Tag Archives: Norway

Limiting barf in bike races

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This would be a stirring endorsement for the Yosemite Sam mudflap industry if they existed for bikes.

But mudguards are readily available and are being touted by Norwegian and Swedish researchers as a way to reduce the risk of gastroenteritis related to bicycle races over courses with animal feces and mud.

The researchers write that Birkebeinerrittet is one of the world’s largest mountain bike races, taking place every year in the mountains in the southeast of Norway. The track is 95 km and around 19,000 participants are expected each year, divided into two races on consecutive days.

The Birkebeinerrittet track crosses an area where many grazing animals are present. Feces from grazing animals can contain enteropathogens and in wet and muddy conditions, mud splashes to the face during cycling may cause infection.

In 2009, the race took place under severe weather conditions, with heavy rainfall during the previous days. That year, an outbreak of gastrointestinal illness affected an estimated 3,800 participants, resulting in one of the largest diarrheal outbreaks in Norway, with significant media coverage and a heavy socioeconomic toll (more than 2500 days of absence from work). A retrospective
cohort study using web-based questionnaires was performed after the race in order to identify any potential common sources. No single food or drink item was identified as the source; however, mud splashes to the face were associated with gastrointestinal illness.

The study also showed that spitting out the first sip when drinking from a bottle or ‘camelbak’ and using mudguards had some protective effect.

Based on the findings from the 2009 study, the organizers recommended that the participants use mudguards and spit out the first sip of water from drinking bottles during the race in 2010. They also implemented environmental control measures, by draining parts of the track and spreading gravel in the sareas more prone to get muddy, and asking sheepowners to gather their animals earlier than the previous year, so fewer animals were close to the tracks.

In 2010 around 19,000 people registered to take part in the races that took place on 27–28 August. Although slightly colder, weather conditions were similar to the previous year. The average temperature was 13.1 C in 2009 and 10.1 C in 2010. Rainfall during the 5 days preceding the races was 43.7 mm in 2009 and 36.6 mm in 2010.

A retrospective cohort study using web-based questionnaires was conducted to measure the use of preventive measures and to assess risk factors associated with gastrointestinal illness. A 69% response rate was achieved and 11,721 records analyzed, with 572 (attack rate 4.9%) matching the case definition, i.e. participants reporting diarrhea within 10 days of race. There was a clear increase in the use of mudguards (96.7% reported access to/receiving information on preventive measures) and a significant decrease in gastrointestinal illness. This may indicate that the measures have been effective and should be considered, both in terms of environmental control measures as well as individual measures.

The complete abstract and paper are available from Epidemiology and Infection at http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8577676

Clean animals result in fewer E. coli: Norwegian PhD research

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Following an E. coli outbreak in 2006, when 17 people fell ill and one child died after eating mutton sausages in Norway, the meat industry introduced a number of measures in order to reduce the risk of food poisoning from meat.

Clean animals and good hygiene during slaughtering are essential preconditions for food safety.

Sigrun J. Hauge of the Norwegian School of Veterinary Science recently defended her doctoral research evaluating measures on farms and in slaughterhouses to reduce levels of dangerous E. coli.

Slaughterhouses have systems for categorizing animals according to how dirty they are. Around 3-5% of the animals that arrive at abattoirs are so soiled that they are categorized as high-risk. Every year, deductions in the price of meat due to dirty animals amount to over 9 million Norwegian kroners.

Soiled slaughter can pose a risk to food safety because feces on hides/wool, intestines, knives and the hands of the butchers can be transferred to the meat during the slaughter process. Hauge studied the factors affecting the cleanliness of animals on farms and how clean or soiled hide affects the contamination of skinned carcasses. Her experiments confirmed that meat from dirty cattle has more E. coli than meat from clean cattle.

Sheep farmers are also subjected to price reductions for dirty and unshorn animals. Hauge’s research showed that the surface of meat from shorn sheep has less E. coli than that of unshorn sheep immediately after skinning and that the point in time that the sheep are shorn before slaughtering is also significant when it comes to the amount of bacteria immediately after skinning. But towards the end of the slaughtering process, all the meat had equal amounts of E. coli on its surface, regardless of when the sheep were shorn.

Dirty and unshorn animals are considered a high risk. They are treated in separate product streams in the slaughterhouses and their meat is not used for raw products such as minced meat and cured meat, but for products that are heat treated before sale (such as sausages and meatballs etc.).

Meat from lambs was hosed with water at 82 °C for 8 seconds in an enclosed "shower" – so-called hot water pasteurization — before it was cooled. This treatment reduced the amount of E. coli on carcasses by 99.5%. After 5 days of cooling, no further E. coli were found on the meat. The recycled water in the shower was of a good microbiological, chemical and physical quality. Immediately after pasteurization, the meat was rather pale, but it regained its normal colour after being cooled for 24 hours.

Hot water pasteurisation is not generally accepted as a hygiene measure in Norway and the EU and the Norwegian Food Safety Authority would have to give its approval, if the method is to be used at slaughterhouses. Hot water pasteurization will obviate the need for separate product streams in abattoirs for high-risk sheep.

Cand.agric. Sigrun J. Hauge defended her doctoral research on 2nd May 2012 at The Norwegian School of Veterinary Science (NVH) with a thesis entitled “Hygienic impact of measures related to unclean cattle and sheep at farm level and in the abattoir.”

46 sick with Shigella from imported fresh basil in Norway

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Eurosurveillance reports today an outbreak of Shigella in Norway that sickened at least 46 people.

Two municipalities were involved. A large cluster (42 cases) was concentrated in north Norway, while a small cluster (4 cases) occurred in the south-east region. Epidemiological evidence and traceback investigations have linked the outbreak to the consumption of imported fresh basil. The product has been withdrawn from the market. No further cases have been reported since 25 October.

On 9 October 2011, the Department of Infectious Disease Epidemiology at the Norwegian Institute of Public Health was informed by the Municipal Medical Officer and the Local Food Safety Authority in Tromsø (northern Norway) about an unusually high number of cases of gastrointestinal disease caused by Shigella sonnei.

A delicatessen and catering company located in the centre of Tromsø received several complaints from customers who had fallen ill with gastrointestinal symptoms after having eaten food items from there.

On 14 October, a small cluster of cases who had not been to Tromsø were reported and the outbreak was classified as national.

An outbreak case was defined as a person with gastrointestinal symptoms with laboratory confirmed infection with S. sonnei with indistinguishable multiple-locus variable number of tandem repeats analysis (MLVA) profiles in Norway after 1 October 2011.

Traceback investigations of ingredients in the pesto served in Tromsø are still ongoing. The same distributer that provided the fresh basil to the catering company in Tromsø also delivered fresh basil to the restaurant implicated in the second cluster in south-east Norway. The distributor imported this herb from a country outside the European Union and has voluntarily withdrawn it from the market. The National Veterinary Institute analysed samples of pesto and other ingredients from the catering company in Tromsø. Samples available for analysis have been negative. An epidemic intelligence information system (EPIS) enquiry has been posted to determine whether other European countries have observed a similar increase in cases infected with S. sonnei. So far, no other countries have reported any recent increase in cases that can be linked to this outbreak.

Pigs in the patch? 20 sick with yersinia linked to lettuce in Norway

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Since February, the Reference Laboratory at the Norwegian Institute of Public Health has identified identical strains of Yersinia enterocolitica O:9 in 20 patients living in Norway.

Interviews with the patients with yersiniosis led to suspicion of a particular pre-packaged lettuce mix that was withdrawn from the market.

Further investigation led to suspicion of several pre-packaged lettuce mixes purchased in grocery stores. Preliminary investigations conducted at the Norwegian Veterinary Institute strengthened this suspicion. The manufacturer has therefore withdrawn a further nine lettuce mixes from the market. The Norwegian Food Safety Authority recommends that consumers should not eat these lettuce mixes. The Norwegian Institute of Public Health is continuing the investigation in co-operation with the Food Safety Authority and Veterinary Institute.
 

E. coli outbreak hospitalizes three children in Norway

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Three small children from Oslo, Akershus and Østfold are in hospital with a serious kidney disease following an E. coli infection.

Oslo University Hospital (Oslo Universitetssykehus) authorities confirm two have developed the potentially fatal Haemolytic-uremic syndrome (H.U.S.), which can also give acute kidney failure and change blood chemistry.

The Institute of Public Health (Folkehelseinstituttet/FHI) says the third child, admitted to Ullevål Hospital, has also developed H.U.S. Medical staff at both hospitals are refusing to give details about their conditions.

The Foreigner reports that no further details were available at this time.
 

Shigella from sugar peas in Scandinavia

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The peas apparently came from Kenya. But that wouldn’t fit the alliteration.

Eurosurveillance reports that in Norway, shigellosis is a mandatorily notifiable disease, and all isolates are submitted to the NIPH for verification and typing. Around 150 cases of shigellosis are confirmed per year, the majority caused by Shigella sonnei. Only around 10 to 20 of the shigellosis cases reported each year are acquired in Norway, usually as secondary cases caused by faecal-oral transmission in households.

An outbreak investigation was initiated on 27 May by interviewing the four confirmed cases using a trawling questionnaire. On the same day the NFSA inspectors visited the two households where suspected cases were reported and found an unopened package of sugar peas imported from Kenya in one household, and the packing of the same brand of sugar peas in the other. The sugar peas were bought in the same shop. Based on this suspicion, it was decided to focus the interviews on consumption of fresh vegetables and lettuce.

By 16 June, the reference laboratory has registered a total of 20 cases with the outbreak strain of Shigella sonnei, who had not travelled abroad prior to illness onset. The cases live in different municipalities, but mainly in the central and western parts of Norway. The date of onset for the first case was 10 May. All cases were adults except for one teenager, and 16 of them were women. All 20 cases reported to have eaten sugar peas, and there were no other obvious common exposures identified. The majority of the patients had bought the sugar peas in one of the large supermarket chains and only a few in another chain. The NFSA traced the suspected food product and found that all the implicated sugar peas were produced in Kenya. One sample from the unopened package of sugar peas collected in a patient household was positive for Shigella sonnei by both PCR methods, but could not be culture-confirmed.

As a response to our urgent inquiry Denmark reported an increase in the number of domestic Shigella sonnei infections in April and May 2009. They initiated an outbreak investigation to find out if the Danish cases were related to the outbreak in Norway. The investigation in Denmark also pointed at sugar peas as the source of the outbreak, and microbiological investigations (including MLVA typing) to compare the outbreak strains are ongoing.
 

Could credit card receipts save children’s lives?

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The Norwegian Institute of Public Health has confirmed a genetic match for an infection of E. coli O157 among three children who developed hemolytic uremic syndrome (HUS) this year.

The Institute reported this week,

“The first child became ill in January, the second in February and the third in March. In addition, a sibling of one of the children has also developed HUS, but it has not yet been confirmed whether this is the same bacterial strain.”

One of the four children—all of which are under the age of ten—has died.

The source of the outbreak has yet to be determined. County food safety officials are currently questioning the families of victims on the children’s meals and testing leftover food, while federal officials are seeking information on any further possible cases (i.e. persons, and particularly children, with bloody diarrhea who test positive for enterohemorrhagic E. coli).

I wonder if they’ve looked into the families’ grocery store receipts?

A peer-reviewed article in the April 15 issue of Clinical Infectious Diseases reports that the source of a 2007 outbreak of E. coli in Denmark was found using credit card information.

Investigators had struggled to determine the source of a strain of E. coli O26 that infected 20 Danish children between February and May of 2007.

Flesh and Stone reports that when interviews failed to yield any likely suspect foods, investigators turned to shopping lists.

“Parents in seven families provided their credit card information and a list of supermarkets where they had shopped. The two supermarket chains that the parents had used most often agreed to help with the investigation. The stores searched their central computers for the precise amount paid and the date and the location of the shop.

“From there, investigators determined that five families had purchased the same brand of fermented, organic beef sausage. A sixth family was linked to the same sausage brand through shopping records provided by the kindergarten attended by two children who became infected with the same E. coli strain, STEC O26. An unopened sample of the sausage also tested positive for the strain.”

Authors of the CID article acknowledged that relying on memory to identify similarities among the diets of outbreak victims diets is often unsuccessful and found credit card information to be “a strong tool in the [current] investigation.”

Investigation of a similar outbreak of E. coli O157 in Iceland successfully used the same method some months later. It could be worth a try for Norway.
 

Botulism in Danish baby food?

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Have you noticed a trend? Blog posts at 4 a.m., bad baby metaphors, bad writing cause my brains are mush?

Must be a baby in the house.

The Norwegian Food Safety Authority (NFSA) writes on their website that there are suspicions that Hipp’s fruit purée with banana and apricot may contain Colstridium Botulinum, following an outbreak of illness in Denmark.

They are now recommending that all parents who have bought jars marked L35655, with a use-by date of 31.12.08 should throw them away.

The Danish Food Safety Authority has sent the fruit purée for test ananlysis, and a final confirmation as to whether the food is poisonous will come at the end of the week.

A quick trip to the Hipp Organic Baby Food web site finds lots of what isn’t in Hipp baby food like melamine or Irish pork, but no mention of botulism.
 

Norovirus at Norwegian hotel hospitalizes 30, sickens dozens

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Norway’s Food Safety Authority (Mattilsynet) says norovirus – originating in staff or cold food served at a hotel buffet or both — swept through the Clarion Hotel Gardermoen, near Oslo’s main airport, Saturday afternoon and evening.

The victims included members of a national diabetes foundation attending a conference and what was supposed to be the foundation’s 60th anniversary party.

Instead, most of them wound up vomiting and suffering from acute diarrhea, especially serious ailments for diabetics. More than 30 were taken to hospital, and scores of other visitors at the hotel also fell ill, including hotel staff and members of a band hired in to play at the foundation’s party.

Here’s another norovirus infosheet from the past with some tips. The originals can be found at foodsafetyinfosheets.ksu.edu