It was probably the raw egg butter: 11 sick with Salmonella, Australia still has an egg problem

A salmonella outbreak linked to three bakeries in the northern suburbs has left nine people in hospital.

SA Health has confirmed 11 cases of salmonella have been reported after people ate Vietnamese rolls from three Angkor Bakery stores.

Deputy chief medical officer Dr Nicola Spurrier said that of those eleven people, nine were hospitalised due to the severity of the poisoning.

 “Early investigations indicate the cases could be linked to raw egg butter, pate or BBQ pork ingredients.

“The businesses complied with a council request on Tuesday to cease using these ingredients and, from today, the businesses have agreed to cease selling all Vietnamese rolls until the source has been identified.

“Cleaning and sanitising procedures have also been assessed and improved,and will continue to be monitored.”

An updated table of raw-egg related outbreaks in Australia is available at raw-egg-related-outbreaks-australia-2-3-2019

Stool samples, Australian style

When I was in the hospital last week for recurring gall issues, I provided a stool sample to check for C. difficile.
Stool samples are the cornerstone of foodborne illness outbreak investigation.
This is what Chapman pooped in to about 8 years ago in Kansas.
Campylobacter and didn’t just hate my cooking.
I was curious about the Australian way, and followed the nurse around.
And took pictures.

Listeria happens in lotsa folks, and not pretty

Listeria monocytogenes is a foodborne pathogen that disproportionally affects pregnant females, older adults, and immunocompromised individuals. Using U.S. Foodborne Diseases Active Surveillance Network (FoodNet) surveillance data, we examined listeriosis incidence rates and rate ratios (RRs) by age, sex, race/ethnicity, and pregnancy status across three periods from 2008 to 2016, as recent incidence trends in U.S. subgroups had not been evaluated. The invasive listeriosis annual incidence rate per 100,000 for 2008–2016 was 0.28 cases among the general population (excluding pregnant females), and 3.73 cases among pregnant females.

For adults ≥70 years, the annual incidence rate per 100,000 was 1.33 cases. No significant change in estimated listeriosis incidence was found over the 2008–2016 period, except for a small, but significantly lower pregnancy-associated rate in 2011–2013 when compared with 2008–2010. Among the nonpregnancy-associated cases, RRs increased with age from 0.43 (95% confidence interval: 0.25–0.73) for 0- to 14-year olds to 44.9 (33.5–60.0) for ≥85-year olds, compared with 15- to 44-year olds. Males had an incidence of 1.28 (1.12–1.45) times that of females. Compared with non-Hispanic whites, the incidence was 1.57 (1.18–1.20) times higher among non-Hispanic Asians, 1.49 (1.22–1.83) among non-Hispanic blacks, and 1.73 (1.15–2.62) among Hispanics. Among females of childbearing age, non-Hispanic Asian females had 2.72 (1.51–4.89) and Hispanic females 3.13 (2.12–4.89) times higher incidence than non-Hispanic whites. We observed a higher percentage of deaths among older patient groups compared with 15- to 44-year olds.

This study is the first characterizing higher RRs for listeriosis in the United States among non-Hispanic blacks and Asians compared with non-Hispanic whites. This information for public health risk managers may spur further research to understand if differences in listeriosis rates relate to differences in consumption patterns of foods with higher contamination levels, food handling practices, comorbidities, immunodeficiencies, health care access, or other factors.

Differences among incidence rates of invasive Listeriosis in the U.S. FoodNet population by age, sex, race/ethnicity, and pregnancy status, 2008–2016

Pohl, A. M., Pouillot, R., Bazaco, M. C., Wolpert, B. J., Healy, J. M., Bruce, B. B., . . . Doren, J. M. (2019).

doi:10.1089/fpd.2018.2548

https://www.liebertpub.com/doi/full/10.1089/fpd.2018.2548

Rotavirus or Norovirus: They’re both spread by poo and lousy handwashing

Rotavirus is a leading cause of acute gastroenteritis (AGE) in children and is highly transmissible. In this study, we assessed the presence of AGE in household contacts (HHCs) of pediatric patients with laboratory-confirmed rotavirus.

 

Between December 2011 and June 2016, children aged 14 days to 11 years with AGE were enrolled at 1 of 7 hospitals or emergency departments as part of the New Vaccine Surveillance Network. Parental interviews, medical and vaccination records, and stool specimens were collected at enrollment. Stool was tested for rotavirus by an enzyme immunoassay and confirmed by real-time or conventional reverse transcription-polymerase chain reaction assay or repeated enzyme immunoassay. Follow-up telephone interviews were conducted to assess AGE in HHCs the week after the enrolled child’s illness. A mixed-effects multivariate model was used to calculate odds ratios.

Overall, 829 rotavirus-positive subjects and 8858 rotavirus-negative subjects were enrolled. Households of rotavirus-positive subjects were more likely to report AGE illness in ≥1 HHC than were rotavirus-negative households (35% vs 20%, respectively; P < .0001). A total of 466 (16%) HHCs of rotavirus-positive subjects reported AGE illness. Of the 466 ill HHCs, 107 (23%) sought healthcare; 6 (6%) of these encounters resulted in hospitalization. HHCs who were <5 years old (odds ratio, 2.2 [P = .004]) were more likely to report AGE illness than those in other age groups. In addition, 144 households reported out-of-pocket expenses (median, $20; range, $2–$640) necessary to care for an ill HHC.

Rotavirus-associated AGE in children can lead to significant disease burden in HHCs, especially in children aged <5 years. Prevention of pediatric rotavirus illness, notably through vaccination, can prevent additional illnesses in HHCs.

Evidence for household transmission of rotavirus in the United States, 2011-2016

7.feb.19

Journal of the Pediatric Infectious Diseases Society, https://doi.org/10.1093/jpids/piz004

Mary E Wikswo, Umesh D Parashar, Benjamin Lopman, et al

https://academic.oup.com/jpids/advance-article-abstract/doi/10.1093/jpids/piz004/5310348?redirectedFrom=fulltext

Food safety culture and Fonzie

I thought food safety culture was sorta cool when I came up with it, independently, in 2006 at IAFP, with Amy the French professor’s inspiration, but soon realized it was just another catch-phrase.

Sorry Frank and Chris.

Culture may mean not repeating the past.

So I chuckled with the onset of age and dementia when Issue 8 of the BRC Food Safety Global Standard, which came into force 1st February 2019, introduced a new clause requiring all companies to:

“Define and maintain a clear plan for the development and continuing improvement of a food safety and quality culture.” This plan must include defined activities for all areas impacting product safety with an action plan on how this is undertaken and measured, and a timeline for implementation. This plan also needs to be reviewed to ensure effectiveness.

A food safety culture is the “shared values, beliefs and norms that affect the mindset and behaviour towards food safety in, across and throughout an organisation.”

“Culture is an instrumental factor in nurturing an organisation’s food safety compliance and is regulated by senior management, most of whom recognise its importance, but often overestimate the level of employee commitment and underestimate the resources needed to maintain it. In reality it cannot be a one-off initiative but requires ongoing commitment to foster a sustained proactive food safety culture.”

Sure, the top-types need to set the tone, but culture is when everyone on the front-line knows microbial food safety.

I always advocated a bottom up kinda approach: the whole concept of food safety culture is empowering the weak links in the food safety system, from farm to fork. Top down will fail, besides, food safety culture jumped the shark years ago.

NSF have developed the food safety culture model which is a web-based application that allows you to undertake a food safety culture survey across your business. It provides comprehensive information to measure your food safety cultural maturity risk level on a risk-rated scale from 1-5.
Uh, OK.

Food safety types need to be more creative with the message and the medium.

Why whole genome sequencing is important for food safety

In 1999, I gave a talk to hundreds of farm leaders in Ottawa and told them that DNA fingerprinting – via PulseNet – would revolutionize foodborne illness outbreak investigations and that farmers better be prepared (the pic is from a 2003 awards ceremony where I was acknowledged for my outreach and extension efforts, the hair was fabulous).

Twenty years later and whole genome sequencing is even further piecing together disparate outbreaks.

Joanie Stiers of Farm Flavor writes that Michigan’s laboratory toolbox now includes whole-genome sequencing, allowing public health officials to stop the spread of foodborne illness faster than ever.

Since January of 2017, the Michigan Department of Agriculture and Rural Development (MDARD) has actively used whole-genome sequencing to precisely identify illness-causing pathogens and defend against widespread outbreaks of foodborne diseases.

MDARD’s Geagley Laboratory works in tandem with laboratories in the U.S. Food & Drug Administration’s GenomeTrakr network, which allows global collaboration in the fight against foodborne illness.

“With food now being distributed worldwide, illness can be spread from anywhere in the world,” says Ted Gatesy, laboratory manager of the microbiology section at Geagley Lab, which houses the whole-genome sequencing. “Using whole-genome sequencing, an illness can be tracked, for the most part, to the point in the food chain where it originated.

Fun with fermentations: Latic acid can maybe make sprouts safer

Legume seeds and sprouts are a rich source of phytoestrogens in the form of isoflavonoids. For the first time, lactic acid fermentation of four types of legume sprouts was used to increase the content of isoflavonoids and microbiological safety.

After germination, the highest content of isoflavonoids was observed in the clover and chickpea sprouts, which amounted to 1.1 g/100 g dw., whereas the lactic acid fermentation allowed the increase to as much as 5.5 g/100 g dw. The most beneficial properties were shown by fermented chickpea sprouts germinated in blue light.

During fermentation the number of lactic acid bacteria increased by 2 Log10CFU/mL (LU), whereas mold decreased by 1 LU, E.coli and Klebsiella sp. by 2 LU, Salmonella sp. and Shigella sp did not occur after fermentation, similar to Staphylococcus epidermidis, while S. aureus and S. saprophyticus decreased by 3 LU and in some trials were not detected.

Lactic acid fermentation of legume seed sprouts as a method of increasing the content of isoflavones and reducing microbial contamination

6.feb.19

Food Chemistry, https://doi.org/10.1016/j.foodchem.2019.01.178

GrażynaBudryn, ElżbietaKlewicka, JoannaGrzelczyk, IlonaGałązka-Czarnecka, Radosław Mostowski

https://www.sciencedirect.com/science/article/pii/S0308814619302675

Washing does almost nothing, except remove the snot from the 3-year-old who sneezed on it

This is a risk communication embarrassment.

Stop Foodborne Illness published this thing the other day, about Rylee & Rusty (not sue if those names were chosen by focus group).

Anyone who writes in all caps is compensating for something, just like I’ve always told my daughters, anyone who says trust me is immediately untrustworthy.

One day when Rylee and Rusty were walking home after school, Rusty pulled an apple out of his bag and started to take a bite. Rylee, grabbing his arm asked, “Hey! Did you wash that?” “I dunno. My mom probably did,” Rusty replied completely puzzled. “HOW old are you?” Rylee asked. “You know food safety is everybody’s responsibility,” she exclaimed with exasperation. “Oh Rylee!” Rusty replied with a shrug of his shoulders, “Why are you making such a big deal out of this?” With her hands on her hips Rylee scowled at him and raised her voice, “WHY am I making a BIG DEAL?!” “Yeah, why?” he asked, calm as ever. “You have heard of E. coli O157:H7, right?” For a minute there Rylee sounded like Ms. Coffman, but then she said, “I sit next to you in science class every day Rustin Archibald Brown. Have you not been listening?” Rusty replied with an uncertain, “No?” “Well,” Rylee said, “E. coli is a kind of bacteria that can make you really sick. So sick, in fact… that if you had to choose between cleaning your room or being sick from E. coli, you’d pick cleaning your room any day of the week!” “That’s pretty sick,” said Rusty, “I hate cleaning my room.” Rylee continued, “Your stomach feels like an elephant is standing on it, you’re puking your guts out, and… well, let’s just say ya make a big mess in the bathroom.” “What did she just say?” he thought to himself. Clutching his stomach Rusty groaned, “Yuck! RY-LEE, stop!” Rylee paused for just a second to take a breath and then Rusty cut in, No more.

BS: Academics feel the invisible hand of politicians and big agriculture

Another takedown piece on conspiracies rather than science.

I got lots of money from big ag and was never compromised in my evidence-based writings.

70 peer-reviewed papers and book chapters, not a lot, but not bad, since they get cited daily, somewhere (thanks to Amy for keeping me up to date, I admit I’m somewhat humbled but also don’t care; I know what we did).

Kate Cox and Claire Brown of The Guardian write that in a windowless conference room epidemiologist Steve Wing was frantically blacking out chunks of his own research.

Wing had been working on a study looking into the impacts of industrial-scale hog operations on health for the University of North Carolina. But the state’s Pork Council had caught wind of the research, and filed a Freedom of Information Act Request (FOIA) to gain access to his findings. “They went after Steve, asking him to turn over any documentation. They went directly to the university and got the lawyers to try and make him hand it over,” says Naeema Muhammad, one of Wing’s community partners.

I consulted on risk communication activities for the U.S. National Pork Board back in the 1990s or thereabouts. I received no money.

The others on the advisory committee were honest and devoted to their research.

Academia don’t pay much (and when it does, they find a reason to dump ya).

Me, I always spoke my mind and never felt any industry pressure – the only pressure I got was from green groups culminating in death threats taped to my lab door.

We had to involve the university cops, which was somewhat hilarious because a couple of grad students had bailed me out of jail or other situations (should be a grad student requirement).

Yes I took money. Yes we did good research that was published in peer-reviewed journals (and sometimes won awards). Yes, like my four Canadian daughters, those students have gone on to have remarkable and varying lives.

Look how young Steve Cropper and Duck Dunn are in this Stax Records clip.

Trump gets his news here: Fox News host says he has not washed his hands in 10 years ‘Germs are not a real thing’

To the chagrin of his co-hosts, Fox and Friends presenter Pete Hegseth told the show’s audience Sunday morning that he hasn’t washed his hands in a decade.

Katherine Hignett of Newsweek writes the revelation came after co-hosts Ed Henry and Jedediah Bila questioned Hegseth’s off-camera consumption of pizza left out after National Pizza Day Saturday. Hegseth had argued that pizza “lasts for a long time.”

Bila then quipped Hegseth “might take a chomp out of” anything on a table “that’s not nailed down”—including mugs.

“My 2019 resolution is to say things on air that I say off air… I don’t think I’ve washed my hands for 10 years. Really, I don’t really wash my hands ever,” Hegseth continued, prompting laughter from his co-hosts.

“Someone help me,” Bila said. “Oh man.”

“I inoculate myself. Germs are not a real thing. I can’t see them. Therefore the’re not real,” Hegseth said.  

“So you’re becoming immune to all of the bacteria,” Bila replied, rolling her eyes. “My dad has that theory too.”

Hegseth later shared a Tweet in support of his unusual concept of health and hygiene with the hashtag “DontWash.”

But the Centers for Disease Control and Prevention states that handwashing is a vital way to prevent the transmission of disease. By washing your hands—especially after using the bathroom—you prevent the spread of harmful bacteria like Salmonella and E.coli that can persist in tiny, invisible particles of human feces

It’s also important to wash your hands after handling raw meat, as this can harbor germs leftover from animal feces.

“A single gram of human feces—which is about the weight of a paper clip—can contain one trillion germs,” the CDC reports.

Filion, K., KuKanich, K.S., Chapman, B., Hardigree, M.K., and Powell, D.A. 2011. Observation-based evaluation of hand hygiene practices and the effects of an intervention at a public hospital cafeteria. American Journal of Infection Control 39(6): 464-470.

Background

Hand hygiene is important before meals, especially in a hospital cafeteria where patrons may have had recent contact with infectious agents. Few interventions to improve hand hygiene have had measureable success. This study was designed to use a poster intervention to encourage hand hygiene among health care workers (HCWs) and hospital visitors (HVs) upon entry to a hospital cafeteria.

Methods

Over a 5-week period, a poster intervention with an accessible hand sanitizer unit was deployed to improve hand hygiene in a hospital cafeteria. The dependent variable observed was hand hygiene attempts. Study phases included a baseline, intervention, and follow-up phase, with each consisting of 3 randomized days of observation for 3 hours during lunch.

Results

During the 27 hours of observation, 5,551 participants were observed, and overall hand hygiene frequency was 4.79%. Hygiene attempts occurred more frequently by HCWs than HVs (P = .0008) and females than males (P = .0281). Hygiene attempts occurred more frequently after poster introduction than baseline (P = .0050), and this improvement was because of an increase in frequency of HV hand hygiene rather than HCW hand hygiene.

Conclusion

The poster intervention tool with easily accessible hand sanitizer can improve overall hand hygiene performance in a US hospital cafeteria.

Wilson, S.M., Jacob, C.J. and Powell, D.A. 2011. Behavior-change interventions to improve hand hygiene practice: A review. Critical Public Health 21: 119-127.

http://www.informaworld.com/smpp/content~content=a934338802~db=all~jumptype=rss

Despite the role of hand hygiene in preventing infectious disease, compliance remains low. Education and training are often cited as essential to developing and maintaining hand-hygiene compliance, but generally have not produced sustained improvements. Consequently, this literature review was conducted to identify alternative interventions for compelling change in hand-hygiene behavior. Of those, interventions employing social pressures have demonstrated varying influence on an individual’s behavior, while interventions that focus on organizational culture have demonstrated positive results. However, recent research indicates that handwashing is a ritualized behavior mainly performed for self-protection. Therefore, interventions that provoke emotive sensations (e.g., discomfort, disgust) or use social marketing may be the most effective.