Raw is risky: 7 sick from NZ mussels

Hawke’s Bay District Health Board is investigating four confirmed cases of Paratyphoid fever and is following up three suspect cases.

All four confirmed cases have required hospital care at Hawke’s Bay Hospital. At least two of the cases ate mussels gathered from Napier’s Ahuriri area. The district health board is also concerned that mussels from the same area, may have been eaten at a Tangi at the Tangoio Marae 11 days ago, and is following that up.

Medical Officer of Health Nick Jones said, “People with Paratyphoid can carry the (Salmonella Enterica) bacteria in their blood and in their stomach and gut so it is possible for it to be passed on through feces. Hand washing was extremely important to help prevent infecting other people as you can get paratyphoid if you eat or drink things that have been handled by a person who has the bacteria.”

 

Raw is risky: Ceviche source of V. cholera 01 in Minn

As we drove the five hours yesterday to Sawtell, NSW, for a week of (ice) hockey for Sorenne, and some R&R for me and Amy (mainly me), Amy was telling me about this one time, she went to Senegal (they speak French) in 2005, and the hosts offered her Tang but she didn’t want to drink it because she had been warned about the water.

Turns out there was an on-going cholera outbreak.

I was driving and thought, should I tell her that cholera is a member of the Vibrio genus?

I kept driving.

Today, while Sorenne is working it on the ice, I’m catching up and came across this report from friends at the Minnesota Department of Health (MDH) published by the U.S. Centers for Disease Control.

On August 20, 2016, the Minnesota Department of Health (MDH) was notified of a case of Vibrio cholerae infection. The isolate was identified as serogroup O1, serotype Inaba at MDH. CDC determined that the isolate was nontoxigenic. The patient was a previously healthy woman, aged 43 years, with history of gastric bypass surgery. On August 16, she experienced profuse watery diarrhea, vomiting, abdominal cramps, and headache. On August 18, she sought care and submitted the stool specimen that yielded the V. cholerae isolate. She reported no recent travel. However, she had consumed ceviche made with raw shrimp and raw oysters at restaurant A on August 14, 49 hours before illness onset. Her husband had a similar illness with a similar incubation period after eating the same foods at restaurant A.

On August 22, MDH sanitarians visited restaurant A and obtained tags and invoices for oyster and shrimp products; the oysters were a product of the United States, and the shrimp was a product of India. Sanitarians also gathered patron contact information and credit card receipts for August 12–14. Two additional patrons reported experiencing a gastrointestinal illness that met the case definition of three or more episodes of watery stool in a 24-hour period within 5 days of eating at restaurant A; one reported eating ceviche and oysters at restaurant A. Review of complaints to the MDH foodborne illness hotline revealed a previous complaint from two persons who reported experiencing watery diarrhea after eating raw shrimp ceviche (but no oysters) at restaurant A on August 2. These persons did not provide stool specimens, but their gastrointestinal illnesses met the case definition, resulting in a total of six cases, including one laboratory-confirmed case. No other V. cholerae O1 Inaba cases were reported in the United States during this outbreak.

The Minnesota Department of Agriculture facilitated sampling of shrimp at the distributor from the same lots served at restaurant A on August 14, and most likely during August 2–13, and sent them to the Food and Drug Administration for culture. Shrimp samples yielded V. cholerae non-O1, non-O139, but V. cholerae O1 was not isolated. In response to the outbreak results, restaurant A placed consumer warnings on their menus about the risks of consuming raw or undercooked food items and identified raw menu items for consumers. Restaurant A also focused on other actions that might facilitate reduction of V. cholerae, including appropriate freezing of food items, and allowing raw food items to soak in lime juice before being served, rather than serving the items immediately after adding lime juice (1,2).

V. cholera has over 150 serogroups and has been identified in a wide range of aquatic life, including seafood (3). Whereas multiple serogroups can cause vibriosis, only serogroups O1 and O139 that also contain the cholera toxin are classified as causes of cholera (4). Previous studies have documented the presence of nontoxigenic V. cholerae O1 from environmental and shrimp samples in India and Southeast Asia (5–7).

This outbreak of domestically acquired, nontoxigenic V. cholerae infections, likely from shrimp consumption, included the first V. cholerae O1 case identified in a nontraveler in Minnesota since active surveillance for Vibrio began in 1996. Since 1996, MDH has detected 26 V. cholerae infections, 21 (81%) of which were non-O1, non- O139, and five of which were O1. Among the four O1 type cases identified before the current outbreak, all patients had a recent travel history to Micronesia or India. This outbreak demonstrates the importance of investigating all seafood eaten by patients with vibriosis. In addition, investigators should include nontoxigenic V. cholerae as a possible etiology of domestic foodborne outbreaks, particularly when foods eaten include those from V. cholerae O1–endemic areas.

Notes from the field: Vibrio cholerae Serogroup O1, Serotype Inaba — Minnesota, August 2016

CDC MMWR

Victoria Hall, Carlota Medus, George Wahl, Alida Sorenson, Melanie Orth, Monica Santovenia, Erin Burdette, Kirk Smith

https://www.cdc.gov/mmwr/volumes/66/wr/mm6636a6.htm?s_cid=mm6636a6_e

 

Whole genome sequencing PR in Australia

In a press release story that oozes with promotional fanfare, foodborne illnesses caused by bugs such as salmonella could be cut by a third in NSW within five years, with food and health authorities adding a “revolutionary” tool to their arsenal.

NSW Health and NSW Food Authority have started using whole genome sequencing technology to more quickly identify a foodborne outbreak and connect it with its source, which could reduce illnesses and even deaths.

“[It’s] a significant breakthrough that could help revolutionise how food-borne illnesses are identified, understood, tracked and managed,” said Dr Craig Shadbolt, the Food Authority’s acting chief executive.

“This will be invaluable in terms of achieving the NSW Government’s Food Safety Strategy goal of reducing foodborne illnesses caused by salmonella, campylobacter and listeria by 30 per cent by 2021.”

That sounds nice, but some practical steps, like not using raw eggs in mayo, aoili, or baked Chinese ice cream, would go farther. In Australia, rates of foodborne salmonella poisoning have climbed from 38 per 100,000 people in 2004 to 76 per 100,000 in 2016, with a record-breaking 18,170 cases last year, according to the National Notifiable Diseases Surveillance System.

A table of raw-egg-based outbreaks in Australia is available at: https://barfblog.com/wp-content/uploads/2017/05/raw-egg-related-outbreaks-australia-5-1-17.xlsx-

Cyclospora gets around

As summer grinds on in the Northern Hemisphere, Cyclospora is again spreading: at least 78 in the UK; 57 in Canada (which appear to be locally acquired; and, 712 lab-confirmed cases in the U.S.

The Centers for Disease Control reports Cyclospora cayetanensis is a single-celled parasite that causes an intestinal infection called cyclosporiasis.

As of August 16, 2017 (3pm EDT), CDC has been notified of 712 laboratory-confirmed cases of cyclosporiasis in persons who became ill in 2017. This number includes persons who reported international travel as well as persons who did not report travel. The reports have come from 36 states.

At least 347 (49%) of these persons did not report international travel (i.e., likely were infected in the United States) and became ill on or after May 1, 2017 (a date after which cases tend to increase each year). These 347 persons were from the following 31 states: Arizona (1), California (5), Colorado (6), Connecticut (18), Florida (36), Georgia (4), Illinois (11), Indiana (3), Iowa (8), Kansas (2), Louisiana (3), Maryland (3), Massachusetts (11), Michigan (1), Minnesota (10), Missouri (8), Montana (2), Nebraska (5), New Hampshire (2), New Jersey (10), New Mexico (1), New York (excluding NYC) (12), New York City (27), North Carolina (19), Ohio (6), Pennsylvania (1), Rhode Island (2), South Dakota (4), Texas (116), Utah (1), Virginia (2), and Wisconsin (7).

At this time, no specific vehicle of interest has been identified, and investigations to identify a potential source (or sources) of infection are ongoing. It is too early to say whether cases of Cyclospora infection in different states are related to each other or to the same food item(s).

Previous U.S. outbreaks of cyclosporiasis have been linked to various types of imported fresh produce (e.g., basil, cilantro, mesclun lettuce, raspberries, snow peas). Consumers should continue to enjoy the health benefits of eating fresh fruits and vegetables as part of a well-balanced diet.

Sprouts still suck: FDA sampling shows sprouts a problem

There’s a reason Walmart and Costco and Kroger stopped selling raw sprouts: they suck, meaning that, like raw milk, they cause a disproportionate percentage of illness based on low consumption rates.

The U.S. Food and Drug Administration wrote in a recent report sprouts are especially vulnerable to pathogens given the warm, moist and nutrient-rich conditions needed to grow them. From 1996 to July 2016, there were 46 reported outbreaks of foodborne illness in the U.S. linked to sprouts. The U.S. outbreaks accounted for 2,474 illnesses, 187 hospitalizations, and three deaths (and, tragically, many more in Canada, Australia, Japan and Europe).

A table of sprout-related outbreaks is available at https://barfblog.com/wp-content/uploads/2016/02/Sprout-associated-outbreaks-2-23-16.xlsx.

From the executive summary:

The U.S. Food and Drug Administration (FDA) set out to collect and test sprouts in 2014 as part of a new proactive and preventive approach to deploying its sampling resources with the ultimate goal of keeping contaminated food from reaching consumers.

The new approach, detailed in the Background section of this report (page 4), centers on the testing of a statistically determined number of samples of targeted foods over a relatively short period of time, 12 to18 months, to ensure a statistically valid amount of data is available for decision making. This approach helps the agency determine if there are common factors – such as origin, season, or variety – associated with pathogen findings.

The FDA issued the sprouts assignment in January 2014 under its new sampling model. The assignment targeted sprouts at three points in the production process (seeds, finished product and spent irrigation water), with the aim of collecting and testing 1,600 samples to determine the prevalence of select pathogens in the commodity. As background, the FDA designed its sampling plan such that if contamination of one percent or greater was present in the commodity, the agency would detect it. The FDA monitored the assignment closely to gather lessons learned and make changes to its sampling procedures if needed to address trends or food safety issues. About one year into the assignment, the FDA decided to stop its collection and testing at 825 samples because it had already collected samples on more than one occasion from many of the sprouting operations known to the agency and its state partners. The sample set acquired was sufficient for the FDA to estimate the bacterial prevalences in the commodity with a 95 percent confidence interval of 0% to 2% for a one percent contamination rate.

The FDA tested only domestically grown sprouts for this assignment because virtually all sprouts eaten in the United States are grown domestically due to the commodity’s delicate nature and relatively short shelf-life. Of note, the industry features a preponderance of relatively small operations.

The FDA tested the sprout samples for three pathogens: Salmonella, Listeria monocytogenes and Escherichia coli (E. coli) O157:H7. Based on the test results, the FDA found the prevalence of Salmonella in the finished product sprouts to be 0.21 percent. The agency also found that the prevalence of Salmonella in seeds (2.35%) was significantly higher than in finished product (0.21%) and in spent irrigation water (0.54%). Based on the test results, the FDA found the prevalence of Listeria monocytogenes in the finished product to be 1.28 percent. There was no significant difference in the prevalence of Listeria monocytogenes based on point in the production process. None of the samples tested positive for E. coli O157:H7. The agency did not test seed for E. coli O157:H7 due to limitations associated with the test method.

Among the FDA’s other findings, the agency found most of the positive samples at a small number of sprouting operations. Specifically, the FDA found violative samples at eight (8.5%) of the 94 sprouting operations visited for purposes of this assignment. The fact that the agency found multiple positive samples at some of these operations underscores the need for sprouting operations to comply with the agency’s Produce Safety Regulation (published November 2015), which seeks to prevent outbreaks of foodborne illness and improve sprout safety.

To address the positive samples, the FDA worked with the firms that owned or released the affected product to conduct voluntary recalls or to have their consignees destroy it, and then followed up with inspections. Of particular note, this sampling assignment helped detect and stop an outbreak of listeriosis while it still entailed a small number of cases, as described in the Public Health Impact section of this report (page 14). This assignment also prompted six product recalls.

The FDA will continue to consider microbial contamination of sprouts and how best to reduce it. Such contamination remains a concern to the FDA given the aforementioned outbreak and the recalls initiated. Going forward, the FDA intends to inspect sprouting operations to ensure they are complying, as applicable, with the Produce Safety Rule, which includes new requirements for sprouts growers. The agency has no plans to conduct additional large-scale sampling of sprouts at this time but may sample the commodity in accordance with its longstanding approach to food sampling, which centers on (but is not limited to) the following criteria:

  • A firm has a previous history of unmitigated microbial contamination in the environment (e.g., human illness, recalled or seized product, previous inspectional history, or environmental pathogens without proper corrective actions by the facility), or
  • Inspectional observations that warrant collection of samples for microbiological analyses.

The complete report is available at https://www.fda.gov/downloads/Food/ComplianceEnforcement/Sampling/UCM566981.pdf?source=govdelivery&utm_medium=email&utm_source=govdelivery

Hong Kong fairytales: More Vibrio: Suspected food poisoning outbreak in tour group

The Centre for Health Protection (CHP) of the Department of Health is investigating a suspected outbreak of food poisoning in a tour group, and hence urged the public to maintain good personal, food and environmental hygiene to prevent food-borne diseases.

Because all foodborne illness is caused by poor personal hygiene, and not contaminated product.

Not

The outbreak affected six members of the tour group, comprising two men and four women aged from 44 to 80, who developed abdominal pain, diarrhoea and vomiting 14 to 40 hours after their lunch buffet in a restaurant in a hotel in Macau on August 13 arranged by a travel agent in Hong Kong.

Among them, three sought medical attention in Hong Kong and required no hospitalisation. All affected persons have been in stable condition.

The stool specimen of one patient tested positive for Vibrio parahaemolyticus upon laboratory testing.

 

Raw is risky: US woman battling cancer dies after eating oysters

I don’t eat much raw food.

Too much risk.

A Texas woman who was vacationing with her husband in Mississippi died last Thursday, after eating raw oysters that were contaminated.

Jane White Cunningham, who had battled leukemia since 2016, had several limbs removed prior to her death in an effort to combat the infection, according to the Houston Chronicle.

“There has been a lot of swelling in her extremities and a lot of pain,” David Cunningham, the 56-year-old’s husband, wrote in an Aug. 8 Facebook post. “Today they had to amputate both legs and her left arm in an attempt to save her life as the infection was spreading rapidly.”

Cunningham was being cared for a Gulfort Mississippi Hospital, with health officials pointing to the bacteria Vibrio as a cause of infection, CBS DFW reported.

Rare chicken hooks UK food porn-types, the country that gave the world mushy peas and mad cow disease: It’s a Salmonella/Campy shit-storm waiting to happen

Just when you thought you’d seen every possible bizarre foodie trend on Instagram, a truly stomach-churning craze comes along to surprise you.

Siofra Brennan of the Daily Mail writes people have been sharing images of their ‘juicy and tender’ meals of medium rare chicken, claiming it’s the best possible way to enjoy the meat, but their claims certainly haven’t gone down well with the masses. 

People have described the craze as ‘salmonella waiting to happen’ with one stating that there’s a ‘special place reserved in hell’ for people who don’t cook their chicken properly. 

However, fans are absolutely insistent that it’s the best way to eat the poultry with one declaring that if you’re not having your chicken medium rare, ‘you’re doing it wrong’.  

People seem particularly keen to find out what firebrand chef Gordon Ramsay thinks of the debacle, frantically tweeting him images of the offending dishes to get his opinion.

His thoughts remain, as yet, unknown.  

(Who gives a fuck?)

Earlier this year Australian Morgan Jane Gibbs found worldwide notoriety with a Facebook snap of a plateful of very pink pieces of chicken with the caption: ‘Just made chicken medium rare chicken strips.

‘They’re so good can’t believe I’ve never tried it like this before,’ she said. 

‘Can’t wait to dig into this with my homemade salad and veges. #healthy #newyearsresolution #clean #cleaneating’

Unsurprisingly the post has gained notoriety online as people tried to figure out if Ms Gibbs is being serious with her nauseating dish.

While the post by Ms Gibbs was most likely a joke, the image itself was of a legitimate dish, origination from a blog promoting tourism in the Japanese region of Shizuoka and the recipe for chicken tataki; chicken seared over hot coals and served raw.

Chicken sashimi is another Japanese dish where the bird is served raw, chefs manage to avoid the issue of pesky food poisoning by serving the meat as fresh as possible and raising the chickens in a hygienic environment.

That’s some microbiological poultry manure (check your organic garden).

To avoid the risk of food poisoning, the NHS recommends that chicken must be cooked through so that the meat is ‘no longer pink, the juices run clear and it’s steaming hot throughout.’ 

No wonder the UK is messed up about chicken, the government-types can’t get advice right.

Use a thermometer and stick it in.

Raw is risky: 25 sickened by oysters in Seattle

A foodborne illness outbreak linked to raw oysters has sickened at least 25 people who dined at local restaurants recently, King County reported on Tuesday. The news comes after the county reported last week that a handful of people got sick eating raw oysters at two Seattle restaurants – The Salted Sea and The White Swan Public House.

The restaurants, however, are not the source of the outbreak, King County says. Most likely, the oysters were mishandled or contaminated before reaching local restaurants, although no specific local oyster beds have been connected to the outbreak.

County health officials believe diners have been sickened by Vibrio, a marine bacteria commonly found in oysters.

“Eating undercooked or raw shellfish, especially raw oysters in warm-weather months, is the main risk for acquiring vibriosis from infection with Vibrio parahaemolyticus,” King County said.

Australia still has an egg problem: WA Salmonella infections explode,1500 sick

It is painfully rewarding that the bureautards in Western Australia are finally catching up to what we’ve been saying for years.

Australia has an egg problem.

A table of Australian egg outbreaks is available at https://barfblog.com/wp-content/uploads/2017/05/raw-egg-related-outbreaks-australia-5-1-17.xlsx.

The West Australian reports the area is experiencing an explosion in stomach bug illnesses, with more than 4,000 cases so far this year and many of them caused by food.

 New figures show 4076 cases of gastrointestinal disease have been reported this year — 31 per cent more than at the same time in the previous two years. The bacterial or viral infections are mostly caused by contaminated food and water or poor hygiene. Much of the surge has been fuelled by a rise in salmonella, with many of the 1566 cases this year associated with eating uncooked eggs.

There has been a big increase in other gastroenteric illnesses, with 358 cases of the viral infection rotavirus, which can make young children seriously ill.

Cryptosporidiosis, which is caused by a parasite, has been reported in 335 people — more than double the number at the same time last year. A WA Health Department spokeswoman said though notifications of salmonella gastroenteritis were declining as expected over winter, the increased levels were a concern.

“The department is concerned about food-borne illness rates in WA, including salmonella risks associated with eggs, and is implementing short and long-term reduction strategies,” she said. The department and local government authorities were focusing on safety surveillance across the food industry, from paddock to plate.

“Eggs are a good source of nutrition, but like many other foods they can be contaminated with bacteria, including salmonella,” the spokeswoman said.

“It is important people handle and prepare eggs safely to reduce the food poisoning risk.”