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.

Testing is necessary evil not food safety solution: Company ignores epi says tests are clean

Despite 31 people sickened with Hepatitis A linked by epidemiology to frozen berries from China, Australian food manufacturer Patties Foods is bragging that tests on its recalled frozen berries from China  are negative.

FROZEN BERRIES RECALLPatties Foods sent about 360 packs of recalled and non-recalled frozen berries for testing at accredited viral laboratories in Europe, North America and Australia, but neither hepatitis A norE. coli was detected in any sample.

Steven Chaur, Patties Foods CEO, said in a statement, “Extensive microbiological and viral testing conducted by Patties Foods shows no evidence of systemic failure of Patties Foods’ quality assurance programs.”

Bullshit.

Anyone in food safety knows that testing is the last resort and proves nothing.

 

Thank you Subway sandwich artists: Hep A exposure in Arkansas

The Arkansas Department of Health (ADH) is warning of a possible Hepatitis A Virus (Hep A) exposure after a Subway employee in Morrilton tested positive for the virus. The Subway is located at 1812 AR-9 Bus, of off I-40 Exit 108, in Morrilton, Arkansas.

hepatitis.AAny individual, who has eaten food from the Morrilton, Ark. Subway between March 25, 2015 and April 5, 2015 and is experiencing symptoms, should contact their primary care provider immediately. Typical symptoms of Hep A include, but are not limited to: fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, or jaundice (yellowing of the skin or eyes).

Hep A is a contagious liver disease that results from infection with the Hepatitis A virus. It can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. A person can transmit the virus to others up to 2 weeks before and one week after symptoms appear.

Organic juice bar employee has hep A in Toronto

I don’t do juice bars.

big.carrotI’ll take my fruit whole.

And I don’t want it organic.

Toronto Public Health is advising anyone who consumed juice at the Big Carrot organic juice bar located at 348 Danforth Avenue in Toronto, Ontario, between March 17, 2015 and April 2, 2015 that they may have been exposed to hepatitis A.  While the risk is low, individuals who consumed fresh organic juice from this food market during these dates should get a hepatitis A vaccination as soon as possible.

An employee of the Big Carrot organic juice bar is a confirmed case of hepatitis A and anyone who consumed fresh juice at the organic juice bar between March 17, 2015 and April 2, 2015 could be at risk of infection.  Toronto Public Health is asking anyone who consumed organic fresh juice at the organic juice bar during these dates to monitor for signs and symptoms, practice thorough hand washing and contact their health care provider if concerned.

 

Market microbial food safety at retail and stop hucksterism: Brisbane campaign to buy local produce

It’s not a new superbug, it’s an outbreak of super stupidity.

A Brisbane TV station finally woke up to Australia’s egg problem, and titled their investigation (bottom), Scientists fear super strain of bacteria behind food poisoning outbreak.

Raw_eggThis refers to the numerous egg-related outbreaks in Queensland and throughout Australia, largely related to a chef snobbery that they have to make their own aioli or mayo using raw eggs.

A table of raw egg related outbreaks in Australia is available at http://barfblog.com/wp-content/uploads/2015/03/raw-egg-related-outbreaks-australia-3-12-15-2.pdf or http://barfblog.com/wp-content/uploads/2015/03/raw-egg-related-outbreaks-australia-3-12-15.xlsx

And in response to the 32 Australians that have been stricken with Hepatitis A from imported frozen fruit, a new initiative is targeting Brisbane shoppers to support local farmers by buying local produce.

Every time some in Brisbane gets religion about buying local, I point out that’s much easier in a sub-tropical climate than, say, Canada.

The scheme involves 100 independent grocers and is backed by Brisbane’s Produce Markets. 

Greengrocer Joseph Guardala said the “hand picked” message was aimed at family shoppers.

He claims greengrocers have better fruit and vegetables than major supermarkets, because they specialize in it.

“They don’t want imported stuff, they want their local fruit to and veg to be locally grown here,” he said

He visits the Brisbane Markets every morning to source the produce for his store, Indooroopilly Fruit. 

“I’m hand picking everything, I’m tasting everything, I open boxes, I even pick through pallets every day, just to get my 24 grapes that I exactly want,” he said.

Here’s hoping you washed your hands properly before spreading Norovirus on all that fresh fruit and veg you touch.

Charlotte restaurant owner says cost of vaccinating food handlers against hepatitis A worth it

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

Businesses are faced with cost/risk/benefit decisions daily.ART_vaccine_032711-copy_1

One 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. Authors of a 2000 Journal of Food Protection 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.

A Charlotte restaurant owner who dealt with a hep A exposure event says the cost to his business was more than the shots, and is suggesting that all food handlers should be vaccinated.

Charlotte restaurant owner is going on the offensive battling perception and health concern over Hepatitis A.

“The restaurant industry is thriving,” said Jon Dressler, owner of three Charlotte-area restaurants.

Last month, however, he received a call no one wants to get.

“We were contacted by the Mecklenburg Health Department that one of our employees had contacted Hep A while on vacation,” said Dressler. “It’s not a cleanliness issue, it’s not an internal issue. The health department didn’t have to shut us down.”

Rather than being upset, Dressler has another idea.

“It would be wonderful if all of Mecklenburg County restaurant workers were required to have the Hep vaccination,” said Dressler.

The National Restaurant Association reports there are 426,000 restaurant workers in North Carolina. The two-set vaccination is about $150 a person.  Meaning, it would cost close to $64 million to vaccinate all restaurant workers in the state.  No one from the state or Mecklenburg County health departments wanted to comment on camera about the need for the vaccine.  However, the CDC did put out a report.

“Slowly, but surely, all of my employees are being vaccinated,” said Dressler.

The restaurant owner isn’t taking chances, making all of his employees get the vaccine.  He admits it’s expensive, but it’s a cost he’s willing to take.

“You weigh the expense of the vaccination versus the expense of any lost business you might incur,” said Dressler.

Why I don’t eat raw shellfish: Viruses in food

The UK Advisory Committee on the Microbiological Safety of Food (ACMSF) has published its extensive review of viruses in the food chain. The ACMSF set up a group to revisit the issue of foodborne viruses in light of developments in this area. The final report considered the most important viruses associated with foodborne infections – norovirus, hepatitis A, and hepatitis E.

heston_blumenthalThe report makes a number of recommendations for government departments, including the need for more research in certain areas, and for clear advice for consumers, for example on cooking shellfish and pork products and information on washing leafy green vegetables and soft fruit. The government will respond in due course when the recommendations have been considered in detail.

Professor Sarah O’Brien, Chair of the ACMSF, said: ‘Until recently it has been difficult to assess accurately the impact of foodborne viruses on public health. However, significant advances in our ability to detect viruses in food, coupled with up- to-date estimates of the burden of illness, highlighted in the ACMSF’s latest update, show us that viruses are very important, preventable causes of foodborne illness.’

Summary

In 1994, in response to the outcomes of a joint Advisory Committee of Microbiological Safety of Food (ACMSF) and Steering Group on the Microbiological Safety of Food (SGMSF) meeting, a Working Group was set up to investigate the science and epidemiology of Foodborne Viral Infections. The Working Group assessed the risk from viruses that were believed to be the primary cause of foodborne illness. This report provides an update to this information and provides a new focus on the viruses which are currently the major route of foodborne illness.

Since the publication of the 1998 report, with the exception of two minor risk assessments on hepatitis E and avian influenza, no formal review on viruses had been performed by the ACMSF. It was decided that as significant developments had been made not only in the detection of foodborne viruses, but also in the amount of information obtained from the Infectious Intestinal Disease (IID) Study in England (published in 2000), which indicated a significant disease burden from enteric viruses in the community, it was important that an Ad-Hoc Group was convened to revisit these issues and to provide an update to the 1998 risk assessment.

norovirus-2The FVI Group first met to begin their consideration in November 2010. Over 32 months, the Group met thirteen times to discuss all aspects of viruses in the food chain from farm to fork. As a starting point for the report, the Group reviewed the recommendations from the 1998 report and gave consideration as to whether these had been adequately addressed or were still relevant. At the same time the recommendations from the 2008 World Health Organisation (WHO) Viruses in Food: Scientific Advice to Support Risk Management Activities Matrix and CODEX Criteria, and the European Food Safety Authority (EFSA) Scientific Opinion on an update on the present knowledge on the occurrence and control of foodborne viruses were reviewed.

Using this information along with data on disease burden in the community and outbreak data (from IID and IID2) the Group agreed the scope of the report and what viruses would be its main focus. It was decided that that due to their potential impact and the paucity of data in this area, norovirus, hepatitis E and hepatitis A would be the main focus of the report, although many of the recommendations would also be applicable to other enteric viruses.

During its consideration, the Group reviewed available data on commodities contaminated at source, i.e. bivalve shellfish, pork products and fresh produce and reviewed data on risks associated with infected food handlers. Environmental contamination was reviewed with consideration given to testing methods such as polymerase chain reaction (PCR), person-to-person transmission and food handlers. The Group also considered the engagement with industry and other Government departments (OGDs) regarding environmental conditions of shellfish waters and its impact on norovirus.

A review of data on issues regarding food contact surface contamination, including survivability and persistence was considered along with options for control at all stages of the food chain e.g. thermal processing, storage etc. The thermal stability of hepatitis E was considered with data presented on the increasing occurrence of the disease particularly in older UK males and the recent case control study on the association with processed pork products.

In order to obtain sentinel data the group investigated the important issue of knowledge gathering and surveillance data regarding foodborne viruses. The current limitations of the data were discussed along with what type of data was needed to provide more useful/accurate information on foodborne virus outbreaks. This review included looking at outbreaks from an Environmental Health Officer (EHO) perspective and how they prioritise what they investigate and the data they collect.

Finally, the group reviewed the consumer perspective on risk. This included looking at how risk is presented and information distributed, as this was likely to impact on any future risk assessment.

Within the report the Group has endeavoured to prioritise the recommendations by separating these into those that will inform risk assessments and those that will impact on risk assessments. Full details are provided in the report; however, key recommendations include:

A better understanding of ‘’foodborne viral disease’ (Chapter 3) is required by investigating the correlation between infective dose and genome titre. Molecular diagnostics, typing and quantification should also be used to better understand the burden of virus contamination in foodstuffs. Work is also recommended to develop the methods used to assess norovirus and hepatitis E infectivity in food samples. This would better inform surveys and could potentially be applied to routine monitoring.

Improved ‘routine surveillance and investigation of foodborne viruses’ (Chapter 5) is required with Government agencies developing a single integrated outbreak reporting scheme. A joined up approach that would also involve the annual consolidation of records would reduce the chance of underreporting outbreaks. Further to this, reliable methods for norovirus whole genome sequencing should be developed to enable virus tracking and attribution.

More research on the ‘contamination of food’ (Chapter 6) through sewage contamination is recommended. In particular work should investigate the effectiveness of sewage treatment processes in reducing norovirus concentrations, including the use of depuration on shellfish species and disinfection treatments. Similarly, research is needed to identify the most effective means of decontaminating ‘fresh produce’ post-harvest (Chapter 7).

With the emerging risk of hepatitis E in pigs, the Group recommends work is undertaken to investigate the heat inactivation of hepatitis E in ‘pork products’ (Chapter 8). Research on the effect of curing and fermentation on hepatitis E in pork products is also recommended.

The full list of conclusions and recommendation are presented at the end of each subject area and are consolidated in Chapter 12 for ease of reference.

The assessments made and conclusions reached by the Group reflect evidence oral and written drawn from the scientific community, Government departments and Agencies, EFSA and the scientific literature. The Group’s full conclusions, identified data gaps and recommendations are brought together at the end of this report. The ACMSF accepts full responsibility for the final content of the report.

Uh oh: health officials investigating multiple hepatitis A cases in Napa; including two food handlers

Most of the hepatitis-A-in-restaurants events follow this formula: A food handler or a server shows symptoms, the virus is confirmed, health folks provide patrons with shots and hopefully no one else gets sick.

The story in Napa County is a bit different: According to the Napa Valley Register, five people, including two food handlers at restaurants are ill and it’s unclear whether this cluster is an outbreak or a coincidence.546b8ec85be23.image

The source of the infection is under investigation. This is the first time in more than five years that acute Hepatitis A infection has been confirmed in a Napa County resident, the county said.

Two cases involve employees of La Toque restaurant and BANK Café and Bar in The Westin Verasa Napa. The source of these infections is unknown and there are no known cases involving customers, the county said in a news release.

The other three cases have no known association with these locations or other public settings, the county said.

In a county news release, Ken Frank of LT Napa Partners, which owns and operates La Toque restaurant and BANK Café and Bar, said, “La Toque restaurant and BANK Café and Bar take the health of our guests very seriously. We have strict health standards in place, and we are cooperating fully with Napa County Public Health to identify the source of the virus.”

Don Shindle, general manager of The Westin Verasa Napa, said, “We continue to assist Napa County Public Health and are taking all appropriate measures to ensure the safety of our guests and associates. We are confident that Frank and his team are diligent in following their high standards and working closely with Napa County Public Health.”

 

 

The burden of foodborne illness: it’s kind of a big deal

Last week I gave a guest lecture to an undergraduate nutrition class at UNC-Chapel Hill on the burden of foodborne illness as sort of an introduction to how and why folks like small farmers, school garden managers, cafeteria staff address food safety.

In a lot of my talks I get looks of bewilderment when I throw up the details from Elaine Scallan (and lots of her colleagues) papers on the burden of foodborne illness. Same with when I show economic estimates from friend of barfblog and all-around-good-guy-with-hipster-glasses Mike Batz (and colleagues). Foodborne illness, is kind of a big deal (at least to us food safety nerds).

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 – which is focused this year on food safety.

Here’s the first post:21d2f2194e7eb6925dac5a428cc518d4398b850316887505b740e8bd0e8ffdd2

Food safety poses a global health problem. According to the World Health Organization, contaminated food can cause more than 200 diseases – and food- and water-borne diseases that cause diarrhea are estimated to kill two million people each year worldwide.

And food safety is not just someone else’s problem.

“Foodborne illnesses are a significant problem in the United States, with massive impacts on public health and the economy,” says Ben Chapman, a food safety expert and researcher at NC State. And the numbers back Chapman up.

According to a 2012 report from researchers at the Emerging Pathogens Institute, Resources For the Future, and the U.S. Department of Agriculture’s Economic Research Service, foodborne illness is estimated to cost the U.S. more than $14 billion annually. (The estimate takes into account factors such as medical costs and productivity losses.)

And a 2011 report from the U.S. Centers for Disease Control and Prevention (CDC) reported an estimated 9.4 million episodes of foodborne illness each year in the U.S. from known pathogens. An additional 38.4 million cases are estimated to come from unspecified or unknown pathogens. In total, foodborne illnesses are thought to contribute to 48 million illnesses annually – resulting in more than 128,000 hospitalizations and 3,000 deaths.

It is, in short, a big deal.

So what are these foodborne illnesses? And how much damage does each of them cause?

In advance of World Health Day, we wanted to explain a handful of the relevant pathogens implicated in foodborne illness.

Campylobacter: Campylobacteris a genus of bacteria, many of which can cause an illness called campylobacteriosis in humans, with symptoms including diarrhea and abdominal pain. People can contract campylobacteriosis from undercooked chicken, from cross-contamination via raw chicken, or from drinking unpasteurized milk.

According to the 2012 paper, campylobacteriosis affects 845,000 people annually in the U.S., costing the nation an estimated $1.747 billion every year and leading to 8,463 hospitalizations.

Listeria monocytogenes: This is a bacterium that causes listeriosis, which is characterized by fever, muscle aches, and sometimes by gastrointestinal problems, such as diarrhea. Listeriosis can be contracted from an incredibly broad range of foods.

According to the 2012 study, listeriosis costs the U.S. $2.577 billion annually, despite the fact that there are only 1,591 illnesses per year. But 1,455 of those illnesses require hospitalization – and 255 result in death.

Norovirus: Noroviruses are the most common cause of foodborne illness in the U.S., affecting an estimated 19-21 million people each year. Symptoms range from vomiting and diarrhea to fever and headache. Transmission comes from ingesting infected feces or vomit particles – for example, by touching a contaminated surface and then touching food or touching your mouth.

According to the 2012 study, noroviruses cost the U.S. $2 billion per year, with more than 14,000 hospitalizations and approximately 150 deaths annually. NC State is a leader in norovirus research, and home to NoroCORE – the Norovirus Collaborative for Outreach, Research, and Education. NoroCORE pulls together norovirus research from 18 institutions, with funding from the U.S. Department of Agriculture.

Salmonella enterica: This is one species of the pathogen that has myriad of subspecies and types – more than 1,400 of which are known to cause human illness. Infection with Salmonella species causes salmonellosis, with symptoms including diarrhea, fever, and cramping. Salmonellosis can be contracted from a variety of sources, ranging from poultry to peanut butter to mangoes.

According to the 2012 study, the subspecies within S. entericaalone costs the U.S. $3.3 billion each year, causing more than one million hospitalizations and almost 400 deaths annually.

What are researchers doing about this?

The four pathogens listed above are just a few of the rogue’s gallery of bacteria and viruses that can cause foodborne illness. But researchers are constantly learning more about these health risks.

“New technology and new research on pathogens, practices and prevention are improving our ability to identify and address foodborne illness,” Chapman says. “The field is really opening up. It’s an exciting time to be involved in food safety research.”

Between now and April 7, we’re planning to publish a series of posts on various aspects of food safety – what we know, what we don’t know, and what we’re working on. We also hope to offer insights to help folks lower the risk of contracting foodborne illnesses. We hope you’ll learn something new.

Note: you can find all of our posts related to food safety here.

Citations:

Batz, Michael B., Sandra Hoffmann, and J. Glenn Morris, Jr. “Ranking the Disease Burden of 14 Pathogens in Food Sources in the United States Using Attribution Data from Outbreak Investigations and Expert Elicitation” Journal of Food Protection, Vol. 75, No. 7, 2012, Pages 1278–1291. doi:10.4315/0362-028X.JFP-11-418

Scallan, Elaine, et al. “Foodborne Illness Acquired in the United States—Major Pathogens” Emerg Infect Dis, Vol. 17, No. 1, 2011. doi:10.3201/eid1701.P11101

BC grocery cashier has hepatitis A (and may have handled some produce)

Nanaimo isn’t just known for its bars anymore (the holiday dessert kind, below exactly as shown).

A cashier at a Nanaimo, British Columbia (that’s in Canada) Superstore has been diagnosed with hepatitis A and according to CTV, may have exposed hundreds of shoppers to the virus. Folks who shopped at the store and used the cashiers for check out specific read-to-eat foods that might have been touched with bare hands are urged to attend a clinic for a shot.Nanaimo-Bars-570x380

Did you consume raw produce or unwrapped food during these following dates and times and go through a cashier? (Not self-checkout):

- February 25 late afternoon and evening
- February 26 afternoon and evening
- February 27 late afternoon and evening
- March 1 all day
- March 4 evening

There will be a drop-in clinic tomorrow, Saturday March 7 from 10am to 3pm at the Beban Park Social Centre on 2300 Bowen Rd.  Dates and times for additional clinics have not yet been set but you can follow online for the latest details.

This warning does not apply to products from any Superstore other than the one at 6435 Metral Drive.

Being specific with the messages about unwrapped foods and produce is a good move. Having handwashing tools close by a cashier is a good idea too.