13 sick; Cryptosporidium in Irish water supply again

Contaminated water has left 13 people with stomach illnesses after two outbreaks of cryptosporidiosis.

The Sun says up to 6,000 people in Roscommon town and its surrounds have south.park.diarrheabeen affected by the bug in the local water supply.

A “boil water notice” has been in place since April 25.

People living and working in the area have been advised by Roscommon County Council and the HSE to boil all water for drinking, preparation of salads and for use in brushing teeth.

Both bodies have set up an Incident Response Team to minimize the risk to the public.

Sales of bottled water have shot up in the area amid concerns that the boil water restriction could remain in place until the system gets the all-clear, which could take several weeks.

Roscommon County Council confirmed three dead calves were removed from a stream which is a tributary of one of the sources for the Roscommon town central water scheme where cryptosporidiosis has been detected.

The townlands affected are Killaraght, Rockingham, Knockvicar, Cootehall, Tarmon Road, Kiltycreighton, Crossna, Derrycashel, Moigh, Carigeenroe, Battlebridge and Ardcarne.

The four main causes of serious childhood diarrhea

Just four pathogens underpin most cases of serious diarrhea in children—the second leading killer of young children worldwide—according to a study published today in The Lancet.

Nature.com reports that out of nearly 40 diarrhea-causing germs, the researchers identified four primary culprits: rotavirus, Cryptosporidium, a toxic type of Escherichia coli, and Shigella. The winnowing of the list could allow health experts to design targeted health campaigns.

“I think what we have done is allow doctors and public health experts to prioritize and potentially save thousands of lives,” says Karen Kotloff, a pediatrician at the University of Maryland, Baltimore, and first author of the study. Diarrheal diseases kill an estimated 800,000 young children each year, second only to pneumonia, which kills around 1.2 million.

6 sick; farm owner denies link to Cryptosporidium outbreak

Five visitors to Cotswold Farm Park and one member of staff are being treated for cryptosporidiosis in the UK.

The farm is run by Countryfile TV host Adam Henson.

Dr David Hunt, consultant for health protection in Public Health England (PHE) Avon, Gloucestershire and Wiltshire told the Wilts and Gloucestershire Standard, “Most of the cases became unwell in April and appear to have visited the park in Adam-henson_280_1307003athe Easter holidays. “The park has co-operated fully with the investigation and has put in place a number of extra measures ahead of the upcoming bank holiday to reduce the risk to future visitors.

Today, host Henson issued a statement on the Cotswold Farm Park website, saying, “It’s been incorrectly reported in some media that cases of cryptosporidium have been linked with us.”

The statement also reads, “There is currently no scientific evidence to confirm that these alleged cases, which occurred over four weeks ago, are linked to Cotswold Farm Park.

“However, we do take public health very seriously so have been proactively liaising with the HSE (Health and Safety Executive) and the local Environmental Health department, to investigate a possibility that these cases may be linked.

“Following a site visit with a HSE inspector and an Environmental health officer it was agreed that Cotswold Farm Park follows best practice procedures in our animal contact areas and we have a proactive approach to educating and informing our staff and visitors of the importance of hand washing.

“We would like to reassure our visitors that we are fully compliant with the industry code of practice for avoiding ill health from farm visits and that there is no reason to avoid contact with animals as long as the correct hand washing procedures are followed.”

Given the number of petting zoo outbreaks, adhering to an industry code of practice and bragging about it is far from convincing.

And handwashing is never enough.

But, the health types will continue with their work, and the story will unfold.

A table of petting zoo outbreaks is available at http://bites.ksu.edu/petting-zoos-outbreaks.

5 sick; help animals on Isle of Man, get Campylobacter

About five cases of Cryptosporidium and Campylobacter have been reported on the island during the past three months.

It is thought some of those affected may have been involved in helping snow-cow_1216616ifarmers to rescue livestock after heavy snow last month.

Food Safety Manager Ivan Bratty told BBC that  simple precautions must be taken.

“These recent cases serve as a timely reminder of the importance of thorough hand washing after handling livestock and before preparing or handling food to prevent infection and the spread of disease in the community,” he said.

“It is also important for anyone suffering from diarrhoea to avoid swimming pools as Cryptosporidium can survive in chlorinated water.”

Food safety is never simple.

458 sick: Calls for sanitation after Australian crypto outbreak

Bendigo residents are being reminded about the importance of good personal hygiene after a state-wide spike in gastro cases.

The Department of Health has confirmed an increase in the number of cases of gastro caused by the cryptosporidium crypto.giardiaparasite which is found in the feces of humans, cattle and other animals.

There have now been 458 cases of cryptosporidiosis notified to the department this year, compared to 88 for the same period last year.

The Department of Health did not have a region by region breakdown of the figures but Bendigo Health confirmed a central Victorian was recently affected by a small gastro outbreak.

Bendigo Health’s infection control manager Jane Hellsten said the best way to prevent highly contagious gastro was through good personal hygiene.

“Hand hygiene, hand hygiene, hand hygiene – I can’t emphasize that enough,” she said.

But handwashing is never enough. Sick people should stay at home, isolating susceptible animals from public swimming areas as much as possible, and don’t eat poop.

300 sick; 2012 UK Cryptosporidium outbreak linked to pre-cut salad

In June 2012, the UK Health Protection Agency first announced 267 people were sick with Cryptosporidium across four areas of the UK, double the normal rate.

Ten months later, HPA says the crypto that sickened about 300 people was most likely linked to eating pre-cut bagged salad products which were likely lettuce.harvestto have been labeled as ‘ready-to-eat.’

The outbreak was short lived and the numbers of cases returned to expected seasonal levels within a month of the first cases being reported. Most of those affected had a mild to moderate form of illness and there were no deaths associated with the outbreak.

During the investigation, the initial link was found between illness and pre-cut spinach. When specific retailers were included in the analysis, the strongest association with infection was found to be with consumption of ready to eat pre-cut mixed salad leaves from a major supermarket chain.

In this analysis, exposure to pre-cut spinach only reached conventional levels of significance for one retailer – a second major supermarket chain. A link to spinach from a number of other retailers was also suggested but these were not statistically significant. Together these findings suggest that one or more types of salad vegetables could have been contaminated.

Dr Stephen Morton, regional director of the HPA’s Yorkshire and the Humber region and head of the multi-agency Outbreak Control Team, said, “Our findings suggest that eating mixed leaf bagged salad was the most likely cause of illness. It is however often difficult to identify the source of lettuce.tomato.skullshort lived outbreaks of this type as by the time that the outbreak can be investigated, the affected food and much of the microbiological evidence may no longer be available.

Dr Alison Gleadle, director of food safety at the FSA, took the opportunity to further confuse consumers, stating, “We’d like to remind everyone of our usual advice to wash all fruits and vegetables, including salad, before you eat them, unless they are labeled ready-to-eat.”

But wasn’t this outbreak linked to ready-to-eat salads? How is that advice of any use? Could have offered some details, like, additional washing of ready-to-eat products is largely ineffective. FSA is refocusing its efforts on farm management to limit such contamination, before it happens.

A spokesthingy for retailer Morrisons said, rather defensively, “Morrisons is not the source of this outbreak. We have received no complaints of illness and no Morrisons products have tested positive for Cryptosporidia.

“The HPA’s claim is based solely on statistics, not testing. The very same statistics also implicated products from other retailers that the HPA recognize as ‘implausible’.”

Why doesn’t Morrison’s say what they do to enhance the safety of products they sell rather than trash epidemiology?

Crypto outbreak in Victoria, Australia pools

Victorians could be in the poo, literally, if they sought relief at the local pool.

Victoria’s chief health officer Dr Rosemary Lester said there has been a three-fold increase in gastro cases after hot weather sparked people seeking to cool off at pool.pooppublic swimming pools.

She urged those who have had diarrhea not to go into a swimming pool for at least 14 days after symptoms had stopped for fear of passing on the bug.

There were 155 Victorian cases of gastro caused by the cryptosporidium parasite last month, three times the February average of 53.

45 sick; checking for Cryptosporidium in NZ water

Hawke’s Bay’s water operators are checking the region’s supplies for contamination of Cryptosporidium.

Health authorities have, according to the New Zealand Herald, issued a warning cryptofollowing the diagnosis of 45 people over the past two months.

Medical Officer of Health Dr Nicholas Jones said the health protection team is analysing information to establish the cause of the outbreak – and expect there is more than one source.

“We’ve been in touch with the water operators and they don’t think they’ve got problems at the moment, but obviously it’s something we’re going to be looking into in more detail,” said Dr Jones.

It’s not just bacteria and viruses; parasites in leafy greens

On July 7, 1997, a company physician reported to the Alexandria Department of Health (ADOH) that most of the employees who attended a corporate luncheon on June 26 at the company’s branch in Fairfax, Virginia, had developed gastrointestinal illness. On July 11, the health department was notified that a stool specimen from one of the employees who attended the luncheon was positive for Cyclospora oocysts. Many others tested positive. It was subsequently revealed in a July 19, 1997, Washington Post story citing pesto_basil_cyclosporalocal health department officials that basil and pesto from four Sutton Place Gourmet stores around Washington D.C. was the source of cyclospora for 126 people who attended at least 19 separate events where Sutton Place basil products were served, from small dinner parties and baby showers to corporate gatherings. Of the 126, 30 members of the National Symphony Orchestra became sick after they ate box lunches provided by Sutton Place at Wolf Trap Farm Park.

In May 2001, 17 people in British Columbia were sickened with cyclospora associated with basil from Thailand. In 2005, 300 people in Florida were sickened with cyclospora from fresh basil.

My aunt was part of that outbreak.

Parasites. They’re everywhere.

Canadian researchers report in the Journal of Food Protection a “relatively high prevalence” of Cyclospora, Cryptosporidium and Giardia in ready-to-eat packaged leafy greens; most of the products were grown in the U.S.

Abstract below.

Detection of Cyclospora, Cryptosporidium, and Giardia in ready-to-eat packaged leafy greens in Ontario, Canada

Journal of Food Protection®, Number 2, February 2013, pp. 192-369 , pp. 307-313(7)

Dixon, Brent; Parrington, Lorna; Cook, Angela; Pollari, Frank; Farber, Jeffrey

http://www.ingentaconnect.com/content/iafp/jfp/2013/00000076/00000002/art00016

Numerous foodborne outbreaks of diarrheal illness associated with the consumption of produce contaminated with protozoan parasites have been reported in North America in recent years. The present study reports on the presence of Cyclospora, Cryptosporidium, and Giardia in precut salads and lettuceleafy greens purchased at retail in Ontario, Canada. A total of 544 retail samples were collected between April 2009 and March 2010 and included a variety of salad blends and individual leafy greens. Most of these products were grown in the United States, with some from Canada and Mexico. Parasites were eluted and concentrated before detection by PCR and immunofluorescence microscopy. DNA sequences were aligned with reference sequences in GenBank. Cyclospora spp. were identified by PCR-restriction fragment length polymorphism in nine (1.7 % ) samples and by DNA sequence analysis. Cryptosporidium spp. were identified in 32 (5.9%) samples; 29 were sequenced and aligned with the zoonotic species Cryptosporidium parvum. Giardia duodenalis was identified in 10 (1.8%) samples, and of the 9 samples successfully sequenced, 7 aligned with G. duodenalis assemblage B and 2 with assemblage A, both of which are also zoonotic. The presence of Cryptosporidium oocysts and Giardia cysts was confirmed in some of the PCR-positive samples using microscopy, while Cyclospora -like oocysts were observed in most of the Cyclospora PCR-positive samples. The relatively high prevalence of these parasites in packaged salads and leafy greens establishes a baseline for further studies and suggests a need for additional research with respect to the possible sources of contamination of these foods, the determination of parasite viability and virulence, and means to reduce foodborne transmission to humans.

30 sickened; crypto outbreaks linked to herbs in Sweden, 2010

According to the current issue of Eurosurveillance, one of Sorenne’s favorite journals, the number of sporadic cases of Cryptosporidium identified in the Stockholm county area increased above the expected limit during October 2010. Additionally, two food-borne outbreaks of cryptosporidiosis occurred in two other Swedish cities: Umeå (4 October) and Örebro (9 October). The outbreak investigations did not reveal any responsible food item, however fresh herbs were suspected. Thirty stool samples, originating from all three events, tested positive for Cryptosporidium oocysts. Polymerase chain reaction (PCR) and subsequent restriction fragment length polymorphism (RFLP) revealed that 27 individuals were infected with C. parvum, two with C. hominis, and one with C. felis. Using sequence analysis of the GP60 glycoprotein gene, a polymorphic marker with high intra-species diversity, we identified the same C. parvum subtype IIdA24G1 in samples from both the Umeå outbreak and the Stockholm area cases, thus indicating a possible outbreak in the Stockholm area and establishing a link between these two events. C. parvum IIdA24G1 has not previously been described in connection with a foodborne outbreak. For the outbreak in Örebro, another subtype was identified: C. parvum IIdA20G1e. These findings demonstrate that subtyping C. parvum isolates using GP60 gene amplification can be used to link cases in an outbreak investigation and we recommend its use in future similar events.

The complete paper is available at http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20318.