Chicken and campy: Foodnet Canada 2011-2012

FoodNet Canada (formerly known as C-EnterNet) is a preventive, multi-partner sentinel site surveillance system, facilitated by the Public Health Agency of Canada, that identifies what food and other sources are causing illness in Canada.

chickenEach sentinel site is founded on a unique partnership with the local public health unit, private laboratories, and water and agri-food sectors, as well as the provincial and federal institutions responsible for public health, food safety, and water safety. The pilot sentinel site (ON site), comprised of the Region of Waterloo, Ontario, has approximately 525,000 residents, with a mix of urban and rural communities and innovation in public health and water conservation.

A second site (BC site) was officially established in the Fraser Health Authority, British Columbia in April of 2010. This BC site includes the communities of Burnaby, Abbotsford, and Chilliwack and has approximately 450,000 residents.

In the ON site, enhanced surveillance of human cases of enteric disease in the community is performed, as well as active surveillance of enteric pathogens in water, food (retail meat and produce) and on farms. In the BC site in 2010, enhanced human disease surveillance began, as did active surveillance of enteric pathogens (for retail produce only).

The following key findings are based on the surveillance data from 2011–2012 in the ON and BC sites:

  • A total of 1663 human cases of 11 bacterial, viral and parasitic diseases were reported within the ON and BC sites between 2011 and 2012. The three most frequently reported diseases (campylobacteriosis, salmonellosis and giardiasis) accounted for 82% of the cases.
  • Campylobacteriosis remained the most commonly reported enteric disease in both sentinel sites, with Campylobacter jejuni being the most common species associated with human campylobacteriosis. The majority of raw chicken samples tested were also contaminated with Campylobacter jejuni. Possible exposure factors included living on a farm or country property, contacting on-farm poultry, contacting household pets, contacting animal manure and consuming spoiled food. Overall, as found in the past, retail chicken meat was considered to be the most important vehicle of transmission for Campylobacter.

Distributions of patient age and gender among the human salmonellosis cases between 2011 and 2012 were similar to those observed historically in both the ON and BC sites. The most commonly reported serovars for human cases of salmonellosis were Enteritidis, Typhimurium, and Heidelberg. Phage type alignment continues to be observed among isolates from endemic human cases, chicken meat, and broiler chicken feces for both Salmonella Heidelberg and Salmonella Enteritidis. A slight decrease was observed in the rate in both sites (in 2011–2012 combined compared to 2010), which is comparable to the national trend observed during the same time period (2, 3, 7, 8). The prevalence of Salmonella on ground chicken was twice the level found on chicken breast. This may highlight the greater chance of product contamination during processing. Overall, possible salmonellosis exposure factors included contact with pet reptiles, retail poultry products, and broiler chicken manure (Table 4.6). The most important possible vehicle of transmission is considered to be retail poultry products.

• Verotoxigenic E. coli (O157:H7 and non-O157:H7 serotypes) infections continue to be primarily acquired domestically, as demonstrated by the low number of travel-related cases in 2011–2012. E. coli O157:H7 PFGE patterns in both human and non-human samples from 2011–2012 continued to show considerable diversity, as observed nationally and within the FoodNet Canada sites, in past years.

• As in previous years, the majority of Yersinia cases are domestically acquired. Among travel-related cases, the majority reported travel to Central or South America in 2011–2012. The incidence in domestically acquired cases was much higher in females than males. None of the swine manure samples in the ON site in 2011 were positive for pathogenic Yersinia (biotype 4, serotype O:3). • As in previous years, pathogenic strains of Listeria monocytogenes were recovered in 2011–2012 from samples of skinless chicken breasts, ground beef, ground chicken and ground turkey, as well as uncooked chicken nuggets. The scientific literature suggests that abattoirs and meat processing environments rather than farm animals may be an important source of L. monocytogenes (21). The retail meat data from many historical surveillance years indicate that pathogenic serotypes of L. monocytogenes are present on raw chicken, beef, and pork meat sold at retail, as well as in bagged leafy greens. Although, based on one PFGE enzyme, there was a match between a human case and a sample of uncooked chicken nuggets in 2011–2012, there were no matches between sources and sentinel site cases of listeriosis in 2011–2012 when both PFGE enzyme patterns were compared. Also, based on one enzyme, a few matches were identified between meat isolates (chicken and beef) and four of the top five PFGE patterns reported at the national level in humans (according to PulseNet Canada data). In 2012, fresh herbs were tested for L. monocytogenes though the pathogen was not detected.

• The majority of Shigella infections were travel-related, with Asia being the most frequently reported travel destination.

FoodNet Canada surveillance identified human pathogenic strains of norovirus on retail soft berries and fresh herbs in 2011–2012. Historically, pathogenic subtypes have also been found in food animal manure, as well as retail pork chops and leafy greens.

Frankenface.berry• Cryptosporidium was found in 2011–2012 on retail soft berries and in untreated surface water. Giardia was detected on retail soft berries and herbs, and water in the same period. Also, Cyclospora was found on soft berries. However, the viability of these pathogens was unable to be determined.

• Travel outside of Canada continued to add to the burden of enteric disease observed in Canada during 2011–2012, with 27% of the reported cases from both sites (combined) likely involving infections acquired abroad. Safe travel practices continue to be important considerations among Canadians.

• Enhanced, standardized laboratory testing across all FoodNet Canada surveillance components (human, retail, on-farm, and water) has allowed for the identification of patterns in subtype distributions among human cases and potential exposure sources over time. Continued surveillance and addition of more sentinel sites will help in refinement of the key findings and inform prevention and control measures for enteric diseases in Canada.


UK supermarket chicken price war ‘putting health at risk’

When I showed up in Australia and started shopping at my local stores – as you do without a car – I noticed the whole chickens were leaking all kinds of bacterial crap.

moneyI spoke with the manager and said, in the U.S., they have additional plastic bags in the meat section and antibacterial wipes.

He said, that’s a great idea, I’ll bring it up at our fortnightly food safety meeting.

The company decided not to do anything because the wipes would cost half-a-cent each.

Other customers I’ve chatted with say they grab a plastic bag from the produce section to further enclose their chicken.

UK professor, Chris Elliott, who led the official inquiry into the horsemeat scandal, says supermarkets are reluctant to bring in changes that could reduce potentially fatal infections from chicken because of the cost.

Food safety versus economics.

E. coli in Qatar

Escherichia coli O157:H7, non-O157 E. coli, and Campylobacter spp. are among the top-ranked pathogens that threaten the safety of food supply systems around the world.

qatar.camelThe associated risks and predisposing factors were investigated in a dynamic animal population using a repeat-cross-sectional study design.

Animal and environmental samples were collected from dairy and camel farms, chicken processing plants, and abattoirs and analyzed for the presence of these pathogens using a combination of bacterial enrichment and real-time PCR tests without culture confirmation. Data on putative risk factors were also collected and analyzed.

E. coli O157:H7 was detected by PCR at higher levels in sheep and camel feces than in cattle feces (odds ratios [OR], 6.8 and 21.1, respectively). Although the genes indicating E. coli O157:H7 were detected at a relatively higher rate (4.3%) in fecal samples from dairy cattle, they were less common in milk and udder swabs from the same animals (1 and 2%, respectively).

Among the food adulterants, E. coli O103 was more common in cattle fecal samples, whereas O26 was more common in sheep feces and O45 in camel feces compared with cattle (OR, 2.6 and 3.1, respectively). The occurrence of E. coli in the targeted populations differed by the type of sample and season of the year.

Campylobacter jejuni and Campylobacter coli were more common in sheep and camel feces than in cattle feces. Most of the survey and surveillance of E. coli focused on serogroup O157 as a potential foodborne hazard; however, based on the PCR results, non-O157 Shiga toxin–producing E. coli serotypes appeared to be more common, and efforts should be made to include them in food safety programs.

 Risk of Escherichia coli O157:H7, non-O157 shiga toxin–producing Escherichia coli, and Campylobacter spp. in food animals and their products in Qatar

Journal of Food Protection®, Number 10, October 2015, pp. 1776-1924, pp. 1812-1818(7)

Mohammed, Hussni O.; Stipetic, Korana; Salem, Ahmed; McDonough, Patrick; Chang, Yung Fu; Sultan, Ali

A lot of poop on UK birds: Campylobacter survey report published

The UK Food Standards Agency (FSA) has published the final report of its year-long survey of Campylobacter levels on UK fresh shop-bought chickens.

chickenThe report is an analysis of the data from the survey carried out by the FSA between February 2014 and March 2015, which showed the levels of Campylobacter found on fresh, whole chickens sold in the UK.

The results for the full year, as previously published, showed:

19% of chickens tested positive for Campylobacter within the highest band of contamination*

73% of chickens tested positive for the presence of Campylobacter

0.1% (five samples) of packaging tested positive at the highest band of contamination.

7% of packaging tested positive for the presence of Campylobacter.

* more than 1000 colony forming units per gram (>1000 cfu/g). These units indicate the degree of contamination on each sample.

The survey results, which were published on a quarterly basis throughout the year, allowed consumers for the first time to compare the Campylobacter levels found on chickens from all of the major retailers. The final report contains data sets of the results from all of the retailers and includes comparisons between different sized birds.

Going public, Dutch style

Mandatory notification can be a useful tool to support infectious disease prevention and control.

silence.commGuidelines are needed to help policymakers decide whether mandatory notification of an infectious disease is appropriate. We developed a decision aid, based on a range of criteria previously used in the Netherlands or in other regions to help decide whether to make a disease notifiable.

Criteria were categorised as being effective, feasible and necessary with regard to the relevance of mandatory notification. Expert panels piloted the decision aid. Here we illustrate its use for three diseases (Vibrio vulnificus infection, chronic Q fever and dengue fever) for which mandatory notification was requested. For dengue fever, the expert panel advised mandatory notification; for V. vulnificus infection and chronic Q fever, the expert panel concluded that mandatory notification was not (yet) justified.

Use of the decision aid led to a structured, transparent decision making process and a thorough assessment of the advantages and disadvantages of mandatory notification of these diseases. It also helped identify knowledge gaps that required further research before a decision could be made. We therefore recommend use of this aid for public health policy making.

 To notify or not to notify: decision aid for policy makers on whether to make an infectious disease mandatorily notifiable

Eurosurveillance, Volume 20, Issue 34, 27 August 2015

P Bijkerk, EB Fanoy, K Kardamanidis, SM van der Plas, MJ te Wierik, ME Kretzschmar, GB Haringhuizen, HJ van Vliet, MA van der Sande

Foodborne Diseases Active Surveillance Network—2 decades of achievements, 1996–2015

The Foodborne Diseases Active Surveillance Network (FoodNet) provides a foundation for food safety policy and illness prevention in the United States.

FoodNet.pyramid.fbi.OverviewFoodNet conducts active, population-based surveillance at 10 US sites for laboratory-confirmed infections of 9 bacterial and parasitic pathogens transmitted commonly through food and for hemolytic uremic syndrome.

Through FoodNet, state and federal scientists collaborate to monitor trends in enteric illnesses, identify their sources, and implement special studies. FoodNet’s major contributions include establishment of reliable, active population-based surveillance of enteric diseases; development and implementation of epidemiologic studies to determine risk and protective factors for sporadic enteric infections; population and laboratory surveys that describe the features of gastrointestinal illnesses, medical care–seeking behavior, frequency of eating various foods, and laboratory practices; and development of a surveillance and research platform that can be adapted to address emerging issues.

The importance of FoodNet’s ongoing contributions probably will grow as clinical, laboratory, and informatics technologies continue changing rapidly.

Foodborne Diseases Active Surveillance Network—2 decades of achievements, 1996–2015

Emerging Infectious Diseases, Volume 21, Number 9,  September 2015

Olga L. Henao Comments to Author , Timothy F. Jones, Duc J. Vugia, Patricia M. Griffin, and for the Foodborne Diseases Active Surveillance Network (FoodNet) Workgroup

Irrigation water, produce and pathogens

The microbiological sanitary quality and safety of leafy greens and strawberries were assessed in the primary production in Belgium, Brazil, Egypt, Norway and Spain by enumeration of Escherichia coli and detection of Salmonella, Shiga toxin-producing E. coli (STEC) and Campylobacter.

strawberryWater samples were more prone to containing pathogens (54 positives out of 950 analyses) than soil (16/1186) and produce on the field (18/977 for leafy greens and 5/402 for strawberries). The prevalence of pathogens also varied markedly according to the sampling region. Flooding of fields increased the risk considerably, with odds ratio (OR) 10.9 for Salmonella and 7.0 for STEC.

A significant association between elevated numbers of generic E. coli and detection of pathogens (OR of 2.3 for STEC and 2.7 for Salmonella) was established. Generic E. coli was found to be a suitable index organism for Salmonella and STEC, but to a lesser extent for Campylobacter. Guidelines on frequency of sampling and threshold values for E. coli in irrigation water may differ from region to region. 

Risk Factors for Salmonella, shiga toxin-producing Escherichia coli and Campylobacter occurrence in primary production of leafy greens and strawberries

International Journal of Environmental Research and Public Health

Siele Ceuppens, Gro S. Johannessen, Ana Allende, Eduardo César Tondo,  Fouad El-Tahan, Imca Sampers, Liesbeth Jacxsens, and  Mieke Uyttendaele

67 sick: Raw oysters can suck and yes, I’ve temped oysters on the grill

Canadian health types are now investigating 67 Canadian cases of Vibrio parahaemolyticus infections in British Columbia and Alberta linked to raw shellfish. The majority of the illnesses have been linked to the eating of raw oysters.

oysters.grillThe risk to Canadians is low, and illnesses can be avoided if shellfish are cooked before being eaten.

In Canada, a total of 67 cases have been reported in British Columbia (48) and Alberta (19). One case has been hospitalized. No deaths have been reported. Individuals became sick between June 1 and August 7, 2015 and all reported consumption of raw shellfish, primarily oysters. The investigation is ongoing to determine the source and distribution of these products.

The following safe food practices will reduce your risk of getting sick from Vibrio and other foodborne illnesses.

-Do not eat raw shellfish.

-Cook shellfish thoroughly before eating, especially oysters. Shellfish should be cooked to a safe internal temperature of 74°C (165°F).

-Discard any shellfish that do not open when cooked.

-Eat shellfish right away after cooking and refrigerate leftovers.

-Always keep raw and cooked shellfish separate.

-Avoid eating oysters, or other seafood, when taking antacids as reduced stomach acid may favour the survival and growth of Vibrio species.

-Always wash your hands for 20 seconds with soap after using the bathroom.

-Avoid exposing open wounds or broken skin to warm salt or brackish water, or to raw shellfish. Wear protective clothing (like gloves) when handling raw shellfish.

-Wash your hands well with soap before handling any food. Be sure to wash your hands, cutting boards, counters, knives and other utensils after preparing raw foods.


Salmonella and campy happen in France too

In 2007, Amy and I spent a few weeks in France, and being the food safety nerd, I was struck by the indifference many of the people I met showed to foodborne illness.

DSC00006.JPGIt seemed to be a point-of-pride amongst the locals to not report foodborne illness.

I’m familiar with the French desire for food to be alive, sexy, and part of a life well-lived, but also saw a lot of people going to McDonald’s.

We stayed for a week at a friend’s cottage in a small town in the south, and we would visit the butcher, who cross-contaminated everything.

We had dinner at a neighbor’s place one night and he confessed, that butcher, “he made me so sick with his chicken.”

And when I got home, someone told me my don’t eat poop story made it onto Letterman, while Amy developed the look.

Researchers report that community incidence estimates are necessary to assess the burden and impact of infections on health and to set priorities for surveillance, research, prevention, and control strategies.

letterman2The current study was performed to estimate the community incidence of campylobacteriosis and nontyphoidal salmonellosis in France from the number of laboratory-confirmed cases reported to the national reference center (NRC). The probabilities of a case in the community visiting a doctor, having a stool sample requested, having a positive laboratory test, and having the case reported to the NRC were estimated using data of national surveillance systems, national hospitalization and health insurance databases, and specific surveys informing about these parameters. Credible intervals (CrI) were calculated using Monte Carlo simulation. In addition, we estimated the number of hospitalizations for both infections in France.

The annual community incidence rate in France is estimated at 842 cases per 100,000 (90%CrI 525–1690) for campylobacteriosis and 307 cases per 100,000 (90%CrI 173–611) for salmonellosis. The annual number of hospitalizations is estimated at 5182 for campylobacteriosis and 4305 for salmonellosis. The multiplication factors between cases ascertained by the surveillance system and cases in the community were 115 for campylobacteriosis and 20 for salmonellosis.

amy.the.look.2007They are consistent with estimates reported in other countries, indicating a high community incidence of campylobacteriosis and salmonellosis in France.

Community incidence of campylobacteriosis and nontyphoidal salmonellosis, France, 2008–2013

Foodborne Pathogens and Disease. 2015 ahead of print. doi:10.1089/fpd.2015.1964.

Van Cauteren Dieter, De Valk Henriette, Sommen Cecile, King Lisa A., Jourdan-Da Silva Nathalie, Weill François-Xavier, Le Hello Simon, Mégraud Francis, Vaillant Veronique, and Desenclos Jean C.


Use a thermometer, color sucks: UK FSA says don’t serve your duck pink

Color is a lousy indicator.

But that doesn’t stop the taxpayer-funded UK Food Standards Agency from issuing nonsensical advice.

smoked-duck-breast1I’ve asked the UK food safety types why they don’t recommend that people use thermometers – as is the advice in the U.S., Canada and Australia – and the response is usually along the lines of, people can’t handle such complicated information.

A colleague received similar advice yesterday from the UK FSA.

Arrogant bullshit.

And not science-based.

The Telegraph reported today that duck should never be served pink as diners could be poisoned by a potential deadly bug more commonly associated with chicken, food officials have said.

While many upmarket restaurants recommend their duck dishes medium-rare, the Food Standards Agency said the poultry should always be cooked “thoroughly” at home.

It warned that the prevalence of the campylobacter bug among ducks was “not dissimilar” to the levels among chickens, where seven in 10 birds are infected.

The bacterium, which makes 280,000 ill every year, is only killed when meat is fully cooked.

On Wednesday the food watchdog said it was concerned that there was a public misconception that duck was different to chicken in that it could safely be served pink.

There’s a public misconception because the bureaucrats are not offering clear, evidence-based information.

Stick it in.