Yearly Archives: 2015

Nosestretcher alert: Maple syrup could help cut use of antibiotics

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Last year all the rage, for a day, was that eating pizza could prevent norovirus. Except that’s not really what the research was about. Today’s concentrated-extract-has-antibiotic-properties story comes from McGill University where researchers have evaluated the effects of maple syrup on human pathogens.

Except not really.syrup

According to the university’s news website, an upcoming publication shows that a phenolic heavy extract made from maple syrup (not maple syrup itself) was ‘mildly effective; against E. coli and Proteus mirabilis.

I’m not sure what mildly means.

The release also says that there was a synergistic effect when used in conjunction with actual antibiotics.

Synergistic wasn’t really defined.

Prof. Nathalie Tufenkji’s research team in McGill’s Department of Chemical Engineering prepared a concentrated extract of maple syrup that consists mainly of phenolic compounds. Maple syrup, made by concentrating the sap from North American maple trees, is a rich source of phenolic compounds.

The researchers tested the extract’s effect in the laboratory on infection-causing strains of certain bacteria, including E. coli and Proteus mirabilis (a common cause of urinary tract infection). By itself, the extract was mildly effective in combating bacteria. But the maple syrup extract was particularly effective when applied in combination with antibiotics. The extract also acted synergistically with antibiotics in destroying resistant communities of bacteria known as biofilms, which are common in difficult-to-treat infections, such as catheter-associated urinary tract infections.

“We would have to do in vivo tests, and eventually clinical trials, before we can say what the effect would be in humans,” Tufenkji says. “But the findings suggest a potentially simple and effective approach for reducing antibiotic usage. I could see maple syrup extract being incorporated eventually, for example, into the capsules of antibiotics.”

Of course, the paper isn’t available yet.

Maybe I’ll have a side of pancakes, with maple syrup, with my magic noro-fighting pizza.

 

Ohio high school prom linked to norovirus outbreak

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In 1997, Dani and I went to prom (below, exactly as shown). The theme was a classic: ‘Under the Sea.’ The venue was filled with bubble decorations, fish and blue streamers.

But no norovirus.FullSizeRender

According to the Chillicothe Gazette, students attending the Zane Trace High School prom last weekend weren’t that lucky; 22 have symptoms consistent with norovirus.

According to Health District spokesman Rami Yoakum, calls began coming into the health district Monday from parents reporting sick children. Thus far, 22 illnesses are believed to be part of the same outbreak, 18 of whom are Zane Trace students.

Kathy Wakefield, director of Public Health Nursing at the health district, said officials believe a norovirus is the culprit.

The health district has been working with the school, advising officials to clean school surfaces, and has also sent letters home to parents describing symptoms and asking them to keep sick children at home and away from sporting events.

Specimens were collected and sent to the state lab in Reynoldsburg. If the results in each case come back all looking similar, the Health District will likely be able to trace back to the source of the contamination, Yoakum said. Presently, health officials feel they have a good idea where the illness may have originated, but don’t want to publicly speculate until until the results from the tests come back and they are sure.

 

It’s all about trade: CFIA sucks at communication

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In 1997, I co-wrote a book called Mad Cows and Mother’s Milk, which included a chapter about how the newly formed Canadian Food Inspection Agency sucked at communication and enforcement regarding bovine spongiform encephalopathy.

mad.cows.mother's.milkA few years later, when Canada had its first case of mad cow disease, the chief vet was proactive, and consumption of beef actually rose.

But when the Maple Leaf listeriosis outbreak killed 23 in 2008, CFIA was left castrated.

It was probably a political thing.

Kelsey Johnson, a reporter with iPolitics, www.ipolitics.ca writes in Canada’s Western Producer that there is nothing more frustrating for a journalist than the inability to get basic information for a story from official channels, particularly at the federal level.

The relationship between the federal government and the Parliamentary Press Gallery is especially strained, one that is unlikely to improve much in the coming months thanks to the rapidly approaching federal election.

Which is why the Canadian Food Inspection Agency’s communication response to the single case of H5N2 avian flu in Ontario has been a pleasant surprise.

The CFIA’s last communications effort, which had been prompted by a leak that revealed a case of BSE had been found on an Alberta farm in February, received heavy criticism from some reporters, including yours truly.

In that particular case, obtaining basic information such as the location of the index farm and the birth farm, was like pulling teeth. The agency’s initial plan was to not make the case public until its monthly reporting period in March, a policy that CFIA and the cattle industry insist is simply standard practice.

RS64This time around CFIA appears to have amended its communication strategy.

Reporters were first informed of the single case of avian flu April 7 through a CFIA news release that was sent to the entire Parliamentary Press Gallery. That in itself is an improvement over the BSE case, when the agency put out a response but didn’t send it to the gallery’s main email, which frustrated several reporters who were unaware of the CFIA’s response.

Kelsey, it’s all about trade.

And while barfblog.com is only 20-years-old, the Rolling Stones released their first album, 51 years ago today (thank you, Buddy Holly).


 

Highway to Hell: 38 sickened with Salmonella at wedding at Arizona winery

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According to Pinal County authorities there are now 38 suspected cases of salmonella poisoning linked to two separate events held at The Windmill Winery in Florence. The food poisonings have been linked to an event on March 18 and a wedding on March 19.

highway.to_.hell_On April 1 the bride’s mother called with the first report of sickness. Four participants of the wedding, another attendee reported to authorities, have been hospitalized.

Kiss the Chef, Catering LLC, a company that authorities say were operating illegally, catered both events. The company refers to itself as “a preferred vendor of The Windmill Winery,” on its Facebook page. The winery includes Kiss The Chef Catering on their website’s list of vendors.

“The two businesses appear to have an exclusive relationship but operate separately,” says Thomas Schyer, director of the Pinal County Public Health Services District. “The kitchen was not authorized to be cooked in.”

The exact source of the salmonella outbreak, while having been narrowed down to two or three ingredients, is still unknown and is undergoing further investigation.

“It’s going to take some time to get it pinned down,” says Schryer, who declined to name the specific cause or causes of the illness, adding that “the interesting thing is that the food was cook separately” for each event.

Ed Farmer, executive chef and owner of Kiss the Chef Catering, declined to comment.

Not just a UK problem and naturopaths are nuts: Campylobacteriosis outbreak associated with consuming undercooked chicken liver pâté — Ohio and Oregon, December 2013–January 2014

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The U.S. Centers for Disease Control reports that on January 8, 2014, the Ohio Department of Health notified the Oregon Public Health Division (OPHD) of campylobacteriosis in two Ohio residents recently returned from Oregon.

pate.beet.dp.mar.12The travelers reported consuming chicken liver pâté* at an Oregon restaurant. On January 10, OPHD received additional reports of campylobacteriosis in two persons who had consumed chicken liver pâté at another Oregon restaurant. Campylobacter jejuni was isolated in cultures of fecal specimens from three patients. OPHD investigated to determine the sources of the illnesses and to institute preventive measures.

Both restaurants reported using undercooked chicken livers to prepare their pâté; an environmental health investigation revealed that the livers were purchased from the same U.S. Department of Agriculture Food Safety and Inspection Service (FSIS)–regulated establishment in the state of Washington. The establishment reported that livers were rinsed with a chlorine solution before packaging. However, culture of five of nine raw liver samples from both restaurants and from the establishment yielded C. jejuni; none of three pâté samples from the restaurants yielded C. jejuni. One human stool specimen and three liver samples were typed by pulsed-field gel electrophoresis (PFGE); the human isolate and one liver sample had indistinguishable PFGE patterns when digested by the restriction enzyme SmaI. The human isolate was susceptible to all antimicrobials tested by CDC’s National Antimicrobial Resistance Monitoring System.

A presumptive case was defined as diarrhea lasting >2 days, within 7 days after consumption of undercooked chicken liver; a confirmed case was defined as laboratory evidence of C. jejuni infection within 7 days after consumption of undercooked chicken liver. In all, three laboratory-confirmed and two presumptive cases of campylobacteriosis following consumption of chicken livers were reported in Ohio and Oregon. Illness onsets ranged from December 24, 2013, to January 17, 2014. Patient age range was 31–76 years; three were women. Based on OPHD’s recommendation, both restaurants voluntarily stopped serving liver. The FSIS-regulated establishment also voluntarily stopped selling chicken livers.

This is the second multistate outbreak of campylobacteriosis associated with consumption of undercooked chicken liver reported in the United States (1). Outbreaks caused by chicken liver pâté are well documented in Europe (2,3). Chicken livers and pâté should be considered inherently risky foods, given the methods by which they are routinely prepared. Pâté made with chicken liver is often undercooked to preserve texture. Consumers might be unable to discern whether pâté is cooked thoroughly because partially cooked livers might be blended with other ingredients and chilled. At FSIS-regulated establishments, such as the one involved in this outbreak, livers are inspected to ensure that they are free from visible signs of disease, but they are not required to be free from bacteria (4). A recent study isolated Campylobacter from 77% of chicken livers cultured (5). Washing is insufficient to render chicken livers safe for consumption; they should be cooked to an internal temperature of 165°F (74°C).

barfblog.Stick It InDuring the outbreak investigation, OPHD learned of a campylobacteriosis case in a Washington state resident who had eaten raw chicken livers that had been chopped into pill-sized pieces and frozen, as prescribed by a naturopathic physician. The livers were from the same establishment that supplied the Oregon restaurants. No isolate from the case was available for subtyping, but culture of frozen pieces of liver collected from this patient yielded C. jejuni.

This report illustrates that follow-up of possible outbreaks identified by routine interviewing by health departments can identify sources of illnesses and result in control measures that protect public health. Campylobacter is thought to be the most common bacterial cause of diarrheal illness in the United States (6), and infection is now nationally notifiable.

1Oregon Public Health Division; 2Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC; 3Washington State Department of Health; 4Ohio Department of Health (Corresponding author: Magdalena K. Scott, magdalena.k.scott@state.or.us, 971-673-1111)

References

CDC. Multistate outbreak of Campylobacter jejuni infections associated with undercooked chicken livers—northeastern United States, 2012. MMWR Morb Mortal Wkly Rep 2013;62:874–6.

O’Leary MC, Harding O, Fisher L, Cowden J. A continuous common-source outbreak of campylobacteriosis associated with changes to the preparation of chicken liver pâté. Epidemiol Infect 2009;137:383–8.

Little CL, Gormley FJ, Rawal N, Richardson JF. A recipe for disaster: outbreaks of campylobacteriosis associated with poultry liver pâté in England and Wales. Epidemiol Infect 2010;138:1691–4.

Food Safety and Inspection Service, US Department of Agriculture. Giblets and food safety. Available at http://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/poultry-preparation/giblets-and-food-safety/ct_index.

Noormohamed A, Fakhr MK. Incidence and antimicrobial resistance profiling of Campylobacter in retail chicken livers and gizzards. Foodborne Pathog Dis 2012;9:617–24.

Scallan E, Hoekstra RM, Angulo FJ, et al. Foodborne illness acquired in the United States—major pathogens. Emerg Infect Dis 2011;17:7–15.

* A spreadable paste made from cooked ground meat (often poultry livers) combined with various other ingredients.

Infant Botulism Caused by Clostridium baratii Type F — Iowa, 2013

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The U.S. Centers for Disease Control reports that in June 2013, a male newborn aged 9 days (delivered after a full-term pregnancy) was brought to a hospital emergency department with a 2-day history of constipation, fussiness, and poor feeding.

drooling-babyThe mother reported her son’s symptoms as excessive crying, reluctance to suck, and difficulty in swallowing milk. Within hours of arrival, the infant became less responsive and “floppy,” and was intubated for respiratory failure. Infant botulism was suspected and Botulism Immune Globulin Intravenous (Human) (BIG-IV), licensed for the treatment of infant botulism types A and B, was administered on hospital day 2. Results of preliminary stool studies were reported positive for botulinum toxin type F on hospital day 3. Clostridium baratii type F was subsequently isolated in stool culture.

National experience with type F botulism in newborns and infants indicates that rapid clinical improvement could occur even without the administration of anti-type F antitoxin. However, 3 days after treatment with BIG-IV the newborn continued to require ventilator support and showed no signs of clinical improvement. On hospital day 6, equine-derived botulism antitoxin heptavalent (A-G) (BAT) was administered to the boy, despite the limited experience reported for its use in pediatric cases. This is the second newborn treated with BAT in the United States; the first was treated in 2008 in Colorado (1).

Within 24 hours of BAT treatment, spontaneous movements of the newborn’s extremities increased. On hospital day 8 the endotracheal tube was removed. By the following day, the boy could tolerate oral feedings, had regained muscle tone and strength in his extremities, and had normal pupillary responses. The only adverse event associated with BAT treatment was an intermittent, low-grade fever that developed within 1 hour of BAT administration and lasted 72 hours. Blood, urine, stool, and cerebrospinal fluid bacterial cultures were otherwise negative. Contrast magnetic resonance imaging of his brain showed normal findings, and cerebrospinal fluid studies for herpes simplex virus and enterovirus also were negative. The newborn was discharged on hospital day 12. At the 2-week follow-up examination, his mother reported he was doing well: taking 100% of his feedings orally, exhibiting no residual weakness, and having normal bowel movements.

The parents reported feeding the newborn ready-to-feed and powdered formula from the same brand. No other solid or liquid foods or homeopathic remedies or supplements were given before symptom onset. No classic risk factors for infant botulism were reported, such as exposure to honey or soil. The parents reported strong winds and minor construction in the area surrounding their home. Pets present in the home included cats, turtles, fish, geckos, sugar gliders, and a mouse.

Environmental samples were collected from 1) feces from all animals in the home, 2) food and water from the turtle enclosure, 3) dust from the vacuum cleaner bag and the windowsill and ceiling fan closest to where the child slept, and 4) potting soil from the only indoor plant in the home. Although Clostridium species were isolated in several of the samples, none produced botulinum toxin.

Through 2012, only 13 cases of C. baratii type F infant botulism have been reported in the United States; this is the third confirmed case in Iowa. Extensive investigations for an environmental source of toxigenic C. baratii have been undertaken, including for all three cases in Iowa (2). Unlike typical infant botulism caused by C. botulinum (3), no source has been identified and prevention strategies remain unknown for C. baratii. While C. baratii infant botulism remains a rarely diagnosed disease, health care providers should maintain a high index of suspicion especially in very young infants who present with new onset floppiness or progressive respiratory failure.

Acknowledgment

Minnesota Department of Health Epidemiology and Public Health Laboratory.

1Division of Infectious Diseases, Department of Pediatrics, Blank Children’s Hospital, Des Moines, Iowa, 2Division of Acute Disease Prevention, Emergency Response, and Environmental Health, Iowa Department of Public Health, 3Infant Botulism Treatment and Prevention Program, California Department of Public Health (Corresponding author: Amaran Moodley, amaran.moodley@unitypoint.org, 515-241-8300)

References

Al-Sayyed B. A 3-day-old boy with acute flaccid paralysis. Pediatr Ann 2009;38:479–82.

Barash JR, Tang TWH, Arnon SS. First case of infant botulism caused by Clostridium baratii type F in California. J Clin Microbiol 2005;43:4280–2.

CDC. Botulism. Atlanta, GA: US Department of Health and Human Services, CDC; 2014. Available at http://www.cdc.gov/nczved/divisions/dfbmd/diseases/botulism/.

Me being a good Australian citizen: Queensland Health should make investigations into food poisoning outbreaks public

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In The (Brisbane) Courier-Mail this morning:

In 2013, at least 50 people, mainly children, became ill with E coli O157 at the Ekka.

claudia.e.coli.petting.zoo.may.14Follow-up in the form of a publicly released formal report following an investigation? Nothing.

Queensland Health has been warned repeatedly about Q fever outbreaks at the Ekka related to the birthing of goats. Again, follow-up? Nothing.

In 2013, at least 130 people, including 55 nursing home patients, were stricken by norovirus in Ipswich and on the Sunshine Coast. Follow-up? Nothing.

In November 2013, at least 220 people were felled by salmonella and one was killed at Melbourne Cup functions, all linked to raw egg-based dishes served by Piccalilli Catering. Follow-up? Nothing. I even wrote to then health minister Lawrence Springborg and received no response. I guess he was busy with Parliament.

In January this year, at least 130 diners were stricken with salmonella after dining at Brisbane’s Chin Chin Chinese Restaurant. Dozens were hospitalised. Follow-up? Nothing.

Last month, 250 teachers contracted salmonella at a conference and an additional 20 people were sickened on the Gold Coast from the same egg supplier. Follow-up? Nothing. Though, to be fair, Councillor Krista Adams, Brisbane City Council Lifestyle Committee chairwoman, was on ABC radio on Monday saying the Queensland Health investigation into the matter was ongoing.

As a food safety professor in Canada and the US who relocated to Brisbane four years ago to support my French professor wife, I look at these outbreaks and wonder: what does Queensland Health do? What does Safe Food Queensland do? I believe in science, however fallible it may be, and my church is the (ice) hockey arena.

I also believe in public disclosure, especially because these investigations are conducted on the Queensland tax dollar. These are hopelessly ineffective agencies, and I’ve seen a lot of agencies, but these are the worst, especially in terms of public disclosure. Not the people, but the structure and confines in which they work for a pay cheque.

Now we’re told that hundreds of Brisbane restaurants, cafes, bakeries and caterers operate below legal safety standards.

Brisbane City Council says it is waging war on shoddy operators in light of a jump in food poisoning outbreaks.

That’s a war of attrition.

sorenne.hockeyaug.14Instead, Brisbane, and Queensland, could make a few changes to hold the food purveyors accountable.

Mandate training; make restaurant inspection disclosures mandatory, rather than voluntary; and create a culture that values microbiologically safe food.

I was coaching an ice hockey game on the Gold Coast on the weekend and the restaurant we went to afterwards was advertising a petting zoo, at the restaurant.

This is a microbiologically horrible idea. Same with zoos at schools and in malls, such as the one at Fairfield.

Queensland is on track to record its worst year on record for salmonellosis, which has infected more than 2500 people, mostly in the southeast, since the start of the year. The state is also recording spikes in other gastrointestinal illness cases, such as campylobacter (1993), cryptosporidiosis (604) and yersiniosis (180).

Data from the council’s Eat Safe star-rating system shows almost 10 per cent of Brisbane’s 6000-plus food operators operate below legal safety standards.

Queensland taxpayers deserve answers to some basic questions about all of the aforementioned outbreaks: How did the outbreak occur? Was this commodity sourced from a food safety-accredited supplier? Did handling by the caterer contribute to this outbreak? What is Queensland Health’s policy on use of raw eggs in dishes to be consumed raw? Is this policy enforced? Is the investigation closed and, if so, why and when was it closed? Will an outbreak investigation report be created and publicised? Why was the previous update erased from the department’s website and on whose authority? What is its policy on making information public?

This isn’t CSI, with its groovy UV lights that make great television but lousy science. Publicly release all surveillance data on raw eggs in Queensland (or Australia), publicly release the menu items at the Brisbane Convention Centre and Grocer & Grind, on the Gold Coast, where two of their own chefs got sick, and tell chefs to stop using raw eggs in dishes they must craft from scratch, such as aioli or mayonnaise. This is nothing new and we have been documenting the problem for years because it is a global food safety embarrassment. The solutions are there. It’s time for leadership.

Dr Douglas Powell is a former professor of food safety in Canada and the US who shops, cooks and ferments from his home in Brisbane, Australia

Listeria in raw milk, again

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Public health types got other things to do than police the raw milk biz, especially when there is an alternative – pasteurization.

raw.milk.claravale (1)New York State Agriculture Commissioner Richard A. Ball today warned consumers in Sullivan County and the surrounding area not to consume unpasteurized raw farm milk from the Richard Dirie Farm due to possible Listeria contamination.  The Dirie Farm is located at 1345 Shandelee Road, Livingston Manor, New York, 12758.

A sample of the milk, collected by an inspector from the department’s Division of Milk Control and Dairy Services on April 7, 2015 was subsequently tested by the Department’s Food Laboratory and discovered to be contaminated with Listeria monocytogenes.     

On April 9, 2015, the producer was notified of a preliminary positive test result. He volunteered to suspend raw milk sales until the sample results were confirmed.  Further laboratory testing, completed on April 15, 2015, confirmed the presence of Listeria monocytogenes in the raw milk sample.  The producer is now prohibited from selling raw milk until subsequent sampling indicates that the product is free of harmful bacteria.

To date, the department knows of no illnesses associated with this product.

Illegal Chinese meat imports in Holland

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Police and food safety inspectors have raided two business premises and two private homes in Zuid-Holland province in an investigation into illegal meat imports from China.

la-fi-mo-china-cofco-20140228-001There has been an EU-wide ban on importing most types of meat from China for human consumption since 2002 because of concerns about drug residues. Officials seized ‘hundreds of boxes’ of meat and meat products during their search, as well as documents and files. The meat is now being tested, the inspectors said in a statement on Wednesday. The investigators are also trying to establish how the meat was brought into the country and what has happened to previous shipments.

145 sickened: 80 victims compensated over E. coli outbreak in Ireland

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Belfast Crown Court heard on Wednesday that compensation was paid to around 80 people by Moviehouse Cinema Limited – the parent company of the former Flicks restaurant at the Cityside complex, which was voluntary closed two days after the second outbreak emerged.

flicks.belfastThe payments ranged from £3,000 to £12,000.

Moviehouse Cinema Limited, which was represented in court by its managing director Michael McAdam, admitted a total of 11 separate food hygiene offences.

They included failing to ensure that food handlers were supervised and instructed, failing to ensure that staff toilets were kept clean, and keeping food at a temperature which was likely to support the growth of pathogenic micro-organisms or the formulation of toxins.

The court heard that Flicks Restaurant was at the centre of two outbreaks of E. coli in 2012 – one in August which affected four people and a second outbreak detected in October where there were 141 confirmed cases.