Author Archives: Douglas Powell

About Douglas Powell

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

A tale of two antimicrobial resistance reports

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I’ll leave the summary of two antimicrobial resistance reports to my friend and hockey colleague (and he’s a professor/veterinarian) Scott Weese of the Worms & Germs Blog (he’s the semi-bald dude behind me in this 15-year-old pic; I’m the goalie; too many pucks to the head):

 Two reports came out this week, both detailing the scourge of antibiotic resistance.

In Canada, the Canadian Council of Academies released “When antibiotics fail: the expert panel on the potential socio-economic impacts of antimicrobial resistance in Canada.”

Not to be outdone, the CDC released Antibiotic Resistance Threats in the United States, 2019.

They’re both comprehensive, with a combined >400 pages explaining that this is a big problem.

I’m not going try to summarize the reports. I’ll just pick out a few interesting tidbits.

From the CCA report (Canada):

According to their modelling, first-line antimicrobials (those most commonly used to treat routine infections) helped save at least 17,000 lives in 2018 while generating $6.1 billion in economic activity in Canada. “This contribution is at risk because the number of effective antimicrobials are running out.”

Antimicrobial resistance was estimated to reduce Canada’s GDP by $2 billion in 2018. That’s only going to get worse unless we get our act together. It’s estimated that by 2050, if resistance rates remain unchanged, the impact will be $13 billion per year. If rates continue to increase, that stretches to $21 billion. Remember, that’s just for Canada, a relatively small country from a population standpoint.

Healthcare costs due to resistance (e.g. drugs, increased length of stay in hospital) accounted for $1.4 billion in 2018.  But remember that people who die from resistant infections can actually cost less. If I get a serious resistant infection and die quickly, my healthcare costs are pretty low since I didn’t get prolonged care. All that to say that dollar costs alone don’t capture all the human aspects. Regardless, this cost will likely increase to $20-40 billion per year by 2050.

In terms of human health, resistant infections were estimated to contribute to 14,000 deaths in Canada in 2018, with 5,400 of those directly attributable to the resistant infection (i.e. those deaths would not have occurred if the bug was susceptible to first line drugs). That makes resistance a leading killer, and it’s only going to get worse.

I’ll stop there. The document has a lot of good information and it’s worth reading if you’re interested in the topic.  They also provided a handy 2-page “infographic” summary if you can’t quite stomach the complete 268-page report (also see image below).

From the CDC report (US):

The document’s dedication says a lot. “This report is dedicated to the 48,700 families who lose a loved one each year to antibiotic resistance or Clostridioides difficile, and the countless healthcare providers, public health experts, innovators, and others who are fighting back with everything they have.”

The forward has some great messages too:

To  stop antibiotic resistance, our nation must:

Stop referring to a coming post-antibiotic era—it’s already here. You and I are living in a time when some miracle drugs no longer perform miracles and families are being ripped apart by a microscopic enemy. The time for action is now and we can be part of the solution.

Stop playing the blame game. Each person, industry, and country can affect the development of antibiotic resistance. We each have a role to play and should be held accountable to make meaningful progress against this threat.

Stop relying only on new antibiotics that are slow getting to market and that, sadly, these germs will one day render ineffective. We need to adopt aggressive strategies that keep the germs away and infections from occurring in the first place.

Stop believing that antibiotic resistance is a problem “over there” in someone else’s hospital, state, or country—and not in our own backyard. Antibiotic resistance has been found in every U.S. state and in every country across the globe. There is no safe place from antibiotic resistance, but everyone can take action against it. Take action where you can, from handwashing to improving antibiotic use.

Some might say it’s alarmist. However, I don’t think it’s alarmist when someone really should be raising the alarm. We need to talk about it more, not less. We need to get people (including the general public, healthcare workers, farmers, veterinarians, policymakers) on board, to realize it’s a big issue that needs to be addressed now. “Short term pain for long-term gain” certainly applies here. We can keep delaying and the numbers will keep going up, or we can invest in solutions.

The numbers are scary but specific numbers don’t really matter in many ways. “Lots” is all we should have to know to get motivated. However, decision-makers like numbers, so these numbers hopefully will be useful to show the impact and potential benefits of investing in this problem, and motivate them to put money into antimicrobial stewardship. Saving lives should be enough, but that often doesn’t cut it. Antibiotic resistance doesn’t have a good marketing campaign. Everyone knows why people were wearing pink last month and why there are some pretty dodgy moustaches this month. Those are important issues, for sure. However, considering the overall impact, antibiotic stewardship needs to get more people behind it if we’re going to effect change.

Another reason to dislike sushi: First report of E. coli O157

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AIMS: The aim of this study was to evaluate the microbiological quality of commercially prepared ready-to-eat (RTE) sushi by enumerating aerobic mesophilic bacteria (AMB) and thermotolerant coliforms (TC) and detecting Escherichia coli and Salmonella ssp. An isolate was identified as E. coli O157:H7 which was evaluated for its virulence and antimicrobial resistance profiling as well as its ability to form biofilms on stainless steel.

METHODS AND RESULTS: There were four sampling events in seven establishments, totalling 28 pools of sushi samples. Mean AMB counts ranged between 5·2 and 7·7 log CFU per gram. The enumeration of TC varied between 2·1 and 2·7 log MPN per gram. Salmonella ssp. were not detected, and one sample was positive for E. coli and was identified as E. coli O157:H7. To the best of our knowledge, this is the first report of E. coli O157:H7 in sushi samples in the world literature. This isolate presented virulence genes stx1, stx2, eae and hlyA. It was also susceptible to 14 antimicrobials tested and had the ability to form biofilms on stainless steel.

CONCLUSIONS: There is a need to improve the good hygiene practices adopted in establishments selling sushi in the city of Pelotas, Brazil. In addition, the isolated E. coli O157:H7 carries a range of important virulence genes being a potential risk to consumer health, as sushi is a RTE food. This isolate also presents biofilm formation ability, therefore, may trigger a constant source of contamination in the production line of this food.

SIGNIFICANCE AND IMPACT OF THE STUDY: The increase in the consumption of sushi worldwide attracts attention regarding the microbiological point of view, since it is a ready-to-eat food. To our knowledge, this was the first time that E. coli O157:H7 was identified in sushi samples.

First report of Escherichia coli O157:H7 in ready-to-eat sushi

21 September 2019

Journal of Applied Microbiology

Ramires T 1  , Iglesias MA 2 , Vitola HS 1 , Núncio ASP 1 , Kroning IS 1  , Kleinubing NR 1 , Fiorentini ÂM 1  , da Silva WP 1  

DOI: 10.1111/jam.14456 

https://europepmc.org/abstract/MED/31541508

Meat fell from the sky in Kentucky 140 years ago

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Emma Austin of the Courier Journal asks, what would you do if chunks of raw meat rained down from the sky?

Hopefully you wouldn’t eat it, but apparently some people did when “a horse wagon full” of hunks fell from the sky on March 3, 1876, covering the yard of a confused farmer’s wife in Bath County.

What was described as “flakes” of meat rained down around Mrs. Allen Crouch, who was making soap in her garden at the time.

An article in The New York Times a week later published the account of Harrison Gill, “whose veracity is unquestionable.” The article said some pieces were three to four inches square, and others stuck to the fences. When the meat first fell, it “appeared to be perfectly fresh.”

The two unidentified men who tasted the meat said it was either mutton or venison.

Over the next two days, curious neighbors and scientists flocked to the Crouches’ farm to try to determine what had caused the strange phenomenon.

There is no definitive agreement about what happened that day, said Kurt Gohde, an art professor at Transylvania University who has researched the incident. There are, however, plenty of theories.

Gohde’s favorite theory is one that he said was presented later in The New York Times that it was “cosmic meat” — flesh of animals from an exploding planet. People were familiar with meteors at the time, but they didn’t know that it would’ve been impossible for the meat to fall through the Earth’s atmosphere without being incinerated. So the explanation was certainly plausible to them, no matter how absurd it sounds today.

One scientist who tested the meat said it was tissue from the lungs of a child or goat, which drew a lot of attention, but didn’t stick.

One theory that didn’t get a lot of attention, Gohde said, was by Robert Peter, a scientist at Transylvania University: vulture vomit.

Peter knew, or at least theorized, that when vultures are startled or need to take off quickly, they may need to lighten their load so they can fly. In such cases, the birds vomit food they’ve recently eaten, possibly even while flying.

This theory is believed today to be the most likely, though Gohde pointed out it has a big hole: To believe the vulture vomit theory is to disbelieve the account of the only person who saw it happen. Mrs. Crouch said when she looked up, the sky was clear, and if vultures were vomiting enough meat to scatter across a football field, Mrs. Crouch presumably would have seen vultures overhead.

The Kentucky Meat Shower is not a historical event taught in classrooms, but there is a children’s book about it, and no, it’s not “Cloudy With a Chance of Meatballs.”

ProMed: 3 women hospitalized with E. coli O157, Wisconsin, RFI

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Over the past 5 days, our health care facility in northwest Wisconsin, USA, has seen 3 women hospitalized with E. coli O157 infection. All presented with significant abdominal pain without fever and watery diarrhea which in 2 progressed to bloody diarrhea. None of the 3 have manifested any evidence of hemolytic-uremic syndrome. Both of the women seen by the Infectious Diseases service stated that their diet contains a lot of salads.

We would appreciate any reports of upswings in the number of cases of this process in the upper Midwest USA or elsewhere.

Raw is risky: Eating raw pig liver from Singapore market may increase risk of hepatitis E

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Danielle Ann of Alvinology reports researchers at the Singapore General Hospital have found definite similarities between the virus strains of Hepatitis E virus or (HEV) in pig liver and human liver.

This means that ingesting raw pork liver could mean you’re ingesting a strain of HEV that’s similar enough to human HEV that it could cause you get infected.

The same report said that people who have contracted HEV has risen steadily over the years. While the researchers could not say if the ingestion of raw pig liver is the main cause of the rise in cases, many local dishes feature this ingredient and do not cook the meat thoroughly.

The same report said that you can acquire the disease from eating contaminated food or substances. Ingesting water that is laced with the disease or accidentally drinking water that has trace amounts of faeces. Eating raw or half-cooked meat that is infected can also transmit the virus to you.

Virginia: Who pees on food?

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Bill Wyatt of the Martinsville Bulletin reports two men have been indicted on charges that one of them urinated on food product at Monogram Foods in Martinsville while the other made a video that was used in an attempt to extort money from the company.

Maurice V. Howard and Devin Jamar Stockton, employees of the janitorial company that services Monogram’s plant, were indicted Aug. 8 for tampering with consumer products, conspiracy to tamper with consumer products and extortion.

A three-count indictment issued by a Federal Grand Jury in the U.S. District Court for the Western District of Virginia, Danville Division said that Stockton is alleged to have videotaped Howard urinating on food and on a door and doorjamb inside the Monogram manufacturing plant at 200 Knauss Drive in Martinsville on or about Feb. 21 and then attempted to extort money from Monogram and Packers Sanitation Services Inc. between March 1 and March 6.

The two men have been arrested and scheduled for trial in February in Danville.

An application for a search warrant filed Oct. 3 by FBI Special Agent Matthew S. Marlowe with the U.S. District Court Clerk’s Office in Roanoke linked the charges to an Apple iCloud account and describes how investigators used that account to build their cases against Howard and Stockton.

Funky duck: Processor goes full tilt on transparency

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The kids in my lab had me buy a video camera in 1999 so we could film stuff and put it on the Intertubes long before youtube existed (and film my 2000 Ivan Parkin lecture at IAFP when I got turned away at the U.S. border).

Twenty years later, Leesburg, Ind.-based Maple Leaf Farms is offering a behind-the-scenes look at its duck farms with its new #MLFarmToFork campaign that focuses on transparency and the company’s commitment to operating responsibly.

According to Rita Jane Gabbett of Meating Place, Maple Leaf Farms will highlight its farm-to-fork process on social media through behind-the-scenes videos, farmer interviews and more.

“We want consumers to know the story behind our duck and our desire for continuous improvement,” explained Maple Leaf Farms Duck Marketing Manager Olivia Tucker. “We’re proud of our animal husbandry practices, our facilities and our people, and we want to showcase how vertical integration allows Maple Leaf Farms to produce the highest quality duck on the market.”

To explain vertical integration and how it benefits the entire supply chain, Maple Leaf Farms has created an animated video that outlines the production process and how products get to consumers’ tables. You can view the video at www.tinyurl.com/MLFarmtoFork.

Food fraud: People are still drinking bleach and barfing

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The U.S. Food and Drug Administration says that unscrupulous sellers have sold “miracle” bleach elixirs for decades, claiming that they can cure everything from cancer to HIV/AIDS, hepatitis, flu, hair loss, and more. Some have promoted it to parents as a way to cure autism in children.

The health claims are false, not to mention abhorrent. When users prepare the solution as instructed, it turns into the potent bleaching agent chlorine dioxide, which is an industrial cleaner. It’s toxic to drink and can cause severe diarrhea, vomiting, life-threatening low blood pressure, acute liver failure, and damage to the digestive tract and kidneys.

Stocknews Brief reports that poison control centers across the country have seen 16,500 cases involving chlorine dioxide since 2014. At least 50 of those cases were deemed life-threatening. Eight people died.

FDA says that the products have been hard to scrub out because of claims on social media, where the drinks are promoted along with false health information.

Salmonella, E. coli O157, Listeria, Campy: 1.9 million foodborne illnesses in US per year

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In an ongoing effort to understand sources of foodborne illness in the United States, the Interagency Food Safety Analytics Collaboration (IFSAC) collects and analyzes outbreak data to produce an annual report with estimates of foods responsible for foodborne illnesses caused by pathogens. The report estimates the degree to which four pathogens – Salmonella, E. coli O157, Listeria monocytogenes, and Campylobacter – and specific foods and food categories are responsible for foodborne illnesses.

The Centers for Disease Control and Prevention (CDC) estimates that, together, these four pathogens cause 1.9 million foodborne illnesses in the United States each year. The newest report (PDF), entitled “Foodborne illness source attribution estimates for 2017 for Salmonella, Escherichia coli O157, Listeria monocytogenes, and Campylobacter using multi-year outbreak surveillance data, United States,” can be found on the IFSAC website.

The updated estimates, combined with other data, may help shape agency priorities and inform the creation of targeted interventions that can help to reduce foodborne illnesses caused by these pathogens. As more data become available and methods evolve, attribution estimates may improve. These estimates are intended to inform and engage stakeholders and to improve federal agencies’ abilities to assess whether prevention measures are working.

Foodborne illness source attribution estimates for 2017 for salmonella, Escherichia coli O157, listeria monocytogenes, and campylobacter using multi-year outbreak surveillance data, United States, Sept.2019

CDC, FDA, USDA-FSIS

https://www.cdc.gov/foodsafety/ifsac/pdf/P19-2017-report-TriAgency-508.pdf?deliveryName=DM10264