We estimated numbers of hospitalizations for norovirus gastroenteritis (NGE) and associated medical costs in Germany, where norovirus testing is high because reimbursement is affected. We extracted aggregate data for patients hospitalized with a primary or secondary code from the International Classification of Diseases, 10th Revision (ICD-10), NGE diagnosis during 2007–2012 from the German Federal Statistics Office.
We assessed reliability of the coding system in patient records from a large academic hospital. Approximately 53,000–90,000 NGE hospitalizations occurred annually in Germany (21,000–33,000 with primary and 32,000–57,000 with secondary ICD-10–coded NGE diagnoses). Rates of hospitalization with NGE as primary diagnosis were highest in children <2 years of age; rates of hospitalization with NGE as secondary diagnosis were highest in adults >85 years of age. The average annual reimbursed direct medical cost of NGE hospitalizations was €31–43 million. Among patients with a NGE ICD-10 code, 87.6% had positive norovirus laboratory results.
Norovirus Gastroenteritis among Hospitalized Patients, Germany, 2007–2012
Kowalzik, F., Binder, H., Zöller, D., Riera-Montes, M., Clemens, R., Verstraeten, T….Zepp, F. (2018). Norovirus Gastroenteritis among Hospitalized Patients, Germany, 2007–2012. Emerging Infectious Diseases, 24(11), 2021-2028. https://dx.doi.org/10.3201/eid2411.170820.
Eric Schlosser writes in this New York Times review of Deborah Blum’s new book, “The Poison Squad,” that a now forgotten chemist at the Department of Agriculture, Harvey Washington Wiley, played a more important role — not only in ensuring the passage of the 1906 food safety bills but also in changing popular attitudes toward government intervention on behalf of consumers.
In 1906 the United States was the only major industrialized nation without strict laws forbidding the sale of contaminated and adulterated food. In their absence, the free market made it profitable to supply a wide range of unappetizing fare. Ground-up insects were sold as brown sugar. Children’s candy was routinely colored with lead and other heavy metals. Beef hearts and other organ meats were processed, canned and labeled as chicken. Perhaps one-third of the butter for sale wasn’t really butter but rather all sorts of other things — beef tallow, pork fat, the ground-up stomachs of cows and sheep — transformed into a yellowish substance that looked like butter.
Harvey Washington Wiley was born in a log cabin on April 16, 1844, a fitting entrance for an American hero. His father was a farmer and a lay preacher in southern Indiana who sheltered escaped slaves as part of the Underground Railroad. Wiley served briefly in the Civil War, studied medicine in Indiana and chemistry at Harvard, and became the first chemistry professor at Purdue University in 1874.
The deliberate adulteration of food had been a problem for millenniums, inspiring government regulations in ancient Egypt, Sumeria and Rome. By the late 1870s, the Industrial Revolution, applied to food processing, provided a variety of new techniques and ingredients useful for committing fraud — artificial flavors, artificial colorings, chemical preservatives. But simultaneous advances in chemistry also facilitated the detection of such fakery. At the request of the Indiana State Board of Health in 1881, Wiley began to study the authenticity of the honey and maple syrup for sale in that state. According to Blum, he used laboratory instruments like the polariscope to uncover that “a full 90 percent of his syrup samples were fakes … and there were ‘beekeepers’ who had not, of late, been bothering to keep bees.” Wiley’s findings soon appeared in Popular Science magazine, and his career as a public crusader was launched.
After being named the U.S.D.A.’s chief chemist in 1882, Wiley spent the next 30 years at the department campaigning for safe food and proper labeling. He supervised a series of investigative reports that gained much public attention, warning about “pepper” made from sawdust, “cocoa powder” containing iron oxides and tin, “flour” laced with clay and powdered white rocks, “whiskey” that was actually watered-down ethyl alcohol tinted brown with prune juice, “coffee” that featured ingredients like sand, tree bark, ground acorns, charcoal and a black powder composed of charred bone. To test the health impact of various additives, he recruited young men to serve as guinea pigs in “hygienic table trials,” serving them questionable ingredients during meals in the basement of U.S.D.A. headquarters — and then observing what happened. Soon known as the Poison Squad, these idealistic volunteers embraced the motto on a sign in their special dining room: “only the brave dare eat the fare.” …
“The Poison Squad” offers a powerful reminder that truth can defeat lies, that government can protect consumers and that an honest public servant can overcome the greed of private interests.
He said the ministry was still awaiting for the results of food samples sent to the lab, adding that stool samples of patients tested positive for ‘Salmonella spp’.
My friend, Roy Costa from Florida, sent along this piece and I deemed it worthy.
The foreign supplier verification rule is foreign to many importers, October 20, 2018
The Foreign Supplier Verification Rule (FSVP), 21 CFR Part 1, Subpart L, is the part of the Food Safety Modernization Act that regulates the importation of food covered by FDA. While the Act when into effect in 2015, some importers have not yet fully implemented an FSVP program.
An FSVP program is a risk-based system that ensures that foreign suppliers meet the same US rules for food safety as domestic suppliers. This means that importers must verify that FDA’s rules, the Current GMP Hazard Analysis and Risk Based Preventive Controls for Human and Animal Foods, and the Produce Safety rules, have been implemented by suppliers.
Importers bare the responsibility for verification of the safety of foods imported into the US. The Customs filings now include a line item for the “FSVP Importer”. This entry utilizes the Dunn and Bradstreet’s unique facility identifier-the DUNS Number; no food maybe imported without this filing. Whoever is identified as the FSVP Importer must be qualified through education and experience to understand any document submitted for verification, and is subject to unannounced FDA inspection.
The FSVP rule allows third-party audits, microbial, physical and chemical testing and operational records to be used for verification purposes. The key documents an importer must verify are the Food Safety Plan of foreign manufacturers, and the records that show compliance with the Produce Safety rule.
In order to understand these complex verification documents, one must understand the Hazard Analysis and Critical Control Point (HACCP) concept. Education in the Preventive Controls and Produce Safety rules will be necessary for most importers. Without a scientific background, understanding how to successfully apply the five preliminary HACCP steps and the seven HACCP principles is impossible, and the Produce rule requires a deep understanding of Good Agricultural Practices.
Some importers will not be qualified to make decisions about supplier approval, or even understand what is required of them, without training.
An importer must prepare his own FSVP program for each commodity he obtains, based on a risk assessment similar to HACCP. He can only do this if he is a FSVP Qualified Individual, although he can hire or use another Qualified Individual, if he is not so qualified.
The barriers of entry are high. If a supplier does not meet the rules, or if the importer cannot verify the safety of foods, no such foods can be obtained. This could put some importers out of business, and restrict trade in foreign foods.
The impact is huge for the global economy. Currently, imported foods make up an estimated 15 percent of the U.S. food supply, including 50 percent of fresh fruits, 20 percent of fresh vegetables and 80 percent of seafood.
The FSVP rule prohibits anyone with a financial interest in the outcome of verification to have a financial interest in an approval decision. The problems with conflicts of interest in this scheme are readily apparent, since many importers also own the operations of the foreign supplier, and virtually all importers have some kind of monetary incentive for bringing products into the US.
FDA has the authority to inspect the records of the FSVP Importer, and they typically do not notify in advance of a routine inspection. Once in the office, FDA has access to virtually all the records of the importing firm, and will expect that the firm has a Qualified Individual, policies and procedures, records, and a risk-based system to make decisions about supplier approval, with an approved supplier list. Without these vital documents, there will be no way an importer can demonstrate compliance.
At this time, FDA is making inspections to primarily educate the industry, but they will act if they find an importer violating US rules or obtaining unsafe foods.
With such dire consequences possible, one would expect that an importer would seek education in areas of legal compliance, but the industry has not shown overwhelming interest in taking the training needed to understand their responsibilities.
Eventually, the agency will take a focused approach to weeding out the non-compliant importing operations, but the job will be difficult. Policing these complex importer arrangements will not be an easy assignment; it is well known the importers sometimes flaunt the rules that have been in place, and engage in port shopping, ignoring Import Alerts, and outright deception. These new regulations should allow FDA to be more effective in detecting criminal activity, and I expect that penalties will be severe for importers who bring in contaminated foods that cause illness and death to US consumers.
I also expect that product liability will eventually stretch back to the importer in such cases, and that lawsuits will take into consideration the compliance history of the importer when perusing justice for victims of foodborne illness.
I strongly recommend that both foreign suppliers and importers take the Food Safety Preventive Controls Alliance FSVP course, and the other FSPCA relevant courses as needed, Preventive Controls for Human and Animal Foods, and Produce Safety Rules, and learn how to develop a compliant FSVP program.
Contact Environ Health Associates, Course Administration Manager; Katherine Jones 386-316-7266 for course registration.
This comes as we investigate a rise in cases of a particular strain of Salmonella Typhimurium which have been linked to lamb and mutton. We first saw an increase in cases of this particular type of salmonella in July 2017. A number of control measures were put into place which led to a significant decline in cases at the end of that year. A total of 118 cases were reported up until May 2018.
Since June 2018, a further 165 cases have been reported (up to 19 October), which led us to put control measures in place. These haven’t led to the same decline in cases as in 2017 and so we are now reminding the public about how to cook and handle raw meat.
Nick Phin, Deputy Director, National Infection Service, PHE said:
The likely cause of the increased numbers of this specific strain of Salmonella Typhimurium is considered to be meat or cross-contamination with meat from affected sheep.
People can be infected with Salmonella Typhimurium in a number of ways such as not cooking their meat properly, not washing hands thoroughly after handling raw meat, or through cross-contamination with other food, surfaces, and utensils in the kitchen.
Prior to July 2017 only 2 cases of this strain (Single Nucleotide Polymorphism address 1.43.67.992.2703.3225. %) had been detected in England.
Between July 2017 and November 2017, the first increase in this strain was observed with 95 cases reported in England, Scotland and Wales. Control measures were implemented which resulted in a decline in cases.
Numbers of cases were at low levels from December 2017 to June 2018 (23 cases during this period).
In June 2018, the numbers of cases increased again and since June 2018 165 cases have been reported.
There was a death in which salmonella was thought to be a contributory factor related to this outbreak last year, but we are not aware of any deaths related to this strain in 2018
OK, I had a bunch of qualified people, and I’m putting the band back together to write a book.
These Turkey folks don’t know shit.
Neither do lots of others.
The purpose of this study is to examine the food safety knowledge of foodservice staff in fast-food restaurants in a Turkish context. Data for this empirical investigation was gathered from a sample of full-time foodservice staff at the different fast-food restaurants in Ankara/Turkey. Respondents self-administered the questionnaires. The total number of 165 questionnaires was obtained in the research location. Results based on the descriptive statistics, staff works in fast food restaurants in Ankara are not knowledgeable on foodborne/food poisoning and the training rate is not at the satisfactory level. In addition, t-test result demonstrates that female respondents are more knowledgeable compared to males. This paper provides implications for managers in terms of minimising the negative effects of foodborne diseases and maximising the employees’ food safety knowledge in a service setting where the food industry is increasing. Theoretically, the current study by examining the food safety knowledge of restaurant staff and providing insights into the foodborne disease in a developing touristic destination lends further contribution to the related literature.
Assessing the food safety knowledge of fast-food restaurant staff in Ankara/Turkey: some strategies from managerial approach
TTG reports a judge sitting at Manchester county court has ordered the disclosure of all documentary evidence relating to investigations carried out by Public Health England (PHE) surrounding cyclospora — a parasite spread by food contaminated with infected human faeces.
According to The Times, many customers claimed Tui did not tell them the Riviera Maya region of Mexico was subject to a public health warning due to cyclosporiasis before they booked.
This is in spite of 359 of the 440 British cases reported between June and October 2016 “involving travel to Mexico”, it is claimed.
Others customers allege they were handed a warning letter “only after their plane landed”.
The purpose of this draft compliance and implementation guidance document is to help covered farms comply with the requirements of the Produce Safety Rule, which establishes science-based minimum standards for the safe growing, harvesting, packing, and holding of produce. Entitled “Standards for the Growing, Harvesting, Packing, and Holding of Produce for Human Consumption,” the rule is part of FDA’s implementation of the FDA Food Safety Modernization Act (FSMA).
The draft guidance provides a broad range of recommendations on how to meet the requirements for most subparts of the rule. It also outlines how to determine whether produce or farms may be eligible for exemptions from certain requirements, or from the rule in its entirety.
Specific regulatory or statutory requirements are cited, and in some cases, specified using the word must. The use of the word should indicates that something is recommended, but not required. The use of the word including means options that are not limited to the described items.
You are encouraged to submit comments on the draft guidance within 180 days of the publish date to ensure your comments are considered while FDA works on the final version of the guidance.
In addition to the draft guidance, there is an At-a-Glance overview of key points in each of the nine chapters described below, as well as a glossary of key terms. The overviews summarize important aspects of each chapter. It is recommended that you review the draft guidance itself for complete information.
Tomorrow morning, a doctor is going to stick a camera up my ass.
I’ve been on the pre-colonoscopy diet for three days now, and today is the broken-jaw version I had when I was 18, but worse.
No protein. No fruits or veg.
Just clear liquids. I have a bunch of chicken stock I made last night.
I live in sub-tropical Brisbane which has a fabulous supply of produce and proteins, and I’m eating Jello.
Later today I have to take some colon blow stuff which involves being on the toilet for about 4 hours.
But at least my poop won’t be black.
Dustin Nelson of Thrillist writes that coal-black slushies are one of Burger King’s Halloween specials this year. It’s a Frozen Fanta Scary Black Cherry, and it’s seriously dark. The drink has attracted an unexpected amount of attention not for its flavor, but for, uh, the impact of its dark hue. In fact, people have been heading to Burger King just to get a good look at the, umm, effects.
Maybe people couldn’t resist the intestinal challenge of an artificially black treat or maybe they remember the unique results of eating that black-bunned Whopper a couple years back. Either way, people are grabbing the cherry treat and reporting on social media that it turns your mouth intensely black. Oh, and it also turns your poop a fun color. Though, no one really agrees on a single color. People have said their results have been black, green, and even blue. Whatever the individual result, it’s not on your usual spectrum of poop colors.
Asked for comment, a Burger King representative said, “For those who want to know, try it and find out.”
My female doctor also had a great suggestion for checking my prostrate, cause I’m of that age too.
She said she could do it while I was passed out for the colonoscopy.
Sign me up.
Another good Brantford boy, Phil Hartman, who was tragically killed by his third wife, is featured below.
A man who contaminated baby food in Germany has been sent to jail for 12-and-a-half years.
Gavin Grey of Eyewitness News reports the 54-year-old had attempted to blackmail retailers by claiming he would point out the poisoned items in return for cash.
He targeted shops in a southern German city.
In court, he admitted placing poisoned jars of adult and baby food in supermarkets and trying to blackmail the owners.
The contaminated jars contained ethylene glycol which is an odourless and toxic liquid used in antifreeze.
Prosecutors said some of the foods contained enough of the poison to kill a child and he was found guilty of five counts of attempted murder.
He was also found guilty of extortion, sending threatening emails to the stores demanding R200 million.
The court heard it was a matter of luck no child had been hurt.
We assessed reliability of the coding system in patient records from a large academic hospital. Approximately 53,000–90,000 NGE hospitalizations occurred annually in Germany (21,000–33,000 with primary and 32,000–57,000 with secondary ICD-10–coded NGE diagnoses). Rates of hospitalization with NGE as primary diagnosis were highest in children <2 years of age; rates of hospitalization with NGE as secondary diagnosis were highest in adults >85 years of age. The average annual reimbursed direct medical cost of NGE hospitalizations was €31–43 million. Among patients with a NGE ICD-10 code, 87.6% had positive norovirus laboratory results.
