From the duh files: should food workers be vaccinated against Hepatitis A?

JoNel Aleccia of NBC News writes the question of whether hepatitis A inoculations should be mandatory for food workers — or whether the cost to business isn’t worth the wider benefit — is gaining renewed attention from federal regulators, health officials and ordinary consumers amid a spate of new restaurant warnings.

hepatitis.AAs many as 17,000 people a year are sickened by hepatitis A, according to 2010 estimates from the Centers for Disease Control and Prevention, and about 95 people die. That’s only a fraction of the 48 million people in the U.S. who are sickened by food poisoning each year, but hepatitis A is the only foodborne bug for which an effective vaccine actually exists.

The hepatitis A virus causes acute liver infection that can trigger lingering illness and even liver failure or death, though that’s rare. It’s spread when a person ingests fecal material from an infected person and causes symptoms that include, fever, chills, nausea, dark-colored urine and jaundice, a yellowing of the skin or eyes.

In 2006, experts began recommending universal hepatitis A vaccines for kids starting at age 1, changing the pool of potential infections.

“There was a very rapid transition in the U.S. over the last half decade,” Murphy said. “We have this gap of adults who are not protected in their 20s, 30s, 40s and 50s.”

In other words, the people most vulnerable to hepatitis A are those most likely to work — and eat — in restaurants.

Bill Marler, a Seattle food safety lawyer has lobbied for mandatory vaccination for food handlers since a hepatitis A outbreak tied to two Subway sandwich shops sickened 40 people in 1999.

“It was a horrible outbreak. We represented a bunch of people including a little boy who lost his liver at 8 years old and required a transplant,” he said.

But restaurant industry officials — and some health officials — note that such outbreaks and consequences, though regrettable, are rare.

Imported berry mix cake suspected to be the source of Hepatitis A in Norway

I’m still pissed I can’t figure out where my frozen berries are coming from.

Sure, I live in a sub-tropical climate with an abundance of berries, but retailers with the frozen berries will go for the cheapest source.

And frozen berries have been a mainstay of my diet for decades (because in Canada, fresh berries are available for about six weeks a year).

Guzman-Herrador et al. report in Eurosurveillance that on 7 March 2014, an increase in hepatitis A virus (HAV) infections was identified in Norway. As of 12 April, 19 cases of HAV infection with a virus strain identical to an ongoing European outbreak have been frozen.berry.cakeidentified. Six probable cases are currently under investigation. On 11 April, a frozen berry mix cake imported from another European country was found as the likely source of the outbreak; the importer has withdrawn the product in Norway.

An international traceback investigation is ongoing to find the origin of the berries used in the cake.

Internationally, there’s been over 11,000 cases of Hepatitis A linked to berries from the Mediterranean region over the past two years.

European Hepatitis A-frozen berry update

More than 1,300 hepatitis A cases have been reported in eleven Member States since January 2013, with 240 confirmed cases related to the ongoing outbreak.

Initially the outbreak was associated with people who had travelled to Italy. However seven Member States- France, Germany, Ireland, Norway, the raspberry.pieNetherlands, Sweden and the United Kingdom- have reported cases of infections in people who had not travelled to Italy.

Preliminary investigations identified frozen berries as the most likely source of infection. Other hypotheses, such as cross contamination in the food production environment or that the outbreak strain is already widespread but previously undetected, have now also been taken into account.

EFSA is leading a trace-back investigation, with the support of affected Member States, the European Centre for Disease Prevention and Control, the European Commission and the Federal Institute for risk assessment (Bfr).

Food Safety Talk 58: Where’s my wallet?

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.1396369706543

In Episode 58 the guys started the show admiring Ben’s new computer, and his House of Clay beer, before talking about Don and Victoria Backham’s treadmill desksRicky Gervais bathtub photosdressing up like a realtor, and confidence intervals.

Don and Ben then welcomed Bill Marler to the show. Bill’s notoriety started with the Jack-in-the-Box outbreak (documented in the book Poisoned). The discussion moved to the Jensen farm legal case, in particular, the criminal aspects of unknowingly shipping contaminated food and the involvement of service providers, i.e. auditors. The guys also discussed the impact on apportioning liability as a result of the recent North Carolina limiting farmers liability law. The conversation then turned to Salmonella and Foster Farm’s chicken and no one could understand why there hadn’t been a recall.

The guys then discussed Listeria and cantaloupes, including CDC’s recommendations and Don’s paper on “Modeling the growth of Listeria monocytogenes on cut cantaloupe, honeydew and watermelon.”

After a short detour via the AVN Awards, Bill got the chance to explain why he generally doesn’t take on norovirus cases and the lengths he goes to before taking on a case, using the Townsend Farm Hepatitis A outbreak as an example. The conversation then turned to auditors and what the impact of the Jensen Farm litigation case might be.

After saying farewell to Bill, Don and Ben talked about podcasting, including Lex Friedman, and Libsyn’s Rob Walch.

In the after dark the guys chatted about House of CardsTrue Detective, Ben’s quirky Aussie accent, Malaysia Airlines flight 370 andLost.

Linked to global frozen fruit outbreak? 28 cases of hepatitis A infection reported in Norway

A total of 28 cases of hepatitis A infection has been reported over the last few months in Norway, where this disease is said to be rare, the Norwegian news Agency NTB reported Saturday, quoting public health officials.

In almost half of the cases, the patients were found to have infected with hepatitis A virus while travelling abroad.

frozen.strawberryThe remaining half got infected in Norway, which was described as a rare occurrence.

Last year there was an outbreak of hepatitis A in the Nordic countries, which was believed to be most likely caused by eating imported frozen berries.

Norwegian health authorities suspect the new outbreak in Norway is also caused by eating contaminated food.

Some NZ fruit potentially contaminated with Hepatitis A

The Ministry for Primary Industries (MPI) is cautioning New Zealand consumers of a small quantity of fresh fruit sold in late February and early March that there is a relatively low risk that this fruit had been contaminated with Hepatitis A virus.

MPI Deputy Director General Scott Gallacher says, “We have been advised that a person packing some varieties of apples and peaches in a Hawke’s Bay New-Zealand-Royal-Gala-Red-Apple-2pcs1packhouse has been diagnosed with Hepatitis A.

“This worker handled Royal Gala and New Zealand Beauty apples and Golden Queen peaches over a four day period while they would have been infectious. Hepatitis A virus can remain infectious on the surface of fruit for some months and transmit infection to other handlers and consumers.”

Mr Gallacher says while some potentially affected fruit has been traced and withdrawn from sale, it is expected that approximately 1400 cartons have been sold, with fruit either consumed or still in some people’s homes.

Mr Gallacher says all fruit involved in this case was for domestic New Zealand supply and has not been exported.

Over 800 sick with Hepatitis A; between indifference and approximation

Our Italian food safety friend, Luca Bucchini, provides an update on the ongoing Hepatitis A outbreak linked to frozen fruits.

An edited version is below, and something will probably be lost in translation.

In Italy, since the beginning of 2013 or shortly before, is currently the most significant outbreak associated with food seen in the western world after the German-based sprout outbreak of 2011.

The cases reported to the Italian authorities, and therefore serious enough to warrant medical attention, associated with berries are at frozen-berriesleast over 800, with a significant proportion of hospital admissions.

It is not surprising that during this epidemic the media have dealt with so little, instead devoting space to hypothetical risks, like GMOs, or of pigs brought before the Parliament.

But how is it possible that the epidemic, although slow, has not yet been stopped, and we do not know the origin (the origin is likely that there were crops irrigated with water contaminated with sewage in Eastern Europe, but do not exclude other possibilities).

At the same time, perhaps for the lack of pressure from public opinion, has definitely contributed little transparent action, slow and uncertain of the Italian authorities. Even the initial identification of the outbreak has not occurred in Italy, despite epidemiological signals of concern, but in Germany and the Netherlands, because of the tourists came back sick, in March, from holidays in Trentino.

At present, the clues on the origin of raw materials lead to Poland. From this country, according to the Italian documents, however, are arriving very little information to find a common origin. Community legislation imposes very specific: you should be able to go back to producing farms without difficulty. It is not clear, however, if the Poles have not applied the rules, or simply resisted requests for information Italian.

It was evident that the frozen berries can remain in the freezer for months or years, which are often consumed without cooking and are used without heat treatment capable of killing viruses (boiling), even for ice cream cakes, ice cream and for many other typical products of consumption in summer. The Ministry of Health has not promoted, and does not endorse, any communication; news on the site is difficult to find.

The scientific data were already clear: the only safe treatment was boiling. But consumers were given mixed messages until September, and even today few know that the official advice is to consume the products only after two minutes of boiling, then without giving any indication as to the tens of thousands of bakeries and ice cream stores. In essence, it is hoped that the problem would pass on its own. Instead, with the berries still in the freezers, the epidemic has diminished in intensity but has not yet passed.

In Italy, the ASL often do not have the aggressiveness needed for epidemiological investigation, and the central coordination is poor. It is based on the analytical findings and, when the problem is of this nature, even from a purely economic point of view it is better to eliminate a suspect lot (not confirmed) more, than letting the problem continue. We are at the point that the most prestigious supermarket chains, industry and the inability of authorities to solve the problem, they said they no longer sell this type of product.

Unfortunately, this myth of a system far superior, and food consequently always free of problems, has become a mantra repeated uncritically, even by those who should have a professional duty to respect the available data.

Lack of transparency is not conducive to the most efficient firms, and any reliable health authority has not only an obligation to act diligently to avoid unnecessary alarms, but also to worry about the economic interests of specific and general. But this search for balance, entrusted to a third party mediator between producer and buyer, it does not work for consumers, for businesses the most virtuous, and the industry continues to have – in this case – the unsolved problem. 

Praise the lord and pass the (potatoes, ammunition) hepatitis A

The Fargo, North Dakota, Catholic Diocese’s new bishop may have exposed hundreds of church members here and in Jamestown to the hepatitis A virus in late September and early October.

“The risk of people getting hepatitis A in this situation is low, but the Department of Health felt it was important for people to know about 10-dogmathe possible exposure,” said Molly Howell, immunization program manager.

The diocese announced Monday that Bishop John Folda is taking some time off after being diagnosed with hepatitis A. The diocese said he contracted the infection through contaminated food while attending a conference for newly ordained bishops in Italy last month.

In New York City, a Hepatitis A  outbreak at a Westchester Square pizzeria, has its neighboring eateries dealing with the side effects.

The New York Daily News reported that several eateries near the still-shuttered New Hawaii Sea restaurant which closed last month after five patrons caught Hepatitis A, say they’re stuck dealing with the stigma of the virus.

Ljubo Kocovic, who opened his own pizzeria 28 years ago in 1985, said because of the Hepatitis scare, business has suffered.

“This is the slowest it has ever been. I’ve never seen an October like this,” Kocovic said. “One guy has a problem, and we all suffer. It’s very stressful.”

Restaurant owner, Nilesh Patel of M&R Coffee Shop agreed.

“People are afraid to come,” he said. “It’s not fair. They made a mistake, they should have to pay the price.”

5 sick; hundreds await Hepatitis A vaccinations after outbreak at Bronx restaurant

DNAinfo reports that within two hours of opening its doors, a city vaccine clinic hoping to target potential victims of a hepatitis A outbreak at a Bronx restaurant — that sickened five with the washing-chicken-post hepatitis.Adisease — had administered roughly 400 shots and had a line of hundreds waiting to be seen, organizers said.

Members of the Medical Reserve Corps, a national network of health workers, had been brought in to help cope with the demand following Friday’s news that four patrons of New Hawaii Sea Restaurant and one worker had fallen ill with the liver disease, according to the Department of Health.

The restaurant, which operates a sit-down eatery with Chinese and Japanese fare as well as offering take-out and catering services at 1475 Williamsbridge Road, has been shut down and would not reopen until all the workers have been vaccinated, Dr. Thomas Farley, the city’s Health commissioner announced Friday.

The city urged anyone who had eaten food from New Hawaii Sea from September 7 and 19 to get vaccinated against hep A as soon as possible, since it is the only way to safeguard against an infection.

“We are trying to get as many people as possible,” said Sam Miller, a DOH spokesman, who noted they were working in a tight time frame.”

“After two weeks’ time the vaccine isn’t effective, so if you were there before, the vaccine isn’t going to help you,” he said. “Anyone experiencing symptoms that ate there before [then] should go to their doctor immediately.”

Does Hepatitis E come from food?

A UK report concludes that 10 per cent of sausages sampled were found to contain Hepatitis E and there is “increasing evidence’ that hepatitis E is a foodborne infection.

The infection was once considered very rare but cases have risen by sausage.grillnearly 40 per cent in a year and there were 657 in 2012.

The virus usually causes only relatively mild symptoms such as sickness, a temperature and muscle pain, which clear up by themselves within a month.

But it can be fatal for the elderly, cancer victims, pregnant women and others with existing liver problems.

Around one in 50 of those infected will die, rising to one in five pregnant women.

Experts say sausages have to be cooked at 70C (158F) for at least 20 minutes to kill the virus but they say that most Britons do not leave them in the oven for this long.

Tests have showed that it can survive at 60C (140F) after an hour.