Finding vomit on an airplane

Illness happens on planes, and when it does it’s miserable.

In 2009 I dealt with campylobacteriosis over a day of travel from Manhattan (Kansas) to Raleigh. In 2013, then four-year-old Jack yacked on a flight which led to a fascinating approach by Delta Airlines involving plastic bags to contain the risk and coffee pods to manage the smell. The flight crew let us off the plane first (although we were in the second-to-last row) as we potentially inoculated the plane and passengers with norovirus.

Maybe the best plane-related outbreak was one reported in Clinical Infectious Diseases a couple of years ago. I’d describe my poop and barf-related imagination as pretty good but I couldn’t have dreamt up the scenario that unfolded on a plane leaving Boston bound for Los Angeles in October 2008.111007015237-sick-throwing-up-airplane-motion-story-top

Members of [the] tour group experienced diarrhea and vomiting throughout an airplane flight from Boston, Massachusetts, to Los Angeles, California, resulting in an emergency diversion 3 h after takeoff.

The problematic flight departed Boston on Oct 8, 2008, heading for Los Angeles and carrying among its passengers 35 members of a leaf-peeping tour group. (Four more members of the group had planned other routes home, while two had been hospitalized in the previous 2 days.)

The outbreak included a passenger with “multiple episodes of diarrhea, with at least 1 occurring in the aisle of the first-class section. The soiled aisle was not cleaned until after completion of the flight.”

As the international discussion of Ebola transmission continues, USA Today writes about bodily fluids on airplanes.

[Linda] Cannon, a teacher from Palatine, Ill., was on a United Airlines flight from Chicago to Las Vegas when she felt something wet on her seat. “I pulled out my hand, which was covered in vomit,” she recalls.

The crewmember cleaned the seat while Cannon changed into some clean clothes. But it didn’t help: Bits of upchuck still coated her seat.

“I sat for 3½ hours with the remnants of vomit on my jeans and underwear,” says Cannon. ” I spent the entire flight with nausea and the woman in the next seat telling me it still smelled.”

The passengers who came into contact with blood, urine and vomit wonder who to blame for the lack of hygiene on a plane, and what they’re doing about it.

The answer is a bit complicated. Of course, airlines are responsible for the cleanliness of their aircraft, and it’s a job they say they take seriously.

At American Airlines, for example, planes are tidied up between flights, which can include cleaning the lavatories, seats and replacing any obviously soiled blankets or pillows.

Overnight, the planes are serviced more thoroughly. The restrooms are serviced, seats and tray tables are wiped down, carpets are vacuumed and blankets and pillows are replaced.

Every month, each aircraft is given a “deep” cleaning, where seat covers are washed and the entire cabin is sanitized using government-approved cleaning agents. 

While there have many been plane-linked outbreaks, a quick overnight servicing with a wipe-down could explain reoccurring noro events.

‘Cruise from hell’ Noro hits Australian cruise ship passengers

Passengers aboard a cruise ship bound for Fremantle say more than 100 people were struck down by a particularly violent bout of gastroenteritis.

The Sea Princess, a 15-deck ship operated by Princess Cruises, left Fremantle for Singapore on August 18 and is due back on Saturday.

vomit cruiseIt missed several stops because of a mechanical issue but passengers have been compensated for the changes.

But the norovirus outbreak on the ship led one passenger to call it “the cruise from hell”.

Another passenger, Burswood real estate agent Jim Edwards, 56, became ill about a week into the cruise and said it was the worst bout of gastroenteritis he had ever had.

He said at least 200 of the ship’s 2000 passengers had contracted the bug – double Princess Cruises’ estimate of 100.

“I couldn’t believe how strong it was,” he said.

“I’m only in my 50s but it took everything out of me and that’s why I was worried about the older people. It was knocking them down like flies.”

A Princess Cruises spokesman said more stringent sanitation procedures were implemented after the first few complaints.

Don’t touch that knob: Norovirus can spread around an entire building within just hours of contaminating one surface

A virus can spread around a whole building within two hours of coming into contact with just one surface, a new study has found, presented at the 54th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) in Washington.

knob.virusA team at the University of Arizona, Tucson found that when a virus, for example the Norovirus, contaminates a single doorknob or elevator button it spreads rapidly through entire office buildings, hotels or hospitals.

The team, led by microbiologist Charles Gerba, used bacteriophage MS-2 as a surrogate for the human Norovirus because it is similar in shape, size and resistance to disinfectants.

They placed it on a single commonly touched surface, such as a door knob or table, at the beginning of a day in office buildings, conference room and in a health care facility in Arizona.

They then tested surfaces capable of carrying infectious organisms, such as light switches, bed rails, table tops, countertops, coffee pots handles, sink tap handles, door knobs, phones and computer equipment for traces of the bacteriophage at various times between two and eight hours later.

The team found that up to 60 per cent of the surfaces sampled were contaminated with the virus within just two to four hours.

However, there is a simple solution for combating the spread, says Mr Gerba, who found using disinfecting wipes registered as effective against viruses like norovirus and flu, along with hand hygiene, reduced the spread by between 80 and 99 per cent.”

Mr Gerba concluded: “The results show that viral contamination of (surfaces) in facilities occurs quickly, and that a simple intervention can greatly help to reduce exposure to viruses.”

Bacterial bombs for a noro outbreak? Australian nursing home given the all-clear

Oh, Bundaberg, we’ve been there and like your rum, but really, 35 residents and 27 staff at an aged care sickened by norovirus?

Bundy-TM-Logo“The staff did a great job in containing the outbreak,” service manager Hazel Lindholm said.

“It could have been a lot worse.”

The service deployed “bacteria bombs” in its fight against the dangerous virus that swept the facility – a new best-practice infection control solution used across Churches of Christ Care for the past 12 months.

Mr Mason said the bombs had received “exceptional results” for the health and wellbeing of clients in the past.

The bombs release a fog which permeates through all surfaces and furnishings in a room, including down drains and plugholes.

They attack dangerous pathogens including norovirus and H1N1 influenza, with no viruses remaining following a treatment.

“The bombs, which we use in conjunction with normal scrubbing of floors and surfaces as part of infection control procedures, offer cost and time benefits eliminating the need for staff to wash the curtains, bedding and clothing for each resident in each room, which is particularly time consuming and inefficient during an outbreak situation,” Mr Mason said.

91 now sick from Norovirus suspected at UK pirate ship lake

A Norovirus outbreak saw a Devon holiday park temporarily close.

BTSKeithandJohnnyAWESeveral holidaymakers fell ill with suspected norovirus in the last fortnight. 

River Dart Country Park, in Ashburton, said that 91 cases of sickness and diarrhea had been reported by visitors to the outdoor activity resort since Friday, August 8.

Following an announcement that water tests were taking place, the park manager closed the site to allow “further investigation”. 

It was due to open today.

On Tuesday, managing director Mark Simpson issued a statement on the park’s website announcing he had made a decision to close the site after a discussion with the Environmental Health Agency and PHE.

I’ve been everywhere: Norovirus transmission between hands, gloves, utensils, and fresh produce during simulated food handling

Human noroviruses (HuNoVs), a leading cause of food-borne gastroenteritis worldwide, are easily transferred via ready-to-eat (RTE) foods, often prepared by infected food handlers.

mapsmaniaIn this study, the transmission of HuNoV and murine norovirus (MuNoV) from virus-contaminated hands to latex gloves during gloving, as well as from virus-contaminated donor surfaces to recipient surfaces after simulated preparation of cucumber sandwiches, was inspected. Virus transfer was investigated by swabbing with polyester swabs, followed by nucleic acid extraction from the swabs with a commercial kit and quantitative reverse transcription-PCR.

During gloving, transfer of MuNoV dried on the hand was observed 10/12 times. HuNoV, dried on latex gloves, was disseminated to clean pairs of gloves 10/12 times, whereas HuNoV without drying was disseminated 11/12 times. In the sandwich-preparing simulation, both viruses were transferred repeatedly to the first recipient surface (left hand, cucumber, and knife) during the preparation. Both MuNoV and HuNoV were transferred more efficiently from latex gloves to cucumbers (1.2% ± 0.6% and 1.5% ± 1.9%) than vice versa (0.7% ± 0.5% and 0.5% ± 0.4%). We estimated that transfer of at least one infective HuNoV from contaminated hands to the sandwich prepared was likely to occur if the hands of the food handler contained 3 log10 or more HuNoVs before gloving. Virus-contaminated gloves were estimated to transfer HuNoV to the food servings more efficiently than a single contaminated cucumber during handling. Our results indicate that virus-free food ingredients and good hand hygiene are needed to prevent HuNoV contamination of RTE foods.

American Society for Microbiology, Applied and Environmental Microbiology, Volume 80, No. 17, Septemper 2014, doi: 10.1128/AEM.01162-14

M. Rönnqvista, E. Ahoa, A. Mikkeläb, J. Rantab, P. Tuominenb, M. Rättöc and L. Maunulaa

http://aem.asm.org/content/80/17/5403.abstract?etoc

5 Things Everyone Should Know About Washing Food (via Quest)

My friend, Matt Shipman, a science writer and public information officer at North Carolina State University writes in the below Quest North Carolina post about washing food (reprinted with permission):

464.thumbnailEverybody eats, and no one wants to eat something that could make you sick.  But there’s a lot of misinformation out there about how and whether you should wash your food.

Food safety is an important issue.  The U.S. Centers for Disease Control and Prevention estimates that each year one in six people in the United States will get sick because of food-borne illness.  And risks can be increased or decreased at every point between the farm and your fork.  Yes, you want to make sure to cook your food to the appropriate temperature, but here are some other tips to help you make good decisions in the kitchen.IMG_8159-sink-16x9-640x360

1. Don’t Wash Meat

Some people think that you’re supposed to wash chicken, turkey, or other meats before cooking.  Those people are wrong.  “Research shows that washing meat can spread dangerous bacteria around your kitchen or food preparation area,” said Ben Chapman, a food safety researcher at North Carolina State University.  “And washing poultry under running water can spray surface contamination up to three feet away.  We cook meat to make it safer; washing meat can only make a meal riskier.”

2. Washing Fruits and Veggies Only Removes up to 99 Percent of Pathogens

“That seems good, but it’s not great,” Chapman said.  By comparison, cooking food can cut the number of bacteria or other microbial pathogens by 99.9999 percent.  And that 0.9999 percent difference can be important.  If a food is contaminated by thousands of microbes, washing off 99 percent means that dozens will be left behind — and that’s enough to make you sick.  That is why people who are immunocompromised, such as some chemotherapy patients, are often discouraged from eating raw fruits and vegetables.

3. Don’t Use Soap

“Although washing has its limitations, vigorously rinsing produce under running water is the most effective way to remove the microbes that cause foodborne illnesses,” Chapman said.  You don’t need to use soap or special cleaning solutions.  In fact, using soap can actually introduce additional risk, because soaps may contain chemicals that aren’t intended for human consumption.

4. You Can’t Get All the Pesticides Off Your Food (but Don’t Panic)

Some minute traces of pesticide will probably be on — or in — your fruits or vegetables when you eat them.  “But being able to detect a pesticide doesn’t mean that it’s a public health problem,” said Chris Gunter, a researcher at NC State who studies vegetable agriculture.  That’s because, after using a pesticide, farmers are required to wait for a specific period of time before harvesting (it’s called a “pre-harvest interval”).  During that time, the pesticide breaks down or washes off, meaning any residual pesticide meets EPA’s human health requirements.

5. Even Organic Food Can Use a Rinse

Just because produce is labeled “organic” doesn’t mean that it’s somehow immune to microbial contamination. Organic farmers usually grow their fruits and vegetables in open fields, just like conventional farmers, and are subject to some of the same risks, such as fecal contamination from wildlife (that is, poop can still get on the food).

“Any time you’re going to eat fresh produce you should rinse it off, if for no other reason than to rinse off dirt,” said Don Schaffner, a food safety researcher at Rutgers.  “And rinsing off produce may offer some risk reduction in terms of microbial pathogens.”

Bonus: Don’t Wash Pre-Washed Veggies

If you’ve bought salad mix that is labeled as “pre-washed,” you really don’t need to wash it again, Schaffner said. In fact, you probably shouldn’t wash it again.  “An expert panel reported in 2007 that consumers who wash these salads again won’t reduce the risk,” Schaffner said, “and may actually create a risk of cross-contamination” where pathogens from other foods get onto the salad.  In this case, being lazy is a virtue. 

Why I don’t eat raw oysters: Norovirus genotypes implicated in two oyster-related illness outbreaks in Ireland

We investigated norovirus (NoV) concentrations and genotypes in oyster and faecal samples associated with two separate oyster-related outbreaks of gastroenteritis in Ireland. Quantitative analysis was performed using real-time quantitative reverse transcription polymerase chain reaction and phylogenetic analysis was conducted to establish the NoV genotypes present.

Raw oystersFor both outbreaks, the NoV concentration in oysters was >1000 genome copies/g digestive tissue and multiple genotypes were identified. In faecal samples, GII.13 was the only genotype detected for outbreak 1, whereas multiple genotypes were detected in outbreak 2 following the application of cloning procedures. While various genotypes were identified in oyster samples, not all were successful in causing infection in consumers. In outbreak 2 NoV GII.1 was identified in all four faecal samples analysed and NoV GII concentrations in faecal samples were >108 copies/g. This study demonstrates that a range of NoV genotypes can be present in highly contaminated oysters responsible for gastroenteritis outbreaks.

Epidemiology and Infection / Volume 142 / Issue 10 / October 2014, pp 2096-2104

P. RAJKO-NENOW, S. KEAVENEY, J. FLANNERY, A. McINTYR and W. DORÉ

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9320778&utm_source=Issue_Alert&utm_medium=RSS&utm_campaign=HYG&utm_reader=feedly

Over 1000 sick from Norovirus at four Finland beaches

The City of Tampere has announced on its web-page that its officials have removed the signs advising people against swimming in the four lakes linked to a recent outbreak of a stomach virus – Tohloppijärvi, Tesomajärvi, Suolijärvi and Kaukajärvi.

norovirus.swimOverall, over one thousand people fell ill with a stomach bug in Tampere. The city also revealed on Tuesday that traces of norovirus were found in the majority of stool samples taken from the affected swimmers.

40 sick, Norovirus suspected at UK pirate ship lake

Public Health officials have confirmed that they suspect Norovirus is the cause of an outbreak of sickness at the River Dart Country Park.

hookmain630Over the weekend more than 40 cases were reported at the holiday park near Ashburton after holidaymakers reported similar symptoms of sickness and diarrhoea.

The pirate ship lake at the holiday park near Ashburton has been drained and closed while the source of the sickness bug is investigated.

The owners of the holiday park confirmed that 40 cases had been reported by Saturday, with five more on Sunday and one on Monday.

Samples and specimens were passed to South Hams District Council Environmental Health department. Results of tests are expected in two days’ time.