Cute guinea pigs or Salmonella factories

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In December 2017, the Colorado Department of Public Health and Environment reported two human Salmonella Enteritidis infections in persons with exposure to pet guinea pigs. The guinea pigs had been purchased from two separate pet stores, belonging to a single chain, and supplied by a common distributor located in California. Clinical isolates were indistinguishable by pulsed-field gel electrophoresis (PFGE), suggesting the infections were related. This PFGE pattern was previously seen in a 2010 multistate outbreak linked to contact with pet guinea pigs (1). An investigation was initiated to determine the number of patients affected and to identify the source of human illnesses.

A case was defined as Salmonella Enteritidis infection with a clinical isolate having an identical PFGE pattern to those from the Colorado isolates and closely related to a guinea pig isolate by whole genome sequencing (WGS), and with onset of clinical signs on or after January 1, 2015. State health departments were asked to review recent Salmonella Enteritidis illness records for patient exposure to guinea pigs. In addition, the U.S. Department of Agriculture’s National Veterinary Services Laboratories was queried for isolates from guinea pigs that matched the outbreak strain. All isolates underwent WGS using high-quality single nucleotide polymorphism (SNP) analysis. An isolate from the 2010 outbreak was sequenced for comparison. Guinea pig purchase invoices were used to trace guinea pigs with an epidemiologic link to human illness back to the distributor of origin.

Nine cases in humans were identified from eight states, including two cases in Colorado and one each in Iowa, Indiana, Massachusetts, Michigan, New York, Vermont, and Virginia. Five of eight patients reported exposure to guinea pigs. Onset dates ranged from July 15, 2015, to December 15, 2017. The median patient age was 12 years (range = 1–70 years). Five patients were female. One patient was hospitalized, and no deaths were reported. Six isolates submitted to veterinary diagnostic laboratories from ill guinea pigs and one isolate from a patient’s guinea pig were sequenced and found to be closely related to the outbreak strain. Including the 2010 isolate tested for comparison, all isolates were within 38 SNPs by WGS.

Traceback information was available for four guinea pigs purchased from two large pet store chains (Figure). The two distributors supplying guinea pigs to pet stores during this outbreak received guinea pigs from multiple wholesalers; however, a single common wholesaler was mentioned by both. This wholesaler also supplied guinea pigs that were associated with cases during the 2010 outbreak.

Following the 2010 outbreak, recommendations including environmental testing were made to the wholesaler regarding Salmonella prevention; however, the actions were not implemented. Failure to implement recommended prevention measures might have contributed to recurrence of the outbreak. To enhance compliance with recommendations made in this outbreak, CDC developed a document containing prevention measures aimed at reducing the prevalence of Salmonella in guinea pig colonies intended for use in the pet industry. Content was also posted on the CDC website to increase consumer awareness of risk for Salmonella infection linked to pet guinea pigs. Recommendations to pet owners during this outbreak focused on proper hand hygiene. Recommendations to distributors and wholesalers included routine monitoring of guinea pigs for Salmonella through diagnostic testing, recordkeeping to aid in traceback, and evaluating husbandry and environmental sanitation practices of guinea pig breeders to reduce the prevalence of Salmonella and other zoonotic diseases of concern to the pet industry (2).

1Epidemic Intelligence Service, CDC; 2Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC; 3Colorado Department of Public Health and Environment; 4Vermont Department of Health; 5National Veterinary Services Laboratories, U.S. Department of Agriculture, Ames, Iowa; 6CAITTA, Inc., Herndon, Virginia.

References

Bartholomew ML, Heffernan RT, Wright JG, et al. Multistate outbreak of Salmonella entericaserotype enteritidis infection associated with pet guinea pigs. Vector Borne Zoonotic Dis 2014;14:414–21. CrossRef PubMed

CDC. Multistate outbreak of Salmonella Enteritidis infections linked to pet guinea pigs.

Atlanta, GA: US Department of Health and Human Services, CDC; 2018. https://www.cdc.gov/salmonella/guinea-pigs-03-18/index.html

Strawberry fields forever: At least 20 sickened with hepatitis A linked to frozen berries from Poland

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Hepatitis A virus is an important cause of food-borne diseases and has been associated with several European outbreaks linked to berries [1–4]. Here, we describe an ongoing outbreak of hepatitis A virus (HAV) in Sweden and Austria and the confirmation of frozen strawberries imported from Poland as the source of infection. The aims are to highlight the importance of sequencing in outbreak investigations and, due to the long shelf-life of the food vehicle, to increase awareness and warnings towards HAV infections related to frozen strawberries in Europe.

According to a report by the scientific journal Eurosurveillance, 20 cases of hepatitis A were reported in six districts of Sweden between June and September 2018, of which 17 were confirmed and three were likely. “In combined epidemiological and microbiological studies, imported frozen strawberries produced in Poland were identified as the source of the outbreak,” the journal said. Also in Austria hepatitis A diseases have been associated with strawberries from the same manufacturer.
Swedish and Austrian researchers have identified strawberries as a source of infection for many hepatitis A diseases in their countries. “Examinations and interviews with kitchen staff showed that the strawberries had never been sufficiently heated before serving. Strawberries were the only food that was common to all cases, “says the Swedish experts.

The best protection against hepatitis A is vaccination, which is available for children 12 months and older.

Hepatitis A outbreak linked to imported frozen strawberries by sequencing, Sweden and Austria, June to September 2018

Eurosurveillance 2018;23(41)

Theresa Enkirch1,2, Ronnie Eriksson3, Sofia Persson3, Daniela Schmid4, Stephan W. Aberle5,Emma Löf1,6, Bengt Wittesjö7, Birgitta Holmgren8, Charlotte Johnzon9, Eva X. Gustafsson8,Lena M. Svensson10, Lisa Labbé Sandelin11, Lukas Richter4, Mats Lindblad3, Mia Brytting1,Sabine Maritschnik4, Tatjana Tallo1, Therese Malm12, Lena Sundqvist1, Josefine Lundberg Ederth1

 https://doi.org/10.2807/1560-7917.ES.2018.23.41.1800528

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2018.23.41.1800528

4 dead 8 sick in EU outbreak of Listeria linked to salmon products beginning in 2015

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A multi-country outbreak of 12 listeriosis cases caused by Listeria monocytogenes sequence type (ST) 8 has been identified through whole genome sequencing (WGS) analysis in three EU/EEA countries: Denmark (6 cases), Germany (5) and France (1).

Four of these cases have died due to or with the disease. It is likely that the extent of this outbreak has been underestimated since the outbreak was identified through sequencing and only a subset of the EU/EEA countries routinely use this advanced technique to characterise L. monocytogenes isolates.

The first case was sampled in October 2015 in Denmark and the most recent case was reported in May 2018 in Germany. In August 2017, Denmark identified the first cluster of cases, which was investigated and linked to the consumption of ready-to-eat cold-smoked salmon produced in Poland. Control measures were implemented and the Member States and competent authorities were informed.

In October 2017, France reported the identification of a matching L. monocytogenes strain in food isolates from marinated salmon originating from the same Polish processing company as identified in the Danish outbreak investigation. This supports the hypothesis that contamination may have occurred at the processing company in Poland. However, due to the lack of WGS data on the isolates found in the environmental and food samples taken at the Polish processing plant, it is not possible at present to confirm the contamination with the L. monocytogenes ST8 outbreak strain at the suspected Polish plant. Moreover, until detailed information on the Norwegian primary producers of the salmon used in the contaminated batches is reported and assessed, possible contamination at primary production level cannot be excluded either.

Although control measures were implemented following the Danish outbreak investigation in September 2017, the identification of the same strain in a salmon product in France and a new human case in Germany suggest that the source of contamination is still active and contaminated products have been distributed to other EU countries than Denmark.

Until the source of infection has been eliminated, new invasive listeriosis cases may still occur. Pregnant women, the elderly and immunocompromised individuals are at increased risk of invasive listeriosis, which is associated with severe clinical course and potentially death.

Cocaine in berry shipment stopped at Canadian border

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As if Salmonella and Hepatitis A in frozen strawberries weren’t bad enough, U.S. Customs and Border Protection officers recently intercepted 280 pounds of cocaine in a shipment of berries crossing into Canada at Port Huron, Mich. (although the story in The Packer does not specify which kind of berries).

The commercial truck shipment was crossing at the Blue Water Bridge Oct. 21, and CPB officers with the Port Huron Anti-Terrorism and Contraband Enforcement Team selected it for an enforcement exam, according to a news release.

During the inspection and interview of the driver, officers found plastic wrapped packages in some of the berry boxes. The officers conducted a field test of the suspected narcotics in the packages, and confirmed it was cocaine, according to the release.

“This arrest demonstrates the continued effort by our officers, their dedication to our border security mission and the focus on the export of illicit narcotics” Port Director Michael Fox said in the release.

The driver, a Canadian citizen, was arrested and the case was sent to the U.S. Attorney’s Office for the Eastern District of Michigan. The suspect was turned over to Homeland Security Investigations, according to the release.

120 sick from Salmonella linked to JBS ground beef

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The U.S. Centers for Disease Control (CDC), public health and regulatory officials in several states, and the U.S. Department of Agriculture’s Food Safety and Inspection Service are investigating a multistate outbreak of Salmonella Newport infections linked to ground beef produced by JBS Tolleson, Inc.

Reported Cases: 120

States: 22

Hospitalizations: 33

Deaths: 0

Recall: Yes

On October 4, 2018, JBS Tolleson, Inc., of Tolleson, Arizona, recalled approximately 6.5 million pounds of beef products, including ground beef, which may be contaminated with Salmonella Newport.

Recalled beef products were produced and packaged from July 26, 2018, to September 7, 2018 and were shipped to retailers nationwide under many brand names.

Products are labeled with the establishment number “EST. 267.” This is usually found inside the USDA mark of inspect

Sixty-three more ill people from 14 states were added to this investigation since the last update on October 4, 2018. Six more states reported ill people: Hawaii, Kansas, New Mexico, Oklahoma, Texas, and Washington.

As of October 23, 2018, 120 people infected with the outbreak strain of Salmonella Newport have been reported from 22 states.

135 sickened: Kelloggs returning Honey Smacks to shelves after Salmonella recall

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Colin Kellaher of The Wall Street Journal reports that Kellogg Co.’s Honey Smacks cereal will begin returning to U.S. shelves next month in limited quantities following a nationwide recall over salmonella concerns.

Maybe the company now knows who makes the Honey Smacks.

The Battle Creek, Mich., cereal maker recalled more than 11 million boxes of Honey Smacks over the summer after a salmonella outbreak linked to a factory that produced the cereal sickened 135 people in 36 states. No deaths were reported in connection with the salmonella outbreak, the Centers for Disease Control and Prevention said in September, and illnesses were reported between March and August.

The U.S. Food and Drug Administration said in a July letter that it found “serious violations” following an inspection of a Gridley, Ill., plant. The agency said the factory, owned by Wisconsin-based Kerry Inc., maintained unsanitary conditions and failed to comply with rules meant to prevent foodborne illnesses. A spokesman for Kerry told The Wall Street Journal in September that as a result of the FDA’s investigation, it has worked to improve sanitation and enhanced employee training among other changes.

Kellogg said cereal production for the Honey Smacks relaunch has been moved to a “trusted and tested” company-owned facility. The company also said it has updated its recipe for the cereal, using simpler ingredients. Boxes of the cereal will be labeled with “New Recipe” in the top left corner.

On Sept. 28, 2018, the Food and Drug Administration wrote the Centers for Disease Control, along with state and local officials investigated a multi-state outbreak of Salmonella Mbandaka infections linked to Kellogg’s Honey Smacks sweetened puffed wheat cereal. The FDA worked with Kellogg’s to voluntarily recall Honey Smacks from the market and conducted an inspection at the manufacturing facility owned by Kerry, Inc., resulting in a warning letter identifying specific problems at the facility.

Just because it says probiotic doesn’t mean it’s good for you

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Cryptosporidiosis, a leading cause of diarrhea among infants, is caused by apicomplexan parasites classified in the genus Cryptosporidium. The lack of effective drugs is motivating research to develop alternative treatments. With this aim, the impact of probiotics on the course of cryptosporidiosis was investigated.

The native intestinal microbiota of specific pathogen-free immunosuppressed mice was initially depleted with orally administered antibiotics. A commercially available probiotic product intended for human consumption was subsequently added to the drinking water. Mice were infected with Cryptosporidium parvumoocysts.

On average, mice treated with the probiotic product developed more severe infections. The probiotics significantly altered the fecal microbiota, but no direct association between ingestion of probiotic bacteria and their abundance in fecal microbiota was observed. These results suggest that probiotics indirectly altered the intestinal microenvironment or the intestinal epithelium in a way that favored proliferation of C. parvum.

Probiotic product enhances susceptibility of mice to cryptosporidiosis

Applied and Environmental Microbiology, 10.1128/AEM.01408-18

Bruno C. M. Oliveira, Giovanni Widmer

https://aem.asm.org/content/84/21/e01408-18?etoc=

Australian drought could lead to spike in crypto cases

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According to The Canberra Times, the current drought affecting parts of Australia could lead to a spike in gastro cases around the country, a population health scientist from The Australian National University has warned.

The warning comes from the results of a study, published in the Journal of Water and Health, found reported cases of cryptosporidiosis, rose significantly in parts of Queensland and the Australian Capital Territory along the Murray Darling Basin during the drought that ended in 2009.

Lead researcher Dr Aparna Lal,  from the ANU Research School of Population Health, said the study estimated the risk of the gastro bug dropped by 84 per cent in the ACT and by 57 per cent in Queensland once the drought ended.

She said 385 cases of the gastro bug were reported in the ACT and 527 in Queensland, out of 2048 cases in the Murray Darling Drainage Basin, from 2001 until 2012.

“Cryptosporidiosis is one of the most common water-related parasitic diseases in the world, and Australia reports the second highest rate of the illness in humans among many developed countries,” Dr Lal said.

Children under five years old are particularly at risk from cryptosporidiosis, and it can cause developmental problems such as stunted growth.

Dr Lal said droughts reduced river volume and flow, thereby potentially increasing the concentration of pathogens such as those that cause gastro.

“As these gastro bugs can also be spread from livestock, land-use change may also contribute to this pattern, due in part to access around waterways,” she said.

Frozen berries should be boiled

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This is why we boil berries at home.

Hepatitis A virus is an important cause of food-borne diseases and has been associated with several European outbreaks linked to berries [1–4]. Here, we describe an ongoing outbreak of hepatitis A virus (HAV) in Sweden and Austria and the confirmation of frozen strawberries imported from Poland as the source of infection. The aims are to highlight the importance of sequencing in outbreak investigations and, due to the long shelf-life of the food vehicle, to increase awareness and warnings towards HAV infections related to frozen strawberries in Europe.

Hepatitis A outbreak linked to imported frozen strawberries by sequencing, Sweden and Austria, June to September 2018

Theresa Enkirch, Ronnie Eriksson, Sofia Persson, Daniela Schmid, Stephan W. Aberle, et al

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2018.23.41.1800528#html_fulltext</a

A short guide to food thermometers

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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.