Mayo Clinic Surgeons Propose New Measures For Indicating Quality Of Lung Surgery

In an era when lung cancer remains the most lethal cancer, accounting for more deaths than colon, breast and prostate cancer combined — and surgery, when possible, is the most effective treatment — Mayo Clinic surgeons have proposed a system of lung surgery quality indicators for surgeons and the public as a method to demonstrate best practices for obtaining positive patient outcomes.

Mayo Clinic surgeons believe the process is necessary because no other method currently exists to measure the quality of care received by patients undergoing lung surgery.

Death rates following surgery are reported. However, because they aren’t adjusted for factors such as patient age and disease severity, they don’t tell the whole story. To overcome this lack of risk adjustment in death rate data, the Mayo Clinic team proposed patient-centered processes that should occur prior to, during and after surgery to assure the likelihood of best surgical outcomes.

“There are certain processes that we can measure and report that clearly indicate whether a patient has received high-quality care around the time of their lung operation,” explains Stephen Cassivi, M.D., Mayo Clinic thoracic surgeon. Dr. Cassivi presented a list of proposed patient-centered quality indicators for lung surgery at the 43rd Annual Meeting of the Society of Thoracic Surgeons this week in San Diego. “Knowing this data can help the patient decide about the care they are about to receive and where to go to receive that care — and equally important, this knowledge can help chest surgery programs improve their quality of care by concentrating on identified weaknesses,” says Dr. Cassivi. “Creating standards through measures of process will allow for directed quality improvement initiatives across all surgical centers.”

The Mayo Clinic List of Quality Indicators

To find the clearest and most meaningful measures to evaluate lung surgery quality, the Mayo Clinic team analyzed the care of 606 lung surgery patients who underwent 628 lung surgeries at Mayo Clinic during one year. The patients’ average age was 65.8 years and ranged from 2 to 93 years.

From the analysis, the following list emerged for processes that should occur prior to surgery because of their potential contribution to positive patient outcomes.

* Pulmonary function testing

* Electrocardiogram

* Smoking history documented

* Smoking cessation therapy offered to those patients still smoking prior to surgery

* Appropriate preoperative staging of cancer

In addition, the Mayo Clinic team identified post-lung surgery practices that improve patient outcome. These include: use of incentive spirometry — a simple breathing exercise meant to increase lung capacity and prevent postoperative pneumonia; timely response to heart rhythm disturbances; defined measures to prevent venous clots (deep vein thrombosis); documented timely attention to pain control for patients’ comfort; and follow-up care planning with the patient prior to discharge from the hospital.

“All of these measures are patient-centered and relevant to the clinical improvement of the patient undergoing lung surgery, and they can be easily documented and assessed,” Dr. Cassivi says. The Mayo Clinic thoracic surgery team suggests that surgeons and hospitals adopt them as standard protocol.

The Next Step

Mayo Clinic will work to formalize its proposal with the Society of Thoracic Surgeons. Adopting these quality process measures as standards and compiling data regarding adherence to these standards could be accomplished using the Society of Thoracic Surgeons national general thoracic surgery database.

Says Dr. Cassivi: “Our Mayo Clinic experience shows that if the whole general thoracic surgery team — from surgeons, to nurses, nurse educators, physician assistants, physical therapists — uses these process measures as indicators of a high quality of care, areas for improvement can be identified and improved in a timely fashion. If all practices used these indicators, the huge variability in care of lung surgery patients could be reduced and overall quality increased.”

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Contact: Amy Knutson
Mayo Clinic

Obesity And Metabolic Disease

Obese individuals often suffer from the metabolic syndrome, which is a combination of medical disorders that increase an individual’s risk for cardiovascular disease and type 2 diabetes. Deregulation of a protein known as mTOR (which is a nutrient sensor that when activated increases energy expenditure by the cell’s of the body) has been implicated in the development of obesity and the metabolic syndrome in humans. Further evidence for this idea is now provided by researchers from McGill University, Canada, who show that mice lacking two proteins known to be effectors of some mTOR functions (4E-BP1 and 4E-BP2) are more obese than normal mice.

In their study, which appears in the February issue of the Journal of Clinical Investigation, Nahum Sonenberg and colleagues show that mice lacking both 4E-BP1 and 4E-BP2, when fed either a normal or high-fat diet, weigh more than wild-type mice. The increased weight gain after being on a high-fat diet was a result of increased fat accumulation, associated with decreased energy expenditure, decreased fat degradation, increased differentiation of fat cells, and increased insulin resistance (one of the main triggers of type 2 diabetes and a contributing factor to the metabolic syndrome). This study indicates that two effectors of mTOR functions are crucial for preventing mice from becoming obese and suggests that 4E-BP1 and 4E-BP2 might provide therapeutic targets for the treatment of obesity and the metabolic syndrome.

In an accompanying commentary, Liangyou Rui from the University of Michigan Medical School, Ann Arbor, puts these observations into the bigger picture of how other mTOR effectors also affect body weight and how this pathway intersects with other molecules known to regulate obesity.

TITLE: Elevated sensitivity to diet-induced obesity and insulin resistance in mice lacking 4E-BP1 and 4E-BP2

AUTHOR CONTACT:
Nahum Sonenberg
McGill University, MontrГ©al, QuГ©bec, Canada.

TITLE: A link between protein translation and body weight

AUTHOR CONTACT:
Liangyou Rui
University of Michigan Medical School, Ann Arbor, Michigan, USA.

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JCI table of contents: Feb. 1, 2007

Contact: Karen Honey
Journal of Clinical Investigation

Bird Flu Officials And Bernard Matthews Say Consumers Not At Risk

Officials investigating the deadly H5N1 bird flu outbreak at a Bernard Matthews turkey farm in Suffolk, UK, have said that consumers are not at risk of bird flu.

Also, Bernard Matthews, founder and owner of the turkey meat company, has spoken about the situation for the first time this week.

Matthews, who is 77 and now occupies a back seat in the management of the company has come forward to emphasize that there has been no attempt to keep information hidden from the authorities, “They know what we know,” he said to the press.

“It’s my name on the packet and I wouldn’t let it go out to the shelves if I thought there was anything wrong with it,” said Matthews.

The Food Standards Agency (UK) has said they could find no evidence that the turkey products the company was voluntarily holding at its cold stores in Suffolk and Chesterfield contained meat from the zone in Hungary that is currently under a restriction order.

The products can now be released into the food chain, the FSA said.

In the meantime the Health Protection Agency (HPA) has completed tests on the three poultry workers who were showing avian flu-like symptoms. A fourth person who was not in direct contact with poultry was also tested as a precaution.

All four patients tested negative for the virus and are now either receiving normal clinical care or have been discharged from hospital.

A flu expert at the HPA, Dr Jonathan Van Tam said that the risk of the workers getting avian flu was very low because they had followed the correct procedures.

He expects more workers will come forward with flu symptoms because that is normal at this time of year. The HPA will continue to offer seasonal flu shots and antivirals to those who may have been exposed to the virus.

The FSA also reported that the State Veterinary Service (SVS, an agency within DEFRA) has permitted the slaughterhouse at the Bernard Matthews Suffolk plant to reopen after it was cleaned and disinfected according to Meat Hygiene Service standards.

The chair of the FSA, Deirdre Hutton said in a prepared statement that the “investigation so far has not found anything that raises the risk to public health.”

The FSA emphasized that this is not a food safety issue. Their advice is that “avian flu does not pose a food safety risk for UK consumers.”

“It is still a possibility that infected poultry has entered the food chain but the risk to public health remains low,” said Ms Hutton.

A full report on the joint investigation by the FSA, the Department of Food and Rural Affairs (DEFRA) and the Health Protection Agency (HPA) is expected to be published tomorrow.

Yesterday authorities in the Netherlands said they would be lifting a ban on allowing poultry to be outdoors. The Dutch agriculture ministry said the ban was put in place following reports that the deadly strain of H5N1 had arrived in Britain via wild birds.

They said “It can be said with relative certainty that the outbreak in England came about through indirect contact with infected companies in Hungary. The option that the outbreak was due to infected wild birds seems less likely.”

The ban will be lifted on 19th February.

The European Food Safety Authority (EFSA) say that the risk of catching the deadly strain of bird is very very small. Only people who have direct frequent contact with infected live birds carry any significant risk of contracting the disease and regulations about hygiene and handling of live birds should be followed to reduce that risk even further.

The EFSA has issued advice (October 2005) on the importance of thoroughly cooking poultry and eggs.

Poultry includes turkey, chicken, duck, goose, and guinea fowl.

Click here for the Food Standards Agency (UK).

Click here for Avian Influenza: Protecting human health from farm to fork (includes link to 7 min Video, World Health Organization)

Written by: Catharine Paddock
Writer: Medical News Today

FDA Approves Omnaris (ciclesonide) Nasal Spray For Allergic Rhinitis

The Food and Drug Administration (FDA) announced today the approval of Omnaris (ciclesonide) nasal spray, a new drug for the treatment of nasal symptoms associated with seasonal and perennial allergic rhinitis, commonly known as hay fever, in adults and children 12 years of age and older.

Although the precise way Omnaris works is unknown, the drug is a corticosteroid. Corticosteroids are hormone-like drugs that suppress the immune response.

Allergic rhinitis is the medical term for the inflamed, runny nose that’s the main symptom of allergies. Seasonal allergic rhinitis is the most common allergic disease. About 35 million Americans suffer from this condition. The ailment’s classic symptoms are watery nasal discharge, and fits of sneezing, and itching that can affect not just the nose but the roof of the mouth, throat and the Eustachian tubes which connect the middle ear to the back of the throat.

The safety and efficacy of Omnaris nasal spray were studied in four randomized placebo controlled clinical trials ranging in duration from two weeks to a year. The studies assessed how well Omnaris treated symptoms (runny nose, nasal itching, sneezing, and nasal congestion) in patients with hay fever. The results of these trials showed that patients treated with Omnaris nasal spray had an 8-10 percent greater reduction in nasal symptoms compared to placebo. The difference between Omnaris nasal spray and placebo was significant.

The most common side effects in clinical studies were headache, nosebleeds, and inflammation of the nose and throat linings.

Omnaris is manufactured by ALTANA Pharma US, Inc. of Florham Park, NJ.

http://www.fda.gov

Blindness From Smoking Terrifies Teens, But Few Realize The Two Are Linked

Teenagers fear blindness more than lung cancer or stroke, but nine out of 10 don’t know that smoking can rob them of their sight in later life, reveals research published ahead of print in the British Journal of Ophthalmology.

The findings are based on the responses of 260 clubbers aged between 16 and 18, collected at four UK venues in Bournemouth, Winchester, Manchester and Southampton.

One in five of the young women were daily smokers (21%), compared with around one in seven (15%) of the young men.

The teens were asked if they knew about the link between smoking and certain diseases, such as stroke, lung cancer, heart disease, and blindness.

Deafness, which is not caused by smoking, was also included, in a bid to balance out the responses.

They were then asked to rank their fears of each disease.

Awareness that smoking caused lung cancer was high, with 81% of respondents recognising the causal link. But the teenagers were not so well informed about the other health consequences of smoking.

Just over one in four (27%) realised smoking was linked to heart disease, and only 15% realised that smoking could also lead to stroke.

Just 5% correctly identified that smoking can also cause blindness, mostly as a result of age related macular degeneration, or AMD for short.

The figure was even lower among those who smoked, just 2% of whom recognised the link.

But teens were far more frightened of losing their sight than of any other smoking related disease, giving it an average score of 4, compared with 3 for lung cancer, and 2 for heart disease and stroke.

Nine out of 10 of the teens said they would give up at the first signs of blindness, prompting the authors to suggest that public health messages about smoking which are aimed at teens, should include the risks of blindness.

While the prevalence of smoking has fallen in the UK, rates among teenagers are still high, warn the authors.

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Contact: Emma Dickinson
BMJ Specialty Journals

Slander Hearing Against Bulgarian Nurses Sentenced To Death In HIV Infection Case Postponed

A hearing in the slander trial brought against five Bulgarian nurses sentenced to death for allegedly intentionally infecting hundreds of Libyan children with HIV has been postponed until later this month, the nurses’ lawyer said on Sunday, Reuters UK reports (Reuters UK, 2/11). The five nurses and a Palestinian doctor in May 2004 were sentenced to death by firing squad for allegedly infecting 426 children through contaminated blood products at Al Fateh Children’s Hospital in Benghazi, Libya. They also were ordered to pay a total of $1 million to the families of the HIV-positive children. The Libyan Supreme Court in December 2005 overturned the medical workers’ convictions and ordered a retrial in a lower court. A court in Tripoli, Libya, in December 2006 convicted the health workers and sentenced them to death. The health workers say they are innocent of the charges, claiming that they were forced to confess and that they were tortured by Libyan officials during interrogations. A Libyan court in June 2005 acquitted nine police officers who had been charged with torturing the medical workers and forcing them to confess (Kaiser Daily HIV/AIDS Report, 2/1). Libyan police officer Juma Mishri and a doctor, Abdulmajid Alshoul, are asking for $3.9 million each in compensation for the nurses’ torture accusations. The nurses’ lawyer, Othman Bizanti, said they were scheduled to be questioned about the slander charges on Sunday at the start of the new criminal trial, but the Tripoli district court granted his request for more time to study the case. The court has set the questioning for Feb. 25, he said (Reuters UK, 2/11). Sofia, Bulgaria, prosecutor Nikolay Kokinov has said the country within four months will bring charges against 11 Libyan police officers for allegedly torturing the nurses into confessing. Kokinov said the charges would allow him to begin a judicial investigation, which could lead to a trial (Kaiser Daily HIV/AIDS Report, 2/1).

“Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Study Tests Oral Insulin To Prevent Type 1 Diabetes

Researchers have begun a clinical study of oral insulin to prevent or delay type 1 diabetes in at-risk people, the National Institutes of Health (NIH) has announced. Type 1 Diabetes TrialNet, an NIH-funded network of researchers dedicated to the understanding, prevention, and early treatment of type 1 diabetes, is conducting the study in more than 100 medical centers across the United States, Canada, Europe, and Australia.

“Our goal is to prevent type 1 diabetes or to delay it as long as possible. If diabetes can be delayed, even for several years, those at risk will be spared the difficult challenges of controlling glucose and the development of complications for that much longer,” said TrialNet study chair Jay Skyler, M.D., of the University of Miami.

In the study, researchers are testing whether an insulin capsule taken by mouth once a day can prevent or delay diabetes in a specific group of people at risk for type 1 diabetes. An earlier trial suggested that oral insulin might delay type 1 diabetes for about four years in some people with autoantibodies to insulin in their blood. Animal studies have also suggested that insulin taken orally may prevent type 1 diabetes. Some scientists think that introducing insulin via the digestive tract induces tolerance, or a quieting of the immune system. Insulin taken orally has no side effects because the digestive system breaks it down quickly. To lower blood glucose, insulin must be injected or administered by an insulin pump.

In type 1 diabetes, a person’s own immune cells destroy the beta cells of the pancreas. Beta cells sense blood glucose and produce the hormone insulin, which regulates glucose and converts it to energy. The immune attack on beta cells begins well before a person develops diabetes and continues long after the disease is diagnosed. In the early stages of autoimmunity, up to 10 years before diabetes is diagnosed, autoantibodies may appear in the blood. These autoantibodies to glutamate decarboxylase (GAD), IA-2, and to insulin itself indicate a greater risk for developing type 1 diabetes. For a person with high-risk genes and all three antibodies, the risk of developing diabetes in the next 5 years is greater than 50 percent.

First- and second-degree relatives of people with type 1 diabetes who may be at risk are being screened through TrialNet’s natural history study, which is examining the immune and metabolic events that precede diabetes symptoms. Screening involves a simple blood test for the autoantibodies that signify diabetes risk. Individuals enrolled in the natural history study are closely monitored for diabetes development and may be eligible to participate in the oral insulin trial or future studies that try to arrest the autoimmune process. Studies for the Newly Diagnosed

TrialNet studies are also aimed at safely preserving insulin production in people recently diagnosed with type 1 diabetes. In the few months after diagnosis, most patients still have a supply of functioning beta cells that, with the help of insulin injections, contribute to good control of blood glucose. If beta cells can be protected, more patients would be able to tightly control their blood glucose, which prevents or delays damage to the eyes, nerves, kidneys, heart, and blood vessels.

One TrialNet study seeks to turn off the immune attack on beta cells with Rituximab, a monoclonal antibody that binds to and temporarily destroys a specific class of immune cells. The Rituximab trial is recruiting patients with type 1 diabetes diagnosed within the previous 3 months. Rituximab is approved by the Food and Drug Administration (FDA) to treat specific forms of lymphoma and moderate to severe rheumatoid arthritis. It is not approved for the prevention of type 1 diabetes.

Also under way is a study testing whether mycophenolate mofetil (MMF) or MMF plus daclizumab (DZB), drugs approved by FDA to prevent rejection after an organ transplant, can slow or arrest the autoimmunity of type 1 diabetes. This study has recruited the needed number of patients.

Study for Newborns at Risk for Type 1 Diabetes

The Nutritional Intervention to Prevent Type 1 Diabetes (NIP) Trial is a pilot study of docosahexaenoic acid (DHA), an omega-3 fatty acid that may have anti-inflammatory benefits that prevent development of the autoimmunity that leads to type 1 diabetes. The NIP study is being conducted in:

* babies less than 5 months old who have immediate family members with type 1 diabetes, and

* pregnant mothers in their third trimester whose babies are at risk for type 1 diabetes, either because the mother has type 1 diabetes herself or other immediate relatives have the disease.

About 5 to 10 percent of the nearly 21 million people with diabetes have type 1, formerly known as juvenile onset diabetes or insulin-dependent diabetes. Type 1 diabetes tends to arise in children and young adults but is also diagnosed in older people. Patients need three or more insulin injections a day or treatment with an insulin pump to maintain blood glucose control. To prevent complications, they must regularly monitor their blood glucose, striving for a range that is as close to normal as possible. The constant challenge of managing the disease poses an enormous burden on patients and their families.

The Type 1 Diabetes TrialNet studies are funded by the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Child Health and Human Development, and the National Institute of Allergy and Infectious Diseases within the NIH. The Juvenile Diabetes Research Foundation International and the American Diabetes Association also support the initiative.

For more information about TrialNet studies, see http://www.diabetestrialnet.org/.

The NIDDK, a component of the NIH, conducts and supports research in diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic and hematologic diseases. Spanning the full spectrum of medicine and afflicting people of all ages and ethnic groups, these diseases encompass some of the most common, severe, and disabling conditions affecting Americans. For more information about NIDDK and its programs, see http://www.niddk.nih.gov/.

The National Institutes of Health (NIH) – The Nation’s Medical Research Agency – includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.niddk.nih.gov/.

Contact: Joan Chamberlain
NIH/National Institute of Diabetes and Digestive and Kidney Diseases

First Asthma Census Highlights Lack Of Control Of Condition, UK

An Asthma UK census has revealed that only 4% of those people questioned have their asthma under control.

The shocking results follow Asthma UK’s first ever asthma control census which was launched on World Asthma Day in May this year. It aimed to raise awareness amongst the 4.1 million adults with asthma in the UK that they may be putting up with symptoms that impact unnecessarily on their quality of life.

The Asthma Control Test, a 60-second, five-point questionnaire was completed online by over 16,000 people. The test which gives a score out of 25, helps to identify the level of asthma control.

Results also highlighted that more than a third of people experienced shortness of breath on a daily basis and for 1 in 4, using their reliever inhaler more than three times a day was a regular occurrence. This is a clear indication that their asthma is not under control as asthma management guidelines state that a person’s asthma is not well managed if they use their reliever inhaler more than three times a week.

The census further revealed that as a person got older, their asthma worsened. For those that completed the test, scores decreased for the older age groups and showed that for many, being woken at night or earlier in the morning with asthma symptoms such as coughing or wheezing, was a regular occurrence.

Professor Martyn Partridge, Chief Medical Advisor at Asthma UK said: ‘The results of this census highlight that a high proportion of people in the UK are putting up with unnecessary symptoms on a daily basis. They could be getting a better night’s sleep, going about their everyday life without thinking about their asthma and using their reliever inhaler far less. With simple and safe medication, their asthma could be under control. I would advise making an appointment to see your GP or asthma nurse so that they can have an asthma review. The ultimate aim should be that you control your asthma, and not that it controls you.’

1. The Asthma Control Test is suitable for people with asthma aged 12 and over.

2. ©2002, by QualityMetric Incorporated. Asthma Control Test is a trademark of QualityMetric Incorporated. “US English version modified for use in UK”

3. Asthma UK is the charity dedicated to improving the health and well being of the 5.2 million people in the UK whose lives are affected by asthma. For up-to-date news on asthma, information and publications, visit the Asthma UK website http://www.asthma.org.uk.

4. For independent and confidential advice on asthma, call the Asthma UK Adviceline, which is staffed by asthma nurse specialists. It is open weekdays from 9am to 5pm on 08457 01 02 03. Or email an asthma nurse at http://www.asthma.org.uk/adviceline.

http://www.asthma.org.uk

Lung Cancer Alliance Hails Courage Of Congressman Norwood And Extends Well Wishes As He Battles Lung Cancer

Today, the Lung Cancer Alliance (LCA) hailed Congressman Charles Norwood (R-GA) for his courage and willingness to publicly disclose his valiant battle with lung cancer.

“Sharing this kind of news with family, friends and constituents is never easy, but in doing so, Congressman Norwood is showing courage and selflessness,” said Laurie Fenton, President of the Lung Cancer Alliance. “Even during this very difficult time, Congressman Norwood continues his lifelong commitment to advocacy for patients’ rights by informing people about the enormous toll lung cancer takes on all sectors of our community. The congressman helps shine the light on the urgent need for more research, earlier detection and better treatments for the number one cancer killer.”

Edward J. Levitt, Executive Director of LCA’s Georgia chapter said, “He is a true hero and we are all praying for him.”

During the twelve years Congressman Norwood has represented eastern Georgia in the U.S. House of Representatives, he has distinguished himself as a nationally recognized leader and the author of major legislation on patients’ rights and health care benefits for veterans and military retirees.

Lung cancer is killing more people each year than breast, prostate, colon, melanoma, liver and kidney cancers combined. Only 16 percent of lung cancer cases are diagnosed at Stage 1, when the cancer can be treated and cured.

The stigma of smoking has led to the under funding of lung cancer research and early detection programs, even though more than 60 percent of new lung cancer cases are diagnosed in people who never smoked, were exposed to significant second-hand smoke (10-15 percent), or in former smokers (50 percent) who had already quit, many of them decades ago.

Both Fenton and Levitt assured Congressman Norwood, his wife, Gloria, and his family of their admiration, support and gratitude.

“We are committed to dedicating our continued efforts in Congressman Norwood’s name to raise awareness of the need for early detection and the devastating statistics on lung cancer that have been ignored for too long,” Fenton said.

The Lung Cancer Alliance (http://www.LungCancerAlliance.org), headquartered in Washington D.C., is the only national non-profit organization solely dedicated to patient support and advocacy for people living with, or at risk for, lung cancer. The Georgia chapter is headed by Executive Director Edward J. Levitt of Acworth, GA.

Lung Cancer Alliance
http://www.LungCancerAlliance.org

Pennsylvania Health Department Investigates Salmonella Cases Linked To Peanut Butter As Part Of National Outbreak

Due to risk of contamination with salmonella, state Health Secretary Dr. Calvin B. Johnson today advised consumers not to eat and to discard Peter Pan Peanut Butter and Great Value Peanut Butter with product codes that begin with the number “2111.”

Nationwide, 288 cases of illness have been linked to the current multi- state salmonella outbreak. In Pennsylvania, 25 cases have been identified in 19 counties: Adams, Beaver, Bedford, Bradford, Bucks, Centre, Clearfield, Dauphin, Elk, Erie, Lackawanna, Lancaster, Lehigh, Luzerne, Montour, Perry, Philadelphia, Tioga, and Wayne.

“The department is working very closely with the federal Centers for Disease Control and Prevention to conduct local public health investigations,” Dr. Johnson said. “If you have any Peter Pan or Great Value Peanut Butter at home, check the product codes for ‘2111.’ If those numbers appear, do not eat the peanut butter and immediately discard it.”

Salmonella is a bacterial infection that affects the intestinal tract and can sometimes affect the bloodstream and other organs. It is one of the most common causes of gastroenteritis, which can include diarrhea and vomiting. Approximately 2,000 cases of salmonella are reported each year in Pennsylvania.

Onset of illness usually occurs in 24 to 72 hours and patients typically recover in 5 to 7 days. Patients often do not require treatment unless they become severely dehydrated or the infection spreads from the intestines. People with severe diarrhea may require rehydration, often with intravenous fluids. Antibiotics are not usually necessary unless the infection spreads from the intestines.

If you have consumed Peter Pan or Great Value Peanut Butter and are experiencing the symptoms described above, contact your primary health care provider.

Pennsylvania Department of Health
http://www.health.state.pa.us