Tag Archives: Campylobacter

113 sick with Campylobacter from Petland puppies

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The U.S. Centers for Disease Control, several states, and the U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (USDA-APHIS) investigated a multistate outbreak of multidrug-resistant Campylobacter infections. Epidemiologic and laboratory evidence indicated that contact with puppies sold through Petland stores were a likely source of this outbreak. This outbreak investigation is over. Illnesses could continue to occur because people may be unaware of the risk of Campylobacter infections from puppies and dogs.

Cute puppies

A total of 113 people with laboratory-confirmed infections or symptoms consistent with Campylobacter infection were linked to this outbreak. Illnesses were reported from 17 states. Illnesses started on dates ranging from January 12, 2016 to January 7, 2018. Ill people ranged in age from less than 1 year to 86, with a median age of 27. Sixty-three percent of ill people were female. Of 103 people with available information, 23 (22%) were hospitalized. No deaths were reported. Whole genome sequencing (WGS) showed that isolates from people infected with Campylobacter were closely related genetically. This close genetic relationship means that people in this outbreak were more likely to share a common source of infection.

Campylobacter bacteria isolated from clinical samples from people sickened in this outbreak were resistant to commonly recommended, first-line antibiotics. This means it may be difficult to treat these infections with the antibiotics usually prescribed for Campylobacter infections. Antibiotic resistance may be associated with increased risk of hospitalization, development of a bloodstream infection, or treatment failure in patients. Using WGS, we identified multiple antimicrobial resistance genes and mutations in most isolates from 38 ill people and 10 puppies in this outbreak. This finding matched results from standard antibiotic susceptibility testing methods used by CDC’s National Antimicrobial Resistance Monitoring System laboratory on isolates from five ill people and seven puppies in this outbreak. The 12 isolates tested by standard methods were resistant to azithromycin, ciprofloxacin, clindamycin, erythromycin, nalidixic acid, telithromycin, and tetracycline. In addition, 10 were resistant to gentamicin, and 2 were resistant to florfenicol.

In interviews, ill people answered questions about the foods they ate and any animal contact in the week before they became ill. Ninety-nine percent of people reported contact with a puppy in the week before illness started, and 87% reported they had contact with a puppy from Petland stores, or had contact with a person who became sick after contact with a puppy from a Petland store. Twenty-five ill people worked at Petland stores.

During the investigation, officials collected samples from pet store puppies for laboratory testing and identified the outbreak strain of Campylobacter in the samples. WGS showed that the Campylobacter isolates from sick people in this outbreak and isolates from pet store puppies were closely related genetically, providing additional evidence that people got sick from contact with pet store puppies.

Ill people reported contact with different breeds of puppies at different store locations in several states. The investigation did not identify a common breeder where puppies infected with the outbreak strain of Campylobacter originated. Puppies in this outbreak may have become infected at various points along the distribution chain when they had contact with infected puppies from other breeders or distributors during transport to pet store locations. Enhanced infection prevention measures throughout the distribution chain may help reduce the spread of Campylobacter infections among puppies.

This multidrug-resistant outbreak highlights the need for responsible use of antibiotics in pets. Education about best practices for Campylobacter disease prevention, diarrhea management in puppies, and responsible antibiotic use is essential throughout the distribution chain to help prevent the emergence and spread of antibiotic resistance. Pet owners should be aware that any puppy or dog, regardless of where it is purchased or adopted, may carry germs like Campylobacterthat can make people sick. Always wash your hands thoroughly with soap and water right after touching puppies and dogs or after picking up their poop. Work with your veterinarian to keep your animal healthy to prevent disease. More information about how to prevent illness when handling puppies and dogs is available for pet owners.

Does Europe have an egg problem? Salmonella cases no longer falling in the EU

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The declining trend of salmonellosis cases in the EU has levelled off according to the annual report on zoonotic diseases published today.

The European Centre for Disease Prevention and Control reports that cases of Salmonella Enteritiis acquired in the EU have increased in humans by 3% since 2014. In laying hens, the prevalence increased from 0.7% to 1.21% over the same period. 

“The increase shown by our surveillance data is worrying and a reminder that we have to stay vigilant,” said Mike Catchpole, ECDC’s Chief Scientist. “Even in a state of high awareness and with national control programmes for S. Enteritidis in place, there is a need for continuing risk management actions at the Member State and EU level,” he added. 

Marta Hugas, EFSA’s Chief Scientist, said: “The decrease of Salmonella has been a success story in the EU food safety system in the last 10 years. Recent S. Enteritidis outbreaks contributed to a change in this trend in humans and poultry. Further investigations by competent authorities in the field of public health and food safety will be crucial to understand the reasons behind the increase.” 

There were 94 530 human cases of salmonellosis reported in the EU in 2016. S. Enteritidis – the most widespread type of Salmonella, accounted for 59% of all salmonellosis cases originating in the EU and is mostly associated with the consumption of eggs, egg products and poultry meat. 

Campylobacter and Listeria

Campylobacter, the most reported food-borne pathogen in humans, was detected in 246 307 people, an increase of 6.1% compared with 2015. Despite the high number of cases, fatalities were low (0.03%). Levels of Campylobacter are high in chicken meat.

Listeria infections, which are generally more severe, led to hospitalisation in 97% of reported cases. In 2016, listeriosis continued to rise, with 2 536 cases (a 9.3% increase) and 247 deaths reported. Most deaths occur in people aged over 64 (fatality rate of 18.9%). People over 84 are particularly at risk (fatality rate of 26.1%). Listeria seldom exceeded legal safety limits in ready-to-eat foods.

Salmonella food-borne outbreaks increasing 

The 4 786 food-borne disease outbreaks reported in 2016 represent a slight increase in comparison with 2015 (4 362 outbreaks), but the figure is similar to the average number of outbreaks in the EU during 2010–2016. 

Outbreaks due to Salmonella are on the rise, with S. Enteritidis causing one in six food-borne disease outbreaks in 2016. Salmonella bacteria were the most common cause of food-borne outbreaks (22.3%), an increase of 11.5% compared to 2015. They caused the highest burden in terms of numbers of hospitalisations (1,766; 45.6% of all hospitalised cases) and of deaths (10; 50% of all deaths among outbreak cases).

Salmonella in eggs caused the highest number of outbreak cases (1 882).

Sounds like Walkerton: More than 750,000 in NZ exposed to potentially unsafe drinking water

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Same old, same old.

Tracy Watkins of Stuff writes complacency, inept officials – a Government inquiry paints a frightening picture of the state of New Zealand’s drinking water, with at least 750,000 of New Zealanders drinking from supplies that are “not demonstrably safe” – a figure described as likely to be a “significant underestimate.”

The inquiry was sparked by the 2016 Havelock North gastro outbreak, which has now been linked to four deaths, and calls for a major overhaul of water supplies, including mandatory treatment.

The Government has now written urgently to all mayors and district health boards asking to check the water they are supplying meets current standards after the inquiry revealed 20 per cent of water supplies were not up to standard.

That 20 per cent affects 759,000 people, of which 92,000 are at risk of bacterial infection, 681,000 of protozoal infection and 59,000 at risk from the long term effects of exposure to chemicals through their water supply.

But that figure was likely to understate the problem, as it did not include more than 600,000 people who drink water from self-suppliers or temporary suppliers, or tourists to places like Punakaiki on the West Coast, which is under a permanent “boil water” notice.

The inquiry found that complacency about the state of New Zealand’s drinking water was common, yet the evidence showed that in many cases it was safer to drink tap water overseas than here.

But its most damning findings related to the Ministry of Health, which it described as inept and negligent in its oversight of a system in which non-compliance with safe standards was high.

The risks for contamination of the water supplies were detailed by the inquiry including damaged pipes, a huge number of private and unknown bores, and the close proximity of sewerage to drinking water assets, a factor that caused surprise among overseas experts.

The second part of the inquiry looked at broader water quality issues.

It found that lessons from Havelock North appeared not to have been learned – compliance figures in the 2016-17 period were still “alarmingly low” and “do not appear to reflect any increased vigilance by suppliers in the aftermath of [that] outbreak”.

“The inquiry found the falling compliance levels with the bacteriological and chemical standards particularly concerning. The decrease in compliance with the bacteriological standards results from an increased number of transgressions, an increased number of supplies with ineffective, delayed or unknown remedial action following transgressions, and an increased number of supplies with inadequate monitoring.

“Twenty-seven supplies failed entirely to take any remedial action after a transgression. In the aftermath of the bacteriological outbreak in Havelock North, these failures to respond effectively to transgressions or to monitor adequately are surprising and unacceptable.”

Less food poisoning associated with employee paid sick time?

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I refer to parenting as hypocrisy disease.

And there’s been more than a few times when Amy has said to me, practice what you preach.

Like barfing and going to work.

People should not work when they are sick.

But in the world of food, people are going to lose their jobs if they don’t show up.

Hsuan et al. write in the American Journal of Preventative Medicine that:

Previous studies suggest an association between paid sick leave (PSL) and better population health, including fewer infectious and nosocomial gastrointestinal disease outbreaks. Yet few studies examine whether laws requiring employers to offer PSL demonstrate a similar association. This mixed-methods study examined whether laws requiring employers to provide PSL are associated with decreased foodborne illness rates, particularly laws that are more supportive of employees taking leave.

Methods:

The four earliest PSL laws were classified by whether they were more or less supportive of employees taking leave. Jurisdictions with PSL were matched to comparison jurisdictions by population size and density. Using difference-in-differences, monthly foodborne illness rates (2000-2014) in implementation and comparison jurisdictions before and after the laws were effective were compared, stratifying by how supportive the laws were of employees taking leave, and then by disease. The empirical analysis was conducted from 2015-2017.

Results:

Foodborne illness rates declined after implementation of the PSL law in jurisdictions with laws more supportive of employees taking leave, but increased in jurisdictions with laws that are less supportive. In adjusted analyses, PSL laws that were more supportive of employees taking sick leave were associated with an adjusted 22% decrease in foodborne illness rates (p=0.005). These results are driven by campylobacteriosis.

Conclusions:

Although the results suggest an association between more supportive PSL laws and decreased foodborne illness rates, they should be interpreted cautiously because the trend is driven by campylobacteriosis, which has low person-to-person transmission.

Association of paid sick leave laws with foodborne illness rates

Am J Prev Med. 2017 Sep 1. pii: S0749-3797(17)30359-8. doi: 10.1016/j.amepre.2017.06.029. [Epub ahead of print]

Hsuan C, Ryan-Ibarra S, DeBurgh K, Jacobson DM

https://www.ncbi.nlm.nih.gov/pubmed/28870665

Campylobacter uses other organisms to multiply and spread

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Campylobacter spp. are extremely sensitive to environmental conditions and do not multiply at temperatures below 30C, however, they can survive temperatures as low as 4C for several months. They remain to be a prevalent pathogen on chicken and identified as a source of many outbreaks associated with unpasteurized milk.

Kingston University researchers have found that Campylobacter jejuni can multiply and spread using another organism’s cells.

Kingston University researchers have shown how a leading cause of bacterial food poisoning can multiply and spread – by using another organism’s cells as a Trojan horse.
Campylobacter jejuni is one of the most common causes of gastroenteritis in the United States and Europe, often infecting humans through raw or undercooked poultry. The new study revealed how the bacteria can infiltrate micro-organisms called amoebae, multiplying within their cells while protected inside its host from harsh environmental conditions.
As well as leading to a better understanding of how bacteria survive, the research could help efforts to prevent the spread of infection, according to lead author and PhD student Ana Vieira.
“Establishing that Campylobacter can multiply inside its amoebic hosts is important, as they often exist in the same environments – such as in drinking water for chickens on poultry farms – which could increase the risk of infection,” she said. “The amoeba may act as a protective host against some disinfection procedures, so the findings could be used to explore new ways of helping prevent the bacteria’s spread by breaking the chain of infection.”
The relationship between Campylobacter and amoebae has been hotly debated in scientific circles – with conflicting findings in previous studies as to whether the bacteria multiply inside, or only in the beneficial environment around, amoebae cells.
The Kingston University team used a modification of a process that assesses the bacteria’s ability to invade cells – called the gentamycin protection assay – to confirm they can survive and multiply while inside the amoeba’s protective environment.
This allows Campylobacter to thrive, escaping the amoeba cells in larger numbers – shining a light on how it spreads and causes disease, professor of microbiology Andrey Karlyshev, a supervisor on the study, explained.
“Our research gives us a better understanding of bacterial survival,” he said. “Because amoebae are widespread, we have shown how Campylobacter bacteria are able to use them as a Trojan horse for infection of the food chain. Otherwise they wouldn’t survive, as they are very sensitive to the environment.”
As part of the study, the researchers showed how a system used by the bacteria to expel toxins – known as a multidrug efflux pump – plays a key role in its ability to thrive within the amoebae.
The team examined how this system helps the bacteria become resistant to antibiotics, which could lead to new methods of preventing resistance from developing, Professor Karlyshev added.
“Campylobacter is becoming increasingly resistant to antibiotics because of their wide use on humans and animals,” he said. “Due to its role in antibiotic resistance and bacterial survival in amoebae, the efflux pump could prove to be a good target for the development of antibacterial drugs.
“Targeting the bacterial factors required for survival within amoebae could help to prevent Campylobacter from spreading in the environment and colonising chickens. This is turn could help reduce its ability to enter the food chain and cause disease in humans.”

 

Use a thermometer: 21 sickened: Campy in UK liver pate, again

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Yorkshire Coast Radio reports Diversorium Ltd, the company which owns and operates the Downe Arms, a country inn hotel in Wykeham near Scarborough, has been fined £8,000 for two serious food hygiene related offences after an outbreak of Campylobacter food poisoning was traced back to contaminated chicken liver pate eaten at the hotel.

Following a prosecution by Scarborough Borough Council, Diversorium Ltd pleaded guilty at Scarborough Magistrates Court to two offences under the Food Safety and Hygiene (England) Regulations after 21 people fell ill following a Christmas party night on 17 December 2016 and a Christmas break package at the hotel during the same month. The court ruled that fines of £5,000 and £3000 respectively should be paid for the offences. The company was also ordered to pay the council £2170 in costs.

The council’s Environmental Health team received complaints from those affected by the food poisoning and during the subsequent investigation it was apparent that there were a number of issues which were not consistent with good hygiene practices and food safety management records were incomplete. In particular, the process for preparing the chicken liver pate had not been validated by appropriate temperature monitoring and recording, and food safety was not being managed effectively. The extensive investigation, carried out in conjunction with Public Health England, concluded that the pate was the most probable cause of the illness. The business was subsequently marked down to a food hygiene rating of 1 (major improvement necessary).

Hockey player diagnosed with Guillain-Barre syndrome

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For some reason, Chapman doesn’t try hard, but he gets the best soundbites

If there was any band to be the lab house band back in the day, it was the Hip.

Hockey, rock ‘n roll, Canada.

Anaheim Ducks forward Patrick Eaves has been diagnosed with Guillain-Barre syndrome, and his hockey career is on hold while he recovers.

The Ducks announced Eaves’ diagnosis Monday, and the club disclosed that the veteran goal-scorer was in intensive care last week.

Eaves is still hospitalized in Newport Beach, California, but his condition has stabilized.

“I’m on the road to recovery,” Eaves said in a statement issued by the Ducks. “I’ve received tremendous amount of support over the last few days, most importantly from my family, friends and teammates. I’m determined to fully overcome this and return to the ice as soon as possible.”

It was probably foodbore Campylobacter.

Guillain-Barre syndrome is a rare disorder in which a patient’s immune system attacks the nervous system, sometimes resulting in death. Eaves’ condition was diagnosed early, an important factor in successful treatment.

Eaves thanked two specialists — Dr. Robert Watkins Sr. and Dr. Danny Benmoshe — for quickly discovering the disorder last week. Ducks general manager Bob Murray also praised the doctors.

“Our sole focus at this time is on Patrick’s general health and well-being,” Murray said. “What defines Patrick Eaves is his strength of character, and that will serve him well in his recovery.”

The 33-year-old Eaves joined the Ducks from Dallas as a late-season trade rental in late February. He played a key role in their push for a fifth straight Pacific Division title, excelling on the power play and racking up 11 goals in 20 games.

Despite missing the final 10 games of the regular season due to injury, he finished with a career-high 32 goals between the Ducks and Stars. He played seven games in the post-season, but sat out the final 10 games with a sprained right ankle while Anaheim reached the Western Conference finals.

Instead of seeking bigger offers in free agency, he re-signed with the Ducks in June, agreeing to a three-year, $9.45 million deal. He was expected to be a key top-six forward for the Ducks this season.

Eaves also has suited up for Ottawa, Carolina, Detroit and Nashville during his 12-year NHL career.


 

7 sick: Not just a UK problem: Outbreak of Campylobacter jejuni associated with consuming undercooked chicken liver mousse

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The U.S. Centers for Disease Control reports that on July 13, 2016, Clark County (Washington) Public Health (CCPH) received a report of diarrheal illness in four of seven members of a single party who dined at a local restaurant on July 6, 2016. The report was received through an online/telephone system for reporting food service–associated illness complaints. Members of the five households in the party reported that their only shared exposure was the restaurant meal. CCPH ordered closure of the restaurant kitchen on July 13, 2016, and began an investigation to identify the source of diarrheal illness and implement additional control measures.

CCPH defined a probable case of restaurant-associated illness as diarrhea lasting >2 days in any restaurant guest or staff member with illness onset from July 1, 2016, to July 23, 2016. After Campylobacter jejuni was cultured from stool specimens submitted by three ill members of the dining party, a confirmed case was defined as culture evidence of C. jejuni infection in any restaurant guest or staff member with onset of diarrheal illness during the same period. Five cases (three confirmed and two probable) were identified, four in restaurant guests and one in a food worker; patient age ranged from 27–46 years; three patients were female.

CCPH conducted a case-control study involving 28 menu items, using 14 non-ill dining companions and restaurant staff members as controls. Consumption of two menu items, chicken liver mousse (odds ratio [OR] = 36.1, 95% confidence interval [CI] = 1.58–828.9), and grilled romaine hearts (OR = 18, 95% CI = 1.19–271.5) were associated with case status. Because of the higher odds ratio of chicken liver mousse and previous Campylobacter outbreaks associated with chicken livers (1,2), the investigation focused on the mousse.

During an inspection on July 15, the sous-chef solely responsible for preparing the chicken liver mousse demonstrated preparation to the CCPH food safety inspector, who observed that the sous-chef used the appearance of the livers alone to determine whether they were fully cooked. Final internal cook temperature of the largest liver measured by the inspector was <130°F (54°C), below the minimum 165°F (74°C) internal temperature deemed necessary by the Food and Drug Administration to eliminate food safety hazards (3). Because raw chicken parts are not required to be free of Campylobacter (4), and the bacteria might be present on the surface of 77% of retail chicken livers (5), CCPH immediately addressed undercooking of the livers.

One patient stool specimen isolate was available for typing by pulsed-field gel electrophoresis (PFGE). The PFGE pattern from this isolate was indistinguishable from those obtained from two chicken liver samples collected in a 2014 campylobacteriosis outbreak in Oregon (1). Chicken livers associated with both the 2014 outbreak and with this outbreak were supplied by the same company. Chicken livers from the lot served at the restaurant on the day of the implicated meal were no longer available; therefore, the U.S. Department of Agriculture could not pursue testing of chicken liver samples.

Among published C. jejuni outbreaks associated with undercooked chicken livers, this outbreak report is the second from the Pacific Northwest (1), and the first in the United States initially reported through an illness complaint system. Because CCPH does not actively investigate Campylobacter cases in persons aged >5 years, and because Campylobacter PFGE is not routinely conducted in Washington, this outbreak would have likely gone undetected if not for the illness complaint system, demonstrating the value of illness complaint investigations to identify outbreaks and mitigate public health risks.

NZ campy outbreak cost $21m

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In Aug. 2016, some 5,500 people in a New Zealand town of 14,000 were sickened with Campylobacter linked to the water supply and three died.

Didn’t chlorinate.

Eric Frykberg of RadioNZ reports the NZ Ministry of Health has found Havelock North’s water contamination cost about $21 million – with residents the worst affected.

The campylobacter infection hit the town last August and afflicted more than 5,000 people with illness, filling the hospital and potentially contributing to three deaths.

The investigators measured the next best thing that people could have been doing if they had not been sick. That and the value of direct costs added up to the total figure of $21,029,288.

A report commissioned by the ministry said some 5088 households were affected by the crisis, and the cost to each household was about $2440.

Those costs included the cost of people getting sick and being unable to go to work or school or carry out other tasks.

Some were unable to look after their children, while others had to drive all over town to visit doctors or to get fresh water or other supplies.

They also had to do far more laundry and cleaning.

This left the households to foot a bill of more than $12,420,000 making up the majority of all costs from the crisis.

The report also said not all consequences of the outbreak could be quantified in monetary terms, with personal stress, loss of public faith in the water supply, and “scarring” of the community adding to the societal bill.

The report said about 25 percent of the population of Havelock North was aged over 65 based on the 2013 Census, and the town also had a large number of school aged children.

Fancy food ain’t safe food, Mark Sergeant’s Rocksalt edition

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An award-winning Folkestone, UK, restaurant run by celebrity chef Mark Sergeant has been given a low food hygiene rating.

Inspectors discovered ‘unsafe’ cooking procedures at Rocksalt, in Folkestone Harbour and the top eatery was told ‘improvement is necessary’.

Callum Wilson of Kent Live reports the damning Environmental Health report, inspectors said diners were at risk of food poisoning.

The restaurant, which has previously received rave reviews, has now had its five star rating taken away and replaced with the much lower rating ‘requires improvement’.

A Shepway District Council environmental health officer took the perfect score away after finding a ‘high risk’ chicken liver was undercooked.

The officer said: “I noted some cooking procedures that could lead to an unsafe product. For example: chicken livers maybe cooked “medium”.

“Chicken liver pate is cooked in the combi-oven. Core temperature is monitored using a probe and the product is considered cooked when it reaches 70 C.

“The time temperature combination for thorough cooking is 70C held for 2 minutes.”

In a warning to the restaurant, the officer said: “Please ensure chicken products are thoroughly cooked (as per your HACCP procedure for high risk products)”.

Rocksalt is co-owned by celebrity chef Mark Sargeant and Josh DeHaan and opened in 2011.

No one at the restaurant was available for comment.

However, a post appeared on the Rocksalt website saying: “We have requested a revisit and have addressed the single cooking technique deemed incorrect.

“We have urgently retrained all staff to our correct procedure.”