Rectal swabs? Eeww: Diarrhea downs 91 police trainees in Philippines

Posted on December 2, 2015 by Douglas Powell

Ninety-one police trainees were hospitalized Friday due to diarrhea in Surigao City, a belated police report said on Tuesday.

Superintendent Daniel Puesca, information officer of the Caraga regional police office, reported to the National Operation Center in Camp Crame said that 50 members of Public Safety Field Training Program (PSFTP) class 2015-02 were rushed to the regional hospital at around 6 p.m. Friday

Another 41 trainees were later taken to the same hospital after also complaining of stomachache after they were given first aid by the staff of the training school.

As of Tuesday, Puesca said the Surigao City health office of the DOH are still working to determine the cause of the diarrhea and water samples have been taken by the regional hospital. The results on the water testing are expected in a week.

Results of rectal swabs and stool examinations conducted on the patients will also be sent to Metro Manila for confirmation.

Whole genome sequencing – it’s all the rage

Posted on November 30, 2015 by Douglas Powell

I returned to the University of Guelph in about 1989 for a press thingy, and asked a former genetics prof (who was an asshole; drinking game, they all were) what was this PCR stuf.

He didn’t tell me how a dude on acid figured it out, but it was now routine.

Today, whole genome sequencing is all the rage, and all I can remember is, another six months of graduate school for you, Powell, go tape those gels.

Our rudimentary DNA sequencing back in 1985 involved a particular skill with masking tape so the gels wouldn’t leak.

And a lot of radioactive phosphorous.

And phenol-based extraction, which has left my one pinky finger smaller than the other.

Science.

Whole genome sequencing (WGS) has emerged as a powerful tool for comparing bacterial isolates in outbreak detection and investigation. Here, we demonstrate that WGS performed prospectively for national epidemiologic surveillance of Listeria monocytogenes has the capacity to be superior to our current approach using pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), multilocus variable-number tandem repeat analysis (MLVA), binary typing and serotyping. Initially 423 L. monocytogenes isolates underwent WGS and comparisons uncovered a diverse genetic population structure derived from three distinct lineages. MLST, binary and serotyping results inferred in silico from the WGS data were highly concordant (>99%) with laboratory typing performed in parallel. However, WGS was able to identify distinct nested clusters within groups of isolates that were otherwise indistinguishable by our current typing methods. Routine WGS was then used for prospective epidemiologic surveillance on a further 97 L. monocytogenes isolates over a 12-month period, providing a greater level of discrimination to conventional typing for inferring linkage to point source outbreaks. A risk based alert system based on WGS similarity was used to inform epidemiologists required to act on the data. Our experience shows WGS could be adopted for prospective L. monocytogenes surveillance, and investigated for other pathogens relevant to public health.

Prospective whole genome sequencing enhances national surveillance of Listeria monocytogenes

J Clin Microbiol. 2015 Nov 25. pii: JCM.02344-15.

Kwong JC, Mercoulia K, Tomita T, Easton M, Li HY, Bulach DM, Stinear TP, Seemann T, Howden BP.

http://www.ncbi.nlm.nih.gov/pubmed/26607978?dopt=Abstract

Testing a necessary evil of food safety: FDA’s microbiological surveillance sampling

Posted on November 25, 2015 by Douglas Powell

As part of the U.S. Food and Drug Administration’s risk-based and preventive approach to food safety, which is at the core of the FDA Food Safety Modernization Act, the agency began developing a new, more robust surveillance sampling approach in 2014. As the agency moves forward with this approach, it will continue to refine procedures based on lessons learned. The goals of the surveillance sampling are to keep contaminated products from reaching consumers and to facilitate a greater understanding of hazards.

FDA will publish information regarding test results on the web, including total number of samples collected/tested, and collection date, sample type, and pathogen detected for positive samples.

The Sampling Approach

Under the new sampling approach, the FDA is collecting a statistically determined number of samples of targeted foods over a shorter period of time—12 to18 months—to ensure a statistically valid amount of data is available for decision making. The sampling approach will help the FDA determine if there are any common factors among positive findings such as season, region, and whether the product was produced domestically or imported. The FDA’s past approach to microbiological surveillance sampling has been to collect a relatively small number of samples for many different commodities over many years.

The sampling design for each food represents what U.S. consumers are likely to find in the marketplace. Accordingly, the agency has considered the volume of the target food that is imported and produced domestically and the number of states/countries that produce the target food.

During the first year of this new effort, the FDA focused on sprouts, whole fresh avocados, and raw milk cheese (aged 60 days). The FDA collected more than 800 samples total and tested them for Salmonella, Listeria monocytogenes and E. coli O157:H7. For fiscal year 2016, The FDA will sample and test cucumbers and hot peppers for Salmonella and E. coli O157:H7, taking 1,600 samples of each commodity. The agency also plans to test hot peppers for Shiga toxin producing E. coli. The FDA will conduct whole genomic sequence testing on any samples that test positive. In the future, the number of samples collected of a targeted commodity may vary, depending on the question(s) the FDA intends to answer. Data from the sampling assignments already conducted will be released soon.

The FDA will evaluate the data or results generated throughout the sample collection period and use the data to inform the agency’s short and longer term decision making. By developing these data sets, the FDA seeks to identify potential vulnerabilities and ways to enhance the food safety system.

Depending on the results, the FDA may react or take certain steps, such as:

Decreasing sampling, if few positive samples are obtained;
Implementing more targeted sampling if trends are identified; for example, if positive samples come from a specific geographic region, a specific facility, or during a particular season;
Follow-up inspections;
Working with state or international regulatory partners to take corrective actions and implement preventive controls;
Developing new or enhanced industry guidance; and
Conducting outreach and information sharing to better protect consumers.

4 dead, 834 sick from Salmonella in cucumbers from Mexico

Posted on November 20, 2015 by Douglas Powell

Who knew cucumbers could be so vile?

The U.S. Centers for Disease Control, multiple states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Salmonella Poona infections.

Epidemiologic, laboratory, and traceback investigations identified cucumbers imported from Mexico and distributed by Andrew & Williamson Fresh Produce as a likely source of the infections in this outbreak.

Two recalls of cucumbers that may be contaminated with Salmonella were announced as a result of this investigation: Andrew & Williamson Fresh Produce and Custom Produce Sales.

838 people infected with the outbreak strains of Salmonella Poona have been reported from 38 states, an increase of 71 cases since the last update on October 14.

165 ill people have been hospitalized, and four deaths have been reported from Arizona (1), California (1), Oklahoma (1), and Texas (1).

PR 101: Campylobacter still present on 76% of UK birds, but heavy contamination is down! Steaming hot sucks

Posted on November 20, 2015 by Douglas Powell

The results for the first quarter of testing, from July to September 2015, show a decrease in the number of birds with the highest level of contamination from the same months last year.

These most heavily contaminated birds are the focus of the current target agreed by industry, which is equivalent to no more than 7% of chickens at retail having the highest levels of contamination. Research has shown that reducing the proportion of birds in this category will have the biggest positive impact on public health.

The new data shows 15% of chickens tested positive for the highest level of contamination, down from 22% in July to September 2014. Campylobacter was present on 76% of chicken samples, down from 83% in the same months of last year.

The results for the first quarter show:

15% of chickens tested positive for campylobacter within the highest band of contamination*

76% of chickens tested positive for the presence of campylobacter

0.3% of packaging tested positive at the highest band of contamination

6% of packaging tested positive for the presence of campylobacter

*More than 1,000 colony forming units per gram (cfu/g). These units indicate the degree of contamination on each sample.

In this first quarter, 1,032 samples of fresh whole chilled UK-produced chickens and packaging have been tested. The chickens were bought from large UK retail outlets and smaller independent stores and butchers. The new survey commenced sampling in July 2015.

The FSA has been testing chickens for campylobacter since February 2014 and publishing the results as part of its campaign to bring together the whole food chain to tackle the problem. Campylobacter is the most common cause of food poisoning in the UK, making an estimated 280,000 people ill every year.

As with the previous survey, the data shows variations between the retailers. Testing of chickens from Co-op and Waitrose show both retailers have made the most significant reductions in the proportion of the chickens they sell that are most highly-contaminated.

Steve Wearne, Director of Policy at the FSA said: ‘It is good to see that some retailers are getting to grips with campylobacter. However, we want to see all of them pulling together to achieve real and lasting reductions.

‘I am also pleased that we are starting to see retailers and processors being open with consumers about what they are doing to tackle the problem and about the impact their interventions are having on the chickens they are selling.’

But FSA continues to insist chicken is safe as long as consumers follow good kitchen practice:

Cover and chill raw chicken: Cover raw chicken and store on the bottom shelf of the fridge so juices cannot drip on to other foods and contaminate them with food poisoning bacteria such as campylobacter;

Don’t wash raw chicken: Cooking will kill any bacteria present, including campylobacter, while washing chicken can spread germs by splashing;

Wash hands and used utensils: Thoroughly wash and clean all utensils, chopping boards and surfaces used to prepare raw chicken. Wash hands thoroughly with soap and warm water, after handling raw chicken. This helps stop the spread of campylobacter by avoiding cross contamination.

Cook chicken thoroughly: Make sure chicken is steaming hot all the way through before serving. Cut in to the thickest part of the meat and check that it is steaming hot with no pink meat and that the juices run clear.

Steaming hot sucks, especially for a science-based agency.

Dangerous E. coli in RTE foods in China

Posted on November 18, 2015 by Douglas Powell

Enteropathogenic Escherichia coli (EPEC) is an important foodborne pathogen that potentially causes infant and adult diarrhea.

The occurrence and characteristics of EPEC in retail ready-to-eat (RTE) foods have not been thoroughly investigated in China. This study aimed to investigate EPEC occurrence in retail RTE foods sold in the markets of China and to characterize the isolated EPEC by serotyping, virulence gene analyses, antibiotic susceptibility test, and molecular typing based on enterobacterial repetitive intergenic consensus–polymerase chain reaction (ERIC-PCR).

From May 2012 to April 2013, 459 RTE food samples were collected from retail markets in 24 cities of China. E. coli in general, and EPEC specifically, were detected in 144 (31.4%) and 39 (8.5%) samples, respectively. Cold vegetable in sauce was the food type most frequently contaminated with EPEC (18.6%). Of 39 EPEC isolates, 38 were atypical EPEC (eae+) and 1 was typical EPEC (eae+bfpA+) by multiplex PCR assays. The virulence genes espA, espB, tir, and iha were detected in 12, 9, 2, and 1 of 39 isolates, respectively, while genes toxB, etpD, katP, and saa were not detected.

O-antigen serotyping results showed that among 28 typeable isolates, the most common serotype was O119, followed by O26, O111, and O128. Many isolates were resistant to tetracycline (64.1%; 25/39), ampicillin (48.7%; 19/39), and trimethoprim/sulfamethoxazole (48.7%; 19/39). ERIC-PCR indicated high genetic diversity in EPEC strains, which classified 42 strains (39 isolates and 3 reference strains) into 32 different profiles with a discrimination index of 0.981.

The findings of this study highlight the need for close surveillance of the RTE foods at the level of production, packaging, and storage to minimize risks of foodborne disease.

Occurrence and characterization of Enteropathogenic Escherichia coli (EPEC) in retail ready-to-eat foods in China

Foodborne Pathogens and Disease. -Not available-, ahead of print. doi:10.1089/fpd.2015.2020.

Zhang Shuhong, Wu Qingping, Zhang Jumei, and Zhu Xuemei

http://online.liebertpub.com/doi/abs/10.1089/fpd.2015.2020

Food detectives: Students investigate mock poisoning in Dubai

Posted on November 12, 2015 by Douglas Powell

What made many of the guests at Noor’s birthday party sick? Why is the school clinic full of students complaining of stomachache, diarrhea and vomiting?

Students from some Dubai schools recently got a chance to investigate such intriguing scenarios, thanks to an initiative launched at the 10th Dubai International Food Safety Conference.

Middle and high school boys and girls donned the roles of “Food Detectives” at the workshops titled so, and used their detective skills to solve the suspected food poisoning cases presented to them.

The Dubai Municipality’s Food Safety Department teamed up with Science Party Dubai to host the special workshops aimed at teaching principles of epidemiological investigation to school children.

Multiple case studies of food poisoning were presented to teams of students who used their detective skills to solve them. They also suggested ways to prevent food poisoning cases.

Arvin Jalali, a ninth grader from GEMS Winchester School told Khaleej Times the students enjoyed learning things that they had not taken seriously earlier.

“Look at all the bacteria around us. How all they can spread! We are really lucky that nothing happened to us so far,” he said.

His schoolmate Imran Hussain Tauqeer said most participants didn’t realise the side effects of what they often do and take for granted.

“Now we know many things about basic food safety. Now we know the importance of hand hygiene, temperature control, and bacteria in raw eggs,” he said.

Teachers present at the workshop echoed the same.

Martha Carol, a teacher with Dar Al Marefa School, said: “They came to know how bacteria grow at certain level of temperature which they feel safe, but is actually not safe. They realized it better when they investigated by themselves.”

Australian researchers summarize surveillance approaches

Posted on November 11, 2015 by Douglas Powell

Foodborne disease surveillance aims to reduce the burden of illness due to contaminated food.

There are several different types of surveillance systems, including event-based surveillance, indicator-based surveillance, and integrated food chain surveillance. These approaches are not mutually exclusive, have overlapping data sources, require distinct capacities and resources, and can be considered a hierarchy, with each level being more complex and resulting in a greater ability to detect and control foodborne disease.

Event-based surveillance is generally the least resource-intensive system and makes use of informal data sources. Indicator-based surveillance is seen as traditional notifiable disease surveillance and consists of routinely collected data. Integrated food chain surveillance is viewed as the optimal practice for conducting continuous risk analysis for foodborne diseases, but also requires significant ongoing resources and greater multisectoral collaboration compared to the other systems. Each country must determine the most appropriate structure for their surveillance system for foodborne diseases based on their available resources.

This review explores the evidence on the principles, minimum capabilities, and minimum requirements of each type of surveillance and discusses examples from a range of countries. This review forms the evidence base for the Strengthening the Surveillance and Response for Foodborne Diseases: A Practical Manual.

Approaches to the surveillance of foodborne disease: A review of the evidence

Foodborne Pathogens and Disease. -Not available-, ahead of print. doi:10.1089/fpd.2015.2013.

Ford Laura, Miller Megge, Cawthorne Amy, Fearnley Emily, and Kirk Martyn

http://online.liebertpub.com/doi/abs/10.1089/fpd.2015.2013

Foodborne outbreaks in Canada 2008-2014

Posted on November 11, 2015 by Douglas Powell

Background: Enteric outbreak investigation in Canada is performed at the local, provincial/territorial (P/T) and federal levels. Historically, routine surveillance of outbreaks did not occur in all jurisdictions and so the Public Health Agency of Canada, in partnership with P/T public health authorities, developed a secure, web-based Outbreak Summaries (OS) Reporting System to address this gap.

Objective: This analysis summarizes the foodborne outbreak investigations reported to the OS Reporting System between 2008 and 2014.

Methods: Finalised reports of investigations between 2008 and 2014 for all participating jurisdictions in Canada were extracted and descriptive analysis was carried out for foodborne outbreaks on etiological agent, severity of illness, outbreak duration, exposure setting and outbreak source.

Results: There were 115 reported foodborne outbreaks included in the analysis. This represents 11.2% of all outbreaks reported in the enteric module of the OS Reporting System between 2008 and 2014. Salmonella was the most commonly reported cause of foodborne outbreak (40.9%) and Enteritidis was the most common serotype reported. Foodborne outbreaks accounted for 3,301 illnesses, 225 hospitalizations and 30 deaths. Overall, 38.3% of foodborne outbreaks were reported to have occurred in a community and 32.2% were associated with a food service establishment. Most foodborne outbreak investigations (63.5%) reported a specific food associated with the outbreak, most frequently meat.

Conclusion: The OS Reporting System supports information sharing and collaboration among Canadian public health partners and offers an opportunity to obtain a national picture of foodborne outbreaks. This analysis has demonstrated the utility of the OS Reporting System data as an important and useful source of information to describe foodborne outbreak investigations in Canada.

Funding for this program was provided by the Public Health Agency of Canada.

An overview of foodborne outbreaks in Canada reported through Outbreak Summaries: 2008-2014

CCDR: Volume 41-11, November 5, 2015: Foodborne Illness

Bélanger P, Tanguay F, Hamel M, Phypers M

http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/15vol41/dr-rm41-11/ar-01-eng.php#footnote1

Safer food saves lives

Posted on November 7, 2015 by Douglas Powell

That’s the view from the U.S. Centers for Disease Control and Prevention, and I agree.

Contaminated food sent to several states can make people sick with the same germ. These multistate outbreaks cause serious illness, and more of these outbreaks are being found. Multistate outbreaks caused 56% of deaths in all reported foodborne outbreaks, although they accounted for just 3% of all such outbreaks from 2010 to 2014. Foods that cause multistate outbreaks are contaminated before they reach a restaurant or home kitchen. Investigating these outbreaks often reveals problems on the farm, in processing or in distribution that resulted in contaminated food. Lessons learned from these outbreaks are helping make food safer. To protect the public’s health, government at all levels and food industries need to work together to stop outbreaks and keep them from happening in the first place.

Food industries can:

Keep records to trace foods from source to destination.

Use store loyalty card and distribution records to help investigators identify what made people sick.

Recall products linked to an outbreak and notify customers.

Choose only suppliers that use food safety best practices.

Share proven food safety solutions with others in industry.

Make food safety a core part of company culture.

Meet or exceed new food safety laws and regulations.

Problem

Multistate foodborne outbreaks are serious and hard to solve.

Multistate outbreaks can be hard to detect.

Contaminated food grown or produced in a single place can wind up in kitchens across America.

People in many states may get sick from a contaminated food, making it difficult to spot the outbreak.

Detecting that an outbreak is happening requires specialized testing of germs in laboratories across the country.

Multistate outbreaks can be hard to investigate.

Investigators depend on sick people to remember what they ate several weeks earlier.

If the problem is a contaminated ingredient, people may unknowingly eat it in many different foods.

Unexpected foods have been linked to recent multistate outbreaks, such as caramel apples and chia powder.

Contaminated food can be hard to trace to the source.

Companies may not have complete records of the source or destination of foods.

Imported food can be even harder to trace to its source, and imports to the US are increasing.

Many different farms may produce the beef in a single burger or the fresh vegetables sold in a single crate.

Innovative methods are helping detect and solve more multistate outbreaks.

New DNA sequencing technology is improving public health’s ability to link germs found in sick people and in contaminated foods.

Information technology is helping investigators in many places work together.

Efforts by food industries are helping trace contaminated foods to their source.

What Can Be Done

The Federal government is

Implementing improved food safety laws and regulations.

Working with state and local health departments to use better methods, including DNA sequencing, to find, investigate and quickly stop multistate foodborne outbreaks.

Helping state and local health departments improve food safety inspections and guidelines.

State and local public health agencies can

Encourage clinical laboratories to quickly submit germs from sick people to the public health laboratory for advanced testing.

Test the germs from sick people quickly to find if others got sick from the same germ.

Interview sick people promptly about what they ate, using standard questions.

Test suspect foods, if available.

Participate in national networks to share improved methods for investigating multistate outbreaks.

Encourage industry actions that focus on preventing foodborne disease.

Health care providers can

Submit germs from sick people quickly to public health laboratories for advanced testing.

Report suspected outbreaks rapidly to the local or state health department.

Inform patients or caretakers of those in high-risk groups that they have an increased risk for food poisoning. These include pregnant women, adults over 65 years, children under 5, and people with weakened immune systems. Steps to prevent food poisoning can be found on: www.foodsafety.gov

Food industries can

Keep records to trace foods from source to destination.

Use store loyalty card and distribution records to help investigators identify what made people sick.

Recall products linked to an outbreak and notify customers.

Choose only suppliers that use food safety best practices.

Share proven food safety solutions with others in industry.

Make food safety a core part of company culture.

Meet or exceed new food safety laws and regulations.

Everyone can

Check for food recalls and information about how to handle and prepare food safely on: www.foodsafety.gov

Take action if you think you have a foodborne sickness:

Talk to your health care provider.

Write down what you ate in the week before you started to get sick.

Report your sickness to the health department if you think you are part of an outbreak.

Assist public health investigators by answering questions about your sickness.

Consider getting a loyalty card where you shop. If there is a recall, the store can use the card to notify you.

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Tag Archives: Surveillance