Raw milk cheeses are commonly consumed in France and are also a common source of foodborne outbreaks (FBOs). Both a FBO surveillance system and a laboratory-based surveillance system aim to detect Salmonella outbreaks.
In early August 2018 5 familial FBOs due to Salmonella spp. were reported to a regional health authority. Investigation identified common exposure to a raw goats’ milk cheese, from which Salmonella spp. were also isolated, leading to an international product recall. Three weeks later, on 22 August, a national increase in Salmonella Newport ST118 was detected through laboratory surveillance. Concomitantly isolates from the earlier familial clusters were confirmed as S. Newport ST118. Interviews with a selection of the laboratory identified cases revealed exposure to the same cheese, including exposure to batches not included in the previous recall, leading to an expansion of the recall. The outbreak affected 153 cases, including 6 cases in Scotland. S. Newport was detected in the cheese and in milk of one of the producer’s goats.
The difference in the two alerts generated by this outbreak highlight the timeliness of the FBO system and the precision of the laboratory-based surveillance system. It is also a reminder of the risks associated with raw milk cheeses.
Outbreak of salmonella Newport associated with internationally distributed raw goats’ milk cheese, France, 2018, 04 May 2020
In December 2018, the Pennsylvania Department of Agriculture (PDA) and Pennsylvania Department of Health (PADOH) were notified of a New York patient with brucellosis caused by infection with Brucella abortus RB51, the live attenuated vaccine strain of B. abortus used to prevent brucellosis in cattle (1). Brucellosis is a serious zoonotic infection caused by the bacteria Brucella spp. The most common sign is fever, followed by osteoarticular symptoms, sweating, and constitutional symptoms (2). Without proper treatment, infection can become chronic and potentially life-threatening (2).
The patient had consumed raw (unpasteurized) milk from dairy A in Pennsylvania.* In July 2017, Texas health officials documented the first human case of domestically acquired RB51 infection associated with raw milk consumption from a Texas dairy (3). In October 2017, a second RB51 case associated with raw milk consumption was documented in New Jersey†; the milk source was not identified at the time.
To determine the RB51 source for the New York case, PDA conducted an environmental investigation at dairy A in December 2018. PDA collected individual milk samples from all cows, excluding those known not to have been vaccinated against B. abortus, and from the bulk milk tank, which included milk pooled from all cows. All milk samples underwent polymerase chain reaction (PCR) testing and culture; whole-genome sequencing (WGS) was performed on patient and milk sample isolates. PDA conducted a traceback investigation of any cow with a milk sample that tested positive for RB51. PADOH worked with the raw milk cooperative that distributed dairy A’s milk to notify potentially exposed consumers and distributed notifications through Epi-X§ to identify cases.
Dairy A sold only raw milk and did not provide RB51 vaccination to cows born there (16 of the 30-cow herd). The remaining 14 cows were born outside the dairy and had inadequate vaccination records to determine whether they had received RB51. Because these cows might have been vaccinated, milk samples were collected from them. RB51 was detected by PCR and isolated in milk samples collected from the bulk tank and a single cow (cow 122). WGS identified two distinct RB51 strains shed by cow 122: one matched the 2018 New York patient’s isolate (3 single nucleotide polymorphisms [SNPs] different) and one, unexpectedly, matched the 2017 New Jersey patient’s isolate (1 SNP different). The two different RB51 strains were also shed from different quarters of cow 122’s udder.
Traceback revealed that cow 122 had received RB51 in 2011 and was purchased by dairy A in 2016. During 2016–2018, dairy A distributed raw milk potentially contaminated with RB51 to 19 states; PADOH notified those states’ public health veterinarians. PADOH provided a letter with RB51 information and brucellosis prophylaxis recommendations to the cooperative, which they distributed to dairy A customers. No additional cases were identified. Cow 122 was excluded from milk production, and serial PCR testing of bulk milk samples were subsequently negative for RB51.
Isolation of two different RB51 strains from different quarters of a cow’s udder has not previously been reported. These infections highlight the need to prevent RB51 infections. Raw milk consumption is also associated with serious illnesses caused by other pathogens, including Campylobacter spp., Shiga toxin–producing Escherichia coli, and Salmonella spp. (4). During 2007–2012, the number of raw milk outbreaks in the United States increased; 66 (81%) of 81 reported outbreaks occurred in states where raw milk sale is legal (5). Pregnant women, children, older adults, and persons with immunocompromising conditions are at greatest risk for infection.¶
To eliminate infection risk from milkborne pathogens, including RB51, all milk should be pasteurized. Because limited information is available about intermittent or continuous RB51 shedding among dairy cows, more research is needed to more fully understand this emerging public health threat for milk consumers. States can also consider the United States Animal Health Associations’ recommendations regarding the need for RB51 vaccination in areas where B. abortus is not endemic in wildlife.
Notes from the field: Brucella abortus RB51 infections associated with consumption of raw milk from Pennsylvania—2017 and 2018, 17 April 2020
Morbidity and Mortality Weekly Report
Joann F. Gruber, PhD1,2; Alexandra Newman, DVM3; Christina Egan, PhD3; Colin Campbell, DVM4; Kristin Garafalo, MPH4; David R. Wolfgang, VMD5; Andre Weltman, MD2; Kelly E. Kline, MPH2; Sharon M. Watkins, PhD2; Suelee Robbe-Austerman, DVM, PhD6; Christine Quance6; Tyler Thacker, PhD6; Grishma Kharod, MPH1; Maria E. Negron, DVM, PhD1; Betsy Schroeder, DVM2
I’m nervous this is not peer-reviewed, has a small sample size, but thought I’d share anyway.
I’ve never fed any of my pets a raw-food diet.
New research due to be presented at this year’s European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) reveals that raw-type dog foods contain high levels of multidrug-resistant bacteria, including those resistant to last-line antibiotics. The potential transfer of such bacteria between dogs and humans is an international public health risk, conclude the authors who include Dr. Ana Raquel Freitas and colleagues from the Faculty of Pharmacy, UCIBIO/REQUIMTE, University of Porto, Portugal.
Enterococci are opportunistic pathogens—so they are part of our normal internal microbiota but can cause infections (for example in patients who are immunosuppressed or hospitalised).
Raw-food-based diets for dogs have grown popularity recently as a healthier choice. Increasing controversy regarding their safety is emerging, with some scientific evidence showing their role as vehicles for transmission of antibiotic-resistant bacteria. In addition, dogs have been described as reservoirs of clinically-relevant ampicillin-resistant (AmpR) Enterococcus faecium, but the source remains unknown.
In this study, the authors analysed enterococci obtained from processed (both dry and wet types) and non-processed (raw-frozen) foods of the main brands commercialised in Portugal. The study included 46 samples (22 wet, 15 dry, 9 raw-frozen) from 24 international brands, sourced from 8 supermarkets and one veterinary clinic. Samples were obtained during September to November, 2019.
Raw-frozen samples were mainly constituted of salmon, chicken, turkey, calf, deer or duck, being a mixture of different meat types, fruits and vegetables.
Samples were cultured and then tested with a range of antibiotics. Enterococci (n=163) were identified in 19/46 (41%) of the samples: 8 of 15 (53%) in the dry foods; 2 of 22 (9%) of the wet samples, and 9 of 9 (100%) in the raw-frozen samples, and identified as the Enterococcus species E. faecium (91 isolates), E. faecalis (59 isolates) or other species (13 isolates).
Across the 9 raw-frozen meat samples, there were 30 E. faecium and 30 E. faecalis recovered. All nine carried multidrug-resistant (MDR) enterococci (20 E. faecium and 22 E. faecalis), including those resistant to a wide range of antibiotics, while only one MDR- E. faecium (resistant to erythromycin/tetracycline/gentamicin) was detected in one of the wet food samples and none in the dry food samples.
Resistance was found to the antibiotics ampicillin, ciprofloxacin, erythromycin, tetracycline, streptomycin and chloramphenicol in all 9 raw-type samples; seven of nine contained enterococci resistant to the last line antibiotic linezolid (78%), and six of nine contained enterococci resistant to gentamicin or quinupristin-dalfopristin. Resistance to clinically-relevant antibiotics such as linezolid, ampicillin or ciprofloxacin was only detected in raw-frozen samples.
The authors conclude: “Our study demonstrates that raw-frozen-foods for dogs carry MDR enterococci including to last-line antibiotics (linezolid) for the treatment of human infections. The close contact of pets with humans and the commercialisation of the studied brands in different EU countries pose an international public health risk if transmission of such strains occurs between dogs and humans. There is strong past and recent evidence that dogs and humans share common multidrug-resistant strains of E. faecium, and thus the potential for these strains to be transmitted to humans from dogs.”
Dr. Freitas adds: “These raw-frozen foods are supposed to be consumed after being thawed and could at least be cooked, to kill these drug-resistant and other bacteria. Although these foods seem to be regulated regarding their microbiological safety by EU authorities, risk assessment of biological hazards should also include antibiotic-resistant bacteria and/or genes besides only establishing the presence of bacterial pathogens, such as Salmonella.”
This is up from 45 cases reported ill at the El Carmen Hospital with symptoms of Salmonella on Tuesday.
Health officials have linked to outbreak to the consumption of sushi at a Bokado sushi store.
“This is an important call for the preparation of these products, they must be cooked. They must not use salmon or raw seafood, they must use cooked products , ” said Health Seremi, Rosa Oyarce.
The Food Standards Agency reports Happy Hounds is recalling certain types of frozen raw dog food because salmonella has been found in the products.
Product details
Frozen Chicken & Beef Sleeve Dog Food
Pack size
1kg
Batch code
1205
Best before
3 September 2020
Frozen Chicken Mince Sleeve Dog Food
Pack size
1kg
Batch code
1205
Best before
3 September 2020
Frozen Chicken Mince Dog Food
Pack size
2.5kg (bag of 4)
Batch code
1205
Best before
3 September 2020
Risk statement
The presence of salmonella in the products listed above. Salmonella is a bacterium that can cause illness in humans and animals. The product could therefore carry a potential risk because of the presence of salmonella, either through direct handling of the pet food, or indirectly, for example from pet feeding bowls, utensils or contact with the faeces of animals.
In humans, symptoms caused by salmonella usually include fever, diarrhoea and abdominal cramps. Infected animals may not necessarily display signs of illness, but symptoms can include diarrhoea.
Action taken by the company
Happy Hounds is recalling the above products. Point of sale notices will be displayed in all retail stores that are selling these products. These notices explain to customers why the products are being recalled and tell them what to do if they have bought the product.
Our advice to consumers
Our advice to pet owners: If you have bought any of the above products do not use them. Instead, return them to the store from where they were bought for a full refund. When handling and serving raw pet food it is always advised to clean utensils and feeding bowls thoroughly after use. Consumers should wash hands thoroughly after handling raw pet food, bowls, utensils or after contact with the faeces of animals. Raw pet food should be stored separately from any food (especially ready to eat foods). Care should be taken when defrosting to avoid cross contamination of foods and surfaces.
WTVR reports health officials announced Saturday an extension of the ban on shellfish harvesting in the waters off Parrot Island in the Rappahannock River in Middlesex County.
The news comes after Virginia Department of Health officials banned the harvesting of oysters and clams in that stretch of the river on Dec. 27 following a Norovirus outbreak in Colorado linked to shellfish harvested from the area.
As a result, oysters harvested between Dec. 1, 2019 through Jan. 11, 2020 are being recalled.
The only oysters affected by the recall were shipped by Rappahanock River Oyster Company from lease numbers 18403, 18417, and 19260 in the Rappahanock River, according to the Virginia Department of Health. The company said the oysters were sold under the Emersum brand name.
Officials noted crabs and fin fish in the river are still safe to catch.
Outbreak News Today reports that French health authorities (Santé publique France) say since December 2019, 179 compulsory declarations (DO) of collective food poisoning ( toxi-infection alimentaire collective-TIAC) suspected of being linked to the consumption of raw shellfish, mainly oysters.
The reports come from the majority of regions in mainland France.
Seventy-seven percent of cases occurred since December 23, with the peak of patients being observed around December 25-27.
The symptoms, mainly diarrhea and vomiting, as well as the incubation times, are compatible with infections with norovirus or other enteric viruses. Stool tests performed to date by the National Reference Center for Gastroenteritis Viruses have confirmed the presence of norovirus and other enteric viruses.
The number of TIAC suspected of being linked to the consumption of raw shellfish is significantly higher than in previous years. Each year between 25 and 120 TIAC suspected of being linked to the consumption of shellfish are reported to Public Health France, of which between 4 and 30 occurred during the December-January periods.
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.
The apparent international rise in foodborne virus outbreaks attributed to fresh produce and the increasing importance of fresh produce in the Australian diet has led to the requirement to gather information to inform the development of risk management strategies.
A prevalence survey for norovirus (NoV) and hepatitis A virus (HAV) in fresh Australian produce (leafy greens, strawberries and blueberries) at retail was undertaken during 2013–2014 and data used to develop a risk profile. The prevalence of HAV in berries and leafy greens was estimated to be <2%, with no virus detected in produce during the yearlong survey. The prevalence of NoV in fresh strawberries and blueberries was also estimated to be <2% with no virus detected in berries, whilst for leafy greens the NoV prevalence was 2.2%.
Prevalence of a bacterial hygiene indicator, Escherichia coli, was also investigated and found to range from <1% in berries to 10.7% in leafy greens. None of the NoV positive leafy green samples tested positive for E. coli, indicating it is a poor indicator for viral risk.
The risk was evaluated using standard codex procedures and the Risk Ranger tool. Taking all data into account, including the hazard dose and severity, probability of exposure, probability of infective dose and available epidemiological data, the risk of HAV and NoV foodborne illness associated with fresh Australian berries (strawberries and blueberries) sold as packaged product was deemed to be low. The risk of foodborne illness from HAV associated with leafy greens was also deemed to be low, but higher than that for fresh berries, due mainly to the potential for recontamination post-processing if sold loose. The risk of foodborne illness from NoV associated with leafy greens was deemed to be low/moderate. Despite the prevalence of NoV in leafy greens being low and the inability to discriminate between infective and non-infective virus using PCR based methodologies, the fact that NoV was detected resulted in a higher risk associated with this pathogen-product pairing; compounded by the higher prevalence of NoV within the community compared to HAV, and the potential for leafy greens to become contaminated following processing if sold loose.
Estimating risk associated with human norovirus and hepatitis A virus in fresh Australian leafy greens and berries at retail 26 August 2019
In early August 2018 5 familial FBOs due to Salmonella spp. were reported to a regional health authority. Investigation identified common exposure to a raw goats’ milk cheese, from which Salmonella spp. were also isolated, leading to an international product recall. Three weeks later, on 22 August, a national increase in Salmonella Newport ST118 was detected through laboratory surveillance. Concomitantly isolates from the earlier familial clusters were confirmed as S. Newport ST118. Interviews with a selection of the laboratory identified cases revealed exposure to the same cheese, including exposure to batches not included in the previous recall, leading to an expansion of the recall. The outbreak affected 153 cases, including 6 cases in Scotland. S. Newport was detected in the cheese and in milk of one of the producer’s goats.
