Barriers to trace-back in a salad-associated EHEC outbreak, Sweden, June 2013

In June-July 2013, six counties notified the Swedish Institute for Communicable Disease Control of enterohaemorrhagic E.coli (EHEC) infections among attendees at a hotel in Dalarna, Sweden. An outbreak control team investigated to identify the source and implement control measures.

lettuce.skull.e.coli.O145We included individuals who attended the hotel between June 19th-25th in a cohort. We asked them about animal contact, swimming, and consumption of food items during this time using a questionnaire. A confirmed case was an EHEC O157:H7 outbreak strain positive individual who developed abdominal pain or diarrhoea between June 20th-July 2nd. We described the outbreak in time, place and person, calculated risk ratios (RR) and 95% confidence intervals (CI). We investigated the kitchen, tested and traced back implicated food items.

172 individuals responded. We identified 19 confirmed cases (Median age: 17 years, 64% female) with symptom onset between June 22nd-27th. Eating green salad on June 20th was associated with illness (RR:3.7;CI:1.3–11). The kitchen mixed green salads without records and destroyed leftovers immediately. Hence we could not conduct trace-back or obtain microbiological confirmation.

Green salad contaminated before entering the kitchen was the likely outbreak source. We recommended early collaboration with food agencies and better restaurant records to facilitate future investigations.

PLOS Currents Outbreaks

Michael Edelstein, Camilla Sundborger, Maria-Pia Hergens, Sofie Ivarsson, Rikard Dryselius, Mona Insulander, Cecilia Jernberg, Yvan Hutin, Anders Wallensten

Sweden listeria outbreak shows decline

“We have had no reports [of listeria] in the last three weeks so we hope that the outbreak is now over, even though it is a little too early to tell just yet,” Viktor Dahl, doctor and epidemiologist at the Public Health Agency of Sweden told The Foreigner, Thursday.

Authorities believe there is a common source of the outbreak.

Whilst the deaths cannot be 100 per cent confirmed to have been caused by the bacteria, amy.pregnant.listeria27 cases of the same type of strain have been reported throughout the country.

Four have died out of these cases, but again, listeria has not been confirmed as the cause of death. This is because most of the affected are elderly and have other diseases such as cancer

The outbreak has been allegedly linked to products produced by the Scan factory, which has recalled many of its items.

Scan has also been forced to close a factory in Kristianstad in southern Sweden’s Skåne County, where high quantities of the bacteria were found, though this facility has not been confirmed as the source.

Listeria cases climb in Sweden, outbreak declared

Sweden’s Public Health Agency has declared a specific outbreak of Listeria during the final three months of 2013, with 41 sickened compared to 25 for the same period the year before.

“There was a clear increase, which led us to suspect that this was an outbreak and therefore we decided to investigate the matter immediately, says Viktor Dahl with the listeriaPublic Health Agency.

While previous Listeria outbreaks have largely been linked to smoked or pickled salmon, investigators suspect cold cuts in the latest increase.

Poop, water and illness

A dozen people – mainly kids — got sick after exposure to raw sewage at a splash pad in Traverse City, Mich., an 8-year-old with cryptosporidium had a dump in a Philadelphia pool that forced its closure July 4, at least 90 people were sickened with Shigella after poop-in-poolswimming at Burrillville’s Spring Lake Beach in Rhode Island, and the municipality of Östersund in northern Sweden has been charged for environmental crimes following an outbreak of cryptosporidium which sickened some 30,000 people in the winter of 2010.

In Sweden, prosecutor Lars Magnusson said, “It concerns the fact that they failed to deliver drinking water free from parasites, and this is something that they are required to do under the drinking water regulations.”

The city established the source of the infection in late 2010, tracing the outbreak to a residential building in the Odensala area of the city. It was found that a sewage pipe had been erroneously connected to a rain water pipe.

Östersund has meanwhile disputed the charges, claiming that it had sufficient checks in place.

In Michigan, city workers discovered June 30 at mid-morning that sewage backed up when a pump station failed and pushed raw caddyshack.pool.poop-1sewage into an underground reservoir that feeds sprinklers for the splash pad, rain arc, and mister.

In Rhode Island, beach manager Cheri Hall rolled out the standard of risk communication bullshit, saying, “We’ve never had a problem. I’ve been manager for 22 years and all of our samples always come back good.”

Sweden hit by 12 more cases of hepatitis A linked to frozen berries

Radio Sweden reports that 12 more cases of hepatitis A in Sweden are probably linked to the same strain of virus first discovered in Denmark frozen.strawberrywhich authorities believe is caused by frozen berries.

Fifty-six cases of hepatitis A have been reported in Sweden since December. Normally, there are five cases a year in the country.

Cases have been reported in other Nordic countries, bringing the total sickened to about 83.

22 sick; Hepatitis A outbreak in Sweden blamed on frozen berries

Swedish authorities announced on Thursday that frozen berries may have been the cause of over 20 Hepatitis A infections in Sweden since December.

The Swedish Institute for Communicable Disease Control (Smittskyddsinstitutet, SMI) warned that the berries may have frozen.strawberrybeen responsible for 22 cases of Hepatitis A in Sweden so far.

The usual contagion rate for the same timeframe is about five people in Sweden.

Experts from the institute advised berry lovers to take caution when consuming any berries bought in Sweden that were sold frozen.

“If you cook them for at least one minute then all the contagion will die or disappear,” Margareta Löfdahl, epidemiologist from the Institute, told the TT news agency.

The people infected in Sweden were infected with the same type of Hepatitis that 30 people in Denmark were diagnosed with recently, which has since been traced to frozen berries and strawberries in particular.

Pizzeria in Sweden mixed sauce with cement mixer

People send me things, and I am grateful. This one’s from Sweden, and some things may be lost in translation.

A customer at a pizzeria in Skåne who found a screw in his kebab went back the day after with his find to confront the pizza bakers. They expressed no surprise, but told me that other customers found the screws in the food, according to the customer who reported the incident.

“The screw was sitting on a pair of pliers that we use throughout the day to add to salad and finally to release it and fall into the kebab box. The screw is black and kebab is black – it’s not easy to see the time,” says the restaurant’s owner told DN.

It was March 8 that the customer bought a kebab at the pizzeria to take away and eat at home. In the food he found to his undisguised astonishment a screw. The day after he went back to the pizzeria to talk about the event and show the screw. The staff seemed, as the customer, do not be surprised, but told me that something like this happened before.

The customer reported the incident to the Environment Agency on the resort. In an unannounced inspection at the pizzeria told the staff that they noticed that the screw on a pair of pliers were plaster gone. It had been replaced with a new screw. Although a nut was missing on the forceps used it anyway in daily operations. Where the original screw gone had not thought about, according to the inspection report that DN seen.

It was also found during the inspection personnel to use a cement mixer for mixing sauces and dressings. It was painted with blue paint – paint flaked off in several places. 

2 kids sick; meat in Sweden recalled over E.coli feces fears

Give the Swedes credit: they’re direct.

None of this, “abundance of caution” crap, when meat is recalled, it’s because sweden.meat.e.coliof crap. reports around six tonnes of hamburger and kebab meat distributed and sold across Sweden may have been contaminated by intestinal bacteria which may have been caused by animal excrement.

The meat, which has been on sale across the country for the past four months, has been found to contain traces of the potentially life-threatening E .coli bacteria.

The contaminated meat was brought to the attention of the authorities when two children fell ill in Västerås in eastern Sweden in January.

The beef has been traced to the distributor Sven P in Stockholm, but is originally from a slaughterhouse in the Netherlands.

30 sickened; crypto outbreaks linked to herbs in Sweden, 2010

According to the current issue of Eurosurveillance, one of Sorenne’s favorite journals, the number of sporadic cases of Cryptosporidium identified in the Stockholm county area increased above the expected limit during October 2010. Additionally, two food-borne outbreaks of cryptosporidiosis occurred in two other Swedish cities: Umeå (4 October) and Örebro (9 October). The outbreak investigations did not reveal any responsible food item, however fresh herbs were suspected. Thirty stool samples, originating from all three events, tested positive for Cryptosporidium oocysts. Polymerase chain reaction (PCR) and subsequent restriction fragment length polymorphism (RFLP) revealed that 27 individuals were infected with C. parvum, two with C. hominis, and one with C. felis. Using sequence analysis of the GP60 glycoprotein gene, a polymorphic marker with high intra-species diversity, we identified the same C. parvum subtype IIdA24G1 in samples from both the Umeå outbreak and the Stockholm area cases, thus indicating a possible outbreak in the Stockholm area and establishing a link between these two events. C. parvum IIdA24G1 has not previously been described in connection with a foodborne outbreak. For the outbreak in Örebro, another subtype was identified: C. parvum IIdA20G1e. These findings demonstrate that subtyping C. parvum isolates using GP60 gene amplification can be used to link cases in an outbreak investigation and we recommend its use in future similar events.

The complete paper is available at

Danish pork recalled in Sweden for Salmonella

Food giant Axfood AB has been forced to recall two tonnes of pork, following test samples showing salmonella bacteria present in the meat.

The Local reports the pork has been sold all over Sweden, but as of yet there have been no reports of anyone falling ill.

According to Axfood’s press manager Ingmar Kroon, the affected meat is pork imported mainly from Denmark, including chops, marinated loin and mince. The products have been sold by supermarket chains Willys, Hemköp, Prisextraand Tempo.

“We’re recalling it from all over the country, but we don’t know how much has already been sold,” he said to the TT news agency, adding, “but only some of the meat has been infected. …

“It’s happened twice this summer that we’ve had infected meat from Denmark, and that might look bad, but Denmark isn’t bad at handling. I definitely don’t want to point the blame at them.”