FoodNet Canada 2013 short report

FoodNet Canada tracks illnesses of the gut, commonly known as food-poisoning, in Canadians and traces them back to their sources, such as food, water and animals. These data are analyzed to help determine which sources are causing the most illness among Canadians and helps us track illnesses and their causes over time.

HappyCow[1]In the 2013 surveillance year, FoodNet Canada was active in two areas: the Region of Waterloo Public Health, and the Fraser Health Authority of lower mainland British Columbia (BC). In each location, or “sentinel site”, enhanced human disease surveillance is performed in parallel with active surveillance of specific bacteria, viruses and parasites and the possible sources to which the ill may have been exposed.

The purpose of this report is to present the preliminary findings from the 2013 surveillance year in both sentinel sites. This report will be followed by a comprehensive annual report which will include more extensive analyses of temporal trends and subtyping information for an integrated perspective on enteric disease from exposure to illness. With eight years of data from two different sentinel sites, FoodNet Canada continues to provide important information on enteric disease in Canada. This information is essential to develop robust food and water safety policies in Canada.

  • In general, the incidence rates of reportable enteric diseases have decreased over the past seven years. In 2013, Campylobacter and Salmonella remain the most common causes of human enteric illness in the sentinel sites, and across Canada. Information gained from the exposure surveillance within FoodNet Canada (retail, farm, and water) provide insight into the potential sources and routes of exposure for both of these pathogens.
  • Campylobacter, Salmonella, and Listeria monocytogenes continue to be commonly found on skinless chicken breasts sold at retail in both sentinel sites, as well as on processed chicken products such as ground chicken and frozen chicken nuggets. Listeria monocytogenes has also consistently been found on ground beef, although at lower levels than in the retail chicken products.
  • Interestingly, all of the parasites and viruses that have been tested for were detected on leafy greens sold at retail in both sentinel sites. This information is shared with food safety partners in industry, Health Canada and the Canadian Food Inspection Agency in an ongoing effort to inform food safety policy. Because these pathogens were detected by molecular approaches, their ability to cause infection is unknown. Further research in this area would be helpful to estimate the risks to humans.
  • At the farm level, Campylobacter remains the most frequently detected pathogen in cattle manure and also appears to be common in turkeys. In broiler chickens, Salmonella is the most commonly detected enteric pathogen.
  • Campylobacter, Salmonella, and VTEC continue to be found in untreated surface water in both rural and urban areas, at freshwater beaches, larger and small reaches of the Grand River, and in irrigation canals and ditches in the two watersheds in the BC site.
  • Exposure to retail meat products remains a potential source of infection for human enteric illness. Other exposure sources, however, such as the farm environment and water, are also possible. Continued monitoring of human illness and the potential exposures is important to ensure the continued health and safety of Canadians.

 

Labels the law for all mechanically tenderized beef in Canada

In a move to cut risk from foodborne E. coli, all mechanically tenderized beef (MTB) sold in Canada from today on must be labelled as such and list instructions on safe cooking.

needle.tenderize.crHealth Minister Rona Ambrose on Thursday announced the new labelling requirements for all uncooked MTB — expanding a rule that’s been in place since July last year for federally licensed beef plants producing steaks and roasts.

The new label must clearly state the beef being sold is “mechanically tenderized,” and must include instructions for safe cooking, stressing the importance of cooking MTB to a minimum internal temperature of 145 F (63 C) and turning over steaks at least twice during cooking.

The Canadian Food Inspection Agency (CFIA) is tasked with verifying retailers’ and packers’ labels meet the new requirements, Health Canada said.

Mechanical tenderization is a common practice for improving beef tenderness and flavour, using needles or blades to break down, penetrate or pierce the meat’s surface and disrupt the muscle fibers, or to inject the meat with a marinade or tenderizer.

mech-tenderized-beef-boeuf-attendris-meca-01-413x280Normally, the risk of E. coli contamination from a rare or undercooked steak, roast or other solid cut of beef is “not a significant concern” since such bacteria would normally be on the surface of the meat and “inactivated” during cooking.

Much like grinding beef, mechanical tenderization can increase the potential for bacteria to transfer from the surface to the centre of the meat.

Unlike ground beef, however, as a Health Canada health risk assessment pointed out last year, it’s “not necessarily apparent by just looking at a mechanically tenderized meat product that it has undergone this process.”

The May 2013 assessment showed “a five-fold increase in risk from MTB products when compared to intact cuts of beef.”

Health Canada noted that in 2012, out of 18 cases of foodborne E. coli O157-related illness from a Canadian outbreak linked to contaminated beef, five cases were considered to be “likely associated with the consumption of beef that had been mechanically tenderized at the retail level.”

The rule covers all solid cuts of MTB, regardless of thickness, which means it will also apply to cubed steaks, “fast fry” or “minute” steaks. It will apply to both pre-packaged and non-pre-packaged products.

MTB that’s packaged on the premises at selection or purchase — such as in a butcher shop or at a clerk-served meat counter — will need to be identified as such before the customer selects a desired cut of beef. An in-store sign would identify a product in a display case as “mechanically tenderized,” for example.

In those cases, once meat has been packaged to give to the customer, the product must carry both the mandatory “mechanically tenderized” label and safe cooking instructions on the “principal display panel.”

Nosestretcher alert: eating locally helps prevent foodborne illness?

The Globe and Mail, based in Toronto and self-proclaimed public record of all thing Canadian, used to be decent. There are still good people there, and some are my friends.

imagesBut this is just crap.

Jason Tetro, a similarly self-proclaimed microbiologist, writes that the first investigations in 2002 focused on comparisons between locally and organically grown foods and those sold in large grocery stores. The results revealed those who chose foods grown closer to home were more likely to have a safer supply with less pesticides, better food quality and, more importantly, less post-harvest handling, which is known to be a significant factor in foodborne infection spread.

No.

By 2010, these differences were solidified as being the basis for better microbiological quality in local foods. Researchers searched for the reasons behind foodborne outbreaks and found links to several well-known problems associated with large-scale farming. …

The most meaningful comparison for consumers comes in the form of statistics. Outbreaks resulting from large-scale farming continue to grab headlines both in the media and scientific literature. In contrast, only a few outbreaks resulting from eating locally grown food have been recorded. In these rare cases, the problems were the result of a significant environmental change, such as a major rain storm or flood. There were almost no cases of local malpractice leading to infection.

This is bullshit.

The only meaningful comparison, statistically speaking, would be to compare incidence of foodborne illness per capita – on a meal eaten basis.

And then he cites the bullshit clean, cook. chill separate, ideology without the source food from safe sources, from farmers who know what they’re doing bit.

1-in-8, sorta like the US; foodborne illness in Canada

The Canadians were busy today, when most of them are off at the cottage.

The Public Health Agency of Canada has joined with the U.S. and now estimates that each year about 1 in 8 Canadians (4 million people) get sick from the food they eat (used to be 1-in-3, or 1-in4).

back_slapFour pathogens cause about 90% of the 1.6 million illnesses caused by known pathogens: Norovirus (1 million cases), Clostridium perfringens (177,000 cases), Campylobacter (145,000 cases) and nontyphoidal Salmonella (88,000 cases). These estimates are based on multiple complementary disease surveillance systems and the peer-reviewed literature.

Understanding the burden of foodborne illness is useful for decision-makers, supporting the development of food safety and public health interventions, for research and for consumer education. Future efforts will focus on estimating the number of foodborne hospitalizations and deaths, the economic cost of food-borne illness and the burden of water-borne illness in order to provide crucial information to support research, policy and action.

A guidance document, Weight of Evidence: Factors to Consider for Appropriate and Timely Action in a Foodborne Illness Outbreak Investigation was developed to assist federal government decision-makers weigh the scientific evidence collected during a foodborne illness outbreak investigation in order to inform risk mitigation actions.

The objective of the document is to provide guidance on how to weigh evidence collected during epidemiologic, laboratory and food safety investigations in a food-borne illness outbreak investigation, as part of an overall health risk assessment process carried out by Health Canada. This is a short summary of the document.

And, to highlight the Public Health Agency of Canada’s Foodborne Illness Outbreak Response Protocol (FIORP), the primary guidance document for investigations of multi-jurisdictional food-borne illness outbreaks in Canada.

Approach: The current version of the FIORP was developed in 2010 by the Public Health Agency of Canada following consultation with Health Canada, the Canadian Food Inspection Agency, and provincial and territorial stakeholders.

Results: The FIORP outlines guiding principles and operating procedures to enhance collaboration and coordination among multiple investigative partners in response to multi-jurisdictional food-borne illness outbreaks. It has provided guidance for the conduct of 22 such investigations led by the Public Health Agency of Canada’s Centre for Food-borne, Environmental and Zoonotic Infectious Diseases between 2011 and 2013. Furthermore, it has also served as a guide for the development of provincial protocols.

Conclusion: The timely and effective investigation of and response to multi-jurisdictional food-borne illness outbreaks in Canada is facilitated and enhanced by the FIORP.

Of course, none of these documents were peer-reviewed and published in scientific journals, so it’s just a lot of back-slapping.

More than Canada would admit: Denmark says ‘serious errors’ in handling of Listeria outbreak with 12 dead, another 12 sick

Denmark’s food safety watchdog made “serious mistakes” in its handling of a listeria outbreak linked to the death of 12 people, the country’s government has said.

ITALY-G8-G5-AGRICULTURE-FARMFood minister, Dan Jørgensen, has blasted the food authorities, Fødevarestyrelsen, over its handling of the Listeria outbreak that has claimed the lives of 12 people in Denmark over the past year.

A Fødevarestyrelsen report has showed there were serious errors in its handling of the case and concluded that it should have carried out its investigation into the source of the outbreak, Jørn A Rullepølser, more quickly and effectively.

“When it is proved there is a direct connection between the food products and deaths, the authorities should immediately launch a thorough investigation of the specific company,” Jørgensen said in a press release. “That hasn’t happened quickly enough, which is lamentable.”

It’s Canada: how to make love in a canoe and shit in the woods

Canada is rich in parks and trails – but not all of them are equipped with washroom facilities.

maxresdefaultOf the 24 nature reserves in Ontario, for example, only two have outhouses. A third has a port-a-potty, but only in the summer months. “Otherwise you’re using the backwoods,” said Megan Anevich, nature reserves coordinator at Ontario Nature.

Leave No Trace Canada, a non-profit organization that promotes outdoor ethics, encourages campers and hikers to travel the backcountry in a responsible manner. One of their seven principles details how to properly dispose of waste – human waste – when camping.

Improper waste disposal can lead to the pollution of water sources and spreading of bacteria and disease.

Beyond the environmental and health concerns, hiking past bits of toilet paper isn’t the picture of nature most are hoping to Instagram. Family dogs accompanying you on the camping trip can also get into improperly disposed of waste.

One of the best bets for disposing of human waste properly is to bury it in a “cathole.”

With a small shovel or garden trowel, dig a hole at least 200 feet away (or around 70 adult paces) away from water, trails and campsites. Dig the hole six to eight inches deep and four to six inches wide. Once you’ve finished your business, cover the hole with soil, leaves and sticks so animals don’t get in there.

In some places you may be required to “pack out” your poop. In these cases you may want to employ the “poop burrito” method of packing out, which involves wrapping your feces in toilet paper, placing that in a ziplock bag, and packing it out in a Tupperware container.

If you find yourself without toilet paper, fear not, “natural” toilet paper is abundant in the woods.

Options for natural toilet paper include certain types of leaves, smooth rocks, sand or snow.

Serve burgers, not hockey pucks; food safety and thermometers

I may have first said that about 15 years ago.

Rob Mancini writes that food safety types have always advocated for the use of thermometers to determine if a food product has reached the required temperature to inactivate pathogens.

 mancini.jun.14This leads to less barfing.

Different types of foods require different temperatures to kill pathogens; don’t memorize the numbers, just know where to reference them. Be careful with poultry because Canada requires a higher temperature than the States, 85°C (185°F) and 74°C (165°F) respectively. Consistency is hard to attain….

Canada Beef and the Canadian Partnership for Consumer Food Safety Education have launched a campaign to save Canadians from eating hockey pucks this summer.

“All too often the humble hamburger is cooked beyond tasty recognition,” says Joyce Parslow, a professional home economist with Canada Beef. “A food thermometer is a quick and very effective way of knowing just when your burger is done. There is no more guessing, which means hockey pucks can stay on the ice and burgers can be enjoyed all summer long.”

The two groups are encouraging Canadians to share a photo of themselves

This is my beautiful wife cooking a roasted chicken and using a digital tip sensitive thermometer to ensure the final internal temperature has reached 74°C (165°F).

Temperature guidelines for all foods can be found at befoodsafe.ca.

Strengthening vet oversight of antimicrobial use in food animals: reducing antibiotics in meat — Part II

Ron Doering, former president of the Canadian Food Inspection Agency and current counsel in the Ottawa offices of Gowlings (Ronald.doering@gowlings.com), reports with part II of his take on antimicrobiasl in food animal production:

While the medical commu­nity recognizes that the emergence and spread of antimicrobial resistance (AMR) in hu­mans is a potential disaster for humanity and that it is the overuse of antimicrobi­als in human medicine that is the largest contributor, there is a broad consensus that the use of antibiotics in animals contributes to the problem, though the scale is still unclear. This uncertainty is due mainly to a failure to adequately control and monitor the use. Health Canada (HC) lacks the authority to control and monitor use because the practice of veterinary medicine falls under provincial juris­diction. Recognizing that almost all practical efforts to reduce the level of antibiotics in meat depend on the more active participation of veterinarians, HC announced recently that it wanted “to develop options to strengthen the veterinary oversight of antimicrobial use in food animals.”

44755363What can veterinarians and their provincial regulatory licensing bodies do now to reduce the threat of AMR? Here are four suggestions:

1. Enhance awareness among members .

While the Canadian Veterinary Medical Association (CVMA) has developed vol­untary Prudent Use Guide­lines, I’m told that many vets are hardly aware of the issue and may not even know of the Guidelines. Concerned enough about this, Ontario’s regulatory body, the Col­lege of Veterinarians of Ontario, just an­nounced that it was launching a project to study the use of antibiotics among food animal veterinarians and to determine if they use the CVMA’s Guidelines in daily practice. Quebec requires a manda­tory day-long AMR program and a test. All provinces should follow Quebec and develop mandatory continuing education programs on antimicrobial stewardship.

2. Fill the regulatory gaps.

As long as vets continue to prescribe off label use and the use of Active Pharma­ceutical Ingredients (APIs) in production medicine, it’s impossible to know the level of antibiotic use. Own Use Importation (OUI) by animal owners is another avenue for which use information is un­available. As one recent report stressed: “The gap in reliable usage data makes it difficult to state with confidence which antimicrobials are used, in what quantities, and for what purposes.” The recent critical assessment by a group of experts, titled “Stewardship of antimicrobial drugs in animals in Canada: How are we doing in 2013?” (Canadian Veterinary Journal, March 2014), highlighted the absolute importance of improving Canada’s monitoring of antimicrobial usage.

3. Conflict of interest issue.

This issue has been flagged by several reports going back to the landmark McEwen Report of 2002. Veterinarians obtain income from the profitable sale of antimicrobials. Decoupling veterinary prescribing from dispensing raises several issues because the current veterinary prac­tice business model is based on an income stream from antimicro­bial sales. Veterinarians should lead a dialogue on this important issue that clearly needs closer examination.

ab.res.prudent.may.144. Antibiotics for disease prevention.

The real issue is not the use of antibiotics for growth promotion or the treating of disease, but whether they should continue to be used for disease prevention. While some antibiotics of very high importance to human health should only be used to treat infection, there are several arguments that some of high or medium importance to human health (what HC calls Category ll and lll, for example tetracyclines) should still, with closer veterinarian oversight, be used for disease prevention. Because major retailers, processors and consumers increasingly demand meat with “raised without antibiotic” claims, the marketplace is forcing changes in practice. But we mustn’t lose sight of the fact that while there are risks to using antimicrobials in animal production, there are also risks with non-use.

Two-thirds of animal diseases are zoo­notic, meaning the disease is transferable to humans. For this and other reasons, I have been a long-time proponent of strengthening the connections between human and animal medicine — the concept known as One Health. In this context, AMR represents an historic opportunity for vets to step up and provide greater leadership. 

Asparagus farmer: he’s not heavy, he’s my cuz

Between the anguished cries in the fetal position after his beloved Boston Bruins were bumped out of the Stanley Cup playoffs (that’s ice hockey to Australians), my cousin, Tim Barrie, manages to carry on the family tradition and farm asparagus.

It’s a late spring in southern Ontario (Cambridge area, to be specific), but Tim says the flavor is great and Tim is always finding the bright side.

tim.barrie.asparagusAnd he knows enough to practice good food safety.

According to the K-W Record, green and sweet asparagus is what spring is all about his 25-acre farm off Kings Road.

Blame a hard snowy winter and a wet spring for a tardy crop at Barrie’s Asparagus Farm, but the good news is it’s lip-smacking luscious and sweet-pea scrumptious.

Two years ago, drought made for a bitterly disappointing harvest, said 52-year-old Tim Barrie. Last year was a great crop for quantity. This year, quality binds every $3-a-pound bunch.

“Taste-wise, it’s as good as I can remember,” Barrie said from beneath his favorite spoked-number-four Bobby Orr ball cap.

This asparagus operation goes back four decades on this former cattle farm. The future is asparagus, Barrie’s father David was told by his father-in-law Homer — an Alliston asparagus grower.

David, who still trims the grass at the farm (and still plays pickup hockey at 80- years-old), listened and became a spear plucker.

His son Tim and his wife Libby run the fields of green and the farmhouse shop now.

Their grown daughters — Mallory, Emily and Hannah — and son Will, 13, help out too.

asparagu.barrieThere are only about 100 asparagus operations in Ontario because it’s labor-intensive. Barrie has 10 locally hired pickers harvesting his 24 acres every day until Canada Day. The spears are spun right into the farmhouse shop and put on sale within an hour of picking off the side of Kings Road.

On Saturday mornings, the parked cars fill up the country roundabout in front of the house, Barrie said. They come for the fresh asparagus. They may leave with pickled asparagus and asparagus barbecue sauce, too. Or asparagus ravioli and asparagus soap. Or asparagus salsa. A fresh batch of that salsa, bottled with a day of picking, is firehouse hot.

They plant strawberries too, along with rhubarb, sweet corn and pumpkins.

They sell some kettle chips, named Spud’s Finest in honour of Barrie’s mother Miriam (she’s my mom’s sister – dp). She grew up on a potato farm before her father turned to, of course, asparagus.

Ron Doering: reducing antibiotics in meat

Ron Doering, the first and only president of the Canadian Food Inspection Agency anyone can remember, and current counsel in the Ottawa offices of Gowlings (Ronald.doering@gowlings.com), writes in his monthly Food Law column that:

Health Canada (HC) and the Canadian Animal Health In­stitute (CAHI), the trade asso­ciation representing Canadian veterinary drug manufacturers, are to be com­mended for their decision on April 10 to follow the American initiative to address the growing concern over antimicrobial resistance in humans by introducing measures to promote the more prudent use of antimicrobials in animal produc­tion. HC announced its intention (1) “to work towards the removal of growth promotion and/or production claims of medically important antimicrobial drugs” and (2) “to develop options to strengthen the veterinary oversight of antimicrobial use in food animals.”

ab.res.prudent.may.14Contrary to many mainstream media reports, this does not mean that Canada is phasing out antibiotic use in meat production. Moreover, both initiatives face several difficult barriers to implementa­tion. This month we look at the difficulties associated with the first proposal, leaving next month for an analysis of why the oversight role by veterinarians must be strengthened if we are ever going to make real progress on what may be the most serious public health problem of our time.

First some law. The licensing and sale of antimicrobials fall under the jurisdic­tion of the federal government and its Food and Drugs Act, but the authority to manage their “use” lies with the provinces. The provinces also have the exclusive authority over the practice of veterinary medicine. What this means is that HC can require that a vet drug no longer have “growth promotion” as an indicated use on its label, but under the current regime it has limited power to actually determine how the drugs are used.

The issue of preventing growth promotion claims, and whether such a step will actually make a real difference, is a complex one. To begin with, most antibiotics are not actually used directly for growth promotion purposes but rather for disease prevention and control, what is often called disease prophylaxis. Removal of growth promotion claims will not prevent drugs to claim and be used for disease prevention. Farmers can continue to give their animals low doses of antibiotics to keep them from getting sick. The Public Health Agency of Canada, estimating that 90 per cent of the medication on farms is used for disease prevention, argues that antimicro­bials should not be used in this way and should be “limited to treating infection and not long-term mass medication for growth promotion or guarding against disease.” Others argue that there is insuf­ficient science to support the conclusion that low doses given to animals contrib­ute to antimicrobial resistance in humans and that outlawing the practice would result in more animal disease and the need for more drugs for disease treat­ment, possibly exacerbating the problem of antimicrobial resistance. When the science is uncertain, policy development is always difficult.

What is clear is that the proposal will not even apply to a large amount of anti­biotic use because of regulatory loopholes that result in part from our jurisdiction­ally fragmented regulatory framework. Our provinces still allow veterinarians to prescribe drugs for purposes not indicated on the product label (extra-label use). Unapproved drugs may be used on ani­mals because it is still legal for drugs to be imported for livestock production “own use” (OUI) if the drug is not offered for resale and it is not a prescrip­tion drug. As well, Active Pharmaceutical Ingredients (APIs) can still be imported by livestock producers to be mixed into feed on farm. None of these unregulated antibiotics are covered by the proposal. The latest Canadian Medical Association Journal contains a critical assessment of Canada’s performance in enhancing antimicrobial stewardship in agriculture and veterinary medicine, but it does state that HC has recently proposed measures to address OUI and API so, hopefully, reforms may be imminent.

As we shall see next month, none of the barriers described above can be adequately tackled without Canada’s veterinarians and their provincial regula­tory bodies taking a greater leadership role in combating the serious and growing problem of antimicrobial resistance in humans. Nowhere is the concept of One Health more compelling.