Health alert issued by Brisbane Grammar School after volunteer canteen worker contracts hepatitis A

Posted on February 29, 2012 by Douglas Powell

Sorenne will not be going to the Brisbane Grammar School for grades 6-12. It’s not the $20,000 a year in tuition, another $20,000 a year for boarding, the $400 for the privilege of applying or that it’s an all-boys school.

I have problems when a school with such a fee structure – or any school — relies on volunteers to run the tuckshop that offers breakfast and lunch, and when a volunteer contracts hepatitis A, the best the school can come up with is, the canteen abides by the proper standards and, “Full food-handling protocol is followed in the school.”

I don’t know what full food-handling protocol is, but some details would be nice. Maybe even a vaccination requirement for all volunteers.

The Courier Mail reports the school told its community by letter on Tuesday, on the urging of public health authorities, that they were under a low-level risk of Hepatitis A.

"We were told a volunteer worker had subsequently been diagnosed with Hep A after she had worked at the canteen,” said a spokeswoman.

"The public health authority spoke to the worker, figured out what she did and when they found out it involved food, as a precautionary measure asked the school to advise everyone. The risk is deemed to be extremely low."

If an E. coli O1157:H7 vaccine for cattle works, who should pay

Posted on November 29, 2011 by Douglas Powell

Elizabeth Weise in USA Today doesn’t really answer the who-should-pay question, but does ask, what if it were possible to almost entirely do away with E. coli in ground beef and it would cost only about a penny a burger?

Food-safety experts say it’s entirely feasible with new technologies that have become available. One is a vaccine, the other a feed additive, which, given early enough, could bring down potential E. coli contamination to negligible levels.

The problem, experts in beef safety say, is that the economics are backward. The new interventions have to be administered long before the cattle are slaughtered, when the calves are young or in feedlots where they’re growing.

It’s hard to figure out who should pay for steps that would take place months and possibly years before the grill starts sizzling. The people who’d have to pay for them aren’t the ones who would reap the direct benefits.’’’

These interventions aren’t perfect, but they’re very good, says Guy Loneragan, a professor of food safety at Texas Tech University in Lubbock. "The question is no longer, ‘Can we get the technologies?’ We’ve got them, or they’re soon to arrive. The question is ‘How do we implement?’ "

So far only two small companies appear to be embracing them. One is a tiny feed lot cooperative in Kansas that’s looking to vaccinate all its cattle "soon." The other is a Meade, Kan., cooperative that’s staking its economic life on calling for retailers nationally to demand these interventions from the packers that supply their meat.

The regulatory landscape "is confusing," says Elisabeth Hagen, USDA’s undersecretary for food safety. "But we’re realizing that there’s an issue here and somehow we have to bring everybody together and focus on the end product, the result of which is the safety of the food that goes to the American consumer."

Loneragan says they’ve gone as far as they can after the animal is slaughtered. Now the focus needs to be on ridding the animals of E. coli O157:H7 before they get to the slaughterhouse. The new methods to do that involve:

•A vaccine. The biggest and potentially most game-changing treatment is a vaccine introduced by Pfizer Animal Health in 2010 and given in a three-shot series starting when the calf is just 6 months old. This gets rid of the E. coli O157:H7 bacteria in 85% of the cattle, says Brad Morgan, a senior food-safety specialist at Pfizer Animal Health in Stillwater, Okla. Not only that, but even among the ones that still have the bacteria in the gut, the injections reduce the amount the animals shed in their manure by 98%, he says.

It’s not all or nothing. Pfizer has done studies showing that if only 50% or even 25% of cattle are vaccinated, rates of E. coli are strongly reduced in the feed yard, and therefore in the packing plant. And Harvard’s Hammitt says his research shows that Americans understand that food can’t be "perfectly safe," but they want safer.

The vaccine costs $4 to $6 per animal for the full series, says Loneragan. There are several other vaccines in the regulatory pipeline here and overseas.

•The probiotic. The other intervention is a probiotic added to feed. These are beneficial bacteria cultures that out-compete the more dangerous forms of E. coli in the cattles’ guts, much as yogurt is said to seed the gut with good bacteria to keep out the bad. Many studies have found that using "the right strain at the right dose you can get a fairly predictable 40% to 50% reduction in E. coli O157:H7," says Loneragan.

The American Meat Institute Foundation, the research arm of the meat industry trade group, says there just isn’t enough data yet to know if these treatments work. While there’s been a tremendous amount of research and it looks promising, "We’re right at the cusp of understanding the technology," says Betsy Booren, the institute’s director of scientific affairs.

Last year Cargill, one of the nation’s largest beef producers, conducted a trial of the E. coli vaccine on 85,000 head of cattle at its Fort Morgan, Colo., beef-processing facility, says spokesman Mike Martin at Cargill’s Wichita headquarters.

The trial’s results were "inconclusive," Martin says, in part because the levels of O157:H7 they found on the cattle in general "were the lowest in years . …" There was "very little difference" in rates between the vaccinated and the unvaccinated cattle, he says.

Loneragan says in the studies he’s done, E. coli O157:H7 levels were indeed low but dropped lower in meat from vaccinated cattle.

In the end, it’s going to take movement by the biggest companies to move the industry. There are two that could make this happen in a second, McDonald’s and Wal-Mart, says Chuck Jolley, a meat industry marketing company executive.

"If either decides to require it, the industry will turn around on a dime," he says.

I just wanted a Dunkin’ Donut and got Hepatitis A instead

Posted on April 16, 2010 by Douglas Powell

Next time go to Tim Hortons.

The Westchester Health Department says some patrons of a New York doughnut shop may have been exposed to hepatitis A by an infected employee.

Acting Health Commissioner Dr. Cheryl Archbald says customers may have been exposed if they had any iced drinks between March 28 and April 6 at a combined Dunkin’ Donuts and Baskin Robbins shop on Washington Street in Peekskill.

A spokeswoman said the employee may have reached into the ice machine with bare hands while he was infected.

The county is offering free post-exposure treatment.

Get vaccinated before grabbing ice with poop on your hands.

Lowering loads: food safety starts on the farm

Posted on February 8, 2010 by Douglas Powell

Every time some government type says there are more cases of E. coli O157:H7 and other dangerous bacteria in the summertime because people barbeque more, I cringe. It’s one of those blame-the-consumer comments when the reality is more complicated.

Most food safety interventions are designed to reduce or eliminate pathogen loads – to lower the number of harmful bugs from farm-to-fork. A piece of highly-contaminated meat can wreck cross-contamination havoc in a food service or home kitchen.

Elizabeth Weise writes in USA Today today that animals carry higher levels of E. coli O157:H7 and friends during the summer months, and summarizes efforts to lower bacterial loads on animals entering slaughter plants.

Jerold Mande, USDA deputy undersecretary for food safety, said last month,

"To take the next big step forward on food safety, we need to do more to have fewer pathogens on food animals when they arrive at the slaughterhouse gate.”

Jim Marsden of Kansas State University said that microbiologically, the biggest "bang for the buck" is cleaning the bacteria off the hide or the carcass to keep it from coming into contact with the meat.

Weise writes that a number of possible interventions are in the works. Each, it is hoped, might take down the incidence of E. coli O157:H7 by a factor of 100. Below is the edited list.

Vaccines: Gut warfare

Probably the most hopeful are vaccines that lower the amount of O157:H7 in cattle’s guts. Two are furthest along, one from a Minnesota company called Epitopix and one by a Canadian company called Bioniche Life Sciences. Epitopix’s vaccine has received preliminary approval from the USDA and is being tested in the USA. Bioniche’s vaccine was approved in Canada last year and is in the approval process in the USA. In addition, scientists at the USDA’s National Animal Disease Center in Ames, Iowa, have developed two more vaccines.

Field trials of the Epitopix vaccine showed that 86% of vaccinated cattle stopped shedding O157:H7 bacteria in their feces. Of those that still were shedding bacteria, there was a 98% reduction in the amount, says Daniel Thomson (left, photo from USA Today), a veterinarian and professor of Production Medicine at Kansas State University in Manhattan, Kan., who has studied the effectiveness of vaccine for the company.

The issue for cattlemen will be the costs of the two or three shots necessary to create immunity and the wear and tear on the cattle caused by bringing them in to be vaccinated. Going through the chute that holds them still while they’re given the shot, necessary to safeguard workers, can cause some cattle to become agitated.

Phages: A spray of bacteria fighters

Cattle walking through a car-wash-like spray of bacteria-eating viruses called phages sounds more science fiction than feedlot, but it’s actually in use across the USA. In cattle, a phage that is specific to E. coli O157:H7 is sprayed on the animals one to four hours before they’re slaughtered. "They like to have them soak," says Dan Schaefer, director of beef research and development at in Wichita. Cargill is testing the spray at one of its plants.

Probiotics: ‘Exclusion’ cultures

Basically these are bacterial cultures much like those in yogurt, given to cattle in their feed. They’re called "competitive exclusion" cultures because they out-compete the bad bacteria and exclude them in the animals’ guts. Michael Doyle, director of the Center for Food Safety at the University of Georgia in Griffin, spent years investigating them.

One for E. coli O157:H7 "worked really well for a while and then it stopped working for a while," he says. Doses required are often higher than those claimed by the companies that sell them, he says. Currently these aren’t approved by USDA or FDA as E. coli reduction methods, so the companies that market them can’t make any specific claims for them.

Sodium chlorate: A ‘suicide pill’

This chemical is used in part to do environmentally safe paper bleaching. But administered in extremely small amounts, it also plays a deadly trick on E. coli O157:H7 and salmonella.

In the oxygen-free environment of a cow’s gut, these bacteria are able to obtain energy from nitrogen. But they can’t tell the difference between nitrogen and chlorate, so if there’s chlorate present, they try to use that. This turns the chlorate into bleach, killing the bacteria from the inside without harming the animal.

Grain vs. high-quality hay

Research in Texas, Kansas and Idaho has shown that switching cattle from grain to a more expensive diet of high quality hay before slaughter may lower E. coli O157:H7 rates, though the findings have not always been consistent.

From an epidemiologic standpoint, it’s clear that these pre-slaughter interventions lower the E. coli O157:H7 burden in the cattle, says Guy Loneragan, a professor of animal science and expert in O157:H7 in cattle at West Texas A&M University in Canyon, Texas.

The question is whether investing money on the ranch and feedlot will save money at the packing plant.

Sorenne’s first Hepatitis A vaccination

Posted on December 10, 2009 by Amy Hubbell

Sorenne’s first birthday was fun but her 1-year doctor’s visit was not. She got 5 shots and a blood draw which left her in tears and a bit leery of nurses for future visits. All I could think about was how thankful I am that she is not a sick child and that this kind of torture is preventative and not curative treatment. I do not know how parents of sick children cope with watching their children suffer. Doug said, “Now imagine watching your child in the hospital with HUS.”

One of Sorenne’s jabs was for Hepatitis A. I got that shot and follow up in 2003-2004 because I was visiting risky countries like Iraq and Senegal. Sorenne will be immunized as a baby and we should never have to worry about at least that illness in the future. Now if only there were a vaccine for dangerous strains of E. coli, Salmonella, and other foodborne illnesses.

H1N1 flu vaccine: strategies questioned

Posted on August 24, 2009 by Megan Hardigree

In a six-hour meeting yesterday, Sunday, August 23, at the Crowne Plaza Hotel in Trevose, Bucks County, Pennsylvania, the H1N1 flu vaccine was discussed. The main question was how to approach the public: “full throttle” and “go slow” options were debated. The meeting included watching videos about pandemics, vaccines, and the brief history of H1N1.

The vaccine would be taken on a voluntary basis regardless of the panel’s decision, but how educating the public, the benefits or risks of the vaccine, and possible mandating of the vaccine seems to be what most of the panel members are concerned with.

Prevention of H1N1 by handwashing did not seem to be a topic of conversation.

This meeting is one of ten that are occurring across the US. To read the full article, click here.

US waits to react to flu discovery in Canadian pigs

Posted on May 4, 2009 by Casey Jacob

As a backlog of state and federal lab test results reached the Centers for Disease Control and Prevention (CDC), the total number of confirmed cases of H1N1 in the US climbed to 244 in 34 states, the Associated Press reported this weekend.

The Globe and Mail reported numbers from the World Health Organization, stating, “Canada, for its part, has tallied 101 cases in seven provinces.”

When news broke that a Canadian swine herd was found suffering from a flu thought to be H1N1, the U.S. Department of Agriculture (USDA) issued a statement assuring that, “this detection does not change the situation here in the United States.”

The statement continued:

“Today’s discovery will not impact our borders or trading with Canada. As prescribed by the World Organization for Animal Health guidelines, any trade restrictions must be based on science so at this time, we are awaiting confirmatory test results before considering any action."

Additionally, while the CDC works on a H1N1 vaccine for humans, the USDA announced it is trying to develop a vaccine for swine. But that’s just standard protocol when a new virus appears.

It seems they’re taking no rash action until there’s evidence to suggest it’s necessary. That sounds like a wise use of resources to me.

The World Health Organization is similarly waiting for evidence before sounding the alert to a pandemic. As reported by the New York Times,

“The World Health Organization announced an increase in the number of confirmed cases of swine flu on Saturday, but said there was no evidence of sustained spread in communities outside North America, which would fit the definition of a pandemic.”

“Dr. Michael J. Ryan, the director of the World Health Organization global alert and response team, said in a teleconference from Geneva, ‘We have to expect that Phase 6 (the level of a pandemic) will be reached. We have to hope that it is not.’”

The public should be made aware of existing risks and what’s being done to manage them. But, there is no good reason to waste resources pretending to manage imaginary risks.

Act on what you know and seek out what you don’t–for the good of the public.

Spanish soccer star Sisi sidelined with hepatitis A

Posted on February 18, 2009 by Douglas Powell

It’s Oscar time and I can’t wait to see which celebrities have to get vaccinated for hepatitis A this year after the parties. But until Sunday, soccer seems to be the source of reminders to get vaccinated against hepatitis A, which is transmitted via human poop.

RC Recreativo de Huelva are set to be without Spain Under-21 midfielder Sisi (right) for at least the next six weeks after the 22-year-old was diagnosed with hepatitis A.

Sisi is not the first U21 international to contract hepatitis A this year. Germany’s Ashkan Dejagah was diagnosed with the same condition in early February and his club – VfL Wolfsburg – are resigned to losing him for a "very long time".

Get vaccinated for hepatitis A or you’ll rue the day

Posted on January 8, 2009 by Douglas Powell

Real Genius was a 1985 fluff film notable for some witty banter, bunny slippers, and that actor Val Kilmer, in the role of science whiz Chris Knight, once had a sense of humor. Like this scene, right:

Dr. Dodd: Why is that toy on your head?
Chris Knight: Because if I wear it any place else, it chafes.

And I wish I’d remembered this classic when Amy was pregnant. I had so many opportunities to use it:

Chris Knight: Do you mind if I name my first child after you? "Dipshit Knight" has a nice ring to it.

I was struck with nostalgia when I read the headline in Canada’s North Bay Nugget this morning, Victim rues not getting vaccinated.

I looked at Amy and said, “You’ll rue the day. Who talks like that? Where’s that line from?”

“I don’t know.”

Then I used a tool my students finally taught me to use a few years ago. It’s called Google. And there it was:

[Kent opens his dorm room door to find his car inside]
Chris Knight: Hey Kent… That’s your car.
Mitch: Kent, you know you’re not supposed to park that on campus.
Kent: You’ve gone too far this time, Knight.
Chris Knight: [whiny, scared voice] I had help!
[points to Mitch]
Kent: You, huh? Well you won’t get away with this. Doctor Hathaway’s gonna hear all about this. You’ll rue the day!
Chris Knight: "Rue the day?" Who talks like that?

And rather than rue the day, get vaccinated for hepatitis A before going to the Dominican Republic. Or you may cause a health scare where you bartend.

The North Bay Parry Sound District Health Unit announced Wednesday there was one case of hepatitis A in the city. Officials advised patrons who had visited the bar Nov. 26, Dec. 3, 4, 10 or 11 to watch for symptoms associated with the virus and contact their health-care providers.

And some more of the witty 1985 banter:

Chris Knight: Sir, let me take this moment to compliment you on your fashion sense, particularly your slippers.

Kent: Uh, I’ll catch up with you guys. I have to go to the bathroom.
Chris Knight: Okay, Kent, but I don’t think that’s going to help your confidence any, do you?

Professor Hathaway: I want to see more of you around the lab.
Chris Knight: Fine. I’ll gain weight.

Chris Knight: Kent puts his name on his license plate.
Mitch: My mom does the same thing to my underwear.
Chris Knight: Your mom puts license plates in your underwear? How do you sit?

Talladega Shake-N-Bake

Posted on October 13, 2007 by Douglas Powell

Is NASCAR a source of infectious disease? Sure, with 200,000 — 300,000 people hanging out in the same area for the weekend.

The Atlanta Journal-Constitution reports that Democrats who advised aides studying public health preparedness at mass gatherings to get immunized for hepatitis A, hepatitis B, diphtheria, tetanus and influenza before going to the UAW-Ford 500 in Talladega last weekend and the Bank of America 500 this weekend northeast of Charlotte, N.C. are now being taunted by Republicans.

Linda Daves, the chairwoman of the North Carolina Republican Party, said,

"Democrats should know that there is no preventive measure yet designed to ward off the blue-collar values and patriotism that NASCAR fans represent. If they aren’t careful, they just might catch some of it."

Republican Rep. Tim Walberg, whose district includes the Michigan International Speedway, said Democrats must not understand the term "rubbin’ is racing," adding,

"To suggest that vaccines are needed to attend NASCAR races is insulting to millions of hardworking Americans who love their country and the smell of burnt rubber."

Shake-N-Bake.

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