7 sick: Multistate outbreak of Shiga toxin-producing E. coli O157:H7 linked to beef products from Adams Farm

The U.S. Centers for Disease Control, multiple states, and the U.S. Department of Agriculture Food Safety and Inspection Service (USDA-FSIS) are investigating a multistate outbreak of Shiga toxin-producing Escherichia coliO157:H7 (STEC O157:H7) infections.

adams-farmSeven people infected with the outbreak strain of STEC O157:H7 have been reported from four states.

Five ill people have been hospitalized. No one has developed hemolytic uremic syndrome, a type of kidney failure, and no deaths have been reported.

Epidemiologic, traceback, and laboratory evidence indicate that beef products produced by Adams Farm Slaughterhouse in Athol, Massachusetts is a likely source of this outbreak.

On September 24, 2016, Adams Farm Slaughterhouse recalled beef, veal, and bison products due to possible E. coli O157:H7 contamination.

The products subject to recall have establishment number EST. 5497 inside the USDA mark of inspection and include several lot numbers and cuts of meat. The full list can be found on the USDA website.

These items were shipped to farmers’ markets, retail locations, and restaurants in Massachusetts, Connecticut, and eastern New York. The products may have been shipped to neighboring states.

We recommend that consumers, restaurants, and retailers do not use, serve, or sell the recalled meat products.

Don’t cook recalled meat products and eat them. Throw the meat out or return it to the place of purchase. If you throw it away, put it in a sealed bag in the trash so that children, pets, or other animals can’t eat it..

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak.

Illnesses started on dates ranging from June 27, 2016 to September 4, 2016. Ill people range in age from 1 year to 74, with a median age of 25. Fifty-seven percent of ill people are female. Five ill people have been hospitalized.

Epidemiologic, traceback, and laboratory evidence indicate that beef products produced by Adams Farm Slaughterhouse in Athol, Massachusetts is a likely source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. All five (100%) of the five people reached for interview reported eating ground beef in the week before they became ill.  Preliminary traceback information indicates that ill people ate ground beef which had been produced by Adams Farm Slaughterhouse.

The Connecticut Department of Public Health collected leftover ground beef from an ill person’s home and from a restaurant for testing; that beef had been produced by Adams Farm Slaughterhouse. Test results showed the outbreak strain of STEC O157:H7 in both samples of the leftover ground beef.

 

Stop kissing cats (and stop touching yourself)

I went through an extremely brief Ted Nugent phase when I was 16.

I was driving my then-girlfriend and her mom somewhere, and thought it’d be cool to put Wango Tango on the 8-track (a prehistoric device used to play music).

cat-scratch-fever-04What an asshole (me and Ted).

Erin Ross of NPR reports that cat-scratch disease, as the name suggests, is spread by cats. It’s long been considered a mild illness, but a study finds that people are getting more serious complications, which can be fatal.

And kissing kittens increases the risk of being infected.

“The scope and impact of the disease is a little bit larger than we thought,” says Dr. Christina Nelson, a medical epidemiologist with the Centers for Disease Control and Prevention and lead author on the study. It’s the first large-scale evaluation of the illness in the United States in over 15 years.

While the total number of people infected with the disease has gone down, the number of people becoming seriously ill has increased. Symptoms typically involve fatigue, fever and swollen lymph nodes. But in a small number of cases, cat-scratch disease can cause the brain to swell or infect the heart. Infections like those can be fatal if they aren’t properly treated.

“Most of the people who get seriously sick from cat-scratch are immunocompromised. The classic example is patients with HIV,” says Dr. Aaron Glatt, chairman of medicine and hospital epidemiology of South Nassau Community Hospital in New York. Glatt was not involved in the study

The fact that there are more people with suppressed immune systems today may be why a larger number of patients are getting dangerously ill, Glatt says. But Nelson thinks that severe cases of cat-scratch disease may have been misdiagnosed in the past. Either way, she says, this study, which was published Wednesday in Emerging Infectious Diseases, is a good first step.

“Cat-scratch is preventable,” Nelson says. “If we can identify the populations at risk and the patterns of disease, we can focus the prevention efforts.”

It’s preventable because you need direct contact with a cat to get it. The disease is caused by bacteria, usually Bartonella henselae, and passed between cats by fleas. The bacteria are also present in flea dirt — the official name for flea feces — which build up in the cats’ fur. It gets on their paws and in their mouths when they groom themselves. If a person is scratched by contaminated claws, they’re at risk of getting the disease.

The study combed health insurance claims from 2005 to 2013, and charted when and where cat-scratch disease is most likely to strike. It found that about 12,000 people will be diagnosed with cat-scratch disease each year, and 500 of them will be sick enough to be hospitalized.

Many of those infected will be children, probably because of the ways kids play with cats. And most of the infections will occur in the South, where heat-and-moisture-loving fleas are more common.

If you want to avoid cat-scratch disease altogether, says Nelson, go somewhere arid —like Colorado or Utah.

But moving to the Rockies isn’t an option for everyone. If you’re stuck in the South, how can you skip cat-scratch?

“Stay away from cats,” says Glass, although he acknowledges that in a country full of cat-lovers, this isn’t really realistic.

“Use adequate flea control and keep your cats indoors,” suggests Nelson. The bacteria can also enter your body through your nose, eyes or mouth, so the CDC recommends washing your hands after touching a cat. Kissing their flea dirt-filled fur probably isn’t a good idea, either. Neither is letting them lick you if you have any scrapes, scabs or open wounds.

Oh. And avoid kittens.

“Younger cats are more likely to have bacteria in their blood,” explains Nelson. Kittens aren’t immune to cat-scratch, so they’re an easy target for the bacteria.

So try to keep from kissing Felix … at least until he’s flea-free.

2600 sick, 5 dead over 14 years: Stop kissing chicks

Backyard poultry flocks have increased in popularity concurrent with an increase in live poultry–associated salmonellosis (LPAS) outbreaks. Better understanding of practices that contribute to this emerging public health issue is needed.

chicken-south-parkWe reviewed outbreak reports to describe the epidemiology of LPAS outbreaks in the United States, examine changes in trends, and inform prevention campaigns. LPAS outbreaks were defined as ≥2 culture-confirmed human Salmonella infections linked to live poultry contact. Outbreak data were obtained through multiple databases and a literature review.

During 1990–2014, a total of 53 LPAS outbreaks were documented, involving 2,630 illnesses, 387 hospitalizations, and 5 deaths. Median patient age was 9 years (range <1 to 92 years). Chick and duckling exposure were reported by 85% and 38% of case-patients, respectively. High-risk practices included keeping poultry inside households (46% of case-patients) and kissing birds (13%). Comprehensive One Health strategies are needed to prevent illnesses associated with live poultry.

Outbreaks of human Salmonella infections associated with live poultry, United States, 1990-2014

Emerg. Infect. Dis., Volume 22, Number 10 – October 2016 [ahead of print], DOI: 10.3201/eid2210.150765

Colin Basler, Thai-An Nguyen, Tara C. Anderson, Thane Hancock, Casey Barton Behravesh

http://wwwnc.cdc.gov/eid/article/22/10/15-0765_article

89 now sick with hep A: What kind of trendy smoothie place gets their frozen strawberries from Egypt?

The U.S. Centers for Disease Control reports that several states, CDC, and the U.S. Food and Drug Administration (FDA) are continuing to investigate a multistate outbreak of foodborne hepatitis A. Information available at this time does not indicate an ongoing risk of acquiring hepatitis A virus infection at Tropical Smoothie Café’s, as the contaminated food product has been removed as of August 8. Symptoms of hepatitis A virus infection can take up to 50 days to appear. As a result, CDC continues to identify cases of hepatitis A related to the initial contaminated product.

tropical-smoothie-cafe89 people with hepatitis A have been reported from seven states: Maryland (10), New York (1), North Carolina (1), Oregon (1), Virginia (70), West Virginia (5), and Wisconsin (1).

39 ill people have been hospitalized. No deaths have been reported.

Epidemiologic and traceback evidence indicate frozen strawberries imported from Egypt are the likely source of this outbreak.

In interviews, nearly all ill people interviewed reported drinking smoothies containing strawberries at Tropical Smoothie Café locations prior to August 8 in a limited geographical area, including Maryland, North Carolina, Virginia, and West Virginia.

On August 8, 2016, Tropical Smoothie Café reported that they removed the Egyptian frozen strawberries from their restaurants in Maryland, North Carolina, Virginia, and West Virginia and switched to another supplier. Out of an abundance of caution, Tropical Smoothie Café has since switched to another supplier for all restaurants nationwide.

If you think you’ve gotten sick from drinking a smoothie containing frozen strawberries from a Tropical Smoothie Café prior to August 8, contact your doctor.

Food handlers should contact their doctors and stay home if they are sick with hepatitis A.

 “To those who have become ill after eating at one of our cafes, we are deeply sorry,” Tropical Smoothie Cafe said in a statement. “We hope you recover quickly and completely.”

The Food and Drug Administration said in a statement that it would increase surveillance of imported strawberries.

 

Where’s the leafy greens lobby? Feds to seek listeria, leafy green connections after Dole outbreak

Mike Hornick of The Packer writes that health officials will begin routinely asking listeria outbreak victims if they consumed leafy greens, according to the Centers for Disease Control and Prevention.

lettuce.skull.noroThe addition of leafy greens to the standard federal questionnaire on listeria comes in response to last winter’s outbreak linked to a Dole Fresh Vegetables salad plant in Springfield, Ohio. That outbreak sickened 33 in the U.S. and Canada and was tied to at least one death. Dole stopped production in January and reopened the plant in April.

It was the first reported listeria outbreak in the U.S. associated with leafy greens, and the eighth with fresh produce. All occurred since 2008, according to an Aug. 26 report by the CDC.

“It is unclear whether the appearance of these outbreaks might be attributed to improved outbreak detection, changes in consumer behavior, or changes in production and distribution,” the report says. “Fresh produce processors are advised to review food safety plans and consider incorporating measures to avoid the growth and persistence of listeria.”

In the Ohio centered outbreak, the older questionnaire failed to identify a common source for seven infections reported by Nov. 30.

Then in December and January, eight new or previously interviewed patients or their representatives took part in open-ended interviews or provided shopper card records.

That revealed the connection. All reported consuming leafy greens in the month before the onset of illness.

Among these, seven reported romaine and six reported spinach, higher than national food consumption estimates of 47% and 24%, respectively. Six patients recalled consuming packaged salad, according to the report.

Dole Fresh Vegetables denied responsibility in two foodborne illness lawsuits that followed the outbreak.

More STEC found: Multistate outbreak of Shiga toxin-producing Escherichia coli infections linked to flour

On July 25, 2016, General Mills expanded its recall to include more production dates. A list of all the recalled flours and how to identify them is available on the Advice to Consumers page.

sorenne.doug.usa.today.jun.11Four more ill people have been reported from two states. The most recent illness started on June 25, 2016.

An infection with another serotype, Shiga toxin-producing Escherichia coli (STEC O26), has been added to this outbreak investigation. STEC O26 was isolated from a sample of General Mills flour (pic, left, from 2011; Sorenne did not eat the flour and awareness of cross-contamination was robust).

One person has developed hemolytic uremic syndrome, a type of kidney failure.

The U.S. Centers for Disease Control, multiple states, and the U.S. Food and Drug Administration(FDA) are investigating a multistate outbreak of Shiga toxin-producing Escherichia coli (STEC) infections.

46 people infected with the outbreak strains of STEC O121 or STEC O26 have been reported from 21 states.

Thirteen ill people have been hospitalized. One person developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

Epidemiologic, laboratory, and traceback evidence indicate that flour produced at the General Mills facility in Kansas City, Missouri is a likely source of this outbreak.

Several recalls and recall expansions have been announced as a result of this investigation.

In July 2016, laboratory testing by General Mills and FDA isolated STEC O26 from a sample of General Mills flour. Whole genome sequencing (WGS) showed that the STEC O26 isolated from the flour sample was closely related genetically to isolates from an ill person. The flour tested was not included in the earlier General Mills recalls.

On July 25, 2016, General Mills further expanded its flour recall to include additional lots.

CDC recommends that consumers, restaurants, and retailers do not use, serve, or sell the recalled flours.

Do not eat raw dough or batter, whether made from recalled flour or any other flour. Flour or other ingredients used to make raw dough or batter can be contaminated with STEC and other pathogens.

Consumers should bake all items made with raw dough or batter before eating them. Do not taste raw dough or batter.

Restaurants and retailers should not serve raw dough to customers or allow children and other guests to play with raw dough.

This investigation is ongoing, and we will update the public when more information becomes available.

 

 

Parents hate my food safety stories, so just a face palm: 611 sick with Salmonella from backyard chicks

Sorenne rode her bike to school on Friday for the first time.

After months of angst, probably because she saw daddy wipe out and get 23 stiches a couple of years ago when she was on training wheels, she rode her bike.

Today (Wed) they had a bike-to-school day to play-bicycle-polo-on-the-tennis courts, and the number of kids and bikes was a bit much to handle.

But that’s a good problem.

picard.face.palmI was chatting with a parent after school, while the kids retrieved their bikes that were stored at the swimming pool due to overload, and I said it was a nice problem to have, and then we chatted about the weather – depths of winter, 24C in Brisbane – and he said I guess spring has sprung, our backyard chickens laid two eggs yesterday, so I guess spring is here.

I smiled but inside I was doing my best Jean-Luc.

The U.S. Centers for Disease Control and Prevention reports there are now eight multistate outbreaks of human Salmonella infections linked to contact with live poultry in backyard flocks.

In the eight outbreaks, 611 people infected with the outbreak strains of Salmonella were reported from 45 states.

Illnesses started on dates ranging from January 4, 2016 to June 25, 2016.

138 ill people were hospitalized, and one death was reported. Salmonella infection was not considered to be a cause of death.

195 (32%) ill people were children 5 years of age or younger.

Epidemiologic, traceback, and laboratory findings have linked the eight outbreaks to contact with live poultry such as chicks and ducklings sourced from multiple hatcheries.

Regardless of where they were purchased, all live poultry can carry Salmonella bacteria, even if they look healthy and clean.

These outbreaks are a reminder to follow steps to enjoy your backyard flock and keep your family healthy.

Always wash hands thoroughly with soap and water right after touching live poultry or anything in the area where the birds live and roam.

baby.chickDo not let live poultry inside the house.

Do not let children younger than 5 years of age handle or touch chicks, ducklings, or other live poultry without adult supervision.

These outbreaks are expected to continue for the next several months since flock owners might be unaware of the risk of Salmonella infection from live poultry or participate in risky behaviors that can result in infection.

Ill people reported purchasing live baby poultry from several suppliers, including feed supply stores, Internet sites, hatcheries, and friends in multiple states. Ill people reported purchasing live poultry to produce eggs, learn about agriculture, have as a hobby, enjoy for fun, keep as pets, or to give as Easter gifts. Some of the places ill people reported contact with live poultry include their home, someone else’s home, work, or school settings.

Public health officials collected samples from live poultry and the environments where the poultry live and roam from the homes of ill people in several states. Laboratory testing isolated four of the outbreak strains of Salmonella.

8 sickened, 1 dead: CDC says Listeria linked to frozen produce is over

The U.S. Centers for Disease Control and Prevention says the investigation into frozen fruits and vegetables produced at CRF Frozen Foods in Pasco, Washington.

veggierecallHowever, people could continue to get sick because recalled products may still be freezers and people who don’t know about the recalls could eat them. Retailers should not sell and consumers should not eat recalled products. Read the Recall and Advice to Consumers and Retailers.

CDC, several states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of Listeria monocytogenes infections (listeriosis).

Listeria can cause a serious, life-threatening illness.

Nine people infected with the outbreak strains of Listeria have been reported from four states since September 13, 2013.

All nine people were hospitalized, and three of them died. Listeriosis was considered to be a cause of death for one person in Connecticut. For the two deaths in Maryland and Washington, listeriosis was not considered to be a cause of death.

Epidemiologic and laboratory evidence indicated that frozen vegetables produced by CRF Frozen Foods of Pasco, Washington and sold under various brand names were a likely source of illness in this outbreak.

On April 23, 2016, CRF Frozen Foods recalled 11 frozen vegetable products because of potential Listeria contamination.

On May 2, 2016, CRF Frozen Foods expanded the initial recall to include all organic and traditional frozen vegetable and fruit products processed in its Pasco, Washington facility since May 1, 2014. More than 350 consumer products sold under 42 separate brands were recalled, as well as at least 100 other products prepared by other companies that contained recalled ingredients from CRF Frozen Foods.

CDC recommends that consumers do not eat, and restaurants and retailers do not serve or sell, recalled organic and traditional frozen vegetables and fruit products and recalled products containing these items.

Recalled items were sold nationwide and in Canada.

A complete list of recalled products is on the FoodSafety.gov website.

42 now sickened from E. coli O121 linked to flour

The U.S. Centers for Disease Control reports that as of June 28, 2016, 42 people infected with the outbreak strain of Shiga-toxin producing E. coli O121 have been reported from 21 states.

wondraOn July 1, 2016, General Mills expanded its recall to include additional lots of Gold Medal Flour, Signature Kitchens Flour, and Gold Medal Wondra Flour.

STEC O121 was isolated from samples of General Mills flour collected from the homes of ill people in Arizona, Colorado, and Oklahoma.

Four more ill people have been reported from four states. The most recent illness started on June 8, 2016. One new state, Indiana, has been added to the list of states with ill people.

Illnesses started on dates ranging from December 21, 2015 to June 8, 2016. Ill people range in age from 1 year to 95, with a median age of 18. Eighty-one percent of ill people are female. Eleven ill people have been hospitalized. No one has developed hemolytic uremic syndrome, a type of kidney failure, and no deaths have been reported.

gold-medal-all-purpose5LBGuidance from the Food and Drug Administration (FDA) and CDC continues to warn that consumers should refrain from consuming any raw products made with flour. E. coli O121 is eliminated by heat through baking, frying, sautéing or boiling products made with flour. All surfaces, hands and utensils should be properly cleaned after contact with flour or dough.

Always the kids: Stop kissing turtles, and stop buying them at flea markets: Outbreaks of Salmonella in US

In August 2015, the U.S. Food and Drug Administration (FDA) notified the U.S. Center for Disease Control of a consumer complaint involving Salmonella Sandiego infection in a child (the index patient), who had acquired a small turtle (shell length <4 inches [<10 cm]) at an Alabama flea market. The subsequent investigation, which included examining data from PulseNet, the national molecular subtyping network for foodborne disease surveillance, identified four multistate Salmonella outbreaks: two involving Salmonella Sandiego and two involving Salmonella Poona. These turtle.kissserotypes have been linked to small turtles in previous outbreaks (1,2).

Although selling small turtles as pets in the United States has been banned since 1975 (3), illegal sales still occur at discount stores and flea markets and by street vendors. CDC investigated to determine the extent of the outbreaks and prevent additional infections.

For this investigation, a case was defined as infection with Salmonella serotypes Sandiego or Poona with the pulse-field gel electrophoresis patterns XbaI JL6X01.0104, JL6X01.0544, JL6X01.0055, JLXX01.0030, or JLXX01.0053 in a person with illness onset January 1–December 31, 2015. A total of 124 cases from 22 states were identified. Median patient age was 7 years (range <1–82 years); 51 patients (41%) were aged <5 years, and 59 (49%) were female. Among 108 patients with available information, 36 (33%) were hospitalized. Thirteen (36%) of the 36 hospitalized patients were aged <5 years. No deaths were reported. Fifty-eight (70%) of 83 patients with ethnicity information were Hispanic.

A total of 104 patients or their caregivers were interviewed; 50 patients (48%) had turtle exposure. Among the 50 patients with reported turtle exposure, the median age was 3 years (range <1–77 years), 30 (60%) were aged <5 years, and 25 (50%) were female. Of the 50 patients with turtle exposure, 48 had information on hospitalization; 18 of the 48 (38%) were hospitalized. Nine of those hospitalized were aged <5 years. Twenty-eight (72%) of 39 patients with ethnicity information were Hispanic. Turtle and turtle environment samples were collected from nine patients’ homes. Of these, 21 isolates of Salmonella were culture-positive: 17 matched the outbreak strains, two were Salmonella Paratyphi B var L-tartrate+, and two were Salmonella Pomona (Table).

An FDA consumer safety officer investigating the flea market where the index patient’s turtle was obtained traced the turtle’s origin to farm A (FDA’s Center for Veterinary Medicine did not pursue legal action regarding the sale by farm A of small turtles to the flea market vendor). Pond water samples from farm A yielded cultures of Salmonella (Table). Although the samples from turtle farm A did not yield the 2015 outbreak strains, two of the three Salmonella Pomona isolates from pond water matched isolates from a patient’s pet turtle’s environment.

The high proportion of patients aged <5 years in these outbreaks emphasizes the risk for illness among young children with small turtles as pets. This finding indicates education is needed to address the risk to children for Salmonella infections from small turtles and other reptiles. Many patients in these outbreaks were Hispanic, which highlights the importance of multilingual messages for effective communication. During these outbreaks, the announcement and prevention messages regarding safe handling of pet reptiles and amphibians were translated into Spanish and posted on the “CDC en Español” website. To ensure wider dissemination, information was also provided to a major Spanish-language news agency.

Transient vendors continue to be a source of illegal sales of small turtles. Educational campaigns at schools, child care centers, carnivals, and flea markets regarding the risk for Salmonella from contact with turtles are important to prevent infections among children.