The public health cost of a hepatitis A outbreak: scallops edition

A recent twitter exchange about corporate food safety folks really becoming compliance teams highlights that all this food safety stuff is nestled somewhere in a web of risk, cost and benefit. Risk and benefit come down to public health and business risk metrics – which can be fraught with limitations and assumptions.screen-shot-2016-11-04-at-7-11-13-am

Risk-based decision making is the mantra in food safety. Picking out an intervention is a starts with a numbers game: calculating the likelihood of an action (like handwashing) and matching that with the prevalence of a pathogen in the system. This is the stuff that gets the math nerds like Schaffner excited (me too). Businesses are faced with risk, cost and benefit decisions daily.

Food safety teams that focus just on compliance are trusting that the compliance folks got the science and risk correct. Sometimes they do. But lawmaking is slow.

The cost part of the equation somewhat straight forward.

One cost that’s been debated in food service for over twenty years is whether or not employers or public health folks should require food handlers to be vaccinated for hepatitis A. Jacobs and colleagues arrived at the conclusion that the public health benefit of vaccinating for hep A doesn’t equal the costs – but doesn’t factor in all the bad publicity, hassle and incident management costs.

Or costs to the public health system. According to KHON2 300+ cases of hepatitis A is costing hundreds of thousands of public health dollars.

The Hawaii Department of Health says it’s spent approximately $336,100 to investigate and respond to the hepatitis A outbreak.

images-1Here’s how it breaks down: $304,600 were spent on normal staff work hours, and an estimated $19,750 went to pay for 300 hours of overtime work.

The rest went to pay for vaccines and lab specimen shipments to the Centers for Disease Control and Prevention, but the health department tells us that was covered by federal grant funds.

It took a lot of work for health officials just to pinpoint the source of the outbreak, including an online survey, numerous interviews with people, and visits to businesses.

Although officials identified the source — imported frozen scallops — they’re still not done with this outbreak. They’re now looking into a hepatitis-A-related death.

“The woman was in and out of the hospital really since she became ill in July, and so there were times where she needed a liver transplant,” said foodborne illness attorney Bill Marler. “She sort of seemed to rally. She got to go home for a little while, and then she was back in the hospital with complications.”

ICAPP voluntarily recalls certain lots of frozen strawberries

The International Company for Agricultural Production & Processing (ICAPP) is voluntarily recalling certain lots of its frozen strawberries out of an abundance of caution in response to a U.S. Food and Drug Administration (FDA) investigation of an outbreak of Hepatitis A.

frozen-strawberryThe recalled products were all distributed for sale to and use in food service establishments nationwide — not for use in food products offered for retail sale to consumers. Nonetheless, ICAPP is issuing this news release publicly to help mitigate any possible risk to the public health and to fully ensure that all recalled products are recovered. Although none of ICAPP’s own testing through an established surveillance program or through third party testing of retained samples has identified the presence of Hepatitis A in any of its products, ICAPP has decided to recall all frozen strawberries that it has imported into the United States since January 1, 2016 out of an abundance of caution.

No other ICAPP products, frozen or fresh, are covered by this voluntary recall.

ICAPP is conducting this voluntary recall after learning that frozen strawberries that it distributed may be linked to a recent Hepatitis A outbreak in the United States. ICAPP has been engaged with FDA in its investigation of this outbreak and is taking this action in consultation with FDA because Hepatitis A virus was detected in four lots of frozen strawberries that were exported to the U.S. by ICAPP. ICAPP is working closely with all of the U.S. distributors of this product to ensure that this recall is effective.

ICAPP is fully committed to producing safe and high quality products; consumer safety is its top priority. ICAPP is conducting a comprehensive review of all of its operations and its suppliers to ensure that the food it produces is safe. ICAPP continues to work closely with federal and state authorities and is conducting this recall in cooperation with FDA.

For questions or more information, consumers may contact ICAPP by email at customerservice@icapp.com.eg or by phone, between 9:00 am and 5:00 pm Cairo local time, at +201-541-1624.

Food Safety Talk 111: The Meat Spot

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.slide-image-1

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.

Episode 111 can be found here and on iTunes.

Show notes so you can follow along at home:

Whole Foods still sucks at food safety: Hep A link in Detroit (vaccines work)

A bromate at the daddy crowd at school pickup yesterday sheepishly admitted that until two years ago, he thought the band Queen was from the U.S.

whole-foodsI asked him, where were the Beatles from?

Liverpool, UK.

Rolling Stones?

Detroit, Michigan, Rock City USA (he was joking).

Regardless of where you’re from, Whole Foods still sucks at food safety.

The Detroit Health Department is investigating two cases of Hepatitis A in connection with the prepared foods section at the Whole Foods Market at 115 Mack Avenue in Detroit, officials said.

One case was diagnosed in an employee at the store who handles and prepared food at the store.

The second case was diagnosed in a Detroit resident who ate at the prepared foods section of the store.

It’s unclear how either case was contracted, officials said. It’s possible the second case might have been contracted from the food handler, health officials said.

The Detroit Health Department recommends anyone who ate prepared foods from the Whole Foods in Detroit between Oct. 6 and Oct. 12 to speak with a doctor.

“While it remains unclear exactly how either of these individuals contracted Hepatitis A, and we know that Whole Foods Market Detroit has a comprehensive food safety protocol, we want to do our best to protect our residents and those of surrounding communities who may have been exposed. Whole Foods has been nothing but cooperative throughout this process,” said Dr. Abdul El-Sayed, executive director and health officer at the Detroit Health Department.

(Canada should also apologize for Rush).

Get vaccinated for hep A

Herbal plants have long been used as traditional medicines to treat diseases caused by microbial pathogens. The hepatitis A virus (HAV) causes acute liver infection through the fecal–oral route. Although the antimicrobial activities of herbal extracts against bacterial and some viral pathogens have been extensively studied, their antiviral properties against HAV have not been investigated thus far.  This study was designed to investigate the inhibitory effect of 16 herbal extracts against HAV.

hep-aSignificant inhibition of HAV was observed only when HAV was co-treated with extracts. Ten out of the 16 herbal extracts demonstrated significant virucidal activity against HAV. Alnus japonica extract at a concentration of 50 μg/mL reduced HAV titer by 3.43 ± 0.24 logs. Artemisia annua, Allium sativum, Allium fistulosum, and Agrimonia pilosa extracts showed 2.33 ± 0.43, 2.10 ± 0.41, 2.07 ± 0.60, and 2.03 ± 0.26-log reductions, respectively. Pleuropterus multiflorus, Eleutherococcus senticosus, Coriandrum sativum, Ginkgo biloba, and Torilis japonica extracts reduced HAV titer by 1.02 ± 0.21 to 1.90 ± 0.33 logs. Among the 10 herbal extracts, Alnus japonica extract was the most potent in inhibiting HAV without exhibiting cytotoxicity.

Antiviral activity of herbal extracts against the hepatitis A virus

Food Control, Volume 72, Part A, February 2017, Pages 9-13, http://dx.doi.org/10.1016/j.foodcont.2016.07.028

http://www.sciencedirect.com/science/article/pii/S0956713516303905

Going public: The hepatitis A case that wasn’t

When there is a chance to protect public health you gotta go public with all the info you have, when you have it. Sometimes new information arises that changes things and makes it look like officials got it wrong – when they didn’t.

Last week, according to The Chronicle, a food handler tested positive for hep A – and it turned out to be a false positive.flat1000x1000075f

A reported case of Hepatitis A at the Chehalis Shop’n Kart last week has been ruled a false positive by county health officials, meaning a worker in the store’s bakery was not infected and baked goods they handled were not contaminated.

An initial press release from the Lewis County Public Health and Social Services last week said a bakery worker tested positive for the virus, which causes an acute liver infection.

But a release issued Friday said this test was a false positive, meaning there was never an infection or risk to customers.

Shop’n Kart owner Darris McDaniel said the containment procedure cost his store thousands of dollars in product they threw away, while also damaging its reputation.

“In the future, if anything would happen again, we would ask for another test right away, because this sent up a lot of bad signals for our business when in fact it wasn’t true,” he said. “We did take the proper steps and acted very quickly.”

I feel much better: Egyptian strawberries in UAE are free of Hepatitis A

According to The National (the UAE paper, not the band) Egyptian strawberries are all good. I’d like to see some sort of data or specifics (like how many samples, how they sampled).

Frozen Egyptian strawberries are free from Hepatitis A, the Ministry of Climate Change and Environment has confirmed. frozen-strawberry

The issue came up last month when the US Food and Drug Administration reported an outbreak of Hepatitis A from Egyptian strawberries in the US. 

The ministry tightened control on frozen strawberries imported from Egypt to prevent any contaminated products that pose a risk to consumers entering the country.

Authorities also collected samples of seven different brands of frozen Egyptian strawberries in UAE markets to conduct laboratory tests.

All clear. Except testing a few batches and not finding hep A has it’s limitations.

Food Safety Talk 109: Pooped on an airplane

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.14502823_10157592450435442_3811567674478483849_n

Episode 109 can be found here and on iTunes.

Show notes so you can follow along at home:

Russia, UAE ban Egyptian produce, Saudi lab say frozen berries safe

Rosselkhoznadzor, the state agricultural safety agency, said on Friday that imports of Egyptian plant products will be banned from next Thursday until Egypt’s authorities take steps to ensure their safety.

jeddah_marriott_no_women_signThe move comes after Egypt, the world’s largest wheat importer, changed its import regulations to ban any ergot fungus in imported wheat.

It had previously accepted 0.05% of it in imported wheat, a level considered harmless.

The new policy hurt Russia, which is one of the major suppliers of wheat to Egypt.

In the past, Russia often slapped bans on agricultural imports amid political or economic disputes with other nations, citing sanitary reasons.

Meanwhile, the UAE has tightened controls on imports of frozen strawberries from Egypt that may be linked to a hepatitis A outbreak in the U.S. that sickened 119 people

The Ministry of Climate Change and Environment on Saturday said it had instructed food control authorities in each of the seven emirates “to tighten control procedures on frozen strawberries imported from Egypt in order to avoid the entry of any contaminated products that pose a risk to the consumer in the country”.

Yesterday, a Saudi laboratory following thorough tests has confirmed that Egyptian frozen strawberries in the market are safe for consumption.

The test negates all the rumours circulating on social media platforms regarding Egyptian frozen strawberry products and their link to the Hepatitis A outbreak reported recently across eight US states.

A day earlier, an official report posted on the Food and Drug Administration’s (FDA) website does not conform to what has been circulated on social media platforms regarding Egyptian frozen strawberries.

The ministry urged the public to refrain from posting or circulating any news on social media platforms without contacting the concerned authorities to verify and validate the credibility of that information before posting.

Yes, that’s exactly how the world works. Some countries also value women as equal citizens, who can drive and play hockey.

And other countries value data. The Saudis offer nothing but an authoritarian decree.

Assholes.

Going public: Missoula edition

The Missoula City-County Health Department is following the mantra of share what you know, what you don’t know and be available for questions following a possible hepatitis A exposure in Missoula, Montana.

According to KPAX, A food handler at a local retailer, the Good Food Store, was confirmed to be ill with the virus and may have exposed thousands of shoppers over the past month.saladbar

Missoula City-County Health Department officer Ellen Leahy says while the food service employee was excluded from work during most of the time that they had symptoms, there is a potential for customer exposure because Hepatitis A can be spread before a person has symptoms – before they know they are infectious or ill.

To address this possibility, the health department is issuing this public notice in conjunction with the Good Food Store, where the employee’s job included preparing foods for the self-serve salad bar. Ready-to-eat-foods such as those found on a salad bar won’t be cooked or washed by the consumer prior to eating and can be a vehicle for contamination.

Leahy says the Good Food Store followed proper sick employee exclusion rules and has excellent policies, practices, and facilities for food handling and hand washing.

The Missoula City-County Health Department recommends the following courses of action:

• If you ate food from the self-serve salad bar at the Good Food Store between August 15 and September 13, please be alert for symptoms of Hepatitis A.

• If you ate food from the self-serve salad bar at the Good Food Store within the past two weeks and have not been previously immunized for Hepatitis A, an immunization given within two weeks of exposure may protect you from getting the disease. Please come to the health department or contact your health care provider as soon as possible to discuss immunization options.

• If you did not eat food from the self-serve salad bar at the Good Food Store, no action is recommended at this time.

Contact the Missoula City-County Health Department at (406) 258-3500 if you have questions or concerns about Hepatitis A.

 

KPAX.com | Continuous News | Missoula & Western Montana