A real headline: Health Officials React To An Outbreak Of Stomach Yuck

I don’t know what Stomach Yuck is, but health department folks in Florida are reacting to it, according to WUWF radio.Wooden-Mannequin-Vomiting-300x198

An outbreak of a nasty stomach bug (Stomachus yuckii? – ben)  has health officials getting the word out about basic hygiene. Dr. John Lanza, the Director of the Florida Department of Health in Escambia County, recently issued a release about a spike in the number of gastrointestinal infections reported in Escambia County.

Lanza says thirty plus people have come down with the illness causing vomiting, diarrhea and fever.  They are all part of the same outbreak, which involved children and workers at day care centers in the county. While you might expect the chilly weather keeping people inside as the cause, Dr. Lanza says it’s not so much the time of year but an event or circumstance that exposes a lot of people to a bug at once that can cause an outbreak like this. He says the classic case is the spring wedding where a sick caterer can cause illness in more than half a wedding party within a few days.

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.

Five Japanese men poisoned by puffer fish after ‘eating highly poisonous liver’

Five men have been poisoned in Japan after allegedly asking a restaurant to serve them banned parts of the world’s most toxic fish.


puffer.fish.liverThe men were having dinner on Friday night in the western city of Wakayama when they ate puffer fish liver, which prompted vomiting and breathing difficulties early the next morning.

Puffer fish – also called blowfish or fugu in Japanese – are the world’s most toxic group of fish and their livers, ovaries and skin contain tetrodotoxin, 100 times more lethal than cyanide.

Yet eating the fish’s flesh is a tradition in Japan, where wealthy diners play the Russian roulette of the restaurant world by dining on sashimi slivers so thin they are almost transparent.

According to a city health official, the men asked to eat a banned, toxic part of the fish – which the most foolhardy fugu aficionados are said to enjoy for the tingling it produces on the lips.

The tingling is only the first symptom of tetrodotoxin poisoning, and is seen as part of the thrill for lovers of the fish.

But if the toxin is served in any significant quantity it then paralyses the muscles, suffocating victims as it reaches their chests and diaphragms while they are still conscious.

The health official said the men were in their 40s and 50s and the restaurant was shut down for five days from yesterday amid an investigation.

 

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

Beware the mud: Mountain bikers and cross-country runners at risk of E.coli poisoning

Mountain bikers and cross-country runners are at risk from the deadly stomach bug E. coli if they get splashed with mud, doctors warned today.

mudMedics at Aberdeen Royal Infirmary say they treated a 23-year-old cyclist for an E. coli O157 infection after he was admitted to the hospital suffering from vomiting, abdominal pain and bloody diarrhea.

The man – a vegetarian – said he had not eaten undercooked meat or vegetables, nor had he spent time with livestock or visiting farms before falling ill.

But eight days before his symptoms began the man had competed in a cycling event along wet, muddy tracks in eastern Scotland.

He, along with other competitors, had removed the mudguards from his bicycle to reduce weight, and mud and water had splashed on his face during the race. 

It is thought this was how he became infected with the bug, which can be found in animal feces and farm slurry.

The man said he had taken part in a ‘Tough Mudder’ event, which involves a 10 -12 mile race with obstacles such as climbing vertical walls and plunging through ice pools.

The cyclist, who has not been identified, recovered – but the doctors have highlighted his case in the Journal of Infection Prevention.

mountain.bike.mudWriting in the research paper, the doctors warned: ‘Sporting endeavours such as cycling and cross-country running events often take participants through such high-risk areas and may be an important cause of contact with E. coli O157.

‘This case highlights such exposure and should alert clinicians to the possibility of E.coli O157 infection and the importance of individuals presenting with bloody diarrhea with a history of participation in similar sporting or other events.’

In 2012, three people contracted E.coli 0O57 infection following a 12-mile ‘Tough Mudder’ event at Drumlanrig Castle, Dumfriesshire, which involved immersion or contact with mud.

Also in 2012, a study of one of the world’s largest mountain bike races, the 95k Birkebeinerrittet in Norway, which annually attracts 19,000 participants, found that when mudguards were attached to bikes, there were fewer cases of gastrointestinal illness.  

The Brits have a way with language: townies wash their hands

Germs. You can’t get away from the blighters. If it’s not the teeming populations of camplylobacter that infest the cavities of supermarketchicken, it’s the E coli, salmonella and worse that disport themselves on our towels and dishcloths.

courtlynn.handwashAgainst these regiments of invisible enemies we deploy a vast arsenal of weapons-grade cleaning products. But while we’re spraying our surfaces with bleach and washing our dishes in Eucalyptus detergent, a shaming 60-odd per cent of us neglect to wash our hands after we’ve visited the loo, according to a Rentokil survey.

While confirming my conviction that you’re better off eating dinner at home, where at least the bugs are mostly familiar, this news has made me reflect on my own handwashing habits which are, I realise, completely perverse.

At home in London, I carry on like Lady Macbeth, washing my hands dozens of times a day. But at weekends, in the stableyard, I find myself cheerfully eating a sandwich from an unwashed hand that moments ago was feeding a horse a mint.

I’ve no idea whether it is my scrupulous townie cleanliness or my robust rural exposure to pathogens that means I’m almost never ill. But either way I view with misgiving Rentokil’s proposed solution to the handwashing recidivists. Stewart Power, its marketing director, predicts that one day every washroom will have a monitoring system “to give us a nudge to wash our hands”.

It’s bad enough being nagged by an electronic voice about an unexplained item in the bagging area. Just imagine the irritation of being slut-shamed by a disembodied nanny in the loo door.

E. coli vaccine effective but seldom used in feedlot cattle

When it comes to foodborne illnesses, few rival E. coli for the damaging effect it can have on humans.

beef.cattleResearch shows that STEC-related bacteria cause more than 175,000 human illnesses per year with an annual direct economic cost ranging from $489 million to $993 million, said Kansas State University agricultural economist, Glynn Tonsor.

Shiga toxin-producing E. coli, often referred to as STEC O157 or simply E. coli, is naturally occurring in cattle and though it does no harm to the cattle, can make humans sick. In some cases it is lethal. To reduce the chances that beef leaving their plants is contaminated with the pathogen, beef processors have implemented hazard control steps and also test their beef products for the presence of E. coli before they leave the plant.

Another potential way to reduce prevalence of E. coli is to vaccinate cattle in feedlots long before they are shipped to processing plants.

“Immunization through vaccination has been a commercially available pre-harvest intervention to reduce E. coli shedding in cattle for about five years,” said Tonsor, who is a livestock marketing specialist with K-State Research and Extension. “Despite demonstrated substantial improvement in human health the vaccine offers, it has not been widely adopted.”

In a recent study he, along with K-State colleague Ted Schroeder, also an agricultural economist, took a closer look at the potential economic impacts of incorporating animal vaccination into E. coli pre-harvest control practices.

A fact sheet is available at Market Impacts of E.coli Vaccination in U.S. Feedlots. Study results have been published in the Agricultural and Food Economics Journal.

The study made clear two primary reasons most feedlot managers don’t use E. coli vaccines. Because cattle themselves are not adversely affected by the pathogen, the presence of E. coli does not hinder cattle feeding efficiency so there are no production costs for feedlots directly associated with the prevalence of E. coli. In other words, it costs no more to feed cattle that have E. coli than it does to feed cattle that don’t.  

Further, there is no well-established market that compensates producers for vaccinating for the pathogen. So generally, the price paid for cattle coming out of feedlots is the same whether the vaccine was used or not. Because administering the vaccine adds costs without direct economic incentives, most cattle feeders choose not to, Tonsor said.

Key findings from the K-State study include:

  • Given the current market setting, producer adoption of E. coli vaccination protocols is likely to remain limited. If such vaccinations were implemented, it would cost U.S. feedlots $1.0 billion to $1.8 billion in economic welfare loss over 10 years if demand didn’t increase with premiums for vaccinated cattle.    
  • Retail or export beef demand increases could spur adoption by feedlot producers. Considering different scenarios, the study found that retail beef demand increases of 1.7 percent to 3.0 percent or export beef demand increases of 18.1 percent to 32.6 percent would be necessary to generate sufficiently higher fed cattle prices to offset the costs associated with vaccination.
  • Production cost decreases to either beef retailers or wholesalers (packers) could also provide an incentive for feedlot producers to vaccinate. The study indicated that cost declines of 2.2 percent to 3.9 percent for retailers or alternatively production cost declines of 1.2 percent to 2.2 percent for packers would be necessary to generate sufficiently higher fed cattle prices to cover feedlot adoption costs, making producers economically neutral to adoption.

“A key point of this research is that limited use of E. coli vaccinations in U.S. feedlots is consistent with the lack of current economic signals for producers to expand adoption,” Schroeder said. “Unless there is a substantial change in market signals presented to feedlot operators, limited use of E. coli vaccinations can be expected in the future.”

Food Safety Talk 73: I Wish They’d Wash Their Hands More

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.Handwashing-Words-In-Shape-Of-Hand

This show starts with Don and Ben talking about the number-six item on their list of things to discuss for the episode:  Yosemite and how beautiful it is; Ben rates it at three thermometers, a rating system they invented.  Ben’s favorite thermometer is the Comark PDT300, even though someone sent him a ThermoWorks Thermapen which is Don’s favorite. Ben’s hockey team has been using thermometers when the grill sausages, this is what Ben’s contribution to the grill-outs.  Ben gets chirped for being the guy who brings the thermometer to the hockey grill. Ben is now supplying thermometers to other hockey guys.

Don talks about his lunch date with a podcast celebrity from the 5by5 network. Don tells the whole story about flying business class from Brazil to Texas then while in Texas, buying comic books and having lunch with Dan Benjamin.  Dan asked Don lots of food safety questions; they didn’t talk much about 5by5.  After this, Don attended the NoroCORE Food Virology meeting with Ben (the guys talked in real life, not just over Skype).

The conversation then turns to food safety culture and what that really means as it is in the literature.  Ben talks about a conversation he had about food safety culture with a person trying to develop a presentation on food safety culture for farmers. Don shares an email from Doug about food safety concerns at [insert big company name] that shared a Dropbox video of text and images displaying poor food safety. The guys then talk about the difficulties of creating a food safety culture when no one thinks it’s important. Ben talks about the many things that must be in place before a food safety culture can begin to be established.

Then conversation then transitions to how to talk about food safety risks. Ben suggests talking about risks frankly. The guys then discuss the uncertainties around risks and how to discuss them.  Discussing how quantitative risk assessments are performed and applied, and the issue of uncertainty messages, also come up in conversation.  Salmonella Hypetheticum then comes up in the conversation.

Don then brings up a book that he has been reviewing about food waste.  The same food waste topic has been featured on a television show that Don’s real life friend Randy Worobo was a guest on.  The issue of food waste and risk is discussed, with a focus on lower income persons and how to manage the need to save money against food safety risk decisions.  The use of fruits and vegetables that are past their optimum date to make infused vodka brings back memories of pruno-associated C. botulinum outbreaks.  Ben appreciates Don for working the math around food safety questions and the time and effort it takes to accurately answer without just ‘no don’t do that thing’.

Ben then brings up the issue of thawing a turkey on the counter the risks associated with that action.  Doug Powell has a paper in the Canadian Journal of Dietetics Practice Research about the calculations around thawing a turkey at room temperature.  Actually, it is ok to thaw a turkey at room temperature if you are within certain parameters.  This topic follows along with the possible Food Safety Talk tag line:  and it’s messy.

Next, Ben wants to talk about communication, but Don talks about the decision to eat fresh produce in Brazil, and other’s decision not to eat the fresh produce while visiting.  While at meetings Ben seems to focus on following the news and typing up Barfblog posts (some people are ok with that and will resist complaining; Ben does type rather loudly).  When Ben gets really into what he is writing, he lets out really loud sighs others have noticed, but Ben hasn’t noticed his inappropriate sighing.

Transitioning back to communication, Ben brings up a hepatitis A outbreak reported in Cumberland County Maine, but without a retail location identified. The State of Maine is taking some flack (could we call this chirping, see above) for their handling of this incident; the State of Maine tried to explain that this is because of a lack of personnel with specific expertise.  Maine has been in the news for other public health issues… a nurse breached a quarantine for Ebola by going for a bike ride.  Don suggests the public health system in Maine may be broken, Ben suggests this may be due to their having just eleven health inspectors for the whole state.

In the After Dark session, Ben reveals the most popular Food Safety Talk episode.  The guys aren’t sure which episode they just completed, 74?, 75?, whatever it takes.  Speaking of documentaries, Don recommends Jodorowsky’s Dune a documentary about a movie that was never made.

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.

Sweden screens for STECs in kids

Background: Shiga toxin (Stx)-producing Escherichia coli (STECs) are the most common cause of acute renal failure in children. The present study evaluated a 10-year STEC polymerase chain reaction screening regimen in children.

dirty.jobs.daycare.e.coliMethods: All routine stool culture specimens from patients below 10 years of age (n = 10 342) from May 2003 through April 2013 in the County of Jönköping, Sweden, were included. Patients were divided in 1 group where analyses of STEC were requested by the clinician (n = 2366) and 1 screening group (n = 7976). Patients who were positive for STEC were tested weekly until they were negative. Clinical data were collected through a questionnaire and by reviewing medical records.

Results: In specimens from 191 patients, stx was found (162 index cases). The prevalence was 1.8% in the requested group and 1.5% in the screening group (P = .5). Diarrhea was the most frequent symptom reported in 156 cases and of these 29 (19%) had hemorrhagic colitis (HC) and 7 children developed hemolytic uremic syndrome (HUS). No difference regarding severity of symptoms between the groups was found. Stx2 predominated in cases with HC (P < .0001) and HUS (P = .04). Median stx shedding duration was 20 days (1–256 days), and no difference in duration was seen between stx types (P = .106–1.00) and presence of eaeA (P = .72).

Conclusions: Most STEC cases were found in the screening group with comparable prevalence and disease severity as in patients where analysis was requested. Furthermore, non-O157 serotypes caused severe disease when carrying stx2, and prolonged shedding of STEC may be a risk for transmission.

 Shiga toxin-producing Escherichia coli in diarrheal stool of Swedish children: Evaluation of polymerase chain reaction screening and duration of shiga toxin shedding

Journal of the Pediatric Infectious Diseases Society

Andreas Matussek, Ing-Marie Einemo, Anna Jogenfors, Sven Löfdahl3 and Sture Löfgren

http://m.jpids.oxfordjournals.org/content/early/2015/02/17/jpids.piv003.full