Vaccines work: Beware the Hep A in Denmark from Morocco

On 2 May 2018, Denmark reported a cluster of hepatitis A virus (HAV) infections with the subgenotype IA strain DK2018_231, through the European Centre for Disease Prevention and Control (ECDC)’s Epidemic Intelligence Information System (EPIS) for food- and waterborne diseases and zoonoses (FWD).

One of the three confirmed cases had travelled to Morocco. In response, five additional European Union (EU) countries (France, Germany, the Netherlands, Spain and the United Kingdom (UK)) reported cases (n = 20) infected with the same strain between 21 January and 10 April 2018.

Concurrently, Germany reported to EPIS that it observed more cases of hepatitis A with travel history to Morocco than expected, compared with the same period in the previous 5 years. Molecular analysis of the HAV VP1/P2A region revealed an unrelated cluster of the HAV subgenotype IB strain V18–16428. Cases infected with this unrelated strain were also reported from France, the Netherlands, Sweden and UK.

The appearance of clusters with a link to Morocco triggered further epidemiological investigations.

Two concurrent outbreaks of hepatitis A highlight the risk of infection for non-immune travelers to Morocco, January to June 2018

5.july.18

Eurosurveillance

Martyna Gassowski, Kai Michaelis, Mirko Faber, Julie Figoni…

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2018.23.27.1800329

Father of Tennessee E. coli victim ‘Nutritionist recommended raw milk’

James Zenker never imagined his young son would battle for his life at just two-years-old.

“It’s affected his kidneys; they shut down,” Zenker said. “It affected his intestines; he couldn’t digest any of his food and its affected his brain — he has a substantial brain injury.”

His son William got E. coli after drinking raw milk linked to French Broad Farm. Zenker said a nutritionist recommended the raw milk to help William fight allergies.

“He’s not able to speak and not able to do the same activities as before he was ill,” Zenker said.

The vast majority of nutritionists, dieticians and physicians I encounter – and it’s frequent with my brain status and trips to emergency – know shit about microbial food safety.

The odd ones do, and they are food safety heros.

But when hospitals continue to serve raw sprouts to immunocompromised people, when they won’t be sold at WalMart in the U.S., I gotta question their food safety credibility.

To reiterate, I stared the Food Safety Network (the original FSN) over 25 years ago as an incoming graduate student in 1993 in the wake of the Jack-in-the-Box outbreak, combining my science and journalism learnings, and because a constant refrain I observed was, I never knew foodborne illness could be so serious.

That’s why I continue to do it as a form of community service (I haven’t been paid since 2016).

Of the 15 children sick with E. coli in Tennessee that has now been linked to consumption of raw milk and contact with ruminants from French Broad Farm, William is the last one left in the hospital. His father said East Tennessee Children’s Hospital saved his son’s life.

The Knox County Health Department said an investigation concluded that the outbreak was caused by two separate sources, the exposure to farm animals and exposure to raw milk.

“While it is rare, it appears we had two sets of children sickened by two different strains of E. coli O157 at the same time. The epidemiological evidence overwhelmingly supported the two-source theory: consumption of raw milk and some type of contact, most likely indirect, with ruminant animals,” said KCHD Director Dr. Martha Buchanan.

William has had several blood transfusions during his recovery and still needs more. His home church Temple Baptist in Powell (no relation – dp) hosted a replacement drive Tuesday for William and the community.

“It’s so encouraging to see people take time out of their busy day and donate from their own life to help Will and others affected by E. coli,” Zenker said.

If you would like more information about future blood drives click here: 
Blood drives scheduled to help children infected with E. coli.

Food fraud: Crab meat from Venezuela linked to 9 cases of vibrio in Maryland

While Maryland Blue Crabs are a staple in the DMV, many places do sell crabs, packaged crab meat, and crab cakes with crab from elsewhere.

Anne Cutler of Fox 26 says the National Aquarium in Baltimore reports that due to environmental degradation and years of overfishing, there’s not enough blue crab in the region to support demand, and grocery stores and restaurants often resort to selling imported crab.

According to ocean conservancy organization Oceana, 33 percent of the seafood purchased in the United States is actually mislabeled.

The National Aquarium reports that under current law, crab meat can be imported from around the world, pasteurized in-state and relabeled as “Maryland crabmeat.”

Nine people have contracted dangerous Vibrio infections in Maryland alone. The state’s Department of Health is warning residents to not eat crab meat from Venezuela.

“We’re selling a lot of crab meat, shrimp, lobster, whatever you want. We’re steaming it for you. And as far as this crab meat, we gotta get it from the eastern shore now, because we heard from the media what’s going on,” said Clarence Goodman, with Jessie Taylor Seafood.

Goodman says the company is not taking any chances — sticking with products almost exclusively from the eastern seaboard. 

The crab in question comes in the little plastic tubs. Consumers should look for a label on the side of the container that says where the meat is from. If it comes from Venezuela, you don’t want to get it.

Diners should also pay attention when buying crab cakes as well.A 2015 study from Oceana found that 38 percent of crab cakes being advertised as having locally sourced Chesapeake blue crab were actually made of imported meat.

In the state of Maryland, only a few dozen restaurants in the state reliably make their crab cakes from local crabmeat and the state does not require restaurants to identify the specific source of the meat.

The state has a listing of “True Blue” local restaurants that serve Maryland blue crab.

Night soil: Kenyans feeding on Sukuma wiki grown in raw sewage

While some city residents have become farmers either by design or default depending on the residential area one resides in, cheap is proving to be life threatening as farmers are now using raw sewage for farming. This means much of the vegetables especially sukuma wiki (kales) on sale in Nairobi are highly contaminated and pose a serious health risk to consumers.

A visit to the sewage collection point in Njiru, Nairobi by Linda Shiundu of TUKO.co.ke revealed the effluence deposited there is always tapped and used for farming by farmers living. The farmers who wished to remain anonymous said instead of waiting for the rains, they would rather take advantage of the 75,000 liters of untreated sewage disposed daily to water their crops. They do so by digging trenches from the deposit site channeling the semi solid human waste into their farms which they use to water the crops and as manure. They mainly grow vegetables like sukuma wiki, spinach and other crops like bananas. Sewage deposited at the sewage collection point around Njiru area is always trapped by farmers living around the collection center and use for planting. The vegetables later on find their way into the market and in to the plates and stomachs of many unsuspecting residents. The vegetables later on find their way into the market.

Despite the health risks posed by the exposed raw sewage including, diarrhea, abdominal pain, vomiting and even death, open food kiosks are also run next to the disposal site. The kiosks are normally flooded with drivers who bring in the hundreds of lorries daily to deposit the sewage.

Raw is risky: NZ raw milk warning as Campylobacter cases rise

Nelson Marlborough Health said in the last four weeks, 24 cases had been notified to the Medical Officer of Health, compared to a range of 6-16 cases in the same period over the previous five years.

A number of known risk factors for campylobacteriosis had been identified in the people affected. These were: drinking raw (unpasteurised) milk or untreated water, and contact with animals and/or nappies.

Nelson Marlborough Medical Officer of Health Dr Stephen Bridgman advised people against drinking raw milk and said it was risky for anyone to consume, but young children and babies, older people, pregnant women and people with a weakened immune system were especially at risk of severe illness.

The public health service was working with the Ministry for Primary Industries, the Ministry of Health and the Institute of Environmental Science and Research to identify the reasons for the increase.

A single source cause was yet to be found and investigations were ongoing.

Mass. restaurant Kitty’s closed after 39 sick from suspected Salmonella

ABC News reports a Massachusetts restaurant has been shut down until further notice after nearly 40 people reported getting sick during a suspected salmonella outbreak.

The North Reading Board of Health posted an advisory saying the state Public Health Department had received complaints from 39 people who said they got sick at Kitty’s late last month. The state confirmed nine cases of salmonella and 30 suspected cases of salmonella.

The source of the outbreak was traced to the antipasto salad.

The restaurant was closed July 5 and allowed to reopen Friday after a sanitization but has since closed again.

Over 500 reports of gastrointestinal illness at Tennessee zip line attraction

The Tennessee Department of Health says it is investigating an outbreak of gastrointestinal illness among visitors to a zip line attraction in Sevier County.

Health officials say they have received reports of more than 500 cases of gastrointestinal illnesses including diarrhea and vomiting from people from multiple states who visited CLIMB Works Zipline Canopy Tour since mid-June 2018.

State and local health investigators are working with the company to identify additional cases, what caused the illnesses and keep more people from getting sick.

State health officials say CLIMB Works has taken appropriate steps and closed temporarily, but has resumed routine operations.

The East Tennessee Regional Health Department says it has taken samples of well water, but the tests are not back yet. A manager at CLIMB Works says they’re not sure what’s causing the illnesses, but they have stopped using and distributing water at the attraction.

Cilmb Works Manager, Brian Turley, says 108 visitors called the business directly to report sickness. He says most of them called, not for a refund, but to inform the business of potential issues. 

Turley says they are offering refunds for anyone affected with illness. 

Speaking with WATE 6 On Your Side, Turley shared a message for visitors:

“We are so sorry. We obviously had no idea or we never would have never let you [visitors] drink our water. We had no idea. It’s so frustrating it wasn’t something we didn’t catch sooner,” said Turley.

4 confirmed sick with Shiga-toxin E. coli associated with I Love Sushi and Sodexo’s Café Mario in Washington state

Seattle’s King County public health is investigating an outbreak of Shiga toxin-producing E. coli (STEC) associated with I Love Sushi and Sodexo’s Café Mario at Nintendo of America campus in Redmond. Café Mario is operated by Sodexo and is not open to the public. At this time, the source of the illnesses has not been identified.

Since July 2, 2018, we have learned that four people (two King and two Snohomish County residents) have tested positive for STEC. All four consumed food from Café Mario in King County and work at the Nintendo of America campus in Redmond. Symptoms included abdominal cramps and bloody diarrhea. Illness onsets occurred during June 25–28, 2018. The four ill people consumed food from Café Mario on multiple days during June 18–22, 2018; one ill person also ate at I Love Sushi on June 19 and June 26, 2018, which is a food establishment that operates out of Café Mario once a week.\

On July 3, 2018, Public Health – Seattle & King County Environmental Health investigators visited Café Mario. Inspections were completed for both Café Mario and I Love Sushi.

At Café Mario, potential risk factors were identified and corrective actions discussed with Café Mario’s management, including inadequate hand washing practices and improper cold holding temperatures of food. At I Love Sushi, potential risk factors were also identified and discussed, including improper temperature storage of foods. Both restaurants were not open on July 4 due to it being a holiday.

On July 5, 2018, investigators closed Café Mario and the onsite I Love Sushi food services. Both restaurants will remain closed until approved to reopen by Public Health. Both food establishments will be required to complete a thorough cleaning and disinfection before reopening. Remaining food products are being held and environmental swabs were collected for laboratory testing. We are currently investigating whether any employees of these restaurants had a recent diarrheal illness. Investigators also reviewed with Café Mario’s management the Washington State Retail Food Code requirement that staff are not allowed to work while having vomiting or diarrhea.

9 dead, 38 sick from Listeria linked to frozen corn in EU back to 2015

My daughters ate a lot of frozen peas and corn when they were young.

Now I’m being told by Europeans I’m stupid.

As I’ve written before, Chapman and I did a bunch of work with the processing vegetable growers in Ontario (that’s in Canada).

We didn’t do any testing, but all the plants we visited had internal Listeria testing and used test-and-hold procedures. That was over 15 years ago.

Additionally, the blanching process should have removed Listeria (but should be verified).

The UK Food Standards Agency, Food Standards Scotland, Public Health England and Health Protection Scotland – that’s a lot of admin types — are reminding people that most frozen vegetables, including sweetcorn, need to be cooked before eating. This includes if adding them to salads, smoothies or dips.

People should always follow manufacturers’ instructions when preparing their food. If the product is not labelled as “ready to eat”, the cooking instructions should always be followed before eating the food hot or cold. 

In the UK, that means piping hot mush.

Any barfbloggers in the EU wanna take a picture of those clear cooking instructions on frozen corn and send them on?

Last week, the European Food Safety Authority said that frozen corn and possibly other frozen vegetables are the likely source of an outbreak of Listeria monocytogenes that has been affecting Austria, Denmark, Finland, Sweden, and the United Kingdom since 2015.

Experts used whole genome sequencing to identify the food source, which initially was thought to be limited to frozen corn. As of 8 June 2018, 47 cases including nine deaths had been reported.

The same strains of L. monocytogenes have been detected in frozen vegetables produced by the same Hungarian company in 2016, 2017 and 2018. This suggests that the strains have persisted in the processing plant despite the cleaning and disinfection procedures that were carried out.

The available information confirms the contamination at the Hungarian plant. However, further investigations, including thorough sampling and testing, are needed to identify the exact points of environmental contamination at the Hungarian plant. The same recommendation applies to other companies belonging to the same commercial group if environmental contamination is detected.

On 29 June 2018, the Hungarian Food Chain Safety Office banned the marketing of all frozen vegetable and frozen mixed vegetable products produced by the affected plant between August 2016 and June 2018, and ordered their immediate withdrawal and recall. This last measure is likely to significantly reduce the risk of human infections and contain the outbreak. All freezing activity at the plant has been stopped.

New cases could still emerge due to the long incubation period of listeriosis (up to 70 days); the long shelf-life of frozen corn products; and the consumption of frozen corn bought before the recalls and eaten without being cooked properly.

To reduce the risk of infection, consumers should thoroughly cook non ready-to-eat frozen vegetables, even though these products are commonly consumed without cooking (e.g. in salads and smoothies). This applies especially to consumers at highest risk of contracting listeriosis – such as the elderly, pregnant women, new-borns and adults with weakened immune systems.

Frozen fruit and veg: That’s what my 2-decade hockey buddy, who also has four Canadian kids about the same age as mine, said when I asked, how do you go about managing the food for all these kids (along with the pets and horses).

But like Hepatitis A in frozen fruit, I now cook the shit out of them.

212 sick: Multistate outbreak of cyclosporiasis linked to Del Monte Fresh produce vegetable tray

The U.S. Centers for Disease Control and Prevention (CDC) reports that Cyclospora cayetanensis is a single-celled parasite that causes an intestinal infection called cyclosporiasis.

As of July 5, 2018 (9am EDT), CDC has been notified of 212 laboratory-confirmed cases of cyclosporiasis in persons who reportedly consumed pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip. The reports have come from four states.

Seven (7) of these people have been hospitalized, and no deaths have been reported.

Epidemiologic evidence indicates that pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip are the likely source of these infections.

Most ill people reported eating pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip.

Most ill people reported buying pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip in the Midwest. Most people reported buying the trays at Kwik Trip convenience stores.

The investigation is ongoing. CDC will provide updates when more information is available.

General advice for consumers about prevention of cyclosporiasis can be found here.

On June 15, 2018, Del Monte Fresh Produce recalled 6 oz., 12 oz., and 28 oz. vegetable trays containing fresh broccoli, cauliflower, celery sticks, carrots, and dill dip. Recalled products were sold in clear, plastic clamshell containers.

Recalled products were distributed to the following stores: Kwik Trip, Kwik Star, Demond’s, Sentry, Potash, Meehan’s, Country Market, FoodMax Supermarket, and Peapod.