Pay attention to food sources: Restaurant inspection grades and illness

Restaurants are important settings for foodborne disease outbreaks and consumers are increasingly using restaurant inspection results to guide decisions about where to eat. Although public posting of inspection results may lead to improved sanitary practices in the restaurant, the relationship between inspection results and risk of foodborne illness appears to be pathogen specific.

belgium-rest_-inspect-13To further examine the relationship between inspection results and the risk of foodborne disease outbreaks, we evaluated results of routine inspections conducted in multiple restaurants in a chain (Chain A) that was associated with a large Salmonella outbreak in Illinois. Inspection results were collected from 106 Chain A establishments in eight counties. Forty-six outbreak-associated cases were linked to 23 of these Chain A restaurants. There were no significant differences between the outbreak and non-outbreak restaurants for overall demerit points or for the number of demerit points attributed to hand washing or cross-contamination. Our analyses strongly suggest that the outbreak resulted from consumption of a contaminated fresh produce item without further amplification within individual restaurants. Inspections at these facilities would be unlikely to detect or predict the foodborne illness outbreak because there are no Food Code items in place to stop the introduction of contaminated food from an otherwise approved commercial food source.

The results of our study suggest that the agent and food item pairing and route of transmission must be taken into consideration to improve our understanding of the relationship between inspection results and the risk of foodborne illness in restaurants.

Understanding the relationships between inspection results and risk of foodborne illness in restaurants

Foodborne Pathogens and Disease. September 2016, ahead of print. doi:10.1089/fpd.2016.2137.

Petrona Lee and Craig W. Hedberg


2-year-old with E.coli returns to Ohio for treatment

There aren’t many experiences worse than caring for an ill child. In my seven years of fatherhood I’ve only dealt with my kids suffering through a handful norovirus infections, a lacerated gum and a cut requiring 14 stitches.

We’ve been lucky.

I get emotional when I read about others dealing with illnesses that are much scarier.Screen Shot 2016-07-05 at 11.11.12 PM

According to WHIO, Collette Dodson contracted pathogenic E. coli in Ivory Coast where her parents are missionaries.

The 2-year-old’s kidneys stopped functioning and she was unable to urinate for 10 days. Her kidneys are functioning at 50 percent now.

The child was first evacuated to a Paris hotel, but the family returned to the U.S. due Jenna Dodson also being pregnant.

“Coming to Dayton Children’s after spending time in hospitals in Africa and the hospital in Paris was like walking into Disney World,” father Justin Dodson said in a release. “The amenities here go above and beyond, and the staff was willing to drop everything to help our family.”

68 sick: 3.1 million ‘Sippee’ cups recalled due to mold

Sippy cups, those seemingly indestructible vessels that toddlers use to quench their thirst have a problem: mold can accumulate.

Tommee Tippee Sippee cupsI used to clean ours with toothpics or thin metal skewers, but that was after hundreds of uses.

Mayborn USA is recalling more than 3 million of their spill-proof Tommee Tippee Sippee cups. The recall affects five types of cups: First Sips Transition cup, Trainer Sippee cup, Sippee cup (including Cute Quips), Sportee bottle and Insulated Swiggle/Sippee tumblers.

All of them have a removable valve, which the Consumer Product Safety Commission says can develop mold if not cleaned well. The agency said 68 kids have gotten sick.

Their symptoms include vomiting and diarrhea, consistent with drinking from a cup containing mold.

Canadians go to Cuban resorts and report getting sick

In 2004 I visited the Dominican Republic, a popular Caribbean destination for Canadians attempting to escape the winter cold, wet and grey. Dani and I took advantage of her spring break and Millennium Scholarship (probably not what they were meant for) and spent a week sitting on the beach, eating buffets and playing scrabble.

It was pretty fun.100B8930

My food paranoia was focused on ice cubes, foods held at the wrong temperature and fresh fruits and vegetables. I don’t think I ate anything that wasn’t fried and stuck to beer all week. Dani wasn’t nearly as ridiculous as I was (she rarely is) and she tried lots of stuff.

The week was a success; not only did we get some Vitamin D, neither of us had any foodborne illness symptoms.

Not quite what recent Canadians visiting Cuba have reported, according to Global News.

Unsanitary washrooms, unsafe food handling practices, unrelenting stomach pains, vomiting and diarrhea: these are some of the complaints being reported about popular Canadian vacations destinations in Cuba promoted and operated by Sunwing Vacations of Toronto.

“It’s very severe, and I am struggling a week later,” said Amanda Klein of Medicine Hat, Alta., who recently returned from Cuba and says she is still experiencing stomach problems.

Klein, 26, spent a week with her boyfriend and two other Canadian couples at the Memories Paraiso Azul Beach Hotel in Cayo Santa Maria, Cuba between Jan. 5 and 12.

But within days of the Canadians’ arrival, Klein says five of the six guests were violently ill with vomiting and diarrhea.

Klein says the group stopped eating at the all-inclusive resort–which they booked through Sunwing Vacations–after witnessing troubling food-handling practices.

“Numerous staff put their hands in food, licked their hands and put their hands in the food we were supposed to eat,” she said.

Klein is among a growing number of Sunwing customers who contacted Global News to complain about becoming ill at the Memories Paraiso Azul resort. Many have posted their accounts of poor conditions and illnesses on Facebook and on

But, Sunwing says it’s is not aware of a significant problem at the resort in Cuba.

“To date the hotel management team at Memories Paraiso Azul has advised us that they have not been made aware of any such cases,” said Jacqueline Grossman, senior director of marketing for Sunwing Vacations.

Grossman says the health and wellbeing of its customers is the company’s “primary concern.”

She acknowledged, however, that travelers have reported illnesses to Sunwing.

“In the past week our customer service department has received information from 10 clients complaining of gastro-illness during their stay at this resort over the last month,” Grossman said.

Sunwing travellers say they got sick at other resorts in Cuba in the last month, too.

Food bugs: ‘You can’t stop what’s comin’ they aren’t waitin’ on you, that’s vanity’

My latest for Texas A&M’s Center for Food Safety: worst failure as a human is that many loving, generous and smart people want to help me.

And I don’t want their help.

But sometimes, people need help, even if they don’t know it.

I sliced the tip off my thumb while making the girls’ lunch – food safety risk – and after three hours of bleeding, I finally took my wife’s advice and ended up with a few stitches.

I apply these lessons to food safety. The outbreaks that occur, the terrible soundbites, the gross mismanagement and I wonder, why didn’t they seek help sooner?

Most of it is psychological, just like my resistance to seek help, or, as one correspondent wrote, “it simply can’t happen. Until it does.”

Top 10 signs someone may need microbial food safety help:

The bugs will keep on coming, and whether it’s pride or vanity, people will ignore the protective measures until they get caught.

Dr. Douglas Powell is a former professor of food safety who shops, cooks and ferments from his home in Brisbane, Australia.

DISCLAIMER: The views and opinions expressed in this blog are those of the original creator and do not necessarily represent that of the Texas A&M Center for Food Safety or Texas A&M University. 

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

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

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

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

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

-Do not eat raw shellfish.

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

-Discard any shellfish that do not open when cooked.

-Eat shellfish right away after cooking and refrigerate leftovers.

-Always keep raw and cooked shellfish separate.

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

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

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

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


You wanna win consumers, make test results public: Blue Bell, Foster Farms say government inspects us, like the Pinto

With Panera removing ingredients it can’t pronounce, and Chipotle further descending into food porn, it’s not surprising the Texas Department of State Health Services and Blue Bell Creameries have agreed to several requirements for Blue Bell to resume selling ice cream from its flagship Brenham plant.

pinto,explodingThey all assume people are stupid.

Blue Bell agreed to the requirements Thursday, which include notifying the health department at least two weeks before producing ice cream so officials can assess the company’s progress.

Foster Farms says it’s leading the poultry industry in controlling Salmonella (after sickening hundreds).

Market microbial food safety at retail so people can choose.

Tragic: Brittany Scadlock dies from pathogenic E. coli infection

Pathogenic E. coli is a horrible bacteria. Between O157 and non-O157 there are an estimated 175,000 illnesses, 2,400 hospitalizations and 20 deaths annually in the U.S.. But those just statistics. Behind each case is a real person. Like Sister Brittany Scadlock who tragically passed away in Brazil from an E. coli infection, according to Herald Extra.

Sister Brittany Scadlock, a 19-year-old missionary for The Church of Jesus Christ of Latter-day Saints, died Wednesday at a hospital in Sao Paulo, Brazil from an E. coli infection.550210f8bb2eb.preview-620

The West Haven resident was serving a mission in Argentina and had been transferred from her mission to the Sao Paulo hospital where she died.
Scadlock was a graduate of Roy High School and, according to media reports, was just 10 days shy of her 20th birthday.

According to family members, they just recently learned she was having medical issues. It was originally thought she was having problems with appendicitis. Unable to fight off the E. coli in her intestinal system, she went into cardiac arrest.

The family is seeking help in funding the transport of Scadlock’s body back to the United States and funeral arrangements 

Hotel guests get sick at Orlando Marriott

An outbreak of gastrointestinal upset that affected several dozen guests who attended a conference at the Orlando World Center Marriott is under investigation by the Orange County Health Department, officials said Thursday.

Orlando World Center MarriottThe guests stayed at the hotel between June 29 and July 7 and have all gone home, said Gary Dybul, director of sales and marketing for the resort. Health officials said it was too early to tell whether the illness was caused by a virus or was foodborne.

Symptoms included nausea, vomiting and diarrhea and lasted on average from 24 to 48 hours, said Dain Weister, health department spokesman.

Most of those affected were adult guests, but a handful of children also fell ill as well as one employee, Weister said. Most symptoms were minor, but one person went to the emergency room for treatment and was released.

Global incidence of human shiga toxin-producing Escherichia coli infections and deaths: a systematic review and knowledge synthesis

Objectives: Shiga toxin–producing Escherichia coli (STEC) are an important cause of foodborne disease, yet global estimates of disease burden do not exist. Our objective was to estimate the global annual number of illnesses due to pathogenic STEC, and resultant hemolytic uremic syndrome (HUS), end-stage renal disease (ESRD), and death.

shannon.2006 Materials: We searched Medline, Scopus, SIGLE/OpenGrey, and CABI and World Health Organization (WHO) databases for studies of STEC incidence in the general population, published between January 1, 1990 and April 30, 2012, in all languages. We searched health institution websites for notifiable disease data and reports, cross-referenced citations, and consulted international knowledge experts. We employed an a priori hierarchical study selection process and synthesized results using a stochastic simulation model to account for uncertainty inherent in the data.

Results: We identified 16 articles and databases from 21 countries, from 10 of the 14 WHO Sub-Regions. We estimated that STEC causes 2,801,000 acute illnesses annually (95% Credible Interval [Cr.I.]: 1,710,000; 5,227,000), and leads to 3890 cases of HUS (95% Cr.I.: 2400; 6700), 270 cases of ESRD (95% Cr.I.: 20; 800), and 230 deaths (95% Cr.I.: 130; 420). Sensitivity analyses indicated these estimates are likely conservative.

Conclusions: These are the first estimates of the global incidence of STEC-related illnesses, which have not been explicitly included in previous global burden of disease estimations. Compared to other pathogens with a foodborne transmission component, STEC appears to cause more cases than alveolar echinococcosis each year, but less than typhoid fever, foodborne trematodes, and nontyphoidal salmonellosis.

Applications: Given the persistence of STEC globally, efforts aimed at reducing the burden of foodborne disease should consider the relative contribution of STEC in the target population.

 Majowicz Shannon E., Scallan Elaine, Jones-Bitton Andria, Sargeant Jan M., Stapleton Jackie, Angulo Frederick J., Yeung Derrick H., and Kirk Martyn D..

Foodborne Pathogens and Disease. June 2014, 11(6): 447-455.