Tag Archives: Norway

Over 300 sickened in Norway: Beware the herbs as chives on scrambled eggs IDed as source

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We investigated an outbreak of gastroenteritis following a Christmas buffet served on 4–9 December 2012 to ~1300 hotel guests. More than 300 people were reported ill in initial interviews with hotel guests.

chive.scrambled eggsTo identify possible sources of infection we conducted a cohort investigation through which we identified 214 probable cases. Illness was associated with consumption of scrambled eggs (odds ratio 9·07, 95% confidence interval 5·20–15·84). Imported chives added fresh to the scrambled eggs were the suspected source of the outbreak but were unavailable for testing.

Enterotoxigenic Escherichia coli (ETEC) infection was eventually confirmed in 40 hotel guests. This outbreak reinforces that ETEC should be considered in non-endemic countries when the clinical picture is consistent and common gastrointestinal pathogens are not found.

Following this outbreak, the Norwegian Food Safety Authority recommended that imported fresh herbs should be heat-treated before use in commercial kitchens.

 An outbreak of enterotoxigenic Escherichia coli (ETEC) infection in Norway, 2012: a reminder to consider uncommon pathogens in outbreaks involving imported products

Epidemiology and Infection / Volume 143 / Issue 03 / February 2015, pp 486-493

E. MacDonald, K.E. Møller, A.L. Wester, U.R. Dahle, N.O. Hermansen, P.A. Jenum, L. Thoresen and L. Vold

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9527898&utm_source=Issue_Alert&utm_medium=RSS&utm_campaign=HYG&utm_reader=feedly

Petting zoos can suck: Second outbreak of infection with a rare Cryptosporidium parvum genotype in schoolchildren associated with contact with lambs/goat kids in Norway

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In March 2012, a second outbreak of Cryptosporidium parvum affected children following a stay at a holiday farm in Norway; the first outbreak occurred in 2009. We studied a cohort of 145 schoolchildren who had visited the farm, of which 40 (28%) were cases.

petting zoo 1Cryptosporidium oocysts were detected in faecal samples from humans, goat kids and lambs. Molecular studies revealed C. parvum subtype IIa A19G1R1 in all samples including human samples from the 2009 outbreak. A dose–response relationship was found between the number of optional sessions with animals and illness, increasing from two sessions [risk ratio (RR) 2·7, 95% confidence interval (CI) 0·6–11·5] to six sessions (RR 8·0, 95% CI 1·7–37·7). The occurrence of two outbreaks 3 years apart, with the same subtype of C. parvum, suggests that the parasite is established in the farm’s environment. We recommend greater emphasis on hand hygiene and routines related to animal contact.

Best practices for planning events encouraging human-animal interactions

Zoonoses and Public Health

G. Erdozain , K. KuKanich , B. Chapman  and D. Powell

http://onlinelibrary.wiley.com/doi/10.1111/zph.12117/abstract?deniedAccess

Educational events encouraging human–animal interaction include the risk of zoonotic disease transmission. It is estimated that 14% of all disease in the US caused by Campylobacter spp., Cryptosporidium spp., Shiga toxin-producing Escherichia coli (STEC) O157, non-O157 STECs, Listeria monocytogenes, nontyphoidal Salmonella enterica and Yersinia enterocolitica were attributable to animal contact. This article reviews best practices for organizing events where human–animal interactions are encouraged, with the objective of lowering the risk of zoonotic disease transmission.

A table of petting zoo outbreaks is available at https://barfblog.com/wp-content/uploads/2014/04/Petting-Zoo-Outbreaks-Table-4-8-14.xlsx.

 

E. coli on a lot of Norwegian meat

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The Norwegian Food Safety Authority (FSA) has discovered antibiotic resistant E. coli bacteria in turkey fillets on the Norwegian market, the Norwegian news agency NTB reported on Tuesday.

uncooked_turkey_breastThe FSA deputy supervisory director, Ole Fjetland, said that the situation is “worrisome” as they had no knowledge on how these bacteria have entered the poultry production in Norway.

The FSA has found the E. coli bacteria in about half of the turkey fillets they tested for monitoring antibiotic resistance.

The FSA has followed the bacteria since 2000 and the new technology they adopted gives results showing that the incidence is much higher than previously thought.

Linked to global frozen fruit outbreak? 28 cases of hepatitis A infection reported in Norway

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A total of 28 cases of hepatitis A infection has been reported over the last few months in Norway, where this disease is said to be rare, the Norwegian news Agency NTB reported Saturday, quoting public health officials.

In almost half of the cases, the patients were found to have infected with hepatitis A virus while travelling abroad.

frozen.strawberryThe remaining half got infected in Norway, which was described as a rare occurrence.

Last year there was an outbreak of hepatitis A in the Nordic countries, which was believed to be most likely caused by eating imported frozen berries.

Norwegian health authorities suspect the new outbreak in Norway is also caused by eating contaminated food.

46 sickened; Shigella outbreak traced to imported basil in Norway, 2011

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While the U.S. extends a comment period for something about improving spice safety (raw herbs have been a known food safety risk for decades), Norway reports on a 2011 outbreak of Shigella sonnei linked to basil that sickened at least 46 people updating previous reports.

On 9 October 2011, the University Hospital of North Norway alerted the Norwegian Institute of Public Health (NIPH) about an increase in Shigella sonnei infections in Tromsø. The isolates had an identical ‘multilocus variable-number tandem repeat analysis’ (MLVA) profile. basil.salmonellaMost cases had consumed food provided by delicatessen X. On 14 October, new S. sonnei cases with the same MLVA-profile were reported from Sarpsborg, south-eastern Norway. An outbreak investigation was started to identify the source and prevent further cases. All laboratory-confirmed cases from both clusters were attempted to be interviewed.

In addition, a cohort study was performed among the attendees of a banquet in Tromsø where food from delicatessen X had been served and where some people had reported being ill. A trace-back investigation was initiated. In total, 46 cases were confirmed (Tromsø= 42; Sarpsborg= 4). Having eaten basil pesto sauce or fish soup at the banquet in Tromsø were independent risk factors for disease. Basil pesto was the only common food item that had been consumed by confirmed cases occurring in Tromsø and Sarpsborg. The basil had pesto.basil.cyclosporabeen imported and delivered to both municipalities by the same supplier. No basil from the specific batch was left on the Norwegian market when it was identified as the likely source. As a result of the multidisciplinary investigation, which helped to identify the source, the Norwegian Food Safety Authority, together with NIPH, planned to develop recommendations for food providers on how to handle fresh plant produce prior to consumption.

Is it always men? Norway says target men to change their food safety behaviors

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I don’t see gender. Except in bed. A group of Norwegian researchers has concluded that to improve food safety, target men, and a strategy is needed to change their behavior and attitudes.

Doesn’t that apply to anything?

Typically, the Norse found “people with higher education reported man.food.idiotpoorer practices than those with lower or no education.”

So the education model is broken. And surveys suck.

Journal of Food Protection
Røssvoll, Elin Halbach1; Lavik, Randi2; Ueland, Øydis1; Jacobsen, Eivind2; Hagtvedt, Therese1; Langsrud, Solveig3

An informed consumer can compensate for several potential food safety violations or contaminations that may occur earlier in the food production chain. However, a consumer can also destroy the work of others in the chain by poor food handling practices, e.g., by storing chilled ready-to-eat foods at abusive temperatures. To target risk-reducing strategies, consumer groups with high-risk behavior should be identified.

The aim of this study was to identify demographic characteristics associated with high-risk food handling practices among Norwegian consumers. More than 2,000 randomly selected Norwegian consumers were surveyed, and the results were analyzed with a risk-based grading system, awarding demerit points for self-reported food safety violations. The violations were categorized into groups, and an ordinary multiple linear regression analysis was run on the summarized demerit score for each group and for the entire survey group as a whole.

Young and elderly men were identified as the least informed consumer groups with the most unsafe practices regarding food safety. Single persons reported poorer practices than those in a relationship. People with higher education reported poorer practices than those with lower or no education, and those living in the capital of Norway (Oslo) reported following more unsafe food practices than people living elsewhere in Norway. Men reported poorer food safety practices than women in all categories with two exceptions: parboiling raw vegetables before consumption and knowledge of refrigerator temperature. These findings suggest that risk-reducing measures should target men, and a strategy is needed to change their behavior and attitudes.

Occurrence of potentially human-pathogenic Escherichia coli O103 in Norwegian sheep

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The investigation of an outbreak of hemorrhagic uremic syndrome in Norway in 2006 indicated that the outbreak strain Escherichia coli O103:H25 could originate from sheep. A national survey of the Norwegian sheep population was performed, with the aim of identifying and describing a possible reservoir of potentially human-pathogenic E. coli O103, in particular of the H-types H2 and H25. The investigation of fecal samples from run_sheep_run585 sheep flocks resulted in 1222 E. coli O103 isolates that were analyzed for the presence of eae and stx genes, while a subset of 369 isolates was further examined for flagellar antigens (H-typing), stxsubtypes, bfpA and astA, and molecular typing by pulsed-field gel electrophoresis (PFGE).

The total ovine E. coli O103 serogroup was genetically diverse by number of H-types, virulotypes and PFGE banding patterns identified, although a tendency of clustering towards serotypes was seen. The flocks positive for potentially human-pathogenic E. coli O103 were geographically widely distributed and no association could be found to county or geographical region.

The survey showed that eae- stx- E. coli O103, probably non-pathogenic to humans, is very common in sheep with 27.5% positive flocks. Moreover, the study documented a low prevalence (0.7%) of potentially human-pathogenic Shiga toxin-producing E. coli O103:H2, while STEC O103:H25 was not detected. However, 3.1% and 5.8% of the flocks were positive for Enteropathogenic E. coliO103 belonging to H-type H2 and H25, respectively. These are of concern as potentially human pathogens by themselves, but more important as possible precursors for human-pathogenic STEC.

Camilla Sekse, Marianne Sunde, Petter Hopp, Torkjel Bruheim, Kofitsyo Sewornu Cudjoe, Bjorg Kvitle, Anne Margrete Urdahl

Applied and Environmental Microbiology. 27 September 2013. 

319 sick; Norway Christmas party E. coli outbreak declared over

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I’m not sure how a foodborne disease outbreak linked to a Christmas party can be declared over before Christmas, but that’s what Norwegian health types have done after 319 people were struck with tourist diarrhea or enterotoxigenic Eschericia coli (ETEC) at a Ringerike, Norway hotel.

The gastrointestinal outbreak happened after guests ate a Christmas buffet Klækken Hotels Hønefoss.e.coliat Klækken Hotels Hønefoss during the period of Dec. 4-9.

Six people were reported as requiring hospitalization for their illness. Guests had mainly diarrhea and abdominal pain, some had vomiting and fever.

The source of the outbreak has not been ascertained.

Preliminary results of surveys made ​​among the guests at the hotel during the relevant period, may indicate that the source of infection is the cold food from the buffet. FSA continues to work on mapping and analysis of these foods .

The Folkehelsinstituttet says since there have been no reports of illness after Dec. 9, the outbreak is over.

Two outbreaks of diarrhea in nurseries in Norway after farm visits, April to May 2009

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As the parents of two young children file a lawsuit against the Cleveland County Fair, part of the 106 sickened and one death from E. coli O157, Eurosurveillance reports on two separate outbreaks of shiga-toxin producing E. coli in two nurseries where the children had recently visited farms  in Norway in 2009. The nursery outbreaks probably wouldn’t have been noticed except for the increased awareness in Norway at the time due to an on-going outbreak of E coli O157 that sickened 13 children and led to one death.

A table of petting zoo outbreaks is available at http://bites.ksu.edu/petting-zoos-outbreaks.

Abstract below.

During a 2009 nationwide outbreak of sorbitol-fermenting Escherichia coli O157 in Norway, the Norwegian Institute of Public Health was notified of diarrhea outbreaks in two nurseries. A link to the nationwide outbreak was suspected and investigated, including retrospective cohort studies. Both nurseries had recently visited farms.

Fecal specimens were obtained from symptomatic children as well as from the farm animals and tested for Campylobacter, Salmonella, Yersinia, Shigella and pathogenic E. coli, and isolates were further characterized.  Nursery A had 12 symptomatic children, and we found the same strain of C. jejuni in feces from children and lambs. Nursery B had nine symptomatic children, including one child with bloody diarrhoea carrying enterohaemorrhagic E. coli (EHEC) O26. EHEC O26 with a similar multiple-locus variable number tandem repeat analysis (MLVA)-profile was found in sheep.  Five children had enteropathogenic E. coli (EPEC) O76. 

Animals were not tested for EPEC O76. We found no significant association between illness and risk factors for either nursery. The isolated pathogens differed from the one involved in the nationwide outbreak. In each nursery outbreak, the pathogens isolated from children matched those found in farm animals, implicating animal feces as the source. Hygiene messages are important to prevent similar outbreaks.

21 sickened; Yersinia enterocolitica outbreak associated with ready-to-eat salad mix, Norway, 2011

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What’s Yersinia doing in salad?

In 2011, an outbreak of illness caused by Yersinia enterocolitica O:9 in Norway was linked to ready-to-eat salad mix, an unusual vehicle for this pathogen.

MacDonald et al report in Emerging Infectious Diseases the outbreak illustrates the need to characterize isolates of this organism, and reinforces the need for international traceback mechanisms for fresh produce. Excerpts below.

Yersiniosis, a notifiable disease in Norway, is the fourth most common cause of acute bacterial enteritis registered by the Norwegian Surveillance System for Communicable Diseases. Approximately 30 domestic cases are reported annually (2010 incidence rate 0.5 cases/100,000 population). In Norway, >98% of cases of Yersinia enterocolitica infection are caused by serotype O:3, which is also the dominant serotype in Europe, Japan, and parts of North America. Infection by Y. enterocolitica is often associated with ingestion of pork because pigs commonly harbor the pathogenic serotypes O:3 and O:9. Recent foodborne outbreaks have been associated with pork products (2,3) and pasteurized milk.

A confirmed case-patient was defined as a person in Norway after January 1, 2011, who had laboratory-confirmed Y. enterocolitica O:9 infection that matched the MLVA profile of the outbreak strain. By May 5, the NRL had registered 21 outbreak case-patients (median age 37 years [range 10–63 years]), of whom 15 were female. Case-patients resided in 10 geographically dispersed municipalities throughout the country. Most case-patients became ill during February 7–March 20.

We traced the suspected salad mix to a single Norwegian company. Under the auspices of the Norwegian Food Safety Authority, we conducted an environmental investigation, including a traceback investigation and a review of production and cleaning procedures at the company. The suspected salad mix contained 4 salad green types: arugula, radicchio rosso, iceberg lettuce, and endive. These ingredients came, unprocessed, from 12 suppliers in 2 European countries. After delivery to the company in Norway, the greens were washed in 2 cold water baths, cut, and packaged. We found no indications of inadequate routines for ingredient control, hygiene, or sampling within Norway. We identified radicchio rosso, a leaf chicory, as the likely source of infection because it can be stored for several months and was the only ingredient included in the suspected salad mix that had delivery, production, and storage dates consistent with the outbreak period. The company in Norway traced the radicchio rosso to 1 of 3 possible growers in 1 European country but was not able to identify the source of contamination. The Norwegian company voluntarily withdrew all salad mixes containing radicchio rosso from the market. After withdrawal of the implicated ingredients, no new outbreak cases were reported.