Shigella, E. coli on sugar snaps in Sweden

Eurosurveillance today reports an outbreak of Shigella dysenteriae type 2 infections during May-June 2009 in Sweden, involving 47 suspected cases of whom 35 were laboratory-confirmed.

The epidemiological investigation based on interviews with the patients pointed at sugar snaps from Kenya as the source. Shigella was not detected in samples of sugar snaps. However, Escherichia coli was confirmed in three of four samples indicating contamination by faecal material.

During April to May 2009 outbreaks with Shigella connected to sugar snaps from Kenya were reported from Norway and Denmark. In the three countries trace back of the indicated sugar snaps revealed a complex system with several involved import companies and distributers. In Sweden one wholesale company was identified and connections were seen to the Danish trace back. These three outbreaks question whether the existing international certification and quality standards that are in place to prevent products from contamination by faecal pathogens are strict enough.

No, they’re not.
 

Beware of pizza in Halmsted, Sweden

The pizza in Halmstad, Sweden apparently sucks.

Food safety inspections allegedly found that almost 90 per cent of establishments that serve pizza failed to meet the minimum levels of hygiene.

The Hallands-Posten reported that just nine of the 70 restaurants in town that serve pizza made the grade. Food safety inspectors were genuinely shocked when they tallied the results of their unannounced checks on restaurants in the coastal town of Halmstad this spring. With the vast majority of the town’s restaurants miserably failing basic hygiene, the inspectors were left wondering what went wrong.

Food safety inspector Ulrika Cederberg told the Hallands-Posten,

“We’re quite shocked. We actually didn’t think it would be this bad. There were nineteen places that didn’t have access to a functioning washbasin with soap and paper towels.”

Among the most appalling findings was one restaurant that was infested with a species of beetle that lives off dried fish, meat and cheese. Inspectors shut the place down immediately.

Another restaurant was given a temporary reprieve when the staff stayed up all night to try and clean up the many failures given out by inspectors. Storing food in toilets and no washbasins were major failings at that restaurant.

Norovirus probable at Swedish pizza joint; almost 600 sick

Pizzeria Alcamo in Jönköping – which is apparently in southern Sweden – was closed Thursday and by today, 593 people said they were sick after a visit or a slice.

It is not yet known whether patrons fell ill as a result of food poisoning or a fast-spreading outbreak of the winter vomiting virus.

The council’s health and safety office has carried out tests on kebab meat, iceberg lettuce and kebab sauce in a bid to isolate the source of the outbreak.
 

Swedish court rules that diarrhea no excuse for speeding

A court in Trelleborg, Sweden, has ruled that a woman’s diarrhea was not a sufficient reason for her to break the posted speed limit while driving.

The district court rejected the 49-year-old woman’s argument that she was forced to drive 53 mph in a 43 mph zone because of her digestive issues, Swedish news agency TT reported Thursday.

The court said the speed limit can only be broken in cases of emergency, which it defined as a danger to someone’s life or to prevent a serious crime.

The woman was ordered to pay her speeding ticket.
 

How much food poisoning is deliberate?

Not deliberately dumb, or deliberately daft, but deliberate with intent for death – or at least dysentery.

Sweden’s security service Säpo is investigating possible sabotage following an incident which left 140 people at the headquarters of Confederation of Swedish Enterprise (Svenskt Näringsliv) suffering from dysentery.

The victims, which included employees of the association, its members, and other guests, all suffered from the illness caused by the Shigella dysenteriae bacteria after eating in the office’s cafeteria several weeks ago, reports the Veckans Affärer magazine.

According to the Metro newspaper, the group claiming responsibility for the attack is a left-leaning, internet-based forum which had previously staged demonstrations outside of the association’s headquarters.

In Texas, an IHOP restaurant has been closed three times in the past five months for repeated occurrences of what health investigators call a rare Salmonella, type C; over 10 people have been sickened.

Group C is a strain that researchers and health officials hardly ever see and it’s so powerful it clings to surfaces and is more resistant to disinfection.

Police have been called in to help with the investigation.
 

Typo in food magazine recipe poisons Swedes

Ten thousand copies of a food magazine were recalled in Sweden last month after a mistake in one of its recipes left four people poisoned.

Matmagasinet’s chief editor Ulla Cocke told AFP,

"There was a mistake in a recipe for apple cake. Instead of calling for two pinches of nutmeg it said 20 nutmeg nuts were needed.”

When Matmagasinet first discovered the mistake it immediately sent out letters to its 50,000 subscribers and placed a leaflet inside the copies sold in the store, cautioning that "high doses of nutmeg can cause poisoning symptoms."

"We publish 1,200 recipes each year, and of course there have been times when they’ve had a bit too much butter or too little flour, but we have never experienced anything like this before,"
Cocke said.

In large doses, nutmeg is a mild hallucinogen
.
 

E. coli kills 2-year-old Swedish girl

The Swedish Institute for Infectious Disease Control said Tuesday that a two-year-old girl has died in Sweden after contracting the lethal enterohaemorrhagic E. coli (EHEC) bacteria, although no source had been identified.

The girl had fallen ill during a visit to Mora in central Sweden on June 29 and had died a few days later at a hospital in Stockholm, the Dagens Nyheter daily reported.

While most strains of E. coli are harmless, EHEC bacteria can produce nausea, diarrhoea and potentially lethal kidney problems, particularly threatening people with weak immune systems such as the elderly and small children.
 

E. coli O157 outbreak in Sweden associated with locally produced lettuce

Outbreaks involving fresh produce do happen in other countries — they’re just not so well reported.

Soderstrom et al. do a nice job in the current Foodborne Pathogens and Disease describing a 2005 outbreak of E. coli O157 in Sweden.

"A total of 135 cases were recorded, including 11 cases of hemolytic uremic syndrome. The epidemiological investigations implicated lettuce as the most likely source of the outbreak, with an OR of 13.0 (CI 2.94–57.5) in the case–control study. The lettuce was irrigated by water from a small stream, and water samples were positive for Stx 2 by PCR. The identical VTEC O157 Stx 2 positive strain was isolated from the cases and in cattle at a farm upstream from the irrigation point."

Watch that irrigation water.

Salmonella in Sweden: no “shit sample from the flock”

Sweden’s English language newspaper, The Local, reported today that 12 people in the Gävle region have contracted salmonella poisoning after eating infected eggs imported from Poland.

The story explains that as salmonella is common in Poland, a special certificate is needed when importing eggs to Sweden to prove that a particular batch is not infected with the bacteria.

Food administration inspector Pontus Elvingsson said tests are generally carried that include "shit samples from the flock."

Certificates obtained by wholesalers at Årstahallarna in Stockholm contained information that was false.

The administration believes that those infected in the eastern town may have fallen ill after eating mayonnaise made with the Polish eggs.

The National Food Administration (Livsmedelverket) said that eggs from the same batch have also been sold in Sollentuna, Botkyrka and Stockholm.

Sprouts in Sweden

Eurosurveillance reports today on an outbreak of Salmonella linked to raw alfalfa sprouts in summer 2007 in Sweden, which sickened at least 51 people.

Almost two years ago, Salmonella in mung bean sprouts sickened 650 Ontarians.

Kingston, Ontario, was ground zero for the great Salmonella sprout outbreak of 2005. After 15 students at Queen’s University visited the emergency ward. puking and pooping, they tested positive for the same strain of Salmonella, a link was made to raw bean sprouts, and the city decided on Nov. 23, 2005 to warn the public. The next day, Dr. Sheela Basrur, Ontario’s Chief Medical Officer of Health, advised the entire province not to eat raw or cooked bean sprouts, including those from grocery stores, home refrigerators or those served at restaurants.

Like undergarments for Britney Spears, Lindsay Lohan and Paris Hilton, sprouts were de facto banned.

As the number of confirmed sick people rose into the hundreds, the Canadian Food Inspection Agency on November 25, 2005, finally issued an advisory for mung bean sprouts manufactured by Toronto Sun Wah Trading Inc. — the largest sprout growth facility in the province.

There was lots of press and a bit of outrage, but after bans, investigations, and promises of doing things differently, raw sprouts again became widely available, as soon as three weeks after the outbreak was identified. To borrow the words of a U.S. Food and Drug Administration official commenting on the return of fresh spinach to supermarket aisles in Oct. 2006, the product was "just as safe as it was before the outbreak."

And if it has, the Canadian public would be the last to know.

On December 16, 2005, Kingston lifted its city-wide ban on sprouts after receiving clearance from CFIA, but the local medical officer of health, Dr. Ian Gemmill, was reluctant, stating, "I’m all for getting a definitive answer to this, but so far, our colleagues at CFIA have not provided us with a process that will assure that bean sprouts are not contaminated."

They still haven’t.

Two years later, such advisories have been magically lifted and sprouts are being placed ever so gingerly on gourmet, supposedly healthy sandwiches, in the complete absence of any evidence that raw sprouts are any safer than they were before the outbreak.

The consumption of raw sprouts has been linked to over 30 outbreaks of foodborne illness throughout North America in the past 15 year affecting tens of thousands of people (a complete list of North American sprout outbreaks is available at http://www.foodsafetynetwork.ca/en/article-details.php?a=2&c=6&sc=36&id=865).

The first consumer warning about sprouts was issued by the U.S. Centers for Disease Control (CDC) in 1997. By July 9, 1999, FDA had advised all Americans to be aware of the risks associated with eating raw sprouts and that the best way to control the risk was to simply not eat raw sprouts. FDA stated that it would monitor the situation and take any further actions required to protect consumers.

At the time, Canadian media depicted the U.S. response as panic at the disco, quoting Health Canada officials who said while some people were at risk, sprouts were generally a low-risk product.

The 650 sick Ontarians were undoubtedly comforted by such assurances.

Sprouts, by nature, present a special food safety challenge because the way they
are grown — high moisture and high temperature — is also an ideal environment for bacterial growth. In addition to their cantankerous temperament, sprouts are impossible to wash, making CFIA’s standby warning to consumers to wash their produce even more pointless than usual.

Because of continued outbreaks, the sprout industry, regulatory agencies, and the academic community, at least in the U.S., pooled their efforts in the late 1990s to improve the safety of the product, including the implementation of good manufacturing practices, establishing guidelines for safe sprout production and chemical disinfection of seeds prior to sprouting.

That approach appears to have reduced the risk in the U.S. as the number of sprout outbreaks has declined. Not so in Canada, where CFIA routinely touts its best practices document.

But are these guidelines actually being followed? And even if they are, is anyone checking?

Thousands of sick people and two years after the world’s largest sprout-related outbreak, in a brazenly bizarre demonstration of Canadian politeness, no victims have stepped forward to complain (several have declined to go public at the last minute), no sprout growers have publicly defended their industry, no government-type has publicly stated why raw sprouts are now safe to eat, and no journalist has bothered to follow up. And there has never been any sort of official write-up on the outbreak.

Sprouts in Canada are just as safe and just as dangerous as ever. Sweden too.

Douglas Powell is scientific director of the International Food Safety Network at Kansas State University,
dpowell@ksu.edu
foodsafety.ksu.edu
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