Epitaph ‘He tried to improve the world, one thermometer at a time’

Soon after Sorenne started at Junction Park State School, I started volunteering in the tuck shop, prepping foods for a few hundred kids on Fridays.

I put in some time, but then politics overtook my food safety nerdiness so I stopped.

But not before I left about 10 Comark tip-sensitive digital thermometers and advised, use them frequently.

While cooking breakfast this morning for 120 school kids, I ran into my friend, Dave, who is currently running the tuck shop, and he told me the thermometers get a regular workout each week, he had to change some batteries last week, and he took one home for cooking.

Now imagine that a tip-sensitive digital thermometer could be used to harness user data (and sell product).

Sapna Maheshwari of The New York Times writes that most of what we do — the websites we visit, the places we go, the TV shows we watch, the products we buy — has become fair game for advertisers. Now, thanks to internet-connected devices in the home like smart thermometers, ads we see may be determined by something even more personal: our health.

This flu season, Clorox paid to license information from Kinsa, a tech start-up that sells internet-connected thermometers that are a far cry from the kind once made with mercury and glass. The thermometers sync up with a smartphone app that allows consumers to track their fevers and symptoms, making it especially attractive to parents of young children.

The data showed Clorox which ZIP codes around the country had increases in fevers. The company then directed more ads to those areas, assuming that households there may be in the market for products like its disinfecting wipes. The Centers for Disease Control and Prevention recommends disinfecting surfaces to help prevent the flu or its spread.

Kinsa, a San Francisco company that has raised about $29 million from venture capitalists like Kleiner Perkins since it was founded in 2012, says its thermometers are in more than 500,000 American households. It has promoted the usefulness of its “illness data,” which it says is aggregated and contains no identifying personal information before being passed along to other companies.

It is unique, Kinsa says, because it comes straight from someone’s household in real time. People don’t have to visit a doctor, search their symptoms on Google or post to Facebook about their fever for the company to know where a spike might be occurring.

“The challenge with Google search or social media or mining any of those applications is you’re taking a proxy signal — you’re taking someone talking about illness rather than actual illness,” said Inder Singh, the founder and chief executive of Kinsa. Search queries and social media can also be complicated by news coverage of flu season, he said, while data from the C.D.C. is often delayed and comes from hospitals and clinics rather than homes.

The so-called internet of things is becoming enmeshed in many households, bringing with it a new level of convenience along with growing concerns about privacy.

Clorox used that information to increase digital ad spending to sicker areas and pull back in places that were healthier. Consumer interactions with Clorox’s disinfectant ads increased by 22 percent with the data, according to a Kinsa Insights case study that tracked performance between November 2017 and March of this year. That number was arrived at by measuring the number of times an ad was clicked on, the amount of time a person spent with the ad and other undisclosed metrics, according to Vikram Sarma, senior director of marketing in Clorox’s cleaning division.

Being able to target ads in this way is a big shift from even seven years ago, when the onset of cold and cough season meant buying 12 weeks of national TV ads that “would be irrelevant for the majority of the population,” Mr. Sarma said. The flu ultimately reaches the whole country each year, but it typically breaks out heavily in one region first and then spreads slowly to others.

While social media offered new opportunities, there has been “a pretty big lag” between tweets about the flu or flulike symptoms and the aggregation of that data for marketers to use, he said.

“What this does is help us really target vulnerable populations where we have a clear signal about outbreaks,” Mr. Sarma said.

Imagine using similar for data for people cooking dinner tonight.

This is what we’re having (above, right; Chapman, about those thermometers?).

A short guide to food thermometers

Chapman still owes me food thermometers.

He says he’ll send them, he says he’ll come to Australia, but nothing.

And he’s supposed to be the co-author on my next book.

It’s so hard to get good help.

But I’ve recruited the best of the past and we’ll get something done if my brain hangs together.

Barbara Gordon of At Right writes that you can’t tell if a food is safely cooked by sight, smell or even taste. A food thermometer is the only way to ensure food is cooked to the proper temperature and harmful bacteria are eliminated.

(Tell that to the British Food Safety Agency and their piping hot directive).

A food thermometer is not needed just for meat and poultry. A safe minimum internal temperature must be reached to avoid food poisoning in all cooked foods. The “danger zone” for perishable foods is between 40° and 140° Fahrenheit. Perishable foods are no longer safe to eat if they have been in this danger zone for more than two hours (one hour in 90° Fahrenheit or above). A food thermometer also is needed after food is cooked to ensure the temperature doesn’t fall into the danger zone. This is especially important for buffet and potluck-style gatherings.

Happy Thanksgiving and a sheep riding on a truck

To my Canadian brethren, who have consumed the 165F minimum temped bird and are now plopped on the couch watching hockey, including reruns of last night’s barnburner of a hockey game where our beloved but hapless (sorta like me) Toronto Maple Leafs pulled out a 7-6 overtime win against Chicago, I can say we did nothing to celebrate this year.

For every day is … never mind.

The house renovations just got finished, the bank account is empty, maybe we’ll pull something off for American Thanksgiving.

And now, a sheep riding on a truck in New Zealand.

“This is a highly unusual incident and not representative of how sheep are transported in New Zealand,” Ministry for Primary Industries spokesman Peter Hyde said.

Ellerslie resident Ada Rangiwai captured the sight on a cellphone while travelling along the city’s southern motorway. The sheep didn’t seem nervous and it was just standing there, unfazed by the attention.

“It was surfing,” she said.

And if you get a facebook request from me to be friends, ignore it. I, like millions of others, have been hacked.

Clean and sanitize your thermometers with the correct compounds

This one isn’t food safety, but there’s something for the microbiology nerds to learn here. Thermometers moving from person-to-person (or in our world, food-to-food) can move pathogens around.

According to the New England Journal of Medicine, a fungal outbreak at a hospital was linked to skin probe thermometers being reused. Fun part is that they were being sanitized between use, just not using the correct compound (in this case they used quat sanitizer) but this was against the manufacturer’s instructions. 

End result: 70 patients with Candida auris over a 2 year period.

A Candida auris Outbreak and Its Control in an Intensive Care Setting

04.Oct.18
New England Journal of Medicine
Eyre DW., Sheppard A., Madder H., Moir I., Moroney R., Quan TP., Griffiths D., GEORGE S., Butcher L., Morgan M., Newnham R., Sunderland M., Clarke T., Foster D., Hoffman P., Borman A., Johnson E., Moore G., Brown C., Walker A., Peto T., Crook D., Jeffery K.
Abstract
BACKGROUND
Candida auris is an emerging and multidrug-resistant pathogen. Here we report the epidemiology of a hospital outbreak of C. auris colonization and infection.
METHODS
After identification of a cluster of C. auris infections in the neurosciences intensive care unit (ICU) of the Oxford University Hospitals, United Kingdom, we instituted an intensive patient and environmental screening program and package of interventions. Multivariable logistic regression was used to identify predictors of C. auris colonization and infection. Isolates from patients and from the environment were analyzed by whole-genome sequencing.
RESULTS
A total of 70 patients were identified as being colonized or infected with C. auris between February 2, 2015, and August 31, 2017; of these patients, 66 (94%) had been admitted to the neurosciences ICU before diagnosis. Invasive C. auris infections developed in 7 patients. When length of stay in the neurosciences ICU and patient vital signs and laboratory results were controlled for, the predictors of C. auris colonization or infection included the use of reusable skin-surface axillary temperature probes (multivariable odds ratio, 6.80; 95% confidence interval [CI], 2.96 to 15.63; P<0.001) and systemic fluconazole exposure (multivariable odds ratio, 10.34; 95% CI, 1.64 to 65.18; P=0.01). C. auris was rarely detected in the general environment. However, it was detected in isolates from reusable equipment, including multiple axillary skin-surface temperature probes. Despite a bundle of infection-control interventions, the incidence of new cases was reduced only after removal of the temperature probes. All outbreak sequences formed a single genetic cluster within the C. auris South African clade. The sequenced isolates from reusable equipment were genetically related to isolates from the patients.
CONCLUSIONS
The transmission of C. auris in this hospital outbreak was found to be linked to reusable axillary temperature probes, indicating that this emerging pathogen can persist in the environment and be transmitted in health care settings. (Funded by the National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Oxford University and others.)

 

 

28 sick with E. coli O121 in Japan, because they like their burgers rare

The Mainichi – great newspaper name – reports a total of 28 people have suffered food poisoning after dining at MOS Burger restaurants in Tokyo and other locations in Japan, the operator and other sources said.

Twelve of the 28 were infected with the same O-121 strain of E. coli bacteria, the Ministry of Health, Labor and Welfare said Friday.

Those affected had dined at 19 restaurants in eight prefectures in eastern and central Japan between Aug. 10 and 23, the operator, MOS Food Services Inc., said.

One of the restaurants in Ueda, Nagano Prefecture, suspended operations for three days through last Wednesday following an order from a local public health office, the company said.

“It is highly likely that (the illness) was caused by foodstuffs supplied (to the restaurants) by the headquarters of the chain,” it said.

Using observation to evaluate training: Canadian High School edition

A couple of old friends Shannon Majowicz and Ken Diplock and colleagues from Waterloo, (that’s in Canada) are doing good work looking at food safety stuff with high school students- evaluating training efficacy using observation. They published their work demonstrating some sustained food safety behaviors following a training program, this month in the Journal of Food Protection.

Kenneth J. Diplock, Joel A. Dubin, Scott T. Leatherdale, David Hammond, Andria Jones-Bitton, and Shannon E. Majowicz. 2018. Observation of High School Students’ Food Handling Behaviors: Do They Improve following a Food Safety Education Intervention?

Greenbank High School Birkdale Merseyside.

Journal of Food Protection: June 2018, Vol. 81, No. 6, pp. 917-925

Youth are a key audience for food safety education. They often engage in risky food handling behaviors, prepare food for others, and have limited experience and knowledge of safe food handling practices. Our goal was to investigate the effectiveness of an existing food handler training program for improving safe food handling behaviors among high school students in Ontario, Canada. However, because no schools agreed to provide control groups, we evaluated whether behaviors changed following delivery of the intervention program and whether changes were sustained over the school term. We measured 32 food safety behaviors, before the intervention and at 2-week and 3-month follow-up evaluations by in-person observations of students (n = 119) enrolled in grade 10 and 12 Food and Nutrition classes (n = 8) and who individually prepared recipes. We examined within-student changes in behaviors across the three time points, using mixed effects regression models to model trends in the total food handling score (of a possible 32 behaviors) and subscores for “clean” (17 behaviors), “separate” (14 behaviors), and “cook” (1 behavior), adjusting for student characteristics. At baseline, students (n = 108) averaged 49.1% (15.7 of 32 behaviors; standard deviation = 5.8) correct food handling behaviors, and only 5.5% (6) of the 108 students used a food thermometer to check the doneness of the chicken (the “cook” behavior). All four behavior score types increased significantly ∼2 weeks postintervention and remained unchanged ∼3 months later. Student characteristics (e.g., having taken a prior food handling course) were not significant predictors of the total number of correctly performed food handling behaviors or of the “clean” or “separate” behaviors, and frequency of cooking and self-described cooking ability were the only characteristics significantly associated with food thermometer use (i.e., “cook”). Despite the significant increase in correct behaviors, students continued to use risky practices postintervention, suggesting that the risk of foodborne disease remained.

Modeling food held out on a hot day

The unofficial start of the summer is this weekend in the U.S. – Memorial day. Folks will be bbqing, cooking out, grilling out, whatever.

There’s a recommendation from USDA that on a hot day, above 90F/32C that food shouldn’t sit out for more than an hour. I couldn’t find a good reference for this. So I started texting Don.

He wasn’t answering. (I found out later it was because he was doing an interview with CBC, that’s a radio/TV network in Canada).

I started looking at a Conference for Food Protection document on how to handle food decisions at retail when the power goes out. Not exactly what I was looking for – all the modeling starts at 41F and doesn’t get as hot as I was looking for.

Then Don finally answered and suggested this paper on Salmonella in cut tomatoes.

Getting warmer.

I finally got into Combase and generated a couple of no-lag growth models for staph (in something like potato salad) and Salmonella. 

The staph model doesn’t go as high as 90F/32C so it’s a bit conservative different. But the Salmonella model shows a 1 log increase in just over an hour.

So yeah, hot days matter.

 

Improving food safety, one thermometer at a time

Sorenne and I were walking home from school yesterday, sweating in the heat and humidity, and were waiting at a light with a young woman who had just got off work at an early childcare place that Sorenne used to attend.

I started up a conversation — it’s a long light – and she told me she had finished university and was taking a gap year, so had to pay the bills and was working.

I asked her what she was planning to do and she matter-of-factly said, “A PhD in clinical psychology.”

“That’s cool, I’ve got a PhD.”

“Oh, what in?”

“Food science, or food safety.”

“I remember you now. You were the parent who was always temping things with a thermometer when we had sausage sizzles.”

“Yup.”

“That was cool.”

Thanks to the barfblog.com community who has wrote back after my personal post about depression and the like.

The little things make a big difference.

Chapman, I need more thermometers.

 

Salmon sushi: 5.6′ tapeworm excreted by California man

Raw can be risky.

Including raw fish used to make sushi, especially if it is not frozen at sea.

Following up my chat with daughter Sorenne while strolling around Noumea, New Caledonia last week, a Fresno man with a daily sushi habit had a 5.5-foot tapeworm lodged in his intestines. He pulled it out himself, wrapped it around a cardboard toilet paper tube and carried the creature into Fresno’s Community Regional Medical Center.

Michelle Robertson, a San Francisco Gate staff writer, reports that Kenny Banh was the lucky doc on shift at the time. He recounted his experience on a recent episode of the podcast “This Won’t Hurt A Bit.”

Banh said the patient complained of “bloody diarrhea” and expressed a desire to get treated for tapeworms.

“I get asked this a lot,” the doctor said. “Truthfully, a lot of times I don’t think they have it.”

This man had it, which he proved to Banh by opening a plastic grocery bag and pulling out the worm-wrapped toilet paper tube.

Banh then asked some questions, starting with: “That came out of your bottom?”

“Yes.”

According to the doctor’s retelling, the patient was using the restroom when he noticed what looked like a piece of intestine hanging out of his body.

 “He grabs it, and he pulls on it, and it keeps coming out,” Banh recounted. He then picks the thing up, “looks at it, and what does it do? It starts moving.”

That’s when the man realized he had a tapeworm stuck in his insides. He headed to the emergency room shortly thereafter, where Banh treated him with an anthelmintic, a single-treatment deworming medication used on humans and dogs alike.

Banh also took it upon himself to measure the specimen on the floor of the hospital. It stretched a whopping 5 feet, 6 inches — “my height,” noted the doctor.

Tapeworms can be contracted in a variety of ways, but Banh said his patient hadn’t traveled out of the country or engaged in any out-of-the-ordinary behavior. The man also professed his love of sushi, specifically raw salmon sashimi, which he confessed to eating daily.

Fresno is located an ample 150 miles from coastline and is not exactly famed for its sushi. The Centers for Disease Control and Prevention warned last February that the rise in popularity of raw fish consumption has likely spurred

The story has attracted attention all over the world, as these things tend to do, says Peter Olson, a tapeworm expert and a researcher at the Natural History Museum’s life sciences department, who was quoted as telling The Guardian, “because they’re gross”. The worm, he says, was “almost certainly something called the broad fish tapeworm … salmon is one of the main ways you would pick it up, if you don’t cook the meat.” The life of the broad fish tapeworm involves more than one host. “A typical life cycle might include a bear that feeds on salmon, then defecates back into the river. The larvae would be passed into the environment and, in the case of an aquatic life cycle like this, it would be eaten by something like a copepod, a little crustacean. When that copepod is eaten by a fish, it would transform into a larval tapeworm and that’s what is being transmitted to a human in this case. That would go to the intestine and grow into this giant worm.”

(On one of our first dates, over 12 years ago – same age as barfblog.com — Amy tried to serve me grilled salmon. I whipped out my trusty tip-sensitive digital thermometer and noted a 98F reading, and said, no way. Cook it.)

The tapeworm is a monstrous and impressive creation. It has a segmented body, with male and female reproductive organs in each segment, so it is capable of self-fertilisation. It does not have a head as such – its “head” is only useful for holding on to its host’s gut, rather than for “eating” (it absorbs nutrients through its skin). In many cases, you would not know you were infected. You might spot bits of tapeworm segment in your stool – small, pale, rice-like bits – or experience stomach pain or vomiting.

Food Safety Talk 143: I Don’t Want Dead Water

Don and Ben chat about Skype and the weather (as always) but do get eventually to food safety stuff including disco dust, diamond lattes, home chicken slaughter, E. coli O157:H7 in Romaine lettuce (or not, or maybe, yes), raw water and frozen biscuits.

Episode 143 can be found here and on iTunes.

Show notes so you can follow along at home: