Calling Ian Betteridge: Are grocery store conveyor belts a significant source of foodborne illness?

I’m sitting at the NoroCORE annual meeting and listening to Aron Hall and others talk about sources of noro illnesses. Stuff like ill food handlers and bare hand contact in full service restaurants rise to the top as risk factors for the most prevalent food-related pathogens. Dirty conveyor belts, not so much.

Tove Danovich of Food Politic interviewed me a couple of weeks ago about issues related to conveyor belts in grocery stores wondering whether they a good source for illnesses?MINOLTA DIGITAL CAMERA

I told her that when it comes to outbreaks and pathogens, I’m not sure the data is there.

If you’re squeamish about the thought of unseen bacterium and pathogens, stop reading. A 2009 study found contamination on 100% of tested grocery store conveyor belts. Though they often seem clean, a lack of dust doesn’t mean they aren’t a breeding ground for bacteria. The question to ask ourselves us is whether these grocery store workhorses have the potential to make us sick.

The study, conducted by Dr. Zhinong Yan, took 100 samples from 42 grocery stores in Michigan. They were tested for “total aerobic bacteria count (TAC), yeast, mold, Staphylococcus aureus (Staph), and coliforms.” Coliforms are a rod-shaped bacteria that are commonly used as bacterial indicators due to their easy cultivation and large presence in fecal matter. If you’ve got coliforms, you’ve got stool (this is not true, the bacteria that make up the coliform group are naturally associated with lots of plants, without poop – ben). Dr. Yan also tested for more dangerous bacteria like MRSA, E. coli, salmonella, and listeria. Luckily, evidence of the most dangerous foodborne pathogens weren’t found.

What was detected, however, were high levels of just about everything else – including coliform bacteria. These belts might not give you stomach flu but probably needed a good round of sanitation. 

Enter the antimicrobial conveyor belt, a cover for your bacteria-covered black belts. Antimicrobial wraps both kill bacteria and are non-porous (read: can actually be cleaned). A somewhat ingenious advertisement from MessageWrap, an antimicrobial surface that can also display ads or other messages, shows that even a child can install it in under an hour.

Yet not everyone is sure that conveyor belts are breeding grounds for dangerous microbes. Benjamin Chapman, Food Safety Specialist, often works with consumers, grocery, and retail stores to curb potential risks. “When we look at conveyor belts, there are two components of risk: what’s the likelihood of pathogens being there and how they could be transferred to food,” he says. While he agrees that conveyor belts are difficult to clean and sanitize, that doesn’t automatically mean they should be a source of worry.

To put it simply, bacteria can be found in any environment – your bathroom, kitchen table, or cooking surfaces at home. Chapman has never found data to prove that conveyor belts are particularly good at transferring pathogens to food. Of course, that doesn’t mean you shouldn’t ask for the belt to be sanitized if the person in front of you has a package of chicken that’s leaking fluid. “If I see something, I’m going to do what I can do make it safer,” Chapman adds.

As for microbial wraps, they may not even get rid of potential contamination. As Chapman put it, “It’s not a magic bullet.” All conveyor belts have seams that are often particularly hard to sanitize and clean whether it’s a wrap or black PVC. If you’re going to find bacteria, that’s a good place to look.

So unless you’re shopping for groceries in a particularly dingy store, chances are good that you have little to worry about. “If there’s going to be food, there’s going to be bacteria,” Chapman says. We’d be sick forever if the mere presence of bacteria was enough to give us a foodborne illness.

Don’t avoid the grocery store just yet but be mindful of the state of the surfaces where you set your food. As for your mild case of bacterial OCD? Chapman may have put it best, “I’m not in the business of knowing how much people should be concerned about something.”

This last bit was in response to a question Tove asked “how concerned should people be?” My philosophy (stolen from many other smart people in the food safety risk analysis work) is that I want to present the risks and let people make their own risk management decisions. How concerned someone is (whether an individual or a food safety nerd at a food company) is a risk management calculation. It didn’t come out quite right.

Maybe something is lost in translation: 4-year-old’s death a misadventure

Kids dying from foodborne illness hits me like a punch in the gut. After following illnesses and outbreaks for 15 years I still take pause to think about my kids when I see a tragic story involving children.

Outbreaks rarely end with the classic smoking gun resolution (a genetically matched strain in the food/environment and stool). Epidemiology, in the absence of pathogen matches, is king and uncertainty is reduced with reliable data and statistics. Once a possible food/site match is made, investigators go out to the field and check the food handling out.broken-telephone

A conscientious investigator can talk about possible risk factors in a report – but the subsequent reporting and broken telephone game of sharing the information can bleed potential factors into must-have-happened fact.

A few years ago an environmental health officer shared her concerns about how the story gets changed between the field and the report interpretation. She had investigated a outbreak blamed on poor handwashing shared with me that her notes showed no soap at the time she was in the kitchen a week after the illnesses were reported – that was translated into poor handwashing by the staff at the time of the outbreak.

She felt that was an extrapolation wrought with assumptions.

Folks who used the example didn’t care.

Getting the risk factor story right really matters.

According to the Straits Times a four-year-old boy in Singapore tragically died from salmonellosis and court proceedings point to food handling practices a shopping center food court stall. Based on the coverage, I’m not sure it’s that simple. And I wouldn’t call it a misadventure.

Shayne Sujith Balasubraamaniam, together with his mother and two-year-old sister, came down with food poisoning on Jan 19 this year, a day after his mother had bought food, including tahu goreng and curry chicken, from a nasi padang stall at Kopitiam food court at Northpoint Shopping Centre.

All three were taken brought to Bukit Batok Polyclinic the next day. Shayne was assessed to be severely dehydrated and was prescribed medication.

He showed apparent signs of recovery, but deteriorated on Jan 22 when his mother found him unconscious at home. He died in hospital about two hours later from salmonella septicaemia.

On Thursday, State Coroner Marvin Bay said in his findings that the boy’s death underscores that careless food handling and inattention to proper hygienic practices can result in catastrophic consequences on young and vulnerable persons. He found the boy’s death to be one of misadventure.

The most significant lapse, the inquiry heard, was the practice of partial cooking and refreezing of chicken parts. The kitchen would receive 80 parts of chicken as a batch. After washing the batch, 60 chicken parts were refrozen for use the next day. They would be stored with plastic bags with other raw food at the freezer, a practice which would encourage cross-infection between the raw and partially cooked food. Swabs from the tongs used to handle food, and the blender found a high concentration of bacteria that exceeded safety limits.

While the post-outbreak investigation demonstrates serious issues with food handling at the business, I’m not sure what was presented is enough to link the salmonellosis. If the stored chicken was partially cooked it implies that it would be further cooked – which if temperatures exceeded 165F would result in a 5-log reduction of Salmonella. Maybe cross contamination between raw and sorta raw chicken is really a factor – especially if there weren’t other illnesses. Or maybe the washing step spread pathogens around the kitchen.

Chinese whistle-blowers to get 60% of food safety fines

The Greater Kaohsiung Council has amended municipal food safety rules to offer whistle-blowers 60 percent of the resulting fines levied on convicted companies — the highest cash reward offered in the nation.

wbCouncilors from across party lines unanimously approved the amendment to food industry regulations, a move fueled by the revelation that Kaohsiung-based Cheng I Food Co has been selling substandard oil to food manufacturers in the latest food scandal to rock the nation.

Cheng I has been fined NT$50 million (US$1.67 million) on charges of violating the nation’s food safety laws. That means that if the new rules had been in effect and the news had been broken by an internal whistle-blower, he or she would have been eligible for NT$30 million in cash.

Similar rules in other cities, municipalities and counties pay between 10 and 50 percent of the fine levied on a convicted firm.

Democratic Progressive Party Kaohsiung Councilor Lian Li-jian, who initiated the move to amend the rules, said giving incentives to workers at companies that could be undertaking illegal practices would help deter unethical acts.

He said that the amendment passed by the council also contains provisions that ensure the safety and job security of workers tipping off the authorities.

The amended food safety regulations further require food makers to keep food storage and waste disposal zones separate at their factories.

12 bizarre foods confiscated from U.S. borders

From BonAppetit.com, people try to sneak in the darndest foods when they’re entering the U.S. From Argentine vicuña patties to Zambian baobab fruit, officials confiscate enough food at the border to throw a months-long (and rather exotic) feast (learn more about it right here).

chinese.beans.oct.14U.S. Customs officials provided BonAppetit.com a copy of their records from fiscal year 2010 to 2013 listing the kinds, quantities, and countries of departure for all the food items they seized from all commercial flights into America. Meanwhile, we sent photographers to LAX to document a day’s haul at the Customs checkpoint. Here’s what we found

My fav is the Chinese long beans which can be easily purchased in L.A.

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People barfing everywhere: Dozens sick at NAACP annual gala

Public health officials are investigating a possible case of food poisoning that left more than 50 attendees at an NAACP gala with terrible vomiting and diarrhea.

donald-sterling-naacp-honor-withdrawn__oPtTwelve people were taken by ambulance to hospitals and treated for dehydration, officials said. And several more drove themselves to hospitals Saturday night and early Sunday morning after getting sick during a banquet dinner commemorating the closing of the 27th Annual NAACP State Convention.

Among those hospitalized was former Oakland Mayor and Assemblyman Elihu Harris, said George Holland, an attorney who heads the civil rights organization’s Oakland chapter.

More than 300 people, including former San Francisco Mayor and keynote speaker Willie Brown, attended the banquet at the grand ballroom of the Sofitel San Francisco Bay Hotel in Redwood City, Holland said. He didn’t know if Brown had fallen ill.

Several people became sick after eating a dinner that included salmon and salad, Holland said. By 10:30 p.m. attendees were throwing up in the hotel lobby, while more than 20 firefighters and paramedics tended to them.

“It was a terrible scene,” Holland said. “Other hotel guests were very upset.”

Quite a few of the sick were teenagers attending the banquet, Holland said. A 5-year-old also fell ill.

Holland said his wife started vomiting early Sunday, and the illness hit him Monday morning. “I was shivering all day long,” he said.

Sofitel, which is part of a French luxury hotel chain, did not return a call seeking comment. Health officials were unable to produce records Tuesday showing whether the hotel has had similar issues in the past, said Robyn Thaw, spokeswoman for the San Mateo Medical Center.

Norovirus grounds NZ plane while health authorities are consulted

In 2013, then four-year-old Jack yacked on a flight which led to a fascinating display of infection control by Delta Airlines involving plastic bags (to contain the potential pathogen) and coffee pods (to manage the smell). The flight crew let us off the plane first, although we were in the second-to-last row, and we potentially inoculated the plane, and passengers, with norovirus.111007015237-sick-throwing-up-airplane-motion-story-top-1

Maybe the best plane-related outbreak was one reported in Clinical Infectious Diseases a couple of years ago. I’d describe my poop and barf-related imagination as pretty good but I couldn’t have dreamt up the scenario that unfolded on a plane leaving Boston bound for Los Angeles in October 2008. The outbreak included a passenger with “multiple episodes of diarrhea, with at least 1 occurring in the aisle of the first-class section. The soiled aisle was not cleaned until after completion of the flight.”

According to the New Zealand Herald  a flight from Queenstown to Christchurch was grounded today as about 40 passengers, all members of a tour group, began feeling ill and reported they had been exposed to norovirus.

“[The flight] was delayed this morning while advice was sought from Canterbury regional public health authorities after reports of unwell passengers on board,” a spokeswoman for Air New Zealand said.

“After public health authorities had assessed the situation the all-clear was given to disembark the passengers, with the unwell passengers advised they cannot be accepted for further travel until they are well again.”

Earlier, one passenger, Charles Finney, tweeted: “Not allowed to leave flight at Christchurch because health authorities worried passengers might have contagious virus! A first for me!”

He continued to update the situation, saying he was “furious” the tour group got on board knowing some of them were unwell.

“Worried about Norovirus. Tour group has had unwell people for days apparently but still travelled!,” he posted.

Good ole’ timey science-off: what’s the best way to wash hands, do sanitizers have a role?

Science is about a world–view of a topic and providing the data to back up that view.

Biology is especially messy.aust.handwashing.oct_.151

International handwashing day was October 15, but I was busy making a mess.

In Australia, the feds have a nice poster and how paper towel is to be used to dry hands, and I’ve never been in a Western country that has more hand driers than paper towel dispensaries.

Proper handwashing requires proper tools.

Ludwig writes in the current issue of Public Understanding of Science (November 2014 vol. 23 no. 8 982-995) to propose a methodological externalism that takes knowledge about science to be partly constituted by the environment. My starting point is the debate about extended cognition in contemporary philosophy and cognitive science. Externalists claim that human cognition extends beyond the brain and can be partly constituted by external devices. First, I show that most studies of public knowledge about science are based on an internalist framework that excludes the environment we usually utilize to make sense of science and does not allow the possibility of extended knowledge. In a second step, I argue that science communication studies should adopt a methodological externalism and accept that knowledge about science can be partly realized by external information resources such as Wikipedia.

Style is important, but content rules.

In this corner, Dr. Keith Warriner of the University of Guelph (that’s in Canada), who writes there are many old-wives tails, rumors and stories that are so ingrained that we don’t know if they are fact or fiction. The list is so long that a popular TV show called “The Myth Busters” is totally devoted to applying science to verify if myths are true or false. The show is for entertainment but it is when myths or non-substantiated knowledge, are actually applied in regulations and guidelines with the thought that someone must have done the science at some point in time.

As many new mothers in the latter part of the 19th century will verify, hand washing has been an essential intervention for minimizing the transfer of pathogens in clinical, food and other environments. The recommended method for washing hands was developed in 1980’s and has not changed significantly through the years. But is the method supported by science?

Myth 1: Antimicrobial soap provides superior hand washing results compared to normal soap

It has been widely accepted that antimicrobial soap is preferred over normal soap for increasing the efficacy of hand washing. Of all the aspects associated with hand washing the comparison of antimicrobial vs. normal soap has been studied to the greatest extent. The general conclusion is that antimicrobial soap supports a marginal increase in the number of bacteria removed from hands. If high inoculation levels are applied to hands then the removal with antimicrobial soap is statistically significantly compared to normal soap. However, with natural skin microflora there is no difference between the efficacy of normal and antimicrobial soap.  

There has been recent research that has suggested that antimicrobial soap can detrimental through disrupting the balance of the skin microflora and irritating the skin. On this basis all the evidence would suggest that antimicrobial soap has no advantages over normal soap.

Myth: Busted

Myth 2: Warm or hot water is better for hand washing than cool water

The FDA have reviewed the recommended water temperature used for hand washing no less than three times. The results of the deliberations was that 110F (43°C) should be set as the recommended temperature in the belief a greater proportion of microbes can be removed. However, all the scientific evidence available suggests that water temperature has no effect on the removal of microbes in the range of 4 -49°C. However, other research in this area has illustrated that water temperature does influence the duration of hand washing with cold or hot water leading to shorter rinse times due to user discomfort.  

Myth: Busted

Myth 3: Paper towels are perform better than air dryers

The method used for drying hands following washing is one of the most contentious issues in the hand hygiene arena. The general thought pattern when devising the hand washing guidelines was that hands needed to be dried to prevent acquisition of contamination from surfaces. This is true to a degree but it should also be noted that hand drying can contribute significantly in reducing microbial levels on hands following washing.

The majority of papers published to date have been pro-paper towels and even the “The Myth Busters” returned the same conclusion. However, it should be noted that many of the comparative studies performed the researchers used hot air hand driers that generated a gentle breeze making the user resort to completing the drying process using ones pants. More modern high speed (air blades) driers certainly can dry hands to the same extent as paper towels within 20 seconds. When a comparison is made between air blades and paper towels there is no difference in terms of microbial log reduction or degree of hand dryness. Given that high speed hand driers are not universally available, the evidence would support the view that paper towels are indeed better that hot air driers.

Myth: True

So does it matter if hand washing protocols are not science based?

It is apparent that many aspects of the hand washing protocol are not based on hard scientific evidence but this does not mean it is the wrong thing to do. Still, by reconsidering if anti-microbial soap is really necessary then skin health could be improved. The savings on energy and water usage by reducing the recommended wash time and temperature could also have a positive impact. Regardless of this, we always need to consider the science when devising guidelines.

In the other corner we have Don Schaffner of Rutgers University (that’s in Jersey). Don writes that an Internet troll is defined by Wikipedia as “a person who sows discord on the Internet by starting arguments or upsetting people… with the deliberate intent of provoking readers into an emotional response…”. Doug knows the way to troll me is to send a link and ask me to blog about it (he really just wants to call me a troll).

An article from weau.com features the headline “Simple Sickness Prevention: Hand-Washing vs. Hand-Sanitizer”, and asks: what is more effective, old fashioned soap and water, or the alcohol based hand sanitizer?

Not a bad start. The story goes on to feature Doctor Jaime Marks, Assistant Professor of Medicine at UW-Health, who offers a variety of opinions on hand washing and hand sanitizer use.

Dr. Marks says it’s okay to use either hand-washing or hand-sanitizer.

Hmm. the FDA CFSAN Food Code 2–301.16(A)(3) would disagree, but I think I’m starting to like Dr. Marks…

If you notice your hands are soiled, you’ll want to wash your hands. Hand washing is at least 45–60 seconds, like singing through “Happy Birthday” twice in your head. With hand sanitizer, you’d want to use it for 20–30 seconds.

Whoops. That went off the rails quickly. Dr. Marks is certainly entitled to his opinion, but I’d like to see the scientific peer-reviewed basis for those statements. I’d waged they don’t exist. At least I’ve never seen them.

Dr. Marks continues…

Both are about equal as far as getting your hands clean as long as your hands are not soiled.

Hmmm. Dr. Marks wins me back. Sort of. In fact sometimes hand sanitizers even work when your hands are soiled.

The story concludes with some muddled statements about good bacteria and bad bacteria, building an immune response and getting a flu shot that don’t really hang together, but I’ll give Dr. Marks partial credit for trying. More credit next time if you cite the literature.

Or, according to The Smashing Pumpkins, “Emptiness is loneliness and loneliness is cleanliness and cleanliness is godliness and god is empty, just like me.”

Raw sprouts with Salmonella strike again; UK wedding guests win compensation

Wedding guests have won tens of thousands of pounds worth of compensation after beansprouts served at a reception caused a deadly outbreak of food poisoning.

wedding.crashersRene Kwartz, 82, died in hospital three weeks after contracting salmonella at a Jewish celebration in Prestwich in August, 2010.

Now 25 other guests who were also struck down with the bug have settled civil cases against caterers Shefa Mehadrin and suppliers Duerden Brothers.

Among them were Colin Thornton, 57, and his wife Rozanne, 53.

Colin, who used to live in Prestwich and now lives in Clitheroe, Lancashire, said: “You expect to go to a wedding reception and have a nice meal, you don’t expect this to happen to anybody.

“I feel very sorry for the family that booked it. They must feel terrible but it wasn’t their fault.”

He added: “It is very annoying that we’ve had to fight for four and a half years for this.

“A person’s life has been lost.”

The outbreak was traced back to a batch of beansprouts served raw in a salmon teriyaki dish.

Expert guidance recommends they are cooked to kill any bacteria.

The bride’s mum Norma Harris was among the others infected, along with the groom and best man.

At the time she said: “We are devastated. My daughter doesn’t want to see her wedding photographs. We are in bits.”

The settlements, negotiated by Slater and Gordon, are understood to range from £1,000 to £5,000.

We document at least 55 sprout-associated outbreaks occurring worldwide affecting a total of 15,233 people since 1988. A comprehensive table of sprout-related outbreaks can be found at http://barfblog.com/wp-content/uploads/2014/08/Sprout-associated-outbreaks-8-1-14.xlsx.