Why does Australia have these huge outbreaks? And an egg problem? 250 now sick from principals’ conference

The number of people who have been struck down by food poisoning since eating at the Brisbane Convention and Exhibition Centre last week as part of a principals conference has jumped to 250.

salmonella.eggsThe cases are spread across Queensland with the highest numbers in Cairns and the Sunshine Coast with 34 cases reported in each of those regions.

About 1400 people descended on the venue for the conference on Thursday and Friday last week.

The outbreak is the second worst case of salmonella poisoning in the state’s history.

The worst was in November 2013 from a Melbourne Cup function with 350 reported cases and 12 hospitalizations.

A 77-year-old women’s death was linked to that outbreak which was suspected to have been caused by bad eggs.

An outbreak of Salmonella in January this year from deep fried ice cream at Chin Chin restaurant (it was the eggs) led to 141 cases with at least eight people hospitalized.

A table of Australian egg outbreaks is available at http://barfblog.com/wp-content/uploads/2015/03/raw-egg-related-outbreaks-australia-3-2-15.xlsx\

2 dead, 29 sick at aged-care: Australia apparently sucks at Salmonella control

Public health authorities are concerned after two new cases of Salmonella emerged at aged care facilities in the Illawarra this week, bringing the total number of patients to 31.

salmonella.aged.care.austLast week authorities were hopeful the outbreak of the food-borne illness at 10 facilities in the Illawarra and Shoalhaven, south-eastern Sydney and the ACT had been contained.

Two elderly residents have died and 16 residents have been hospitalised after contracting a rare strain of salmonella, with the onset of the first case on January 21.

175 sick with Salmonella: Brisbane Convention and Exhibition Centre kitchen dumps eggs and poultry, Lloyds of London is a food safety auditor?

I can’t make this stuff up.

The Brisbane Convention and Exhibition Centre will continue to source food from the same suppliers, but has suspended the use of poultry and eggs, after the second-worst outbreak of salmonella poisoning in Queensland’s history.

powell.egg.nov.14Despite the indication of potential food poisoning, poultry and eggs weren’t struck off the menu until late yesterday.

Up to six events were held at the centre yesterday.

Chief Health Officer Dr Janette Young said that the usual suspects in salmonella poisoning are poorly cooked meat, poultry, eggs and egg products.

General manager of the BCEC Bob O’Keeffe said yesterday afternoon he hadn’t considered suspending food services while the causes of the outbreak were still unknown, before a dramatic about-face from a spokeswoman later in the day.

“Not really, no. We’ve done 20 years of it, of systems and the systems have got better and better every year and we have the records of the products and the service and the timing and the suppliers,” Mr O’Keeffe had said. A spokeswoman later said eggs and poultry were being suspended as a “prudent and precautionary approach.”

About 200 people who attended the 2015 principals conference on Thursday and Friday last week have been struck down, with at least 24 people hospitalized.

The BCEC has also appointed food safety auditor Lloyds of London to begin an investigation today.

Look to the raw egg dishes that Australian chef types seem to prefer.

Here’s an updated table.

Australia still has an egg (food porn) problem: Former partner of MKR judge investigated after food poisoning incident at Double Bay Public School

The story below from the Wentworth Courier gives a taste of the disdain and food porn that permeates Australian egg culture.

mayonnaise.raw.eggA table of egg-based Salmonella outbreaks is available here.

The former partner of TV chef Manu Feildel has been implicated in a Salmonella poisoning incident at the Double Bay Public School’s Year 6 farewell event.

The incident, which occurred in December 2014, has since been the subject of a NSW Food Authority and NSW Health investigation.

A NSW Food Authority spokeswoman said an investigation had linked the salmonella outbreak “to a raw egg sauce served”.

“The NSW Food Authority has worked with the home-based catering business involved … and provided the operator with advice, guidance and information in relation to food safety requirements.”

Ronnie Morshead, Feildel’s partner for more than a decade and the owner-operator of Red Sage Catering which catered the function, said yesterday she had sent the Food Authority’s findings on to the school’s principal Andrea Garling.

“I believe the school is still waiting on an official report from the director of public health (Mark Ferson),” Ms Morshead said.

“But I understand, as far as (Professor Ferson) was concerned the whole (investigation) was complete.”

Last week, the Courier published details of six confirmed cases of salmonella following the farewell.

Prof Ferson, the South East Sydney Local Health District public health director, said on Monday that “more than six people were affected”, but as the Food Authority had completed its investigation, there was no need for him to conduct ­interviews with other victims.

A parent, who did not want their name published, said upwards of 25 people had fallen ill, including their own child who was still yet to fully recover.

raw.egg.mayo“How can there have been a thorough investigation when not every body has been interviewed?” the parent said.

“There’s talk of reimbursing medical bills but this is so much more than that. What about all that unnecessary suffering?” Prof Ferson said his ­department had identified the farewell event as the source of a salmonella outbreak after receiving ­unusual lab results.

The school has declined to comment and has directed questions to the NSW Education Department.

A spokesman did not ­respond to the Courier’s questions yesterday.

175 principals sick: Brisbane needs to up its food safety

An op-ed by me in this morning’s Brisbane Courier-Mail:

g20.brisbane.14If Brisbane wants to be the world-class city it aspires to be, put aside obsessions with TV cooking shows, with political inanities, with imports and focus on what makes people — such as 175 delegates at a school principals’ conference — sick.

After decades of food safety research, I can conclude anyone who serves, prepares or handles food, in a restaurant, nursing home, day care centre, supermarket or local market needs some basic food safety training. And the results of restaurant and other food service inspections must be made public and mandatory.

Here’s why. Parenting and preparing food are about the only two activities that no longer require some kind of certification in Western countries. To coach little kids ice hockey in Brisbane, which I do, required 16 hours of training. But anyone can serve food.

Cross-contamination, lack of handwashing and improper cooking or holding temperatures are all common themes in food-service related outbreaks — the very same infractions that restaurant operators and employees should be reminded of during training sessions and are judged on during inspections.

eat.safe.brisbaneThere should be mandatory food handler training, for say, three hours, that could happen in school, on the job, whatever. But training is only the start. Just because you tell someone to wash their hands after using the toilet before they prepare salad for 100 people doesn’t mean it is going to happen; weekly outbreaks of hepatitis A confirm this. There are incentives that can be used to create a culture that values safe food and a work environment that rewards hygienic behaviour.

Next is to verify that training is being translated into safe food handling practices through inspection, which should be public and mandatory.

Brisbane’s star system is voluntary, which means an owner can choose to not display results if they suck. The best cities — Toronto, Los Angeles, New York — have mandatory disclosure.

In the absence of regular media scrutiny, or a reality TV show where camera crews follow an inspector into a place unannounced, how do diners know which of their favourite restaurants are safe?

Cities, counties and states are using a blend of websites and letter or numerical grades on doors, and providing disclosure upon request.

In Denmark, smiley or sad faces are affixed to restaurant windows.

Publicly available grading systems rapidly communicate to diners the potential risk in dining at a particular establishment and restaurants given a lower grade may be more likely to comply with health regulations in the future to prevent lost business.

More importantly, such public displays of information help bolster overall awareness of food safety among staff and the public — people routinely talk about this stuff. The interested public can handle more, not less, information about food safety.

I volunteer at my daughter’s school tuck shop — no inspection, no training — and they’re serving meals to kids. Principals visiting Brisbane, unfortunately, learnt the importance of food safety.

Dr. Douglas Powell is a former professor of food safety at the University of Guelph in Canada and Kansas State University in the U.S., who is now based in Brisbane.

 dpowell29@gmail.com

0478 222 221

Up to 164 sickened after attending school principal’s conference in Australia

As misguided calls for Aussie-only produce bear fruit, up to164 delegates from across Queensland attending a school principals’ conference at Brisbane’s Convention and Exhibition Centre have been sickened, possibly with Salmonella.

pink.floyd.educationCheck the egg-based dishes (a table of Australian egg-based Salmonella outbreaks is available here).

Twenty-two people so ill they had to be admitted to hospital.

Queensland Health last night confirmed it had launched an investigation.

The Courier-Mail reports that blood tests of one patient indicated salmonella poisoning.

Queensland Teachers Union president Kevin Bates said last night delegates had suffered severe illness.

“The symptoms have been described as vomiting, nausea and severe dehydration,” Mr Bates said.

One sick principal questioned food handling standards.

“All the hot food – curry and rice and so on – was in pretty white bowls without heating. Not a bain-marie in sight,” the principal said.

Queensland Secondary  Principals’ Association president Andrew Pierpoint said an email was sent to principals yesterday urging them to contact a doctor if they felt ill.

Queensland Health communicable diseases director Dr Sonya Bennett said the education department had contacted the health office on Sunday afternoon to raise concerns about the number of conference attendees who had fallen ill.

The Brisbane Convention and Exhibition Centre did not return calls yesterday.

Salmonella and E. coli in sprouts in Mexico, oh my

Data on the presence of diarrheagenic Escherichia coli pathotypes (DEPs) in alfalfa sprouts and correlations between the presence of coliform bacteria (CB), fecal coliforms (FC), E. coli, DEPs, and Salmonella in alfalfa sprouts are not available. The presence of and correlations between CB, FC, E. coli, DEPs, and Salmonella in alfalfa sprouts were determined.

santa.barf.sprout.raw.milkOne hundred sprout samples were collected from retail markets in Pachuca, Hidalgo State, Mexico. The presence of indicator bacteria and Salmonella was determined using conventional culture procedures. DEPs were identified using two multiplex PCR procedures. One hundred percent of samples were positive for CB, 90% for FC, 84% for E. coli, 10% for DEPs, and 4% for Salmonella. The populations of CB ranged from 6.2 up to 8.6 log CFU/g. The FC and E. coli concentrations were between , 3 and 1,100 most probable number (MPN)/g. The DEPs identified included enterotoxigenic E. coli (ETEC; 2%), enteropathogenic E. coli (EPEC; 3%), and Shiga toxin–producing E. coli (STEC; 5%). No E. coli O157:H7 strains were detected in any STEC-positive samples. In samples positive for DEPs, the concentrations ranged from 210 to 240 MPN/g for ETEC, 28 to 1,100 MPN/g for EPEC, and 3.6 to 460 MPN/g for STEC. The Salmonella isolates identified included Salmonella enterica serotype Typhimurium in three samples and Salmonella enterica serotype Enteritidis in one. STEC and Salmonella Typhimurium were identified together in one sample. Positive correlations were observed between FC and E. coli, between FC and DEPs, and between E. coli and DEPs. Negative correlations occurred between CB and DEPs and between CB and Salmonella. Neither FC nor E. coli correlated with Salmonella in the sprout samples.

To our knowledge, this is the first report of ETEC, EPEC, and STEC isolated from alfalfa sprouts and the first report of correlations between different indicator groups versus DEPs and Salmonella.

 

Presence and correlation of some enteric indicator bacteria, diarrheagenic Escherichia coli pathotypes, and Salmonella serotypes in alfalfa sprouts from local retail markets in Pachuca, Mexico

01.mar.15

Journal of Food Protection®, Number 3, March 2015, pp. 484-627, pp. 609-614(6)

Rangel-Vargas, Esmeralda; Gómez-Aldapa, Carlos A.; Torres-Vitela, M. del Refugio; Villarruel-López, Angélica; Gordillo-Martínez, Alberto J.; Castro-Rosas, Javier

http://www.ingentaconnect.com/content/iafp/jfp/2015/00000078/00000003/art00020

Health department links undercooked and reheated barbecue linked to Salmonella illnesses

Growing up in Canada, barbecue was an event, or an outside cooking appliance. In North Carolina barbecue is a food.

And for some, sort of a religion.

Barbecue is made by slow cooking pork (often a whole hog) in a smoker for hours until the meat is tender enough to be pulled off of the bones. The kind I like is tossed in a vinegar and pepper sauce (that’s Eastern North Carolina style) and served with a couple of vegetable sides.bbq-tom-vin-m__05901.1405326372.1000.1200

Kind of like what led to almost 70 cases of salmonellosis last fall at a conference in Bessemer City, NC. According to the Gaston Gazette, the heath department’s investigation fingered the pork dish as the likely vehicle for the pathogen.

The investigation began after multiple people sought treatment for a stomach illness in early October.

The local health department collected information and found that many of the patients had attended a conference between Oct. 1 and 5 at Living Word Tabernacle Church in Bessemer City.

A report released this week found that Boston butts prepared by a church member were the likely culprits.

The pork was cooked overnight in a smoker a day before it was served. Then it was returned to the smoker the day of the meals.

Some of the pork hadn’t cooked all the way through in time for lunch so it was cooked longer then taken to the church for dinner.

The church member who cooked the meat said it was cooked at 350 degrees the first night, but no cooking temperature was given for when the pork was put back on the grill the next day.

Three people were hospitalized.

The purpose of the health department study isn’t to cast blame. It’s to educate, according to health officials.

The church was not required to have a permit to serve the food because the meals were free, but proper food preparation and storage should always be observed, said Samantha Dye with Gaston County Health and Human Services.

Salmonella in tahini sauce in Canada

Amira brand Tahini Sauce has been recalled for Salmonella as part of an investigation by the Canadian Food Inspection Agency (CFIA) into a foodborne illness outbreak.

tahini.sauce.salmThere have been no reported illnesses associated with the consumption of this product.

That’s going to happen, products get tested as part of an epidemiological investigation, come back positive, gotta go public.

Consumers should not consume the recalled product described below.

Recalled products

Brand Name Common Name Size Code(s) on Product UPC
Amira Tahini Sauce 750 g None 0 69467 40101 0

‘Lab confirmation should never be a requisite to implicating food in an outbreak’ Epidemiology is getting hammered to protect interests

From Australia to Wisconsin to cucumbers, epidemiology is getting hammered with a bunch of people defending their turf by saying, there’s no definitive proof.

spongebob.oil.colbert.may3.10The hepatitis A outbreak in Australia linked to Chinese frozen berries that has now sickened 19 has prompted many an Aussie to proclaim, I’ll never use frozen berries, without acknowledging they live in a sub-tropical climate, not Canada. And that preservation technologies work, when used properly.

The raw milk dairy farmers in Pepin County, Wisconsin, are denying charges that their raw milk served at a potluck dinner last September sickened at least 39 students and coaches affiliated with the Durand High School football team with Campylobacter.

Information collected from 65 students, coaches and parents indicated that consumption of milk was the only exposure statistically associated with the illness, DHS spokeswoman Jennifer Miller said.

For instance, the report said that some of the 38 people sickened at the dinner did not eat chicken, that 32 drank unpasteurized milk, and that six others drank milk consumed from a store-bought jug that could have contained pasteurized or unpasteurized milk.

Also, DATCP staff collected cow manure specimens from the Reeds’ cows and genetic fingerprinting proved that the bacteria that caused the illness at the dinner was the same bacteria strain found on the Reeds’ farm, Miller said.

But it’s the Salmonella-in-cucumbers outbreak – publicly unknown until a week ago — that reveals how deep interests influence.

An 18-week Salmonella outbreak linked to fresh cucumbers in 2014 sickened at least 275 people across 29 U.S. states, and killed one man.

Several of us in the food safety world – and probably the cucumber-consuming world – were left wondering, why didn’t we know about this?

Here’s the explanation from Dr. Bob (Bob Whitaker, chief science officer at the U.S. Produce Marketing Association; if anyone calls me Dr. Doug, I glare, and say, that’s Dr. Evil to you; I didn’t spent seven years in Evil University to be Mr. Evil):

epidemiology.WATER PUMP3_Page_4.storyThe Centers for Disease Control (CDC) issued their Morbidity and Mortality Weekly Report (MMWR) today. Anything with “morbidity” and “mortality” in the title is probably not going to rank highly on your general reading list and this weekly report was fairly typical of the reports published by CDC; highly technical and detailed, very informative, but probably targeted to a fairly specific audience.

So mere mortals are too dumb to understand?

Unfortunately, the process of identifying the cause of an illness outbreak and then further identifying how the people became ill and where that product originated from involves, as a first step, time consuming reporting of patient sample microbiology from local communities to states and perhaps up to the federal level. Often the process of just collecting this type of information and recognizing that there may be an illness outbreak exceeds the shelf life of our perishable products. Once an outbreak has been recognized, the epidemiological traceback or the process of determining what people might have come in contact with to make them ill can begin.

Epidemiology involves patient surveys, case control studies and correlation coefficients and can be time consuming and may yield multiple potential contamination vehicles. Finally, once potential food vehicles are identified, a traceback can be conducted to learn where patients might have obtained or consumed a specific food and investigators can work back to where the food was ultimately grown, harvested, packed or processed. Once production locations are identified, investigators can take microbial samples in an attempt to match any strains from the production environment to those isolated clinically from patients or in some limited cases from the food itself. Often by the time all of these vitally necessary steps have been completed, the crop is long gone and direct proof for how the contamination occurred or the source of the contamination is impossible to ascertain. Such was the case described by this Salmonella outbreak related to cucumbers.

CDC also disclosed that they employed consultations with industry experts early on in their investigation to gather information about industry practices, crop production cycles in the suspected region and product distribution. This is a positive step and is the result of a great deal of effort by the industry and CDC to determine how to engage industry to better inform investigations.

More accurate and rapid epidemiological investigations will ultimately help our industry determine what went wrong when these unfortunate illness outbreaks occur and are assigned to a produce item. This will help us direct research efforts aimed at identifying mitigation steps that can reduce the risk of further occurrences and assist operators in building improved risk and science-based food safety programs.

So why wasn’t the public informed there were a bunch of sick people?

Sounds more like the produce cone of silence.

Kirk Smith, epidemiology supervisor for the Minnesota Department of Health, told the Washington Post four years ago it’s rare for scientists investigating foodborne illness outbreaks to test the exact food suspected of carrying pathogens. By the time symptoms occur and a foodborne illness is reported and confirmed, the product in question has likely been consumed or has exceeded its shelf-life and been thrown away.

Instead, scientists, like detectives, interview victims, collect data, analyze patterns and match food “fingerprints” to determine the likely source of an outbreak.

“The majority of outbreaks, we don’t have the food to test,” Smith said. “Laboratory confirmation of the food should never be a requisite to implicating a food item as the vehicle of an outbreak.

“Epidemiology is actually a much faster and more powerful tool than is laboratory confirmation.”

As we have written, often during an outbreak of foodborne illness there are health officials who have data indicating that there is a risk, prior to the public. During the lag period between the first public health signal and some release of public information there are decision makers who are weighing evidence with the impacts of going public.

There is no indication in the literature that consumers benefit from paternalistic protection decisions to guard against information overload.