clean.

The agency also advises people to always wash their hands thoroughly with soap and water after touching a puppy or dog, after handling their food and after cleaning up after them. Also, don't let dogs lick around your mouth and face, open wounds, or areas with broken skin.

The release says the CDC the investigation is ongoing and the agency will provide updates when more information is available.

More action needed to protect patients from antibiotic-resistant infections, which kill an American every 15 minutes, CDC says

Cover of CDC report; to download it, click here.

More action is needed to protect Americans from antibiotic-resistant infections, 2.8 million of which occur in the U.S. each year, killing more than 35,000 people, one about every 15 minutes, says the federal Centers for Disease Control and Prevention.

On top of that, 12,800 people died from an infection that is not drug-resistant but is "caused by the same factors that drive antibiotic resistance—antibiotic use and the spread of germs," the CDC said in its report, Antibiotic Resistance Threats in the United States, 2019. "The number of people facing antibiotic resistance is still too high. More action is needed to fully protect people."

Hospitals are a main battleground in the fight. The word "hospital" appears 188 times in the 148-page report, which was issued days after the Leapfrog Group's latest rankings of patient safety at hospitals nationwide, including 50 in Kentucky. The most common grade, on an A-to-F scale, was a C, and the report showed that many hospitals had difficulty dealing with resistant infections.

The University of Louisville Hospital got a D overall in the Leapfrog Group's patient-safety ratings and was rated poorly in dealing with one of the major antibiotic-resistant infections, Methicillin-resistant staphlycoccus areus (MRSA), and C. diff, an infection related to the use of antibiotics. Click to enlarge.

The report's foreword, by CDC Director Robert Redfield, sums up the history of antibiotics in personal terms: "In March 1942, Mrs. Anne Miller of New Haven, Connecticut, was near death. Infectious germs had made their way into her bloodstream. Desperate to save her, doctors administered an experimental drug: penicillin, which Alexander Fleming discovered 14 years earlier. In just hours, she recovered, becoming the first person in the world to be saved by an antibiotic. Rather than dying in her thirties, Mrs. Miller lived to be 90 years old.

"Today, decades later, germs like the one that infected Mrs. Miller are becoming resistant to antibiotics. You could have one in or on your body right now—a resistant germ that, in the right circumstances, could also infect you. But—unlike the bacteria that threatened Mrs. Miller—the bacteria may be able to avoid the effects of the antibiotics designed to kill them. Unfortunately, like nearly 3 million people across the United States, you or a loved one may face an antibiotic-resistant infection."

The use of antibiotics has a self-defeating element: the growth of genetically different bacteria and fungi that have mutated into forms that are resistant to the antibiotics or picked up resistance traits from other germs through mobile genetic elements. Also, antibiotic use encourages development of Clostridioides difficile, or C. diff., a bacterium "that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon," says the Mayo Clinic. The CDC report says 223,900 cases of C. diff. occurred in 2017, killing at least 12,800 Americans.

"Dedicated prevention and infection control efforts in the U.S. are working to reduce the number of infections and deaths caused by antibiotic-resistant germs, but . . . CDC is concerned about rising resistant infections in the community, which can put more people at risk, make spread more difficult to identify and contain, and threaten the progress made to protect patients," the CDC said in announcing the report. "The emergence and spread of new forms of resistance remains a concern."

What is to be done? "Public-health prevention programs targeting resistant germs can and have worked to slow spread and save lives, but more needs to be done," the report says. "The U.S. and global community must scale up these effective strategies and develop new strategies to prevent infections and save lives. In the United States, infection prevention activities have proven effective in slowing the spread of resistant germs. This includes:

• Strategies to decrease spread within healthcare settings (e.g., implementing hand hygiene)
• Vaccinations
• Implementing biosecurity measures on farms
• Responding rapidly to unusual genes and germs when they first appear, keeping new threats from spreading

Ky.-based Infection-control activist calls for screening all patients, isolating infected ones, making hospital risk ratings more reliable

An infection-control activist says every hospital patient in the U.S. should be screened for a certain type of staph infection that can be deadly, citing data that shows this is the best way to decrease the spread of such infections.

Dr. Kevin Kavanagh of Somerset, chair of Health Watch USA, made several assertions and recommendations in a commentary published in the medical journal Antimicrobial Resistance & Infection Control, and also wrote an op-ed about the issue for BioMed Central. 

The commentary was prompted by new data from the federal Centers for Disease Control and Prevention showing that more than 119,000 people in America had a staph infection in 2017, and nearly 20,000 of them died from it.

These numbers reflect rates for all Staphylococcus aureus infections, including methicillin-resistant Staphylococcus aureus, or MRSA, and methicillin-susceptible Staphylococcus aureus, or MSSA.

Centers for Disease Control and Prevention chart; click on it for a larger version

After dropping by an average of 17 percent a year between 2005 and 2012, the rate of decline for hospital-onset MRSA has stalled. The report notes that the U.S. is not on track to meet its goal of 50% reduction by 2020.

Department of Veterans Affairs hospitals had a much larger decrease in MRSA infections, as opposed MSSA, since 2005: 55% and 12%, respectively.

Kavanagh says the difference is that the VA has universal MRSA surveillance and isolates all MRSA carriers, and those results mirror the results in the United Kingdom's National Health Service, which has similar infection-control practices.

"These findings support the contention that the marked decline in hospital-onset MRSA infections observed in these studies is due to interventions which are specifically targeted towards MRSA," he writes.

Kavanagh argues that because MRSA is regularly found in 2% of hospital patients, all U.S. hospitals should screen all patients for MRSA when admitted.

He says hospitals have moved away from early identification and isolation of MRSA carriers as a first line of intervention, to strategies that are based on poorly designed studies — perhaps as a reaction to patient-advocacy groups' push to mandate MRSA testing and isolation, which is costly.

Kavanagh further argues that daily bathing with the antiseptic chlorhexidine, a common practice in U.S. hospitals, is not supported by solid research. He says one study supporting it has data interpretations that have been questioned, and has "apparent conflicts of interest." He also argues that random, controlled trials haven't demonstrated uniform effectiveness of chlorhexidine bathing.

Kavanagh also points out instances where facilities have asked for "risk adjustments" to be made for their rates of hospital-acquired infections, such as adjusting the numbers to allow for high rates of infection among opioid users. He holds firm that this should not be allowed.

He argues that instead of adjusting numbers to make the problem seem less than it really is, hospitals should follow a standard of care that includes not only screening and isolation, but decolonization, which means getting rid of the MRSA virus in people who carry it in their nose or on their skin even though they are not sick with a MRSA infection.

Kavanagh says some of Kentucky's major hospitals have the highest numbers of MRSA infections in the U.S., but after manipulating the data for "risk adjustment" they are designated "no different from national benchmark."

He calls for a different way of thinking about MRSA in the U.S. that includes increased transparency; making surveillance, isolation and decolonization a standard of care that is fully funded; and a more comprehensive tracking system.

He concludes, "Until these reforms are universally enacted in the United States health-care facilities, I have grave reservations that the epidemic of drug-resistant bacteria will be brought under control."

E. coli outbreak keeps spreading, but may be slowing down

The outbreak of E. coli infection centered in Kentucky has spread to nine other states, the federal Centers for Disease Control and Prevention announced April 23. However, preliminary evidence suggests the number of new cases is declining.

Officials said they are still trying to find the source of the outbreak, which evidence suggests is ground beef.

"CDC is not recommending that consumers avoid eating ground beef at this time," the agency said. "Consumers and restaurants should handle ground beef safely and cook it thoroughly to avoid foodborne illness. At this time, CDC is not recommending that retailers stop serving or selling ground beef."

Escherichia coli is a common bacterium found in the digestive tracts of mammals. Certain strains, such as the one numbered O103, which is identified with this outbreak, can produce Shiga toxin, which causes diarrhea (often bloody), severe stomach cramps, and vomiting.

The strain of E. coli has been identified in 156 sick people, 20 of whom were hospitalized. No deaths have been reported from the outbreak. Kentucky has 65 cases; Tennessee has 41, Georgia 33 and Ohio eight. A CDC chart indicated that fewer cases have been reported in recent weeks, but it can take as long as four weeks for the disease to develop.

U.S. Centers for Disease Control and Prevention chart, adapted by Kentucky Health News; click on it for a larger version

Kentucky has 16 confirmed cases of salmonella from pre-cut melons; health officials say you should throw it all out

CNN image

Health officials are advising Kentuckians to throw away all of their pre-cut cantaloupe, watermelon and honeydew, since 16 cases of salmonella have been linked to these products.

The Kentucky Department of Public Health advises that all pre-cut melon be thrown out because the label may not clearly indicate that the product came from Caito Foods from Indianapolis, which distributed the fruit. The products have been sold under several brands and labels.

Caito issued a voluntary recall of these pre-cut melons April 12 in 16 states, including Kentucky. The recall also advises stores to quit selling these products. The recall does not include whole melons.

Salmonella Carrau is a bacteria that makes people sick. Symptoms usually develop 12 to 72 hours after exposure and include diarrhea, fever and stomach cramps. The illness usually lasts four to seven days. Children under 5, adults older than 65 and those with weakened immune systems are at the greatest risk of being severely affected. The release notes that most adults recover with antibiotics.

These infections are part of a nine-state salmonella outbreak that have all been linked to the pre-cut fruit. So far, the Centers for Disease Control and Prevention reports that 93 people have been infected with the disease and 23 people have been hospitalized because of it. No deaths have been reported. Most of the sick have been adults over 50.

“Exposure to salmonella bacteria can be debilitating and potentially life-threatening, especially for small children and individuals with weakened immune systems,” Dr. Jeff Howard, the state's public-health commissioner, said in a news release. “Anyone experiencing signs or symptoms of illness should seek medical care and clinicians should be aware of this ongoing outbreak to ensure suspected cases receive testing and investigative follow-up."

The news release notes that salmonella infection is an extremely common infection in the Kentucky so lab testing is needed to confirm if an illness is linked to this outbreak.

CDC says ground beef likely source of E. coli outbreak, but hasn't been able to identify the source; Kentucky has most cases

Centers for Disease Control and Prevention map

Investigation of people stricken by the recent outbreak of E. coli "suggests that ground beef is the source of this outbreak," the Centers for Disease Control and Prevention announced Friday. "At this time, no common supplier, distributor, or brand of ground beef has been identified."

The outbreak, centered in Kentucky, has sickened 109 people and sent 17 to the hospital, the CDC reported. One case was found this week in Indiana, making the sixth state touched by the outbreak. Kentucky has 54 cases, Tennessee 28, Georgia 17, Ohio 7 and Virginia 2.

The agency said it is continuing its probe "to determine the source of ground beef supplied to grocery stores and restaurant locations where ill people ate. At this time, CDC is not recommending that consumers avoid eating ground beef or retailers stop serving or selling ground beef."

However, the agency cautioned, "Raw ground beef should be handled safely and cooked thoroughly to kill germs that could cause foodborne illness." It offered detailed advice: to consumers, retailers, and restaurants:

• Consumers should cook ground beef to an internal temperature of 160˚F.
• Wash hands with soap and water after touching raw ground beef.
• Keep raw meat separate from foods that won’t be cooked before eating.
• Thoroughly wash countertops, cutting boards, plates, and utensils with hot, soapy water or a bleach solution after they touch raw meat.
• Don’t eat raw or undercooked ground beef.
• After cooking ground beef, refrigerate within two hours and use within three to four days.
• Thaw ground beef in the refrigerator. Cook or refreeze within two days.
• Talk to your doctor if you have symptoms of an E. coli infection.

Escherichia coli is a common bacterium found in the digestive tracts of mammals. Certain strains, such as the one numbered O103, which is identified with this outbreak, can produce Shiga toxin, which causes diarrhea (often bloody), severe stomach cramps, and vomiting.

"Most people recover within a week, but some illnesses can last longer and be more severe," the CDC says. "Antibiotics are not recommended for patients with suspected E. coli infections until diagnostic testing can be performed and E. coli infection is ruled out." More information is at https://www.cdc.gov/ecoli/ecoli-prevention.html.

20 test positive for E.coli and six of them are hospitalized, mostly in Central Kentucky; state health department searching for source

E. coli symptoms (Graphic by JR Bee, Verywell Health)

Twenty Kentuckians have tested positive for an infection caused by a strain of E. coli bacteria, and public health officials say they have not yet identified the source of the outbreak, the state Department for Public Health said.

Investigators said some element of food distribution is the likely cause of the outbreak, which has struck both children and adults, mostly in Central Kentucky.

The health department reports that no deaths have been linked to the outbreak, but six people have been hospitalized.

Health-care providers across the state have been alerted to watch for patients with quick-onset diarrhea, which can be associated with E. coli. The release says this is a particular strain of E. coli that produces a type of toxin, called Shiga toxin, that can be dangerous for those infected.

“Exposure to E. coli bacteria can be debilitating and potentially life-threatening, especially for small children and individuals with weakened immune systems," said Public Health Commissioner Dr. Jeff Howard. "With this in mind, the Department for Public Health has taken swift action to identify patients, ensure appropriate testing, and follow-up care as we work to determine the source."

Howard encouraged everyone to be aware of the signs and symptoms of E.coli infections and to seek care if they exhibit any of them.

Symptoms typically include stomach cramps and diarrhea, including bloody diarrhea. Symptoms usually start two to five days after consuming contaminated food. The state news release notes that the infection can sometimes lead to hemolytic-uremic syndrome, a serious complication that can cause kidney failure a week or more after the onset of diarrhea.

"State health officials are working with staff at local health departments in the counties with suspected or confirmed cases to determine the source of the infections," says the release.

To prevent E. coli infections:

• Wash hands frequently for at least 20 seconds with soap and warm water, especially before eating,after going to the bathroom, when handling raw meat and eggs, and after handling or petting animals 
• Thoroughly wash produce before eating
• Thoroughly cook meat
• Clean and sanitize food preparation areas
• Avoid swallowing lake or pool water
• Drink only pasteurized milk
• Frequently clean and sanitize restrooms, including door knobs and faucet

If you believe you have an E.coli infection, call your health-care provider, write down what you ate in the week before you got sick, report your illness to the health department, and be prepared to answer questions about your illness, the health department advises.

Romaine lettuce is OK to eat unless it was grown in the Central Coast region of California, federal agencies say

Romaine lettuce (Photo from Getty Images)

After urging Americans not to eat any romaine lettuce, two federal agencies have limited their warning to lettuce grown in the Central Coast region of California.

The Centers for Disease Control and Prevention and the Food and Drug Administration say romaine  grown elsewhere, or in greenhouses or hydroponically, has not been linked to the outbreak of E.coli bacterial infections.

The agencies advise consumers to check labels or store signs for the source of any romaine lettuce, and if you have already purchased romaine (or any lettuce mix containing it) and aren't sure where it was grown, throw it out and thoroughly clean your refrigerator.

No single grower, supplier or distributor has been identified as the source of the lettuce that caused the infections.

"CDC officials recommend that clinicians not prescribe antibiotics to anyone infected with this bacteria as some studies suggest that these drugs could increase a patient’s risk of developing a serious complication from the illness," Sheri Rudavsky reports for The Indianapolis Star.

Ky. leads nation in overuse of antibiotics, one reason for rise of drug-resistant bacteria; here's how to avoid serious infections

Dr. Kevin Kavanagh
(Lexington Herald-Leader photo)

An infection-control activist offers a dire warning about drug-resistant bacteria and offers tips on how to protect yourself from these deadly super-bugs in an op-ed piece for the Lexington Herald-Leader.

"There is a war going on, reminiscent of a zombie apocalypse," writes Dr. Kevin Kavanagh, who is also the board chairman of Health Watch USA. "The insidious agent is spread easily between people; a bite is not required. It does not turn its captors into mindless killing drones but instead, when they least expect it, they are slowly eaten from the inside out.The apocalypse is called drug-resistant bacteria, and so far, modern medicine is failing miserably at stopping it."

The federal Centers for Disease Control and Prevention reports that at least 2 million Americans are infected with a drug-resistant bacterium every year, and at least 23,000 of them die from it. There are signs that the problem will only get worse.

Kavanagh reports that some projections of the annual death toll from drug-resistant infections will reach tens of millions worldwide, surpassing cancer and heart disease as the leading cause of death. This has been widely written about, including stories from CBS News, BBC, Scientific America and STAT, to name a few.

Antibiotic resistance has been linked to the over-prescription of antibiotics; patients not finishing their entire antibiotic course; overuse of antibiotics in livestock and fish farming; poor infection control in health-care settings; poor hygiene and sanitation; and the absence of new antibiotics being discovered, Andrew Duong reports for InfectionControl.tips.

The overuse and over-prescription of antibiotics is a real problem in Kentucky. Kavanagh writes that Kentucky's antibiotic use is more than double the usage in other states and that the fluoroquinolone (Cipro, Floxin) class of antibiotics is prescribed at one of the highest rates, often inappropriately.

Centers for Medicare and Medicaid Services map shows  ZIP-code-level rates for antibiotics prescribed per 1,000 fee-for-service Part D Medicare beneficiaries in 2016. Dr. Kevin Kavanagh of Health Watch USA calls Kentucky the "bulls-eye of antibiotic overuse."

He adds that health-care providers have a responsibility to be the "gatekeeper[s] of antibiotic usage," but all too often "succumb to patient pressure."

"For most common illnesses, antibiotics are not effective," Kavanagh writes. "They will not work on viruses that cause the common cold nor on the flu. They will also not work on most 'sinus' infections."

Kavanagh adds details on how misuse of antibiotics can lead to a dangerous gastrointestinal infection caused c. diff (clostridium difficile), which is "almost impossible to get rid of" since it is not only resistant to many antibiotics but can transform into a spore that can remain inactive for years, only to reemerge when the body is in a weakened state.

"You know this is a bad actor when severe cases are being cured (and to a very high degree) by using a tube to place someone else’s feces into the patient’s GI tract," he writes. "Even the mention of this a decade ago would have been meet with ridicule and disbelief but 'desperate times call for desperate measures.' Lucky this one works."

Kavanagh offers these tips to protect yourself:

• Avoid the use of antibiotics whenever possible.
• Stay healthy, maintain good hygiene and get your vaccinations.
• When seeking health care, ask about a facility's MRSA (methicillin-resistant staphylococcus aureus) and c. diff rates, and any recent outbreaks of other dangerous bacteria.
• Check Hospital Compare, which offers information about the quality of care at over 4,000 Medicare-certified hospitals, to determine the facility’s track record on these measures.
• Kavanagh warns that a hospital's ability to handle these infections doesn't mean they are good at preventing them. He advocates for a "seek-and-destroy" methodology, similar to the one used by the Veterans Administration and England's National Health Service.
• If you are going for surgery and are not offered a test to see if you are a MRSA carrier, ask for one. If you are told it is not cost effective, he writes, "Remember it is a $10 preoperative test."
• Kavanagh notes that there is "solid evidence that MRSA preoperative screening is needed for most major surgeries" to determine which preoperative antibiotics are needed or if intervention is needed to prevent an infection, called decolonization.

Swimmer's ear can be very painful; here are tips to prevent it

photo: CDC

One of the best parts of summer is swimming, but it can cause a condition called swimmer's ear that can be extremely painful.

Acute otitis externa, or swimmer's ear, happens when water stays in the ear too long, which creates a perfect environment for bacteria to grow.

"Swimming is a significant risk factor, especially in fresh water," Kara Jones-Schubart, a clinical assistant professor at the Texas A&M College of Nursing, told HealthDay News. "For most people, swimmer's ear is a one-time occurrence, but for others, it can take a more chronic form."

Symptoms of swimmer's usually begin with itching in the outer ear, but this can progress to redness in the outer ear along with some warmness and pain and pain when the infected ear is tugged on or moved.

Treatment for the condition varies depending on the severity of the case, but often includes antibiotic ear drops.

The Centers for Disease Control and Prevention offers these prevention tips for swimmer's ear: wear earplugs, custom fit ear-molds or a swim cap while swimming; use a towel to dry your ears after swimming; tilt and shake your head to drain water from your ears after swimming; and to use a hair dryer on a very low setting while holding it at least a foot away from the affected ear to dry it out after swimming.

The Mayo Clinic suggests an at-home preventive treatment for swimmer's ear "if you know you don't have a punctured eardrum." A solution of one part white vinegar to one part rubbing alcohol is poured by one-teaspoon amounts into each ear and then allowed to drain out. This will help prevent the growth of bacteria and fungi that can cause swimmer's ear, Mayo says. Similar over-the-counter products are available.

More cautiously, the CDC says it is important to consult a health-care provider before using any kind of ear drops for swimmer's ear. Like Mayo, it cautions that ear drops should not be used by people with damaged ear drums, but also adds that people with ear tubes, outer ear infections, and ear drainage should not use ear drops.

In addition, the CDC points out that it's important to not place any object in the ear canal, like cotton swabs or cotton balls, as they can push material deeper into the ear canal. It also suggest that you should also ask the pool operator if the disinfectant and pH levels are checked at least twice per day, noting that properly disinfected pools with correct pH levels are less likely to spread germs.

Swimmer's ear is not the same as the common childhood ear infection, otitis media,which is an infection of the middle ear. The CDC says that if you can wiggle the outer ear without pain, it is probably not swimmer's ear.

Got a virus? You don't need an antibiotic but you might get one; Kentucky leads the nation in outpatient antibiotic prescriptions

Antibiotics don't cure illnesses caused by viruses, and can even cause "dire consequences" when used inappropriately, so it's important to take them only when necessary, says a news release from the state Cabinet for Health and Family Services.

"Antibiotics are the only drugs where use in one patient can impact the effectiveness in another patient," Andrea Flinchum, a registered nurse and coordinator for the Kentucky Department for Public Health’s Healthcare-Associated Infection Prevention program. "They are wonderful tools in fighting bacterial or fungal infections – but prescribing them for viruses or taking them for illnesses they do not treat, can cause bacteria to become resistant to these drugs."

Parents need to know that illnesses like the common cold, the flu, runny noses (even with yellow and green mucus), coughs, bronchitis, sore throats, most sinus infections and some ear infections are usually viral and antibiotics won't cure them, says the federal Centers for Disease Control and Prevention. In addition, antibiotics won't help your child feel better and won't keep others from catching your child's illness. Viral illnesses usually go away without treatment in a week or two.

The problem is that when your child takes an antibiotic when they don't need it it kills the good bacteria in your child's body, which can lead to complications, like diarrhea or yeast infections.

Overuse can also lead to bacteria developing resistance to a medication, making infections stronger and harder to kill. Sometimes these infections are so severe that they cannot be cured with antibiotics and thus require stronger treatments, and possibly hospitalization. The CDC estimates that each year 2 million Americans get an infection with antibiotic-resistant bacteria and every year 23,000 of those patients die.

The CDC estimates that more than half of the antibiotics given for upper respiratory infections and nearly a third of antibiotics used in hospitals are prescribed inappropriately. Kentucky has the highest prescribing rate for antibiotics in the outpatient setting in the U.S., Flinchum noted.

"It is critical to use these life-saving drugs when truly necessary, while also using the right drug at the right dose and duration to protect the effectiveness of antibiotics," said Flinchum. "We encourage clinicians to improve prescribing habits and patients to ask their providers if antibiotics are truly needed for their care."

Tips for smart antibiotic use:

• Don't insist on an antibiotic if your health care provider diagnoses your child's illness as a virus.
• Remember, antibiotics only treat bacterial infections.
• Some ear infections DO NOT require antibiotics.
• Most sore throats DO NOT require an antibiotic, unless it's strep throat.
• Green colored mucus is NOT a sign that an antibiotic is needed.
• Take as prescribed, not doing so can cause antibiotic resistant infections.
• Don't save half-used bottles of antibiotics for future use.
• Don't share antibiotics.
• Prevent infections by keeping your hands washed.
• Get a flu vaccine.
• If taking an antibiotic, call your doctor if you don't see improvement within three days.

Salmonella outbreak in 35 states linked to live poultry; 21 cases reported in Kentucky; here are some tips to avoid infection

U.S. Centers for Disease Control and Prevention photo

Poultry specialists from the University of Kentucky are urging Kentuckians who raise chickens or ducks to take extra precautions against salmonella infection, since 21 cases have been reported in the state.

“Any contact with live poultry puts you at risk for salmonella infection,” Jacqueline Jacob, UK poultry extension project manager for the College of Agriculture, Food and Environment, said in a news release. “Salmonella germs can be in the birds’ droppings and on their bodies and also on their cages, coops, hay, plants and the soil where they live and roam.”

Salmonella is a bacteria that makes people sick. Symptoms usually develop 12 to 72 hours after exposure and include diarrhea, fever and abdominal cramps. The illness usually lasts four to seven days. Children under 5, adults older than 65 and those with weakened immune systems are at the greatest risk of being severely affected.

These infections are part of a seven-state salmonella outbreak that have all been linked to contact with life poultry from multiple hatcheries. Jacob cautioned that any chicken can carry salmonella, even if it looks clean and healthy.

So far, more than 300 people have been infected, with more than one-fourth of those children aged 5 or younger, according to the federal Centers for Disease Control and Prevention.

“Many of the cases in the current outbreak are linked to backyard flocks, so we want to remind folks of simple things they can do to protect themselves," Jacob said.

Tips to avoid infection:

• Wash hands thoroughly with soap and water immediately after touching live poultry or anything in the area where they live.
• Do not let live poultry inside the house, or around areas where food or drink is located.
• Do not let children younger than 5 handle or touch live poultry without supervision.
• Adults should supervise the handwashing of young children.
• Keep poultry away from your nose, mouth and eyes.
• Wash your hands with sanitizer that has a 99 percent or higher bacteria kill rate after handling poultry at shows and fairs.

“It’s also a good practice to be careful when you wash equipment or eggs in the kitchen sink,” Jacob said. “You don’t want to cross contaminate food. Always use a good disinfectant to clean up in the kitchen when you’re finished.”

Click here for more advice from the CDC for backyard flock owners.

Bacteria that can't be treated by any antibiotic now in U.S.; Kentucky ranks first in one type of antibiotic-resistant infection

A colorized scanning  of E.Coli
Credit: CDC/Jancie Haney Carr

For the first time, researchers have found a person in the United States carrying bacteria that can't be treated by "last resort" antibiotics.

The antibiotic-resistant bacteria found in the 49-year-old Pennsylvania woman's urine was from a strain of E.coli bacteria that is resistant to an antibiotic called colistin, a last-resort drug with serious side effects that is used only when other antibiotics don't work.

For example, colistin is used to treat the superbug carbapenem-resistant Enterobacteriaceae, commonly called CRE, which health officials call a "nightmare bacteria."

Nearly half of patients who become infected with CRE die from it, Lena H. Sun and Brady Dennis report for The Washington Post.

The Pennsylvania woman was able to be treated with other antibiotics, but the discovery of the colistin-resistant strain has placed health officials on alert.

Health officials say it's not time to panic, but there is great concern that this colistin-resistance gene could spread to other bacteria that are also antibiotic-resistant creating many more bacteria strains that are untreatable, reports the Post.

The colistin-resistant strain was first found in pigs, raw pork and a few people in China in November. It has also been found in Europe.

“It basically shows us that the end of the road isn’t very far away for antibiotics — that we may be in a situation where we have patients in our intensive care units, or patients getting urinary-tract infections for which we do not have antibiotics,” CDC Director Tom Frieden told the Post.

Separate research found that the same colistin-resistant strain was found in a sample from one pig intestine in the United States. Colistin is widely used in Chinese livestock, but is not used in the United States, though plenty other antibiotics are, Tom Philpott reports for Mother Jones.

"Around 80 percent of the antibiotics sold in the United States go to livestock farms, and of that, 60 percent are considered crucial to human medicine," Philpott writes. Farmers mostly use antibiotics to help their livestock grow faster.

Yohei Doi, an infectious-disease doctor at the University of Pittsburgh, told the Post that he thought the widespread use of the antibiotic in Chinese livestock is likely what has led to the bacteria evolving and gaining resistance to the drug, and then leaping from livestock to humans through food.

Dr. Kevin Kavanagh, a retired physician and chairman of HealthWatch USA, said he isn't convinced that the U.S. pig was infected by livestock from China. He noted that colistin is commonly used to treat CRE, cystic fibrosis and that a form of colistin can be found in many over-the-counter topical antibiotics.

"It's probably more likely that the pig in the U.S. obtained this from the farmer's medicine cabinet than from another pig in China," Kavanagh said.

Experts in infectious diseases have called for action to curb the overuse of antibiotics in livestock worldwide. They have also warned that if these antibiotic-resistant bacteria continue to spread, treatment options could be severely limited.

Kavanagh  recognized the importance of research around the overuse of antibiotics in livestock but said that he thought more emphasis should be placed on the human side of healthcare related to antibiotic-resistance bacteria than the agriculture side of it.

 "The foremost emphasis should be placed on controlling antibiotic usage, controlling the spread of these organisms and surveillance of these organisms. ... We don't really know how many infections exist because we have a fragmented reporting system, but you know how many cows there are in each county," he said.

The federal Centers for Disease Control and Prevention estimates that at least 2 million people are infected with antibiotic-resistant bacteria each year, and 23,000 die.

Kentucky ranked first in MRSA cases, July 2014 - June 2015.

HealthWatchUSA

Kentucky has one of the highest prescribing rates of antibiotics in the nation and also leads the nation in another antibiotic resistant infection called MRSA (methicillin-resistant staphylococcus areus).

"Overuse of antibiotics has got to stop," says Kavanagh said. "The use of antibiotics needs to be curtailed to only when it is necessary. ... Every time you take an antibiotic you remove your good bacteria and run a real risk of activating a superbug in your body which can cause you extreme harm and even death. You should only take antibiotics when you have to take them."

Pharmaceutical companies have stepped away from developing new antibiotics because they aren't very profitable. But William Schaffner, medical director of the National Foundation for Infectious Diseases, told WebMD, "The Infectious Diseases Society of America has been working with Congress and with industry to create incentives for the pharmaceutical industry to reopen its antibiotic research laboratories."

In addition, "Late last year, as part of a broader budget deal, Congress agreed to give hundreds of millions of dollars to the federal agencies engaged in the battle against antibiotic-resistant bacteria," reports the Post.

Raw milk suspected as cause of bacterial infections among four children in Hardin County and one in Oldham County

Five children in the Louisville region were recently hospitalized with E. coli bacterial infections, and all had consumed unpasteurized milk, state health agencies found. Investigators have not yet proven that raw milk caused the infections, but "found raw milk was the only common factor among the sick children," Forrest Berkshire reports for The Kentucky Standard in Bardstown and The News-Enterprise of Elizabethtown.

Four of the children are from Hardin County, and one is from Oldham. All went to a hospital to be treated for complications of E. coli, which attacked their red blood cells and affected their kidneys. The Lincoln Trail District Health Department said tests of milk from the suspected dairy and distributors were negative for E. coli, a bacterium common to the intestinal tracts of mammals.

"Pasteurization is the process of heating a liquid such as milk to a high enough temperature to destroy disease-causing microorganisms," Berkshire explains. "It also increases the shelf life of milk by destroying spoilage microorganisms and enzymes."

The state Department for Public Health said, "DPH is stressing the dangers of unpasteurized milk after learning all the affected children had consumed it and because it is a known source of E. coli bacteria, as well as numerous other pathogens that can lead to illness."

Selling raw milk is illegal in Kentucky, but is available through a "herd share," which allows members to buy an interest in a cow that allows them to take the milk home. "Northern Kentucky U.S. Rep. Thomas Massie, a Republican, introduced two bills earlier this year he characterized as 'milk freedom legislation' and would strip the U.S. Food and Drug Administration of its authority to police raw milk sales," Berkshire writes. Supporters of raw milk say it helps people resist disease and promotes better growth, stronger teeth and better behavior.

However, the federal Centers for Disease Control and Prevention conducted a study over a decade that found "the risk of outbreaks caused by raw milk is at least 150 times greater than the risk of outbreaks caused by pasteurized milk," Berkshire reports.

Kentucky law requires milk must be pasteurized, and officials encourage buyers to check labels to make sure it is, and throw it out if pasteurization cannot be confirmed. "Even negative tests do not guarantee that raw milk is safe to drink," the CDC says on its "Raw Milk Questions and Answers" webpage. "People have become very sick from drinking raw milk that came from farms that regularly tested their milk for bacteria and whose owners were sure that their milk was safe." (Read more)

'Superbug' considered the worst one yet is still not widespread in Kentucky hospitals, but officials predict it is coming

A new deadly superbug that is almost totally resistant to antibiotics and kills about half who get bloodstream infections has found its way to community hospitals in the Southeastern United States, Laura Ungar reports for The Courier-Journal.

 "We haven't seen much here, but I'm sure it's coming," Forest Arnold, an epidemiologist at University of Louisville Hospital and an associate professor of infectious diseases at the university, told Ungar.

CRE, short for carbapenem-resistant Enterobacteriaceae, are a family of bacteria that have, over time, become resistant to antibiotics called carbapenems, which are considered drugs of last resort for this type of infection. It can cause a range of illnesses depending on where it infects the body, ranging from gastrointestinal illness to pneumonia to bloodstream infections.

A recent study in the journal Infection Control and Hospital Epidemiology indicates CRE increased "fivefold" at community hospitals in several southeastern states from 2008 to 2012, Ungar reports. Kentucky was not part of the study, but researchers say the rates "reflect a growing problem across the region and throughout the country." 

"People need to be aware," Arnold told Ungar. "It will eventually get here."

Experts report that overuse of antibiotics is one of the main reasons for these superbugs, Ungar writes. And Dr. Kevin Kavanagh, an infection-control activist who leads the Somerset-based watchdog group Health Watch USA, told Ungar that  Kentucky has one of the nation's highest rates of antibiotic use, sometimes prescribed unnecessarily.

"CRE is very dangerous," Kavanagh said. "It is almost totally resistant to antibiotics."

Ungar reports that local hospitals have seen growing numbers of CRE, citing examples of University Hospital with a case last year in which the patient died, and Norton Healthcare, with three cases in the first three months of last year and 10 others between 2010 and 2013.

Last year, the federal Centers for Disease Control and Prevention warned that CRE had spread from one medical facility in 2001 to numerous facilities in 46 states in 2013, Ungar notes. CDC Director Tom Frieden has labeled  CRE "nightmare bacteria," calling them the worst of the growing list of antibiotic resistant germs that "take hold in health care settings."

 One in 25 hospitalized patients has at least one health care-associated infection on any given day, according to the U.S. Centers for Disease Control and Prevention, with C. difficile, which causes 14,000 American deaths per year and MRSA, which one study shows kills 18,000 Americans a year, being  two of the most common, Ungar reports.

Doctors say they hope to control CRE before it becomes as common as MRSA, which has spread to communities, Ungar reports.

 "So far, CRE are just in the health care setting," Kavanagh told Ungar. " 'If it continues to grow and escape into the community, it will be an even bigger problem' and the medicines doctors count on to cure bacterial infections will no longer work against them."

Kavanagh told Ungar that "antibiotics should be used only when they are absolutely necessary, and hospitals must remain vigilant about ensuring health care workers wash their hands often, keep rooms and medical equipment clean, wear gowns and gloves when appropriate and separate infected patients from others."

"If the emergence and spread of superbugs aren't prevented,'we'll be in a post-antibiotic era'," Kavanagh told Ungar. "And the danger is not going to go away unless we change the course of how we do things."

Deadly, drug-resistant bacteria are becoming more common in Kentucky hospitals; key lawmaker wants to require public reporting

Nightmarish, drug-resistant bacteria that cause deadly infections are becoming more common in Kentucky hospitals, and a leading legislator on health issues says they should be required to report each case.

The state Department for Public Health and hospital officials are investigating the presence of carbapenem-resistant Enterobacteriaceae, or CRE, at Kindred Hospital Louisville, right, a long-term and transitional care facility.

“Since July, we have identified about 40 patients in whom we have cultured the organisms from one or more body fluids,” Dr. Sean Muldoon, chief medical officer for Kindred, told Laura Ungar of The Courier-Journal.

These superbugs kill about half of the patients who get infected. They have become resistant to nearly all the antibiotics available today, including drugs of last resort. CRE infections are caused by a family of germs that are a normal part of a person's healthy digestive system but can cause infections when they get into the bladder, blood or other areas where they don't belong, says the federal Centers for Disease Control. The presence of CRE in bodily fluids doesn’t mean someone is infected by the bacteria, because the patient could also be “colonized” by the bacteria without developing an infection, said Muldoon. CRE may be present in a patient before he or she is admitted to the hospital, or it can be transmitted from patient to patient at the hospital, Ungar notes.

Officials at several Louisville-area hospitals told The Courier-Journal last month that they have seen a growing number of CRE cases in recent years, reports Ungar. The CDC issued a warning report about the bacteria last month, but there has only been one "outbreak" of CRE listed for Kentucky. (Read more)

Given the threat of this bacteria, the CDC has called for quick action to stop these deadly infections, and the chairman of the House Health and Welfare Committee wants to tighten up CRE reporting requirements.

Rep. Tom Burch, D-Louisville, sent a letter to Gov. Steve Beshear proposing a new regulation that would mandate immediate reporting of CRE infection or colonization to the state. Burch said he plans to introduce a bill that would require such reporting by health-care facilities, and he is working with Dr. Kevin Kavanagh of the Somerset, Ky.-based watchdog group Health Watch USA, reports Ungar.

“If it gets in the community and spreads, we’re in trouble,” Kavanagh told Ungar. Burch emphasized this level of risk in his letter to the governor, saying that health-department involvement is crucial to preventing this deadly bacteria from "developing a foothold in Kentucky."

Nightmare, drug-resistant superbugs, including one that kills half the people who get it, are a big threat

"Nightmare bacteria" leading to deadly infections that are difficult and sometimes impossible to treat are on the rise in American hospitals, and threaten to spread to otherwise healthy people outside of medical facilities, according to a federal Centers for Disease Control Vital Signs report published Tuesday.


These superbugs, carbapenem-resistant Enterobacteriaceae, or CRE, have become resistant to nearly all the antibiotics available today, including drugs of last resort. According to the report, CRE infections are caused by a family of germs that are a normal part of a person's healthy digestive system, but can cause infections when they get into the bladder, blood or other areas where they don't belong.

The report says almost all CRE infections are found in patients receiving serious medical care, and they kill up to half of patients who get bloodstream infections from them. In addition to spreading among people, CREs easily spread their antibiotic resistance to other kinds of germs, making those potentially untreatable as well.

Only 10 years ago, such resistance was hardly ever seen in this group of germs. Although these superbugs are uncommon, their prevalence has quadrupled in the past decade in medical facilities in 42 states, the CDC says.

The report calls for immediate action to stop the spread of these deadly infection; it is a critical time for U.S. doctors, nurses lab staff, medical facility leaders, health departments, states, policymakers and patients to help fight the spread through coordinated and consistent efforts.

The report asks patients to do three things: Tell your doctor if you have been hospitalized in another facility or country, take antibiotics only as prescribed, and insist that everyone wash their hands before touching you. For more details, click here for the Vital Signs report.