Resistant Salmonella causes 6,200 illnesses a year in US

Chris Dall of the Center for Infectious Disease Research Policy reports the U.S. Centers for Disease Control and Prevention (CDC) has published new estimates of the incidence of antibiotic-resistant Salmonella infections in the United States, putting the burden at about 6,200 cases annually.

ab-res-salmIn a report in Emerging Infectious Diseases, CDC researchers estimate the overall incidence of resistant salmonella infections as roughly 2 for 100,000 persons per year from 2004 to 2012They also determined that clinically important resistance was linked to four specific Salmonella serotyopes: Enteritidis, Newport, Typhimurium, and Heidelberg.

Nontyphoidal Salmonella causes an estimated 1.2 million foodborne illnesses and about 450 deaths each year, according to the CDC. While most people who get Salmonella infections recover within a week and do not require antibiotics, more severe infections are generally treated with either ampicillin, ceftriaxone, or ciprofloxacin. Resistance to these drugs can result in increased hospitalization, invasive illnesses, and death.

The new estimates are based on data from the US Census Bureau and from two surveillance systems the CDC uses to track Salmonella and drug-resistant Salmonella: The National Antimicrobial Resistance Monitoring System (NARMS) and the Laboratory-based Enteric Disease Surveillance (LEDS) system. NARMS monitors resistance in Salmonella by testing isolates from infected individuals and determining the percentage of isolates that show resistance. LEDS collects Salmonella surveillance data, including serotypes, from state and territorial public health labs.

The researchers defined three mutually exclusive categories of resistance for the study: ampicillin-only resistance, ceftriaxone/ampicillin resistance, and ciprofloxacin nonsusceptibility.

According to the LEDS data, there were 369,254 culture-confirmed Salmonella infections from 2004 through 2012. Four primary serotypes—Enteritidis, Typhimurium, Newport, and Heidelberg—accounted for 52% of all fully serotyped isolates. NARMS tested 19,410 isolates from 2004 through 2012, and overall resistance was detected in 2,320 isolates. Ampicillin-only resistance was the most common resistance pattern detected, followed by ceftriaxone/ampicillin resistance and ciprofloxacin nonsusceptibility.

Using these data, the researchers determined that from 2004 to 20012 there were approximately 6,200 resistant culture-confirmed infections annually. Overall incidence was 1.93/100,000 person-years for any clinically important resistance, 1.07 for ampicillin-only resistance, .51 for ceftriaxone/ampicillin resistance, and .35 for ciprofloxacin nonsusceptibility.

The authors note that while Enteritidis, Typhimurium, Newport, and Heidelberg account for only half of all culture-confirmed Salmonella infections, the four serotypes accounted for 73% of the Salmonella infections that involved clinically important resistance.

The predominance of these four serotypes, they write, reflects their ability to persist in food animals, be transmitted through the food system, and cause illness. It also suggests that strategies to reduce Salmonella infections caused by these four serotypes could have an impact on the incidence of resistant infections overall.

“The 4 major serotypes that have been driving the incidence of resistant infections should continue to be high priorities in combating resistance,” the authors write.

The report also notes that two of these serotypes—Typhimurium and Newport—have been associated with outbreaks of drug-resistant Salmonella infections linked to contaminated meat, which highlights the need for NARMS to continue monitoring emerging resistance patterns by serotype.

The authors caution, however, that while this estimate of resistant Salmonella infection incidence will help define the magnitude of the problem and guide prevention efforts, it might be telling only part of the story. That’s because it relies on culture-confirmed infections only.

The CDC has estimated that for every culture-confirmed case of Salmonella, there may as many as 29 undetected cases. That could put the annual US incidence as high as 180,000 cases.

Darwin parents urged to vacuum up gecko and frog poo amid spike in Salmonella cases

Darwin is in northern Australia.

It’s close to the equator.

geckoIt’s hot.

ABC News reports Top End parents are being urged to vacuum up tiny brown and white droppings of gecko poo amid an above-average rise in salmonella cases affecting young children.

Darwin annually records above national average rates of salmonella, especially among children under five during the humid months around Christmas.

This wet season is no different, however the past month has seen an unexpected rise in cases.

“We’re getting about 50 per cent more than we’d expect at the moment,” Dr Peter Markey, head of disease surveillance at the NT Centre for Disease Control, said.

There are many different strands of salmonella, with the disease’s spread generally linked to contaminated food, warm conditions, polluted water, unclean surfaces and the spread of faecal matter.

Symptoms include fever, diarrhoea, vomiting and dehydration, with children and the elderly especially badly affected.

Dr Markey said Top End-specific research conducted by the centre in recent years had identified many well-known risk factors.

“We’ve isolated salmonella from geckos, lizards, snakes. Dogs and cats and turtles are important carriers too. Goldfish even, because aquarium water can be contaminated.”

Dr Markey said young children handling pets and then not washing their hands would often lead to them getting sick, however some might be getting sick from actually eating tiny animal faeces.

Gecko poo is generally elongated and brown, sometimes with a tip of white, and is often mistaken for mouse or rat droppings.

“Toddlers of course live on the ground and crawl around and put anything in their mouths,” Dr Markey said.

“We showed that regular vacuuming can help.

“It’s important to get that gecko poo or the frog poo off the ground or balcony.”

 

Pigeons: Rats with wings (and Salmonella factories)

Sane New Yorkers regard them as rats with wings, and they make use of the many tools to combat pigeons on their property. But things get complicated when a neighboring property owner doesn’t care that pigeons are emitting toxic piles of excrement in a shared space between buildings.

pigeon-rats-wingsSuch was the case on the Upper West Side, where pigeons set up housekeeping on a grocery store’s outdoor air vents and cooling system. Residents of a co-op that shares a courtyard with the grocery store hired an exterminator, but the nests remain. The store’s management did not respond to calls. What’s a co-op board to do?

“The mere presence of pigeon droppings in the courtyard is an unsanitary condition” and could be grounds for a violation, Kempshall McAndrew, a real estate lawyer at Anderson Kill, tells the New York Times’ Ask Real Estate column. The board should keep the courtyard free of pigeon droppings in case an inspector visits.

Beyond that, McAndrew advises the co-op board to call the Department of Health and Mental Hygiene directly, bypassing 311. The board should photograph the area, documenting the nests as the source of the problem. It should also keep records of calls to the grocery store and of the exterminator’s efforts.

Mac and cheese products recalled due to possible salmonella contamination

TreeHouse Foods, Inc. has announced a voluntary recall of certain macaroni and cheese cup products containing cheddar cheese seasoning which may be contaminated with Salmonella.

salm-mac-cheeseThe company said it was notified by its supplier that the milk powder used in the seasoning has the potential for Salmonella contamination.

The following products are affected by the recall:

Big Win Original Macaroni & Cheese Dinner with a UPC number of 001182258403 and a best-by date of 10/25/2017

Cheese Club Express Mac Macaroni & Cheese Dinner with a UPC number of 004149817167 and any of the following best-by dates: 11/3/2017; 11/4/2017; 11/18/2017; 11/22/2017; 10/20/2017; 10/21/2017; 10/23/2017; 10/29/2017; 11/1/2017; 11/2/2017; 11/11/2017; 11/16/2017; 11/17/2017; 11/22/2017; 11/23/2017; or 11/28/2017

Great Value Macaroni & Cheese Original Cups with a UPC number of 007874208249 and any of the following best-by dates: 10/22/2017; 10/19/2017; 10/27/2017; 10/28/2017; 11/3/2017; 11/7/2017; 11/18/2017; 11/20/2017; or 11/21/2017

Consumers who have purchased any of the above products are urged to dispose of or return the products to the place of purchase for a full refund. They were sold at stores nationwide, including Walmart.

No illnesses have been reported to date.

$11.2M settlement: ConAgra finalizes deal in tainted peanut butter case

Russ Bynum of Federal News Radio reports that in November 2006, the U.S. Centers for Disease Control and state health officials began investigating an outbreak of salmonella infections ultimately blamed for sickening at least 625 people in 47 states and killing nine.

peanut-butter-peter-panInvestigators traced the salmonella to jars of Peter Pan and Great Value brand peanut butter produced in Sylvester, Georgia.

ConAgra officials blamed moisture from a leaky roof and a malfunctioning sprinkler system at the Georgia plant for helping salmonella bacteria grow on raw peanuts.

ConAgra launched a huge recall in February 2007, destroying and urging consumers to throw out all of its peanut butter produced since 2004.

Peter Pan peanut butter vanished from store shelves for months. Meanwhile, ConAgra spent $275 million on upgrades at the Georgia plant and adopted new testing procedures to screen peanut butter for contaminants.

Six months later, in August 2007, ConAgra announced it was ready for Peter Pan to return to supermarkets.

Today, ConAgra faces a court hearing to finalize an $11.2 million settlement — including the largest criminal fine ever in a U.S. food safety case — to resolve federal charges in a salmonella outbreak that sickened hundreds who ate tainted Peter Pan peanut butter.

A federal criminal investigation followed the outbreak. More than eight years after the Peter Pan recall, in May 2015, the Justice Department announced charges and a pre-arranged plea deal with ConAgra.

The agreement called for ConAgra Grocery Products Company, a ConAgra subsidiary, to plead guilty to a single misdemeanor charge of shipping adulterated food. No charges were brought against executives of ConAgra, which was based in Omaha, Nebraska, at the time but has since moved its headquarters to Chicago.

ConAgra issued a statement saying the company didn’t know its peanut butter was contaminated with salmonella before it was shipped. However, the plea agreement documents note that ConAgra knew peanut butter made in Georgia had twice tested positive for salmonella in 2004. Prosecutors said the company destroyed the tainted peanut butter and identified likely sources of contamination, but ConAgra had not finished fixing those problems by the time of the 2007 outbreak.

STEC surveillance: EU edition

On 1 December 2016 the third version of the Epidemic Intelligence Information System for food- and waterborne diseases and zoonoses (EPIS-FWD) was launched. With this development, the European Centre for Disease Prevention and Control (ECDC) moved one step further towards the One Health approach.

In collaboration with the European Food Safety Authority (EFSA), the Molecular Typing Cluster Investigation (MTCI) module was expanded to also allow the assessment of Salmonella, Shiga toxin-producing Escherichia coli (STEC) and Listeria monocytogenes microbiological clusters based on non-human isolates (i.e. food, feed, animal and environmental) and on a mix of non-human and human isolates.

Depending on the type of cluster assessed, the MTCIs are coordinated by ECDC or EFSA or jointly by both agencies together with public health and/or food safety and veterinary experts from the involved European Union (EU) and European Economic Area (EEA) Member States.

ECDC collects human typing data through the European Surveillance System (TESSy) since 2013 [1]. Typing data from non-human isolates can now be submitted by the food and veterinary authorities of the EU/EEA Member States through the EFSA molecular typing data collection system. Furthermore, the joint ECDC-EFSA molecular typing database allows the comparison of the typing data collected by ECDC and EFSA.

First launched in March 2010, the Epidemic Intelligence Information System for food- and waterborne diseases and zoonoses (EPIS-FWD) has become an important tool for assessing on-going public health risks related to FWD events worldwide. Currently, 52 countries from five continents have access to the outbreak alerts in the EPIS-FWD [2].

Since its launch, 305 outbreak alerts have been assessed through the EPIS-FWD; 32 (10%) were from countries outside of the EU/EEA which underlines the global dimension of the system.

The Health Security Committee, a part of the European Commission and the officially nominated public health risk management authority in the EU/EEA, has access to the EPIS-FWD to ensure the link between risk assessment and risk management. The World Health Organisation (WHO), including the International Network of Food Safety Authorities (INFOSAN) managed jointly by the Food and Agriculture Organisation of the United Nations (FAO) and WHO, is invited to contribute to the discussions in the EPIS-FWD when international outbreaks involve non-EU/EEA countries.

Through this new version of EPIS-FWD, ECDC and EFSA are encouraging the sharing of data between sectors and aspire to strengthen the multi-sectorial collaboration at international and national levels.

New version of the epidemic intelligence information system for food- and waterborne diseases and zooonoses (EPIS-FWD) launched

Eurosurveillance, Volume 21, Issue 49, 08 December 2016, DOI: http://dx.doi.org/10.2807/1560-7917.ES.2016.21.49.30422

CM Gossner

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=22666

FSA idiots: Cooking until the juices run clear is a bad way to tell if the meat is done

It’s sorta sad when the PhD boffins at the UK Food Standards Agency get stood up by Cooks Illustrated.

chicken-thermWorse when they fail to acknowledge the error of their ways, but still earn the big bucks.

Cooking a chicken until its “juices run clear when pricked” is pretty standard poultry advice but, according to Cook’s Illustrated, it’s not a very dependable way to tell if your chicken is properly cooked.

As reported by Claire Lower of Skillet, though myoglobin (the molecule that gives meat its pink or red hue) does lose its color when heated, the temperature at which the color change occurs can vary depending on a whole bunch of factors. In fact, when Cook’s Illustrated tested this theory, they found the color of the juice had very little to do with the temperature of the meat:

But when we cooked whole chickens, in one case the juices ran clear when the breast registered 145 degrees and the thigh 155 degrees—long before the chicken was done. And when we pierced another chicken that we’d overcooked (the breast registered 170 degrees and the thigh 180 degrees), it still oozed pink juices.

The takeaway? Get a thermometer, use it, and never under-cook or overcook your chicken again.

Stick it in and use a thermometer.

barfblog-stick-it-in

 

Spread the safe salad message – at retail

The Packer writs in an editorial that the produce industry is justified in being upset about the latest accusation of lax food safety practices, but also acknowledges the industry has a strong food safety message and should be eager to share it.

lettuceIt’s important that retailers and foodservice providers know the industry’s response to the most recent attack, this time from a United Kingdom study that raises concerns about salmonella in bagged salads

How to do that?

Because at retail, the person consumers are going to ask is some minimum-wage kid who is stocking produce when a shopper walks by.

Most people want to go shopping, not do homework.

They are an abundance of tools that have been developed to help support risk communication at retail.

On the front lines.

Where sales are won and lost.

Market microbial food safety at retail rather than offering boilerplates.

Data says so: Australia does have a raw egg problem

Statistics show that the consumption of foods containing raw or minimally cooked eggs is currently the single largest source of foodborne Salmonella outbreaks in Australia.

garlic_aioliI based a large part of my research career on verifying the soundbite, ‘we have released guidelines’ or, ‘we follow all recommendations’ by arranging to have students see what actually goes on.

In October 2014, the New South Wales Food Authority released Food Safety Guidelines for the Preparation of Raw Egg Products (the Guidelines). Despite this, outbreaks continued to take place, particularly where business hygiene and temperature control issues were apparent. In addition, businesses and councils approached the Food Authority for advice on desserts containing raw eggs and other unusual raw egg dishes. As a result, the Guidelines were recently updated and give specific reference to Standard 3.2.2, Division 3, clause 7 of the Australia New Zealand Food Standards Code to ensure that only safe and suitable food is processed.

To reduce the risk of foodborne illness outbreaks caused by Salmonella, retail businesses are advised to avoid selling food containing raw or minimally cooked eggs. The Guidelines give food businesses that do sell food containing raw egg specific safety steps for its preparation and clear guidance and advice on what they must do to meet food safety regulations. The revised Food Safety Guidelines for the Preparation of Raw Egg Products is available at www. foodauthority.nsw.gov.au/_Documents/ retail/raw_egg_guidelines.pdf.

raw-eggsOr as the Australian Food Safety Information Council now says, buy, don’t make aioli or mayonnaise.

This is nice but of no use to consumers at a restaurant who order fish and chips  with a side of mayo or aioli. I’ve already begun an ad hoc investigation – because I don’t want my family to get sick – and can say that out of the 15 times I’ve asked over the past few years – is the aioli or mayo made at the restaurant or bought commercially – the server invariably returns and proclaims, We only use raw eggs in our aioli or mayo.

Wrong answer.

Only once, so far, has an owner or chef said, we know of the risk, we only use the bought stuff. And they’re ex-pat Canadians.

Giv’r, eh.

A table of Australian egg outbreaks is available at http://barfblog.com/wp-content/uploads/2015/10/raw-egg-related-outbreaks-australia-10-9-15.xlsx

Leafy green cone of silence: Salad producers say don’t be scared by ‘ridiculous’ study

In a time when facts don’t matter and Donald Trump is President-elect, there is scrutiny of any new study, and rhetoric is increasingly common.

spongebob-oil_-colbert-may3_-10Socrates, via Plato, had some thought on rhetoric (yes I dabbled in philosophy many decades ago, didn’t everyone experiment in university?).

Still no comment from the Leafy Greens Marketing Agreement but they sent a few of their spokesthingies out to counter a study that says Salmonella grows in cut leafy greens, even at refrigerator temperatures..

Ashley Nickle of The Packer reports that Bruce Taylor, CEO and founder of Salinas, Calif.-based Taylor Farms, emphatically denounced the study.

“We find the artificial conditions created by this study to be ridiculous,” Taylor said in an e-mail. “Producers of bagged salads do not have ‘juice’ in the salad bag, and producers take painstaking steps to avoid the introduction of salmonella or any other pathogen.”

The conclusion regarding refrigeration was the only notable one in the study, said Trevor Suslow, a member of the technical committee of the Center for Produce Safety. Scientists would expect salmonella to be able to survive at the temperature recorded in the study but would not expect it to grow, he said.

“People will definitely be trying to reproduce their results as far as growth under refrigeration temperature for salmonella,” Suslow said. “That’s, for me, the key issue.”

Suslow, an extension research specialist at the University of California-Davis, said it is already known that a bagged salad is an environment in which salmonella can have the nutrients it needs to grow, which is why the industry has focused so intently on ensuring no pathogens make it into bags into the first place.

Drew McDonald, vice president of quality, food safety and regulatory affairs at Salinas-based Church Brothers Farms, said in an e-mail that, although the researchers did some things well, he also had some issues with the study.

“From my read, the study essentially grew salmonella in juices extracted from actual bagged salads in a mixture of sterile water,” McDonald said. “The issue is that in the ‘real’ world the salmonella has to come from somewhere (the surface of the leaf for example) but along with this would be many other microorganisms. That they were able to grow salmonella under these forced, artificial conditions without any competition from other organisms is not surprising.”

lettuceAlong with the growth conditions, the washed status of the lettuce also gave McDonald pause.

“From my understanding, (the) project used ‘bagged salad,’” McDonald said. “I am assuming this means it was already washed. The fact that they added salad juice and salmonella after it had already been bagged and washed really just shows how important it is to not cross-contaminate cleaned product.”

The researchers, as a result of their findings, suggested people eat bagged salads as soon as possible after purchase to minimize risk. They wrote in a question-and-answer supplement to the release that they no longer keep their bagged salads in the refrigerator longer than one day.

“Ridiculous recommendation,” Taylor said in his e-mail. “For 30 years consumers have enjoyed hundreds of millions of bagged salads weekly with great benefit to their health and wellbeing.”

Jennifer McEntire, vice president of food safety and technology at United Fresh Produce Association, also disagreed with the recommendation.

“People should always follow the instructions, including best-by dates, on packages, mainly so that they experience the best quality product,” McEntire said in an e-mail. “People shouldn’t be afraid to keep salad in their refrigerators for the full duration of the shelf life.”

She may mean use-by dates.

Suslow described the study as another piece of the puzzle in trying to find long-term solutions for food safety issues, but he was not impressed by it.

“Sort of generating a lot of additional concern and fear without any real basis for changing what (is) sort of standard practice isn’t necessarily helpful,” Suslow said. “Could hurt the category, but probably no more so than other things such as those instances when there are outbreaks or recalls.

“I think consumers understand that there’s no such thing as zero risk,” Suslow said (smartest thing anyone said in this story). “They understand and appreciate the convenience of packaged salads with multiple ingredients with very healthy mixed leafy greens, and that’s how the category has grown.”