Food Safety Talk 73: I Wish They’d Wash Their Hands More

Food Safety Talk, a bi-weekly podcast for food safety nerds, by food safety nerds. The podcast is hosted by Ben Chapman and barfblog contributor Don Schaffner, Extension Specialist in Food Science and Professor at Rutgers University. Every two weeks or so, Ben and Don get together virtually and talk for about an hour.  They talk about what’s on their minds or in the news regarding food safety, and popular culture. They strive to be relevant, funny and informative — sometimes they succeed. You can download the audio recordings right from the website, or subscribe using iTunes.Handwashing-Words-In-Shape-Of-Hand

This show starts with Don and Ben talking about the number-six item on their list of things to discuss for the episode:  Yosemite and how beautiful it is; Ben rates it at three thermometers, a rating system they invented.  Ben’s favorite thermometer is the Comark PDT300, even though someone sent him a ThermoWorks Thermapen which is Don’s favorite. Ben’s hockey team has been using thermometers when the grill sausages, this is what Ben’s contribution to the grill-outs.  Ben gets chirped for being the guy who brings the thermometer to the hockey grill. Ben is now supplying thermometers to other hockey guys.

Don talks about his lunch date with a podcast celebrity from the 5by5 network. Don tells the whole story about flying business class from Brazil to Texas then while in Texas, buying comic books and having lunch with Dan Benjamin.  Dan asked Don lots of food safety questions; they didn’t talk much about 5by5.  After this, Don attended the NoroCORE Food Virology meeting with Ben (the guys talked in real life, not just over Skype).

The conversation then turns to food safety culture and what that really means as it is in the literature.  Ben talks about a conversation he had about food safety culture with a person trying to develop a presentation on food safety culture for farmers. Don shares an email from Doug about food safety concerns at [insert big company name] that shared a Dropbox video of text and images displaying poor food safety. The guys then talk about the difficulties of creating a food safety culture when no one thinks it’s important. Ben talks about the many things that must be in place before a food safety culture can begin to be established.

Then conversation then transitions to how to talk about food safety risks. Ben suggests talking about risks frankly. The guys then discuss the uncertainties around risks and how to discuss them.  Discussing how quantitative risk assessments are performed and applied, and the issue of uncertainty messages, also come up in conversation.  Salmonella Hypetheticum then comes up in the conversation.

Don then brings up a book that he has been reviewing about food waste.  The same food waste topic has been featured on a television show that Don’s real life friend Randy Worobo was a guest on.  The issue of food waste and risk is discussed, with a focus on lower income persons and how to manage the need to save money against food safety risk decisions.  The use of fruits and vegetables that are past their optimum date to make infused vodka brings back memories of pruno-associated C. botulinum outbreaks.  Ben appreciates Don for working the math around food safety questions and the time and effort it takes to accurately answer without just ‘no don’t do that thing’.

Ben then brings up the issue of thawing a turkey on the counter the risks associated with that action.  Doug Powell has a paper in the Canadian Journal of Dietetics Practice Research about the calculations around thawing a turkey at room temperature.  Actually, it is ok to thaw a turkey at room temperature if you are within certain parameters.  This topic follows along with the possible Food Safety Talk tag line:  and it’s messy.

Next, Ben wants to talk about communication, but Don talks about the decision to eat fresh produce in Brazil, and other’s decision not to eat the fresh produce while visiting.  While at meetings Ben seems to focus on following the news and typing up Barfblog posts (some people are ok with that and will resist complaining; Ben does type rather loudly).  When Ben gets really into what he is writing, he lets out really loud sighs others have noticed, but Ben hasn’t noticed his inappropriate sighing.

Transitioning back to communication, Ben brings up a hepatitis A outbreak reported in Cumberland County Maine, but without a retail location identified. The State of Maine is taking some flack (could we call this chirping, see above) for their handling of this incident; the State of Maine tried to explain that this is because of a lack of personnel with specific expertise.  Maine has been in the news for other public health issues… a nurse breached a quarantine for Ebola by going for a bike ride.  Don suggests the public health system in Maine may be broken, Ben suggests this may be due to their having just eleven health inspectors for the whole state.

In the After Dark session, Ben reveals the most popular Food Safety Talk episode.  The guys aren’t sure which episode they just completed, 74?, 75?, whatever it takes.  Speaking of documentaries, Don recommends Jodorowsky’s Dune a documentary about a movie that was never made.

New Food Safety Infosheet: Hepatitis A illnesses linked to frozen berries in Australia

Australian public health officials have identified an outbreak of hepatitis A and linked illnesses to consuming Nanna’s frozen berries sold by Patties Foods.

Food safety infosheet highlights:

–  Health officials have confirmed 20 illnesses to date.

– The berries were produced by Patties Foods, which has issued a recall on three products.Screen Shot 2015-02-27 at 9.13.39 PM

– Officials expect cases to increase as the incubation period of the virus ranges from 15-50 days and those who are infected may not yet be showing symptoms.

Click here to download the food safety infosheet.

Food purchases remain faith-based, at market or megalomart: 4 sick with scombroid from tuna in Sydney

As the buy-local mantra becomes indoctrinated in Australia with 18 confirmed sick with hepatitis A from frozen Chinese berries, a Sydney café has vowed to change suppliers after four were sickened with scombroid poisoning linked to tuna from Thailand.

No country is an island, even Australia.

Going public: Signs of Australian hepatitis A outbreak linked to frozen berries month before public disclosure

Australian health types should be further embarrassed by their lack of disclosure, public notification and political pandering after it was revealed today that the first case of hepatitis A linked to frozen berries was diagnosed on January 3 but it took more than a month to recall the berries from supermarkets.

266570-ed20eaa0-b5e3-11e4-89a7-658c9eaa89c0Senate Estimates has been told there were three cases of Hepatitis A diagnosed in Victoria between January 3 and February 6.

Experts investigated to find a common link between the affected patients and identified the common factor as Nanna’s 1kg frozen mixed berries.

This meant it was not until February 12 that Ausfoodnet Victoria informed a national network of food regulators of the three cases.

It then took another two days before food company Patties announced a voluntary recall of the berries from supermarket shelves on February 14.

It was not until February 17 the government set up a national incident room to deal with the outbreak which has now spread to 18 people.

Australia’s Chief Medical Officer Professor Chris Baggoley said before the incident room was set up, epidemiologists and other experts in food safety were already working on containing the Hepatitis outbreak.

Uh-huh.

To the importer who says there’s no proven link, I say, epidemiology still works: 18 confirmed sick with hep A from frozen Chinese berries

As the number of confirmed hepatitis A cases in Australia from frozen berries grown in China rose to 18 over the weekend, as political rhetoric about imports and local food reached staggering new heights, the company continued to insist there’s no firm link between a national hepatitis A outbreak and its recalled berries.

epidemiology.WATER PUMP3_Page_4The company says its imported Chinese berries were recalled on health department advice despite a lack of proof from accredited laboratories of a link to the hepatitis A virus (HAV).

“At this point, we have not been provided any remaining consumer product to test from the 13 confirmed HAV cases to clinically verify there is indeed a link with the Nanna’s Mixed Berries,” managing director and chief executive Stephen Chaur said in a statement on Friday.

Mr Chaur said the company had rigorous testing that went beyond the Australian standards requirement that five per cent of imported fruit containers be tested.

“Patties Foods’ documented test regime is among the highest, testing 20 per cent of all the containers when they arrive in Australia,” he said.

But Mr Chaur said sample testing for microbial and viral markers had been increased to 100 per cent of imported frozen berries from all countries.

The company has checked quality control testing documents back to June 2014 and says they’re satisfied no biological indicators outside Australian guidelines have been detected.

Great. Prove it and make the data public.

Hepatitis A vaccines work: Michigan, 2013

Hepatitis A virus (HAV) infections among persons with developmental disabilities living in institutions were common in the past, but with improvements in care and fewer persons institutionalized, the number of HAV infections has declined in these institutions. However, residents in institutions are still vulnerable if they have not been vaccinated.

hepatitis.AOn April 24, 2013, a resident of a group home (GH) for adults with disabilities in southeast Michigan (GH-A) was diagnosed with hepatitis A and died 2 days later of fulminant liver failure. Four weeks later, a second GH-A resident was diagnosed with hepatitis A. None of the GH-A residents or staff had been vaccinated against hepatitis A. Over the next 3 months, six more cases of hepatitis A were diagnosed in residents in four other Michigan GHs. Three local health departments were involved in case investigation and management, including administration of postexposure prophylaxis (PEP). Serum specimens from seven cases were found to have an identical strain of HAV genotype 1A.

This report describes the outbreak investigation, the challenges of timely delivery of PEP for hepatitis A, and the need for preexposure vaccination against hepatitis A for adults living or working in GHs for the disabled.

CDC MMWR 64(06);148-152

Susan R. Bohm, Keira Wickliffe Berger, Pamela B. Hackert, Richard Renas, Suzanne Brunette, Nicole Parker, Carolyn Padro, Anne Hocking, Mary Hedemark, Renai Edwards, Russell L. Bush, Yury Khudyakov, Noele P. Nelson, Eyasu H. Teshale

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a4.htm?s_cid=mm6406a4_x

Vaccines work: So says Kristen Bell (and Israel)

Data on long-term impact of universal national vaccination programmes against hepatitis A are lacking. We aimed at evaluating the impact on hepatitis A incidence of the Israeli toddlers-only universal routine two-dose vaccination programme against hepatitis A initiated in 1999.

kristen-bell1All hepatitis A episodes reported to the national surveillance system from 1993 to 2012 were analysed in relation to the vaccination programme and coverage. Mean vaccine coverage in Israel between 2003 and 2010 was 92% for the first dose, given at 18 months of age, and 88% for the second dose, given at 24 months.

The annual hepatitis A incidence declined from a mean of 50.4 per 100,000 in the period between 1993 and 1998 to a mean of <1.0, during the period from 2008 to 2012, representing a reduction of >98%. The decline was evident in all ages and ethnicity groups, including unvaccinated populations.

Of the 1,247 cases reported nationwide between 2002 and 2012, the vaccination status could be ascertained in 1,108 (89%). Among them, only 20 (2%) were reported be vaccinated with one dose and three (<1%) received two doses.

The sustained results of this long-term impact study suggest that a toddlers-only universal routine two-dose vaccination programme is highly effective and practical. These findings underscore the importance of sustainability in both the surveillance systems and vaccination programmes and will aid to determine vaccination policies.

The impact of a national routine immunisation programme initiated in 1999 on Hepatitis A incidence in Israel, 1993 to 2012

Euro Surveill. 2015;20(7)

Levine H, Kopel E, Anis E, Givon-Lavi N, Dagan R.

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=21040

http://www.today.com/parents/kristen-bell-get-vaccinated-whooping-cough-if-you-want-hold-2D80499716

And Penn and Teller (NSFV).

Lots of support for restaurant that had food handler with hepatitis A

n a truly Canadian move, more than 70 owners, management and staff from Sudbury bars and restaurants ate and drank at a Sudbury, Ontario (that’s in Canada) Casey’s in a show of solidarity. In early February over a thousand patrons might have been exposed to hepatitis A after a food handler was diagnosed with the virus. According to The Sudbury Star, even the local health unit, the folks who ran the hep A shot clinics, hosted a retirement party for over 40 folks at the restaurant.default-1

Last week, Peddler’s Pub invited fellow establishments to join them in a show of support for the Kingsway bar and grill, which suffered a publicity setback last month when an employee was diagnosed with hepatitis A and patrons were urged to get vaccines through the Sudbury and District Health Unit.

“It’s one of those unfortunate things that can happen to any restaurant,” said Peddler’s marketing manager Cliff Skelliter. “Casey’s is such an important part of our community. A lot of people have jobs there and the owners are amazing, just absolute sweethearts.”

Dave Temmerman, co-owner of Hard Rock, brought a contingent of 14 people affiliated with his Elm Street pub.

“In times like this it’s nice to know who your friends are and stick together,” said Temmerman.

The public should have no fear of dining at Casey’s, he said, as standards of hygiene at this restaurant are as strict as any he’s encountered.

“I’ve worked in a lot of places, and it’s one of the cleanest I’ve worked in,” he said. “What happened to them is just a bad deal. People in the industry know it can happen to anybody, and it’s not because their place is dirty.”

Casey’s owner Marty Wills said the endorsement of counterparts means a lot.

“It’s wonderful what all the other restaurants have done,” he said. “They’ve been getting together and showing a little love, a little support for us, because they understand we didn’t do anything wrong.”

The hepatitis A that was detected in a Casey’s employee “was never created here,” said Wills. “She just happened to work here.”

Having a clean restaurant (whatever that means) doesn’t really matter; in this situation, risk is influenced by the food handler’s handwashing behavior. US FDA risk factor studies have shown that handwashing compliance in food service isn’t great. Requiring your staff to have hep A vaccinations would avoid stuff like this.

Hepatitis A in Nanna’s berries; seen and heard

As companies and consumers check their freezers, past menus and, receipts, health officials anticipate that confirmed cases will continue to grow (The Age):

The number of cases of Hepatitis A linked to the consumption of frozen berries imported from China has climbed to at least 14.

Thirty-four government schools have advised the Victorian Education Department that some of their students have consumed berries that have been recalled because of the hepatitis A imported frozen berry outbreak.1424036630491

The number of schools affected suggests that potentially hundreds of students ate berries from one of four lines of frozen berries before they were recalled in recent days by Bairnsdale-based food company Patties Foods.

 

Another example of questioning the world of epidemiology; gotta be tough to be an epi (Business Insider Australia):

On its website, Patties Foods says “The link between our products and the reported illnesses has not yet been confirmed,” in response to its own question about meeting medical costs.

“This makes it too early to comment,” the company said.

The local-food-is-safer contingent is out – without data (Sunshine Coast Daily):

Long-time Chevallum strawberry farmer Rick Twist, co-owner of Twist Brothers, said he could not understand why people continued to risk purchasing overseas products to save a few dollars when the integrity of local produce was so much higher.

“Why the hell do people buy this stuff from those countries when their standards are so low and ours are so high?” Mr Twist said.

“Australian berries… our regulations are so tight and so strong, I think they’re the best in the world.”

And the outbreak has hit rugby (Yahoo News):

The Tigers confirmed on Tuesday that three senior players had approached club management on Monday with concerns that berries they ate may have been contaminated.

Captain Robbie Farah and veteran winger Pat Richards were later named in news reports as two players who underwent precautionary blood tests for the virus.

[Coach Jason] Taylor declined to name the trio of players but said they had shown no symptoms and the club had no confirmed cases of infection.

“It’s really simple. A couple of guys have eaten some of the berries that have been recalled, and that’s the end of the story,” Taylor said.

“We’re not overly concerned about it. We’re just being really cautious. It’s a smart move to make sure we are ticking all the boxes and all the guys are OK.

“We don’t feel that is going to come to that point (of infection) but we are doing due diligence on it.”

Some good amateur medical assessment there, Coach Taylor.

Charlotte restaurant server diagnosed with hepatitis A

When I was a PhD student I volunteered as a dishwasher in a restaurant as part of my food safety-related research. I saw lots of things, but the two things I remember most is that I was often asked to work with a server to do some salad plating; and I had to listen to a lot of Pink Floyd.

There was some Tom Petty, and The Clash, but a lot of Pink Floyd.

Servers, while not traditionally thought as food handlers, are often involved with scooping beverage ice, putting silverware together and sometimes, as I experienced, salad preparation.mondo_446339a

And when a server is confirmed ill with hepatitis A, even if they are superstars at handwashing, a whole lot of business hurt happens. Stuff like public health clinics and loss of confidence.

According to WCNC, a server at a Charlotte-area restaurant, Dogwood Southern Table and Bar, has the virus and may have exposed patrons in early February.

Health officials say the worker did not prepare food, but was responsible for polishing silverware and severing food. Monday afternoon, the Health Department offered a walk-in clinic for free vaccination.

One customer who received the vaccination, who did not want to be identified, said she was surprised by the news.

“I’m very concerned because I have small kids at home and so I worry about not just myself, but my family, and so it’s unfortunate.”

So far about 20 people have been vaccinated.