Authorities shut Mecca restaurant after 18 suffer food poisoning

Gulf News reports 18 people suffered food poisoning after they were served at a famous restaurant in the Saudi holy city of Mecca, prompting authorities to close it down.

Municipal authorities in Mecca shut down the restaurant in line with a related decision from the Ministry of Municipal and Village Affairs that cited a health report blaming the eatery for the incident.

The restaurant has been closed down for one month with a name-to-shame notice posted on its front, saying the shutdown was due to food poisoning.

In recent months, Saudi Arabia has stepped up inspection tours of commercial establishments nationwide to ensure compliance with health rules, including precautions against COVID-19.

Hand hygiene in Nepal

Background: Hand hygiene is one of the most effective preventive measures in the transmission of infection. Proper hand hygiene strategies in health care facilities can reduce nosocomial infections and antimicrobial resistance.

Objectives: This study aims to assess the baseline hand hygiene skills among health care workers and the impact of education and training on it. Design: Interventional cross-sectional single center study.

Method: It was conducted among 181 health care workers of Alka Hospital Pvt. Ltd. During both pre and post-test, participants were asked to perform hand hygiene with soap and water as per WHO guidelines. Pretest was conducted to assess baseline skills of health care workers regarding hand hygiene. An observer would score whether each of the steps were performed correctly, using a checklist. It was followed by intervention in the form of training, education and demonstration of hand hygiene. Post-test was conducted to assess the changes in skills after intervention. Results: There was an overall improvement in the hand washing skills post intervention indicated by an increase in median score, which was 8 for pre-intervention and 9 for post-intervention.

Doctors and nurses had better practice regarding hand hygiene in comparison to other participants. Those participants who had prior training on infection prevention and control, were found to have better hand hygiene skills post-intervention.

Conclusion: Training and educational interventions are the effective tools to improve hand hygiene skills of the health care workers. Performing such interventions at regular intervals can be helpful. Keywords: hand hygiene, health care workers, training and education.

Hand hygiene skills of the health care workers and the effect of training and educational intervention: A single center cross-sectional study

Bangladesh Critical Care Journal

Gentle Sunder Shrestha*1 , Manjit Shrestha2 , Roshan Sharma2 , Ramchandra KC3 , Bibeka Shrestha4 , Rojika Pradhan5 , Pankaj Joshi

DOI: https://doi.org/10.3329/bccj.v9i1.53050

http://scholar.google.com/scholar_url?url=https://www.banglajol.info/index.php/BCCJ/article/view/53050/37517&hl=en&sa=X&d=8568963706660951838&ei=DtaKYKCLJMyWywTm8KLQDA&scisig=AAGBfm3SJ7-dM6dRbRQx-R7lj-8CAuBnUA&nossl=1&oi=scholaralrt&hist=5kxqCikAAAAJ:5428478285509672052:AAGBfm0um7xNxqfVpArKOWnp4NG6xAm5og&html=&folt=cit&fols=

UK toddler left fighting for life with organ failure after eating seagull poo

Harri Evans of Lancaster Live writes a toddler was left fighting for his life at a North West hospital and suffering kidney failure after eating seagull poo as he played in the garden.

Jaydon Pritchard, who is just 18 months old, is now doing much better after his ordeal, but is still “not out of the woods” according to his grandparents Arwel and Christine, who look after him along with his mother Tiffany at their home in Amlwch in Anglesey, off the north west coast of Wales.

Jaydon started to feel unwell in early April but was discharged by doctor after they thought he was suffering from a virus.

But Jaydon (below) continued to be sick and sleep lots and then his grandfather said they heard a “horrible noise coming from his cot”.

Mr Pritchard said: “He was having a fit, so we called for an ambulance straight away.

“He had another fit before the ambulance arrived and another three fits on the way to the hospital. It was like he was looking through you. He didn’t recognise anyone.

“There was a point where we really thought we were going to lose him. It was horrific.”

After being rushed to Ysbyty Gwynedd for the second time, a team from Alder Hey Children’s Hospital in Liverpool was sent to pick up Jaydon within a few hours – reports North Wales Live.

He was hooked up to a dialysis machine and received three blood transfusions during his 19-day stay at the children’s hospital.

Mr Pritchard said: “The doctors diagnosed him with kidney failure and told us that he had E. coli poisoning from having ingested the seagull faeces.

“We were fearing the worst at the time, seeing his little body hooked up to the dialysis machine and his face turned yellow.”

FDA speaks: E. coli O157 in leafy greens

Between August and December 2020, the U.S. Food and Drug Administration (FDA) and multiple state and federal partners were involved in an outbreak investigation related to E. coli O157:H7 illnesses and the consumption of leafy greens. The outbreak, which caused 40 reported domestic illnesses, was linked via whole genome sequencing (WGS) and geography to outbreaks traced back to the California growing region associated with the consumption of leafy greens in 2019 and 2018. FDA, alongside state and federal partners, investigated the outbreak to identify potential contributing factors that may have led to leafy green contamination with E. coli O157:H7. The E. coli O157:H7 outbreak strain was identified in a cattle feces composite sample taken alongside a road approximately 1.3 miles upslope from a produce farm with multiple fields tied to the outbreaks by the traceback investigations. In addition, several potential contributing factors to the 2020 leafy greens outbreak were identified.

Isolates within this cluster of illnesses are part of a reoccurring strain of concern and are associated with outbreaks that have occurred in leafy greens each fall since 2017. The two most recent outbreaks associated with this strain were an outbreak in 2018 (linked to romaine lettuce from the Santa Maria growing region of California) and an outbreak in 2019 (linked to romaine lettuce from the Salinas growing region of California). Clinical isolates from cases in this 2020 outbreak appear more closely related to those from the 2019 outbreak than the 2018 outbreak. In addition, several specific food and environmental isolates that appear to be highly related to this 2020 outbreak include a fecal-soil composite sample collected by FDA in February 2020 from the Salinas growing region and two leafy green samples collected in 2019 by state partners as a part of the 2019 investigation that traced back to the Salinas growing region.

As part of this investigation, tracebacks of leafy greens consumed by ten ill individuals from eleven points of service were conducted. Although that traceback investigation was based on a relatively small number of the total cases, it was based on those cases which presented the strongest evidence via purchase card information, invoices, bills of lading, and electronic data. The traceback investigation identified the Salinas growing region of California as a geographical region of interest.

In light of this most recent finding, combined with previous outbreak investigation findings in the region, FDA has identified key trends regarding the issues of a reoccurring strain, a reoccurring region, and reoccurring issues around adjacent and nearby land use of primary importance in understanding the contamination of leafy greens by E. coli O157:H7 that occurred in 2020 and previous years.

FDA also recognizes the interconnection between people, animals, plants, and their shared environment when it comes to public health outcomes. As such, we strongly encourage collaboration among various groups in the broader agricultural community (i.e. livestock owners; leafy greens growers, state and federal government agencies, and academia) to address this issue. With this collaboration, the agricultural community, alongside academic and government partners, can work to identify and implement measures to prevent contamination of leafy greens. FDA recommends that these parties participate in efforts to understand and address the challenge of successful coexistence of various types of agricultural industries to ensure food safety and protect consumers against foodborne illnesses.

Frank Yiannas, Deputy Commissioner for Food Policy and Response – Food and Drug Administration said in a release that as part of our ongoing efforts to combat foodborne illness, today the U.S. Food and Drug Administration published a report on the investigation into the Fall 2020 outbreak of Shiga Toxin-Producing E. coli (STEC) O157:H7 illnesses linked to the consumption of leafy greens grown in the California Central Coast. The report describes findings from the investigation, as well as trends that are key to understanding leafy green outbreaks that are linked to the California Central Coast growing region, specifically encompassing the Salinas Valley and Santa Maria growing areas every fall since 2017.

We released our preliminary findings earlier this year that noted this investigation found the outbreak strain in a sample of cattle feces collected on a roadside about a mile upslope from a produce farm. This finding drew our attention once again to the role that cattle grazing on agricultural lands near leafy greens fields could have on increasing the risk of produce contamination, where contamination could be spread by water, wind or other means. In fact, the findings of foodborne illness outbreak investigations since 2013 suggest that a likely contributing factor for contamination of leafy greens has been the proximity of cattle. Cattle have been repeatedly demonstrated to be a persistent source of pathogenic E. coli, including E. coli O157:H7.

Considering this, we recommend that all growers be aware of and consider adjacent land use practices, especially as it relates to the presence of livestock, and the interface between farmland, rangeland and other agricultural areas, and conduct appropriate risk assessments and implement risk mitigation strategies, where appropriate. Increasing awareness around adjacent land use is one of the specific goals of the Leafy Greens Action Plan we released last March, which we’re also announcing is being updated today to include new activities for 2021.

During our analysis of outbreaks that have occurred each fall since 2017, we have determined there are three key trends in the contamination of leafy greens by E. coli O157:H7 in recent years: a reoccurring strain, reoccurring region and reoccurring issues with activities on adjacent land. The 2020 E. coli O157:H7 outbreak associated with leafy greens represents the latest in a repeated series of outbreaks associated with leafy greens that originated in the Central Coast of California (encompassing Salinas Valley and Santa Maria) growing region (that’s me and Frank and the woman who wants to divorce me in our Kansas kitchen, 10 years ago)

In the investigation, the FDA recommends that growers of leafy greens in the California Central Coast Growing Region consider this reoccurring E. coli strain a reasonably foreseeable hazard, and specifically of concern in the South Monterey County area of the Salinas Valley. It is important to note that farms covered by the Food Safety Modernization Act (FSMA) Produce Safety Rule are required to implement science and risk-based preventive measures in the rule, which includes practices that prevent the introduction of known or reasonably foreseeable hazards into or onto produce.

The FDA also recommends that the agricultural community in the California Central Coast growing region work to identify where this reoccurring strain of pathogenic E. coli is persisting and the likely routes of leafy green contamination with STEC. Specifically, we have outlined specific recommendations in our investigation report for growers in the California Central Coast leafy greens region. Those recommendations include participation in the California Longitudinal Study and the California Agricultural Neighbors workgroup. When pathogens are identified through microbiological surveys, pre-harvest or post-harvest testing, we recommend growers implement industry-led root cause analyses to determine how the contamination likely occurred and then implement appropriate prevention and verification measures.

In response, Tim York wrote in The Packer that on April 16 the California LGMA Board took decisive action to endorse pre-harvest testing guidance. The guidance recommends pre-harvest testing specifically when leafy greens are being farmed in proximity to animal operations. 

It’s the intention of the board to include pre-harvest testing as part of the LGMA audit checklist so the government can verify that all LGMA members are in compliance. 

This is the first time an entire commodity group will be required to conduct pre-harvest testing.

This is a big deal, but a necessary response to the recent U.S. Food and Drug Administration report on outbreaks associated with lettuce in 2020.  The findings and regulatory language used by FDA in this report were nothing short of a warning shot that calls on our industry to do more to stop outbreaks. 

And so, we must do more.

Updating LGMA’s required food safety practices is an involved process that seeks input from scientists, food safety experts and the public. No other entity is capable of making such widespread change as quickly as we can.<

Some weeks ago, in the first piece I wrote for The Packer as CEO of the California LGMA, I stressed the need for collaboration with the retail and foodservice buying community, noting that we must lean on each other to make needed improvements together. And now, I am asking for your help.

Updating LGMA’s required food safety practices is an involved process that seeks input from scientists, food safety experts and the public. No other entity is capable of making such widespread change as quickly as we can.

Produce on-farm food safety

From planting to distribution, fresh produce can be contaminated by humans, water, animals, soil, equipment, and the environment. Produce growers play an essential role in managing and minimizing on-farm food safety risks. Because of an increase in public awareness about produce safety, farmer food safety education has become an important research and extension topic. This review article summarizes findings by researchers who have evaluated produce growers’ food safety knowledge and attitudes and the effectiveness of food safety educational programs for growers.

A search of on-line databases, journal archives, conference abstracts, and reference lists of relevant studies was conducted to locate peer-reviewed articles on produce growers’ food safety knowledge and behavioral changes. Study selection criteria included publications in English, publication between 2000 and 2019, and a focus on one of six topics: handling of agricultural water, soil amendments, domesticated animal and wildlife management, worker health and hygiene, food safety plans and record-keeping, and cleaning and sanitation. Forty-three published articles were included in the analysis. Handling of agricultural water and soil amendments were the two topics least understood by growers, whereas worker health and hygiene were the best understood. Food safety educational interventions were evaluated in 13 studies, and most studies used in-person workshops and self-reported pre- and postintervention knowledge assessments. Most reported increased knowledge, some reported improved attitudes and perceived behavioral control, and only four reported behavioral changes. Because of small sample sizes, many studies did not include a statistical analysis of the differences between pre- and postintervention survey results. This review article provides insights and guidance for the development of food safety education for produce growers.

Produce growers’ on-farm food safety education: A review

Journal of Food Protection

HAN CHEN ; AMANDA J. KINCHLA ; NICOLE RICHARD ; ANGELA SHAW ; YAOHUA FENG

https://doi.org/10.4315/JFP-20-320

https://meridian.allenpress.com/jfp/article/84/4/704/449180/Produce-Growers-On-Farm-Food-Safety-Education-A

It’s how I act, not what I say

Cognitive biases play an important role in creating and perpetuating problems that lead to foodborne illness outbreaks. By using insights from behavioral ethics, we argue that sometimes people engage in unethical behavior that increases the likelihood of foodborne illness outbreaks without necessarily intending to or being consciously aware of it.

We demonstrate these insights in an analysis of the 2011 Listeriosis outbreak in the U.S. from the consumption of contaminated cantaloupes. We then provide policy implications that can improve our understanding of other kinds of disease outbreaks and epidemics.

Behavioral Ethics and the incidence of foodborne illness outbreaks

Journal of Agricultural and Environmental Ethics

Harvey James Jr and Michelle Segovia

https://link.springer.com/article/10.1007/s10806-020-09837-w

Three die of salmonella poisoning linked to herbal remedy in Denmark

The BBC reports 19 people have been treated in hospital, according to Denmark’s SSI health agency. Those involved in the outbreak are aged between two and 92.

All those affected ate Husk brand psyllium husk capsules from batches recalled by manufacturer Orkla Care.

Authorities found traces of salmonella in the products at patients’ homes.

The herbal products are generally used as a laxative. Luise Müller of Denmark’s Statens Serum Institut said it was the first time the agency had found a herbal medicine to be the cause of a salmonella outbreak.

It is not clear which ingredient could have caused the poisoning.

Yes, dogs too: Canine norovirus

Canine norovirus (CNV) is a diarrhea-causing pathogen in canines. In this study, 268 canine diarrheic fecal samples were collected from 13 pet hospitals across three provinces in China between March 2017 and May 2019, and 7.8% (21/268) samples were detected as CNV-positive by RT-PCR. Phylogenetic analysis of twenty-one CNV RdRp fragments showed that eighteen of the strains clustered in GVI.2, two clustered in GVI.1 and one clustered in GIV.2. The complete RdRp, VP1, and VP2 genes of four GVI.2 strains obtained from three provinces were successfully sequenced.

Phylogenetic analyses based on the RdRp, VP1, and VP2 genes showed that the GVI.2 strains from this study were closely related to USA GVI.2 strains. The complete genome of GVI.2 strain Dog/M9/18/CH was successfully sequenced, it was 7905 nucleotides (nt) in length and shared 95.9% nt identity with the sole available, nearly full-length genome of GVI.2 strain genome. To our knowledge, this is first description of the molecular prevalence of CNV in mainland China, and the first report of a complete GVI.2 genome. These findings will extend our understanding of epidemics and the genetic evolution of CNV.

First detection of canine norovirus in dogs and a complete GVI.2 genome in mainland China

Infection, Genetics and Evolution

Huiqiang Maa, Hua Yueab, Yingying Luoa, Siyi Lia, Cheng Tangab

https://doi.org/10.1016/j.meegid.2021.104879

https://www.sciencedirect.com/science/article/abs/pii/S1567134821001763

Coronavirus outbreak bumps hand hygiene compliance

Hand hygiene is a cornerstone of infection control,1,2 yet compliance remains low, averaging 50% across hospitals nationwide.1 Audit and feedback can improve compliance,3 but audits traditionally occur using direct observation, capturing few events and leading to inaccurate measurements.4 To address this, some institutions have implemented automated monitoring.1,4 

Woman washing her hands at the kitchen sink. There are vegetables out of focus in the background.

To further validate hand hygiene compliance measurements from automated monitoring and estimate the upper bound of compliance achievable with such systems, we describe changes in compliance during the COVID-19 pandemic as measured by the automated system at our institution, one of the largest such deployments nationally.

Hand hygiene compliance rate during the COVID-19 pandemic

JAMA Internal Medicine

Sonya Makhni, MD, MBA1,2Craig A. Umscheid, MD, MS1,2,3Jackie Soo, MPH, ScD3Vera Chu, MS, MLS(ASCP)CM4Allison Bartlett, MD, MS2,4,5Emily Landon, MD1,2,4Rachel Marrs, DNP, RN, CIC4

doi:10.1001/jamainternmed.2021.1429

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2779293

Brucellosis sickens dozens in Algeria after drinking goats milk

Outbreak News Today reportsAlgerian media is reporting an outbreak of brucellosis in Batna. According to the report, 31 people were infected with brucellosis in the municipality of Ares after consuming goat’s milk.

This followed the discovery of a focus of the disease that infected 119 goats from a herd of 155.

Brucellosis is a contagious disease of animals that also affects humans. The disease is also known as Bang’s Disease. In humans, it’s known as Undulant Fever.

The Brucella species are named for their primary hosts: Brucella melitensis is found mostly is goats ,sheep and camels, B. abortus is a pathogen of cattle, B. suis is found primarily in swine and B. canis is found in dogs.

The more common ways people get infected with brucellosis include: First, individuals that work with infected animals that have not been vaccinated against brucellosis. This would include farmers, slaughterhouse workers and veterinarians.

They get infected through direct contact or aerosols produced by the infected animal tissue. B. abortus and B. suis are most common.

The second way is through ingesting unpasteurized dairy products.

Brucellosis is also an occupational hazard to laboratory workers who inappropriately handle specimens or have an accident or spill. Brucella is highly infectious in the aerosolized form.

If someone gets infected with Brucella, the incubation period is about 2-3 weeks, though it could be months. Fever, night sweats, severe headache and body aches and other non-specific symptoms may occur.