86,000 sickened: Waterborne outbreaks in Nordic Countries, 1998 To 2012

Water.

We love it, take it for granted, and yet water can be the source of horrific outbreaks, like E. coli O157 in Walkerton, Ontario, Canada.

walkertonA total of 175 waterborne outbreaks affecting 85,995 individuals were notified to the national outbreak surveillance systems in Denmark, Finland and Norway from 1998 to 2012, and in Sweden from 1998 to 2011. Between 4 and 18 outbreaks were reported each year during this period.

Outbreaks occurred throughout the countries in all seasons, but were most common (n = 75/169, 44%) between June and August. Viruses belonging to the Caliciviridae family and Campylobacter were the pathogens most frequently involved, comprising n = 51 (41%) and n = 36 (29%) of all 123 outbreaks with known aetiology respectively.

Although only a few outbreaks were caused by parasites (Giardia and/or Cryptosporidium), they accounted for the largest outbreaks reported during the study period, affecting up to 53,000 persons. Most outbreaks, 124 (76%) of those with a known water source (n = 163) were linked to groundwater. A large proportion of the outbreaks (n = 130/170, 76%) affected a small number of people (less than 100 per outbreak) and were linked to single-household water supplies. However, in 11 (6%) of the outbreaks, more than 1,000 people became ill.

Although outbreaks of this size are rare, they highlight the need for increased awareness, particularly of parasites, correct water treatment regimens, and vigilant management and maintenance of the water supply and distribution systems.

Waterborne Outbreaks in the Nordic Countries, 1998 To 2012

Eurosurveillance, Volume 20, Issue 24, 18 June 2015

B Guzman-Herrador, A Carlander, S Ethelberg, B Freiesleben de Blasio, M Kuusi, V Lund6, M Löfdahl, E MacDonald, G Nichols, C Schönning, B Sudre, L Trönnberg, L Vold, J C Semenza, K Nygård

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=21160

9 sick with campy: Wales (mystery) restaurant closed after outbreak

A Cardiff restaurant has been closed after an outbreak of food poisoning.

mystery-restaurantSeven people with confirmed campylobacter infection and two people with suspected infection ate at the restaurant during the weekend of May 16, Public Health Wales (PHW) confirmed.

Science nonsense: No mention of thermometers for UK chicken

How can a supposed science-based organization be taken seriously when it won’t incorporate science-based recommendations into its taxpayer-payer funded advice?

chicken.thermMaybe the Brits think they above such pedantic notions.

According to the UK Food Standards Authority, chicken is safe as long as consumers follow good kitchen practice including, ake sure chicken is steaming hot all the way through before serving. Cut in to the thickest part of the meat and check that it is steaming hot with no pink meat and that the juices run clear.

BS.

FSA has just published results from its year-long survey of campylobacter on fresh chickens. Campylobacter is a food bug mainly found on raw poultry and is the biggest cause of food poisoning in the UK.

Cumulative results for samples taken between February 2014 and February 2015[1] have now been published as official statistics, including results presented by major retailer. The report can been found via the link further down this page.

The results for the full year show:

  • 19% of chickens tested positive for campylobacter within the highest band of contamination*
  • 73% of chickens tested positive for the presence of campylobacter
  • 1% (five samples) of packaging tested positive at the highest band of contamination
  • 7% of packaging tested positive for the presence of campylobacter

*More than 1,000 colony forming units per gram (>1,000 cfu/g). These units indicate the degree of contamination on each sample.

More than 4,000 samples of fresh whole chilled chickens and packaging have been tested. The chickens were bought from large UK retail outlets and smaller independent stores and butchers. The data shows variations between the retailers, but none has met the target for reducing campylobacter (see table below). A full analysis of the survey results, including the publication of the raw data and the full year results for smaller supermarkets and shops, is being carried out by the FSA and will be published later in the summer.

Further details of the ongoing testing of chickens for campylobacter were also confirmed by the FSA. A new survey will start this summer and once again sample fresh whole chickens from all types of shops. Continued testing will help the FSA to measure the impact of the interventions now being introduced by the industry to tackle campylobacter.

The FSA has welcomed the publication today of case studies by Marks & Spencer, Morrisons, the Co-op and Waitrose  showing the results of their recently implemented campylobacter reduction plans. The data show significant decreases in the incidence of campylobacter on their raw whole chickens. The tests were carried out on more recent samples than those taken from the FSA survey samples, with some targeted to demonstrate the effect of particular interventions.

Campy sucks: UK mother to sue Thomas Cook after bout of holiday food poisoning

A mother who was forced to miss two months of work after being struck down by food poisoning on a family holiday is calling on the EU to do more to prevent tainted meat from reaching the dinner plate.

tiara-beach-hotel-1Helen Witts, from Pontyclun, Wales, said her symptoms – vomiting, diarrhea and stomach cramps – were so severe she had to take eight weeks of sick leave from her job as a school driver assistant.

The 51-year-old contracted campylobacter and was diagnosed shortly after returning from Sunny Beach, Bulgaria, where she stayed at the Tiara Beach Club Hotel.

Helen fell ill on the penultimate day of her trip with her 58-year-old partner, Colin, and 15-year-old son, Liam, last August.

She said she used her own medication to ease her stomach cramps, but her condition worsened when she returned home to Wales.

A Thomas Cook spokesperson told MailOnline Travel: ‘Thomas Cook takes health and hygiene issues very seriously and maintaining the safety of our customers is our number one priority.”

Uh-huh

Campy isn’t kosher and kosher doesn’t mean microbiologically safe: NYC investigating reports of food poisoning at synagogue dinner

New York City’s Department of Health and Mental Hygiene is investigating reports of food sickness following an event at a Manhattan synagogue dedicated to exotic kosher cuisine.

kosher.dinner.may.15The May 5 dinner, held at Congregation Shearith Israel, known as the Spanish-Portuguese synagogue, was meant to highlight animals and other foods that are kosher but rarely consumed by observant Jews, such as oxtail, locusts, quail eggs and organ meat from calves, chickens, ducks and other animals. The so-called Halakhic Dinner combined the exotic dishes with Jewish teachings about them and was led by the synagogue’s rabbi, Meir Soloveichik. Similar dinners have taken place in past years.

After the dinner, about 20 people reported gastrointestinal distress, according to Vos Is Neias, an Orthodox blog and news site. The blog cited Dani Klein, who runs the YeahThatsKosher blog and attended the dinner, as saying that his wife tested positive after the dinner for campylobacter, a bacteria associated with raw or uncooked poultry, unpasteurized dairy products or contaminated water, poultry or produce.

A spokesman for the city’s Department of Health, Christopher Miller, told JTA, “We’re investigating and working with the synagogue.”

“Did you know that giraffes are kosher? How about locusts? They are!” read a promotion for the event on Shearith Israel’s website. “Rabbi Soloveichik will entertain and enlighten with a special lecture over dinner. We’ll learn about some far out there kosher foods, and we’ll eat a few of them too. Goat, venison, bison and squab are just a few of the expected featured ingredients. Come hungry and adventurous.”

Facepalm-inducing chicken cooking messages from FSA

I don’t know exactly how much it costs to produce a video and put on a massive media campaign in the U.K..

That’s really a question for the folks at McCann-Erickson or Holloway Harris.tumblr_mo5rk6sgpd1qf6r9co2_5001

A rudimentary calculation leads me to believe that the UK FSA spent at least a couple of million pounds on production, media buying and message placement for their current chicken hero (not to be confused with chicken gyro) campaign (below, exactly as shown).

Roughly equivalent to the cost of 300,000 digital tip-sensitive thermometers.

The very tool that they must not think that U.K. households have.

Because they never mention temperatures.

And go with the increasingly frustrating – and not science based – steaming hot, no pink meat and clear juices suggestion.

Maybe investing in thermometers instead of commercials is a better approach to the Campy issue.

Campylobacter jejuni infection associated with raw milk consumption – Utah, 2014

To be presented at the U.S. Centers for Disease Control and Prevention’s 64th Annual Epidemic Intelligence Service (EIS) conference April 20-23 in Atlanta.

colbert.raw.milkSummary: Despite routine testing, raw milk from a Utah dairy sickened 99 people with Campylobacter; 1 died and 10 were hospitalized. A 2-month shutdown failed to stop the outbreak and the dairy’s raw milk permit was revoked.

Abstract:

Background: In Utah, raw milk sales are legal from farm to consumer. Despite routine bacterial and coliform

counts by the Utah Department of Agriculture and Food (UDAF), raw milk-related illnesses occur. In May 2014, the Utah Department of Health (UDOH) identified a cluster of 3 Campylobacter jejuni infections with indistinguishable pulsed-field gel electrophoresis (PFGE) patterns. All patients reported consuming Dairy A’s raw milk. Routine testing of UDAF-licensed Dairy A’s raw milk was acceptable. We investigated to identify a source and prevent additional infections.

Methods: UDAF used onsite milk neutralization technique to preserve C. jejuni during testing. Utah’s electronic disease surveillance system identified cases. Confirmed illness was defined as diarrhea caused by C. jejuni matching the cluster PFGE pattern. Probable illness was diarrhea and contact with a confirmed patient or raw milk purchased from Dairy A. Confirmed patients were interviewed by using a standardized questionnaire.

Results: During May 9–July 31, a total of 89 (52 confirmed and 37 probable) cases were identified. Eleven (21.2%) confirmed patients were hospitalized; 1 died. Twenty-five (48.1%) confirmed patients reported having consumed Dairy A raw milk. Fifteen (28.8%) confirmed patients reported having eaten queso fresco. Dairy A’s raw milk yielded C. jejuni with the cluster PFGE pattern. UDAF suspended Dairy A’s raw milk permit on August 4 for 2 months. Additional cases occurred in November; UDAF revoked Dairy A’s raw milk permit on December 1.

Conclusions: Routine testing of raw milk does not ensure its safety. Mandatory reporting, timely sample collection, pathogen testing, and onsite milk neutralization likely led to C. jejuni detection. Linking case and raw milk PFGE patterns might identify the source and allow implementation of control measures.

Not just a UK problem and naturopaths are nuts: Campylobacteriosis outbreak associated with consuming undercooked chicken liver pâté — Ohio and Oregon, December 2013–January 2014

The U.S. Centers for Disease Control reports that on January 8, 2014, the Ohio Department of Health notified the Oregon Public Health Division (OPHD) of campylobacteriosis in two Ohio residents recently returned from Oregon.

pate.beet.dp.mar.12The travelers reported consuming chicken liver pâté* at an Oregon restaurant. On January 10, OPHD received additional reports of campylobacteriosis in two persons who had consumed chicken liver pâté at another Oregon restaurant. Campylobacter jejuni was isolated in cultures of fecal specimens from three patients. OPHD investigated to determine the sources of the illnesses and to institute preventive measures.

Both restaurants reported using undercooked chicken livers to prepare their pâté; an environmental health investigation revealed that the livers were purchased from the same U.S. Department of Agriculture Food Safety and Inspection Service (FSIS)–regulated establishment in the state of Washington. The establishment reported that livers were rinsed with a chlorine solution before packaging. However, culture of five of nine raw liver samples from both restaurants and from the establishment yielded C. jejuni; none of three pâté samples from the restaurants yielded C. jejuni. One human stool specimen and three liver samples were typed by pulsed-field gel electrophoresis (PFGE); the human isolate and one liver sample had indistinguishable PFGE patterns when digested by the restriction enzyme SmaI. The human isolate was susceptible to all antimicrobials tested by CDC’s National Antimicrobial Resistance Monitoring System.

A presumptive case was defined as diarrhea lasting >2 days, within 7 days after consumption of undercooked chicken liver; a confirmed case was defined as laboratory evidence of C. jejuni infection within 7 days after consumption of undercooked chicken liver. In all, three laboratory-confirmed and two presumptive cases of campylobacteriosis following consumption of chicken livers were reported in Ohio and Oregon. Illness onsets ranged from December 24, 2013, to January 17, 2014. Patient age range was 31–76 years; three were women. Based on OPHD’s recommendation, both restaurants voluntarily stopped serving liver. The FSIS-regulated establishment also voluntarily stopped selling chicken livers.

This is the second multistate outbreak of campylobacteriosis associated with consumption of undercooked chicken liver reported in the United States (1). Outbreaks caused by chicken liver pâté are well documented in Europe (2,3). Chicken livers and pâté should be considered inherently risky foods, given the methods by which they are routinely prepared. Pâté made with chicken liver is often undercooked to preserve texture. Consumers might be unable to discern whether pâté is cooked thoroughly because partially cooked livers might be blended with other ingredients and chilled. At FSIS-regulated establishments, such as the one involved in this outbreak, livers are inspected to ensure that they are free from visible signs of disease, but they are not required to be free from bacteria (4). A recent study isolated Campylobacter from 77% of chicken livers cultured (5). Washing is insufficient to render chicken livers safe for consumption; they should be cooked to an internal temperature of 165°F (74°C).

barfblog.Stick It InDuring the outbreak investigation, OPHD learned of a campylobacteriosis case in a Washington state resident who had eaten raw chicken livers that had been chopped into pill-sized pieces and frozen, as prescribed by a naturopathic physician. The livers were from the same establishment that supplied the Oregon restaurants. No isolate from the case was available for subtyping, but culture of frozen pieces of liver collected from this patient yielded C. jejuni.

This report illustrates that follow-up of possible outbreaks identified by routine interviewing by health departments can identify sources of illnesses and result in control measures that protect public health. Campylobacter is thought to be the most common bacterial cause of diarrheal illness in the United States (6), and infection is now nationally notifiable.

1Oregon Public Health Division; 2Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC; 3Washington State Department of Health; 4Ohio Department of Health (Corresponding author: Magdalena K. Scott, magdalena.k.scott@state.or.us, 971-673-1111)

References

CDC. Multistate outbreak of Campylobacter jejuni infections associated with undercooked chicken livers—northeastern United States, 2012. MMWR Morb Mortal Wkly Rep 2013;62:874–6.

O’Leary MC, Harding O, Fisher L, Cowden J. A continuous common-source outbreak of campylobacteriosis associated with changes to the preparation of chicken liver pâté. Epidemiol Infect 2009;137:383–8.

Little CL, Gormley FJ, Rawal N, Richardson JF. A recipe for disaster: outbreaks of campylobacteriosis associated with poultry liver pâté in England and Wales. Epidemiol Infect 2010;138:1691–4.

Food Safety and Inspection Service, US Department of Agriculture. Giblets and food safety. Available at http://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/poultry-preparation/giblets-and-food-safety/ct_index.

Noormohamed A, Fakhr MK. Incidence and antimicrobial resistance profiling of Campylobacter in retail chicken livers and gizzards. Foodborne Pathog Dis 2012;9:617–24.

Scallan E, Hoekstra RM, Angulo FJ, et al. Foodborne illness acquired in the United States—major pathogens. Emerg Infect Dis 2011;17:7–15.

* A spreadable paste made from cooked ground meat (often poultry livers) combined with various other ingredients.