Gross: Family encounters vomit on a plane

Illness happens on planes, and when it does it’s miserable.

In 2009 I dealt with campylobacteriosis over a day of travel from Manhattan (Kansas) to Raleigh. In 2013, then four-year-old Jack yacked on a flight which led to a fascinating approach by Delta Airlines involving plastic bags to contain the risk and coffee pods to manage the smell. The flight crew let us off the plane first (although we were in the second-to-last row) as we potentially inoculated the plane and passengers with norovirus.6a00d834e06b8c69e200e54f7819da8834-800wi

According to MyFoxOrlando, the Shirley family encountered a bunch of vomit on a United flight to DC – and maybe their own norovirus inoculation event.

Scott Shirley had boarded a United Airlines flight with his wife and son when the trio noticed an unusual smell after placing their carry-on bags underneath their seats. After realizing their bags were damp, the family recognized the odor as vomit.

“She [Shirley’s wife] reached down and rubbed the ground and goes “the whole ground is wet,” and then she put it to her nose and goes “Oh my god! This is throw up,” Shirley explained to WUSA9.

Shirley says his wife (who ironically, works for FDA -ben) suffers from mysophobia — fear of germs– and she immediately began crying she was so upset. The airline did acknowledge that a passenger seated in that area had become sick on an earlier flight but the family was told it had been cleaned by the cabin crew.

“It was clear that no one had cleaned the area where we were sitting, because there was no evidence of any chemical smell what so ever. This was purely that distinct smell of vomit on our hands and backpacks,” Shirley told the Daily Mail.

CDC recommends using a chlorine bleach solution with a concentration of 1000–5000 ppm to clean and disinfect an area where someone has vomited. Hard to do that on a plane with all the carpet.

One dead, 20 ill with botulism following Ohio church potluck

Potlucks can be scary. I prefer to attend events organized and attended by other food safety nerds. They should at least know how to safely cook/prepare/transport/serve stuff.

If I attend a potluck in the real world, I typically stick to the bread products and high acid fruits. I’m trying to avoid the unknown.

Like botulism.

According to MyFox28, at least 21 attendees of a Lancaster, Ohio church potluck dinner have botulism. Tragically, one individual has died.6kiGZPDQ

Health officials say all of the people who are ill attended a potluck at Cross Pointe Free Will Baptist Church Sunday.

Three of the patients are in critical condition, and 10 patients were taken to other hospitals.

Health officials 50 to 60 people attended the potluck.

The hospital says a neurologist determined a patient had botulism Tuesday morning, and a short time later, two other cases were identified. All 19 of the patients came in to the Emergency Department at Fairfield Medical Center.

The Fairfield Medical Center is reminding the community that botulism is not contagious, so there is no threat to the community. But medical officials are encouraging anyone who was at the potluck to come to the emergency department.

There’s no indication as to what food contained the botulinum toxin. It could be linked to home-canned foods (as most botulism cases in the U.S. are) or maybe baked potatoes wrapped in foil that were held at room temperature – something that I’ve seen at potlucks before.

130 sickened by soft cheese in 2002: It was the birds

In 2005, Chapman and I went on a road trip featuring a lot of food and funny hats (I also met my wife, got a job at Kansas State and we birthed barfblog.com; 10 years, over 10,000 posts and 42,000 direct subscribers).

DSC00012.JPGFirst stop was Prince George, British Columbia (that’s in Canada) where Chapman was afraid he would get eaten by bears and they had foam parties.

Our host was Lynn Wilcott (on the left, wearing a funny hat).

DSC00009.JPGIn 2002, Lynn and Lorraine McIntyre investigated two outbreaks of Listeria related to soft cheese.

They weren’t allowed to publish for a while because the cases were in litigation, and then well, 10 years went by.

 

 

 Soft ripened cheese (SRC) caused over 130 foodborne illnesses in British Columbia (BC), Canada, during two separate listeriosis outbreaks. Multiple agencies investigated the events that lead to cheese contamination with Listeria monocytogenes (L.m.), an environmentally ubiquitous foodborne pathogen. In both outbreaks pasteurized milk and the pasteurization process were ruled out as sources of contamination. In outbreak A, environmental transmission of L.m. likely occurred from farm animals to personnel to culture solutions used during cheese production. In outbreak B, birds were identified as likely contaminating the dairy plant’s water supply and cheese during the curd-washing step. Issues noted during outbreak A included the risks of operating a dairy plant in a farm environment, potential for transfer of L.m. from the farm environment to the plant via shared toilet facilities, failure to clean and sanitize culture spray bottles, and cross-contamination during cheese aging. L.m. contamination in outbreak B was traced to wild swallows defecating in the plant’s open cistern water reservoir and a multibarrier failure in the water disinfection system. These outbreaks led to enhanced inspection and surveillance of cheese plants, test and release programs for all SRC manufactured in BC, improvements in plant design and prevention programs, and reduced listeriosis incidence.

 DSC00013.JPGMcIntyre, L., Wilcott, L and Naus, M. 2015. Listeriosis outbreaks in British Columbia, Canada, caused by soft ripened cheese contaminated from environmental sources. BioMed Research International, vol. 2015, Article ID 131623, 12 pages, 2015. doi:10.1155/2015/131623.

 http://www.hindawi.com/journals/bmri/2015/131623/

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Duh files: Doctors don’t always ask about pet-related health risks

According to NPR, if you’re being treated for cancer, an iguana might not be the pet for you.

goat.petting.zooDitto if you’re pregnant, elderly or have small children at home.

Pets can transmit dozens of diseases to humans, but doctors aren’t always as good as they should be in asking about pets in the home and humans’ health issues, a study finds.

And that goes for people doctors and animal doctors. “The fact that they’re equally uneducated is concerning,” says Jason Stull, an assistant professor of veterinary preventive medicine at Ohio State University and lead author of the review, which was published Monday in the Canadian Medical Association Journal. “There hasn’t been a great dialogue between the veterinary community, the human health community and the public.”

Amphibians, reptiles, rodents and young poultry can spread Salmonella. Back in 2013 the Centers for Disease Control and Prevention warned of an outbreak of a rare strain of Salmonella among people who had pet hedgehogs, and suggested that people lay off cuddling the adorable creatures.

Parasites like giardia and Cryptosporidium cause diarrheal disease and can be spread by dogs and cats. Those are nasty but treatable. Rarer parasites like Echinococcus tapeworms can cause liver failure and death.

People should be sure to let their human health-care providers know that they have pets, Stull says, and let the vet know if there are family members who are at greater risk of animal-borne infections. That includes children under age 5, pregnant women, older people, and anyone with a weakened immune system due to things like chemotherapy, HIV/AIDS or organ transplants.

If you’re intrigued by the notion of Fluffy as disease vector, you’ve got friends at (decent hockey player Scott Weese’) Worms and Germs  blog from the University of Guelph. They’re closely following the new outbreak of canine flu, for example.

At The Ohio State University and partner institutions, researchers have compiled the latest information from more than 500 studies worldwide to make recommendations on how families can minimize the risk of disease transmission by choosing the right type of pet, or by making small changes in how they enjoy the pets they already have.

The review was published in the April 20 issue of CMAJ (Canadian Medical Association Journal).

Toronto looks at daycares, nursing homes for DineSafe

While other cities continue to fight a losing war against restaurant inspection disclosure, Toronto is planning to expand its red-yellow-green placard system to daycares, hospitals, nursing homes and school cafeterias, 20 months after a Ryerson University/Star investigation revealed serious gaps in the city’s heralded DineSafe program.

toronto.dinesafeDr. David McKeown, Toronto’s medical officer of health is recommending city council expand DineSafe to food-serving institutions including daycares, hospitals, nursing homes and school cafeterias. They would have to prominently display green (pass), yellow (cautionary pass) or red (fail) health inspection results.

McKeown also wants the notices posted for public pool and spa water tests.

Expanding DineSafe disclosure “will increase compliance with health and safety requirements and result in improved public health,” he states in a report released Monday.

About 2,000 food-serving institutions are not covered by stringent DineSafe requirements introduced 14 years ago and credited with reducing dangerous health violations by Toronto restaurants.

Because daycares, hospitals, nursing homes and other institutions “serve vulnerable populations, they are considered high-risk food premises requiring at least three compliance inspections annually,” the report states.

“You guys get the credit for pushing us to disclose,” Toronto Public Health food safety manager Jim Chan said at the time.

However, institutions were not forced to display green, yellow or red signs at their entrances.

McKeown’s proposed bylaw would expand DineSafe to “premises where food or milk is manufactured, processed, prepared, stored, handled, displayed, distributed, transported, sold or offered for sale, but does not include a private residence.”

Beef industry not sold on E. coli vaccine

The beef industry has been slow to adopt an E. coli vaccine that could keep people from getting sick.

e.coli.vaccineMeat companies have been trying to clean up their E. coli problem. Infections are down 30 percent from the late 90s. Still, most E. coli outbreaks are from beef.

An E. coli vaccine has been on the market for years that could reduce the risk of getting sick. It’s not a vaccine for people, it’s a vaccine for cows. But not many cows are getting it.

“I’m not aware of anybody who’s currently giving the vaccine,” said Galen Erickson, a feedlot specialist at the University of Nebraska Lincoln.

There are two vaccines. One is sold in the U.S. by Zoetis, and has been around about 5 years. There’s also a Canadian vaccine from a company called Bioniche (now Telesta Therapeutics).

Zoetis would not release sales information for their U.S. vaccine, but a 2011 survey by the U.S. Department of Agriculture found only 2.4 percent of feedlots over 1,000 head of cattle used the vaccine.

Neither vaccine has had many takers even though field trials have been promising. Galen Erickson was part of a group that studied the vaccine’s effectiveness.

“For sure, the vaccine that we worked with, which is Bioniche’s vaccine, is very effective with a 60 percent reduction,” Erickson said. “That’s certainly conclusive that it works.”

Erickson says feedlots want to cut E. coli. Some use an anti-microbial feed additive to reduce E. coli numbers. But the vaccines are more effective and Erickson says cattle feeders would use a vaccine if they could afford it.

E. coli vaccines cost $8 – $15 dollars per cow. That may not seem like much, but over time that could swallow up a feedlot’s profits.

“Any time you add even what look like small costs per head, it very quickly takes a sizable chunk out of their profitability,” said Ted Schroeder, an agricultural economist at Kansas State University who recently studied the economics of the E. coli vaccine.

“The challenge is, I don’t know that anyone knows how much a probability reduction you can get in those recall events, and/or their size, and/or their magnitude by just vaccinating,” Schroeder said. “But it’s on all (the meat packers’) radar screens.”

Multistate outbreak of multiple Salmonella serotype infections linked to sprouted chia seed powder – United States, 2014

To be presented at the U.S. Centers for Disease Control and Prevention’s 64th Annual Epidemic Intelligence Service (EIS) conference April 20-23 in Atlanta.

chia.mr.tBackground: Salmonella causes 1.2 million infections and 380 deaths annually in the United States. On 5/6/2014, PulseNet, the national molecular subtyping network for foodborne disease surveillance, identified a cluster of Salmonella Newport infections with the same novel outbreak strain. US states, FDA, Canada, and CDC investigated to identify the source and prevent additional illnesses.

Methods: We defined a case as infection with an outbreak strain with onset 1/1/2014–7/22/2014. We conducted open-ended interviews to identify common exposures in the week prior to onset, administered supplemental questionnaires to refine hypotheses, collected products for testing, and performed traceback investigations.

Results: We identified 31 case-patients in 16 states; 22% (5/23) were hospitalized. Ninety percent (19/21) of case-patients reported consuming chia seeds or powder; 79% (15/19) of those specifically reported consuming chia seed powder of variable brand names. Traceback identified a Canadian firm as the common supplier for the sprouted chia seed powder. Multiple products containing sprouted chia seed powder from this firm were recalled and FDA denied admission of these products into the US until testing could confirm the products were no longer contaminated. During the investigation, testing of chia-containing products yielded two more Salmonella strains (Hartford and Oranienburg) that also caused illnesses; these were included in the outbreak.

Conclusions: Epidemiologic, traceback, and laboratory evidence identified sprouted chia seed powder processed at a single firm as the outbreak source. Although sprouted chia seeds are a novel Salmonella outbreak vehicle, this investigation highlights the well-documented risks for foodborne illness associated with the sprouting process. Firms choosing to produce sprouted seed products should follow available guidance to reduce the risk of bacterial contamination.

Listeria monocytogenes linked to whole apples used in commercially produced, prepackaged caramel apples – United States, 2014-2015

To be presented at the U.S. Centers for Disease Control and Prevention’s 64th Annual Epidemic Intelligence Service (EIS) conference April 20-23 in Atlanta.

caramel.appleBackground: Listeria monocytogenes (Lm) infection is the third leading cause of death from foodborne illness in the United States. Lm isolates undergo pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS) to identify disease clusters. In November 2014, two multistate clusters of Lm infections with distinct PFGE patterns were detected. Due to geographic and temporal overlap and a case with co-infection, they were investigated together to identify the source and prevent illnesses.

Methods: Cases were defined as illnesses with highly related Lm strains by WGS reported to PulseNet, the national molecular subtyping network for foodborne disease surveillance, with onset from 10/17/2014 to 2/12/2015. Information was collected on foods consumed in the weeks before illness onset using hypothesis-generating questionnaires and open-ended interviews. Case-patient food exposures were compared with data from listeriosis patients with genetically unrelated Lm using Fisher’s exact test. Traceback was performed to identify the suspect food source. WGS was performed on all case-patient, produce, and environmental isolates.

Results: Thirty-five cases from 12 states and 1 from Canada were identified; 34 patients were hospitalized and seven died. Three cases of meningitis occurred among healthy children. Twenty-eight (90%) of 31 patients reported consuming prepackaged caramel apples (multiple brands) compared with 1 (2.8%) of 36 patients with unrelated Lm isolates (p<0.001). Environmental and produce samples from a common apple supplier were highly related to clinical isolates by WGS. Three caramel apple producers and the apple supplier issued voluntary recalls.

Conclusions: Whole apples used in prepackaged caramel apples were the outbreak source. This is a new vehicle for Lm infections. Research is needed to understand factors specific to caramel apple production to prevent further contamination and illness.

Outbreak of Salmonella Newport infections linked to cucumbers – United States, 2014

To be presented at the U.S. Centers for Disease Control and Prevention’s 64th Annual Epidemic Intelligence Service (EIS) conference April 20-23 in Atlanta.

animal.house.cucumber (1)Background: Salmonella causes approximately 1 million foodborne infections and 400 deaths annually in the United States. In August 2014, PulseNet, the national molecular subtyping network for foodborne disease surveillance, detected a multistate cluster of Salmonella Newport (SN) infections with an indistinguishable pulse-field gel electrophoresis pattern. This strain has previously been linked to tomatoes from the Delmarva Peninsula of the Eastern US. We investigated to identify the source and prevent further illnesses. Methods: A case was defined as an illness with the outbreak strain with onset from 5/20/2014- 9/30/2014. Information was collected on travel, restaurant, and food exposures in the 7 days before illness onset using a structured questionnaire. Reported food frequencies were compared to the 2006-2007 FoodNet Population Survey. A non-regulatory traceback was performed to identify the source of food items consumed in illness sub-clusters. Whole genome sequencing (WGS) was conducted to further characterize relatedness of Salmonella isolates.

Results: A total of 275 cases from 29 states and DC were identified; 34% (48/141) were hospitalized and 1 death was reported. A significantly higher percentage of ill persons consumed cucumbers in the week before illness onset than expected, (62% vs. 46.9%, p=0.002). Traceback of 8 illness subclusters led to a common cucumber grower in the Delmarva region of Maryland. WGS analysis showed that genetic sequences of clinical isolates from MD and DE were highly related but distinct from a NY sub-cluster.

Conclusions: Epidemiologic and traceback evidence suggest cucumbers were a major source of illness in this outbreak. This is the first multistate outbreak of SN infections linked to a produce item from the Delmarva Peninsula other than tomatoes, suggesting an environmental reservoir may be responsible for recurring outbreaks.

Campylobacter jejuni infection associated with raw milk consumption – Utah, 2014

To be presented at the U.S. Centers for Disease Control and Prevention’s 64th Annual Epidemic Intelligence Service (EIS) conference April 20-23 in Atlanta.

colbert.raw.milkSummary: Despite routine testing, raw milk from a Utah dairy sickened 99 people with Campylobacter; 1 died and 10 were hospitalized. A 2-month shutdown failed to stop the outbreak and the dairy’s raw milk permit was revoked.

Abstract:

Background: In Utah, raw milk sales are legal from farm to consumer. Despite routine bacterial and coliform

counts by the Utah Department of Agriculture and Food (UDAF), raw milk-related illnesses occur. In May 2014, the Utah Department of Health (UDOH) identified a cluster of 3 Campylobacter jejuni infections with indistinguishable pulsed-field gel electrophoresis (PFGE) patterns. All patients reported consuming Dairy A’s raw milk. Routine testing of UDAF-licensed Dairy A’s raw milk was acceptable. We investigated to identify a source and prevent additional infections.

Methods: UDAF used onsite milk neutralization technique to preserve C. jejuni during testing. Utah’s electronic disease surveillance system identified cases. Confirmed illness was defined as diarrhea caused by C. jejuni matching the cluster PFGE pattern. Probable illness was diarrhea and contact with a confirmed patient or raw milk purchased from Dairy A. Confirmed patients were interviewed by using a standardized questionnaire.

Results: During May 9–July 31, a total of 89 (52 confirmed and 37 probable) cases were identified. Eleven (21.2%) confirmed patients were hospitalized; 1 died. Twenty-five (48.1%) confirmed patients reported having consumed Dairy A raw milk. Fifteen (28.8%) confirmed patients reported having eaten queso fresco. Dairy A’s raw milk yielded C. jejuni with the cluster PFGE pattern. UDAF suspended Dairy A’s raw milk permit on August 4 for 2 months. Additional cases occurred in November; UDAF revoked Dairy A’s raw milk permit on December 1.

Conclusions: Routine testing of raw milk does not ensure its safety. Mandatory reporting, timely sample collection, pathogen testing, and onsite milk neutralization likely led to C. jejuni detection. Linking case and raw milk PFGE patterns might identify the source and allow implementation of control measures.