Lawsuit filed in norovirus-linked fatality

Foodborne norovirus is linked to around 5.5 million illnesses a year and costs the U.S. around $3 billion annually. Fortunately most of the cases result in a couple of days of really bad vomiting or diarrhea – but usually not deaths (an estimated 150 annually).

According to Oregon Live, a 2013 norovirus outbreak at Maggie’s Buns may have resulted in a unique and tragic outcome: 43-year-old Kevin Weeks’ died a week after exposure to the pathogen.Screen Shot 2015-03-17 at 12.53.52 PM

The wife of a 43-year-old man who died after allegedly eating food contaminated with the norovirus has filed a $2.9 million lawsuit against a popular Forest Grove restaurant.

Stacey Weeks faults Maggie’s Buns for catering a meal that she believes was tainted with the norovirus. Her husband, Kevin Weeks, was a spokesman for the Oregon Department of Forestry and ate the food at the work event on Friday, March 15, 2013.

Public health investigators said 15 other people fell ill by the following Saturday, but most were feeling better by Monday. Weeks, however, died the following Tuesday — four days after dining at the gathering.

Investigators determined that most of those who were sickened ate watermelon, cantaloupe, pineapple or strawberries from a fruit tray. But investigators said in March 2013 that they didn’t know how the virus ended up there.

The virus is spread directly among people through contact or through contaminated food, water or surfaces. It’s highly contagious, but doesn’t usually kill.

Shortly after Weeks died, deputy state medical examiner Dr. Clifford Nelson said Weeks was exposed to the norovirus at the event, but it appeared that Weeks had health problems that caused his death. Nelson said, however, that he was awaiting some test results before he could draw a final conclusion.

Oliver Sacks on learning he has terminal cancer: How We Die and A Gentle Death

Oliver Sacks, a professor of neurology at the New York University School of Medicine, the author of many books, including “Awakenings” and “The Man Who Mistook His Wife for a Hat,” has revealed he is dying, via the N.Y. Times.

oliver.sacks“My luck has run out,” is how Sacks, 81, announced to the world Thursday that he has terminal cancer.

The neurologist and author — his autobiography comes out this spring, and he has “several other books nearly finished — revealed his condition in an op-ed in Thursday’s New York Times that was soon being widely shared, and admired, online.

Here are five of the most frequently quoted words of wisdom from the column:

  1. Self-assessment: “I cannot say (nor would anyone who knows me say) that I am a man of mild dispositions. I am a man of vehement disposition, with violent enthusiasms, and extreme immoderation in all my passions.”
  2. Detachment: “I still care deeply about the Middle East, about global warming, about growing inequality, but these are no longer my business; they belong to the future.”
  3. Gratitude: “I have loved and been loved; I have been given much and I have given something in return.”
  4. Focus: “There is no time for anything inessential.”
  5. Inimitability: “When people die, they cannot be replaced. They leave holes that cannot be filled, for it is the fate — the genetic and neural fate — of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.”

This is what I wrote in Toronto’s Globe and Mail book review section in 1994, about my grandmother, who ended her own life in 1983.

After five years of painstaking care for her husband, who was slowly deteriorating from the cerebral ravages of Alzheimer’s disease, she decided that a sixth was not worth facing.

Her death was quick and without warning. One moment we were saying goodbye before a routine trip to the store, the next I was transferring her from car to wheelchair at the hospital emergency ward. Within 30 minutes she was officially deceased, the result of a major pharmaceutical overdose.

Looking back, I’ve often wondered what I would say to her, given the chance. Don’t do it, life is really okay. You are not alone. Things will get better.

But in reality, life is often harsh, she was often alone, and the prospects of yet another winter, trekking to the hospital each day to watch the person she had spent the vast majority of her life with become even more unfamiliar, meant that things certainly were not about to get better; at least not in any foreseeable future.

Humans have created powerful myths and rituals to accompany death, writes Sherwin Nuland in How We Die, but perhaps none more bizarre than the modern hospital, “where it can be hidden, cleansed of its organic blight, and finally packaged for modern burial. We can now deny the power not only of death but of nature itself. We hide our faces from its face, but still we spread our fingers just a bit, because there is something in us that cannot resist a peek.”

Dr. Nuland, a physician who has authored several books about the medical profession and continues to teach surgery and the history of medicine at Yale University, says this book was written to demythologize the process of dying, to present it in its biological and clinical realities. The changes at a cellular and organ-level that accompany heart attacks, stroke and cancer are presented in detail that may be intimidating to the uninitiated. Then again, any person who is faced with life-threatening disease can quite rapidly assimilate the medical jargon — they have to. Physicians capable of talking in clear, simple language are rare.

Marilynne Seguin’s A Gentle Death is an attempt to help ease that journey for patients and their families. Sequin, a registered nurse for over 30 years as well as a founding member and executive director of the Toronto-based Dying With Dignity tells how she, like Nuland, was trained to prolong life at all costs. Experience has taught her to question prevailing attitudes of the medical establishment and she stresses that patients must become informed and responsible for the medical decisions that affects their lives.

In presenting the many examples of people approaching death who Sequin has cared for, a common theme emerges. Rather than a passive silence, many approaching death wish to be at home, surrounded by the noise of children — the noise of life — rather than the sobering silence of loneliness.

Both books try to dispel the hero myth, the one where the nurse or physician is never to allow the patient to lose hope. Yet hope and wishing for miracles get in the way of true discussion; it robs people of their death.

Nuland writes we are currently in the vitamin era, following previous attempts to prolong life through the pseudoscience of monkey glands, mother’s milk, and, as King David tried, sleeping between two virgins. Coming soon will be expanded attempts to prolong life through the mass availability of human growth hormone, derived by genetic engineering, and gene therapy. Only “accurate knowledge of how a disease kills,” writes Nuland, “serves to free us from unnecessary terrors of what we might be fated to endure when we die. We may thus be better prepared to recognize the stations at which it is appropriate to ask for relief, or perhaps to begin contemplating whether to end the journey altogether.”

Which leads to the hotly debated topic of physician-assisted suicide and the right of rational individuals to decide how and when to end their lives. At this point the two books differ strongly. Nuland approves of Living Wills and other advanced care directives, instructing physicians what treatments to withhold in the face of terminal illness, but he strongly disapproves of physician-assisted suicide. Seguin, whoever, sees no distinction. Much of her book is devoted to a frank discussion of the practical advantages and limitations of such approaches.

Nuland, however, fails to come clean on the topic, when he mentions in passing that, “Like so many of my colleagues, I have more than once broken the law to ease a patient’s going, because my promise, spoken or implied, could not be kept unless I did so.” Seguin states quite clearly that many physicians have engaged in such activity, so why not create clear, legally-binding rules, as has been done in the Netherlands.

One Dutch physician who supports the new law says society needs a counterweight for the enormous technology of modern medicine. But more importantly he says, it gives the patient a chance to take leave openly of his children, his grandchildren, and others.

That openness seems crucial to further public discussion of death and dying. I still wonder what I would say to someone who is about to leave this earth on their own accord. Both books provide unique and moving insight into such conversations. Perhaps I now know what I might have said to my grandmother.

Canadian backpacker dies after ‘drinking tea in Peru shaman ceremony that caused her to vomit until she passed out’

A 32-year-old Canadian woman died as she drank tea at a Peru shaman ceremony. 

255C1D4400000578-2941085-image-a-1_1423143920090Jennifer Logan of Saskatoon, Saskatchewan was backpacking through the country when she had a fatal medical reaction as she drank tea designed to make people vomit, purge and cleanse the body at a rainforest retreat on January 17.

She had to be taken by motorcycle and then boat to the nearest hospital, but she could not be revived by doctors, who say the woman died of a pulmonary edema.

Amy Logan, the victim’s youngest sister who recently traveled to Peru with her mother to retrieve her sister’s remains, told CBC; ‘We suspect the tea had a role.’

Officers have examined the cup Ms. Logan drank out of and the jug while also conducting interviews with staff  as they investigate the death.

Ms. Logan’s sister explained that the participants at the two week long all-female retreat at the Canto Luz Centre outside Puerto Maldonado were each given tea to drink.

Mother and daughter die, suspected food poisoning in Delhi

A 50-year-old woman and her daughter died and her son survived a suspected food poisoning allegedly after consuming food they bought from a nearby eatery in KR Garden in Jeevanahalli, Bengaluru north on Sunday night.

chicken-biriyaniThe deceased have been identified as Padmavathy, 50, a homemaker and her daughter Deepa, 22, a final year bachelor of arts students. The son of Padmavathy, son Satish, 27, working as a team manager with online e-commerce firm, Flipkart.

According to the police, the incident came to light during the early hours of Monday morning when a neighbour went to check on the family and found Deepa lying unconscious on her bed. He immediately informed the police who rushed to the spot and found Deepa dead.

Checking later it was found Padmavathy was admitted by Satish but was later declared dead while undergoing treatment in a hospital. Investigation into the tragedy revealed that the family had ordered Biriyani and noodles from a nearby eatery on Sunday night. The family dined together around 10 pm. While Padmavathy and Deepa ate noodles, Sathish ate Biriyani following which the trio complained of discomfort. Within no time, the three started vomiting. While Deepa went inside her room and slept after vomiting couple of times, Sathish rushed her mother to a nearby hospital owing to her deteriorating condition where later Padmavathy succumbed.

Norovirus outbreak, including a death, linked to Kansas Meals on Wheels; handwashing issues cited

When I was a kid I used to visit my grandparents in Campbellford,Ontario (that’s in Canada) a bunch. My grandparents lived most of their lives in Toronto (that’s also in Canada) but had retired to this town about 2hrs outside of the city.

My grandparents were into community stuff: volunteering for the hospital auxiliary, organizing charity curling bonspiels and golf tournaments and driving some of their more elderly neighbors to doctor’s appointments.Unknown-1

And my grandfather drove around some food for Meals on Wheels.

I remember being about 8 and going on his route one spring break morning. He grabbed some already-food-filled covered trays and then took a bunch of apples and oranges in bulk. This was before I knew anything about food safety; I didn’t really notice anything about bare hand contact or handwashing.

According to chanute.com, a norovirus outbreak, tragically including a death, has been linked to a Meals on Wheels service in Kansas.

It has been confirmed by the Kansas Department of Health and Environment that the source of the norovirus outbreak in the Neosho County area last week was Meals on Wheels in southeast Kansas.

KDHE Health Programs Public Information Officer Aimee Rosenow said the numbers of confirmed ill have not changed since Friday when there were 29 confirmed ill. 

Rosenow said epidemiology staff are still working on the case to narrow down the source of infection.

A Jan. 8 food safety inspection of the Chanute Senior Services of SEK facility found problems with hand washing and properly arranging food in coolers to avoid cross-contamination. Samples were also taken of all food from the batch delivered Jan. 6.

KDHE Public Health Public Information Officer Aimee Rosenow said KDHE does not have an autopsy report confirming the cause of death as Norovirus infection and cannot release the name of the deceased. 

“We do know that the patient was ill and has been served by this program,” she said.

Over the past year UNC-Chapel Hill food policy student (and frequent barfblog contributor) Ashley Chaifetz has been researching food handling practices and infrastructure at food pantries in North Carolina (as part of a USDA CAP grant on STECs). Volunteers provide a particular challenge for food safety as they may be transient and have varying food safety values. 

 

 

 

Nine people choke to death eating rice cakes in Japan

Japan’s habitual New Year killer has struck again, after nine people were reported to have died in recent days from choking on rice cakes.

mochiMochi – glutinous cakes of pounded rice – are traditionally eaten in vast quantities over the holidays, usually in soup, or toasted and served with sweet soy sauce and wrapped in dried seaweed.

Several people die eating the starchy delicacy every January, but this year the number is particularly high.

Local media reported that nine people had died over the holidays, while 13 others were in a serious condition in hospital. 

‘In my field, likely is not the same as layman term of likely’ Singapore court questions source of 4-year-old’s death from Salmonella

A boy of four who died after contracting Salmonella did not necessarily get it from a nasi padang stall where his mother bought food, a court heard.

nasi.padangAt a further inquest into the death of Shayne Sujith Balasubraamaniam on Jan 22 last year, State Coroner Marvin Bay found that it was only a “likelihood” that he contracted the infection from food consumed at the stall.

He, his mother and two- year-old sister suffered fever, diarrhoea and vomiting on Jan 19, a day after eating food bought from Kopitiam food court in Northpoint shopping centre.

His mother had bought home tahu goreng for him, and rice, chicken curry and bergedil (potato cutlets) for the three of them on Jan 18.

All three were taken to a polyclinic where Shayne was assessed to be severely dehydrated and prescribed medication.

He showed signs of recovery on Jan 21 but his condition worsened the next day. The cause of death was primarily consistent with salmonella septicaemia.

Two days later, the implicated food stall was inspected and found to have hygiene lapses.

The stallholder, Madam Siti Abibah Guno, was fined a total of $1,400 last month for failing to register a food handler, and protect food in a covered receptacle.

She has since cancelled her foodstall licence after Kopitiam terminated her tenancy agreement in November.

Recalled to the stand yesterday, Dr Hishamuddin Badaruddin, assistant director at the Health Ministry’s Communicable Diseases Division, could not conclude 100 per cent that the source of infection was the nasi padang stall.

The further hearing was held as the State wanted the court to clarify the coroner’s phrasing last October that it was “highly likely” the family had contracted the infection from the stall.

At the last hearing, Dr Hishamuddin had said lapses such as the way food was prepared could have contributed to bacterial growth, particularly the practice of partial cooking and refreezing of chicken parts.

He testified yesterday that the results of environmental swabs showed no salmonella in the stall nor in the food samples taken.

While there was salmonella bacteria found in the three family members, there was nothing else to link it to the stall.

He agreed with State Counsel Zhou Yihong, who assisted in the inquiry, that although he used the word “likely”, this likelihood of bacteria found in the cases was actually quite low.

“In my field, the word likely is not the same as the layman term of likely,” he said.

‘Cosmetic’ milk in Australia: Raw milk remains untested

Raw milk producers are not being subjected to the same rigorous testing as dairy farmers who produce milk for ­human consumption.

raw.milk.aust.cosmetic.dec.14United Dairy Farmers of Victoria president Tyran Jones said milk from dairy farms was subjected to stringent tests to ensure its safe consumption, but no such tests existed for “raw” milk or “bath” milk.

Mr Jones said milk from his Gruyere farm, 50km northeast of Melbourne, went straight into a refrigerated vat to be chilled to 4C. “It is tested daily for bacteria. The milk factory takes a sample and sends if off for independent testing every day,” he said.

His comments come after a three-year-old child died and several others fell ill after drinking “bath” milk from Victoria’s Mountain View ­Organic Dairy, which is sold as a cosmetic product but has been stored next to consumables in many Victorian stores.

Craig Dalton of The Conversation writes that the Australian Competition and Consumer Commission (ACCC) has been investigating the role of microbiological contamination in cosmetic injuries, which has resulted in recalls in some instances. ACCC Deputy Chair Delia Rickard recently noted that cosmetic surveys revealing microbiological contamination were a timely reminder as the trend to produce all natural and all organic products may increase pressure on manufacturers to produce cosmetics with less preservatives or less effective natural preservatives.

Complicating this issue is that bath milk is often sold in containers that look just like drinking milk containers and may be stored in refrigerators alongside drinking milk. This may provide a false sense of security leading people to believe it is a food or as safe as a food.

bath.milkNevertheless, raw milk apologist are out in force, with David Gumpert writing, the vultures are circling in force with news that an Australian three-year-old may have died from drinking raw milk. 

This is news raw milk opponents have lusted after for many years, and now they mean to use it for full effect, tying it to a new study from the U.S. Centers for Disease Control that suggests illnesses from raw milk are rising.  Even though raw milk is already highly restricted in Australia, there are calls for a complete ban now that raw milk has been “proven” by this death to be unacceptably risky. 

Most intriguing, the farmer accused of producing the milk that led to the three-year-old boy’s death says he has been told the child was seriously ill before drinking raw milk. The child’s parents may have been providing raw milk in hopes of improving the child’s health. 

Um, what about the other three kids under five-years-old who developed hemolytic uremic syndrome but have (sorta) recovered?

I child dead, 4 sick in Australia from raw milk; US says outbreaks quadrupled

Amidst reports that the number of U.S. outbreaks caused by non-pasteurized milk increased from 30 during 2007–2009 to 51 during 2010–2012, a child in Victoria (that’s in Australia) has died and four have become ill from raw milk.

868179-068aae70-8035-11e4-9659-e3748623bf5fUnpasteurised milk is illegal to sell for human consumption in Australia, but the product consumed by the child was classed as cosmetic so was allowed on the shelves.

The child recently died on the Mornington Peninsula after drinking what was marketed as a cosmetic product and labeled “bath milk”, the Victorian Health Department said.

The U.S. Centers for Disease Control and Prevention said Wednesday that the average number of outbreaks from contaminated unpasteurized milk more than quadrupled from three a year between 1993 to 2006 to about 13 between 2007 and 2012.

Overall, there were 81 outbreaks in that last period, sickening nearly 1,000 people, including 73 who were hospitalized. The CDC said that more than 80 percent of the illnesses happened in states where retail sales of raw milk are legal.

Most outbreaks were caused by Campylobacter spp. (77%) and by nonpasteurized milk purchased from states in which nonpasteurized milk sale was legal (81%). Regulations to prevent distribution of nonpasteurized milk should be enforced.

Pasteurization is an effective way to improve milk safety; however, in the United States, illness related to consumption of nonpasteurized milk continues to be a public health problem. The first statewide requirements that dairy products be pasteurized were enacted in Michigan in 1948 (1). In 1987, the US Food and Drug Administration banned the interstate sale or distribution of nonpasteurized milk. However, the laws regulating intrastate sales are set by each state (2). Regulations for intrastate sales of nonpasteurized milk vary from complete bans to permitting sales from farms or retail outlets (2). Even in states in which sale of nonpasteurized milk is illegal, milk can often be obtained through other means. For example, some states allow cow-share or herd-share agreements, in which buyers pay farmers a fee for the care of a cow in exchange for a percentage of the milk produced (3,4).

Consumption of nonpasteurized milk has been associated with serious illnesses caused by several pathogens, including Campylobacter spp., Shiga toxin–producing Escherichia coli, and Salmonella enterica serotype Typhimurium (3,4). Despite the health risks associated with consuming nonpasteurized milk, the demand for nonpasteurized milk has increased (3,5,6). Recently, many state legislatures have considered relaxing restrictions on the sale of nonpasteurized milk (2,6). We report that the number of outbreaks associated with nonpasteurized milk increased from 2007 through 2012.

The Study

A foodborne disease outbreak is defined as the occurrence of >2 cases of a similar illness resulting from ingestion of a common food. State and local health departments voluntarily report outbreaks to the Foodborne Disease Outbreak Surveillance System of the Centers for Disease Control and Prevention through a standard web-based form (www.cdc.gov/nors). We reviewed outbreaks reported during 2007–2012 in which the food vehicle was nonpasteurized milk. Outbreaks attributed to consumption of other dairy products made with nonpasteurized milk, such as cheese, were excluded. We analyzed outbreak frequency, number of illnesses, outcomes (hospitalization, death), pathogens, and age groups of patients. Data on the legal status of nonpasteurized milk sales in each state were obtained from the National Association of State Departments of Agriculture (79) and an online search of state regulations. The sources from which nonpasteurized milk was obtained or purchased were categorized according to the description from the state outbreak reports, when available.

colbert.raw.milkDuring 2007–2012, a total of 81 outbreaks associated with nonpasteurized milk were reported from 26 states. These outbreaks resulted in 979 illnesses and 73 hospitalizations. No deaths were reported. The causative agent was reported for all outbreaks. Of the 78 outbreaks with a single etiologic agent, Campylobacter spp. was the most common pathogen, causing 62 (81%) outbreaks, followed by Shiga toxin–producing E. coli (13 [17%]), Salmonella enterica serotype Typhimurium (2 [3%]), and Coxiella burnetii (1[1%]) (Figure 1). Three outbreaks were caused by multiple pathogens (Figure 1). The number of outbreaks increased from 30 during 2007–2009 to 51 during 2010–2012. During 2007–2009, outbreaks associated with nonpasteurized milk accounted for ≈2% of outbreaks with an implicated food; during 2010–2012, this percentage increased to 5%. The number of outbreaks of Campylobacter spp. infection also increased, from 22 during 2007–2009 to 40 during 2010–2012.

How milk was obtained was reported for 68 (84%) outbreaks. Nonpasteurized milk was obtained from dairy farms (48 [71%] outbreaks), licensed or commercial milk sellers (9 [13%]), cow- or herd-share arrangements (8 [12%]), and other sources (3 [4%]). Of the 81 outbreaks, 66 (81%) were reported from states where the sale of nonpasteurized milk was legal in some form: Pennsylvania (17 outbreaks), New York, Minnesota (6 outbreaks each), South Carolina, Washington, and Utah (5 outbreaks each). A total of 15 (19%) outbreaks were reported in 8 states in which sales were prohibited. Among these outbreaks, the sources of nonpasteurized milk were reported as a dairy farm (6 outbreaks), cow or herd share (4 outbreaks), and unknown (5 outbreaks).

Conclusions

Within this 6-year period, the number of outbreaks associated with nonpasteurized milk increased. The number of outbreaks caused by Campylobacter spp. nearly doubled. The average number of outbreaks associated with nonpasteurized milk was 4-fold higher during this 6-year period (average 13.5 outbreaks/year) than that reported in a review of outbreaks during 1993–2006 (3.3 outbreaks/year) (4). This increase was concurrent with a decline in the number of states in which the sale of nonpasteurized milk was illegal, from 28 in 2004 to 20 in 2011 (79) and with an increase in the number of states allowing cow-share programs (from 5 in 2004 to 10 in 2008) (8,9). The decision to legalize the sale of nonpasteurized milk or allow limited access through cow-share programs may facilitate consumer access to nonpasteurized milk (5). The higher number of outbreaks in states in which the sale of nonpasteurized milk is legal has been reported elsewhere (4).

The legal status of nonpasteurized milk sales in 1 state can also lead to outbreaks in neighboring states. In a 2011 outbreak of Campylobacter spp. infections associated with nonpasteurized milk in North Carolina, where sales of this product were prohibited, milk was purchased from a buying club in South Carolina, where sales were legal. Another outbreak of Campylobacter spp. infection in 2012 implicated nonpasteurized milk from a farm in Pennsylvania, where sales are legal; cases from this outbreak were reported from Maryland, West Virginia, and New Jersey, all of which prohibit sale of raw milk (10). All patients residing outside Pennsylvania had traveled to Pennsylvania to purchase the milk (10).

Outbreaks associated with nonpasteurized milk continue to pose a public health challenge. Legalization of the sale of nonpasteurized milk in additional states would probably lead to more outbreaks and illnesses. This possibility is especially concerning for vulnerable populations, who are most susceptible to the pathogens commonly found in nonpasteurized milk (e.g., children, senior citizens, and persons with immune-compromising conditions). Public health officials should continue to educate legislators and consumers about the dangers associated with consuming nonpasteurized milk; additional information can be obtained at http://www.cdc.gov/foodsafety/rawmilk/raw-milk-index.html. In addition, federal and state regulators should enforce existing regulations to prevent distribution of nonpasteurized milk.

Ms Mungai is a surveillance epidemiologist at the Atlanta Research and Education Foundation and at the Centers for Disease Control and Prevention. Her interests include infectious disease epidemiology and food safety.

References

Steele JH. History, trends and extent of pasteurization. J Am Vet Med Assoc. 2000;217:175–8 . DOIPubMed

Weisbecker A. A legal history of raw milk in the United States. J Environ Health. 2007;69:62–3 .PubMed

Oliver SP, Boor KJ, Murphy SC, Murinda SE. Food safety hazards associated with consumption of raw milk. Foodborne Pathog Dis. 2009;6:793–806. DOIPubMed

Langer AJ, Ayers T, Grass J, Lynch M, Angulo FJ, Mahon BE. Nonpasteurized dairy products, disease outbreaks, and state laws—United States, 1993–2006. Emerg Infect Dis. 2012;18:385–91. DOIPubMed

Buzby JC, Gould LH, Kendall ME, Timothy FJ, Robinson T, Blayney DP. Characteristics of consumers of unpasteurized milk in the United States. J Consum Aff. 2013;47:153–66.

David SD. Raw milk in court: implications for public health policy and practice. Public Health Rep. 2012;127:598–601 .PubMed

National Association of State Departments of Agriculture. NASDA releases raw milk survey 2011 [cited 2012 Nov 2]. http://www.nasda.org/file.aspx?id=3916

National Association of State Departments of Agriculture. Dairy division of national association of state departments of agriculture raw milk survey, November, 2004 [cited 2012 Nov 2]. http://www.nasda.org/File.aspx?id=1582

National Association of State Departments of Agriculture. NASDA releases raw milk survey 2008. [cited 2012 Nov 2]. www.nasda.org/File.aspx?id=2149

Longenberger AH, Palumbo AJ, Chu AK, Moll ME, Weltman A, Ostroff SM. Campylobacter jejuni infections associated with unpasteurized milk—multiple states, 2012. Clin Infect Dis. 2013;57:263–6. DOIPubMed

Suggested citation for this article: Mungai EA, Behravesh CB, Gould LH. Increased outbreaks associated with nonpasteurized milk, United States, 2007–2012. Emerg Infect Dis [Internet]. 2015 Jan [date cited]. http://dx.doi.org/10.3201/eid2101.140447

1 child dead: Safety of food a mystery – even to Cambodia gov’t

In Tbong Khmum, an otherwise reportedly healthy 6-year-old girl’s death, after eating snacks suspected to be contaminated, has prompted a local food-poisoning scare and raised larger questions about the safety of Cambodia’s food distribution.

2541200628_948fb10627On November 15, three girls in Dambe district started seizing and vomiting, according to the district authorities.

One of the girls was particularly badly affected. After 24 hours of severe gastrointestinal symptoms and convulsing, her parents headed to the provincial hospital, but she died before a doctor could see her, the village chief told the Post.

Though no cause of death has been confirmed, local officials blamed two packaged imported snacks the girls shared hours before becoming ill.

The village chief confiscated the remaining packages for sale, and the provincial Health Department sent samples to labs in Phnom Penh. But after two weeks, the samples failed to test positive for a contaminant, which didn’t surprise the health workers.

“Cambodia doesn’t have lab equipment for checking this kind of sample,” said Keo Vannak, director of the provincial Health Department, adding that the treats have been sent abroad for better analysis.

While questions remain about what caused the girls’ sickness, the village is in a panic about its food supply.

“Our villagers are scared to buy packaged foods,” said Phath Sath, the village chief.

Despite confronting an enormous problem of nutrient wastage through diarrheal diseases – which kill millions annually – there is no “coordinated program of food surveillance and little analytical data regarding microbiological or chemical contamination of food” in Cambodia, the government says.