Just cook it doesn’t cut it: Campy in veal liver

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A matched case–control study in Quebec, Canada, evaluated consumption of veal liver as a risk factor for campylobacteriosis. Campylobacter was identified in 28 of 97 veal livers collected concurrently from slaughterhouses and retailers. Veal liver was associated with human Campylobacter infection, particularly when consumed undercooked.

Recent investigations conducted in Quebec, Canada, after an increased number of sporadic campylobacteriosis illnesses suggested that consumption of veal liver may be a risk factor for campylobacteriosis. Many of the persons infected reported eating veal liver, and many of those had eaten it pink or undercooked. The association between campylobacteriosis and the consumption of meat products, including chicken liver and offal from different animal species, has been previously described (1–5). We designed an epidemiologic study to examine the relationship between veal liver consumption and campylobacteriosis.

We conducted a matched case–control study to examine a potential association between veal liver consumption and campylobacteriosis, using salmonellosis cases as controls. The study began in September 2016 and continued for 9 months. Salmonellosis and campylobacteriosis cases are reportable in Quebec; we selected all subjects from the provincial reportable disease registry. We used a systematic sampling method to select every fifth reported campylobacteriosis case-patient >45 years of age. We paired each campylobacteriosis case-patient with 1 salmonellosis case-patient by age group (45–64 and >65 y) and sex; both infections were confirmed by fecal culture. We matched case-patients if the salmonellosis sample was collected within a window of 7 days before to 60 days after the campylobacteriosis sample was collected. Inclusion criteria for cases and controls were infection that was sporadic and domestically acquired. Exclusion criteria were co-infection with another pathogen, being part of a recognized outbreak, or contact with a gastroenteritis case-patient <10 days before illness.

We administered a structured questionnaire by telephone to collect information on exposures in the 7 days before illness onset. Exposures were consumption of meat and unpasteurized milk products, contact with animals, drinking and recreational water exposures, and occupational exposures. In particular, we investigated consumption of a variety of livers and the degree to which they were cooked. We conducted matched univariate and multivariate analysis to estimate odds ratios (OR) for each exposure.

In addition, we collected samples of veal, chicken, pork, and beef livers from slaughterhouses and retail stores in Quebec between October 2014 and March 2017. We tested each liver specimen for the presence of Campylobacter, Salmonella, and Escherichia coli O157:H7 by using standardized methods (6,7).

We matched a total of 112 campylobacteriosis cases to salmonellosis cases. We found no significant statistical difference in the age or sex distribution of retained cases or controls and the excluded patients. The species of Campylobacter were C. jejuni (79.5%), C. jejuni/coli undifferentiated (3.6%), C. coli (0.9%), other (1.8%), and not identified (14.3%). Among campylobacteriosis case-patients, 42 (37.5%) consumed veal liver and 29 (69.0%) ate it undercooked.

Only the consumption of veal liver and having contact with farm animals were statistically significantly associated with campylobacteriosis (Table 1). After applying the Bonferroni correction to adjust for multiple comparisons (0.05 level of significance divided by 45 variables tested yields α = 0.001), only veal liver consumption remained as a statistically significant exposure (matched OR 9.50, 95% CI 3.39–26.62; p = 0.000001).

Among veal liver consumers, adequate cooking (e.g., well-cooked vs. pink or rare, on the basis of the participant’s subjective observation) was protective. Specifically, 13 (30.2%) of 43 case-patients versus 6 (85.7%) of 7 controls ate their veal liver well-cooked (unmatched OR 0.07, 95% CI 0.002–0.72; p = 0.02). Multivariate analysis using logistic regression confirmed that a statistically significant association between the consumption of veal liver and campylobacteriosis remained when all other exposures were included as covariates. Although we conducted this study among persons ≥45 years of age, it is reasonable to assume that eating veal liver, especially undercooked, would also carry risk for younger persons.

We sampled 339 veal, pork, chicken, and beef livers collected from 138 retailers and 16 slaughterhouses. When we evaluated all livers collected at both locations, we detected Campylobacter in 28.0% of veal livers, 22.2% of pork livers, 36.8% of chicken livers, and 19.1% of beef livers (Table 2). We detected Salmonella more frequently in chicken livers (22.1%) and pork livers (19.1%) than in veal livers (3.1%); we did not detect Salmonella in beef livers. We rarely identified E. coli O157:H7 in livers of any kind. The proportion of contaminated livers differed between animal species and also with respect to location of sampling. A higher proportion of veal livers (35.7%) collected from retailers were contaminated by Campylobacter, compared with veal livers collected from slaughterhouses (16.2%). We observed the reverse for chicken and pork livers. The reason for these variations is unclear at this time, but this finding may be an artifact resulting from the relatively small number of samples taken at each location.

Cattle are a well-known reservoir for a variety of Campylobacter species, such as C. jejuni, C. coli, and C. fetus (8,9). Campylobacter species have been isolated from beef intestinal contents and also from beef bile, bile ducts, gallbladder, and liver (10–14). The gallbladder and bile contain substances that have a chemoattractant effect on C. jejuni, which explains the presence of Campylobacter within the biliary tract (10,15). Liver contamination varies between animal species (10–14). Chicken liver, for example, can be contaminated by Campylobacter and Salmonella and has been the source of several outbreaks (3,4,11,13). Because few case-patients consumed livers from other animal species during our study, we were not able to identify any substantial risks associated with those exposures.

Because livers may be collected from several animals and stored together, they may be contaminated during the evisceration process or by cross-contamination (11). Both the external and internal tissue of a liver may be contaminated with Campylobacter, and inadequate cooking may not fully inactivate Campylobacter and Salmonella (10,11), which is a cause for concern because ≈70% of the patients with campylobacteriosis who consumed veal liver in our study reported eating it undercooked. We did not examine possible cross-contamination of foods and surfaces and the host-related factors that may increase the risk for enteric diseases.

Conclusions

Our study identified a strong and statistically significant association between the consumption of veal liver and sporadic, domestically acquired campylobacteriosis among persons >45 years of age in Quebec. We found that adequate cooking of veal liver mitigates the risk of infection. We detected Campylobacter in almost one third of veal livers we sampled from slaughterhouses and retail stores, which supports our finding that veal liver consumption is a risk factor for campylobacteriosis. In light of these results, we recommend the dissemination of safe food handling practices for veal liver and other offal for retailers, food establishments, slaughterhouses, and the general public.

Dr. Gaulin is a physician epidemiologist who works in public health at the Protection Branch of the Ministry of Health in Quebec, Canada. She works in infectious diseases on enteric and nonenteric disease surveillance and also coordinates provincial outbreak investigations.

Veal Liver as Food Vehicle for Human Campylobacter Infections

Gaulin C, Ramsay D, Réjean Dion R, Simard M, Gariépy C, Levac É, et al. Veal liver as food vehicle for human Campylobacter infections. Emerg Infect Dis. 2018 Jun [date cited]. https://doi.org/10.3201/eid2406.171900

DOI: 10.3201/eid2406.171900

https://wwwnc.cdc.gov/eid/article/24/6/17-1900_article#suggestedcitation

Food Safety Talk 153: While They Are Poopin’

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Don and Ben talk about human pathogens in produce and trying to define baseline for prevalence (which is complicated, and it depends). The conversation then goes to a discussion on Don’s appearance on Do By Friday and where podcasts fit into extension and outreach. The show ends on some listener feedback and the guys trying to figure out the history of consumer-focused storage time/temperature guidance.

Man in the bathroom checking internet with iPhone 5s smartphone, always connected.

Episode 153 is available on iTunes and here.

Show notes so you can follow along at home:

E. coli O26 triggers recall of cheese sold in Avoca, Ireland

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A notice issued on the Food Safety Authority of Ireland’s website read: “Following detection of shiga toxin-producing Eschericia coli O26 in a raw milk cheese, the above batch of Camembert de Normandie cheese is being recalled by La Fromagerie du Plessis.

“A point-of-sale recall notice is displayed in Avoca stores which sold the affected batch advising customers not to eat this batch.”

The affected product is the Camembert de Normandie au lait cru, 250g with approval number FR 14 608 001 CE.

The batch code is 260218DS0 with a use-by date of May 2, 2018.

Pennsylvania family coping with daughter’s E. coli death

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Jaccii Farris of 69 News reports a community rallies around a Bucks County family who is dealing with a heartbreaking loss.

They say their preschool-aged daughter died because of the E. coli bacteria.

Someone close to the Robert family started a YouCaring page to help with medical expenses after three members of the family were stricken by the bacteria back in April.

The pictures of the family of four posted on the site are from a happier time. 

Now, members of the community are coming to their side at their darkest hour.

According to the website, on April 15th the Robert’s son Tyler was hospitalized at Children’s Hospital of Philadelphia with a strain of E. coli that impacts the kidneys.

But soon after he was admitted, his mother and sister Hailey became ill.

Hailey was also admitted to CHOP.

Over the next two weeks, the family posted daily updates. Tyler was doing better, but Hailey was struggling.

May 2 came the hardest post a mother could make. Hailey lost her battle against the bacteria.

The Pennsylvania Department of Health confirms that an E. coli death occurred at CHOP, but would not name the victim due to HIPAA.

Officials say the death is not related to the recent E. coli cases associated with lettuce from the Yuma, Arizona region. 
Bucks County family loses daughter to E. coli

Melboune beware: Shit with dangerous E. coli can survive a long time in river sediment

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Bed sediment resuspension is a potential source of faecal microorganisms in the water column of estuaries. As such, it is important to identify the survival of faecal microorganisms in these bed sediments and understand how bed sediment resuspension impacts the quality of estuarine waters.

This study explores the effect of bed sediment resuspension on Escherichia coli on concentrations in the water column and the persistence of E. coli in the water column and bed sediments of the Yarra River estuary in South‐Eastern Australia. Using sediment cores, we identified that the resuspension of both surficial sediments (e.g., by tidal movements) and deeper bed sediments (e.g., by large storm events) can increase E. coli concentrations in the water column by up to 20 times in estuaries in oceanic climates. Bed sediment resuspension can result in increased E. coli concentrations in the water column even up to 24 days after E. coli first enters the estuarine water.

This study demonstrates that faecal microorganisms, such as E. coli, can persist for extended periods in estuarine bed sediments, which may then be re‐entrained into the water column via recreational activities, high flow events, or tidal fluctuations. If the survival and resuspension processes observed here hold true for pathogenic microorganisms, the resuspension of bed sediments may indeed represent an increased public health risk.

Escherichia coli survival and transfer in estuarine bed sediments

C. Schang, A. Lintern, P. L. M. Cook, G. Rooney, R. Coleman, H. M. Murphy, A. Deletic, D. McCarthy

https://doi.org/10.1002/rra.3281

https://onlinelibrary.wiley.com/doi/full/10.1002/rra.3281

Pins found in pepperoni sticks, sausage sold in B.C.

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Nanaimo, British Columbia (that’s in Canada) may be famous for its Nanaimo bars, but now police are investigating after pins were found in meat products sold throughout Nanaimo, B.C.

RCMP (that’s the Royal Canadian Mounted Police, where’s your horse?) say they’ve had three reports about food tampering at separate stores in the Vancouver Island city since December 2017, but no injuries have been reported.

In each case, a pin — similar to one used for sewing — was found in a pepperoni stick or Ukrainian sausage made by Grimm’s Fine Foods.

Police say they haven’t received any reports involving other Grimm’s products, or any other meat products in Nanaimo or elsewhere.

Investigators believe the products were tampered with while on display.

Const. Gary O’Brien says the public needs to be especially vigilant and inspect meat products before eating them.

We don’t need no edumacation

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For all the folks out there trying to educate consumers and others about food safety, forget it.

Stick with stories.

Pink Floyd figured that out in 1980, in what would become the soundtrack for my grade 12 (Stones’ Some Girls was the soundtrack for grade 10) and a weirdly accurate foretelling of my first marriage.

121 sick, 52 hospitalized, 14 with kidney failure and 1 death linked to Yuma romaine E. coli outbreak

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I’m not sure in what universe, the-growing-area-has-stopped-harvesting is a useful explanation for an outbreak of foodborne illness that has sickened 121 and hospitalized almost 50 per cent.

And this picture from 12 years ago is still apt.

I’ll write a much more scathing indictment of the 10-year-experiment in self-fellatio practiced by the Leafy Greens Marketing Association in my upcoming book, Food Safety Fairy Tales.

For now, let it be known that according to the U.S. Centers for Disease Control, E. coli O157:H7 linked to romaine lettuce has sickened 121 people in 25 states.

52 people have been hospitalized, including 14 people who have developed hemolytic uremic syndrome.

One death was reported from California.

This investigation is ongoing, and CDC will provide updates when more information is available.

‘Your mother was a hamster and your father smelt of elderberries’ There’s no taunting like a French taunting

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I’ve applied for a bunch of Australian public service jobs, to pay the bills, support my family, but I loath myself for doing so.

I should just write.

Or taunt French people.

One of my applications got promoted to the next level, where I was required to complete a one-hour test to demonstrate fluency – I cannot make this up – in logical, verbal and numerical elements.

I probably failed, and that’s why the best and brightest get promoted upwards.

John Wilson of The Canberra Times writes that Monty Python were never accused of holding back from crude humour. One of their more memorable lines – “I fart in your general direction” – uttered by the Insulting Frenchman, fits this bill. Yet their scenes are often divorced from reality, skirting outside the bounds of the possible.

However you say it – flatulence, bum sneezes, letting one rip or plain old farting – it is (usually) an involuntary act that is met with embarrassment. This is particularly true in the office, where it certainly is not met with the triumphant gloating of the Insulting Frenchman.

So it may surprise some readers to learn that intentional farts are in fact frequently cited as sources of workplace grievances and evidence of bullying. Not only are accusations levelled that a colleague farted in their general direction, it is often the case that someone farted in their specific direction.

The rest of the story has the smelly details.

My five daughters all made fart jokes, until they reached puberty. Then it’s just embarrassing.

So, I’m savoring every moment of daughter Sorenne peeling one off in the morning and proudly proclaiming, ‘Excuse me, I farted.’

Don’t wash your chicken or turkey before cooking

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Washing chicken or turkey for that matter is a cross-contamination nightmare. Cook your bird to 74C (165F) and verify with a digital tip sensitive thermometer. No need for washing. If you’re in Canada, the temperature to inactivate Salmonella mysteriously jumps to 82C (180F) for whole poultry, depending on the jurisdiction.

No wonder the public gets confused.

It is true that people are what they eat. The foods we eat say a lot about our general body’s health. However, before eating any food, people are always advised to wash them, even before
cooking. However, did you know that there are some food types you don’t need to wash before cooking? Well, there are some foods you will wash before cooking while others should just be cooked straight away. Here are three major foods you should never wash before cooking:
Chicken
Washing chicken before cooking it is very wrong. People think rinsing a chicken removes germs and bacteria from it, which is never true. Salmonella, which commonly grows on chicken will only be killed when chicken is cooked at temperatures above 165 degrees. Washing it does nothing good for the chicken.
Eggs
Many people tend to wash eggs before breaking them to cook. However, this is just a waste of time as eggs have their own protective layer that prevents any bacteria from getting inside. More so, washing the eggs might remove this protective layer exposing them to contamination which will make them go bad faster.
Fish
People think washing fish will remove any bacteria on it. Washing fish will only be robbing it of its flavor. Just like the bacteria in chicken will be killed when cooing it, so will the bacteria in fish.
Therefore, before washing these three foods, just know that you will be washing off their flavor.