‘We strongly advise you not to Google search ‘Hepatitis A’ as you may access inaccurate and possibly worrying information.’

I play hockey with a bunch of technology nerds and last night’s post game dressing room chatter included a discussion on recalled emails. Instead of the intended message of ‘oh, I made a mistake, don’t read that last one,’ it leads to increased attention and urgency in reading the recalled message to see what the sender didn’t want you to see.

Sort of like telling someone not to Google something likely leads to that person immediately Googling it.yorkshire-puddings

That’s what a school in the UK did in an effort to reduce panic after 20 cases of hepatitis A was identified in a couple of schools, according to the Yorkshire Evening Post.

An outbreak of Hepatitis A in two Leeds schools has seen national health chiefs offer mass vaccinations in the LS9 area.

Public Health England (PHE) stepped in after around 20 cases of the rare virus were confirmed in the area, sparking a vaccination program that will impact thousands of school staff and residents.

The YEP understands that the 630-pupil Richmond Hill Primary School, in Clark Lane, and 460-pupil Brownhill Primary Academy, in Torre Drive, are the two schools where all staff and pupils are being immunized.

A message put out to parents at Richmond Hill Primary School urges them not to “panic” over the situation. It reads: “We strongly advise you not to Google search ‘Hepatitis A’ as you may access inaccurate and possibly worrying information.”

PHE is working with Leeds City Council and the NHS in Leeds to vaccinate those most likely to have come into contact with the carriers. Around 300 people have taken up the vaccine when offered so far, and PHE is stressing that anyone who has not yet been offered the vaccination does not need it at the current time.

There were only 367 reported cases of Hepatitis A infection in England and Wales during 2010.

I Googled hepatitis A and found some good information sources.

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San Jose restaurant no longer gettin’ shiggy wit it

Marisco’s San Juan #3 restaurant linked to 200 cases of shigellosis is due to be open for business tomorrow according to KCRA. Although a source of the outbreak wasn’t confirmed, the working theory is that an infected food handler was to blame.

The Department of Environmental Health reinspected Marisco’s San Juan #3, which has been closed since Oct. 18, and approved it for reopening after finding it no longer poses a risk to public health from shigella bacteria, officials said.

County officials said the restaurant’s owners voluntarily discarded all food products on site, cleaned and sanitized the facility and retrained all employees in proper food handling methods. Employees who tested negative for shigella are being allowed to return to work.

Health officials determined that an outbreak of illness connected with the restaurant at 205 N. Fourth St. that caused 190 people to become sick was caused by shigella, a contagious diarrhoeal illness.

The source was most likely from an infected food handler at the restaurant who contaminated the entrees with their hands, officials said. But the exact source of the outbreak has not been determined, and officials have said it might never be identified.

Keep food out of animal education events

Next week I’m tagging along on a field trip with Jack’s first grade class. They’ve been studying the solar system and we’re headed to the planetarium to view the stars and learn about space missions.

No animal exhibits involved in this trip, but I’m sure those are in the future.

I plan on chaperoning any school trips the boys take to the farm, the fair or the petting zoo to help with the onsite risk management.070414.T.FF_.AGEDCENTER1

But, as today’s MMWR highlights, a lot of the disease risk stuff needs to be taken care of before with good planning and procedures.

Yeah, hand washing matters, but so does not letting kids bring lunch/snacks into a contaminated environment.

Or serving food directly in the barn to a 1,000 kids.

Or as Curran et al. say,  ‘These environments should be considered contaminated and should not be located in areas where food and beverages are served’
During April 20–June 1, 2015, 60 cases (25 confirmed and 35 probable) were identified (Figure). Eleven (18%) patients were hospitalized, and six (10%) developed hemolytic uremic syndrome. No deaths occurred. Forty primary cases were identified in 35 first-graders, three high school students, one parent, and one teacher who attended the event. Twenty secondary cases were identified in 14 siblings, four caretakers, and two cousins of attendees.

Food was served inside the barn to adolescents who set up and broke down the event on April 20 and April 24. During April 21–23 approximately 1,000 first-grade students attended the event, which included various activities related to farming. Crude attack rates were higher among those who assisted with setup on April 20 or breakdown on April 24 (three of 14 high school students; 21%) and among attendees on April 21 (22 of 254 students; 9%), than among attendees on April 22 (six of 377 students; 2%) and April 23 (seven of 436 students; 2%).

Animals, including cattle, had been exhibited in the barn during previous events. Before the dairy education event, tractors, scrapers, and leaf blowers were used to move manure to a bunker at the north end of the barn. Environmental samples collected in this area yielded E. coli O157:H7 PFGE patterns indistinguishable from the outbreak strains.

Although it might not be possible to completely disinfect barns and areas where animals have been kept, standard procedures for cleaning, disinfection, and facility design should be adopted to minimize the risk for exposure to pathogens (1). These environments should be considered contaminated and should not be located in areas where food and beverages are served. Hands should always be washed with soap and clean running water, and dried with clean towels immediately upon exiting areas containing animals or where animals have been kept previously, after removing soiled clothing or shoes, and before eating or drinking. Event organizers can refer to published recommendations for preventing disease associated with animals in public settings.

Here’s a set of guidelines we came up with for folks to use when choosing whether to take a trip to these animal events.




There’s a lot of norovirus in Nevada schools

The famed winter vomiting virus appears to be making life miserable for Nevada school kids. According to the Reno Gazette Journal over 1700 students in 20 schools have had the virus over the past 5 weeks and the outbreak appears to be spreading.

The case count might be real or it might be inflated due to self reporting (kids who want to stay home) or protective parents who don’t want noro in their house (keeping their kids home).

An outbreak of norovirus has reached such heights in local public schools that health officials stopped counting the number of people infected by the highly contagious illness, which causes days of diarrhea and vomiting.200187143-001

But the Washoe County Health District estimates – based on schools’ absenteeism and reported illnesses – that 1,760 students and staff have been afflicted at 20 schools and a few daycare centers, quadrupling the number of infections since the outbreak started at half as many schools on Oct. 1.

“We were hopeful it wouldn’t get to this point,” said county Director of Epidemiology Randall Todd, noting the virus’ rapid spread to a new school every few days.

The health district has advised the Washoe County School District and families to do three things at outbreak schools, which are concentrated in northern Reno, Spanish Springs and Sparks. The health district isn’t identifying the affected daycare centers.

Disinfect high-traffic areas of the school where surfaces are repeatedly touched, such as railings, desks, chairs and doors. Thoroughly clean and disinfect the area around a vomiting incident up to a 25-foot radius.

Wash hands frequently with soap and water — antibacterial hand-sanitizer does not kill the virus.

Sick students and staff must stay out of school for 72 hours after their last symptoms.

Such a “substantial outbreak” wouldn’t be possible if parents and staff were following all three protocols advised for outbreak schools, said Todd, positing that at least one recommendation isn’t being followed.

The health district hasn’t recommended closing any schools, and school officials said they don’t want to go there either for the sake of academics.

But they’re in luck. The week-long fall break starts Monday.

“We’re keeping our fingers crossed that fall break will give us the boost we need to put this behind us,” said Todd.

Some people in Canada have Salmonella Infantis; 8 hospitalized

According to the Public Health Agency of Canada, 34 individuals in 8 provinces have Salmonella. No source has been identified. S. Infantis has been linked to live poultry, chicken meat and dry dog food in the past few years.

The Public Health Agency of Canada is collaborating with federal and provincial public health partners to investigate an outbreak of Salmonella infections in eight provinces. At this time, no source has been identified and the investigation is ongoing.canada

Currently, there are 34 cases of Salmonella Infantis illness in eight provinces: British Columbia (3), Alberta (6), Saskatchewan (2), Manitoba (2), Ontario (16), Quebec (3) Nova Scotia (1), and New Brunswick (1). Individuals became sick between June 12 and September 20, 2015. The majority of cases (62%) are female, with an average age of 41 years. Eight people have been hospitalized, and all have recovered or are recovering. No deaths have been reported.

What me worry? Growers worry over critical media coverage of food

This is just dumb. Stop whining to your pals and start providing food safety information to tell your story.

what.me.worryYuma County’s nearly $3 billion agriculture industry is responsible for a large percentage of its total prosperity, and local cities and businesses are working to further expand its influence with agritourism-based attractions and events.

But many industry figures said they’re worried about critical media coverage cutting into consumer demand for Yuma-grown crops at last week’s Southwest Arizona Futures Forum session about preserving the area’s water supplies.

A paragraph near the top of the “plan of action for Yuma” compiled at the end of the all-day meeting attended by more than 100 began with, “the community must directly address negative ads and comments regarding the agriculture industry with positive facts about regarding efficient food production and the importance of food safety.”

Attendees of the conference cited articles such as an August column in The Washington Post, “Why Salad is So Overrated,” by contributor Tamar Haspel, who said the dish which employs so many of the vegetable crops grown in the Yuma area “has almost nothing going for it. It occupies precious crop acreage, requires fossil fuels to be shipped, refrigerated, around the world, and adds nothing but crunch to the plate.”

‘Elementary school kids, younger kids probably aren’t the best when it comes to hygiene’

We’ve successfully made it through a couple of months of school in our house without any illnesses. I’m not sure if my kids’ recent obsession with handwashing is a factor (I suspect it is) or whether we’ve just been lucky.

Kids and norovirus are a common pair. Last month an estimated 700 students missed school in Person County, NC with the virus (or stayed home to avoid it; only two cases were confirmed). Today, AP reports that 400 kids in northern Nevada at 11 schools likely have noro.norovirus-2

The Washoe County Health District said it believes the norovirus outbreak first started on Sept. 16 at a Reno elementary school, where 150 students and 11 staff members have reported symptoms, including nausea, vomiting, diarrhea and abdominal cramping.

As of Friday, the Washoe County School District reported that the outbreak had spread to 9 other elementary schools, a high school and some associated daycare centers. It has been centered in Reno, with one Sparks elementary school.

Most of the nearly 400 people affected have been elementary school children. The high school teachers who were sickened also traced their illnesses to the affected elementary school kids, whom they were related to.

“Elementary school kids, younger kids probably aren’t the best when it comes to hygiene,” said Phil Ulibarri, a county health department spokesman.

The school district has also been advised to thoroughly clean schools, which Ulibarri said means sanitizing a 25-foot radius where there is vomiting or diarrhea, including going as high as six feet up along walls.

Awesome, the Nevada folks are using the best available science.

Fortune looks at the business of food safety and Blue Bell

Powell has often used the term, making people sick is bad for business; or as Fortune Magazine alliterates, the food industry has a $55.5 billion problem. Peter Elkend and Beth Kowitt of Fortune published sister pieces on the intersection of food safety and business focusing on Blue Bell’s recent listeria outbreak and re-entry to the marketplace.

Kowitt writes,

Food-borne illness is a giant, expensive challenge for companies big and small—and the surprise is, their exposure to the risk (and the liability when linked to an outbreak) is arguably bigger than ever. “Thirty years ago if you had a little problem, you were not going to get discovered,” says David Acheson, former associate commissioner for foods at the U.S. Food and Drug Administration, who today runs a consulting firm. “Now the chances of getting caught are significant, and it can be the end of your company.”acf7763f-9190-4bd1-8e69-ae99293596d0

For instance, since 2006 investigators have fingered a bacterial strain called E. coli O157:H7 (at one time widely thought to be found only in meats) in bags of baby spinach, in hazelnuts, and in cookie dough. They’ve identified botulism in pasteurized carrot juice and found salmonella in peanut butter, ground pepper, jalapeño peppers, Turkish pine nuts, and pistachios. They’ve discovered hepatitis A virus in pomegranate seeds; cyclospora in bagged salad mix; and Listeria monocytogenes in ice cream.

“I’m skeptical that these are new connections,” says Ben Chapman, associate professor of food safety at North Carolina State University, who runs a website called the Barfblog (I meant new pathogen/food contamination -ben). “It’s stuff that’s always been there, and now we’re looking for it.” That would help explain why FDA-regulated food recalls have more than doubled over the past decade, to 565 last year, according to insurance company Swiss Re—with nearly half related to microbiological contamination. In interviews with more than 30 experts, nearly all said the rise in recalls was less an indicator of deteriorating food safety than it was of our improving capacity to connect the dots between foods and microbes.

Molecular techniques (PFGE to whole genome sequencing) also get a shout out from friend of barfblog, Linda Harris.

Up until the 1990s, most outbreaks we found were in the same geographic location—the church picnic where everyone eats the same bad potato salad and calls in sick the next day. Then new technology enabled scientists to determine the various DNA fingerprints of food-borne bacteria, which were uploaded into a common database. Investigators were suddenly able to link disparate cases of illness by finding bacterial matches. “It revolutionized outbreak investigation,” says Linda Harris, a microbiologist in the department of food science and technology at the University of California at Davis.

Whole genome sequencing is the biggest advance I’ve seen in my 15 years in food safety.

In the Blue Bell piece, Peter Eklund writes,

The episode reveals not only how difficult it is to trace the source of food-borne illness but also what happens when a company is slow to tackle the causes—and doesn’t come clean with its customers. Experts say Blue Bell’s responses this year were an example of “recall creep.” That occurs when executives hope that taking limited action—as the company did five times when informed of findings of listeria—will solve the problem and minimize commercial damage, only to find themselves forced to expand the recall repeatedly. It’s the opposite of Johnson & Johnson’s actions in the 1982 Tylenol-tampering episode, when the brand famously saved its reputation by swiftly recalling every bottle of the medication.

blue-bell-ice-cream-600Eklund and I spoke a lot about Blue Bell’s sharing of information specifics, which I’ve criticized as lacking. When a company is linked to illnesses and deaths and they say stuff like ‘food safety is important to us’ or ‘we’re going to step up what we are doing around microbiolgical sampling, cleaning and sanitation’ or ‘we’re hiring the best’ it often lacks substance. Sure, tell folks what you are doing but more important is pulling back the curtain on how many samples, what they are looking for, how they determined where and what to look for and what they are going to do if they find an issue. That’s what we mean by marketing food safety.

But Eklund quotes Gene Grabowski, a PR consultant involved in Blue Bell’s response as playing the we’re sorry and trust us game,

“In my playbook, you apologize sincerely once and then you move on.” (He has been supplanted by a team from PR giant Burson-Marsteller led by Karen Hughes, who served as a top White House communications adviser to George W. Bush.) “Had the company known then what it knows now,” Grabowski says, “it would have done a full recall of all products earlier than it did.”

Two decades into the world of online discussions, immediate news exchange, and Twitter flame wars and some are still sadly following the apologize and move on approach.

Food Safety Talk 80: Literally the hummus I’m eating

Food Safety Talk, a bi-weekly podcast for food safety nerds, by food safety nerds. The podcast is hosted by Ben Chapman and barfblog contributor Don Schaffner, Extension Specialist in Food Science and Professor at Rutgers University. Every two weeks or so, Ben and Don get together virtually and talk for about an hour.  They talk about what’s on their minds or in the news regarding food safety, and popular culture. They strive to be relevant, funny and informative — sometimes they succeed. You can download the audio recordings right from the website, or subscribe using iTunes.1442690399236

The show opens with a discussion of Don’s mic stand and quickly segues into “Linda’s Famous Cigar Story”, and Ben’s annual pollen throat. After a discussion of their various ailments, Don wishes Ben an almost 37th birthday.

Ben is currently expecting a new macbook, which was discussed on Episode 116 of the Talk Show. Don shares his recent experiences looking at Apple Watch in the Apple Store, and his preference for the Milanese Loop and his new burr grinder and aeropress.

When the talk turns to food safety, Ben talks about his work with Family & Consumer Sciences in North Carolina, (called Family and Community Health Sciences at Rutgers University) and how Ben has recently changed his training practices from classroom lecture to supermarket and restaurant inspection field trips based on inspiration from Dara Bloom.

This inspires Don to talk about the work he’s doing to help documentary film makers doing a story on shelf life dating of foods especially milk. Ben shares some of the myths circulating about expired milk including this bogus article from Livestrong, and the work he’s doing on expired food and food pantries.

From there the discussion moves to other shelf life myths including the egg float or shake tests, and why they are bogus, as well as places to go for good egg information, because someone on the Internet will always be wrong.

The discussion turns to recalled hummus recall messaging and Ben’s post hockey snacking tips.

As the guys wrap up the show they briefly talk about Blue Bell ice cream and the doses of Listeria that might have made people sick and the future of food safety given the advances in molecular biology, clinical microbiology and whole genome sequencing. Ben shares some final thoughts on Salmonella in spices and how whole genome sequencing might impact that industry too.

In the brief after dark, Ben and Don talk about yoga, and getting healthy, the Turing Test, and the new Star Wars movie trailer.

Person County NC has a lot of norovirus

Or so it seems.

CBS is reporting that almost 700 students, about 14% of the district, missed school today due to gastro illnesses that appear to be from norovirus, according to CBS News.

Superintendent Danny Holloman said there were 668 absences in the district Thursday, or 14 percent of the student population. Most of the absences came from Person High School, where more than 300 students stayed home.10849902_719581291471357_3442145704847569295_n1-300x3001-300x300

Holloman said it’s not known how many students are actually sick and how many stayed home as a precaution.

CBS Raleigh affiliate WRAL reports Holloman realized something was going around just before lunch time yesterday, when large numbers of students were going home sick.

According to the Person County Health Department, a local doctor’s office experienced a similar situation with several patients and staff members coming down with virus-like symptoms last week. The North Carolina Division of Public Health asked that samples be collected from students to use for testing. The samples will be tested for both norovirus and other enteric pathogens, officials said.