Raw milk in UK? FSA Board wants more evidence

The UK Food Standards Agency board has asked for the FSA to maintain the current regulations controlling the sale of raw milk, while further evidence is gathered to allow board members to make a final decision on whether to revise the rules.

colbert.raw.milkFollowing a review of the current raw milk regulations, the FSA had proposed exploring the scope for wider access to raw milk, including limited sales from vending machines in shops.

The proposals were discussed today by the Board. They concluded that additional evidence was required on risks from specific pathogens. More detail was also requested on the proposed testing regime that would be necessary to allow extended sales while maintaining consumer protection. The Board said a final decision should not be made until the European Food Safety Authority has delivered the findings of its own review of the risks from raw milk which is expected in December 2014.

The FSA will now consider the conclusions in more detail and agree a timeframe for delivering the additional work the Board has requested.

UK take-away shut down after 14 people sickened with Salmonella

The Woks Cooking eatery on Richard Hesketh Drive in the Westvale area of Kirkby was shut down on Monday after 14 people caught Salmonella.

woks.cookingA number of people – suffering from fever, diarrhoea and vomiting – were diagnosed with food poisoning.

One man told the ECHO he had spent a night in intensive care after his kidneys failed.

Speaking from his sick bed in Fazakerley hospital, he said he was “lucky to be alive”.

He said: “I went to intensive care and my kidneys failed. I also spent four nights in critical care.

“I bought special fried rice and a couple of days later I was ill. I had severe diarrhea and I was vomiting. I called the doctor and the ambulance came out for me. I felt awful.”

Another of those affected by the outbreak was Paula Pierce’s 24-year-old daughter, who ended up on morphine.

Paula, who manages the nearby Railway pub, told the ECHO: “My daughter Chantelle had a steak and kidney pie and hot and sour soup from there a week Monday ago. She wasn’t feeling well later on. She went to the doctors on the Tuesday and was diagnosed with food–poisoning.

A spokesman for Knowsley Council said: “The premises are closed subject to an Emergency Prohibition Order.”

The council said it was investigating a number of cases of Salmonella infection linked to a takeaway establishment in Knowsley.

To date there have been 14 laboratory confirmed cases.

Dr Alex Stewart, from the Cheshire & Merseyside PHE Centre said: “Investigations are still on-going and all public health measures have been put in place.”

Open letter to the FSA on the publication of Campylobacter survey results

Richard Lloyd of Which? a UK consumer organization, writes to the UK Food Standards Agency to say:

chicken.thermI am writing to express our grave concern about the proposal being put to the FSA Board to withhold information about the levels of the deadly food poisoning bacteria Campylobacter in supermarket chickens. Campylobacter is a major public health issue. 72,000 people were reported to have suffered Campylobacter food poisoning last year and it kills an estimated 100 people every year.

As you know, the main source for the bacteria is in raw chicken which is why the FSA decided to undertake testing across supermarkets, butchers and convenience stores and publish the results on a quarterly basis with information by retailer and processor.

The publication of the performance of each retailer is in the public interest. The FSA should not sit on this survey data which it initially intended to publish in full.

The FSA was set up because of concerns about commercial and political interference in decisions about food safety. It is with great regret that it has become necessary to remind you of your role to put consumers first, be independent and operate transparently.

At your board meeting today, I urge you to reject the proposal to withhold this information and instead to publish the results in full on a quarterly basis in order to provide consumers with this important information and help to drive up standards.

Barbecue alert after spike in UK Campylobacter food poisoning

I’m tired of the summer BBQ rhetoric. I lived in Canada and BBQed throughout the winter.

The risk isn’t that more people are BBQing, it’s that livestock have higher levels of pathogens in warmer weather.

ben-newBut way to blame consumers.

More than 1,000 people have become ill with vomiting and diarrhea in five weeks – up 27 per cent on the average figure for the same period over the past three years.

Experts are reminding barbecue lovers about the importance of handling and cooking chicken properly following the surge in illness cause by the campylobacter bacteria.

These UK experts don’t know shit; probably the same ones who say cook until piping hot.

NHS Scotland laboratories have confirmed a total of 1,073 infections with Campylobacter but, as not all patients will have contacted the health service for advice, the actual number of people who have developed symptoms is likely to be higher.

135 sick; maybe piping hot isn’t the best advice: Nottingham takeaway Khyber Pass closed after E. coli ‘outbreak’

I have no idea why it takes the Brits so long to inform people of impending health risks, other than the bureaucrats think they know better than the plebes.

the-khyber-passMore than 100 people fell ill after an “outbreak” of E. coli at a Nottingham takeaway, prompting an investigation by Public Health England.

The city council shut down The Khyber Pass in Hyson Green last month after reports of 13 people falling ill.

Now it has discovered 135 cases of gastrointestinal problems, 17 of which have been confirmed as E. coli.

The cause of the bug is not known and the restaurant will remain closed until the investigation is complete.

Paul Dales, from Nottingham City Council, said: “While a high number of cases with food poisoning-like symptoms relating to Khyber Pass have been reported to us, we are confident the closure of the premises has contained the outbreak.”

Nobody was available to comment from The Khyber Pass.

Uh-huh.

UK owner counts cost of cockroach-infested takeaway

A takeaway owner whose shop was shut down by food safety inspectors after they found rodent droppings and cockroaches there has been ordered to pay almost £2,000.

Seven Sisters Kebabs + PizzaErdem Sert, who ran Seven Sisters Kebabs + Pizza, in Seven Sisters Road, Tottenham, admitted a string of food hygiene offences when he appeared at Highbury Corner Magistrates’ Court on July 2.

It followed a visit by Haringey Council’s food safety officers on March 7, when they immediately shut down the takeaway after finding cockroaches crawling on the floor and work surfaces and rodent droppings.

Sert pleaded guilty to failing to keep the premises in a good clean state, failing to keep it free from pests and failing to ensure that food was not at risk of contamination.

Go beyond piping hot? new UK food poisoning figures published

New research published by the Food Standards Agency gives the most detailed picture yet of how many people suffer from food poisoning in the UK every year and how much food poisoning can be attributed to different foods.

Ministry-Silly-WalksThe findings are important as official data for food poisoning cases significantly under-estimates how big the problem is, as only the most serious cases get reported. Most people do not seek treatment from their GP, and not all GPs carry out tests for specific pathogens, so these unreported cases are not captured in routine surveillance data.

The data from this study, coupled with data from official statistics, refines our previous estimates of the real burden of foodborne disease and so will help focus efforts to reduce levels of food poisoning in the UK.

The study found that:

There are more than 500,000 cases of food poisoning a year from known pathogens. This figure would more than double if it included food poisoning cases from unknown pathogens.

Campylobacter was the most common foodborne pathogen, with about 280,000 cases every year.

The next most common pathogen was Clostridium perfringens with 80,000 cases, and norovirus was third with an estimated 74,000 cases.

Salmonella is the pathogen that causes the most hospital admissions – about 2,500 each year.

Poultry meat was the food linked to the most cases of food poisoning, with an estimated 244,000 cases every year.

After poultry, produce including vegetables, fruit, nuts and seeds, caused the second highest number of cases of illness (an estimated 48,000 cases), while beef and lamb were third (an estimated 43,000 cases).

The researchers were able to identify about half a million cases of food poisoning every year attributable to 13 specific pathogens. However, 10 million cases of infectious intestinal disease (IID) a year are not yet attributed to a specific pathogen. If these cases had similar rates attributable to food then this would bring the overall figure to in excess of a million cases a year.

Professor Sarah O’Brien, the study’s lead researcher from the University of Liverpool, said: ‘These findings will help the FSA to target its resources more effectively in tackling food poisoning. They confirm that the FSA is right to put campylobacter at the top of its priority list. It is the biggest food safety problem we have and more needs to be done to tackle it.’

Steve Wearne, Director of Policy at the FSA, said: ‘This study is a very important part of the research we fund to increase our knowledge of food safety and the risks that all of us are exposed to. Reduction of campylobacter is our top food safety priority, and that is borne out by this research. We recently revised our campylobacter strategy and we, in collaboration with industry, must now push on to find the solutions that will stop so many people getting ill.’

The research is an extension of the IID2 study, published in September 2011, which estimated the numbers of cases of IID in the UK. The IID2 extension was commissioned by the FSA to use the data generated from the IID2 study, and other sources, to estimate the burden of foodborne disease in the UK.

Step away from the baguette ‘Unsafe’ sandwiches destroyed after joint raid on UK firms

Around 1,260 unsafe food items have been destroyed after a coordinated operation in Witley Industrial Estate in Southall.

doug.wine.breadFood safety officers from Ealing Council worked with the police and the Home Office to carry out the raid early in the morning of May 28, with council officers targeting unsafe food production and seizing 360 baguettes as a result of poor temperature control.

Ealing magistrates last week ordered the food to be destroyed and awarded the council full costs of £591.36.

Another business operating at the same estate also agreed to voluntarily dispose of 900 food items which had not been produced hygienically.

During the operation, police officers from Southall Green Safer Neighbourhood Team arrested a 20-year-old man for a public order offence.

Officers from the Home Office’s Immigration Enforcement team also arrested a 28-year-old Indian man, who had overstayed his visa.

He has been placed on immigration bail and must report to the Home Office while his case is progressed.

219 sick: Bognor Butlins holidaymakers in Norovirus legal action

Lawyers representing 219 people struck down by a highly contagious stomach bug at a Butlins holiday camp in West Sussex have started legal action.

The holidaymakers fell ill between May and July 2011 following a norovirus outbreak at the camp in Bognor Regis.

Irwin Mitchell solicitors said court proceedings had started following a denial of liability by Butlins’ parent company Bourne Leisure.

Butlins said: “We will robustly defend the speculative action.”

Amandeep Samra, from Irwin Mitchell, which is seeking compensation for its clients, said the court papers were being sent to Birmingham County Court where the case will be heard.

Among those taken ill were two groups from London – members of the Ealing Handicapped Irish Dancers and Mencap Hillingdon North.

Solicitors will argue they had been served undercooked food, and had seen pigeons on tables and flies on and around uncovered food.

They will also allege there were sewage smells around parts of the resort, and on occasions, the swimming pool was “cloudy with slime around the edges”.

A spokesman for Butlins at Bognor Regis said: “We operate our resorts to the highest health and safety standards and work closely with the Health and Safety Executive to ensure that our guests’ safety takes priority.”

Hugh Pennington: Food and microbes, learning from the past

Professor Hugh Pennington provides a fifty-year historical perspective on food safety to mark the Institute of Food Science and Technology’s Jubilee. Edited comments below:

IFST formally adopted its constitution on 13 May 1964. By pure coincidence, on the same date the first victim of the Aberdeen typhoid outbreak developed a high fever. Still feared, the evil reputation of the disease had long outlived its impact. The typhoid standard mortality ratio in England and Wales had fallen more than two hundred fold in the first 50 years of the twentieth century, and had then been reduced to almost zero by antibiotics.
Nevertheless, there was much fear in May, June and early July 1964 when 507 Aberdonians contracted the disease. Nobody died from the direct effects of infection, so the outbreak was old-fashioned in terms of its causative microbe, but modern in terms of its effects. This contrast extended to its handling. Casualty figures of sufferers and their names and addresses were published regularly in the local papers as if the Second World War was still in progress, and the end of the outbreak was announced as the ‘All Clear’. However in modern style, the Aberdeen Medical Officer of Health, Dr Ian MacQueen, gave daily press conferences and appeared nightly on television (although his approach was old-fashioned in that he had a pipe which he rapped on his desk, turning and pointing it towards reporters who asked awkward questions). Unfortunately, his microbiological knowledge was wanting. The main thoroughfare in town, Union Street, was sprayed with disinfectant. The University sent a note to external examiners ‘There is a remote risk of infection through perspiration on examination scripts. Examiners who wish to take precaution on this score should wear cotton gloves’. MacQueen’s pronouncements led to Aberdeen being dubbed the ‘Beleaguered City’. A royal visit was deemed necessary to start rehabilitation; Her Majesty came on 28 June.

big_bill_in_groundhog-731047The cause of the outbreak was Salmonella Typhi contained in a can of improperly manufactured corned beef imported from Argentina. It had been sold sliced in a small, new supermarket in Aberdeen between 6 and 9 May, infecting about 50 people, many of them young women living in the prosperous west end of the town, who had consumed it as part of a slimming diet. The slicing machine became contaminated and transferred the organism to other cold meats, the consumption of which caused the other 450 cases and prompted the joke ‘that only in Aberdeen would you get 500 slices out of a can of corned beef’. The first patient to be discharged from hospital, a 23 year-old woman, was presented with a sash proclaiming her ‘Typhoid Queen 1964’. …

A raw milk–borne outbreak in 1981 in Keith, in the north-east, was a signal Salmonella event for Scotland because of its regulatory impact. Since 1970 there had been 50 milk-borne Salmonella outbreaks in Scotland affecting more than 3,500 individuals, with 12 deaths. The Keith outbreak affected 650, with 2 deaths. An economic study of this outbreak showed a mid-range cost per patient of £2637. The retail sale of unpasteurised milk was banned from August 1983. Sad to say, there are still individuals in Scotland who campaign to reverse this rational evidence-based policy.

The Salmonella outbreak at Stanley Royd Hospital, a psychogeriatric hospital in Wakefield, started on the August Bank Holiday weekend of 1984. At the time of the outbreak it had 788 resident patients; 355 fell ill and Salmonella Typhimurium was isolated from stools from 218. One hundred and six of the 980 staff had symptoms. Nineteen patients died, the last on the 9th of September. A Public Inquiry was announced on September 14th. It determined that the cause of the outbreak was contaminated cold roast beef served to the patients on the 25th of August. The organism had a poultry source and almost certainly had come from chicken carcases that had been defrosted.

As a horror story the Inquiry Report is hard to beat. The hospital kitchens had been constructed in 1865. Their open drainage channels had resident cockroaches which were attractive scapegoats for the source of the infection. However, FOOD & MICROBES they were an oriental kind which could not climb and they were negative for Salmonella. On the other hand, the rat that was killed in the kitchen on the 11th October was infected with the outbreak strain. But the Inquiry concluded that ‘the condition of this creature was more likely to have been a consequence than a cause of the outbreak’. It was a victim. Attempts had been going on for years to upgrade or replace the kitchens, but nothing had been done. The Inquiry concluded that this was ‘a remarkable example of what well intentioned individuals can fail to achieve unless someone is charged with the responsibility of ensuring that careful attention to detail does not lead to a complete cessation of all activity other than the production of paper’. There had been paralysis by analysis.

Salmonella Typhimurium struck again in North Wales and Cheshire in 1989. Six hundred and forty were affected, half on each side of the border. Seventy-four were hospitalised and three died. As in Aberdeen, sliced meats were the culprit, but in this case the pork and ham cross-contaminated the tinned corned beef cut on the same machine. …
In the early 1980s the Salmonella situation began to change with the rise of Salmonella Enteritidis, in particular phage type 4. In England and Wales in 1982, 413 isolations were made from humans, accounting for 3% of all such non-typhoidal Salmonellas. The numbers increased steadily, reaching a peak in 1993 with 17,257 isolations, accounting for 56% of all non-typhoidal Salmonellas. In 1988 (12,522 Enteritidis isolations) matters had already come to a head when the Chief Medical Officer for England instructed hospitals to stop using raw egg in favour of pasteurised products. Edwina Currie, Parliamentary Under-Secretary for Health, felt it was time to act and in early December she said on Independent Television News ‘most of the egg production in this country, sadly, is now infected with Salmonella’. She didn’t say ‘don’t eat eggs’, but nevertheless egg consumption fell. She said later ‘both MAFF and the producers took a dim view of my action; they regarded me as the problem, and that if I were removed the issue would go away. I was informed that writs had been served and I resigned from office on 16 December. Subsequently I discovered that there were no writs’. At this point Kenneth Clarke, the Minister of Health, persuaded Margaret Thatcher to set up a Cabinet Committee on food safety (MISC 138); its work led to the 1990 Food Safety Act. Salmonella Enteritidis is now a shadow of its former self. Specific targeting by vaccinating poultry has worked well. It still outnumbers Salmonella Typhimurium, but only just. In 2012 there were 2169 isolations reported from humans in England and Wales.

hugh.penningtonTwo other food borne diseases took off in the 1980s. Control measures to date for neither Campylobacter nor E.coli O157 can be considered a success. The 1975 edition of the bacteriologist’s bible, ‘Topley and Wilson’s Principles of Bacteriology, Virology and Immunity’, mentions Campylobacter only as a rare medical curiosity, ‘as occasionally causing disease in man, mostly in patients already debilitated by some other illness’. It does not describe it as a cause of infectious intestinal disease. But by 1981, with 12,168 laboratory diagnosed cases, it had overtaken Salmonella in England and Wales in this regard. Laboratory methods for its routine identification only became available in 1977, and it is reasonable to suppose that this explains much of the increase shown by the early statistics. Campylobacter has received much less media attention than it probably deserves. This is because it hardly ever causes dramatic outbreaks and journalists find its name hard to spell. Attempts to establish the precise routes of transmission have been greatly impeded by the sporadic nature of the overwhelming majority of cases and the difficulty in fingerprinting strains coupled with their significant genetic diversity. This diversity also indicates that control by vaccination is unlikely to be effective. Studies on chicken carcases and recent work using modern genotyping methods have shown that poultry meat is the most important source. Milk-borne outbreaks have also shown the importance of cattle as a source. Campylobacter control was a top priority for the Food Standards Agency from its inception in 2000, when 58,236 laboratory diagnoses were reported in England and Wales. In that year it published a ground breaking Report of the Study of Infectious Intestinal Disease (IID) in England, which demonstrated the true scale of the problem in its conclusion ‘for every 136 cases of IID in the community, 23 presented to a GP, 6.2 had a stool sent routinely for microbiological examination, 1.4 had a positive result, and one was reported to the PHLS’ CDSC.’ There was early optimism that a focus on improved hen house hygiene was bearing fruit. The number of laboratory reports of human infections fell to 44,577 in 2004. But the optimism was misplaced; the figures have since risen steadily, reaching 65,032 in 2012.

Campylobacter and E.coli O157 are similar in that neither is pathogenic in its usual hosts (ruminants for the latter). But E.coli O157 is different because one can be certain that its emergence as a new pathogen was not just a statistical event caused by the development of a new laboratory test, but was due to evolution in action in real time. The first cases in England occurred in 1983 in Wolverhampton. A retrospective search of E.coli strains collected in previous years showed that it was a new pathogen. Events since have demonstrated its ability to spread from person-to-person; at least 20% of cases in food-borne outbreaks have been amplified in this way and outbreaks in nurseries and childcare establishments occur regularly. The incidence of infection in the UK is only matched internationally by that in Canada. Within the UK, for many years incidence in Scotland has been more than double that in England. In 2012, 795 diagnoses were made in England and 236 in Scotland, which has a population of less than one tenth that of England. Only about 40% of cases in Scotland are food-borne. Infection leads to the haemolytic uraemic syndrome (HUS) in 10-15% of cases. This complication is much more common in children under 5 and in the elderly. Once an infection has been established, it cannot be prevented by any medical measures. About 10% of HUS cases are left with  permanent damage, either renal or neurological, and about 4% die. These effects and its propensity to cause outbreaks have made it a focus of attention, rather than the incidence of infection. Two foodborne outbreaks have had regulatory impacts.

The central Scotland outbreak occurred in November and December 1996. Seventeen died directly from infection with the outbreak strain, all elderly, and 503 fell ill. John Barr, a butcher at Wishaw, was responsible. He was prosecuted, pleaded guilty on charges under the Food Safety Act, and was fined £2250. The outbreak strain was isolated from gravy retained from a church lunch (eight died), a vacuum packing machine, and a range of raw and cooked meats. I conducted an inquiry for the Secretary of State for Scotland. In consequence a butchers’ licencing scheme was introduced throughout the UK and £19M was provided to facilitate the acceleration of the implementation of HACCP. Memory of the outbreak coupled with the impact of BSE and vCJD led to the formation of the Food Standards Agency in 2000.

Subsequently, the number of outbreaks of IID associated with butchers fell; there were 5 in 2000, 3 in 2001, none in 2002 and 2003, and one in 2004. But in 2005 a big outbreak occurred in South Wales, affecting 44 schools with 118 laboratory confirmed cases. One 5-year old boy died. William Tudor, the butcher responsible for supplying contaminated cold meats to the schools was prosecuted. He pleaded guilty to six offences of placing unsafe food on the market and one of failing to protect food against the risk of contamination, and was sentenced to 12 months imprisonment. I chaired a Public Inquiry into the outbreak. My report was published in March 2009. Fifteen of its recommendations focused on HACCP and related issues. Unfortunately, many of the deficiencies found at Tudor’s in 2005 were exactly the same as those at Barr’s in 1996. The central problem was the failure to prevent cross-contamination. One example suffices. Working surfaces, implements and machinery at Barr’s were being cleaned with a green liquid. Because it was labelled ‘biodegradable’ his staff thought that it killed bacteria. However, my laboratory found that the outbreak E.coli O157 strain grew in it neat. So Recommendation 6 of my 2009 Public Inquiry Report revisited and reiterated Recommendation 10 of the 1964 Milne Report: ’only detergents and sterilisers whose bactericidal properties have been proved should be used in food premises; the responsibility for approving such materials should rest with the central health departments’. The time has come for its implementation!

George Santayana was right when he said that ‘Those who cannot remember the past are condemned to repeat it’ and this doesn’t only apply to the prevention of food-borne infectious diseases.

I congratulate the IFST on its Jubilee. We need it today more than ever.