1 dead, 60 sick: Gastro outbreak in Guyana

Kaieteur News reports that at least one person has died and 60 sick suffering from symptoms consistent with gastroenteritis. This is according to information filtered to the Ministry of Public Health to the Government Informationgastro Agency (GINA), which suggests that at least 60 individuals have sought care at the Baramita Health Centre manifesting symptoms of vomiting and diarrhoea.

Dr-George-Norton-310x165It was in fact mounting cases of vomiting and diarrhoea that caused the Ministry to commence a close monitoring process of the indigenous locale.

The Region One area had an outbreak of gastro-enteritis infection in the past resulting in the deaths of a few children.

Minister of Public Health, Dr. George Norton, on Thursday evening recalled, “Some years ago, right in Parliament here, Mr. (David) Granger moved a motion for an investigation on the Commission of Inquiry into deaths in the North West district, particularly the Port Kaituma area, of children dying of gastro-enteritis. For some reason or the other there (has) been a closing off of the media, in terms of providing the public with information about that situation.

“We want to do it differently. We want to be the first to let the media know that we are on top of the situation that has existed, not in Port Kaituma now, but in the village of Baramita,” Minister Norton said.

Baramita, which has a population of about 3,000 and 20 satellite villages, has one Health Center, which is manned by a Community Health Worker, a Medic and a Doctor.

But, according to Minister Norton, the situation is under control. He however noted that the issue is of great concern to the Ministry, and therefore a team of officials will be deployed to the area to educate the residents about the illness and measures they can take to avoid it.

But there are some challenges in accessing some of the satellite villages, Minister Norton has admitted since these areas are only accessible by All Terrain Vehicles (ATVs).

Minister Norton also said that another challenge in addressing the outbreak has been found to be that “the population is not cooperating.”

“They don’t want to use the bleach in the water or the tablets that we’re using in the water because they said it tastes bad. Secondly, they’re not carrying through with the medications we’re giving them to use, and they are not all attending the clinics even though the clinics are there, available for them. So we’re running into some difficulties there. But the situation has improved from what it was from the beginning,” Minister Norton explained.

In 2013, there was an outbreak in the North West District area, where a total of 529 residents from Port Kaituma and surrounding communities were infected, most of whom were children. There were three reported deaths.  Prior to that, there was an outbreak in 2009 and six residents died.

John Krasinski competes in a vomit-off against Stephen Colbert

Practicing one of his favorite things, actor John Krasinski competed in a vomit-off against “The Late Show” host Stephen Colbert on Tuesday (Jan. 5). Previously, the “13 Hours” actor’s wife, Emily Blunt, appeared on the show and took Colbert to task on one of his famous comedic bits.

Stemming from a comedy sketch he did with Steve Carrell, titled “Waiters Who Are Nauseated By Food,” the actor did his best pretend puking during a read-through of the climactic scene from “A Few Good Men.”

Food Safety Talk 85: I’m the jerky police

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.o-BEEF-JERKY-facebook

Ben and Don host a special guest, Dan Benjamin, podcasting pioneer and founder of 5by5, the inspiration for Food Safety Talk. After sharing what they were eating (because that makes for a good podcast) and Ben and Don tell the Food Safety Talk origin story about Episode Zero as part of the IAFP 100 year anniversary StoryCorps project. The guys talk with Dan about the podcast content niche, who the community of listeners are (both inside and outside the food safety world).

The conversation moves into how Don is food safety expert to the podcasting stars and the guys talk about some of the risk assessment questions Dan and Haddie text Don that usually start with ‘Can she eat this?’

The discussion goes into kids getting sick, spurred by Dan’s children coming home with gastro illnesses. Don and Ben each have stories about taking care of vomiting children. The guys talk about Immunity, resistance and probabilities of feces being positive, transfer and introduction into the body. Don describes how risk modeling calculations work taking all the factors into account. Dan tells an analogous story about immunity and his grandfather’s metallurgy job. The guys use a hypothetical situation of a child projectile vomiting into someones mouth to help explain acquired immunity and vaccinations. Dan’s child illness discussion pushes the guys into CDC’s Infection control guidelines and restaurant food handlers and glove use. Dan tells a detailed story of his son’s vomiting event which includes norovirusrotavirus, oatmeal, sink disposal, aerosolization, infection control, clean-up and incubation. A norovirus outbreak at Chipotle becomes a topic and the guys talk about brand impacts of an outbreak.

The hygiene hypothesis makes an appearance as does brain eating amoebas.

Dan describes Ben as the jerky police which goes back to an interview Ben did on 5by5 where they talked about risks associated with drying beef without heat treating. Dan gives hints on his super special recipe. The guys talk dehydrating manufacturers instructions(which may or may not be validated), water activity, Shigatoxin-producing E. coil and marinades. Don and Ben come up with a plan for a jerky how-to podcast and website fusing some of the validation studies (including one from our friends Harrison and Harrison).

Kid barfs in UK pool, parents concerned

When someone barfs or craps at the pool we frequent, everyone is moved to another pool, big chunks removed and the water hyper-chlorinated.

pool-puke-vomit-1918A swimming lesson was interrupted after a child vomited in the pool, causing concern for children and parents alike.

Youngsters aged six and seven were enjoying a swimming lesson in the training pool at the Dolphin Centre, in Darlington town centre, when the incident happened on Monday (December 14) evening.

Bosses at the Darlington Borough Council-run centre said ‘all necessary checks’ were carried out following the vomiting incident.

That is at odds with the account of one mother, who said the pool was not cleared after the child was sick and attendants used a net to fish bits of vomit out of the pool.

The mother-of-three, who wished to remain anonymous, said: “My daughter was having a swimming lesson and another little girl suddenly got out of the pool and we were all wondering what was wrong and if she was okay.

“After about five minutes, I saw the attendants fishing around the pool with a net and that’s when we found out the girl had been sick in water.

“I immediately wanted my daughter out of the pool and I realised there were two pieces of sick floating next to her.

“Nobody knew what was happening and I asked one of the lifeguards why they had not taken my kid out of the pool.”

A council spokeswoman said: “We follow comprehensive industry guidelines when dealing with any incident like this.

Don’t stand so close to me: Gastro events amongst US folks

I don’t like The Police, but I do like government surveillance systems that help us all know where people are barfing and why.

vomitAcute gastroenteritis (AGE) is a major cause of illness in the United States, with an estimated 179 million episodes annually. AGE outbreaks propagated through direct person-to-person contact, contaminated environmental surfaces, and unknown modes of transmission were not systematically captured at the national level before 2009 and thus were not well characterized.

Reporting Period: 2009–2013.

Description of System: The National Outbreak Reporting System (NORS) is a voluntary national reporting system that supports reporting of all waterborne and foodborne disease outbreaks and all AGE outbreaks resulting from transmission by contact with contaminated environmental sources, infected persons or animals, or unknown modes. Local, state, and territorial public health agencies within the 50 U.S. states, the District of Columbia (DC), five U.S. territories, and three Freely Associated States report outbreaks to CDC via NORS using a standard online data entry system.

Results: A total of 10,756 AGE outbreaks occurred during 2009–2013, for which the primary mode of transmission occurred through person-to-person contact, environmental contamination, and unknown modes of transmission. NORS received reports from public health agencies in 50 U.S. states, DC, and Puerto Rico. These outbreaks resulted in 356,532 reported illnesses, 5,394 hospitalizations, and 459 deaths. The median outbreak reporting rate for all sites in a given year increased from 2.7 outbreaks per million population in 2009 to 11.8 outbreaks in 2013. The etiology was unknown in 31% (N = 3,326) of outbreaks. Of the 7,430 outbreaks with a suspected or confirmed etiology reported, norovirus was the most common, reported in 6,223 (84%) of these outbreaks. Other reported suspected or confirmed etiologies included Shigella (n = 332) and Salmonella (n = 320). Outbreaks were more frequent during the winter, with 5,716 (53%) outbreaks occurring during December–February, and 70% of the 7,001 outbreaks with a reported setting of exposure occurred in long-term–care facilities (n = 4,894). In contrast, 59% (n = 143) of shigellosis outbreaks, 36% (n = 30) of salmonellosis outbreaks, and 32% (n = 84) of other or multiple etiology outbreaks were identified in child care facilities.

Interpretation: NORS is the first U.S. surveillance system that provides national data on AGE outbreaks spread through person-to-person contact, environmental contamination, and unknown modes of transmission. The increase in reporting rates during 2009–2013 indicates that reporting to NORS improved notably in the 5 years since its inception. Norovirus is the most commonly reported cause of these outbreaks and, on the basis of epidemiologic data, might account for a substantial proportion of outbreaks without a reported etiology. During 2009–2013, norovirus accounted for most deaths and health care visits in AGE outbreaks spread through person-to-person contact, environmental contamination, and unknown modes of transmission.

Public Health Action: Recommendations for prevention and control of AGE outbreaks transmitted through person-to-person contact, environmental contamination, and unknown modes of transmission depend primarily on appropriate hand hygiene, environmental disinfection, and isolation of ill persons. NORS surveillance data can help identify priority targets for the development of future control strategies, including hygiene interventions and vaccines, and help monitor the frequency and severity of AGE outbreaks in the United States. Ongoing study of these AGE outbreaks can provide a better understanding of certain pathogens and their modes of transmission. For example, certain reported outbreak etiologies (e.g., Salmonella) are considered primarily foodborne pathogens but can be transmitted through multiple routes. Similarly, further examination of outbreaks of unknown etiology could help identify barriers to making an etiologic determination, to analyze clinical and epidemiologic clues suggestive of a probable etiology, and to discover new and emerging etiologic agents. Outbreak reporting to NORS has improved substantially since its inception, and further outreach efforts and system improvements might facilitate additional increases in the number and completeness of reports to NORS.

Outbreaks of Acute Gastroenteritis Transmitted by Person-to-Person Contact, Environmental Contamination, and Unknown Modes of Transmission — United States, 2009–2013

Centers for Disease Control and PreventionMorbidity and Mortality Weekly Report; Surveillance Summaries; December 11, 2015 / 64(SS12);1-16

My noro nightmare: vomit on a plane

A few years ago I had a noro nightmare.

Jack, my then four-year-old son, and I were visiting my brother and sister-in-law in Calgary (that’s in Canada). I was there for a talk, Jack tagged along to hang out with the fam – and so we could buy him hockey equipment (there’s way more selection in the true north).Jackpic2

As we went from store to store, in and out of the car, Jack said that his stomach hurt. I asked him what would make him feel better and he suggested eating Doritos would do the trick.

Ten minutes later, half a bag in, Jack yacked all over the car.

We went home, he stayed on the couch all day complaining of stomach cramps. He fell asleep around 6pm.

We left for the airport at 5am the following morning and he puked in the car (and all over his clothes) again.

After going through security and customs we boarded our first flight to Minnesota. Jack seemed to be better and wasn’t complaining of nausea. When we got to our connection airport he talked me into buying him an ice cream sundae. It wasn’t my proudest parenting moment.

Back in the air about an hour following the dessert-for-lunch meal and all was fine. Until we hit some turbulence as we approached Raleigh. The shaking plane triggered another round of puke, which ended up on him and the window.

The flight attendants responded quickly, and provided me with plastic bags to contain the pukey clothes and coffee pods to manage the smell.

Because there are some sympathy yackers out there.

The flight crew let us off the plane first (although we were in the second-to-last row). I picked Jack up with one arm, carried the vomit-covered clothes bag in the other with our carry-on strapped on my back. I squeezed down the aisle, potentially inoculating the plane with norovirus.

The post-script to the story is that while I didn’t get sick (surprising since I handled all the puke) my brother and sister-in-law did. And maybe a few other passengers.

Stomach bug sweeps 49ers world titles

I didn’t know David Gilmore was a sailor.

49er_skiff.svgA stomach bug has many sailors at the 49er world championships off Buenos Aires battling bouts of vomiting and diarrhea.

“We don’t really know why everyone is getting sick, but at least a third of the fleet has come down with stomach pains, diarrhea and vomiting,” said Australia’s Olympic gold medallist Nathan Outteridge.

Outteridge’s crewmate Iain Jensen was among those hit by the bug.

Outteridge said the water wasn’t clean and recent thunderstorms and rain had pushed filth onto the race course, which most sailors hadn’t expected in Argentina.

“In Rio everyone knows it’s dirty and takes precautions accordingly and looks after themselves, whereas here everyone gets told it’s just muddy water, but there’s a lot of filth in there as well,” he said.

With one more day of racing before the fleet splits for the men’s skiff 49er finals series, Outteridge and Jensen sit 17th, while Joel Turner and Lewis Brake are in 23rd.

David Gilmour and Rhys Mara follow in 27th, and Will and Sam Phillips are ranked 28th.

Safer food saves lives

That’s the view from the U.S. Centers for Disease Control and Prevention, and I agree.

powell.food.safety.aug.15Contaminated food sent to several states can make people sick with the same germ. These multistate outbreaks cause serious illness, and more of these outbreaks are being found. Multistate outbreaks caused 56% of deaths in all reported foodborne outbreaks, although they accounted for just 3% of all such outbreaks from 2010 to 2014. Foods that cause multistate outbreaks are contaminated before they reach a restaurant or home kitchen. Investigating these outbreaks often reveals problems on the farm, in processing or in distribution that resulted in contaminated food. Lessons learned from these outbreaks are helping make food safer. To protect the public’s health, government at all levels and food industries need to work together to stop outbreaks and keep them from happening in the first place.

Food industries can:

Keep records to trace foods from source to destination.

Use store loyalty card and distribution records to help investigators identify what made people sick.

Recall products linked to an outbreak and notify customers.

Choose only suppliers that use food safety best practices.

Share proven food safety solutions with others in industry.

Make food safety a core part of company culture.

Meet or exceed new food safety laws and regulations.

Problem

what.is.safe.food.09Multistate foodborne outbreaks are serious and hard to solve.

Multistate outbreaks can be hard to detect.

Contaminated food grown or produced in a single place can wind up in kitchens across America.

People in many states may get sick from a contaminated food, making it difficult to spot the outbreak.

Detecting that an outbreak is happening requires specialized testing of germs in laboratories across the country.

Multistate outbreaks can be hard to investigate.

Investigators depend on sick people to remember what they ate several weeks earlier.

If the problem is a contaminated ingredient, people may unknowingly eat it in many different foods.

Unexpected foods have been linked to recent multistate outbreaks, such as caramel apples and chia powder.

Contaminated food can be hard to trace to the source.

Companies may not have complete records of the source or destination of foods.

food.that.doesn't.make.you.barf.09Imported food can be even harder to trace to its source, and imports to the US are increasing.

Many different farms may produce the beef in a single burger or the fresh vegetables sold in a single crate.

Innovative methods are helping detect and solve more multistate outbreaks.

New DNA sequencing technology is improving public health’s ability to link germs found in sick people and in contaminated foods.

Information technology is helping investigators in many places work together.

Efforts by food industries are helping trace contaminated foods to their source.

What Can Be Done

The Federal government is

Implementing improved food safety laws and regulations.

Working with state and local health departments to use better methods, including DNA sequencing, to find, investigate and quickly stop multistate foodborne outbreaks.

Helping state and local health departments improve food safety inspections and guidelines.

State and local public health agencies can

Encourage clinical laboratories to quickly submit germs from sick people to the public health laboratory for advanced testing.

Test the germs from sick people quickly to find if others got sick from the same germ.

Interview sick people promptly about what they ate, using standard questions.

Family guy barfTest suspect foods, if available.

Participate in national networks to share improved methods for investigating multistate outbreaks.

Encourage industry actions that focus on preventing foodborne disease.

Health care providers can

Submit germs from sick people quickly to public health laboratories for advanced testing.

Report suspected outbreaks rapidly to the local or state health department.

Inform patients or caretakers of those in high-risk groups that they have an increased risk for food poisoning. These include pregnant women, adults over 65 years, children under 5, and people with weakened immune systems. Steps to prevent food poisoning can be found on: www.foodsafety.gov

Food industries can

Keep records to trace foods from source to destination.

Use store loyalty card and distribution records to help investigators identify what made people sick.

Recall products linked to an outbreak and notify customers.

Choose only suppliers that use food safety best practices.

Share proven food safety solutions with others in industry.

Make food safety a core part of company culture.

Meet or exceed new food safety laws and regulations.

Everyone can

Check for food recalls and information about how to handle and prepare food safely on: www.foodsafety.gov

food.safety.stickerTake action if you think you have a foodborne sickness:

Talk to your health care provider.

Write down what you ate in the week before you started to get sick.

Report your sickness to the health department if you think you are part of an outbreak.

Assist public health investigators by answering questions about your sickness.

Consider getting a loyalty card where you shop. If there is a recall, the store can use the card to notify you.

Careful with barf: Queensland woman sues Woolworths over vomit slip

A Queensland woman is suing Woolworths for $750,000 after she slipped on a puddle of an employee’s vomit near the entrance of the Ipswich store.

vomit_here_by_seedpix_at_flickrBefore the fall Jennifer Hunt said she was a fit woman who cared for her husband, but the Courier Mail reports she now relies on her daughter to be her carer.

“I’d just walked in. I didn’t even see it. I just went down,” she said.

“At first I thought it was orange juice, but then I smelt it and thought ‘This is somebody’s vomit’.”

The claim states Mrs Hunt injured her lower back, left hip, her knees and her left foot in the fall in November 30, 2012.

The supermarket chain has disputed the extent of her injuries.

Norovirus surrogates are tough to inactivate in cotton and polyester

A couple of years ago Sam, the almost-5-year-old yacked all over the backseat of the van on a car trip. The polyester carpeting and cotton fabric-covered seats smelled for weeks. We even tried to hose the van out, leaving the doors open for a couple of days (and then a frog set up shop in there).

It was most likely motion sickness that led to Sam’s vomit event, but people with noro puke on all sorts of surfaces. My friend Angie Fraser and colleagues at Clemson just published what happens when you try to inactivate norovirus surrogates on different surfaces including polyester and glass.

From the discussion: images

Our results indicated that surface and virus type had a significant influence on RE (that’s recovery efficiency – ben). We found that both FCV and MNV exhibited higher RE when inoculated onto glass than either polyester or cotton. In addition, the recovery of both viruses from cotton was significantly lower than that of polyester. Compared with FCV, MNV exhibited a higher recovery from soft porous surfaces; however, it was only significant for cotton. Previous studies have also document- ed the ability of HuNoV surrogates to be recovered with greater efficiency from hard nonporous surfaces than from soft porous surfaces. Viruses may become more tightly bound to soft porous surfaces due to their ability to absorb the virus-containing media and trap viruses in the subsurface.

Recovery and Disinfection of Two Human Norovirus Surrogates, Feline Calicivirus and Murine Norovirus, from Hard Nonporous and Soft Porous Surfaces

Journal of Food Protection, Number 10, October 2015, pp. 1776-1924, pp. 1842-1850(9)

Yeargin, Thomas; Fraser, Angela; Huang, Guohui; Jiang, Xiuping

Abstract:

Human norovirus is a leading cause of foodborne disease and can be transmitted through many routes, including environmental exposure to fomites. In this study, both the recovery and inactivation of two human norovirus surrogates, feline calicivirus (FCV) and murine norovirus (MNV), on hard nonporous surfaces (glass) and soft porous surfaces (polyester and cotton) were evaluated by both plaque assay and reverse transcription quantitative PCR method. Two disinfectants, sodium hypochlorite (8.25%) and accelerated hydrogen peroxide (AHP, at 4.25%) were evaluated for disinfection efficacy. Five coupons per surface type were used to evaluate the recovery of FCV and MNV by sonication and stomaching and the disinfection of each surface type by using 5 ml of disinfectant for a contact time of 5 min. FCV at an initial titer of ca. 7 log PFU/ml was recovered from glass, cotton, and polyester at 6.2, 5.4, and 3.8 log PFU/ml, respectively, compared with 5.5, 5.2, and 4.1 log PFU/ml, respectively, for MNV with an initial titer of ca. 6 log PFU/ml. The use of sodium hypochlorite (5,000 ppm) was able to inactivate both FCV and MNV (3.1 to 5.5 log PFU/ml) below the limit of detection on all three surface types. AHP (2,656 ppm) inactivated FCV (3.1 to 5.5 log PFU/ml) below the limit of detection for all three surface types but achieved minimal inactivation of MNV (0.17 to 1.37 log PFU/ml). Reduction of viral RNA by sodium hypochlorite corresponded to 2.72 to 4.06 log reduction for FCV and 2.07 to 3.04 log reduction for MNV on all three surface types. Reduction of viral RNA by AHP corresponded to 1.89 to 3.4 log reduction for FCV and 0.54 to 0.85 log reduction for MNV. Our results clearly indicate that both virus and surface types significantly influence recovery efficiency and disinfection efficacy. Based on the performance of our proposed testing method, an improvement in virus recovery will be needed to effectively validate virus disinfection of soft porous surfaces.