Yearly Archives: 2015

Source of Salmonella paratyphi B still a mystery

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I like sushi, but I’m picky about where I eat it.

I avoid places that use ground tuna or back scrape (which I learned about after a 2012 Salmonella outbreak). But a current outbreak is making me evaluate my choice to eat any raw fish dish. According to CDC over 50 cases of a unique Salmonella paratyphi B variant are likely linked to tuna sushi, especially spicy tuna sushi which is usually ground.tuna_roll1

There are lots of pathways for Salmonella to get into sushi tuna. The pathogen could have been introduced on a fishing boat, in a processing plant, during packaging or in transport. Hygiene, cross-contamination or sanitation are all a possibility – and that’s what I told Rachael Ratner of Live Science.

Raw tuna is the suspected source of a new outbreak of Salmonella, but how does tuna become contaminated with the bacteria in the first place?

It’s not typical for fish in a natural environment to harbor Salmonella, the way it is, say, for cows to harbor E. coli in their guts, said Benjamin Chapman, a food safety specialist and associate professor at North Carolina State University.

Although, a 2006 Australian study showed tropical fish aquariums could be a reservoir for Salmonella paratyphi B

Experts say that the Salmonella probably wasn’t living on the fish itself, but rather the tuna became contaminated at some point when the food was being handled.

The Salmonella could come from people who handled the food in a restaurant or a processing facility (processing is likely looking at the illness distribution -ben), and didn’t properly wash their hands, Chapman said.

Because health officials have not identified a specific product tied to the current outbreak, it’s too soon to say how the tuna might have become contaminated.
“The more information that we get about [the product], the easier it would be to look for contamination roots,” Chapman said.

But in general, the risk of foodborne illness is higher with raw or undercooked meats, compared with cooked meats, Chapman said. That’s because the extra step of cooking can kill potential pathogens. With raw meats, “there’s no step in between handing [and eating] to reduce risk,” Chapman said.

Don’t eat poop especially if it falls out of the sky onto birthday cake

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I’ve been to some uncomfortable family gatherings where a few too many beer have led to awkward conversations. My experiences seem like a, uh, party next to what AOL reports happened to folks in Pennsylvania during a teenager’s sweet 16 party: the sky rained poop.

According to My Fox Philly, human waste rained down from the sky just after Jacinda blew out the candles on her cake, coating her guests and the rented canopy in feces. Her family believes the waste came from planes that were flying overhead and may have improperly disposed of the aircraft’s bathroom contents.

“Out of nowhere, from the sky, comes a bunch of feces, lands on her,” Jacinda’s dad told Fox.

The only thing more embarrassing than your party being ruined by poop rain is having your dad tell the local news about it afterwards.

53 sick: Salmonella in raw fish, is anyone surprised

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With my advancing age and lower immune strength, I don’t go for the raw seafood.

tuna.sushiI used to like the raw tuna, but now it’s seared.

I never liked sushi.

Now, the U.S. Food and Drug Administration along with the Centers for Disease Control and Prevention (CDC) and state and local officials are investigating a multistate outbreak of Salmonella Paratyphi B variant L(+) tartrate(+) infections possibly linked to sushi made from raw tuna. 

According to the CDC, 53 people infected with the outbreak strain have been reported from 9 states: Arizona (10), California (31), Illinois (1), Mississippi (1), New Mexico (6), South Dakota (1), Virginia (1), Washington (1), and Wisconsin (1). Most of the ill people have been reported from states in the southwestern United States or reported travel to this area of the country. Among 46 persons with available information, 10 (22%) have been hospitalized, and no deaths have been reported. At this time, the investigation has not conclusively identified a food source, but most ill people interviewed reported eating sushi containing raw tuna in the week before becoming ill.  At this time, a common brand or supplier of raw tuna has not been identified.

While local and state health officials continue to interview patients, the FDA is increasing its monitoring of tuna. Additionally, FDA is conducting a traceback investigation.  The FDA is evaluating and analyzing records to determine whether there is a common source of tuna.  In this effort, the FDA works with its investigational partners to identify clusters of people made ill in separate geographic areas and works to trace the path of food eaten by those made ill back to a common source.  This is labor intensive and painstaking work, requiring the collection, review and analysis of hundreds and at times thousands of invoices and shipping documents.

According to the U.S. Centers for Disease Control and Prevention

*As of May 21, 2015, a total of 53 people infected with the outbreak strain of Salmonella Paratyphi B variant L(+) tartrate(+) have been reported from nine states.

Ten ill people have been hospitalized. No deaths have been reported.  

*This outbreak is caused by Salmonella Paratyphi B variant L(+) tartrate(+) bacteria.

The illness caused by this bacteria typically includes diarrhea, fever, and abdominal cramps 12-72 hours after an exposure. 

Salmonella Paratyphi B variant L(+) tartrate(+) does not cause paratyphoid fever, enteric fever, or typhoid fever.

*The investigation has not conclusively identified the source of this outbreak, but most ill people interviewed reported eating sushi made with raw tuna in the week before becoming ill.

In interviews, 34 (94%) of 36 ill people reported eating sushi made with raw tuna in the week before becoming ill.

At this time, a common brand or supplier of raw tuna linked to illnesses has not been identified, and there are no specific steps for restaurants, retailers, or consumers to take to protect their customers or themselves.

More food tampering with potatoes in Canada

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Maybe it’s boring living on the east coast of Canada, maybe there’s some mob retribution by messing with potatoes, but seriously, if you want revenge, do it Jersey style.

Television programme : The Sopranos starring James Gandolfini asThe Canadian Food Inspection Agency (CFIA) is advising consumers of a possible food tampering situation involving potatoes following consumer complaints where nails and needles appear to have been inserted into potatoes.

To date complaints have been received from Atlantic Canada.

As tampering is a criminal offense, the Royal Canadian Mounted Police are leading the investigation into this matter. The CFIA is supporting the investigation.

There have been no confirmed illnesses or injuries associated with the consumption of these products. As a precaution, consumers should carefully check potatoes for foreign objects.

Anyone who finds any foreign metal objects in a potato is asked to refrain from throwing out the potato, metal object or the bag and any tags related to the product. Please contact your local police so the potatoes and related items can be passed along to the investigators.

 

2 dead, hundreds sickened in German Salmonella outbreak: It can come from free-range and organic eggs

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From the duh files:

egg.dirty.feb.12Berlin-based consumer protection organization Foodwatch warned about the state of food animal farming and called for stronger regulations for maintaining animals on Thursday. This follows an outbreak of salmonella that killed two and sickened hundreds, thought to have hailed from a Bavarian company.

The source of the outbreak is believed to be Bavarian egg producer Bayern-Ei. The district attorney for the city of Regensburg is investigating whether the company “brought dangerous food onto the market” in the past year, while animal rights activists have criticized the company for keeping large groups of chickens in small, overcrowded cages.

Theo Ziegler, senior public prosecutor in Regensburg, said that should their suspicions be confirmed, the firm would have to answer for the two deaths following the outbreak in mid-2014. Hundreds of people in Germany, the UK, Austria, France and Luxembourg fell ill from the same strain of salmonella.

Officials in Britain and Austria, which each lost a citizen to the outbreak, claim they are certain at least one of the deaths can be traced to Bayern-Ei.

Foodwatch cautioned in a report on the egg industry that no matter what the nature of egg production – free-range, cage-free, caged or organic – the humane treatment and safety of the products is not guaranteed.

Duh.

Salmonella ‘nightmare’ on Egypt holiday

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The parents of a 10-year-old girl who contracted salmonella during a nightmare holiday in Egypt are taking legal action.

coral-sea-waterworldMichelle Muzquiz and James Monks’ daughter Jasmin, who was nine at the time, fell ill on returning home after contracting food poisoning.

Her parents also fell ill with gastric illness days into their week-long honeymoon holiday at the Coral Sea Waterworld, in October 2013.

Now the couple from Westhoughton have instructed solicitors Irwin Mitchell to investigate and work to gain compensation from tour operator TUI UK for their ordeal.

The firm of solicitors is already representing 12 other people affected by similar problems at the same resort following holidays in 2012.

Triathlon champ puts Salmonella behind

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The Bahama Islands Info reports that with a bout of salmonella behind him, 2-time Pineappleman Sprint Triathlon champion Simon Lowe, will be back to defend his title June 6 in Gregory Town, Eleuthera.

poster4_high_res_488162693“I was sicker than I have ever been in my life,” said Lowe, 32, of the illness that kept him out of Treasure Cay, Abaco’s triathlon in March. “I was out of training for about a month and when I started again in early February it was very disheartening because it felt like I was starting again from scratch. After a few weeks though I felt the fitness coming back and I am now pretty much where I was before the illness happened.”

214 sickened at teen hockey tournament in Finland

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Chapman and I get sorta excited when food safety intersects with hockey.

ben.family.feb.15So after watching Anaheim take a 2-1 lead after two periods over Chicago, and several OMG e-mails, I can note that in Finland last month, about 30 teens got sick with Salmonella at the Riga Cup.

And then the numbers went to over 200.

But the authors, writing in Eurosurveillance, do a much better job describing the outbreak, so I’ll go back to figuring out my practice plan for this weekend.

On 14 April 2015, a general practitioner in a municipal public health authority in Finland notified the National Registry for Food and Waterborne Outbreaks (RYMY) [1] about a cluster of 30 cases of gastrointestinal disease. All had attended the Riga Cup on the 3 to 6 April weekend 2015 and six had laboratory-confirmed Salmonella serogroup D infection.

The Riga Cup is an annual international youth ice-hockey competition where mainly male teams, with occasional female players, participate. Players in the event are officially categorised in five age groups comprising individuals between 10 and 18 years-old. In 2015, the competition consisted of five tournaments lasting three to four days each, which took place over five consecutive weekends from 27 March to 26 April. The competition attracted 197 teams from Europe, including Belarus, Russia and Ukraine as well as 16 European Union and European Free Trade Association (EU/EFTA) countries. Finland contributed 50 teams. The total number of international and national participants was around 5,000. Tournaments were played according to age groups in four hockey arenas, which were used in parallel, with arena A being the main arena. A fifth arena was added on the last weekend of the tournament. Lunches and dinners for the teams were included in the competition package. The teams, including their male and female coaches and officials, were scheduled to have their meals at the arenas where they were playing. Breakfasts were taken at the hotels where the teams stayed.

Following the notification of the first cluster of cases in mid-April, the Finnish National Institute for Health and Welfare (THL) monitored notifications reported to the National Infectious Disease Registry (NIDR) in order to capture Salmonella infections with a travel history to Latvia. Names were cross-checked against a list of the Finnish players in the Riga Cup obtained from the tournament website. Other cases of Salmonella sp. in NIDR with travel history to Latvia were contacted to determine whether they had participated in the tournament as an accompanying family member or official. Cases were identified according to the outbreak case definition.

doug.sorenne.hockey.apr.14Since this led to the finding of other possible clusters in different parts of Finland, THL invited on 21 April, the Finnish clubs participating in the Riga Cup 2015 to an online survey in order to describe and determine the magnitude of the outbreak. This survey asked about demographics, dates of participation in the competition and place of accommodation. Further, the respondents were requested to specify the tournament venues where they had eaten and on which dates, along with a description of what had been consumed. It was also enquired whether any foods and beverages had been taken outside the venues. Date of onset of diarrhea with three or more loose stools a day, fever (≥38°C), headache, nausea, vomiting, or stomach ache were questioned as were any possible hospitalisations.

As of 8 May, 65 persons with Salmonella sp. infection, who had participated as players or officials in the Riga Cup 2015 between 27 March and 26 April 2015 and had onset of symptoms on or after 27 March were identified by the NIDR in Finland. By the same date, 315 persons had also responded to the online survey. Of these, 31 respondents were classified as confirmed, and were among the 65 confirmed cases identified by the NIDR. The survey additionally identified 57 suspected cases.

Of the 88 cases identified in the survey (Figure), 78 (87%) were male, the median age was 13 years (range: 8–66 years), 7 (8%) had been hospitalised, 86/87 (99%) had been playing at arena A and 39/88 (44%) participated during the tournament taking place over the second weekend of the competition.

Nine patient isolates were microbiologically characterised [2-4] at THL. The isolates were selected so that they represented clusters identified in different participating teams from different parts of Finland (Figure). All nine cases had been infected by S. Enteritidis phage type 1 (PT1) with multilocus variable-number tandem repeat analysis (MLVA) profile 3–10–6-4–1 (SENTR7-SENTR5-SENTR6-SENTR4-SE3). The isolates were susceptible to the standard panel of antibiotics tested (ampicillin, cefotaxime, chloramphenicol, gentamicin, mecillinam, meropenem, nalidixic acid, perfloxacin, streptomycin, sulfonamide, tetracycline, and trimethoprim). S. Enteritidis PT1 is rare in Finland as well as in Norway and Sweden (Lin Thorstensen Brandahl and Cecilia Jernberg, personal communications, May 2015), but common in Baltic countries, Russia and Korea [5,6].

On 16 April, THL launched an urgent inquiry through the Epidemic Intelligence Information System for Food and Waterborne Diseases (EPIS-FWD) [7] to identify cases in other countries. Potentially affected non-EU countries were informed of the outbreak via the World Health Organization and were given access to EPIS-FWD.

On 24 April, a Rapid Risk Assessment of the outbreak by the European Centre for Disease Control and Prevention (ECDC) [8] was distributed through the Early Warning and Response System (EWRS). On the request from Latvia, ECDC deployed a fellow from the European Programme for Intervention Epidemiology Training (EPIET) from Finland to support the investigation in Riga on 26 April 2015.

On 29 April, the Latvian Centre for Disease Prevention and Control (LCDC) contacted the leaders of all teams participating in the Riga Cup, except the Finnish and Norwegian teams, which had already been contacted by their national public health authorities, by email and asked if they were aware of cases of gastroenteritis with onset during or after the tournament.

2004HockeyTournanment 051An ECDC expert on food and waterborne disease outbreaks joined the investigating team in Riga on 4 May 2015. As of 8 May, seven countries (Estonia, Finland, Hungary, Lithuania, Norway, Sweden, and the United Kingdom (UK)) have reported a total of 214 cases with gastrointestinal symptoms. Identical MLVA profiles to the Finnish cases were confirmed in one Norwegian and three Swedish patient isolates. The MLVAs were performed at the Department of Food-borne Infections at the Norwegian Institute of Public Health, and Public Health Agency of Sweden, respectively. The results were communicated through EPIS and at telephone conferences concerning the outbreak (Lin Thorstensen Brandahl and Cecilia Jernberg, personal communications, May 2015).

Food and environmental investigations in Latvia

Based on the information gained from the first detected cluster in Finland, the cafeteria at arena A was suspected as the source of outbreak [8]. On 16 April, the THL and the Finnish Food Safety Authority, Evira, alerted their respective counterparts in Latvia through the EWRS [9] and the Rapid Alert System for Food and Feed [10]. On the same day, the LCDC in collaboration with the Latvian Food and Veterinary services inspected the kitchen at arena A, interviewed all kitchen staff and their family doctors, and collected fecal samples and environmental and food samples. None of the kitchen staff reported gastrointestinal symptoms during the Riga Cup and all the samples were negative for S. Enteritidis. No cases of S. Enteritidis related to Riga Cup were registered in Latvia and the number of S. Enteritidis cases did not exceed the average level in March and April 2015.

Follow-up controls took place at arena A on 24 and 27 April. Members of one team playing at the tournament on the second weekend of the competition, with five suspected cases, had only eaten their meals in arena B, so arena B was inspected on 29 April. Menus were retrieved from all arenas and wholesale suppliers were identified via the purchase receipts. The arena restaurants had been contracted by the organiser and advised to serve the same lunch and dinner menus to the participating teams. The meals were mainly prepared at the tournament arenas. The caterers at the venues served the team members a separate menu than the public during the weeks in between the tournament weekends. Leftovers of the food served to the teams were discarded at the end of each day. Latvian teams did not take lunch and dinner at the venues.

Control measures

Physicians in Finland were alerted about the outbreak by news bulletins (on 15, 20 and 30 April) [11]. The Finnish ice-hockey teams scheduled to play on the last tournament weekend were prior advised to take standard hand hygiene and food safety precautions, such as eating only cooked foods and drinking bottled beverages.

In Latvia, two other junior ice hockey events took place in Riga, from 28 April to 2 May 2015 and from 14 to 16 May 2015 respectively. As some Finnish teams were to take part in these two events, the Finnish public health authorities informed these teams and the Finnish Ice Hockey Association on 27 April about the Riga Cup outbreak and ongoing investigation. Standard hand hygiene and food safety precautions were recommended and participants were also advised to notify THL in case gastrointestinal symptoms appeared during or after the competition.

On 30 April and 8 May the Latvian public health authorities contacted the organisers of both events and recommended to consume only well-cooked foods and maintain proper hand hygiene. In addition, a phone number to a specialist from the Latvian public health authority was provided in case any of the event participants would develop gastroenteritis symptoms.

Conclusions

This outbreak was first detected by municipal public health authorities in Finland. Due to budget cuts at THL since 2015 Salmonella isolates of foreign origin are no longer typed nor are the cases monitored in real time and outbreaks of foreign origin can only be identified at a local level. This will delay detection of Salmonella outbreaks among travellers. Cross-border outbreaks and outbreaks related to mass gatherings pose special problems [12-15] and cooperation between national authorities and ECDC is needed. The investigation to determine the source of the outbreak is ongoing and a retrospective cohort study among event participants from several EU/EFTA countries is underway in order to identify the source.

Acknowledgements

We would like to thank experts from THL, The Centre for Disease Prevention and Control of Latvia, Latvian Food and Veterinary Services, national focal points of affected countries and ECDC which are continuously contributing to the outbreak investigation.

Conflict of interest

None declared.

Authors’ contributions

Anne-Katrine Pesola, Triin Pärn, Sari Huusko, Jurijs Perevoščikovs, Jukka Ollgren, Saara Salmenlinna, Taru Lienemann, Celine M. Gossner, Niklas Danielsson and Ruska Rimhanen-Finne reviewed and approved the manuscript. Anne-Katrine Pesola acted as outbreak coordinator, Anne-Katrine Pesola, Triin Pärn, Sari Huusko, Jurijs Perevoščikovs, Jukka Ollgren, Celine M. Gossner, Niklas Danielsson and Ruska Rimhanen-Finne carried out the epidemiological investigation. Saara Salmenlinna and Taru Lienemann, carried out the microbiological investigation, Anne-Katrine Pesola, Triin Pärn and Ruska Rimhanen-Finne drafted the manuscript and data analysis. All co-authors critically reviewed the draft of the paper and approved the final version.

 References

Finnish food Safety Authority Evira. Elintarvike- ja vesivälitteisten ruokamyrkytysepidemioiden ilmoittaminen ja raportointi. [Food and waterborne outbreaks, notification and reporting]. Finland; 2014. Finnish. Available from: http://www.evira.fi/portal/fi/tietoa+evirasta/asiointi/sahkoinen+asiointi/elintarvikkeet/ruokamyrkytysepidemioiden+raportointi+rymy/

Issenhuth-Jeanjean S, Roggentin P, Mikoleit M, Guibourdenche M, de Pinna E, Nair S, et al. Supplement 2008-2010 (no. 48) to the White-Kauffmann-Le Minor scheme. Res Microbiol. 2014;165(7):526-30. http://dx.doi.org/10.1016/j.resmic.2014.07.004 PMID:25049166

Ward LR, de Sa JD, Rowe B. A phage-typing scheme for Salmonella enteritidis. Epidemiol Infect. 1987;99(2):291-4. http://dx.doi.org/10.1017/S0950268800067765 PMID:3315705

Hopkins KL, Peters TM, de Pinna E, Wain J. Standardisation of multilocus variable-number tandem-repeat analysis (MLVA) for subtyping of Salmonella enterica serovar Enteritidis. Euro Surveill. 2011;16(32):19942. PMID:21871223

Hasenson LB, Kaftyreva L, László VG, Woitenkova E, Nesterova M. Epidemiological and microbiological data on Salmonella enteritidis. Acta Microbiol Hung. 1992;39(1):31-9. PMID:1632197

Kang ZW, Jung JH, Kim SH, Lee BK, Lee DY, Kim YJ, et al. Genotypic and phenotypic diversity of Salmonella enteritidis isolated from chickens and humans in Korea. J Vet Med Sci. 2009;71(11):1433-8. http://dx.doi.org/10.1292/jvms.001433 PMID:19959892

Gossner CM, de Jong B, Hoebe CJPA, Coulombier D, and European Food and

Multinational Outbreak Of Salmonella Enteritidis Infection During An International Youth Ice Hockey Competition In Riga, Latvia, Preliminary Report, March And April 2015

Eurosurveillance, Volume 20, Issue 20, 21 May 2015

A K Pesola, T Pärn, S Huusko, J Perevoščikovs, J Ollgren, S Salmenlinna, T Lienemann, C Gossner, N Danielsson, R Rimhanen-Finne

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=21133

Campy sucks: UK mother to sue Thomas Cook after bout of holiday food poisoning

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A mother who was forced to miss two months of work after being struck down by food poisoning on a family holiday is calling on the EU to do more to prevent tainted meat from reaching the dinner plate.

tiara-beach-hotel-1Helen Witts, from Pontyclun, Wales, said her symptoms – vomiting, diarrhea and stomach cramps – were so severe she had to take eight weeks of sick leave from her job as a school driver assistant.

The 51-year-old contracted campylobacter and was diagnosed shortly after returning from Sunny Beach, Bulgaria, where she stayed at the Tiara Beach Club Hotel.

Helen fell ill on the penultimate day of her trip with her 58-year-old partner, Colin, and 15-year-old son, Liam, last August.

She said she used her own medication to ease her stomach cramps, but her condition worsened when she returned home to Wales.

A Thomas Cook spokesperson told MailOnline Travel: ‘Thomas Cook takes health and hygiene issues very seriously and maintaining the safety of our customers is our number one priority.”

Uh-huh

Campy isn’t kosher and kosher doesn’t mean microbiologically safe: NYC investigating reports of food poisoning at synagogue dinner

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New York City’s Department of Health and Mental Hygiene is investigating reports of food sickness following an event at a Manhattan synagogue dedicated to exotic kosher cuisine.

kosher.dinner.may.15The May 5 dinner, held at Congregation Shearith Israel, known as the Spanish-Portuguese synagogue, was meant to highlight animals and other foods that are kosher but rarely consumed by observant Jews, such as oxtail, locusts, quail eggs and organ meat from calves, chickens, ducks and other animals. The so-called Halakhic Dinner combined the exotic dishes with Jewish teachings about them and was led by the synagogue’s rabbi, Meir Soloveichik. Similar dinners have taken place in past years.

After the dinner, about 20 people reported gastrointestinal distress, according to Vos Is Neias, an Orthodox blog and news site. The blog cited Dani Klein, who runs the YeahThatsKosher blog and attended the dinner, as saying that his wife tested positive after the dinner for campylobacter, a bacteria associated with raw or uncooked poultry, unpasteurized dairy products or contaminated water, poultry or produce.

A spokesman for the city’s Department of Health, Christopher Miller, told JTA, “We’re investigating and working with the synagogue.”

“Did you know that giraffes are kosher? How about locusts? They are!” read a promotion for the event on Shearith Israel’s website. “Rabbi Soloveichik will entertain and enlighten with a special lecture over dinner. We’ll learn about some far out there kosher foods, and we’ll eat a few of them too. Goat, venison, bison and squab are just a few of the expected featured ingredients. Come hungry and adventurous.”