Ben Chapman

About Ben Chapman

Dr. Ben Chapman is an associate professor and food safety extension specialist at North Carolina State University. As a teenager, a Saturday afternoon viewing of the classic cable movie, Outbreak, sparked his interest in pathogens and public health. With the goal of less foodborne illness, his group designs, implements, and evaluates food safety strategies, messages, and media from farm-to-fork. Through reality-based research, Chapman investigates behaviors and creates interventions aimed at amateur and professional food handlers, managers, and organizational decision-makers; the gate keepers of safe food. Ben co-hosts a biweekly podcast called Food Safety Talk and tries to further engage folks online through Instagram, Twitter, Facebook, YouTube and, maybe not surprisingly, Pinterest. Follow on Twitter @benjaminchapman.

Thunder Bay restaurant food handler has hepatitis A

There’s a lot of hep A in food handlers making the news. Regardless of whether the staff member is a superstar handwasher, or not so stellar, folks who are exposed will be lining up for shots somewhere. And the stigma associated with the business is hard to shake.

According to the Thunder Bay News Watch (that’s in Canada), Bight Restaurant and Bar is experiencing the hepatitis A rollercoaster.51h4OC-rlZL._SY300_

The Health Unit is investigating a case of hepatitis A in an employee of Bight Restaurant and Bar, located at 2210 Sleeping Giant Parkway, Unit 100, Marina Park.

Anyone who visited this restaurant between March 23 and April 12 may have been exposed to the hepatitis A virus.

Patrons who have previously completed the two-dose hepatitis A vaccine series or the three-dose Twinrix® series would be protected. Staff of the restaurant is being offered immunization. Although the vaccine is most effective if given within 14 days of exposure, the Health Unit will be offering a free vaccination clinic on Saturday, April 18 from 12:00 to 3:00pm at 999 Balmoral Street (corner of Balmoral and William Street) for those that visited the establishment between March 23 and April 12.

Two in New Mexico suspected to have botulism

One of the roles I inherited when I came to North Carolina is organizing the judges for annual home food preservation competition at the State Fair. I didn’t know a whole lot about preserving (other than the science) when I took over six years ago but I spent some time with experienced canners who taught me the hands on stuff.Botulism

Deviating from the prescribed steps can create the perfect environment for Clostridium botulinum spore outgrowth, germination and toxin production. Of the 20-30 cases of botulism in the U.S. every year, the majority are linked to improper home canning. It’s one nasty illness.

According to News West 9, two adults in New Mexico are being treated for symptoms that look like botulism.

The New Mexico Department of Health is cooperating with the Texas Department of State Health Services and the Centers for Disease Control and Prevention (CDC) on an investigation of two patients who are hospitalized in Texas with suspected botulism. The source is currently being investigated but is likely contaminated food. The patients are two adults from Lea County.

Nosestretcher alert: Maple syrup could help cut use of antibiotics

Last year all the rage, for a day, was that eating pizza could prevent norovirus. Except that’s not really what the research was about. Today’s concentrated-extract-has-antibiotic-properties story comes from McGill University where researchers have evaluated the effects of maple syrup on human pathogens.

Except not really.syrup

According to the university’s news website, an upcoming publication shows that a phenolic heavy extract made from maple syrup (not maple syrup itself) was ‘mildly effective; against E. coli and Proteus mirabilis.

I’m not sure what mildly means.

The release also says that there was a synergistic effect when used in conjunction with actual antibiotics.

Synergistic wasn’t really defined.

Prof. Nathalie Tufenkji’s research team in McGill’s Department of Chemical Engineering prepared a concentrated extract of maple syrup that consists mainly of phenolic compounds. Maple syrup, made by concentrating the sap from North American maple trees, is a rich source of phenolic compounds.

The researchers tested the extract’s effect in the laboratory on infection-causing strains of certain bacteria, including E. coli and Proteus mirabilis (a common cause of urinary tract infection). By itself, the extract was mildly effective in combating bacteria. But the maple syrup extract was particularly effective when applied in combination with antibiotics. The extract also acted synergistically with antibiotics in destroying resistant communities of bacteria known as biofilms, which are common in difficult-to-treat infections, such as catheter-associated urinary tract infections.

“We would have to do in vivo tests, and eventually clinical trials, before we can say what the effect would be in humans,” Tufenkji says. “But the findings suggest a potentially simple and effective approach for reducing antibiotic usage. I could see maple syrup extract being incorporated eventually, for example, into the capsules of antibiotics.”

Of course, the paper isn’t available yet.

Maybe I’ll have a side of pancakes, with maple syrup, with my magic noro-fighting pizza.

 

Ohio high school prom linked to norovirus outbreak

In 1997, Dani and I went to prom (below, exactly as shown). The theme was a classic: ‘Under the Sea.’ The venue was filled with bubble decorations, fish and blue streamers.

But no norovirus.FullSizeRender

According to the Chillicothe Gazette, students attending the Zane Trace High School prom last weekend weren’t that lucky; 22 have symptoms consistent with norovirus.

According to Health District spokesman Rami Yoakum, calls began coming into the health district Monday from parents reporting sick children. Thus far, 22 illnesses are believed to be part of the same outbreak, 18 of whom are Zane Trace students.

Kathy Wakefield, director of Public Health Nursing at the health district, said officials believe a norovirus is the culprit.

The health district has been working with the school, advising officials to clean school surfaces, and has also sent letters home to parents describing symptoms and asking them to keep sick children at home and away from sporting events.

Specimens were collected and sent to the state lab in Reynoldsburg. If the results in each case come back all looking similar, the Health District will likely be able to trace back to the source of the contamination, Yoakum said. Presently, health officials feel they have a good idea where the illness may have originated, but don’t want to publicly speculate until until the results from the tests come back and they are sure.

 

It’s gross: fish and chip shop owner fined for sanitation issues

I was explaining to an American friend what a chip butty was this weekend. The oh-so-British delicacy of white bread, butter and french fries all wrapped up into an artery stopping sandwich. The butty was a menu favorite of my grandfather (who introduced me to it when I was a kid) and you could only get one at real pubs (the ones that show Manchester U on Saturday mornings and illegally serve beer before 11) or traditional fish and chip shops.

Like the Nevill Street Chippy in Southport (that’s in England).JS61352288

According to the Liverpool Echo, Chippy owner Kim Paskin was recently fined for breaching local sanitation rules following an inspection.

They found the inside of the microwave that was used to heat up mushy peas and beans to be coated in grime, as well as the can opener being covered in ‘brown grime’ and the top lid of the chest freezer in the potato preparation room to be covered in flour and ‘not sufficiently cleaned or maintained.’JS61351526

Cigarette butts were found on the floor of a food storage area – indicating that people were smoking on the premises – where canned drinks and cans of beans and peas were kept.

The prosecution for Sefton Council noted a ‘tennis-ball sized hole’ in the wall which led out onto the yard, which inspectors said would be an access point for vermin into the kitchen and preparation areas – although there was no evidence to suggest there were any on the premises.

These are all nasty, but only one foodborne illness risk factors showed up:

Inspectors also found insufficient hand washing facilities, with the bottom of the wash basin covered in grime and no soap or hand drying facilities available.

The other stuff fits the yuck factor category, but no handwashing sink/equipment/soap is bad news.

 

 

 

From the rerun files: norovirus hits cruise ships

I’ve never been on a cruise. Sometimes we talk about taking one, hopping from island to island and relaxing on the open seas.

And then comes another round of norovirus outbreaks. Lots of news coverage, throwbacks to the poop cruises and pictures of the CDC Vessel Sanitation program officials boarding ships.

Restaurants are linked to 64 per cent of norovirus outbreaks. CDC says that cruise ships get a lot of the attention but onlyaccount for only about 1 per cent of norovirus outbreaks. But not everyone goes on a cruise. In 2013, according to the Florida-Carribean Cruise Association 11.7 million North Americans (out of a total of ~530 million residents) went on cruises.Screen Shot 2015-04-14 at 10.46.44 PM

It’s a numbers game: one per cent of the outbreaks happen in a setting that just two per cent of the population visit. Like Schaffner says, what’s the Crusies ?

But norovirus is everywhere. But being stuck on a ship with projectile vomiting doesn’t sound fun. According to the Guardian, two separate Royal Caribbean ships are experiencing outbreaks and are on their way back to San Diego.

Health officials are investigating what caused the outbreaks aboard the ships bound for California, both owned by Royal Caribbean Cruises Limited. The ships docked on Monday and Tuesday in San Diego.

Celebrity Cruises reported 106 sick passengers on board the Celebrity Infinity, which arrived on Monday in California. The ill vacationers accounted for 5% of the 2,117 travelers on board. Six of the more than 900 crew members were also sick.

Epidemiologists from the Centers for Disease Control are investigating the outbreak, and collected eight stool samples on board. Crews are tightening sanitation and disinfection procedures. 

Crew members are planning a “staged disembarkation” to avoid exposing healthy passengers to sick ones, potentially contaminating them with the infectious stomach virus.

Foodborne Illness: Consumer Costs, Consequences, and Choices (via The Abstract)

I’m collaborating with Matt Shipman, public information officer at NC State University and curator of The Abstract, on a set of food safety-related posts from other NCSU folks as we roll toward WHO’s World Health Day on April 7– which is focused this year on food safety. Here’s a post on consumer purchasing issues as they relate to food safety from my friend Kathryn Boys, an assistant professor of agricultural and resource economics at NC State.

Changes to our food system have increased the availability and variety of foods for U.S. consumers, but these changes have also introduced food safety challenges that can have significant impacts on human health and the economy. Researchers are working to develop new food safety tools – and in the meantime there are actions consumers can take to lower their risk of foodborne illness.Boys-Food-Safety-HEADER-848x477

The U.S. Centers for Disease Control and Prevention (CDC) estimates that 48 million instances of foodborne illnesses occur annually in the U.S., resulting in 128,000 hospitalizations and 3,000 deaths. The value of medical costs, productivity losses, long-term mental and other health impacts, and the costs of premature deaths stemming from these events is substantial. The fourteen pathogens that account for a majority of U.S. foodborne illness have recently been estimated to cost the U.S. economy $14 billion and cause a loss of 61,000 quality-adjusted life years annually.

The potential for a specific foodborne illness outbreak to have a broad and significant impact on human health and the economy is compounded by the integration and globalization of food supply chains. Historically, because of perishability and the fact that produce was predominantly consumed in its raw form, incidents involving produce contaminated in a farm setting would have only affected consumers geographically near the farm. Today, through improved transportation and logistics networks and increased processing, that same produce has the potential to be used in a wider variety of products and affect consumers far from where it was grown.

In addition, identifying the source of contamination may be challenging and time consuming for food wholesalers and other distributors who aggregate products from across many suppliers and who have not implemented traceability practices. And that delay in tracing the source of the contamination means there is more time in which additional consumers may become sick.

When Illness Strikes: Impact on Individual Consumers

A majority of consumers who become ill due to foodborne illness recover at home or with minor medical assistance. In cases of severe illness that can be attributed to either food prepared outside of their home (i.e., restaurants), or contaminated prior to entering their home, consumers may pursue legal remedy for their illness. Information on the number or outcomes of cases settled out of court is not available. We do have some insight, however, of food safety cases settled through jury trials.

Buzby, et al., analyzed federal jury trials (1988-1997) for foodborne pathogens to determine which factors of the incident/case most influenced the trial outcomes. These authors found that 31.4 percent of cases were won by plaintiffs, and juries awarded a median of $25,560 (ranging from $0 to $2.37 million in 1998 dollars). Demographic characteristics of the plaintiff, the ability of plaintiffs to link their illness to a specific pathogen, and the severity of the health impact resulted in higher awards.

Given increasing public and media attention to foodborne illness, continued integration of food supply networks, and improved traceability systems, it is likely that both the number of cases and the amount of these awards will increase over time. I am currently working with collaborators at Virginia Tech and the USDA Economic Research Service to examine this issue.

Foodborne Illness: Preventative Market Measures

Most U.S. consumers have faith in the safety of food supply chain. In general, consumers expect their products to be free from dangerous levels of contamination and to be efficiently recalled if there is a problem. However, the incidence of foodborne illness suggests that problems remain.

Higher levels of food safety can be attained for most food products, lowering the risk of purchasing a contaminated product. But increased food safety comes at a cost.

Research has explored how much more consumers are willing to pay for higher levels of food safety.

In general, findings indicate that U.S. consumers are willing to pay more for higher levels of safety due to risk from microbial, chemical or physical (e.g., metal) contamination. How much more, however, has been found to vary considerably depending on the research setting, the particular food products being studied, the extent of risk reduction, and the research participants’ adherence to safe food handling practices, perception of risk, and demographic characteristics.  The same is true for perceived threats to food safety from other sources.

Consumers concerned about pesticide residues or genetic modification, for example, are willing to pay higher prices for organic and non-GMO foods. Consumer willingness to pay to avoid other food technologies, such as artificial colorants, fruit-ripening technologies, growth hormones and other growth promotants, and nanotechnology (among many others) has been summarized by Lusk, et al.

Consumers interested in decreasing their risk of foodborne illness have the option of buying products from companies with good food safety records, and to keep abreast of product recalls and safety alerts. Once food has entered the home, the food handling and sanitation practices that consumers can take to limit their risk of foodborne illness are generally well known. Information about safe food handling techniques can be found at http://www.foodsafety.gov/index.html.

In the future, additional tools are also likely to be available to consumers. By way of example, food producers often signal the presence (or absence) of specific food attributes through a growing array of food certification and labeling schemes. While at present, there is no label to identify products with higher levels of microbial food safety, it is possible that one may emerge. In addition, human vaccines are currently under development to protect against illness due to Escherichia coli, Salmonella, and Campylobacter. These and other tools are likely to significantly change the food safety market and policy landscape in coming years.

Listeria in low moisture foods? Sure. Sabra hummus recalled; I chucked mine

My kids don’t eat much. Their staples include bagels, buns, peanut butter, carrots, apple sauce.

And hummus.

Their brand of choice is Sabra.

I just got home from a hockey game (a 7-2 loss, we got smoked) and opened up my email and saw that a few Sabra hummus products have been recalled due to Listeria. According to a recall notice on the FDA website, it’s only few specific lots, and the recall was initiated following a routine sample by Michigan regulatory folks found contamination.SubstandardFullSizeRender-1

And I’m left with a bunch of questions. I need to know this stuff to better understand the risk to my kids.

How much contamination was there (10 cfu/g? 1,000,000 cfu/g?)?

How long was the product in storage/transport before I bought it. Now that I think of it, how long has it been in my fridge?

The stuff I have been feeding my kids has different codes. Were the containers I have made in the same facility? On the same line?

And why is Sabra so specific about the recalled SKUs? Did they have a sanitation clean break between lots?

SubstandardFullSizeRender-4Have they validated their sanitation procedures?

How well did the sanitation crew do their job?

We’ve seen other recalls expand as further information is discovered, will this one?

In the absence of answers (to stuff that should go into a recall notice) I’m chucking the half-finished containers.

And we’ll buy a different brand tomorrow.

 

Seafood Safety 101: Vibrio in Shellfish

I’m collaborating with Matt Shipman, public information officer at NC State University and curator of The Abstract, on a set of food safety-related posts from other NCSU folks as we roll toward WHO’s World Health Day on April 7– which is focused this year on food safety. Here’s a post on Vibrio in shelfish by Liz Bradshaw, a postdoctoral research scholar in NoroCORE – the Norovirus Collaborative for Outreach, Research, and Education, based at NC State. 

People around the world are eating more and more seafood, and if you’re from the southeastern United States, oysters and other shellfish are a desirable delicacy for many. Most people are aware that eating raw or undercooked seafood can put them at risk for food-related illness, and while they have seen the warnings on restaurant menus, but may not know the specific microbes to blame. This post focuses on what is arguably the most important pathogen found in seafood (which is also on the rise) – Vibrio bacteria.Oysters-848x477

Vibrio refers to a genus of Gram-negative, rod-shaped bacteria, and they are found naturally in brackish and saltwater environments, as they need salt to survive and grow. They also like to multiply in warm water, and the majority of human cases happen in the summer months. Out of around a dozen Vibrio species that cause disease in people, two species – V. parahaemolyticus and V. vulnificus– are most often associated with eating raw or undercooked seafood, particularly molluscan shellfish (oysters, clams, mussels, and cockles). These bacteria can also enter through a wound or by ingesting seawater, but these cases are less common.

V. parahaemolyticus usually causes watery diarrhea, vomiting, and abdominal pain, sometimes with a fever and chills. People are usually sick for three days, and though unpleasant, the majority of people recover just fine, without needing prescription medications. The CDC estimates there are 35,000 V. parahaemolyticus cases a year in the United States.

V. vulnificus is a rarer but more sinister creature, and is often associated with fatalities. Most people with V. vulnificus experience symptoms similar to V. parahaemolyticus, but the bacteria are a particular threat to those who are immunocompromised or have underlying health conditions such as liver disease, diabetes, or cancer. In these patients, the bacteria can enter the bloodstream (septicemia), causing severe fever, skin lesions, and shock. Around 50 percent of these patients die, and that is often in the face of aggressive antibiotic treatment and supportive care, which is more than a little scary.  V. vulnificusinfection is, however, a rare disease; there are only about 30 cases a year in the United States.

The incubation periods (the time between eating the contaminated shellfish and becoming sick) are quite different for the two bacteria. V. parahaemolyticus starts making itself known around two to 48 hours after exposure, while V. vulnificus takes one to seven days. A clinical diagnosis using bacterial culture is still needed to be sure Vibrio is the culprit, in large part because symptoms like nausea and vomiting, and even the more severe septicemia, can be caused by a wide variety of microbes.

Norovirus-Liz-B-headshotUnfortunately, Vibrio cases have been on the rise, and according to the CDC’s most recent Food Safety Progress Report, we saw a 75 percent increase in cases in 2013 compared to 2006-2008, and a 32 percent increase compared to 2010-2012 in the United States.  The majority of these 2013 cases (62 percent, or 144 cases) were V. parahaemolyticus, and 9 percent (21 cases) were V. vulnificus. It is also believed that for every V. parahaemolyticus case that is reported, there are 142 cases that go undiagnosed. This is probably due to an underreporting of cases, as many laboratories do not use the special culture media needed to grow the bacteria. To improve our understanding of the impacts these bacteria, Vibrio infections were made a notifiable disease in 2007, which means that lab-confirmed cases have to be reported to the state health departments, which then inform the CDC. Unfortunately, we know considerably less about the significance of Vibrio infections in other parts of the world.

For the love of the food, oyster aficionados have created some interesting myths on how to reduce their risk of disease from eating raw oysters, such as the notion that covering the oysters in hot sauce will kill bacteria. The old adage about only eating oysters in months containing an “R” has been around since the 1500’s, and while the V. vulnificus levels in water are higher in the summer months, the CDC says that 40 percent of cases actually occur in the R-containing months between September and April. Similarly, some people think they can tell when an oyster is not safe to eat, but Vibrio bacteria do not change the taste, smell, or appearance of shellfish.

Thankfully, the bacteria are quite susceptible to heat.  People can reduce their risk of infection by ordering cooked oysters when they go to restaurants, or when preparing oysters at home, to follow a few simple precautions, which are outlined at Foodsafety.gov.

References:

CDC. 2014. Notes from the Field: Increase in Vibrio parahaemolyticus Infections Associated with Consumption of Atlantic Coast Shellfish – 2013. MMWR 63(15): p. 335-336. Accessed at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6315a6.htm?s_cid=mm6315a6_x

CDC. 2014. Incidence and Trends of Infection with Pathogens Transmitted Commonly Through Food – Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2006–2013. MMWR 63(15): 328 – 332. Accessed at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6315a3.htm?s_cid=mm6315a3_w

CDC. 2015. Vibrio illness (Vibriosis). Accessed at http://www.cdc.gov/vibrio/

FDA. 2014. Raw Oyster Myths. Accessed at http://www.fda.gov/Food/ResourcesForYou/HealthEducators/ucm085385.htm

Foodsafety.gov. 2015. Vibrio infections. Accessed at http://www.foodsafety.gov/poisoning/causes/bacteriaviruses/vibrio_infections/

Street food vendors in Hyderabad, India have some food safety issues

I’m a food truck kind of guy, but I prefer to eat from places that have to follow the basic rules of sanitation. In North Carolina mobile food vendors have to be linked up with a physical kitchen (for cooling and prepping food) and even then they are inspected. Keeping food safe in a truck can be done, but it takes vigilance and a sense of hazard identification.

And not using water from a toilet.1680787-poster-1280-water-reuse-graphic

Like what the Times of India reported about some street food vendors in Hyderabad, India.

Every sixth Hyderabadi taking street food is falling sick from food-borne infections (whoa, I’d like to see the data -ben), says a study that directly observed the hygienic practices followed by 500 food vendors and small restaurants in different parts of the city. 

The most common ailments reported by denizens after eating street food or ‘stale’ food served by some established restaurants are diarrhea, abdominal pain, nausea and vomiting, reveals a study released to mark the ‘food safety’ theme on World Health Day. 

And here’s why: The majority of street food vendors (423 out of 500 surveyed) were found drawing untreated water for cooking from nearby apartments, while only seven were using protective head cover. None were using protective gloves and almost all used nearby shops to dump their raw material overnight. 

“Our team, which also communicated with customers, came across around 50 vendors with tobacco addiction, leaving the remnants of the ash on the food being served,” said Dr K Suresh, president of Osmania Medical College Doctors’ Forum, who led the study. 

Worse, 15 out of 500 vendors were found drawing water for cooking from toilets of nearby apartments, while almost all were found to skip hand washing after a visit to the toilet or lavatory. This is what the 30-member team of MBBS undergraduates led by Dr Suresh found after analyzing data gathered from street- vendors from December-2014 to February-2015.