A former professor of food safety and the publisher of barfblog.com, Powell is passionate about food, has five daughters, and is an OK goaltender in pickup hockey. Download Doug’s CV here.
Dr. Douglas Powell
editor, barfblog.com
retired professor, food safety
3/289 Annerley Rd
Annerley, Queensland
4103
dpowell29@gmail.com
61478222221
I am based in Brisbane, Australia, 15 hours ahead of Eastern Standard Time
The case study is part of a wider project done by ECDC within the context of EU Decision 1082/2013/EU on serious cross-border threats to health. It is part of a multi-country case study project that investigates the synergies between communities affected by serious public health threats and the institutions (both health- and non-health-related) mandated to prepare for and respond to them.
The premise for the project is that affected communities are increasingly recognised as key resources in public health emergencies, and that the concerns and experiences of ordinary people should be harnessed as an important part of the response.
Community engagement and institutional collaboration in Iceland during a norovirus outbreak at an outdoor/scout centre (10-15 August 2017)
Bristol News reports employees at a Bishopsworth café have been fined for food hygiene offences after pleading guilty to a string of safety standards breaches.
Laura West and Donna Flanagan, who were running the small Butter Me Up premises at Highridge Road, were also ordered to pay totals including prosecution costs of £2,937 and £2,855 respectively at Bristol Crown Court last week after pleading guilty to a number of offences at an earlier hearing.
The pair were also given an open-ended Hygiene Prohibition Order, banning them from participating in the management of any food business which, if breached, amounts to a criminal offence which could lead to a prison sentence.
Environmental Health officers from Bristol City Council launched an immediate investigation and visited the café in July 2018, having been alerted to the death of an elderly gentleman from suspected food poisoning after he and a friend were hospitalised.
Officers discovered that the business had been operating since November 2015 but had not registered with the Council since it opened. The café was also displaying a food safety sticker with a rating of 5, the highest rating, which belonged to a previous business at the same address.
Environmental health officers noted a range of further food safety offences, including little to no food hygiene and safety training, no written food safety management, poor pest control and lack of reliable disinfection practices. Environmental swabs and a cloth that had been used for handling equipment showed that food poisoning bacteria were widespread throughout the premises, indicating poor cleaning practices.
Alexandria Hein of Fox News reports a 43-year-old man in China who was suffering from seizures and loss of consciousness went to the doctor after his symptoms persisted for several weeks, only to discover that he had hundreds of tapeworms in his brain and chest, reports say.
The patient, identified as Zhu Zhongfa, allegedly had eaten undercooked pork, which was contaminated with Taenia solium, a parasitic tapeworm.
“Different patients respond [differently] to the infection depending on where the parasites occupy,” Dr. Huang Jianrong, Zhongfa’s doctor at Affiliated Hospital of Zhejiang University School of Medicine, told AsiaWire. “In this case, he had seizures and lost consciousness, but others with cysts in their lungs might cough a lot.”
Jianrong explained that the larvae entered Zhongfa’s body through the digestive system and traveled upward through his bloodstream. He was officially diagnosed with cysticercosis and neurocysticercosis, and given an antiparasitic drug and other medications to protect his organs from further damage, according to AsiaWire.
Jianrong said his patient is doing well after one week, but the long-term effects from the massive infestation are unclear.
The Centers for Disease Control and Prevention (CDC) recommends cooking meat at a safe temperature and using a food thermometer in an effort to avoid taeniasis. Humans are the only hosts for Taenia tapeworms, and pass tapeworm segments and eggs in feces which contaminate the soil in areas where sanitation is poor. The eggs survive in a moist environment for days to months, and cows and pigs become infected after feeding in the contaminated areas.
Once inside the animal, the eggs hatch in the intestine and migrate to the muscle where it develops into cysticerci, which can survive for several years. This infects humans when they eat contaminated raw or undercooked beef or pork, according to the CDC.
CBS News reports the rapid spread of a stomach virus through the Greater Albany School District has forced the closure of all schools in the district for the rest of the week. The closure comes days after a Colorado school district of about 22,000 students was forced to close after a similar viral outbreak tore through its 46 schools.
CBS Portland affiliate KOIN-TV reported the school district in Linn County, Oregon, was trying to contain the spread of the virus, which causes vomiting and diarrhea.
The district disinfected buildings over the weekend, but kept Periwinkle Elementary School closed Monday after consulting with the Linn County Health Department. On Monday evening, the Greater Albany district said on Facebook that after consulting with state and county health officials — and noting a jump in absences in their other schools — that all schools would close and reopen December 2.
Officials said cleaning teams will continue to disinfect and sanitize throughout the closure.
In Colorado, hundreds of students were sickened by symptoms similar to those of norovirus, a highly-contagious virus that causes vomiting and diarrhea. After the illness jumped quickly from school to school, officials were forced to take the unusual step of closing all 46.
“When we have 20 kids actively vomiting in a school that already has 17% gone we know that we’ve got a problem. We have to stop the exposure,” said Tanya Marvin, the head of nursing for the school district.
CBS Local reports that with food delivery platforms like Uber Eats, GrubHub and Postmates bursting at the seams, we wanted to know what some delivery people were doing with your food before you took a bite.
One food delivery driver – whose identity is concealed – told CBSLA’s David Goldstein he’s heard drivers talk about helping themselves to your order.
“Taking sips of soda all the time….sticking a straw in it and drinking it and putting another top on it,” he said.
So Goldstein’s team set up hidden cameras in restaurants and watched as food delivery people came to pick up – many of whom walked out with open bags where they can easily taste your food.
Cameras caught one man pick up a delivery order at a Fatburger restaurant in North Hollywood. After he put the bag on the front seat of his car, he proceeded to eat what looks like French fries.
As he backs out, he appears to put another fry into his mouth.
He proceeded to make two deliveries within minutes. On the first, the driver was seen wiping his fingers on his leg and then appears to lick them clean in his mouth.
The second delivery was the Fatburger order to a house in North Hollywood.
Goldstein then showed the video to Naimie Ojeil, who said the order was for his teenage kids.
“Horrible, disgusting,” he said.
When Goldstein confronted the driver at a later date, he didn’t have much to say.
Cameras caught another driver pick up a delivery, placing the bag on the passenger seat in his car, and then a minute or so later, he moves the bag, puts his hand inside and grab some fries before he drives away.
Wheat flour has recently been recognised as an exposure vehicle for the foodborne pathogen Shiga toxin-producing Escherichia coli (STEC). Wheat flour milled on two sequential production days in October 2016, and implicated in a Canada wide outbreak of STEC O121:H19, was analysed for the presence of STEC in November 2018.
Stored in sealed containers at ambient temperature, the water activity of individual flour samples was below 0.5 at 6 months post-milling and remained static or decreased slightly in individual samples during 18 months of additional storage. STEC O121 was isolated, with the same genotype (stx2a, eae, hlyA) and core genome multilocus sequence type as previous flour and clinical isolates associated with the outbreak. The result of this analysis demonstrates the potential for STEC to persist in wheat flour at levels associated with outbreak infections for periods of up to two years. This has implications for the potential for STEC to survive in other foods with low water activity.
Shiga toxin-producing Escherichia coli survives storage in wheat flour for two years
This study was conducted to validate a simulated commercial baking process for plain muffins against E. coli O121 (isolated from the recent illness outbreak associated with flour), and compare the thermal inactivation parameters (D- and z-values) of cocktails of four isolates of E. coli O121 and three serovars of Salmonella (Newport, Typhimurium, and Senftenberg) in muffin batter.
Flour samples were spray inoculated with the E. coli O121 or Salmonella cocktails, dried back to the pre-inoculation weight to achieve ~7 log10 CFU/g, and used to prepare muffin batter. For the muffin baking validation study using E.coli O121, muffin batter was baked at 375 °F (190.6 °C) oven temperature for 21 min followed by 30 min of ambient cooling. The E. coli O121 population decreased by >7 log10 CFU/g in muffins by 17 min of baking, and was completely eradicated after 21 min of baking and ambient cooling. The D-values of E. coli O121 and Salmonella cocktails in muffin batter at 60, 65 and 70 °C were 42.0 and 38.4, 7.5 and 7.2, and 0.4 and 0.5 min, respectively; whereas the z-values of E. coli O121 and Salmonella were 5.0 and 5.2 °C, respectively.
Comparison of survival and heat resistance of Escherichia coli O121 and salmonella in muffins
No good journal does that. They have lots of submissions.
The spam emails highlight the wild west of predatory journals, often with names that try to imitate real journals. Today’s was the “New American Journal of Medicine”, a not-so-subtle variation of the New England Journal of Medicine or the American Journal of Medicine. It looks like that journal has published a total of 8 papers in 2019. I looked at one of them and ‘crap’ is my generous assessment. It’s a paper that recommends a treatment for pregnant women and it’s one page long, does not disclose the funding source, fails to fulfill pretty much every standard reporting requirement for a clinical trial and reports essentially no specific data or analysis. But, it’s ‘published data’ and on someone’s CV.
The state of the scientific literature is pretty messed up. “Show me the study” has been a common refrain, but it’s not as useful these days because anything can get published.
Why?
Too many journals.
Predatory journals.
Profit.
Good journals screen out the weak articles. High impact journals publish a minority (5-25% of submissions…and most often people only send their best papers to those journals). Some journals are still good quality and take lower impact papers that are still good science. Some journals take whatever they can get, trying to screen out the bad science.
Others…they take whatever they can get, as long as the authors can pay. Sadly, there are literally thousands of those.
Some people don’t realize we don’t get paid to write scientific papers. Some journals publish at no cost, but increasingly, there are publication fees that may range from a few hundred to a few thousand dollars. That, itself, isn’t necessarily the problem. Some journals charge fees so that the papers can be open access (available to anyone, without a need for a subscription). However, some journal charge a couple thousand dollars, make a nice profit and don’t particularly care about the science.
As someone who’s an associate editor, editorial board member and frequent reviewer for many journals, I see the good and bad.
I see papers that should be published accepted.
I see good quality papers rejected by good journals, knowing they’ll still end up in another good journal.
I see bad papers rejected.
However, I also see…
Horrible quality papers rejected that I know will end up published somewhere.
It’s frustrating to be reviewing a paper that’s complete crap, knowing it will find a home in a journal eventually. Yes, it will most likely be in a bottom feeder journal that many of it of us in the scientific community know is dodgy. However, not everyone will realize that and there will still be ‘published data’ to refer back to. Sometimes, that’s just frustrating, because poor quality science shouldn’t be published. However, when it deals with clinical matters (e.g. diagnosis, treatment…) it can be harmful, since poor quality or invalid data shouldn’t form the basis of decisions. Yet, it happens.
There have been a couple ‘stings’, where fake (and clearly garbage) papers have been submitted to journals. The highest profile was one that was published in Science (Bohannon, 2013). The author submitted a paper to various journals, with the following set-up “Any reviewer with more than a high-school knowledge of chemistry and the ability to understand a basic data plot should have spotted the paper’s short-comings immediately. Its experiments are so hopelessly flawed that the results are meaningless.” More than 50% of open access journals accepted it.
There are many reasons these dodgy journals are used.
“Publish or perish” isn’t quite true but it’s pretty close. Junior faculty need to show productivity to keep their positions or move into the increasingly elusive tenured positions. Scientific papers is a key metric, because it’s easy to count.
Some people get taken advantage of, not realizing the journal is predatory (or that fees are so high, until after the paper is accepted).
Commercial profit. Companies want to say their products are supported by published data. If the data aren’t any good, the amount of money that it takes to get something published is inconsequential for most companies.
Open access isn’t inherently bad. There are excellent open access journals that charge a couple thousand dollars per paper but have high standards. Open access is ideal as it means the science is available to everyone. It just has to be acceptable science, and that’s where things start to fall apart.
Anyway…enough ranting. I always like to say “don’t talk about a problem without talking about a solution” but I don’t have an easy solution. More awareness is the key, which is why sites that track predatory journals, such as Beall’s List, are important. It’s a good update on a sad state of affairs.
This is not food safety but could be. A colleague never knew this story, so I found it and shared it with him.
And know all of youse who don’t like it, start your own blog.
Oh, and hit delete.
That’s me and grandma, 1963.
Wrote this for the Globe and Mail in 1994
How We Die
Reflections on Life’s Final Chapter
Sherwin B. Nuland
1994
Alfred A. Knopf
278 pages
A Gentle Death
Marilynne Seguin, R.N.
1994
Key Porter Books
249 pages
$19.95
Review by Douglas Powell
My grandmother ended her own life. After five years of painstaking care for her husband, who was slowly deteriorating from the cerebral ravages of Alzheimer’s disease, she decided that a sixth was not worth facing.
Her death was quick and without warning. One moment we were saying goodbye before a routine trip to the store, the next I was transferring her from car to wheelchair at the hospital emergency ward. Within 30 minutes she was officially deceased, the result of a major pharmaceutical overdose.
Looking back, I’ve often wondered what I would say to her, given the chance. Don’t do it, life is really okay. You are not alone. Things will get better.
But in reality, life is often harsh, she was often alone, and the prospects of yet another winter, trekking to the hospital each day to watch the person she had spent the vast majority of her life with become even more unfamiliar, meant that things certainly were not about to get better; at least not in any foreseeable future.
Western society is finally being forced to grapple with some of the difficult consequences that arise when medical technology conflicts with individual rights and freedoms. In Canada, Nancy B., a 25 year-old quadriplegic, and Sue Rodriquez, who suffered from the degenerative wasting of Lou Gehrig’s disease, have challenged existing laws and brought the question of when to say enough is enough to the arena of public debate. The discussion is welcome and the only antidote to the private anguish of such decisions, as is forcefully brought home in two new books.
Humans have created powerful myths and rituals to accompany death, writes Sherwin Nuland in How We Die, but perhaps none more bizarre than the modern hospital, “where it can be hidden, cleansed of its organic blight, and finally packaged for modern burial. We can now deny the power not only of death but of nature itself. We hide our faces from its face, but still we spread our fingers just a bit, because there is something in us that cannot resist a peek.”
Dr. Nuland, a physician who has authored several books about the medical profession and continues to teach surgery and the history of medicine at Yale University, says this book was written to demythologize the process of dying, to present it in its biological and clinical realities. The changes at a cellular and organ-level that accompany heart attacks, stroke and cancer are presented in detail that may be intimidating to the uninitiated. Then again, any person who is faced with life-threatening disease can quite rapidly assimilate the medical jargon — they have to. Physicians capable of talking in clear, simple language are rare.
Nuland is blunt. Despite the gripping television constructs, few of the 350,000 Americans who suffer cardiac arrest each year actually survive. Nuland observes that after the vain attempts at resuscitation, the critical response team eventually stops and the mood is transformed from heroic rescue to dejected gloom of failure. But it’s the patient and their families that Nuland, like any good — and increasingly rare — general practitioner focuses on. “The patient dies alone among strangers: well-meaning, empathetic, determinedly committed to sustaining his life — but strangers nonetheless. There is no dignity here.”
Then there’s the story of Dr. Nuland as young intern and his first crisis when a patient went into massive cardiac. Using all his training, Nuland opened the man’s chest and began to massage his heart, as was the routine practice at the time, but to no avail. The man died. Yet suddenly he “threw back his head once more and, staring upward at the ceiling with the glassy unseeing gaze of open dead eyes, roared out to the distant heavens a dreadful rasping whoop that sounded like the hounds of hell were barking. Only later did I realize that what I heard was McCarty’s version of the death rattle, a sound made by spasm in the muscles of the voice box, caused by the increased acidity in the blood of a newly dead man. It was his way, it seemed, of telling me to desist — my efforts to bring him back to life could only be in vain.” Or, as Nuland constantly reminds the reader, “we rarely go gentle into that good night.”
Marilynne Seguin’s A Gentle Death is an attempt to help ease that journey for patients and their families. Sequin, a registered nurse for over 30 years as well as a founding member and executive director of the Toronto-based Dying With Dignity tells how she, like Nuland, was trained to prolong life at all costs. Experience has taught her to question prevailing attitudes of the medical establishment and she stresses that patients must become informed and responsible for the medical decisions that affects their lives.
In presenting the many examples of people approaching death who Sequin has cared for, a common theme emerges. Rather than a passive silence, many approaching death wish to be at home, surrounded by the noise of children — the noise of life — rather than the sobering silence of loneliness.
Both books try to dispel the hero myth, the one where the nurse or physician is never to allow the patient to lose hope. Yet hope and wishing for miracles get in the way of true discussion; it robs people of their death. Nuland confronts this reality head on when he describes how, when his brother Harvey was diagnosed with bowel cancer in 1989, he made “a series of mistakes. … I became convinced that telling my brother the absolute truth would ‘take away his only hope.’ I did exactly what I have warned others against.” Harvey was enrolled in an experimental therapy that showed initial promise but in the end increased and prolonged his anguish. Eventually, Harvey returned home to die.
These two books, and others, are a continuation of an expanding public interest in death. Certainly part of that interest can be attributed to the demographics of baby boomers. The group that first discovered drugs, free love, parenthood, the mid-life crisis and menopause has now discovered death. And along with those who want to face biological realities there will be those who desire to live beyond their biological means. Nuland writes we are currently in the vitamin era, following previous attempts to prolong life through the pseudoscience of monkey glands, mother’s milk, and, as King David tried, sleeping between two virgins. Coming soon will be expanded attempts to prolong life through the mass availability of human growth hormone, derived by genetic engineering, and gene therapy. Only “accurate knowledge of how a disease kills,” writes Nuland, “serves to free us from unnecessary terrors of what we might be fated to endure when we die. We may thus be better prepared to recognize the stations at which it is appropriate to ask for relief, or perhaps to begin contemplating whether to end the journey altogether.”
Which leads to the hotly debated topic of physician-assisted suicide and the right of rational individuals to decide how and when to end their lives. At this point the two books differ strongly. Nuland approves of Living Wills and other advanced care directives, instructing physicians what treatments to withhold in the face of terminal illness, but he strongly disapproves of physician-assisted suicide. Seguin, however, sees no distinction. Much of her book is devoted to a frank discussion of the practical advantages and limitations of such approaches.
Nuland, however, fails to come clean on the topic, when he mentions in passing that, “Like so many of my colleagues, I have more than once broken the law to ease a patient’s going, because my promise, spoken or implied, could not be kept unless I did so.” Seguin states quite clearly that many physicians have engaged in such activity, so why not create clear, legally-binding rules, as has been done in the Netherlands.
One Dutch physician who supports the new law says society needs a counterweight for the enormous technology of modern medicine. But more importantly he says, it gives the patient a chance to take leave openly of his children, his grandchildren, and others.
That openness seems crucial to further public discussion of death and dying. I still wonder what I would say to someone who is about to leave this earth on their own accord. Both books provide unique and moving insight into such conversations. Perhaps I now know what I might have said to my grandmother.
Douglas Powell is a graduate student at the University of Guelph.
The premise for the project is that affected communities are increasingly recognised as key resources in public health emergencies, and that the concerns and experiences of ordinary people should be harnessed as an important part of the response.
