Foodborne illness outbreaks from microbial contaminants in spices, 1973-2010

Posted on May 9, 2013 by Doug Powell

Spices are something people, food service and even manufacturers may pooh-pooh when considering the risks of microbial contamination. Black pepper, white pepper, red pepper, rainbow pepper, curry, anise, fennel, turmeric, broccoli powder and mixtures. Don’t get me started on herbs. Van Doren et al. review spice related outbreaks in Food Microbiology; abstract below:

This review identified fourteen reported illness outbreaks attributed to consumption of pathogen-contaminated spice during the period 1973-2010. Countries reporting outbreaks included Canada, Denmark, England and Wales, France, Germany, New Zealand, Norway, Serbia, and the United States. Together, these outbreaks resulted in 1,946 reported human illnesses, 128 hospitalizations and two deaths. Infants/children were the primary population segments impacted by 36% (5/14) of spice-attributed outbreaks. Four outbreaks were associated with multiple organisms. Salmonella enterica subspecies enterica was identified as the causative agent in 71% (10/14) of outbreaks, accounting for 87% of reported illnesses.Bacillus spp. was identified as the causative agent in 29% (4/10) of outbreaks, accounting for 13% of illnesses. 71% (10/14) of outbreaks were associated with spices classified as fruits or seeds of the source plant. Consumption of ready-to-eat foods prepared with spices applied after the final food manufacturing pathogen reduction step accounted for 70% of illnesses. Pathogen growth in spiced food is suspected to have played a role in some outbreaks, but it was not likely a contributing factor in three of the largerSalmonella outbreaks, which involved low-moisture foods. Root causes of spice contamination included contributions from both early and late stages of the farm-to-table continuum.

Food MicrobiologyJane M. Van Doren, Karen P. Neil, Mickey Parish, Laura
Gieraltowski, L. Gould hannah, Kathy L. Gombas.

http://translate.google.com/translate?sl=fr&tl=en&u=http://www.sciencedirect.com/science/article/pii/S074000201300083X

Raw milk sickened scores despite inspections

Posted on May 5, 2013 by Doug Powell

The majority of those sickened in raw milk outbreaks is children under 10-years-old. And there’s good immunological reasons for that. If adults want to take the risk with raw milk, they will, just like with cigarettes and alcohol. But parents generally don’t have a scotch and smoke with their 4-year-olds.

That’s what I told Karen Rowan of My Health News Daily in her report about a report appearing in Clinical Infectious Diseases, summarizing a Jan. 2012 campylobacter outbreak linked to raw milk that sickened 148 people in four states.

The dairy that sold the milk had a permit for selling unpasteurized milk, and had passed all inspections. The farm was among the largest sellers of unpasteurized milk in the state.

The dairy also tested its own milk for E. coli bacteria more often than was required. The vast majority of the sick people drank the milk before its “best by” date.

The only deficiencies that investigators found were that a mechanical milk bottle capper was broken, so employees had capped the bottles by hand, and that the water used to clean equipment was cooler than recommended (110 to 120 degrees Fahrenheit, instead of 160 to 170 degrees F).

But these issues were “minimal,” and this campylobacter outbreak demonstrates “the ongoing hazards of unpasteurized dairy products.”

Douglas Powell, a professor of food safety at Kansas State University advises that raw milk not be given to children. “As adults, you’re free to choose. But don’t give it to your kids.”

The people sickened in the outbreak ranged in age from 2 to 74, the report said. Typically, campylobacter infections cause diarrhea, abdominal pain and fever that last about a week, and most people get better on their own. In the outbreak, 10 people were hospitalized.

The dairy immediately suspended unpasteurized milk sales when it was informed of the outbreak.

The researchers recommended that state ofﬁcials consider more regulation of unpasteurized milk, such as monthly pathogen testing.

Mysterious illness sickens coroner’s conference attendees in Missouri

Posted on March 15, 2013 by Doug Powell

How gruesome is this: dozens attending a coroner’s conference at the Truman Hotel & Conference Center became ill after dinner Wednesday night.

Capital Region Medical Center confirmed seeing a few people that night and Thursday in the emergency department. One person was hospitalized, but a hospital spokesperson said the patient had a pre-existing condition that was aggravated by the sudden illness.

The wife of Randolph County coroner Gerald Lundsford told connect midmissouri that, as of Thursday evening, her husband was still feeling awful.

No word on exactly how many people were affected. The source of the illness is also unknown at this time.

376 sickened; pet frogs linked to salmonella outbreak in kids

Posted on March 11, 2013 by Doug Powell

More reasons for the parents at school to hate me. 376 reasons.

Small water frogs marketed and sold as pets are linked to an outbreak of Salmonella infections from 2008 to 2011, according to a report from the U.S. Centers for Disease Control and Prevention (CDC).

The report published in Pediatrics on Monday found the infection sickened 376 people in 44 U.S. states and sent 29 percent of those infected to the hospital – mostly children.

“This was the first Salmonella outbreak associated with aquatic frogs, and in this case the frogs are often marketed as good pets for kids,” said Shauna Mettee Zarecki, the study’s lead author from the CDC in Atlanta.

“The majority of people didn’t realize there were any risks from these amphibians or other amphibians, like turtles and snakes,” she added.

While most people hear about Salmonella-contaminated food, Zarecki said reptiles and amphibians also carry the bacteria. Humans can become infected after handling the animals, cleaning their containers or coming in contact with contaminated water.

In the new report, Zarecki and her colleagues write that researchers from the CDC – along with state and local health departments – investigated an outbreak of Salmonella infections, mostly among children, in 2008.

By early 2009, the number of cases returned to normal before the researchers could find a cause. The investigation was started again when five more children were infected with the same strain of Salmonella in Utah later that year.

To find what was behind the outbreak, the researchers interviewed people who were infected with that strain of Salmonella from January 2008 through December 2011. They asked each person what animals and food they were exposed to in the week before they got sick.

They then compared the data from 18 people with that strain of the bacteria to 29 people who were infected with a different type of Salmonella.

Overall, they found 67 percent of the people in the new outbreak were exposed to frogs during the week before their illness, compared to 3 percent in the comparison group.

The majority of people who came in contact with a frog during the week before they got sick remembered the type – an African dwarf frog.

The investigation eventually led to an African dwarf frog breeding facility in Madera County, California. There, researchers found the same strain of the bacteria in the facility’s tank water, tank cleaning equipment, water filters and floor drains.

The facility started distributing frogs again in June 2011, after the owner voluntarily shut down the operation and instituted cleaning measures.

The researchers write, however, that African dwarf frogs can live for five to 18 years, which means infected frogs may still be in homes and continue to cause illness.

“The important consideration with any aquatic pet is to provide adequate filtration to keep the water clean and perform regular partial water changes,” said Dr. Nicholas Saint-Erne, a veterinarian for PetSmart, Inc., in a statement to Reuters Health.

“If these aquariums are in homes, children under five (years old) shouldn’t be allowed to clean the aquarium,” said Zarecki, adding that also applies to people with weakened immune systems.

“Pets are wonderful. We think they’re a great learning tool for children, but some pets just aren’t appropriate for children or individuals,” she added.

250 prisoners in Quebec City ill with food poisoning

Posted on March 10, 2013 by Doug Powell

Some 250 prisoners and 25 employees of a Quebec City prison have been ill since last night with what the director of Public Health is calling food poisoning.

CBC News reports a dishwasher at the prison, in the Charlesbourg borough of Quebec City, may be the cause. The hot steam cycle of the machine, which sterilizes the dishes, had stopped working.

The dishwasher was reportedly installed four weeks ago.

The kitchen has been closed, and prisoners and personnel still at the detention centre were fed a catered lunch today.

Epidemiology witches don’t get enough credit

Posted on January 16, 2013 by Ben Chapman

Foodborne illness outbreaks are messy. Not just for the unlucky individuals feeling the consequences in the bathroom, but for investigators and business owners. An outbreak is rarely solved with a smoking gun (like a pile of deer poop). Often the source is determined by the Nate-Silveresque witches in the epidemiology department. I’m in awe of the folks who take the available data well after an incident happens and utilize statistics to uncover clues to a vomit or diarrhea mystery.

Looking at the predictable responses that often pop up from business operators during an outbreak investigation, I’m not sure a lot of other folks outside the food safety world share this awe. All they seem to want to see are test results.

Count Ming Chang of Ming’s Sushi and Dimsum in the ever-so-exciting home of the Petes, Peterborough, Ontario (that’s in Canada) as someone who needs to see a Salmonella-positive sample to be convinced.

Lance Anderson of My Kawartha quotes Chang as saying, “They found nothing” (meaning no positive samples).

Ming Chang, owner of the Lansdowne Street West restaurant, says the local health unit gave the green light to reopen morning after all salmonella testing turned up negative results.

According to the health unit, in December 18 salmonella cases were identified from patrons who had eaten at the restaurant.

Mr. Chang isn’t convinced to outbreak started at his restaurant considering all tests the health unit conducted came back negative.”It could have come from anywhere,” he adds (yeah, but the epidemiological data the health unit has seems to point to Ming’s).

Mr. Chang says the health unit shut him down after some people got sick even though salmonella wasn’t found in the business. “They went on people’s testimonies. Basically I was found guilty before being proven guilty,” says Mr. Chang.”We’ve passed all our inspections here for the past two years.”

Maybe epidemiology’s image needs a makeover. If only it was called Kardashiology, maybe folks would pay attention.

East London pub holiday dinner linked to deadly Clostridium perfringens outbreak

Posted on January 4, 2013 by Ben Chapman

The holiday season seems to bring out the worst food safety outcomes in food businesses and in homes. Sometimes the illnesses are linked to big family or community dinners prepared by folks who aren’t used to cooking for crowds. Other times, outbreaks are linked to restaurant staff that take time-saving shortcuts by cooking lots of food ahead and not handling it well before service.

Looks like the latter has happened in the UK and tragically has resulted in a death. According to BBC News, a mother of a 14-year-girl and at least 30 people became ill from a Christmas Day meal served at the Railway Hotel. Investigators subsequently recovered Clostridium perfringens from stool samples.

[Della] Callagher’s husband John said he took her to hospital on Boxing Day but is angry doctors told her to go home.
“We went to hospital and she had an injection then they told her to go home and lay down,” he told BBC London.

“There was no blood test.”
He said she got worse the next day and was taken to hospital where she died.

“If she was rolling around on the floor they would have admitted her – but because she was dignified she wasn’t,” he said. “We have been working with environmental health officers at Havering Council to identify the cause of illness and any links to food eaten at the venue.

A spokeswoman for The Railway Hotel, which remains open, offered condolences to the family. She added: “We are fully co-operating with the environmental health and Health Protection Agency teams while they conduct a thorough investigation.

“However until this investigation is complete we can’t speculate about the possible cause or source.”

Clostridium perfringens spores often survive cooking but are not a problem until the food is held at an improper temperature. Precooked not reheated to 165°F and hot-held above 135°F ~~increases~~ decreases the chance that any vegetative cells still present will survive and wont allow any remaining spores to germinate and outgrow to form more cells.

I think my house is contaminated with norovirus; it’s only a matter of time before it gets to me

Posted on January 3, 2013 by Ben Chapman

The outbreak cluster index case was an 18-month-old girl puking all over her bed. And her mom. Case 2 was the mom, who spent 12 hours in and out of the bathroom a day later. Case 3 was the 18-month-old’s grandfather who was sharing a bathroom with the mom.

Our guest bathroom.

The grandfather, known to my kids as Pop-Pop, spent a next night in the bathroom and was still recovering when he set out on a 14 hour drive back to Canada.

I swear it wasn’t our cooking.

Through my amateur epidemiology I think my house is now contaminated with norovirus and it’s only a matter of time before it gets to me. Even though I’ve hit the toilet with a bunch of chlorine (I went with the 5,000ppm CDC recommends) it’s a waiting game.

Puke and diarrhea from an individual ill with norovirus is particularly problematic as each gram of, uh, matrix contains millions of virus particles that are ready to infect, replicate and be expunged out towards the next host. It’s a pretty awesome biological cycle. Most of what is known about spread of noro from vomit to comes from outbreak investigations. Proximity to the event is related to attack rates (closer to the puddle and spray = increased likelihood for illness). Toilets can also be a source of spread (with a flush comes aerosolization).

In what has become one of my favorite ideas, some folks in the UK are testing out a vomit-spewing machine to evaluate spread of virus particles.

At the Health and Safety Laboratory in Derbyshire, northern England, where researcher Catherine Makisondeveloped the humanoid simulated vomiting system and nicknamed him “Vomiting Larry”, scientists analyzing his reach found that small droplets of sick can spread over three meters.

“The dramatic nature of the vomiting episodes produces a lot of aerosolized vomit, much of which is invisible to the naked eye,” Goodfellow told Reuters.

Larry’s projections were easy to spot because he had been primed with a “vomitus substitute”, scientists explain, which included a fluorescent marker to help distinguish even small splashes – but they would not be at all easily visible under standard white hospital lighting.

It may seem like an idea hatched in a dorm room, but machines like this are important for the food and food service industry. Recommendations for cleaning and sanitizing after a puke event need to be built on the data that something like Vomiting Larry can provide – do I need to pay as much attention to the light switch or faucet as I did the toilet bowl, lid and handle? There isn’t a whole lot of evidence to dictate practices.

248 sick, mainly kids, from six multistate outbreaks of human Salmonella infections linked to small turtles

Posted on December 7, 2012 by Doug Powell

A total of 248 persons infected with the outbreak strains of Salmonella Sandiego, Salmonella Pomona, and Salmonella Poona have been reported from 34 states, up from 219 in October.

The U.S. Centers for Disease Control reports:

• 28% of ill persons have been hospitalized, and no deaths have been reported;

• 68% of ill persons are children 10 years of age or younger, and 33% of ill persons are children 1 year of age or younger;

• 49% of ill persons are of Hispanic ethnicity and information about the association between reptiles and Salmonella is now available in Spanish;

• results of the epidemiologic and environmental investigations indicate exposure to turtles or their environments (e.g., water from a turtle habitat) is the cause of these outbreaks;

72% of ill persons reported exposure to turtles prior to their illness;

89% of ill persons with turtle exposure specifically reported exposure to small turtles (shell length less than 4 inches); and,

• 34% of ill persons with small turtles reported purchasing the turtles from street vendors, and 17% reported purchasing small turtles from pet stores.

Small turtles are a well-known source of human Salmonella infections, especially among young children. Because of this risk, the Food and Drug Administration has banned the sale and distribution of these turtles as pets since 1975. Turtles with a shell length of less than 4 inches in size should not be purchased as pets or given as gifts.

The full report is available at http://www.cdc.gov/salmonella/small-turtles-03-12/index.html.

Norovirus experts discuss advancing sanitation and diagnostic science while outbreak highlights importance

Posted on November 8, 2012 by Ben Chapman

I hung out at the NoroCORE annual meeting in Atlanta this week and heard about new science on detection, inactivation, prevention and surveillance from a group of collaborators brought together by my friend and colleague Lee-Ann Jaykus. NoroCORE is a collaborative supported by USDA-NIFA through a big $25 million 5-year grant.

Throughout the day, industry, regulatory and consumer stakeholder groups brought up lots of research, outreach and extension needs: Stuff like how do we get beyond outbreaks being a poor indication of virus disease burden; how should folks who are ill from handling foods prepared for others; how much norovirus starts out as foodborne and how much is secondary person to person transmission; and, how much does cleaning and sanitizing after a noro outbreak vary from routine sanitation.

As the U.S. north east deals with a, uh, nor’easter following superstorm/frankenstorm/hurricane Sandy there are still folks without power who seeking heat and food at shelters.

A norovirus outbreak (maybe foodborne, but probably person-to-person is sweeping through at least one of the shelters. According to the NY Times:

Some men and women returned to the school, on West 49th Street, late Monday night after being bused to other shelters that would not take them in, including the John Jay High School campus in Park Slope, another makeshift evacuation center. It was coping with an outbreak of norovirus, a common and highly contagious intestinal bug. The virus has hit 13 children since Friday, and that building’s reopening as a school was delayed until Thursday, after all the people were moved out and it underwent a thorough cleaning.
Jay Varma, the deputy commissioner for disease control at the city’s Department of Health and Mental Hygiene, said the outbreak was not surprising, considering the time of year and the fact that “these are schools and there wasn’t an expectation that they would be long-term facilities for the homeless.”

He said that the virus could not live for long after the school was disinfected and cleaned. “We don’t think there is a risk to students after they get back to school,” he said.
The zeal for sanitizing was strong at Graphic Arts, where reports of floors used as toilets spurred outrage and alarm. But there, as at other evacuation centers being partially or completely cleared for students, the evacuees said they had no better options. And they offered another perspective on the bathroom problems.

“Some are disabled and seniors,” said John Lewis, a man with an unkempt gray beard who said he worked in the kitchen of a private Hasidic school in Brooklyn before problems with his landlord left him living on the streets in Chelsea. “Some are not able to move fast enough to make it to the toilet. Some couldn’t make it to the third floor,” where the only bathroom available to the men was located. It had one working toilet.

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