Water, conduit of bacteria to produce: Onion growers can live with FDA rule

Idaho and Oregon onion growers say they can live with the water quality provisions included in the FDA’s final produce safety rule, which was released Nov. 13.

onion.water.oregonTwo years ago, they were worried the proposed water quality provisions in FDA’s originally proposed produced rule could put them out of business. But industry officials said the FDA heard their concerns and re-wrote the rule in a way that onion growers are OK with.

To go from a rule that would have seriously impacted the economics of the onion industry “to a rule that’s livable for us and allows us to stay in business is a huge victory,” said Kay Riley, chairman of the Idaho-Eastern Oregon Onion Committee.

When FDA first proposed its produce safety rule in 2013, it included water quality standards limiting how much generic E. coli bacteria could be present in agricultural water.

If the water didn’t meet those standards, farmers had to immediately stop using it. Virtually none of the surface water used by onion growers in Eastern Oregon and Southwestern Idaho meets those standards.

The water quality standards still exist in the final rule.

But FDA altered them to allow growers to meet the standards, even if their water exceeds the minimum bacteria levels, if they can show through scientific evidence that bacteria dies off at a certain rate from the last day of irrigation until harvest.

The bulb onions grown in this region are left in the field to dry for a few weeks following harvest. Field trials by Oregon State University researchers have shown these onions will meet the so-called die-off provisions.

“The thing that’s great about it is they actually listened to us,” Riley said. “I would deem it a tremendous victory compared to what it could have been.”

But the final rule still requires farmers to test their water annually, even if they meet the die-off provisions. Onion growers say the testing will be costly and time-consuming and they hope to be able to skip them.

“They are still going to require testing and that’s going to be the hardest thing to deal with,” said Stuart Reitz, an OSU cropping systems extension agent in Ontario. “The final rule is not ideal but it’s not that bad. It’s one onion growers can live with.”

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.

Chlorine is still a friend: Gastro from water wells in Canada

Waterborne illness related to the consumption of contaminated or inadequately treated water is a global public health concern.

water.well.ontAlthough the magnitude of drinking water-related illnesses in developed countries is lower than that observed in developing regions of the world, drinking water is still responsible for a proportion of all cases of acute gastrointestinal illness (AGI) in Canada.

The estimated burden of endemic AGI in Canada is 20·5 million cases annually – this estimate accounts for under-reporting and under-diagnosis. About 4 million of these cases are domestically acquired and foodborne, yet the proportion of waterborne cases is unknown. There is evidence that individuals served by private systems and small community systems may be more at risk of waterborne illness than those served by municipal drinking water systems in Canada. However, little is known regarding the contribution of these systems to the overall drinking water-related AGI burden in Canada.

Private water supplies serve an estimated 12% of the Canadian population, or ~4·1 million people. An estimated 1·4 million (4·1%) people in Canada are served by small groundwater (2·6%) and surface water (1·5%) supplies. The objective of this research is to estimate the number of AGI cases attributable to water consumption from these supplies in Canada using a quantitative microbial risk assessment (QMRA) approach. This provides a framework for others to develop burden of waterborne illness estimates for small water supplies. A multi-pathogen QMRA of Giardia, Cryptosporidium, Campylobacter, E. coli O157 and norovirus, chosen as index waterborne pathogens, for various source water and treatment combinations was performed. It is estimated that 103 230 AGI cases per year are due to the presence of these five pathogens in drinking water from private and small community water systems in Canada.

In addition to providing a mechanism to assess the potential burden of AGI attributed to small systems and private well water in Canada, this research supports the use of QMRA as an effective source attribution tool when there is a lack of randomized controlled trial data to evaluate the public health risk of an exposure source. QMRA is also a powerful tool for identifying existing knowledge gaps on the national scale to inform future surveillance and research efforts. 

Estimating the burden of acute gastrointestinal illness due to Giardia, Cryptosporidium, Campylobacter, E. coli O157 and norovirus associated with private wells and small water systems in Canada

Epidemiology and Infection, August 2015, pages 1-16, DOI: 10.1017/S0950268815002071

H.M. Murphy, M.K. Thomas, P.J. Schmidt, D.T. Medeiros, S. McFadyen, and K.D.M. Pintar


Hope for future drugs? Exploring vulnerabilities of Cryptosporidium

Cryptosporidium parvum is a gastrointestinal parasite that can cause moderate to severe diarrhea in children and adults, and deadly opportunistic infection in AIDS patients.

crypto.glcolysisBecause C. parvum is resistant to chlorine disinfectant treatment, it frequently causes water-borne outbreaks around the world. A study published on Nov. 12th in PLOS Pathogens provides a detailed analysis of a C. parvum protein that is central to glycolysis — the only pathway by which the parasite can generate energy — and identifies it as a potential drug target.

Guan Zhu and colleagues, from Texas A&M University in College Station, USA, study the parasite’s metabolism during its complicated life-cycle. C. parvum exists both in free stages (where parasites are in the environment or in the host’s digestive tract) and intracellular stages following host cell invasion, during which the parasite occupies a specialized compartment — the parasitophorous vacuole — which is delineated by a host-cell derived border called the parasitophorous vacuole membrane (PVM).

For this study, the researchers focused on lactate dehydrogenase (LDH), an enzyme central to glycolysis. Glycolysis is the only metabolic process by which organisms like C. parvum — that lack functional mitochondria to derive energy from oxygen — can generate ATP, the universal biological energy storage molecule. They found that the C. parvum LDH (CpLDH) protein is found inside the parasite’s cells during the free stages, but is then transferred to the PVM during intracellular development, indicating involvement of the PVM in parasite energy metabolism, and specifically, in lactate fermentation. They also demonstrate that two known LDH inhibitors, gossypol and FX11, can inhibit both CpLDH activity and parasite growth.

The researchers summarize that their observations “not only reveal a new function for the poorly understood PVM structure in hosting the intracellular development of C. parvum, but also suggest LDH as a potential target for developing therapeutics against this opportunistic pathogen, for which fully effective treatments are not yet available”. Acknowledging that the ultimate validation of CpLDH as a drug target requires tools for knockout or knockdown of genes of interest in Cryptosporidium, they say recent advances towards this goal raise hope that such validation will be possible in the near future.

Overall, they conclude that “the present data, together with the fact that C. parvum relies on glycolysis for producing ATP, support the notion that CpLDH is worth exploring as a potential target for the development of anti-cryptosporidial therapeutics.”

Australian parents warn of brain-eating parasite that killed baby boy

When Queensland mum Jodi Keough gave her children hoses to cool down with on a hot day, she had no clue it would lead to the death of her precious baby boy.

49c7026ff26063b321a181d8c3d24360One-year-old Cash died in April this year from what’s being called a “brain-eating parasite” that was thriving in the water at Jodi and Laine Keough’s cattle station, near Townsville.

Little is known about the extraordinarily rare disease that led to Cash’s death, but what is known is that he is the third child in central west Queensland to die from it.

And tonight, Australian Story looks at the amoeba that could be lurking in the water at many Australian rural homes.

“It’s rare but it’s deadly,” clinical microbiologist Dr Robert Norton tells the program.

“It’s something that rural Australia needs to be aware of.”

Naegleria fowleri thrives in fresh, warm water more than 25C. It’s caused at least 300 deaths worldwide, and at least 25 in Australia, and causes severe inflammation and brain destruction when contracted through the nose.

Mrs Keough said that’s exactly how her “very happy little boy”, Cash, became infected. She thinks it happened as he played with a garden hose on a hot day.

Don’t poop in pools: when it happens, take action

The incidence of recreational water-associated outbreaks in the United States has significantly increased, driven, at least in part, by outbreaks both caused by Cryptosporidium and associated with treated recreational water venues.

diaper.poolBecause of the parasite’s extreme chlorine tolerance, transmission can occur even in well-maintained treated recreational water venues (e.g. pools) and a focal cryptosporidiosis outbreak can evolve into a community-wide outbreak associated with multiple recreational water venues and settings (e.g. childcare facilities).

In August 2004 in Auglaize County, Ohio, multiple cryptosporidiosis cases were identified and anecdotally linked to pool A. Within 5 days of the first case being reported, pool A was hyperchlorinated to achieve 99·9% Cryptosporidium inactivition. A case-control study was launched to epidemiologically ascertain the outbreak source 11 days later. A total of 150 confirmed and probable cases were identified; the temporal distribution of illness onset was peaked, indicating a point-source exposure. Cryptosporidiosis was significantly associated with swimming in pool A (matched odds ratio 121·7, 95% confidence interval 27·4–∞) but not with another venue or setting.

The findings of this investigation suggest that proactive implementation of control measures, when increased Cryptosporidium transmission is detected but before an outbreak source is epidemiologically ascertained, might prevent a focal cryptosporidiosis outbreak from evolving into a community-wide outbreak.

Preventing community-wide transmission of Cryptosporidium: a proactive public health response to a swimming pool-associated outbreak – Auglaize County, Ohio, USA

Epidemiology and Infection / Volume 143 / Issue 16 / December 2015, pp 3459-3467



Cow poop: Use fencing, buffer zones wisely

 Fencing or buffer strips to keep cattle out of streams shouldn’t be a first move, University of California-Davis rangeland watershed specialist Kenneth Tate said during a livestock water quality seminar Oct. 22 in Fairfield, Wash.

cow.poop2Best management practices include maintaining healthy cattle or placing salt away from streams to avoid contamination, he said.

“The absolute last place I would recommend a start is to consider fencing off creeks, because first and foremost, we don’t know that it’s required,” he said. “Start with the cheap stuff, the easy stuff, and build your way into it, just as you would with any business going into a new venture.”

Best management practices need to make economic sense to ranchers, Tate said.

“There’s a lot of things to think about before you start erecting hundreds of miles of fence,” he said.

More than 90 percent of microbes in a pile of manure, or range cow fecal pat, never leave, Tate said. Depending on temperature or environmental conditions, they die very quickly. It removes a lot of the potential microbial pollutants, he said.

Most microbes are trapped roughly a yard around the pat. Microbes reduce by 70 to 90 percent for every additional yard they travel, such as in runoff during a storm.

The first step is deciding whether a buffer zone is needed, and how efficiently a location traps pollutants, Tate said.

“It really comes down to site-specific conditions and the magnitude of the risk,” he said. “It’s not a one-size-all answer. Anybody who tells you (it) is is oversimplifying our extremely complex world.”


Ice fingered but epi can be ‘squishy’ 61 sickened by Norovirus at journalists’ conference

Two months after a norovirus outbreak at Bali Hai restaurant, county health officials have fingered ice as the foodborne source that sickened at least 61 people — including three in a wedding party.

norovirus-2“We’re certain it had something to do with the ice” served at the annual awards banquet of the local Society of Professional Journalists, said county spokesman Michael Workman. “We’re not certain how it got in the ice.”

In its final report to the San Diego SPJ, the county said 84 of the 172 people at the July 29 banquet returned surveys on what they ate and other issues. Fifty were sickened by norovirus type GI.1. (Eight others also reported getting ill.)

Three diners elsewhere in Bali Hai also got GI.1 — part of a wedding party of 140.

“We have to [classify it as] food poisoning,” Workman said, rather than a sick person spreading the gastrointestinal disease.

A Sept. 4 report said, “We did not link any food service workers with the illness,” but Workman on Tuesday told Times of San Diego that “we can’t say yes or no” to whether an employee caused the outbreak.

Workman stressed that Bali Hai remains “rated for high” for hygiene. “Everyone involved — from the people who attended [the banquet] and from the restaurant … did the right thing.”

County spokesman Workman saluted Bali Hai management.

“The restaurant had a great hygiene procedure, really good,” he said. “They are on the up-and-up on what they do and what they teach their employees. The employees have been there a long time. So they get it.”

But Workman acknowleged the county’s findings can be “squishy” and “it’s not an exact science.”

But: “We’re confident it’s been taken care of.”

Minimize risk: Tracking shellfish contamination

Some shellfish, especially raw oysters, may contain dangerous levels of the pathogen Vibrio parahaemolyticus (Vp), a cousin of the bug that causes cholera.

Raw oystersWhen ingested, Vp can cause the food poisoning called vibriosis, which usually entails an unpleasant three days of nausea, diarrhea, fever and chills. In rare cases and among vulnerable populations—the very young, very old or those with weakened immune systems—the bacterium can cause a more serious blood infection. Vp, which can also cause skin infections, leads to about 30 hospitalizations and kills one to two people each year, according to the Centers for Disease Control and Prevention.

In Massachusetts, 58 cases of Vp-related illnesses were reported to the Department of Public Health in 2013, up from 13 cases in 2011. The state banned oyster harvesting in waters off Cape Cod, Martha’s Vineyard and Nantucket as well as off the towns of Plymouth, Kingston, Duxbury and Marshfield that year. The last two years waters in New York, Oregon and Washington State have been closed to oystering.

Vp occurs naturally in most marine ecosystems, but it typically has only been linked to disease in warm coastal areas, such as the Gulf of Mexico. The recent emergence of Vp-associated illness linked to seafood from waters off Alaska, Long Island and Massachusetts has made public health officials and others sit up and take notice, says Meghan Hartwick, who received a master’s degree in conservation medicine from Cummings School in 2012 and now works to predict and control future outbreaks.

oysters.grillWhy has Vp-related illness spread to more northern latitudes? Some scientists speculate it might have to do with climate change and rising ocean temperatures. “When we see these kinds of outbreaks in historically cold-water areas, it’s really unusual,” says Hartwick, who is studying the Vibrio species as a Ph.D. student in biology at the University of New Hampshire.

Hartwick hopes to develop a predictive mathematical model that can warn public health officials and shellfish growers when Vp outbreaks might occur. She helped implement such an environmental surveillance tool for cholera in Vellore, India, as part of her conservation medicine program at Tufts.

Nationwide, Vibrio parahaemolyticus cases are also on the rise. The Centers for Disease Control reports a 115 percent increase since 1996, when the agency started tracking Vp-associated illnesses. Of the 431 cases the CDC confirmed in 2012, six were fatal. Officials also suspect that Vp is vastly underreported, by as much as tenfold.

Hartwick is studying the Vibrio population in the Great Bay tidal estuary on the New Hampshire coast that empties into the Gulf of Maine. Collaborating with UNH colleagues with expertise in microbial ecology, genetics, molecular evolution and remote sensing, Hartwick is trying to understand the role the bacteria plays within Great Bay’s ecosystem.

The “sole goal [of Vp] in life is not to be a human pathogen,” she says. “Vp is an intrinsic part of the flora and fauna of most marine and estuarine ecosystems.”

In the spring and summer, Hartwick collects water and sediment samples and gathers data about water temperature, salinity, pH levels and anything else that might affect the bacteria’s numbers. Over time, she hopes to map how much and which species of Vibrio bacteria are present in Great Bay during the summer, as well as what factors might promote an outbreak.

In addition to developing a Vibrio early-warning tool, Hartwick and the UNH team, including her advisor, bacteriologist Stephen Jones, are working with shellfish growers to figure out how to prevent future outbreaks. After all, no one wants to sell food that makes people sick, she says.

“We’re not blindly throwing a dart and hoping it solves the problem,” Hartwick says. “We’re asking, ‘What is the problem, and what’s the best way to address it,’ so there are no unnecessary burdens placed on the shellfish industry, and there’s also no unnecessary illness. It’s sustainable science contributing to sustainable policy.”

Now into a second summer of collecting samples in Great Bay, Hartwick says she eventually would like to do work in sustainable development on a global scale. Disrupting ecosystems is one of the surest ways to trigger epidemics, such as cholera, she says, and disease is one of the heaviest economic burdens developing nations have to bear.

“If a developing nation can navigate that, it can jump ahead economically,” she says. “It’s hard for me not to think, ‘How can we conserve the environment and improve human health and the economy and education—everything at once?’ My approach is to minimize disease.”

3 sick: Crypto outbreak in Tenn.

Some Scott County parents are on edge after two local children have been hospitalized with a gastrointestinal illness caused by a common microscopic parasite.

crypto.Public-Pool-Dangers-800Cryptosporidiosis is being blamed for at least three illnesses in Scott County children this week, creating a sense of alarm on social media as news of their sickness has spread.

The first local child to be admitted to the hospital was a young girl from Oneida. Initially fearing an appendicitis attack, her mother, Tracy Shoopman, drove her to East Tennessee Children’s Hospital in Knoxville on Tuesday. There, doctors admitted her for testing, and on Wednesday confirmed a diagnosis of cryptosporidiosis.

The same day, another child from Scott County — a student at Huntsville Elementary School — was also diagnosed with cryptosporidiosis by doctors after being hospitalized at Children’s Hospital. Her mother, Mindy Wagaman, told the Independent Herald that her daughter was hospitalized late Tuesday night after she started vomiting blood.

Both children remained hospitalized Thursday.

Also on Wednesday, a third child, also a student at Huntsville Elementary, was diagnosed with the illness by Children’s Hospital doctors. However, she was treated in the hospital’s emergency room and released.

A fourth child, a student at Huntsville, was being tested for the illness.

At first glance, there was no apparent connection between the four cases of the illness — which health officials say is most commonly caught from contaminated water sources. According to the CDC, the illness can be caught by swimming in contaminated bodies of water, which can include streams or lakes but can also include treated water sources, such as pools or splash pads. Because the parasite is resistant to common water treatment methods, it can survive in pools after being unknowingly introduced to the water by someone who is sick.

Knoxville’s WBIR reported last week that East Tennessee health officials are seeing a major spike in crypto cases this year. The story quoted Darci Hodge, Children’s Hospital’s director of quality and infection control, as saying the hospital has confirmed 29 cases of crypto this year — far higher than the next highest single-year number of five cases.