17 sick with E. coli from petting area at Brisbane fair; handwashing or sanitizers never enough

With 17 sick from shiga-toxin producing E. coli linked to the animal area at the Queensland state fair, or Ekka, neighboring Gold Coast says they’re boosting hygiene for their fair that starts Friday.

royal.petting.zooBut it probably isn’t enough.

Queensland Health today confirmed that eight people have tested positive to STEC and another nine have reported symptoms.

Gold Coast Show marketing manager Leisa Martin says the usual precautions have been increased.

“This year in keeping with the guidelines from Queensland Health we have actually put in more of those stations than Queensland Health has advised in an effort to ensure the same unfortunate occurrence does not happen at our show,” she said.

“So of course after you have been near the animals use one of the hand sanitiser stations that are nearby.”

The U.K. and many scientists say hand sanitizers are sorta useless in the presence of an organic matter; handwashing with soap and vigorously running water, followed by drying with paper towel is recommended procedure.

But in several previous petting zoo outbreaks, handwashing was not a factor: bacterial can be present on many surfaces or even aerosolized.

Maybe those guidelines should be updated.

A table of petting zoo outbreaks is available at http://bites.ksu.edu/petting-zoos-outbreaks.

130 sick, 12 outbreaks; alert over sickness at UK petting farms

Public Health England says, so far this year, there have been 12 disease outbreaks linked to petting farms across England, affecting 130 people.

The advice is to wash your hands with soap and water – antibacterial gels ekka.petting.zooand wipes will not always work.

Dr Bob Adak, head of gastrointestinal diseases at Public Health England, said: “These outbreaks of illness serve as a reminder for anyone visiting a petting farm of the need to wash their hands thoroughly using soap and water after they have handled animals or been in their surroundings – particularly before eating.

“Although we can avoid obvious dirt there will be millions of invisible bacteria spread all around the farm which can get onto our hands.

“By being aware and by doing these simple things we can help to avoid illness and enjoy a fun day out.”

Anyone with kids knows these suggestions are not simple.

We have additional suggestions, but they’re under peer review at the royal.petting.zoomoment.

A table of petting zoo outbreaks is available at http://bites.ksu.edu/petting-zoos-outbreaks.

A list of risk factors at petting zoos and animal contact events at fairs can be found in: Erdozain G, Kukanich K, Chapman B, Powell D. 2012. Observation of public health risk behaviours, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011. Zoonoses Public Health. 2012 Jul 30. doi: 10.1111/j.1863-2378.2012.01531.x. [Epub ahead of print]

 

It’s like unprotected sex; many vets sickened by animals they treat

Erstwhile veterinarian Gonzalo starts a year of clinical rotations today.

This is the time when veterinary students mysteriously diagnose themselves with whatever ailment the animals have.

ace-venturaApparently in some cases it’s true.

Almost one in two vets contract infections from animals they treat because of bad hygiene practices, a study has found.

Research by the University of Sydney’s Veterinary Science department shows poor infection control has led to 44.9 per cent of vets contracting an infectious disease during their career.

More than 75 per cent of the 344 veterinarians questioned used masks, gowns or gloves when performing surgery, dental work and post-mortem examinations.

However, about half (40 to 70 per cent) didn’t use adequate protection when treating animals with respiratory, neurological, gastrointestinal and dermatological disease.

“Our profession appears to have a complacent attitude towards the use of personal protection,” said the study’s author, Dr Navneet Dhand.

“Not using appropriate protection when necessary is just like having unprotected sex with a stranger and thinking that it will be alright.”

 

Poop Doggy Dog Part II

Ashley Chaifetz, a PhD student studying public policy at UNC-Chapel Hill writes,

Two weeks ago, my dog’s food was recalled. After inquiring via the Natura consumer relations line, I was sent a voucher as compensation for the 30-lb. bag my dog Chloe had already consumed. So I got another one.IMG_5238

I recently read that Natura had expanded the recall of its products. From the website:

Out of an abundance of caution, we are extending our recall to include all Natura dry dog, cat and ferret food and treats that have expiration dates on or before March 24, 2014. We are sorry for the disruption, but we simply want to ensure that every product meets our highest quality standards.

I checked my new bag and it’s dated March 14, 2014 (and included in the expanded recall). I called Natura and the operator explained to me that Natura wanted a clean break and that they decided to be extra cautious in recalling the food. They want to know that 100% of what is on store shelves is safe. I didn’t get any details about what had changed for Natura, except that by expanding the recall, they would have more faith in the products left in the stores. They just weren’t sure about the products with expiration dates on or before March 24, 2014 and felt it was better to be judicious.

 I’ve decided to not use this product anymore; I am uncertain of their current ability to produce the safest product possible. I didn’t want a voucher (even though Chloe loves their food). Natura’s customer service understood, even agreeing to send me a refund for the bag I tossed in the trash.

 Chloe deserves to eat food that isn’t at increased risk of making her sick. I’m not confident that Natura is really addressing risks, as I still don’t have answers about the reasoning behind the expanded recall.

The company does its own internal testing. Make it public. Prove to consumers your product is safe. And if you have the data, market it at retail, cause I want food that won’t give my dog diarrhea or make my dog barf.

Ashley Chaifetz studies how the government influences what we eat (and keeps it safe), consumes too many carrots, and survived Campylobacter in 2011.

Regulations do not equal enforcement, and (partly) why the other parents hate me: reptile- and amphibian-associated Salmonellosis in childcare centers

Sorenne starts a new kindy at the end of Jan. 2013, which is the end of summer in Brisbane.

Because it’s now the beginning of summer (google schoolies and Gold Coast), I went to an information meeting last night for new parents, which was also the annual general meeting and incredibly dull.

My neighbors already refer to me as grumpy, but this was over the top; and I had an engineer friend to share our collective quinquagenarian grumpiness.

We were the only two 50-somethings in the crowd; the other parents probably thought we were the grandparents of our respective 4-year-olds (and that’s apparently going to happen soon enough).

I haven’t heard such nonsense about sustainability since I had to debate self-proclaimed environmentalist types about genetically engineered foods 12 years ago.

(I was told by a current child care type this morning that every center is working sustainability into everything to comply with government funding requirements; yet they still require vast amounts of paperwork because e-mail is somewhat baffling, and that paper has to be protected in a plastic enclosure; my friend said they must go through a lot of toner.)

We heard about all the things the kids did in the past year, like plant a garden and harvest and eat their own produce, the beehive they established, how they had potlucks with exotic foods, and all the reptiles they got to pet over the year.

But when the nice lady talked about how they had a nude food policy – food without packaging, and encouraged healthy foods, but that refrigeration was only offered for lunches — I dutifully raised my hand.

“My daughter arrives at 8 a.m., and you want healthy snacks, like produce, but afternoon tea isn’t until around 2ish so that’s six hours at room temperature. Isn’t there a health risk there?”

Three parents immediately chimed in and said, don’t be dumb, just put it in a little cooler.

I’d like to see the verification studies of microbial growth on cut produce in one of those coolers and six hours of temperature abuse (it gets a little hot here in the summer; and spring; and fall).

I didn’t pursue the issue any further, but earned the wrath and derision of a bunch of use-stereotype-here-like-hippie-yuppie-earthtone parents who will hate me next year.

I love my work.

And this report from Emerging Infectious Diseases will get passed on to the kindy.

Salmonella spp. infection represents a major public health problem in the United States; nearly 1.4 million human cases and 600 associated deaths are reported each year (1). Reptile and amphibian exposures might cause >70,000 of these cases annually (2). Furthermore, children are at increased risk of acquiring Salmonella spp. and experiencing severe manifestations of disease (3,4). Given the increasing popularity of reptiles and amphibians as pets, reptile- and amphibian-associated salmonellosis is a substantial public health concern (5).

The public has a generally low level of awareness that Salmonella spp. can be acquired from reptiles and amphibians (6); a poll conducted by the US Centers for Disease Control and Prevention (CDC) during 2003 showed that as few as 4 of 49 states require pet stores to provide information about salmonellosis to persons purchasing reptiles (4). A Food and Drug Administration ban, activated in 1975, on the sale of small turtles subsequently prevented an estimated 100,000 cases of salmonellosis in children each year (7). To further reduce the risk of reptile- and amphibian-associated salmonellosis, the CDC has issued recommendations advising that children <5 years of age avoid contact with reptiles and amphibians and that these animals not be kept in childcare centers. The CDC also recommends that all persons wash their hands after handling reptiles and amphibians (8).

We reviewed the regulations as of December 2011 for childcare centers in all US states aimed at preventing reptile- and amphibian-associated salmonellosis. To gather these data, we searched the websites for each state’s public health department or the state’s equivalent of an early childhood learning agency. When searches on the Internet did not yield the desired information, the appropriate state agencies were contacted by phone or email. In some instances, we corresponded with the designated State Public Health Veterinarian.

Overall, only 50% of states had regulations that required staff and/or children to wash their hands after touching any animals in childcare centers. Twelve states banned reptiles from childcare centers; 3 of these 12 states also banned amphibians, and these were the only states we found to have banned amphibians from childcare centers. While some states did not allow potentially dangerous or harmful animals in childcare centers, a minority of these states went further to expressly ban reptiles as well (of the 23 states that banned potentially dangerous or harmful animals, 8 states also banned reptiles). One state (Colorado) explicitly banned reptiles, amphibians, and potentially dangerous or harmful animals from childcare centers and also required staff and children in the center to wash their hands after touching animals.

This survey has several limitations. Given the ambiguity in the language used in some regulations and that the language was not standardized between states, we might have misinterpreted some of the documents we reviewed. Furthermore, we might have unintentionally overlooked regulations that were already in place during our investigation, and hence our findings might underestimate the true number of states that have such policies. In some cases, cities and counties have regulations that provide increased protection beyond those implemented at the state level.

In summary, we found great variation between state regulations for childcare centers aimed at reducing transmission of Salmonella spp. from reptiles and amphibians to humans. The discrepancy in the regulations of states that banned potentially dangerous or harmful animals from childcare centers but that did not also specifically ban reptiles and amphibians was paradoxical, considering the well-recognized risk that these animals pose for transmitting Salmonella spp. We do not know how many childcare centers across the United States currently house reptiles or amphibians. However, our data suggest that there is room for revision of the regulations in many states which could in turn augment efforts to prevent Salmonella spp. transmission from reptiles and amphibians. We believe that the recommendations issued by the CDC for the prevention of salmonellosis from reptiles and amphibians (4) could serve as a practical guide as state regulations are updated. Our own experience has indicated that greater collaboration between public health organizations and the agencies responsible for setting regulations for childcare centers can be informative and productive. Similarly, state agencies can work with the pet industry and childcare centers to develop approaches that are mutually beneficial.

Although pets provide many benefits to humans, particularly during the early years of life (9), any exposure that children have to animals must pose minimal risk to the children’s health. Ultimately, keeping reptiles and amphibians out of childcare centers and requiring that staff and children wash their hands after touching animals offers a simple way to better safeguard the health of children while having a minimal effect on practices of childcare centers.

Neil M. Vora , Kristine M. Smith, Catherine C. Machalaba, and William B. Karesh

Author affiliations: Author affiliations: Columbia University, New York, New York, USA (N.M. Vora);EcoHealth Alliance, New York (N.M. Vora, K.M. Smith, C.C. Machalaba, W.B. Karesh)

Acknowledgments

We thank Casey Barton Behravesh, Carina Blackmore, Bryan Cherry, John Dunn, Karl Musgrave, Joni Scheftel, Sally Slavinski, Faye Sorhage, and Carl Williams for their clarification on state and national regulations aimed at reducing the risks of salmonellosis and their advice on conducting this survey. We also thank members and staff of the National Association of State Public Health Veterinarians and the National Resource Center for Health and Safety in Child Care and Early Education for their assistance.

This survey was generously funded by the Mars Foundation and New York Community Trust.

References

Mead PS, Slutsker L, Dietz V, McCaig LF, Bresee JS, Shapiro C, Food-related illness and death in the United States. Emerg Infect Dis. 1999;5:607–25. DOIPubMed

Mermin J, Hutwagner L, Vugia D, Shallow S, Daily P, Bender J, Reptiles, amphibians, and human Salmonella infection: a population-based, case-control study. Clin Infect Dis.2004;38(Suppl 3):S253–61. DOIPubMed

Mermin J, Hoar B, Angulo FJ. Iguanas and Salmonella Marina infection in children: a reflection of the increasing incidence of reptile-associated salmonellosis in the United States. Pediatrics.1997;99:399–402. DOIPubMed

Centers for Disease Control and Prevention. Reptile-associated salmonellosis—selected states, 1998–2002. MMWR Morb Mortal Wkly Rep. 2003;52:1206–9 .PubMed

Pickering LK, Marano N, Bocchini JA, Angulo FJ. Exposure to nontraditional pets at home and to animals in public settings: risks to children. Pediatrics. 2008;122:876–86. DOIPubMed

Centers for Disease Control and Prevention. Multistate outbreak of human SalmonellaTyphimurium infections associated with aquatic frogs—United States, 2009. MMWR Morb Mortal Wkly Rep. 2010;58:1433–6 .PubMed

Cohen ML, Potter M, Pollard R, Feldman RA. Turtle-associated salmonellosis in the United States. Effect of Public Health Action, 1970 to 1976. JAMA. 1980;243:1247–9. DOIPubMed

Centers for Disease Control and Prevention. Turtle-associated salmonellosis in humans—United States, 2006–2007. MMWR Morb Mortal Wkly Rep. 2007;56:649–52 .PubMed

National Association of State Public Health Veterinarians, Inc. Compendium of measures to prevent disease associated with animals in public settings, 2011: National Association of State Public Health Veterinarians, Inc. MMWR Recomm Rep. 2011;60(RR-04):1–24.

Siloed agencies hindered in efforts to fight animal-to-human diseases

The multiple agencies in the U.S. at the local, state and federal level – operating in their own silos – is restricting public health efforts to control zoonoses.

New York University sociologist Colin Jerolmack found even though many newly emerging infectious diseases readily spread from one species to another, “agency members interpret certain diseases as ‘livestock diseases’ or ‘wildlife diseases,’ and they view categories of animals outside their purview as irrelevant to their institutional prerogatives. Consequently, there is little sense of mutual understanding and common goals – and thus little coordination – across these various organizations.”

Jerolmack’s study, which appears in the journal Sociology of Health and Illness, examined the following agencies and departments: a state Department of Health (DOH); the Department of Agriculture (USDA); a state Department of Wildlife; a state Department of Agriculture; and the Centers for Disease Control and Prevention (CDC). Through interviews with agency or departmental personnel, he looked at how the distinct organizational cultures of these agencies produced incompatible or even competing agendas that hampered efforts to respond to zoonoses—infectious diseases that can be passed between species.

Jerolmack’s interviews revealed several instances in which agencies and departments adopted a siloed, rather than cooperative, approach when faced with zoonoses:

• A state Department of Agriculture official who bristled at efforts to remove livestock that may have posed a health risk to residents because, “We’re here to support anyone doing farming [and] keeping animals… We want people to continue keeping animals on their property.”

• “Strained” relationships between a state’s Department of Health and Department of Agriculture “sometimes meant that the DOH did not receive information on circulating diseases in animals that may become a problem for humans later on.” A DOH employee, noting that bird flu strains, particularly those found in livestock, can mutate quickly, said such outbreaks should be considered vital public health information—a view not shared by that state’s Department of Agriculture.

• A city public health official, responding to an outbreak of salmonella, did not turn to the state’s Department of Agriculture, the USDA, or any other agencies involved in animal health for help or information. Nor did it share information with them. The official “mentioned the need to change residents’ cultural practices, but neglected veterinary medicine solutions,” Jerolmack recounts.

• The same agency adopted a siloed approach in addressing other zoonoses, such as Lyme disease and West Nile virus: “It did not regularly communicate with animal agencies or analyze surveillance data on disease outbreaks in animals, but instead responded with medical and educational campaigns once one or more people became infected,” Jerolmack writes.

Jerolmack notes the CDC has recognized the need to do a better job of building relationships with the veterinary world. In 2006, it created the Geographic Medicine and Health Promotion Branch, which tracks the flows of both humans (as travelers) and animals (as they are imported or exported), and its director, Dr. Nina Marano, is a veterinarian. He adds that during an outbreak of rabies in the 1990s, state agencies worked together to stem the tide of the disease—a response he views as an “example of the successful alignment of priorities and action among the myriad agencies responsible for human and animal health.” However, his study found these instances to be the exception rather than the norm.

Gonzalo Erdozain: TV doctors are not real doctors; don’t know jack about risks involved with petting zoos

Unfortunately, TV doctors are often idolized and imitated. Seeing Ellen Pompeo (Meredith Grey from Grey’s Anatomy) take her almost two-year-old daughter to a petting zoo demonstrates there is a long way to go reducing zoonotic diseases transmission and prevention awareness at petting zoos.

Children under the age of five are considered a high-risk group, add a pacifier, petting a baby goat, and a rabbit, and there is a high-risk situation for zoonotic disease transmission. Baby ruminants and poultry intermittently excrete substantial numbers of germs, which is why it is not recommended to have these young animals at petting zoos. Pacifier, bottles, or any items that will end up in the visitor’s mouth are all conduits for the fecal-oral route of exposure to pathogens. Keep children under five on your arms at all times, prevent strollers and baby items from entering the human-animal contact areas, and if you pet an animal, thoroughly wash your hands with soap and water afterwards.

Petting zoo-related outbreaks have been recorded worldwide; an updated table is available at http://bites.ksu.edu/petting-zoos-outbreaks.

Happy cows come from British Columbia, too

I like having a glass of wine with my dinner every now and then. It tastes good and they say it’s good for you, so I don’t even have to feel guilty about it.

Apparently, a group of farmers in British Columbia think the health benefits also apply to cattle. The idea is a variation of the Kobe beef, where cattle are fed beer. Unlike Kobe beef, the wine is not fed every day.

“It’s during the final 90 days leading up to their slaughter that they are fed red wine supplied by a number of wineries in the Okanagan Valley.”

The final product is sweeter-tasting meat that is supposedly more tender. Plus, the cows get to die buzzed.

I wonder, if they did this with dairy cows, would wine and cheese parties become obsolete?

Is grass-fed and organic beef microbiologically safer than conventional? No

There are any number of agricultural production systems out there, each with their own way of making a buck and each with a certain level of hucksterism involved. I focus on whether the system and the end product are microbiologically safe. The best producers use techniques – regardless of political ideology – that fit best in their production system in their geographic location.

A new study in Foodborne Pathogens and Disease compared bacterial contamination rates and antimicrobial resistance in bacteria from 50 grass-fed and 50 conventionally produced beef products. The researchers from Purdue University and China concluded there was no safety advantage for either group.

The abstract is below:

Contamination rates and antimicrobial resistance in bacteria isolated from “grass-fed” labeled beef products
Foodborne Pathogens and Disease
Jiayi Zhang, Samantha K. Wall, Li Xu, Paul D. Ebner
http://www.liebertonline.com/doi/abs/10.1089/fpd.2010.0562
Abstract
Grass-fed and organic beef products make up a growing share of the beef market in the United States. While processing, animal handling, and farm management play large roles in determining the safety of final beef products, grass-fed beef products are often marketed as safer alternatives to grain-finished beef products based on the potential effects of all-forage diets on host microbiota. We conducted a series of experiments examining bacterial contamination rates in 50 beef products labeled as “grass-fed” versus 50 conventionally raised retail beef products. Coliform concentrations did not differ between conventional and grass-fed beef (conventional: 2.6 log10 CFU/mL rinsate; grass-fed: 2.7 log10 CFU/mL rinsate). The percentages of Escherichia coli positive samples did not differ between the two groups (44% vs. 44%). Enterococcus spp. were frequently isolated from both grass-fed beef products (44%) and conventional beef products (62%; p=0.07). No Salmonella or E. coli O157:H7 isolates were recovered from any of the meat samples. Enterococcus spp. isolates from conventional beef were more frequently resistant to daptomycin and linezolid (p<0.05). Resistance to some antimicrobials (e.g., chloramphenicol, erythromycin, flavomycin, penicillin, and tetracyline) was high in Enterococcus spp. isolated from both conventional and grass-fed beef. There were no differences in the percentages of antimicrobial resistant E. coli isolates between the two groups. Taken together, these data indicate that there are no clear food safety advantages to grass-fed beef products over conventional beef products.

 

Never Kiss a Froggy Frog

To entertain Sorenne today, we stopped by the Hallmark store at the Manhattan Mall. In addition to her favorite Webkinz, we found miniature (living) frogs in little glass cubes. Sorenne was fascinated with what she called, “fish.”

Accompanying the display was a clearly posted warning about handling reptiles. Although frogs are amphibians, I was delighted to see the information. I asked the store staff if I could take a picture. They were taken aback by the request but didn’t mind. The poster from the CDC highlights what Doug has often said in the past: “Do not nuzzle or kiss your pet reptile.” Other tips include:

- Always wash your hands thoroughly after you handle your pet reptile, its food and anything it has touched.
- Keep your pet reptile in a habitat designed for it; don’t let it roam around the home.
- Keep your pet reptile and its equipment out of the kitchen or any area where food is prepared.
- Keep reptiles out of homes where there are children under 1 year of age or people with weakened immune systems. Children under 5 should handle reptiles only with adult/parental guidance. And, they should always remember to wash their hands afterwards.

We didn’t buy a frog today, but I’m sure that request will come in time.