Vaccines work: More than 3700 people vaccinated after possible Hardee’s Hepatitis A exposure in SC

The South Carolina Department of Health and Environmental Control (DHEC) says it has provided 3,706 vaccinations through its hepatitis A vaccine clinics in Spartanburg and Greenville.

hardee'sThey say vaccinations are being offered to individuals who might have been exposed to hepatitis A at two Hardee’s restaurants located in Spartanburg County.

The restaurants are located at:

12209 Greenville Highway in Lyman

1397 E. Main St. in Duncan.

DHEC’s Spartanburg and Greenville county health departments will continue to provide post-exposure treatments Monday through Friday, 8:30 a.m. to 5 p.m., through September 29, 2015.

We’re just hosts on a viral planet: Hepatitis A in seals version

Scientists in the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health have discovered a new virus in seals that is the closest known relative of the human hepatitis A virus. The finding provides new clues on the emergence of hepatitis A. The research appears in the July/August issue of mBio, the online open-access journal of the American Society for Microbiology.

seal.ball“Until now, we didn’t know that hepatitis A had any close relatives, and we thought that only humans and other primates could be infected by such viruses,” said lead author Simon Anthony, assistant professor of Epidemiology. “Our findings show that these so-called ‘hepatoviruses’ are not in fact restricted to primates, and suggest that many more may also exist in other wildlife species.”

Hepatitis A viral infection, which impacts 1.4 million people worldwide annually, can cause mild to severe illness. It is a highly contagious disease that is usually transmitted by the fecal-oral route, either through person-to-person contact or through consumption of food or water. “Our data suggest that hepatitis A and this new virus share a common ancestor, which means that a spillover event must have occurred at some point in the past,” said Anthony. “It raises the question of whether hepatitis A originated in animals, like many other viruses that are now adapted to humans.”

The researchers discovered the new virus while investigating a deadly strain of avian influenza that killed over 150 harbor seals off the coast of New England in 2011. In an effort to determine what viruses might co-occur with influenza, researchers performed deep sequencing of all the viruses present in three of the marine mammals. They discovered a new virus that was genetically similar to hepatitis A and named it phopivirus. An analysis of additional animals living off the coast of New England (29 harbor seals, 6 harp seals and 2 grey seals) identified phopivirus in 7 more animals. The researchers say the virus appears to be fairly common in seals based on the juvenile animals examined for their study, and so far there is no evidence that it causes them any harm. However, they caution that further research is needed in mature seals, because if it acts anything like hepatitis A it might only cause disease in adults.

In the natural history of phopivirus and hepatitis A, it is unclear whether a common ancestor (virus) spilled over from humans to seals, vice versa, or from a third unrelated host that has not yet been identified. However various factors, including the fact that the virus was found in different species of seals, suggest that the virus has been present in seals for a fairly long time. The researchers next plan to look at species that have close interactions with seals to see if they can find other wildlife reservoirs of hepatitis A-like viruses. “Coyotes regularly scavenge dead seals along the coast, so it would be very interesting to examine coyotes to see if they have any similar viruses,” said Katie Pugliares, a senior biologist at the New England Aquarium in Boston who was also involved in the study. Another project might study humans who eat seal meat to see if the seal virus has ever spilled over.

The vast majority of emerging infectious diseases in humans have origins in wildlife. In recent years, scientists in the Center for Infection and Immunity led by Simon Anthony have been working with partners at the EcoHealth Alliance, University of California Davis, and others under the auspices of the United States Agency for International Development’s PREDICT program to identify potential zoonotic viral threats to human health. “Our goal”, said W. Ian Lipkin, director of the Center and John Snow Professor of Epidemiology, is “to try to understand drivers of infectious disease emergence thereby enhancing pandemic preparedness.”

But we still made money: Frozen berries recall costs Patties Foods

The Nanna’s frozen berries Hepatitis A scare and subsequent recall has caused Patties Foods to log a headline profit decline of almost 90 per cent.

frozen-berriesPatties Foods, the supplier of the product, today posted a net profit of $2.1m for the twelve months to the end of June, an 87 per cent decline on the prior year’s $16.7m.

On an underlying basis, excluding one-off items, net profit after tax came in at $15.4m for the year, compared with the firm’s guidance of $15m.

A string of Hepatitis A cases in New South Wales and Victoria earlier this year sparked the product recall as health officials blamed the Nanna’s brand 1kg mixed berries which Patties manufactures. The company reportedly sourced strawberries, blackberries, raspberries and blueberries from China.

“The frozen berries recall had a significant impact and was the primary reason for the approximate $14.6m reduction in net profit,” chairman Mark Smith said. The direct costs of the recall, the non-cash impairment of the frozen fruits business cost $13.6m before tax.

“However, it is important to note that total company revenue grew by 3.7 per cent despite the effects of the frozen berries recall, which indicated that the savoury business performed solidly with all core brands growing revenue and profit,” Mr Smith said.

Revenue for the group rose to $257m, up from the prior year’s $248m.

My frozen berries are now all boiled for a minute, linked to thousands of sickness in EU over past decade

Frozen berries have been linked to 26 cases of food contamination in the European Union in the past nine years.

frozen.strawberryHepatitis A, norovirus (a type of viral gastroenteritis) and Shigella sonnei (a type of dysentery) infections were identified as the main threat from the berries.

That’s according to a review released last week, which showed there had been 32 independent outbreaks of disease caused by contaminated frozen berries in the EU between 1983 and 2013, with more than 15,000 cases of norovirus reported.

It comes after Australian food processor Patties Foods recalled some of its frozen berries — which it imports from China — when 34 cases of Hepatitis A were linked to the products in February.

The Weekly Times revealed in March Australia had suffered dozens of its own food safety scandals in the past decade — mostly linked to contaminated fruit.

Frozen berries, how I used to love you, and now I cook you

Epidemiological investigations of outbreaks of hepatitis A virus (HAV) and norovirus (NoV) infections in the European Union/European Economic Area (EU/EEA) in the last five years have highlighted frozen berries as a vehicle of infection.

frozen.strawberry-300x225Given the increasing berry consumption in the EU over the last decades, we undertook a review of the existing evidence to assess the potential scale of threat associated with this product. We searched the literature and four restricted-access online platforms for outbreak/contamination events associated with consumption of frozen berries. We performed an evaluation of the sources to identify areas for improvement. The review revealed 32 independent events (i.e. outbreak, food contamination) in the period 1983–2013, of which 26 were reported after 2004. The identified pathogens were NoV, HAV and Shigella sonnei. NoV was the most common and implicated in 27 events with over 15,000 cases reported. A capture–recapture analysis was performed including three overlapping sources for the period 2005–2013.

The study estimated that the event-ascertainment was 62%. Consumption of frozen berries is associated with increasing reports of NoV and HAV outbreaks and contamination events, particularly after 2003. A review of the risks associated with this product is required to inform future prevention strategies.

Better integration of the available communication platforms and databases should be sought at EU/EEA level to improve monitoring, prevention and control of food-borne-related events.

Food-borne diseases associated with frozen berries consumption: A historical perspective, European Union, 1983 to 2013

Eurosurveillance, Volume 20, Issue 29, 23 July 2015

Tavoschi L, Severi E, Niskanen T, Boelaert F, Rizzi V, Liebana E, Gomes Dias J, Nichols G, Takkinen J, Coulombier D.

Clear as mud: Australia hep A outbreak sparks labeling changes but isn’t food safety

Green and gold kangaroo labels will show consumers how much of their food contains local ingredients and whether it was made in Australia, but the changes have been criticised by a consumer advocate for not requiring the origin of non-local ingredients.

MadeInAus_729pxThe new labelling system, which is expected to make food slightly more expensive, followed demands for clearer information on the origin of food products following an outbreak of hepatitis A caused by frozen berries imported from China earlier this year. 

Prime Minister Tony Abbott and Agriculture Minister Barnaby Joyce unveiled the new food labels on Tuesday, saying some businesses would start using them on a voluntary basis before the end of the year.

“If a product has got the green and gold kangaroo triangle, it is made or processed in Australia,” Mr Abbott said. “If the product has the gold bar, the product is Australian.”

The gold bar will display the proportion of local ingredients used in the food product.

From next year, Australian manufacturers will be required to carry the labels, which, are the result of a four-month senate inquiry into country-of-origin food labelling laws. The review was called after 28 people were infected with hepatitis A from frozen berries imported from China in February.

Asked how the labels would help prevent similar future outbreaks, Mr Abbott was quick to distinguish the labels from food safety standards. “Different people might have different views about where you are most likely to be confident in the quality of your food. 

“But they are two separate issues. We are dealing with one. Obviously it is up to the various levels of government to deal with the other.”

Tom Godfrey, a spokesman for consumer group Choice, said manufacturers should make it clear where all their ingredients are sourced from “and take on board the option to list the main ingredients of their products”.


Kitchen worker with hepatitis A confirmed at Original Joe’s in Alberta

Alberta Health Services is warning patrons who ate at an Original Joe’s in Strathmore after confirming a kitchen worker has hepatitis A.

original.joesPatrons who consumed food at the restaurant and bar, located at #8, 100 Ranch Market between June 9 to 19, are eligible for a hepatitis A vaccine. Those who only consumed beverages don’t require the vaccine.

The agency has confirmed that one of the restaurant’s kitchen workers contracted the disease, likely while traveling.

Alberta Health says odds are low that the worker has spread the disease but because Hepatitis A can contaminate food, it’s issued a warning to restaurant patrons.

34 sickened: Proposed new Australian food labelling laws released following Hepatitis A outbreak

Food packaging would be stamped with pie or triangle graphs illustrating how much of the product is locally grown under a proposed overhaul of labelling laws. two-month consultation study into food labelling regulations has found food can be ‘Made in Australia’ without any Australian ingredients. It also concluded consumers find current laws “confusing and irrelevant” and business considered the existing requirements “burdensome”.

The government initiated the overhaul of food labelling laws in the wake of the contaminated frozen berries scandal in February.

The Department of Industry and Science says the common ‘Made in Australia from local and imported ingredients’ label is meaningless.  It wants to scrap a current accounting production test known as the Safe Harbour Defence, which allows a manufacturer to label their food as Australian made if half the “transformation” or processing has taken place in Australia.

Given the production test includes labour and transport it is often difficult to process a food in Australia made from imported ingredients below the 50 per cent “transformation” threshold, meaning the so-called protection is redundant.

“It appears burdensome for business, yet of little relevance for consumers,” the department’s paper says.

Under new labels being considered, a graphic would included for food partially made in Australia as well as text which would clearly explain what is done in Australia and the proportion of Australian ingredients.

There would be no graphic for imported foods but text would be required to state where the food was manufactured and the origin of ingredients.

Get vaccinated for hep A before an outbreak: Utah restaurant gets support from customers

Keeping with the Utah theme, Cedar City residents have been heading over to The Pizza Cart to support the restaurant, after a food handler working at the restaurant tested positive for Hepatitis A.

pizza.cartLarisa Banks of Cedar City started an event on Facebook for supporters of the The Pizza Cart to come out and enjoy the restaurant on Friday.

“They have the best pizza and a great atmosphere,” she said. “My husband and I are small business owners in town and it is really hard to see another local business get hurt by something that is really out of their control. We just wanted to show our support.”

Banks said she was offended by some of the comments she heard in town – and on Facebook – and wanted to bring more attention that The Pizza Cart is not to blame.

“The whole thing about this (Hepatitis A) case is that it could have literally happened to anyone,” she said. “Any restaurant in town that has people working for them and handling food, it could have happened to them. The Pizza Cart was super classy with their online news release, they have been up front and honest and they took responsibility for everything, so we should support them for it.”

The Pizza Cart owner Cindy Murray, said, “It is unknown how the employee contracted the virus. However, this employee is recovering and will not be returning to work until medically cleared. All of our other employees have received the Hepatitis A vaccination.”

Hepatitis A, frozen berries, and hockey

I’ve been playing, coaching, and even sometimes administering hockey – the ice kind – for almost 50 years.

wayne-gretzky-nseI’ve seen every kind of parent, and as I age, I just pay attention to the kids, and tell the parents, get away from my bench.

So it’s not surprising that my volunteer gig as a food safety helper at the kid’s school didn’t end well.

It was, however, like the time Chapman worked in a restaurant for a month, educational.

Australia has an on-going outbreak of hepatitis A that has sickened at least 34, linked to frozen imported berries.

Europe has had tens-of-thousands-sickened in a different outbreak, and why I now always boil my frozen berries.

When the Australian outbreak hit the news, the person who runs the tuck shop wrote in the school newsletter they “would never use frozen berries.”

This is a common conceit I hear from Brisbane-types, which is convenient living in a sub-tropical climate.

So I wrote to the tuck shop person thingy and said, your unequivocal declaration goes against 150 years of freezing technology, that not everyone lives in a sub-tropical climate (Ontario? Canada?) and that the berries could be safely handled if cooked.

She came back with some stuff about sustainability, and all I could see was every hockey parent who thought their kid was the next Wayne Gretzky.

I grew up with Gretzky.

Food Standards Australia New Zealand has completed a risk statement on hepatitis A virus and imported ready-to-eat (RTE) berries. This statement has been given to the Department of Agriculture which is the enforcement agency for imported food.

 FSANZ uses an internationally recognized approach when assessing food safety risks which involves looking at: 

the likelihood of a food safety issue occurring

the consequence of the food safety issue.

We also look at mitigating factors, e.g. is the product going to be cooked or practices and procedures that can mitigate risk further.

The risk statement concluded that, hepatitis A virus in RTE berries produced and handled under Good Agricultural Practices (GAP) and Good Hygienic Practices (GHP) is not a medium to high risk to public health. control strategies minimize contamination at the primary production and food processing points of the supply chain

Regulatory authorities across the world, including those where outbreaks linked to berries or other produce have occurred, agree that hepatitis A virus contamination is best managed through good quality agriculture and hygiene practices throughout the supply chain.

Guidance is widely available on the good agriculture practices and good hygienic practices that focuses on preventing fresh produce becoming contaminated with viruses such as hepatitis A virus. For example, controls over the quality of water and fertilizers used in the field, as well as the hygiene of workers throughout the supply chain.

While there have been outbreaks associated with hepatitis A in ready-to-eat berries, they are infrequent internationally and rare in Australia

Over the last 25 years, there have been six reported outbreaks of hepatitis A associated with eating ready-to-eat berries around the world. A few of these were in Europe (involving mixed berries and strawberries grown and packed in Europe) and one was in New Zealand (involving domestically grown raw blueberries).

While one of these outbreaks was very large, when taken in the context of the amount of berries sold and traded throughout the world and the amount of berries consumed, the frequency of outbreaks is extremely low.

Hepatitis A infection can be incapacitating but it is not usually life-threatening and long-term effects are rare

Not all people exposed to the hepatitis A virus actually get sick. People who become infected might never show any symptoms. Unlike other foodborne illness, it is rare for small children to present with any symptoms. Long-term effects of having the virus are extremely rare and full recovery usually occurs in a number of weeks.

Because of the difficulties in detecting hepatitis A virus in food, there is very little data on level of contamination of ready-to-eat berries, but the evidence that is available suggests it’s very low.

Data on hepatitis A virus contamination are limited, partly because it is very difficult to test for the virus in food. But the data that is available from testing following outbreaks and the incidence of outbreaks themselves suggest contamination is rare.

There are no internationally agreed criteria for testing of berry fruits for the presence of hepatitis A virus.

Testing for E. coli can be used as an indicator of hygienic production. However, the presence of E.coli does not necessarily mean a food is unsafe and it is not a reliable test for the presence or absence of hepatitis A virus.

Hepatitis A virus cannot reproduce (increase in numbers) in RTE berries

Unlike some microorganisms like bacteria, hepatitis A virus doesn’t grow in food, so levels won’t increase during processing, transport and storage.

Many of the foods considered medium to high risk are foods that are associated with the kinds of microorganisms that can quickly multiply in food. These microorganisms are common and known to be responsible for a high number of outbreaks.

What does this advice mean for importers of ready-to-eat berries?

The Department of Agriculture has issued an Imported Food Notice in response to FSANZ’s advice.

What this means is that from 19 May 2015 importers of berries from any country must be able to demonstrate the product has been sourced from a farm using good agricultural practices.

In addition, good hygienic practices must be evident throughout the supply chain.

If not, then the berries could be considered to pose a potential risk to human health.

FSANZ has previously examined the issue of hepatitis A virus in produce following an outbreak in semi-dried tomatoes in 2010. Following that assessment, FSANZ determined that routine testing for viruses in food is of limited use because:

the virus in contaminated food is usually present at such low levels the pathogen can’t be detected by available analytical methods

viruses can be unevenly distributed and a result can be negative but food can still be unsafe

a positive result can come from the presence of genomic material from inactive or non-infectious virus in the food, but this doesn’t mean the virus is active.

What’s happening with the recalled berries?

In February 2015 FSANZ provided preliminary advice to the Department of Agriculture on the frozen berries linked to the outbreak.   

 FSANZ advised the department that current epidemiological evidence and some uncertainty about food safety controls implemented by the supplier of the berries indicates the product is a medium risk to public health until further information becomes available.

 Patties Foods has told regulators about the company’s testing regime for the products in question including:

ground water testing on the field (for microorganisms, salt and chemicals) 

pesticide testing on the field

pesticide and micro testing in the factory (including for E.coli, Salmonella and Listeria)

heavy metal testing in the factory

Further tests including microbiological tests were conducted pre-shipment and post shipment (after the product arrived in Australia).

Patties has initiated a more stringent testing program and has commenced an extensive testing program for the presence of hepatitis A virus in affected product. 

What is being done to ensure all recalled product is off the shelves?

 In Australia, state and territory regulatory authorities are responsible for working with the manufacturer or producer to ensure stock is removed from shelves.

 Victorian authorities who are managing this recall are also conducting testing on affected product.

How do we know no other berry products are affected?

 Patties Foods has informed FSANZ that the factory involved in processing the berries does not supply products to any customers other than Patties.

Is it true that a hepatitis A outbreak is more serious than other foodborne illness?

No. Foodborne illness as a result of bacteria such as Listeria, Salmonella and Campylobacter can be deadly, particularly for vulnerable populations.

 There are an estimated 4.1 million cases of foodborne illness each year in Australia.

 The latest report on foodborne illness estimates that each year there are more than 31,000 hospitalisations due to foodborne illness and 86 deaths. 

 Four pathogens (norovirus, pathogenic Escherichia coli, Campylobacter and nontyphoidal Salmonella species) are responsible for 93 per cent of the cases where the pathogens were known. until the end of April, 2015 there have been 97 cases of hepatitis A this year  in Australia (including the 34 cases linked to RTE frozen berries). At the same time last year there were 105 cases. Nearly half of all cases of hepatitis A reported in Australia are usually from people returning from overseas travel.

And my new grandson turned six-days-old. Maybe he’ll be a hockey player, maybe a risk assessor, maybe something else.