The U.S, Centers for Disease Control that Cryptosporidium is the leading cause of outbreaks of diarrhea linked to water and the third leading cause of diarrhea associated with animal contact in the United States.
During 2009–2017, 444 cryptosporidiosis outbreaks, resulting in 7,465 cases were reported by 40 states and Puerto Rico. The number of reported outbreaks has increased an average of approximately 13% per year. Leading causes include swallowing contaminated water in pools or water playgrounds, contact with infected cattle, and contact with infected persons in child care settings.
What are the implications for public health practice?
To prevent cryptosporidiosis outbreaks, CDC recommends not swimming or attending child care if ill with diarrhea and recommends hand washing after contact with animals.
I told Amy when I die and my brain is carved up in Sydney, my epitaph should be, improving food safety, one thermometer at a time.
I still feel naked when cooking without a thermometer.
According to a study conducted by researchers at Purdue University, few people use thermometers when they cook—even if they know how.
One of the major reasons that consumers don’t use thermometers, researchers found, is because they tend to draw inspiration from outside sources—celebrity chefs, cookbook authors, magazines, restaurant managers, and food blogs. These outlets rarely ever mention or demonstrate the importance of cooking food to proper temperatures.
“We see that celebrity chefs simply rely on time estimates in their recipes or cut through the meat to show there is no blood or pink. That doesn’t always mean the food is safe, however,” says Yaohua “Betty” Feng, an assistant professor of food science at Purdue. “That affects the behaviors of home cooks and professional cooks. If their role models aren’t using thermometers, why should they? But if chefs preparing food on television or social media would include the use of a thermometer to ensure the food is thoroughly cooked, it would have an impact on their viewers.”
Feng worked with University of California’s Christine M. Bruhn to analyze 85 studies from over two decades to understand knowledge, attitudes, and behaviors associated with thermometer use. Despite it being considered a best practice in home and professional kitchens, thermometer use is low.
In one study, two-thirds of people reported owning a meat thermometer, but less than 20 percent used it all the time to check the temperature of chicken, and less than 10 percent used it all the time for hamburgers. About half of consumers say that thermometers aren’t necessary to check the doneness of egg or meat dishes.
Feng also noted that many people are unsure which type of thermometer to buy or how to correctly use them, including where to place the thermometer in the food, the correct endpoint temperatures, proper temperature calibration for the thermometer, and proper cleaning and sanitation. About 95 percent of people in one study did not clean their thermometers after use.
The U.S. Department of Agriculture National Institute of Food and Agriculture’s Agriculture and Food Research Initiative supported this research. The results were published in the Journal of Food Protection in January 2019.
The main goal of the present paper is to overview, using the example of pigs/pork, the developments in official meat inspection in the European Union that occurred from 2000 onwards. The developments aim at transition from traditional, macroscopic examination of slaughtered animals to a risk and meat-chain based, comprehensive meat safety assurance system.
pig
The scientific reasoning for those developments and the generic framework of a modernised system as proposed by the European Food Safety Authority, as well as the current status and future perspectives of related changes, are considered. Also, the main factors hampering the implementation of the changes in practice and possible directions for further work needed to overcome them are outlined.
From traditional meat inspection to development of meat safety assurance programs in pig abattoirs- the European situation
I’m a fan of agritourism, whether that’s touring a bunch of backyard chicken coops or learning about animals, I see value in this stuff. It’s not without risk though – and managing that risk is imperative. A while ago someone asked me about the types of food businesses I like to frequent, from a food safety perspective, and I thought about it a while and came up with this: I like to eat food from places where the people involved in making decisions are constantly worried about making people sick. Like it’s their nightmare. Not places that tell me not to worry about stuff.
My petting zoos/animal interaction wants are the same.
A few years ago my friend (and Carolina Hurricane superfan), Dr. Megan Jacob and I took a couple of visits to animal education/interaction sites to get some ideas about what people do (visitors and organizers). From those visits we saw a lot of stuff that made us think we need to take a different approach. Lots of signs saying to wash hands. Don’t bring food around the animals, don’t bring strollers.
And not a lot of people following the messages. I don’t blame the visitors. I blame us (or at least the collective us) for not doing a better job at saying why it’s important, not having enough people there with reminders and actively helping visitors reduce their risks.
A couple of years ago Gonzalo Erdozian esteemed member of the barfblog team, looked at what was available at a bunch of small petting zoo sites/events in Kansas and Missouri – and came up with some great suggestions after finding lots of risky practices (abstract is below). Reducing risks at fairs and petting zoos isn’t a simple thing – it’s a mix of having the tools, people to point patrons to them, and explaining the risks (without being jerks).
Gonzo found that the reminders really worked.
After those visits, Megan and I, with the help from some others put together a workshop for NC folks who run these events and sites. We learned a whole bunch more from the participants – one of the biggest takeaways for me was that organizers were reluctant to engage in these discussions because although they knew that there was a risk, they didn’t want to alert people who were there that it was risky because maybe they wouldn’t come. I’m not sure what the correct word for that is, but it seems paternalistic or something. One philosophy we’ve followed at barfblog is that people can handle risk discussions and we’re kinda responsible to have them. And let the participants choose.
I home almost daily past the Kelley Building, ground zero for an E. coli O157:H7 outbreak in 2011 linked to 25 illnesses at the NC State Fair. The building wasn’t considered to be an animal contact area – a petting zoo – but was a spot that was a popular cut-through from an entrance gate to the midway area. Organizers of the fair led a commission to look at what happened, and made changes – having more handwashing stations, passive reminders and actively having actual people reminding; further limiting access to non-petting zoo animal buildings; and, increasing cleaning and sanitation.
People brought food, strollers, and their hands touched a lot of likely contaminated handles and rails.
A 2-year-old boy died and three others were sickened upon contracting the E. coli virus after coming into contact with farm animals at the San Diego County Fair, according to authorities.
The child was hospitalized after visiting the county fair two weeks ago, and died Monday after complications stemming from the virus, the San Diego County Health and Human Services Agency confirmed on Friday. The other three children did not need medical attention.
A 2-year-old boy died and three others were sickened upon contracting the E. coli virus after coming into contact with farm animals at the San Diego County Fair, according to authorities.
The child was hospitalized after visiting the county fair two weeks ago, and died Monday after complications stemming from the virus, the San Diego County Health and Human Services Agency confirmed on Friday. The other three children did not need medical attention.
The frustrating nexus of these (and all the other illnesses) is that it’s good for folks to learn about agriculture and farming and food by seeing and interacting – and that very situation is risky.
What doesn’t help is when the agricultural community scoffs at these illnesses (I haven’t heard it on this one, but have in the past) essentially saying that handwashing is common sense, so these illnesses happen because people are ignorant. Except that all falls apart because we (the folks in the know) haven’t done our job telling folks how they can manage some of the risk of getting sick, and how organizers are also trying to reduce the risk to patrons. By missing that, we’re not doing everything we can to ensure that the safe behaviors take place. And that makes me sad.
Outbreaks of human illness have been linked to visiting settings with animal contact throughout developed countries. This paper details an observational study of hand hygiene tool availability and recommendations; frequency of risky behavior; and, handwashing attempts by visitors in Kansas (9) and Missouri (4), U.S., petting zoos. Handwashing signs and hand hygiene stations were available at the exit of animal-contact areas in 10/13 and 8/13 petting zoos respectively. Risky behaviors were observed being performed at all petting zoos by at least one visitor. Frequently observed behaviors were: children (10/13 petting zoos) and adults (9/13 petting zoos) touching hands to face within animal-contact areas; animals licking children’s and adults’ hands (7/13 and 4/13 petting zoos, respectively); and children and adults drinking within animal-contact areas (5/13 petting zoos each). Of 574 visitors observed for hand hygiene when exiting animal-contact areas, 37% (n=214) of individuals attempted some type of hand hygiene, with male adults, female adults, and children attempting at similar rates (32%, 40%, and 37% respectively). Visitors were 4.8x more likely to wash their hands when a staff member was present within or at the exit to the animal-contact area (136/231, 59%) than when no staff member was present (78/343, 23%; p<0.001, OR=4.863, 95% C.I.=3.380-6.998). Visitors at zoos with a fence as a partial barrier to human-animal contact were 2.3x more likely to wash their hands (188/460, 40.9%) than visitors allowed to enter the animals’ yard for contact (26/114, 22.8%; p<0.001, OR= 2.339, 95% CI= 1.454-3.763). Inconsistencies existed in tool availability, signage, and supervision of animal-contact. Risk communication was poor, with few petting zoos outlining risks associated with animal-contact, or providing recommendations for precautions to be taken to reduce these risks.
I really like fruits and berries. All kinds of fruits are my go-to snacks and over the past few years I’ve discovered how much I like tropical fruits like mango and papaya.
And today CDC and FDA announced another outbreak of Salmonella (this time Uganda) traced to the fruit, causing at least 62 illnesses to date (with 23 hospitalizations).
According to the CDC release, there’s some notable stuff:
Of 33 ill people with available information, 22 reported being of Hispanic ethnicity.
The hospitalization rate in this outbreak is 66 percent among people with information available. The hospitalization rate inSalmonellaoutbreaks is usually around 20 percent.
Most of the sick people in this outbreak are adults over 60.
The hepatitis A vaccine is the best way to prevent HAV infection.
The following groups are at highest risk for acquiring HAV infection or developing serious complications from HAV infection in these outbreaks and should be offered the hepatitis A vaccine in order to prevent or control an outbreak:
People who use drugs (injection or non-injection)
People experiencing unstable housing or homelessness
Men who have sex with men (MSM)
People who are currently or were recently incarcerated
People with chronic liver disease, including cirrhosis, hepatitis B, or hepatitis C
One dose of single-antigen hepatitis A vaccine has been shown to control outbreaks of hepatitis A and provides up to 95% seroprotection in healthy individuals for up to 11 years.1,2
Pre-vaccination serologic testing is not required to administer hepatitis A vaccine. Vaccinations should not be postponed if vaccination history cannot be obtained or records are unavailable.
“Outbreak-associated” status is currently determined at the state level in accordance with each state’s respective outbreak case definition.
Outbreak-related hepatitis A deaths are defined at the state level in accordance with each state’s respective hepatitis A-related death definition. Some states are reviewing death certificates on a regular basis to actively find hepatitis A-related deaths, while other states are utilizing passive surveillance.
Outbreak start date is defined at the state level and may represent the earliest onset date of an outbreak case (AR, AZ, UT), the left censor date for which cases are considered part of the outbreak based on the state outbreak case definition (AL, CA, CO, FL, GA, ID, IL, IN, KY, LA, MA, MI, MO, NC, NH, OH, SC, TN, VA), or when a state declared a hepatitis A outbreak (NM, WV).
CDC’s Response
In response to all hepatitis outbreaks, CDC provides ongoing epidemiology and laboratory support as well as support on vaccine supply and vaccine policy development. When requested, CDC sends “disease detectives” to affected areas to evaluate and assist in an outbreak response. CDC alerts other public health jurisdictions of any increases in disease. All jurisdictions are encouraged to be watchful for increases in hepatitis A cases. CDC also works with state and local health officials to ensure hepatitis A vaccine is targeted to the correct at-risk populations and that supply is adequate.
Postexposure Prophylaxis
Postexposure prophylaxis (PEP) is recommended for unvaccinated people who have been exposed to hepatitis A virus (HAV) in the last 2 weeks; those with evidence of previous vaccination do not require PEP.
NOTE: CDC recommends that all children be vaccinated against hepatitis A at age 1 year. Parents or caregivers who are unsure if a child has been vaccinated should consult the child’s health-care provider to confirm vaccination status.
HAV Specimen Requests
State health departments wanting to submit specimens must contact CDC at hepaoutbreaklab@cdc.gov for approval before shipping specimens to CDC. Only specimens that that have tested positive for anti-hepatitis A IgM and meet any of the following criteria will be considered.
Specimen from a case patient in a county that has not yet reported a hepatitis A case in an at-risk population;
Specimen from a case patient who doesn’t report any known risk factors or contact with at-risk populations (e.g., household or sexual contact, volunteering at a homeless shelter);
Specimen from a case patient suspected to be associated with foodborne transmission;
Archived/stored specimen from a patient who has died, and whose classification as an outbreak-related death requires nucleic acid testing beyond anti-HAV IgM-positivity; or
Other patient specimens not meeting the above criteria that require nucleic acid testing or molecular characterization (to be discussed on a case-by-case basis).
CDC is developing educational materials to support the outbreak at the state and local levels. Most materials include an area where local information can be inserted. Your organization’s contact information can be typed into the blue colored rectangle. To upload your logo, click on the white space below the blue colored rectangle. In the pop-up box, select browse and upload a PDF version of your logo.
Fact Sheets
One page visual fact sheets encouraging vaccination for:
Two page visual fact sheet pdf icon[PDF – 615 KB] that includes information on hepatitis A prevention, transmission, symptoms and encourages multiple populations to get vaccinated
Printing Instructions: These cards should be printed double-sided on 4.25” x 5.5” perforated postcard templates that print four double-sided cards per page. The print settings must be set to “Actual size” or “Custom Scale 100%” to ensure accurate alignment of the two sides of the cards.
Pocket Card Printing Instructions: These cards should be printed double-sided on business card templates that print six double-sided cards per page. The print settings must be set to “Actual size” or “Custom Scale 100%” to ensure accurate alignment of the two sides of the cards.
Scott Weese of the Worms and Germs Blog, a prof, vet, from the University of Guelph, and more importantly, a dude I played hockey with all those years ago, writes, as I was writing the post below, my youngest daughter walked in the door and said “a chick pooped on me today.”
(He’s one of the bald dudes in this pic from 2005: hint, leave when you’ve won, and have a full head of hair, which I did)
It wasn’t a total surprise since I’d heard a vague statement from her about maybe having chicks in the class for the end of the year.
Is it potentially fun and/or educational?
Sure. If it’s done right.
Is it done right?
Doesn’t sound like it.
Chicks are cute and can be entertaining. They can also be educational. Yet, contact with them is clearly associated with disease. While I get an infosheet from the school and have to sign something every time one of my kids does any other type of activity, there was no notice about this particular activity, no information about risks and preventive measures, nothing about what to do if a child is at high risk for severe disease, or anything else.
Just my kid telling me she got pooped on.
I’m not overly concerned. She’s healthy, outside of the main high risk groups, and washed her hands after the incident. Yet, I don’t know (and doubt the school knows) whether that applies to everyone in the class or other kids that might have contact with the chicks. The chicks are also being kept in a classroom where the students eat.
A lot could be done to minimize and communicate the risks. We tried approaching the provincial Ministry of Education and school boards quite a few years ago to look into animal exposures in schools, and there was basically zero interest in the subject. Whether that’s because there was no awareness of the issues or no desire to find out what’s actually going on is hard to say.
Now on to the post I was writing…
CDC has related an updated investigation notice about Salmonella from backyard poultry. As of June 13th, 279 infected people have been identified in 41 states, with cases dating back to January 1st, 2019.. That probably means a few thousand people have actually been infected, since reported disease numbers are typically dwarfed by the real number of cases.
The strains that have been linked to the outbreak are Salmonella Agona, Anatum, Braenderup, Infantis, Montevideo and Newport
30% of infected people were children younger than 5 years old, which is the group that typically gets sick or seriously ill from Salmonella.
26% of people were hospitalized. Fortunately, no deaths were reported.
About 40% of isolates were multidrug-resistant.
77% of infected individuals reported contact with chicks or ducklings from places like agricultural stores, mail order supplies and hatcheries.
One of the outbreak strains has also been found in backyard poultry in Ohio.
I’m not against animals in schools or backyard poultry. I’m just against being stupid. There are lots of things that can be done to reduce risks, and too often those easy, cheap and practical measures are ignored.
Frank didn’t waste any time after leaving Wal-Mart for government.
Good on ya.
But guidance is not enforcement.
My group learned that the hard way 20 years ago.
And they still serve sprouts to immunocompromised people in Australian hospitals despite a ridiculous number of outbreaks.
“Over the past 22 years, the U.S. Food and Drug Administration (FDA) has investigated 50 reported outbreaks of foodborne illness associated with contaminated sprouts. Together, these outbreaks resulted in more than an estimated 2,600 cases of illness. Last year, there were two reported outbreaks associated with sprouts, resulting in more than an estimated 100 illnesses. Studies indicate that contaminated seed is the likely source of most sprout-related outbreaks, as this commodity is inherently more susceptible to these issues because they are grown in warm and humid conditions that are favorable for bacteria like Salmonella, Listeria and E. coli,” said FDA Deputy Commissioner for Food Policy and Response Frank Yiannas.
“The FDA is committed to taking swift action to respond to outbreaks related to sprouts and keep our food supply safe, but we also know that measures to prevent issues from happening in the first place are an important element of protecting consumers. By studying outbreaks related to sprouts over the years, we have been able to recommend changes in the industry to help lower the incidence of sprout-related outbreaks. Today’s new draft guidance is another critical step, like the Sprout Safety Alliance or sprout-specific requirements of the Produce Safety Rule, the agency is taking to prevent illnesses related to sprouts.”
FDA today released a proposed draft guidance, “Reducing Microbial Food Safety Hazards in the Production of Seed for Sprouting,” intended to make the sprout seed industry (seed growers, conditioners, packers, holders, suppliers, and distributors) aware of the agency’s serious concerns with the continuing outbreaks of foodborne illness associated with the consumption of raw and lightly-cooked sprouts.
Incorporating aspects of the Codex Code of Hygienic Practice for Fresh Fruits and Vegetables Annex II, Annex for Sprout Production; the International Sprout Growers Association-Institute for Food Safety and Health’s “U.S. Sprout Production Best Practices”; and Good Agricultural Practices, the FDA’s draft guidance issued today provides the agency’s recommendations to firms throughout the production chain of seed for sprouting. It states that if a grower, holder, conditioner, or distributor reasonably believes that its seeds are expected to be used for sprouting, we recommend that the grower, holder, conditioner, or distributor take steps that are reasonably necessary to prevent those seeds from becoming contaminated. We also recommend that firms throughout the supply chain – from seed production and distribution through sprouting – review their current operations related to seeds for sprouting.
Happy birthday to my beautiful and brainy wife who has guided me through the last few years as my brain goes away, is manager of Sorenne’s hockey team, and has taken on a lot that she didn’t sign up for.
(She’s driving me to the neurologist in about an hour).
This pic is shortly after we met in 2005.
She’s wearing her trademarked, I’m-a-French-professor-so-I-get-to-wear-outrageous-scarfs look, and I’m wearing a shirt from the long gone New Zealand Food safety Authority.
Most of the people who got sick ate commercial grown mussels harvested in Coromandel.
“It is possible that the strain of vibrio parahaemolyticus is unusually aggressive, which may mean that even low numbers could cause illness,” NZ food safety director of regulation Paul Dansted said.
“Additional testing of mussels and the waters that they are being grown in is also underway to help us understand why this has happened.
“The mussels at the centre of the outbreak were all bought in their raw state, in the shell. They are not the mussels that can be bought in plastic pottles. Those mussels are cooked and marinated and are not affected.”
NZ Food Safety says people need to be careful when cooking mussels and heat them above 65C. It’s also advised to wash hands after handling shellfish, and avoid cross-contamination between raw and cooked shellfish.
