Vets have the best drugs: Minneapolis investigates police use of ketamine on suspects

The veterinarian’s choice of drug – the horse sedative, ketamine – has been used by Minnesota police types to sedate people in custody, according to NPR.

I was married to a vet for 16 years and she had lots of tales about ketamine, but no evidence she used it herself, but I’ve met a few vets in rehab, and they liked their ketamine.

Ketamine, a powerful sedative is used in hospitals as an anesthetic and more recently, to treat depression. It’s also been called the date-rape drug. And now, city investigators in Minneapolis have found that police officers there directed paramedics to inject the drug into people on the street to subdue them. This, according to a draft report that was obtained by the Star Tribune. Andy Mannix is the reporter at the Star Tribune who broke the story, and he’s with us now. Andy Mannix, welcome. Thanks so much for speaking to us

MARTIN: What did we find from this report? I mean, for example, how do we know that the police were directing the paramedics to use the powerful sedative? And were there some other patterns that emerged when they reviewed all this information?

MANNIX: One of the issues that’s been alarming to a lot of people is just like how casually police and paramedics talk about this drug. So, we have one example where there’s a person who’s sort of being combative. The police officer is talking about ketamine. Give him a shot of ketamine – stuff like that. And then they give him two shots and then the guy sort of starts coming out of it and so they give him another shot. And the police officer – he says, he just hit the K-hole. So, they’re talking about in a way that’s almost like joking about it. There’s other examples of people saying, you know, calling a paramedic and saying bring ketamine, bring ketamine.

MARTIN: So tell us, who was being injected with this drug and what happened to them?

MANNIX: So most of the time they are – they’re calls dealing with someone who may be intoxicated or in a mental health crisis, you know, sort of like a minor nuisance crime – if a crime has been committed. So, in terms of what happens to these people, almost all of them – actually I think all of them get taken to the hospital.

MARTIN: The reports suggest that there was a large increase in the use of ketamine in recent years. There were reported of 3 incidents in 2012 and then there were 62 last year. Does the report offer any insight into why?

MANNIX: We have, in interviews with medical staff, asked that question many times and they say that there are more – there’s been a record amount of incidents involving severely agitated people. Paramedics and doctors would say that’s when someone is so agitated that they may hurt themselves or hurt somebody else. So they’re saying they’re running into more examples of this kind of behavior on the street.

MARTIN: On the other hand, though, the county hospital where the EMTs work was conducting studies on ketamine. The question arises, were they being sort of pressured?

MANNIX: You know, the scope of the oversight report is mostly police, but they do touch on this a little bit. There’s one case in particular where someone, you know, being recorded on police body camera asks why they sedated somebody and the paramedic talks about the study and says well, you know, we’re doing this study and so we needed to give them ketamine. There was one woman we talked to who had relapsed on alcohol and she was in her apartment and her sponsor, an AA, called and said can you just do a welfare check on my friend. I just want to make sure she’s OK. They ended up coming into her apartment – said she didn’t want this drug, they gave it to her anyway.

She wakes up 24 hours later with a breathing tube down her throat. And then on her way out, they hand her this form that says, by the way, you know, you’re enrolled in this study. And that’s pretty common, that’s a pretty typical story. There are several investigations going on right now including one with former acting U.S. Attorney General Sally Yates. She’s been appointed by the mayor, here, to come in and do an independent investigation. So obviously they’re very concerned.

MARTIN: That’s Andy Mannix. He’s a reporter at the Star Tribune in Minneapolis. Andy, thanks so much for speaking to us.

MANNIX: Hey, thanks for having me.

Defense matters

The head coach of the Australian state of Queensland , a fellow Canadian, told us parents and coaches earlier this year, anyone can play defense, it’s easy, offense is hard.

I disagree.

But that’s just my opinion.

Defense wins Stanley Cups and Super Bowls.

Defense takes discipline.

Defense is hard.

I played four years as a linebacker in football and would crush anybody who tried to cross the line.

Any food company knows this, because they do not want to be tomorrow’s headline, just because someone messed up.

This is a picture of my daughter playing defense in practice (thanks Julie). Look at how the goalie is ideally placed, with his foot up against the post and his stick outside the post. Look at the angling Sorenne is using on her teammate.

Those are boring things but they win games.

And help people not barf from food.

This is Sorenne protecting the blue-line last week (thanks again, Julie).

Defense matters.

Petting zoos as a source of shiga-toxin producing E. coli in Austria

Hey Gonzo, they cited us.

Too bad your soccer teams suck, and I don’t care.

But I do care when others cite the gumshoe work we put into our research activities.

And I especially care when every year, I tell our public school or the local shopping mall that petting farms around kids can lead to heartache.

They call me crazy, just like they continue to top salads with raw alfalfa sprouts at Brisbane Private Hospital, despite my protestations.

I do what I can.

These others are microbiological idiots.

There, I’m done.

Despite their general low incidence, Shiga toxin-producing Escherichia (E.) coli (STEC) infections are considered an important public health issue due to the severity of illness that can develop, particularly in young children.

 We report on two Austrian petting zoos, one in Tyrol (2015) and one in Vorarlberg (2016), which were identified as highly likely infection sources of STEC infections. The petting zoo related cases involved a case of hemolytic uremic syndrome (HUS) due to STEC O157:HNM in 2015 and an outbreak of STEC O157:H7 infections affecting five young children and two adults in 2016. The HUS case accounted for 2.8% of the 36 STEC O157:HNM/H7 infections notified in Austria in 2015 (5,9% of 17 HUS cases). The seven cases described for 2016 accounted for 4.0% of the 177 human STEC infections documented for Austria in 2016, and for 19% of the 36 STEC O157:HNM/H7 infections notified that year.

The evaluation of the STEC infections described here clearly underlines the potential of sequence-based typing methods to offer suitable resolutions for public health applications. Furthermore, we give a state-of-the-art mini-review on the risks of petting zoos concerning exposure to the zoonotic hazard STEC and on proper measures of risk-prevention.

A table of petting zoo outbreaks is available at https://www.barfblog.com/wp-content/uploads/2017/08/Petting-Zoo-Outbreaks-Table-7-26-17.xlsx

Erdozain G, Kukanich K, Chapman B, Powell D. 2012. Observation of public health risk behaviours, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011. Zoonoses Public Health. 2012 Jul 30. doi: 10.1111/j.1863-2378.2012.01531.x. [Epub ahead of print]

Outbreaks of human illness have been linked to visiting settings with animal contact throughout developed countries. This paper details an observational study of hand hygiene tool availability and recommendations; frequency of risky behavior; and, handwashing attempts by visitors in Kansas (9) and Missouri (4), U.S., petting zoos.

Handwashing signs and hand hygiene stations were available at the exit of animal-contact areas in 10/13 and 8/13 petting zoos respectively. Risky behaviors were observed being performed at all petting zoos by at least one visitor. Frequently observed behaviors were: children (10/13 petting zoos) and adults (9/13 petting zoos) touching hands to face within animal-contact areas; animals licking children’s and adults’ hands (7/13 and 4/13 petting zoos, respectively); and children and adults drinking within animal-contact areas (5/13 petting zoos each). Of 574 visitors observed for hand hygiene when exiting animal-contact areas, 37% (n=214) of individuals attempted some type of hand hygiene, with male adults, female adults, and children attempting at similar rates (32%, 40%, and 37% respectively). Visitors were 4.8x more likely to wash their hands when a staff member was present within or at the exit to the animal-contact area (136/231, 59%) than when no staff member was present (78/343, 23%; p<0.001, OR=4.863, 95% C.I.=3.380-6.998). Visitors at zoos with a fence as a partial barrier to human-animal contact were 2.3x more likely to wash their hands (188/460, 40.9%) than visitors allowed to enter the animals’ yard for contact (26/114, 22.8%; p<0.001, OR= 2.339, 95% CI= 1.454-3.763). Inconsistencies existed in tool availability, signage, and supervision of animal-contact.

Risk communication was poor, with few petting zoos outlining risks associated with animal-contact, or providing recommendations for precautions to be taken to reduce these risks.

Petting zoos as sources of shiga toxin-producing Escherichia coli (STEC) infections

27.june.18

International Journal of Medical Microbiology, DOI: 10.1016/j.ijmm.2018.06.008 

Sabine Schlager, Sarah Lepuschitz, Werner Ruppitsch, Oksana Ableitner, Ariane Pietzka, Sabine Neubauer, Anna Stöger, Heimo Lassnig, Claudia Mikula, Burkhard Springer, Franz Allerberger
http://www.x-mol.com/paper/721663

Reducing food waste is good, but is it safe?

Organizations dedicated to hunger relief have grown in recent years to increase their capacity to reach more food insecure populations for example, Feeding America served 11% more meals in 2016 than in 2015.

One barrier to ensuring food safety during the diversion and donation of food is lack of effective training for volunteers. Some programs are affiliated with universities and as such rely on student volunteers. Students have been shown to have risky practices in food-handling environments and can create situations in which food distributed by hunger-relief organizations can be at risk for unintentional contamination.

Using a food recovery program at a large, land-grant university, food-handling behaviors of student volunteers were observed in-person and compared to self-reported behaviors and self-identified training needs gathered via a survey.

Commonly observe behaviors were improper handwashing, inconsistent record keeping, and the use of unclean or contaminated equipment for example, during deliveries only 13% of volunteers were observed washing their hands at least once, while 69% self-reported doing so.

Training volunteers is necessary in view of the vulnerability to foodborne illness of those receiving recovered food. Trainings specifically for this audience should include unique handling scenarios adapted to food handler best practices.

Food-handling behaviors of student volunteers in a university food recovery program

Food Protection Trends, Volume 38, Issue 4, Pages 284-294, 2018

Lester Schonberger, Renee R. Boyer, Melissa W. Chase

http://staging.nxtbook.com/nxtbooks/trilix/fpt_20180708/stage.php#/44

42: Tea towels a source of bacteria in kitchen

I was never a paper towel kinda guy.

I have about 30 tea towels, including one with images of all of Sorenne’s prep (kindergarten) pals and teachers.

They are my go-to sweat rags, hand wipes and kitchen cleaner-uppers.

As advised by The Hitchhikers’ Guide to the Galaxy, never leave home without a towel.

About five go into the laundry every day.

According to a study published by the University of Mauritius, and presented recently at the annual meeting of the American Society for Microbiology, your kitchen towels may be the leading culprit of pathogen advancement.

“Our study demonstrates that the family composition and hygienic practices in the kitchen affected the microbial load of kitchen towels,” said Dr. Biranjia-Hurdoyal. “We also found that diet, type of use and moist kitchen towels could be very important in promoting the growth of potential pathogens responsible for food poisoning,” she said.

Researchers collected a total of 100 kitchen towels after one month of use. Using standard biochemical tests, they concluded that 49% of the kitchen towels collected in the study had bacterial growth. The bacterial growth increased in number with family size—whether by extended family, or the presence of children.

Experts discourage using kitchen towels for multiple purposes (wiping utensils, drying hands, holding hot utensils, wiping/cleaning surfaces) because they had a higher bacterial count than single-use towels. They also warn against using humid towels because they too showed higher bacterial count than dry ones. Pathogens on kitchen towels would indicate that they could bear some responsibility for cross-contamination in the kitchen and, ultimately, food poisoning. Households with children, older adults or others with immunosuppression should be especially vigilant about hygiene in the kitchen.

But, like other studies of sponges and things, the researchers don’t account for the level of cleaning in a particular household. Five a day, into the laundry.

And rather than blame consumers, have a look at bacterial loads on chef aprons.

Study says: Communication is most important skill for public-health types

The professional development of environmental public health professionals in Canada is guided by a set of 133 discipline-specific competencies. Given the diversity of practice in environmental public health, certain competencies may be more important to job effectiveness depending on a practitioner’s context. However, the most important competencies to job effectiveness by context are unknown. Thus, the objectives of this study were to prioritize the discipline-specific competencies according to their importance to job effectiveness, and determine if importance varied by demographic variables.

A quantitative discrete-choice method termed best–worst scaling was used to determine the relative importance of competencies. Discrete choice information was electronically collected and analyzed using Hierarchical Bayesian analysis.

Our analysis indicates that communication was most important to job effectiveness relative to the other categories. Competency statements within each category differed in their importance to job effectiveness. Further, management and front-line practitioners differed in the importance placed on five of the eight categories.

This information can be used to guide new training opportunities, thereby investing in the capacity of environmental health professionals to better protect population health.

Prioritizing professional competencies in environmental public health: A best-worst scaling experiment

Aug. 2018

Environmental Health Review, vol. 61 no. 2, pg 50-63

Lauren E. Wallar,* Scott A. McEwen,* Jan M. Sargeant,* Nicola J. Mercer, Andrew Papadopoulos*

 https://doi.org/10.5864/d2018-014

http://pubs.ciphi.ca/doi/abs/10.5864/d2018-014

How produce gets contaminated in the field: A review

Foodborne illness resulting from the consumption of contaminated fresh produce is a common phenomenon and has severe effects on human health together with severe economic and social impacts.

The implications of foodborne diseases associated with fresh produce have urged research into the numerous ways and mechanisms through which pathogens may gain access to produce, thereby compromising microbiological safety.

This review provides a background on the various sources and pathways through which pathogenic bacteria contaminate fresh produce; the survival and proliferation of pathogens on fresh produce while growing and potential methods to reduce microbial contamination before harvest.

Some of the established bacterial contamination sources include contaminated manure, irrigation water, soil, livestock/ wildlife, and numerous factors influence the incidence, fate, transport, survival and proliferation of pathogens in the wide variety of sources where they are found. Once pathogenic bacteria have been introduced into the growing environment, they can colonize and persist on fresh produce using a variety of mechanisms.

Overall, microbiological hazards are significant; therefore, ways to reduce sources of contamination and a deeper understanding of pathogen survival and growth on fresh produce in the field are required to reduce risk to human health and the associated economic consequences.

 

Sources and contamination routes of microbial pathogens to fresh produce during field cultivation: A review

Food Microbiology, vol. 73, pg. 177-208

Oluwadara Alegbeleye, Ian Singleton and Anderson Sant’Ana

https://doi.org/10.1016/j.fm.2018.01.003

https://www.sciencedirect.com/science/article/pii/S0740002017310158?via%3Dihub

Will it mean fewer sick people? Trump’s plan to consolidate federal food safety efforts won’t work

Timothy D. Lytton, Associate Dean for Research & Faculty Development and Distinguished University Professor & Professor of Law at Georgia State University College of Law writes in this contributed op-ed that:

The Trump administration on June 21 unveiled an ambitious plan to consolidate federal food safety efforts within the U.S. Department of Agriculture.

Currently, 15 agencies throughout the federal government administer 35 different laws related to food safety under the oversight of nine congressional committees.

The administration calls this system “illogical” and “fragmented.”

“While [the USDA’s Food Safety Inspection Service] has regulatory responsibility for the safety of liquid eggs, [the Food and Drug Administration in the Department of Health and Human Services] has regulatory responsibility for the safety of eggs while they are inside of their shells,” the document explains. “FDA regulates cheese pizza, but if there is pepperoni on top, it falls under the jurisdiction of FSIS; FDA regulates closed-faced meat sandwiches, while FSIS regulates open-faced meat sandwiches.”

Concern about this state of affairs has been fueling similar consolidation proposals for decades.

But my research for a forthcoming book on the U.S. food safety system suggests that the Trump administration plan faces a number of challenges that make a major reorganization of federal food safety regulation both impractical and undesirable.

The curious division of labor between the U.S. Department of Agriculture and the Food and Drug Administration dates back to the passage of two laws enacted in 1906.

The Meat Inspection Act mandated inspection of all beef carcasses. The Pure Food and Drug Act prohibited the sale of adulterated food in interstate commerce.

Initially, both laws were implemented by officials at the USDA. Its Bureau of Animal Industry placed inspectors trained in veterinary science at every meat plant. Meanwhile, its Bureau of Chemistry employed laboratory scientists to test foods for adulteration.

In 1940, Franklin Roosevelt moved the Bureau of Chemistry, by then renamed the Food and Drug Administration, out of the USDA and into the Federal Security Agency, which later became the Department of Health and Human Services. Today, the FDA is responsible for overseeing the production of most foods other than meat and poultry.

Separately, the Bureau of Animal Industry was renamed the Food Safety Inspection Service, which is still responsible for all meat and poultry inspections.

Concerns about regulatory fragmentation grew as Congress assigned new tasks related to food safety to a variety of other agencies.

For example, Congress instructed the Federal Trade Commission to regulate food advertising, the Environmental Protection Agency to set pesticide tolerances and the National Marine Fisheries Service to inspect seafood.

Proponents of putting food safety under the roof of a single agency have argued that the current system causes confusion because different agencies produce inconsistent standards.

They further allege that overlapping jurisdictions create inefficiencies and that inadequate coordination leaves gaps in coverage. They also worry that the involvement of so many different actors diffuses political accountability.

The first high-profile proposal to consolidate federal food safety regulation was made in 1949, during the Truman administration, when a presidential commission recommended transferring food safety oversight to the USDA, just as the Trump administration has.

In 1972, consumer activist Ralph Nader advocated creating a new consumer safety agency to oversee food safety. And a few years later, a Senate committee recommended moving the USDA’s food safety responsibilities to the FDA.

Those are just three examples of more than 20 such proposals from both sides of the political aisle, including one by President Barack Obama in 2015.

None of these consolidation efforts succeeded for the same reasons the current one is unlikely to work now.

First of all, the many congressional committees that currently oversee agencies that regulate food safety are unlikely to support any reorganization that would reduce their power. Congressional oversight affords lawmakers who serve on committees opportunities to help interest groups and constituents in exchange for political support.

Similarly, industry associations are unlikely to support a reorganization that would disrupt their relationships with existing agencies. Consolidation threatens to reduce their access and influence over agency decisions.

In addition to the political obstacles to consolidation, there are practical problems. Merely merging the 5,000 food safety officials in the FDA and the 9,200 officials in the FSIS under the oversight of a single administrator would not eliminate the differences in jurisdiction, powers and expertise responsible for the current bureaucratic fragmentation. Meaningful consolidation would require a complete overhaul of federal food safety laws and regulations, a task of extraordinary legal and political complexity.

Moreover, consolidating food safety efforts in a single agency might create new forms of fragmentation. For example, transferring the FDA Center for Veterinary Medicine’s program for regulating drug residues in beef and poultry to the USDA would separate it from the FDA’s veterinary drug approval program.

And finally, reorganization is costly and would take years for the different agency teams newly working together to develop bonds of trust and cooperation. And these costs would have to be paid upfront, without a clear idea of whether the expected gains will ever pay off.

Consolidation need not be all or nothing.

For example, some have proposed more modest consolidation of inspection services, policy planning and communications that would be less costly and not so difficult.

Nonetheless, Congress has shown little interest in considering any bureaucratic reorganization of federal food safety regulation, even a partial consolidation.

In other words, the Trump administration may have to settle for the less ambitious goal of better interagency coordination, which offers an alternative way to address concerns about duplication and coverage gaps. This more modest approach would not, however, address the persistent problem of fragmentation.

In food safety, as in other regulatory reform arenas, it may turn out that half a loaf is better than none.

Because chefs have goggles that can see bacteria: English World Cup team refusing food from Russian room service over poisoning fears, source claims

Team England is reportedly on an even stricter diet than usual at the 2018 FIFA World Cup, as players have allegedly been banned from eating food from room service at their Russian hotel (me watching soccer, left, exactly as shown).

The Three Lions stars are “under strict orders to reject any food not approved by their expert chefs,” The Sun is reporting. According to the outlet, security is on “high alert” at the team’s ForRestMix hotel in Repino, Saint Petersburg, given fears surrounding the nerve attack on ex-spy Sergei Skripal and his daughter Yulia earlier this year.

“Nothing is being left to chance. The players are going to do exactly as told. Nothing will pass their lips apart from food and drink provided by chefs and nutritionists,” a source told The Sun. “If the players are hungry they must contact somebody within the management to get a snack. They can’t just reach into the mini bar or buy something from a shop.”

“These rules are always in place at tournaments because of diets, and there is always a fear of food poisoning which could destroy their performance. But for the World Cup in Russia it is very, very strict,” they added.

But while elite players are snacking on light fare including sushi, oatcakes with cream cheese, and herbal teas, this isn’t the first time that head coach Gareth Southgate has made headlines for cracking down on his player’s diets.

Earlier this year, Southgate coordinated with the Starbucks at the hotel where his team was staying to remove all treats and ban the sale of sugary drinks to his squad ahead of this summer’s World Cup, the Evening Standard reported.

Now that the games have officially begun, nutritionists and chefs have arrived to support the team in Russia, and all precautions are being taken.

“Health inspectors will take food samples and freeze them to look at if something happens,” Tim De’Ath, who has worked as Team England’s head chef for 10 years, told The Sun.

Standard operating procedure for these kind of events, or schools in Japan.

Raw is risky: Meghan Markle had to give up eating favourite food after marrying Harry

Australia has this weird love of everything royal – at least on the news.

If Harry farts, it’s reported; if one of the kids picks their nose, it’s reported.

And now, Meghan Markle, the Duchess of Sussex, has been told by Royal Butler Grant Harold, she will have to stop eating her most adored cuisine – seafood.

Mr Harold explained this is because the Royal Family don’t eat it due to food poisoning fears.

He told Express.co.uk: “It is a very sensible move to abandon having seafood when out and about on public duties.

“We don’t want a member of the Royal family having a serious reaction to food poisoning, especially if she is on an overseas tour.”

In 2013, Meghan revealed her “ideal food day” would consist of a “dinner of seafood and pasta” with a Negroni cap it all off.

But this isn’t the only fancy food off the table for the newest addition to the family.

The butler added: “As well as shellfish, it would also be quite appropriate for foods such as foie gras to be avoided.”

Prince Charles is said to have banned the delicacy from the palace in 2008 over animal rights concerns.