53 sick: Salmonella in raw fish, is anyone surprised

With my advancing age and lower immune strength, I don’t go for the raw seafood.

tuna.sushiI used to like the raw tuna, but now it’s seared.

I never liked sushi.

Now, the U.S. Food and Drug Administration along with the Centers for Disease Control and Prevention (CDC) and state and local officials are investigating a multistate outbreak of Salmonella Paratyphi B variant L(+) tartrate(+) infections possibly linked to sushi made from raw tuna. 

According to the CDC, 53 people infected with the outbreak strain have been reported from 9 states: Arizona (10), California (31), Illinois (1), Mississippi (1), New Mexico (6), South Dakota (1), Virginia (1), Washington (1), and Wisconsin (1). Most of the ill people have been reported from states in the southwestern United States or reported travel to this area of the country. Among 46 persons with available information, 10 (22%) have been hospitalized, and no deaths have been reported. At this time, the investigation has not conclusively identified a food source, but most ill people interviewed reported eating sushi containing raw tuna in the week before becoming ill.  At this time, a common brand or supplier of raw tuna has not been identified.

While local and state health officials continue to interview patients, the FDA is increasing its monitoring of tuna. Additionally, FDA is conducting a traceback investigation.  The FDA is evaluating and analyzing records to determine whether there is a common source of tuna.  In this effort, the FDA works with its investigational partners to identify clusters of people made ill in separate geographic areas and works to trace the path of food eaten by those made ill back to a common source.  This is labor intensive and painstaking work, requiring the collection, review and analysis of hundreds and at times thousands of invoices and shipping documents.

According to the U.S. Centers for Disease Control and Prevention

*As of May 21, 2015, a total of 53 people infected with the outbreak strain of Salmonella Paratyphi B variant L(+) tartrate(+) have been reported from nine states.

Ten ill people have been hospitalized. No deaths have been reported.  

*This outbreak is caused by Salmonella Paratyphi B variant L(+) tartrate(+) bacteria.

The illness caused by this bacteria typically includes diarrhea, fever, and abdominal cramps 12-72 hours after an exposure. 

Salmonella Paratyphi B variant L(+) tartrate(+) does not cause paratyphoid fever, enteric fever, or typhoid fever.

*The investigation has not conclusively identified the source of this outbreak, but most ill people interviewed reported eating sushi made with raw tuna in the week before becoming ill.

In interviews, 34 (94%) of 36 ill people reported eating sushi made with raw tuna in the week before becoming ill.

At this time, a common brand or supplier of raw tuna linked to illnesses has not been identified, and there are no specific steps for restaurants, retailers, or consumers to take to protect their customers or themselves.

Italian child in hospital with Listeria from homemade cheese

A child of 18 months in Vigevano, in the province of Pavia, is hospitalized in serious condition in the pediatric ward of the Policlinico San Matteo in Pavia due to listeriosis, after eating a homemade cheese made with unpasteurized milk.

cheese_mites430x300Talking with the parents of the young patient, doctors have learned in recent days that the child ate a cheese that had been prepared at home. Once arrived at San Matteo, the child has undergone brain surgery to reduce complications of meningoencephalitis.

Raw is risky: E. coli in veal tartare sickened 7

An Escherichia coli O157:H7 outbreak occurred in 2013 that was associated with the consumption of beef and veal tartares in the province of Quebec. This report describes the results of the ensuing investigation.

veal.tartareMaterials and Methods: As the outbreak was identified, all individuals in the province of Quebec affected with the same strain of E. coli O157:H7 as defined by pulsed-field gel electrophoresis were interviewed using a standardized questionnaire. Cases reported from other provinces in Canada were interviewed by their public health authorities and the results were reported to the Quebec public health authorities. Microbiological and environmental investigations were conducted by the Sous-ministériat à la santé animale et à l’inspection des aliments du Ministère de l’Agriculture, des Pêcheries et de l’Alimentation du Québec, by the Ville de Montréal’s Food Inspection Branch, and by the Canadian Food Inspection Agency at the restaurants, suppliers, and slaughterhouses identified.

Results: In total, seven individuals in three different Canadian provinces became ill following infection with the same outbreak strain of E. coli O157:H7. Two cases were hospitalized and one had severe hemolytic uremic syndrome. No deaths were reported. Two restaurant locations serving different tartare meals including, beef, veal, salmon, tuna, and duck were identified as potential sources of the outbreak. No deficiencies at the restaurant locations were observed during inspections by food inspectors.

Conclusions: The risk of consuming tartare can be lowered when basic hygienic rules are followed, temperature is strictly controlled, and fresh meat is used. However, even if handling, chopping, and temperature control during storage of the meat are considered adequate, tartare is a raw product and the risk of contamination is present. Consumers should be advised that consuming this product can lead to serious illness. 

Escherichia coli O157:H7 outbreak associated with the consumption of beef and veal tartares in the province of Quebec, Canada in 2013

Foodborne Pathogens and Disease

Gaulin Colette, Ramsay Danielle, Catford Angela, and Bekal Sadjia

http://online.liebertpub.com/doi/abs/10.1089/fpd.2014.1919

 

Public health has better things to do: Increased outbreaks associated with nonpasteurized milk

The number of US outbreaks caused by nonpasteurized milk increased from 30 during 2007-2009 to 51 during 2010-2012. Most outbreaks were caused by Campylobacter spp. (77%) and by nonpasteurized milk purchased from states in which nonpasteurized milk sale was legal (81%).

rw.milk.outbreaks.2Regulations to prevent distribution of nonpasteurized milk should be enforced.

Increased outbreaks associated with nonpasteurized milk, United States, 2007-2012.

Emerging Infectious Diseases, 2015 Jan;21(1):119-22. doi: 10.3201/eid2101.140447.

Mungai EA, Behravesh CB, Gould LH.

http://www.ncbi.nlm.nih.gov/pubmed/25531403

Australian farmer prosecuted for supplying unpasteurised milk under cow share scheme

Mark Tyler of South Australia says the raw milk distributed from his 50 or so cows at his Willunga Hill property to shareholders who paid $30 plus a fortnightly boarding fee, then picked up their milk regularly from the farm, is safe.

colbert.raw.milkA judge didn’t agree.

The Tylers could face a fine of up to $50,000 for breaching food regulations.

Raw milk sales are illegal and the South Australian Government argued the couple’s “cow share” arrangement constituted a sale under the Food Act.

“We’ve got over 2,000 people drinking it every day, really no one’s having an issue,” said Tyler.

“There’s virtually no proven cases of raw milk causing illness in people.”

Nosestretcher.

There has been a push by legislators to crack down on raw milk sales across Australia since a three-year-old Victorian boy died last year.

Salmonella sticks to older lettuce better

Salmonella can bind to the leaves of salad crops including lettuce and survive for commercially relevant periods. Previously studies have shown that younger leaves are more susceptible to colonization than older leaves and that colonization levels are dependent on both the bacterial serovar and the lettuce cultivar.

lettuceIn this study, we investigated the ability of two Lactuca sativa cultivars (Saladin and Iceberg) and an accession of wild lettuce (L. serriola) to support attachment of Salmonella enterica serovar Senftenberg, to the 1st and 5–6th true-leaves and the associations between cultivar-dependent variation in plant leaf surface characteristics and bacterial attachment. Attachment levels were higher on older leaves than on the younger ones and these differences were associated with leaf vein and stomatal densities, leaf surface hydrophobicity and leaf surface soluble protein concentrations. Vein density and leaf surface hydrophobicity were also associated with cultivar-specific differences in Salmonella attachment, although the latter was only observed in the older leaves and was also associated with level of epicuticular wax.

 Older leaves of lettuce (Lactuca spp.) support higher levels of Salmonella enterica ser. Senftenberg attachment and show greater variation between plant accessions than do younger leaves.

Microbiology Letters [ahead of print]

Paul J. Hunter , Robert K. Shaw , Cedric N. Berger , Gad Frankel , David Pink , Paul Hand

http://femsle.oxfordjournals.org/content/early/2015/05/06/femsle.fnv077

It’s called a chlorine monitor: If you wash fresh produce, buy one

Maintaining effective sanitizer concentration is of critical importance for preventing pathogen survival and transference during fresh-cut produce wash operation and for ensuring the safety of finished products. However, maintaining an adequate level of sanitizer in wash water can be challenging for processors due to the large organic load in the wash system.

tomato.dump.tankIn this study, we investigated how the survival of human pathogens was affected by the dynamic changes in water quality during chlorine depletion and replenishment in simulated produce washing operations. Lettuce extract was added incrementally into water containing pre-set levels of free chlorine to simulate the chlorine depletion process, and sodium hypochlorite was added incrementally into water containing pre-set levels of lettuce extract to simulate chlorine replenishment. Key water quality parameters were closely monitored and the bactericidal activity of the wash water was evaluated using three-strain cocktails of Escherichia coli O157:H7, Salmonella enterica, and Listeria monocytogenes. In both chlorine depletion and replenishment processes, no pathogen survival was observed when wash water free chlorine level was maintained above 3.66 mg/L, irrespective of the initial free chlorine levels (10, 50, 100 and 200 mg/L) or organic loading (chemical oxidation demand levels of 0, 532, 1013 and 1705 mg/L). At this free chlorine concentration, the measured ORP was 843 mV and pH was 5.12 for the chlorine depletion process; the measured ORP was 714 mV and pH was 6.97 for the chlorine replenishment process.

 This study provides quantitative data needed by the fresh-cut produce industry and the regulatory agencies to establish critical operational control parameters to prevent pathogen survival and cross-contamination during fresh produce washing.

 Inactivation dynamics of Salmonella enterica, Listeria monocytogenes, and Escherichia coli O157:H7 in wash water during simulated chlorine depletion and replenishment processes

Food Microbiology, Volume 50, September 2015, Pages 88–96

Bin Zhou, Yaguang Luo, Xiangwu Nou, Shuxia Lyu, Qin Wang

http://www.sciencedirect.com/science/article/pii/S0740002015000556

This is happening: Baby formula made of raw milk in US

The Washington Post reports that three years ago, after giving birth to her daughter, Nancy Noe had to accept the disappointing fact that she wasn’t producing enough breast milk to feed her baby.

colbert.raw.milkAfter trying everything—like frequent pumping and help from a lactation consultant—she did what she considered the next best thing: she went in search of the most organic baby formula she could find. “Reading the ingredients on the commercial formulas hardly made me feel any better,” Noe said recently. “I had no idea what any of this stuff was. I wanted another option.”

Then that she came across a recipe for a make-at-home formula created by the Weston A. Price Foundation (WAPF), whose stated mission is to restore nutrient-dense foods to the American diet. The formula is made using raw, or unpasteurized, cow’s milk and 13 additional ingredients—like homemade whey, lactose, gelatin, and healthy oils—designed to mimic the fat and nutrients in human breast milk.

Nancy was nervous to feed raw milk to her 7-week-old baby, and it initially didn’t go well. Her daughter experienced cheese-like vomiting, strange colored stool, and a lot of upset. “At first I thought, ‘What am I doing?’ ” Noe said. “But after two weeks, she began to thrive. She grew well, slept well, and loved her bottle. She’s now a very healthy 3-year-old.”

But the idea of a do-it-yourself formula—especially one made with raw milk— unsurprisingly has very vocal opponents.

“The idea that you would feed raw milk to an infant is completely insane,” says Katherine Lilleskov, a Brooklyn-based lactation consultant and RN. “With their weakened immune systems, infants are particularly vulnerable to harmful bacteria. It’s our job to keep our babies away from that stuff, not willingly feed it to them.

The WAPF formula was first developed nearly 20 years ago by Sally Fallon Morell, the foundation’s founding president, and nutritionist Mary Enig, early advocates for whole foods. Since then, Fallon estimates, nearly 20,000 families have used her recipe to feed their babies, and the number of parents experimenting with the formula doesn’t seem to show signs of abating. Fallon argues that the formula provides immune-stimulating, health-promoting, and antimicrobial components very similar to human breast milk, and hears often from parents happy to have found an alternative to commercial formula.

Nuts.

Nanotech to make produce safer?

Nearly half of foodborne illnesses in the U.S. from 1998 through 2008 have been attributed to contaminated fresh produce. Prevention and control of bacterial contamination on fresh produce is critical to ensure food safety. The current strategy remains industrial washing of the product in water containing chlorine.

(an effective on-farm food safety program helps)

lettuceHowever, due to sanitizer ineffectiveness there is an urgent need to identify alternative antimicrobials, particularly those of natural origin, for the produce industry.

A team of researchers at Wayne State University have been exploring natural, safe and alternative antimicrobials to reduce bacterial contamination. Plant essential oils such as those from thyme, oregano and clove are known to have a strong antimicrobial effect, but currently their use in food protection is limited due to their low solubility in water. The team, led by Yifan Zhang, Ph.D., assistant professor of nutrition and food science in the College of Liberal Arts and Sciences, explored ways to formulate oil nanoemulsions to increase the solubility and stability of essential oils, and consequently, enhance their antimicrobial activity.

“Much of the research on the antimicrobial efficacy of essential oils has been conducted using products made by mixing immiscible oils in water or phosphate buffered saline,” said Zhang. “However, because of the hydrophobic nature of essential oils, organic compounds from produce may interfere with reducing the sanitizing effect or duration of the effectiveness of these essential oils. Our team set out to find a new approach to inhibit these bacteria with the use of oregano oil, one of the most effective plant essential oils with antimicrobial effect.”

Zhang, and then-Ph.D. student, Kanika Bhargava, currently assistant professor of human environmental sciences at the University of Central Oklahoma, approached Sandro da Rocha, Ph.D., associate professor of chemical engineering and materials science in the College of Engineering at Wayne State, to explore options.

“In our research, we discovered that oregano oil was able to inhibit common foodborne bacteria, such as E. coli O157, Salmonella and Listeria, in artificially contaminated fresh lettuce” said Zhang. “We wanted to explore the possibility of a nanodelivery system for the oil, which is an area of expertise of Dr. da Rocha.”

The team initially considered the use of solid polymeric nanoparticles for the delivery of the oil, but da Rocha suggested the use of nanoemulsions.

“My team felt the use of nanoemulsions would improve the rate of release compared to other nanoformulations, and the ability of the food grade surfactant to wet the surface of the produce,” said da Rocha. “We were able to reduce L. monocytogenes, S. Typhimurium, and E. coli O157 on fresh lettuce. Former Ph.D. student Denise S. Conti, now at the Generics Division of the FDA, helped design the nanocarriers and characterize them.”

The team added that while there is still work to be done, their study suggests promise for the use of essential oil nanoemulsions as a natural alternative to chemicals for safety controls in produce.

“Our future research aims to investigate the antimicrobial effects of essential oil nanoemulsions in various combinations, as well as formulate the best proportions of each ingredient at the lowest possible necessary levels needed for food application, which ultimately will aid in maintaining the taste of the produce.”

More information: The study, “Application of an oregano oil nanoemulsion to the control of foodborne bacteria on fresh lettuce” appears in the May 2015 issue of Food Microbiology. www.sciencedirect.com/science/article/pii/S0740002014002676