Driving down I-75 from Detroit to Englewood, Florida (starting point was Brantford, Ontario, that’s in Canada) for a couple of weeks became a summer-time routine because gramps was only there in his mobile home in the winter months, and I guess it prepped me for summers in Kansas and Brisbane.
But we never stopped at a Cracker Barrel which littered the Interstate.
Despite its down-home appearance, the food was shit and over-priced.
According to Fox 55the clock is ticking for customers to get vaccinated after a Saginaw County restaurant worker tests positive for Hepatitis A.
The person last worked at the Bridgeport Township Cracker Barrel on Sunday, Aug. 25.
But the Saginaw County Health Department (SCHD) is urging anyone who ate there between Sunday, Aug. 25 and Wednesday, Aug. 28 to get vaccinated right away.
“With an exposure you have up to two weeks to get vaccinated,” explained Health Officer Christina Harrington with the SCHD. “It’s going to prevent you from getting the disease.”
And yes, I own this album (above, left, listen for the reference to I-75 in the version below) and Chapman hates it.
According to Produce Retailer, online grocery shopping remains an option that most people do not use, according to a new poll.
Gallup found that 81% of U.S. consumers never order groceries online, while 11% do so at least once a month, according to a news release.
That’s nice.
I remember a line from a Kurt Vonnegut novel about how increasing technology would be silly because he wouldn’t be able to go to the bank and chat with his favorite teller.
I’m back home now after almost 3 weeks away, and it’s a shock.
Sure there’s booze and genetics, but there’s other stuff going on in my brain that we mere mortals just can’t diagnose at this time.
My brain will go to the Sports Bank in Sydney when I die.
But that may not be for a long time.
And I can’t imagine life without going to my Commons and laboratory – the supermarket – at least every other day.
I am fortunate to be surrounded by people and professionals who love and care for me. It’s quite humbling, but as Chapman has said, I’ve done my time and don’t owe anyone anything.
Ben, that’s not how it works.
I decided to change things up while my partner and daughter went to the U.S. for two weeks and I tried out a new mental health facility.
After almost three weeks I am revitalized, passionate, and engaged.
I’m writing, I’m exercising, I’m eating well, I’m heathy. These are the cornerstones of on-going functioning.
And I’m finally starting – if not to love myself – to better understand who I am, what’s actually important, and the awful, awful damage that alcohol and the pursuit of being important has done to myself and those around me.
And all those pucks to the head, the PTSD from the car crash, the four years of playing linebacker in football, and the numerous concussions from just falling down.
If it gets to on-line grocery shopping, cart me away.
Rebecca Trager of Chemistry World reports U.S. researchers have created a handheld detection system that is sensitive enough to catch just a few particles of norovirus.
University of Arizona biomedical engineer Jeong-Yeol Yoon and his team have created a highly sensitive portable detection system capable of spotting norovirus at levels that can make people sick. The work was presented the American Chemical Society’s national meeting in San Diego, California on 27 August.
As few as 10 norovirus particles can cause vomiting and diarrhoea in humans and the virus is extremely contagious so early detection is vital to prevent outbreaks. However, the virus does not grow in laboratory cultures and current detection methods rely on specialised and time-consuming PCR (polymerase chain reaction) techniques.
Yoon’s research team previously developed a smartphone-based device that measured light-scattering from norovirus-bound polystyrene beads in a paper microfluidic chip. It has now improved the device’s detection limit by changing to a fluorescence-based method.
‘I looked at Amazon.com and saw that they sell a lot of these smartphone attachments – smartphone microscope attachments – that turn your phone turns into a microscope, and by adding a couple of other components, I could convert the smartphone-based microscope into a fluorescence microscope,’ Yoon explains.
The setup uses a microscope accessory with a separate light source and two optical filters. He and colleagues also designed a 3D printed case to house the components.
To test a sample, it is first added to the paper microfluidic chip, followed by a suspension of fluorescent beads labelled with norovirus antibodies. After three to five minutes, the antibodies bind to any norovirus particles in the sample, creating aggregates of the fluorescent beads that spread out along the channels of the chip. The resulting increase in fluorescence intensity around each norovirus particle can be detected by taking a picture of the chip with the smartphone’s camera.
An app that the team has also developed then analyses the picture to calculate the sample’s norovirus concentration from the pixel count in the image. So far, the lowest detection limit corresponded to about 5 or 6 norovirus particles per sample, Yoon says. He estimates that the material costs of this system, aside from the cell phone and app development costs, are about $200.
Every year, studies about food handlers’ food safety knowledge, attitudes, and practices are published. Some results of these papers have been rather controversial, especially those related to food safety practices.
The two most common methods for evaluating food safety practices – self-assessment and observation – are generally treated as interchangeable, but they can have different meanings. The objective of this study was, therefore, to differentiate between the observed and self-reported food safety practices of food handlers, verifying the effect of different variables in these food safety indicators through structural equation modeling, and examining the relationship between cognitive factors and these practices.
A questionnaire with 37 questions was given to 183 food handlers to evaluate their food safety knowledge, attitudes, self-reported practices, and risk perceptions. For the observed assessment method of evaluating the food handlers’ practices (observed practices), a checklist was developed, and food handlers were observed during one workday.
Two models were developed based on the results of these two assessment methods. In the first model a significant positive effect of knowledge and a negative effect of risk perception on self-reported practices were observed. Food handlers with high risk-perception about their practices reported less adequate practices. Positive food safety attitudes acted as a moderator dampening the positive effect between knowledge and self-reported practices. In the second model a significant positive effect of knowledge on observed practices. Attitudes strengthened the positive effect between knowledge and observed practices.
A direct effect of attitude on observed practices was not observed. In conclusion, self-reported practices and observed practices are different and should be used and discussed properly.
The differences between observed and self-reported food safety practices: A study with food handlers using structural equation modeling 23 August 2019
The U.S. Centers for Disease Control reports in August 2018, two Oregon patients with diagnosed Salmonella infection were interviewed using a standard enteric illness questionnaire; both patients reported having eaten raw cake mix.
Standardized interview questionnaire data collected from 207 Oregon patients with salmonellosis in 2017 indicated a 5% rate of consumption of raw “cake mix or cornbread mix” (Oregon Health Authority, unpublished data, 2017). The binomial probability that both 2018 patients were exposed to raw cake mix by chance was determined to be 0.003, prompting the Oregon Health Authority (OHA) to collect and test the contents of 43 boxes of unopened cake mix of various brands from six retail locations. OHA sent samples to the Institute for Environmental Health Laboratories in Lake Forest Park, Washington, for pathogen testing. Salmonella Agbeni was isolated from an unopened box of white cake mix from manufacturer A, and whole genome sequencing (WGS) data describing the isolate were uploaded to the U.S. National Library of Medicine’s National Center for Biotechnology Information (NCBI) website (https://www.ncbi.nlm.nih.gov/pathogensexternal icon). OHA used the NCBI database to compare sequence data with the cake mix isolate (PNUSAS056022) and then consulted CDC’s System for Enteric Disease Response, Investigation, and Coordination (SEDRIC), a web-based, outbreak investigation tool designed for collaborative, multistate investigations of enteric disease outbreaks.* On October 19, OHA determined that clinical isolates from four patients from Maryland, Ohio, and Wisconsin, with specimen isolation dates ranging from June to September 2018, were genetically related to the Salmonella Agbeni isolate from the unopened box of white cake mix, within four single nucleotide polymorphisms (SNPs).
On October 22, 2018, OHA notified state public health counterparts in the three states of this finding and inquired about raw cake mix exposures among their patients. The Wisconsin patient reported having consumed an entire box of raw white cake mix over several days during the likely exposure period. In addition, WGS analysis indicated that this clinical isolate was closely related genetically (within one SNP) to the isolate cultured from the Oregon white cake mix. On October 25, CDC requested officials in Maryland, Ohio, and Wisconsin to interview patients using a questionnaire with specific questions about baking exposures.
On October 31, the Food and Drug Administration (FDA) initiated an investigation of manufacturer A with regard to the Salmonella-positive white cake mix. In addition to the investigation and document collection, FDA collected samples including an ingredient (flour), finished cake mix, and environmental samples. All collected samples tested negative for Salmonella. On November 5, a voluntary recall of manufacturer A’s classic white, classic butter golden, signature confetti, and classic yellow cake mixes was announced because they might be contaminated with Salmonella bacteria.
On January 14, 2019, CDC declared this outbreak, which totaled seven cases in five states,† to be over (1). This is the first time that OHA used WGS data on the publicly available NCBI website to detect a multistate outbreak associated with a widely distributed consumer product, which resulted in product action. WGS of food and environmental isolates and subsequent analysis on the NCBI and SEDRIC platforms are emerging as useful tools in identifying outbreaks associated with widely distributed products with long shelf lives and low background rates of consumption, such as raw cake mix. Detection of these outbreaks is typically difficult and relies mainly upon epidemiologic evidence from investigation of a larger number of cases (2–4). These efforts also highlight the value of collaboration between public health epidemiologists and laboratorians as well as the use of new technological tools for outbreak detection. During outbreak or cluster investigations, food and environmental samples should be collected as quickly as possible whenever practical, particularly when epidemiologic data suggest an association. WGS, in conjunction with the NCBI website and SEDRIC, can be used to identify genetically related isolates quickly.
US: Notes from the field: Multistate outbreak of salmonella Agbeni associated with consumption of raw cake mix – five states, 2018
The ‘Poop it’ kit uses illustrated stories and rewards to educate four to eight-year-olds about what a healthy poo looks like.
It was developed by Professor Kerry Reid-Searl from CQUniversity, who partnered with paediatric nurses, academics, and undergraduate students.
The inspiration behind the project comes from the professor’s desire to take the embarrassment out of talking about what we flush down the toilet.
“Many people are ashamed or reluctant to talk about poo, yet there is such an important link between good health and poo,” she said.
“As a nurse I have encountered many children with bowel problems, and my understanding from the anecdotal responses from parents of these children is that the psychosocial impact can be significant.
“So this project is very much about giving children an awareness of a topic that probably fascinates them, but more importantly provides them with information that can influence their everyday being.”
What does a healthy poo look like?
It’s already a topic that gets kids giggling. But to make learning about what goes into making good and bad poo fun, the professor and her team created characters that illustrate the meaning behind the shape of the poo we make.
“There are seven different types of poos, from rabbit droppings right through to gravy-type poos, but the best healthy poo is a sausage-shaped poo where it’s like a sausage — smooth and brown.”
Personally, my family has no taboos when talking about poo or farts or burps – expected from someone who’s idea of community service is writing on barfblog.com – at least until Sorenne reaches puberty, which is soon, and then I’ll just be an embarrassment until she needs money, about 10 years later. If the 4 Canadian daughters are anything to go by (right, with my father, Jan. 2019 in Brantford) it’s a set pattern.
And it may be arriving sooner than expected. I just facetimed daughter S in Arizona where she is staying with her maternal grandmother for the night, and she blew me off after a couple of minutes to go chat with a friend in Brisbane.
Emergency units on the island received several patients reporting food poisoning symptoms after eating at the restaurant, which as then identified as the source of the illness.
The Balearic Islands’ public health department says the number of cases could rise even higher because some are not reported immediately when initial symptoms are less severe.
Proceedings against the restaurant have been opened by local government bodies.
Thousands of British holidaymakers visit Majorca each year with many heading to resorts like Magaluf and Palma Nova that are just a short bus or taxi ride from the capital.
I love my shellfish – mussels and scallops (oysters are sorta gross) – but the kid was diagnosed with a shellfish allergy so they’re an occasional lunch while she’s at school.
Health types in the UK report on six cases of diarrhetic shellfish poisoning (DSP) following consumption of mussels in the United Kingdom (UK). The mussels contained high levels of heat-stable okadaic acid (OA)-group toxins. Here we describe the environmental and epidemiological investigation carried out in response to the outbreak.
In June 2019 (day 0), Public Health England South West was notified by the local authority of three diners who were unwell following consumption of mussels in a restaurant 5 days earlier. The local authority had determined that the restaurant had had received a batch recall notice, also 5 days earlier, from the shellfish producer for the mussels because of elevated toxin levels but this was not seen before the mussels were served that day. On day 1, PHE South West received a report from the county neighbouring the first of gastrointestinal illness linked to mussels from the same producer. A multi-agency outbreak control team was therefore convened on day 2 and led by the PHE South West health protection team.
An alert was sent to all health protection teams across England on day 2 asking about any reported cases of gastrointestinal illness following consumption of mussels. Local authorities in areas of product distribution were informed of the identified risk by email. Persons reporting illness who were identified by local authorities as having consumed the affected mussels were asked by PHE to complete a bespoke questionnaire on exposure and clinical data.
A probable case of DSP was defined as an individual with diarrhoea, three or more loose stools in 24 h, or vomiting or abdominal cramps or nausea, with date of onset from 7 days before to 1 day after notification of the outbreak, and time of onset 30 min to 24 h following consumption of mussels harvested from the affected site. Confirmed cases were as probable, but with an absence of pathogens in a stool sample that would otherwise explain illness.
Thirteen individuals reported to have been unwell after consumption of mussels were contacted. Completed questionnaires were received from seven individuals, of which three were confirmed, and three probable cases. The cases ate at four separate venues. One respondent did not meet the case definition as symptom onset was more than 24 h following consumption.
The mean age of cases was 59 years (range: 37–76 years); three were male and three were female. All cases reported eating steamed mussels. Five cases ate mussels as a main course and one as a starter. Reported portion sizes ranged from 11 to 50 mussels.
The mussels were produced in an offshore marine area. A routine shellfish monitoring programme is in place throughout England and Wales, including at the affected site. As a part of this programme, the water column is sampled every 2 weeks from April to September and cell counts of potentially harmful algal species are measured. Shellfish flesh samples are also tested for the presence of selected European Union (EU)-regulated biotoxins every 4 weeks during April to September each year unless phytoplankton counts and/or shellfish toxins are quantified above specified warning limits that require further precautions, including re-testing and closure.
Lipophilic toxin determination, including that for OA-group toxins, is routinely carried out using the method specified in in the EU-Harmonised Standard Operating Procedure for determination of lipophilic marine biotoxins in molluscs by LC-MS/MS [1]. Additional flesh and water samples were taken in advance of the planned sampling date following a report to the local authority from a local fisherman of a red-coloured algal bloom six miles offshore from the production site.
The local authority determined the source of the mussels by questioning venues linked to reports of illness. Subsequently, the shellfish producer provided the outbreak control team with a complete list of all businesses who had received the affected mussels. Mussels from the site were harvested daily from 9 to 5 days before notification of the outbreak for commercial sale. The mussels were not tested by the producer for the presence of toxins. A large volume of mussels was distributed to seafood wholesalers, restaurants and pubs, and subject to the recall notice distributed by the producer 5 days before reports of illness to PHE. A limited number of businesses not linked to any known cases, including wholesalers, retailers, restaurants and pubs, responded to the recall stating they had sold some of the affected produce. No produce was found to still be in circulation at the time of the outbreak response.
Water column and shellfish flesh sampling results are summarised in Table 2. Measured densities of Dinophysis spp. in the water column increased rapidly from being undetectable 16 days before outbreak notification to 1,600 cells per litre 7 days before, coinciding with the time of harvesting of the affected batch and exceeding the England, Wales and Northern Ireland Food Standards Agency trigger level of 100 cells per litre. The level of total OA-group lipophilic toxins in mussel flesh was 338 µg OA equivalents (eq) per kg, following application of measurement uncertainty, 7 days before outbreak notification. This exceeded the maximum permitted limit (MPL) of 160 µg OA eq per kg defined by European Commission (EC) regulation 853/2004 [2]. Toxin concentrations quantified showed that an average of 94% of the OA-group toxins present in the mussels consisted of OA itself, with the remainder being dinophysistoxin 2 (DTX2).
Water column sampling 7 days before outbreak notification did not detect other harmful algal species apart from Pseudo-nitzschia spp., the causative diatom for domoic acid responsible for amnesic shellfish poisoning, at 1,320 cells per litre. This is below the trigger level of 150,000 cells per litre for this species.
Routine shellfish sampling at the same site during the same time period did not detect paralytic shellfish poisoning toxins. Trace levels of yessotoxins were detected, but along with traces of azaspiracids, they were well below regulatory levels. Amnesic shellfish poisoning toxins were below the limit of quantitation (LOQ).
In response to the elevated toxin levels quantified and reported 5 days before outbreak notification, the shellfish bed was immediately closed for harvesting as per standard practice in England. The Food Standards Agency urgently contacted local authorities of places where the affected product had been distributed to ensure that wholesalers and venues had acted upon the recall. Venues were asked whether any product had been frozen, for example in the form of stock, as this would not deactivate the toxin, but there was no evidence this had been done.
Discussion
We report on six cases of DSP associated with consumption of mussels harvested in the South West of England. Without an available validated test for relevant toxins in human samples, the diagnosis was made based on characteristic clinical symptoms, including diarrhoea, abdominal pain, nausea and fever/chills, elevated levels of OA-group toxins in the flesh of mussels from the same batch as those consumed, the absence of faecal pathogens in stool of cases and epidemiological evidence of exposure to the produce.
DSP occurs following consumption of seafood containing high levels of the heat-stable OA-group toxins produced by dinoflagellates including Dinophysis spp., and is characterised by a rapid-onset of self-limiting gastrointestinal illness [3,4]. Recognised outbreaks of DSP are rare. Seventy cases were identified in 2013 following consumption of mussels harvested around the Shetland Islands [5] and 49 cases were identified in 1998 following consumption of UK-harvested mussels in London [6]. Outbreaks have been recorded in recent years in China, the United States, France and Canada [4,7–9].
The lowest-observed-adverse-effect level of OA is 45 to 50 µg OA eq per person [4,10]. In our study, an average main course portion of mussels (500 g in shell) would provide 41 µg OA eq., using a flesh weight yield of 24% [11]. This level of exposure is consistent with DSP as the cause of illness considering variability in portion sizes, flesh yield, body weight and toxin levels at the production site. Individual mussel sizes served were unavailable but would likely vary. Therefore, overall estimated portion weight was used to calculate the exposure dose. A limitation is that body weight (bw) was not recorded for cases and because of this, OA eq per kg bw could not be calculated.
A shellfish biotoxin programme monitoring the occurrence of harmful algal blooms and toxins in classified shellfish production areas in the UK, alongside food business operator checks, remains a robust system to protect population health. Nonetheless, a rapid increase in concentrations of Dinophysis spp. cells within the waters of the production site may have contributed to the outbreak, in tandem with shellfish harvesting occurring before official control results were reported and site closure. Whyte et al. (2014) demonstrated that a similar rapid increase in Dinophysis levels, resulting from a change in prevailing wind direction, occurred in the 2013 Shetland Islands origin outbreak [5]. Transdisciplinary research is required to predict future risk and inform monitoring, particularly given likely changes in the distribution of potentially-toxic species particularly if temperature of ocean water increases [12]. Our investigation suggested that affected produce may have been sold by restaurants and pubs with no known linked cases. Given that DSP is a self-limiting illness that may be under-reported by cases and has low awareness among clinicians, the actual number of persons affected in this outbreak is likely to be higher [13].
This outbreak highlights that clinicians and public health professionals should be aware of algal-derived toxins as a potential cause of illness following seafood consumption, and that the need for effective end-product testing of shellfish to ensure food safety remains.
Outbreak of diarrhetic shellfish poisoning associated with consumption of mussels, United Kingdom, May to June 2019
Mohamad Fadli Mohd Saleh, 38, an auxiliary police officer, died of sepsis and multi-organ failure a week after eating from a bento box prepared by Spize.
This was about five hours after the food had been prepared at Spize’s River Valley outlet between 9.30am and 10.30am.
A post-mortem initially stated the cause of Fadli’s death as cardiorespiratory failure.
A subsequent report found that Fadli had died of sepsis and multi-organ failure following acute gastroenteritis.
Seven separate suspected food-borne incidents were linked to Spize between Nov. 6 and 9.
Numbers
211 people consumed food from Spize.
73 people fell sick
47 people of them were hospitalised, including Fadli
36 tested positive for salmonella
The other 35 have recovered from salmonella.
The salmonella outbreak was described as “unusually severe”.
Salmonella is a “self-limiting disease”, with an incubation period of between 12 and 36 hours.
This Spize incident had an immediate incubation period that was much shorter, within just eight hours, and there was a high hospitalisation rate.
The possibility of there being a virulent strain of pathogens was ruled out after an investigation.
The severity of those affected was perhaps due to the increased bacteria loads of the contaminated food item.
Details of packed bento:
There were three types of rice placed in the bento boxes:
Indonesian rice, which included egg fried rice, prawn omelette mung beans and tofu;
Malaysian rice, which included kampung fried rice, chicken sambal and stir-fried morning glory; and
Chinese rice, which was egg fried rice with Chinese sausage, omelette, crispy fish and other ingredients.
State coroner Kamala Ponnampalam said in her case findings Aug 23/19, “The joint investigations by the agencies uncovered several alarming lapses in the food handling and food preparation methods which directly contributed to the outbreak of acute gastroenteritis,” said the coroner.
Strains of salmonella were found on the ready-to-eat bento sets at Spize’s River Valley Road outlet, where the food was prepared.
The bacteria was also found on raw food items and commonly touched surfaces such as a door handle leading to a cold room and the cold room rack at the restaurant.
“This was suggestive of cross-contamination with raw meat, borne by the food handlers,” said the coroner.
“There was also faecal matter detected in the ready-to-eat food (belacan egg fried rice) and on the kitchen tools like the chopping board and knife used in the chicken rice preparation which points to poor hygiene practices, either in the handling of unclean raw meat, or in poor personal hygiene.”
Seven of the 34 food handlers were not registered with NEA and had not attended the basic food hygiene course.
There was no soap provided at the restaurant’s basin, so it was likely that the food handlers did not wash their hands with soap before handling cooked ingredients, preparing meals, after handling raw ingredients, or after touching other parts of the kitchen.
This could have led to cross-contamination of salmonella bacteria between the raw ingredients and cooked food, the court heard.
But we never stopped at a Cracker Barrel which littered the Interstate.
But the Saginaw County Health Department (SCHD) is urging anyone who ate there between Sunday, Aug. 25 and Wednesday, Aug. 28 to get vaccinated right away.
