Careful with that cow: 56 sick from Salmonella linked to contact with dairy

The U.S. Centers for Disease Control reports this outbreak investigation is over. Illnesses could continue because people may not know they could get a Salmonella infection from contact with dairy calves or other cattle.

CDC, several states, and the U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (USDA-APHIS) investigated a multistate outbreak of multidrug-resistant Salmonella Heidelberg infections. Epidemiologic and laboratory evidence indicated that contact with dairy calves and other cattle was the likely source of this outbreak.

A total of 56 people infected with the outbreak strains of Salmonella Heidelberg were reported from 15 states.  Illnesses started on dates ranging from January 27, 2015 to November 25, 2017. Of those with available information:

35% of people were hospitalized. No deaths were reported.

35% of people in this outbreak are children younger than 5 years.

Epidemiologic, laboratory, and traceback investigations linked ill people in this outbreak to contact with calves, including dairy calves.

In interviews, ill people answered questions about contact with animals and foods eaten in the week before becoming ill. Of the 54 people interviewed, 34 (63%) reported contact with dairy calves or other cattle. Some of the ill people interviewed reported that they became sick after their calves became sick or died.

Surveillance in veterinary diagnostic laboratories showed that calves in several states were infected with the outbreak strains of multidrug-resistant Salmonella Heidelberg

Information collected earlier in the outbreak indicated that most of the calves came from Wisconsin. Regulatory officials in several states attempted to trace the origin of calves linked to more recent illnesses. A specific source of cattle linked to newer illnesses was not identified.

Antibiotic resistance testing conducted by CDC on clinical isolates from ill people shows that the isolates were resistant to multiple antibiotics.

Antibiotic resistance may be associated with increased risk of hospitalization, development of a bloodstream infection, or treatment failure in patients.

Whole genome sequencing analysis identified predicted antibiotic resistance in outbreak-associated isolates from 48 ill people, in 88 isolates from cattle, and in 13 isolates from animal environments.

These findings match results from standard antibiotic resistance testing methods used by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory on 10 isolates from 9 ill people and 1 animal. All 10 isolates were resistant to amoxicillin-clavulanic acid, ampicillin, cefoxitin, ceftriaxone, streptomycin, sulfisoxazole, and tetracycline. In addition, nine had reduced susceptibility to ciprofloxacin, nine were  resistant to trimethoprim-sulfamethoxazole, six were resistant to nalidixic acid, four were resistant to chloramphenicol, and one was resistant to gentamicin. All 10 isolates tested were susceptible to azithromycin and meropenem.

Follow these steps to prevent illness when working with any livestock:

Always wash your hands thoroughly with soap and water right after touching livestock, equipment, or anything in the area where animals live and roam. Use dedicated clothes, shoes, and work gloves when working with livestock. Keep and store these items outside of your home.

It is especially important to follow these steps if there are children younger than 5 years in your household. Young children are more likely to get a Salmonella infection because their immune systems are still developing.

Work with your veterinarian to keep your animals healthy and prevent diseases.

It is important to remember that cattle can carry Salmonella and not appear sick. However, in this outbreak, some people did notice illness in their cattle, especially among calves. Livestock handlers should watch for sicknesses in dairy calves and consult their veterinarian if needed.

60 days don’t mean shit: 1 dead, 28 sick from E. coli O157:H7 in raw milk cheese, Canada, 2013

Between 12 July and 29 September 2013, 29 individuals in five Canadian provinces became ill following infection with the same strain of Escherichia coli O157:H7 as defined by molecular typing results. Five case patients were hospitalized, and one died.

Twenty-six case patients (90%) reported eating Gouda cheese originating from a dairy plant in British Columbia. All of the 22 case patients with sufficient product details available reported consuming Gouda cheese made with raw milk; this cheese had been produced between March and July 2013 and was aged for a minimum of 60 days. The outbreak strain was isolated from the implicated Gouda cheese, including one core sample obtained from an intact cheese wheel 83 days after production.

The findings indicate that raw milk was the primary source of the E. coli O157:H7, which persisted through production and the minimum 60-day aging period. This outbreak is the third caused by E. coli O157:H7 traced to Gouda cheese made with raw milk in North America.

These findings provide further evidence that a 60-day ripening period cannot ensure die-off of pathogens that might be present in raw milk Gouda cheese after production and have triggered an evaluation of processing conditions, physicochemical parameters, and options to mitigate the risk of E. coli O157:H7 infection associated with raw milk Gouda cheese produced in Canada.

Outbreak of Escherichia coli O157:H7 infections linked to aged raw milk gouda cheese, Canada, 2013

Andrea Currie, Eleni Galanis, Pedro Chacon, Regan Murray, Lynn Wilcott, Paul Kirkby, Lance Honish, Kristyn Franklin, Jeff Farber, Rob Parker, Sion Shyng, Davendra Sharma, Lorelee Tschetter, Linda Hoang, Linda Chui, Ana Pacagnella, Julie Wong, Jane Pritchard, Ashley Kerr, Marsha Taylor, Victor Mah, and James Flint

Journal of Food Protection, vol. 81, No. 2, 2018, pg. 325-331

doi:10.4315/0362-028X.JFP-17-283

https://www.ncbi.nlm.nih.gov/pubmed/29369688

PR before publication still a bad idea: Food safety on TV doesn’t go out of style

If you were deserted on a desert island, what would be the top 5 records/CDs/cassettes/8-tracks you would bring?

Stones, Beggar’s Banquet

Stones, Let it Bleed

Tragically Hip, Up to Here

Blue Rodeo, 5 Days in May

Old and in the Way

Just a suggestion.

I’m spit-balling here.

Repetition is the norm. Karl Popper had something to say about that.

In 2004, my laboratory reported (and by reported I mean published in a peer-reviewed journal) that, based on 60 hours of detailed viewing of television cooking shows, an unsafe food handling practice occurred about every four minutes, and that for every safe food handling practice observed, we observed 13 unsafe practices. The most common errors were inadequate hand washing and cross-contamination between raw and ready-to-eat foods.

Once the paper was published, it made headlines around the globe.

And then it started getting replicated. Texas, Europe, a few other places, and Massachusetts.

Now Germany.

BfR is presenting a research project on the topic of TV kitchen hygiene at International Green Week.

I’ve e-mail the folks at BfR who published this stuff and asked them whether it was peer-reviewed or not.

That was last week.

No answer.

Maybe something was lost in translation.

There were errors on average every 50 seconds, with the most common being dirty hands wiped on a tea towel and chopping boards being reused without first being cleaned.

They then tested two groups of participants making chicken salad with home-made mayonnaise based on a cooking video – one of which showed a chef who followed recommendations and another which showed a cook with poor hygiene. 

Those shown the video with the exemplary kitchen hygiene complied with the recommended measures more frequently when cooking the dish by themselves.

Prof Hensel added: “The results show that the kitchen hygiene presented in cooking shows may have an influence on the hygiene behaviour of the viewers.

“TV cooking shows can therefore take on a role model function by sharpening awareness of kitchen hygiene instead of neglecting it.”

Keep on spit-balling.

Mathiasen, L.A., Chapman, B.J., Lacroix, B.J. and Powell, D.A. 2004. Spot the mistake: Television cooking shows as a source of food safety information, Food Protection Trends 24(5): 328-334.

Consumers receive information on food preparation from a variety of sources. Numerous studies conducted over the past six years demonstrate that television is one of the primary sources for North Americans. This research reports on an examination and categorization of messages that television food and cooking programs provide to viewers about preparing food safely. During June 2002 and 2003, television food and cooking programs were recorded and reviewed, using a defined list of food safety practices based on criteria established by Food Safety Network researchers. Most surveyed programs were shown on Food Network Canada, a specialty cable channel. On average, 30 percent of the programs viewed were produced in Canada, with the remainder produced in the United States or United Kingdom. Sixty hours of content analysis revealed that the programs contained a total of 916 poor food-handling incidents. When negative food handling behaviors were compared to positive food handling behaviors, it was found that for each positive food handling behavior observed, 13 negative behaviors were observed. Common food safety errors included a lack of hand washing, cross-contamination and time-temperature violations. While television food and cooking programs are an entertainment source, there is an opportunity to improve their content so as to promote safe food handling.

Hosts on a viral planet: When Herpes infects the eye

In the summer of 1985, I was working in a cool lab, and about to enter the final year of my undergraduate degree in molecular biology and genetics.

And I was living with a girl.

In Aug. 1985, we got tickets to go see Neil Young and the International Harvesters at the CNE (the Canadian National Exhibition, or the Ex) and I fell ridiculously ill.

I was in bed for two weeks, barfing, and in agony – a great way to start a new relationship that would bear four beautiful daughters.

I made it out of bed to see Neil and the Harvesters.

The next day I went home to Brantford, Ontario, Canada.

I was really, really sick, my eye really, really hurt, and my parents suggested I go see the eye doctor.

Within 5 minutes, he diagnosed eye Herpes, prescribed a retroviral cream, and I was quickly cured.

Yeah, science.

I have been exceedingly public about this story in the fantastical hope that others may be spared some of the pain, or at least have it contained.

Sarah Zhang of The Atlantic writes – 33 years later – that Herpes simplex virus type 1 is best known as the culprit behind cold sores. When it’s not causing itchy, crusty sores on the mouth, it hides in the bundle of nerves that run through the face. And it’s super common. An estimated 50 to 90 percent of people harbor lifelong infections of HSV-1—largely without incident.

But in some cases, HSV-1 can run through that bundles of nerves in the face and erupt in the eye. Or maybe it gets into the eye from the outside. No one is really sure. In any case, HSV-1 can definitely infect the eye. (In case you’re wondering: HSV-1 can also cause genital infections, though it’s herpes simplex virus type 2 that is more commonly associated with genital herpes.)

Herpes in the eye is as bad as it sounds. The virus infects the cornea, forming tree-like branching ulcers across the eye. It can cause irritation, pain, sensitivity to light, and ultimately blindness if untreated. Herpes in the eye is a leading cause of blindness in the world. The cornea, after all, is a transparent layer of tissue at the front of the eye, whose job is essentially to let in as much light as possible. Infection can turn the cornea cloudy—permanently.

In most cases, herpes infections in the eye can be treated with antiviral drugs like Zovirax, but the herpes viruses are becoming increasingly resistant to these drugs. Scarred corneas can also be replaced with a transplant, but past infection makes the eye more likely to reject the new tissue. Plus, once you get herpes in the eye, it can keep coming back—just like cold sores. “For some patients that experience this, there’s absolutely nothing we do,” says Dan Carr, an HSV-1 researcher at the University of Oklahoma. “Essentially they’re going to go blind if something else doesn’t happen”—if new treatments don’t become available.

Enter now a surprising new study about herpes. Deepak Shukla, a virologist at the University of Illinois at Chicago, and colleagues have identified a molecule called BX795 that clears HSV-1 infections in human cells and in mice—with few side effects, it seems.

It’s a surprise because Shukla’s team originally threw BX795 onto HSV-1-infected cells thinking it would make the viruses grow better in the lab. (They were trying to study the virus’s basic functions.) That’s because BX795 is known to inhibit a enzyme called TBK1 that turns on the human immune response. Dampen the immune response, and you should get more viruses, right?

“We saw the opposite,” says Shukla. BX795 appears to play another role in yet another human enzyme that viruses hijack to synthesize their own viral proteins. Shukla’s team tested BX795 in cultured human cells, human corneas, and mice with herpes eye infections. It worked to suppress the herpes virus in all those cases—and often at lower concentrations than existing antiviral drugs.

Most exciting of all, BX795 could represent an entirely new class of drugs for herpes. Existing drugs generally work by inhibiting the virus’s DNA (or RNA) replication, blocking it from making more copies of itself. Since the drugs work in such similar ways, it’s easy for the virus to evolve resistance to all of them. “A second class is almost nonexistent. That’s where I think our discovery is really important,” says Shukla. BX795, remember, prevents protein synthesis instead. Shukla is now testing it to see if BX795 offers broad protection against other related viruses like those causing chicken pox and mono.

I spent the weekends of 1979 bagging rock, and while I thought I was just really bored, I had mono.

 

Woman’s rare eye infection highlights (low) risk of parasite spread by flies

Susan Perry of the Minnesota Post reports an Oregon woman is the first known person to become infected with a tiny parasitic worm that lives in the eyes of cattle, according to a case study report published Monday by researchers at the Centers for Disease Control and Prevention (CDC).

Although common in animals, eye-worm infections in humans are extremely rare. And, if caught and treated early, they don’t cause any permanent damage to the eye.

“This is only the 11th time a person has been infected by eye worms in North America,” lead author Richard Bradbury, who heads the CDC’s Parasite Diagnostics and Biology Laboratory, told CNN. “But what was really exciting it that it is a new species that has never infected people before. It’s a cattle worm that somehow jumped into a human.”

The woman, 28-year-old Abby Beckley, was working on a salmon boat in Alaska two summers ago when her left eye became irritated and inflamed. A week later, when the symptoms didn’t go away, she decided to investigate.

BuzzFeed reporter Nidhi Subbaraman, who interviewed Beckley, describes what happened next:

Standing at the mirror in the galley, [Beckley] plucked at her eyeball, as if extracting a contact lens. 

“I put my fingers in there in kind of a picking motion and I pulled out a worm,” Beckley [said]. “I looked at my finger and it was moving and I was shocked.” 

Beckley said she woke up her bunkmate to show her the worm, a piece of tangled white fluff wriggling at the end of her index finger. “She confirmed I wasn’t crazy,” Beckley said.

Over the course of the next few days she pulled out about a half dozen more worms. “I was living with these things, and I’d just keep pulling them out when I’d feel them,” Beckley said. 

Beckley flew home and went to see specialists at the Oregon Science and Health Laboratory in Portland. They extracted two more worms, and sent one to the CDC for analysis. It was identified as being the nematode Thelazia gulosa, which commonly infects the eyes of cattle, but had never been found in humans.

The case report was published online in the American Journal of Tropical Medicine and Hygiene, where it can be read in full.

Restaurant closed due to a cockroach infestation

I have always been curious to see what others thought on the following:
How many chances should the Health Department give a food service/retail establishment that has been chronically shut down before permanently having their business license rescinded?
I’m not talking about the minor violations that are encountered during a routine inspection, more of the deliberate critical infractions that can severely impact public health. As practicing food safety professionals, where do we draw the line? Inspections are a snap shop in time and food safety resonates upon behaviors for positive change. But what do we do with those select few places that simply don’t care and abide by the mentality that if I am fined, well it’s the cost of doing business? I’ve heard this and I’m sure others have as well. I would love to hear what Barfblog readers have to say regarding this matter.

A vile cockroach-infested restaurant has been shut down after revolting insects were discovered throughout the dilapidated building.
The pests were found hiding in the fridge door seal, preventing it from closing properly, and crawling around exposed foods, food containers and over kitchen surfaces.
Guildford Magistrates’ Court heard stomach-turning evidence of how owner Amjad Parvez Butt had been seen coughing over food, then failing to use soap when washing his hands.
Mr Butt was charged with seven counts of food safety and hygiene regulations contravention, all of which he pleaded guilty to.
Under routine inspection on June 27 last year, an environmental health officer from Rushmoor Borough Council visited the Lali Gurash Nepalese restaurant in Aldershot.
In the initial report, read to the court on Wednesday (February 14), the officer said: “When I arrived, I witnessed Mr Butt coughing while preparing food – he then washed his hands without using soap.”
The general first impression was that Mr Butt was not preparing food safely and an in depth inspection began.
After examining the fridge, it became apparent the door would not close properly due to a number of cockroaches living within the door seal.
The officer also noticed the building had structural damage, including a hole in the wall, through which clear daylight could be seen and gaps in the flooring near the waste pipes.
Further evidence of insect activity was discovered in the basement, around food preparation areas and in the proximity of exposed onions and potatoes.
During the inspection it also became apparent that Mr Butt had not been filling in the mandatory safer food, better business (SFBB) checks that RBC enforces, with the last entry filed more than five weeks prior to the visit.
The restaurant was closed and Mr Butt was ordered to arrange for a pest control team to install traps throughout the building.
A few days later, officers returned to discover a full life cycle of cockroaches in the traps, indicating that they had been present in the area for a minimum of six weeks.
Officers consistently monitored the progress of the restaurant until July 20, when, in the absence of any infestation, it was deemed acceptable for re-opening.
During the scheduled three-month re-visit, Mr Butt was asked to produce his SFBB documents, which he was unable to do, and the restaurant was once again closed.
In court, with the assistance of a translator, he explained that he was unable to read and write and claimed that his daughter was going to complete the checks for him but was away on holiday at the time.
The 53-year-old said: “When I first noticed the cockroaches I bought some spray and contacted pest control but they never got back to me.
“When I was told to close the restaurant and destroy the food, I did.
“I have lost a lot of profit and it is the first time this has happened – I ask for forgiveness.”

The rest of the story can be found here

New class of antibiotics may be capable of killing superbugs

When I was younger my mother got me a job in a hospital as a nurse’s aide while I finished my studies at university. As part of my duties I had to ensure patients that had methicillin-resistant Staphylococcus aureus (MRSA) were well taken care of. I was in my second year of University at that time and was vaguely familiar with this bug. Then came vancomycin resistant Enterococcus (VRE).
I left.

Anne Stych of Biz Women reports

Scientists studying microorganisms living in soil have discovered a new class of antibiotics that could kill deadly superbugs without triggering resistance.
The discovery leads researchers to believe there’s “a reservoir of antibiotics in the environment we haven’t accessed yet,” said Sean Brady, an associate professor at Rockefeller University in New York, who led the study.
The research, published in the journal Nature Microbiology, said the newly-discovered antibiotics kill superbugs including methicillin-resistant Staphylococcus aureus (MRSA), a potentially deadly infection that is resistant to several antibiotics.
A team led by Brady discovered the new class of antibiotics, called malacidins, while cloning and sequencing DNA from microorganisms in soil samples contributed by people across the United States, The Washington Post reported.
They were looking for microorganisms with a known gene that acts as an “on/off” switch and makes it more difficult for microbes to develop antibiotic resistance, per the Post.
The World Health Organization (WHO) last month called antibiotic resistance a “serious situation” worldwide in both low-income and high-income countries.
The organization’s research showed that resistance to commonly-used antibiotics varied widely among the 22 reporting countries, with resistance to penicillin in bacterial pneumonia cases ranging from zero to 51 percent, while E coli bacteria antibiotic resistance levels ranged from 8 percent to 65.
According to the U.S. Centers for Disease Control and Prevention, each year at least 2 million people in the United States become infected with bacteria that are resistant to antibiotics. At least 23,000 people die as a direct result, while many more die of conditions that were complicated by an antibiotic-resistant infection.
Worldwide, deaths from antibiotic-resistant infections are predicted to reach10 million a year by 2050, per the Post.
“Some of the world’s most common — and potentially most dangerous — infections are proving drug-resistant,“ said Dr . Marc Sprenger, director of the WHO Antimicrobial Resistance Secretariat. “And most worrying of all, pathogens don’t respect national borders. That’s why WHO is encouraging all countries to set up good surveillance systems for detecting drug resistance that can provide data to this global system.”
Researchers said although the discovery is promising and reveals the untapped biodiversity of our ecosystem, it will take years for the new class of antibiotics to be developed for practical use.

 

Listeria hysteria in South Africa

My wife and I were discussing this morning the horror that is occurring in South Africa regarding the Listeria outbreak. My wife is a professional dancer for an African modern dance group-NAfro in Winnipeg (Canada) and very interested in African culture. I have had the pleasure of speaking with her choreographer a number of times regarding issues in Africa (his home) which are primarily political in nature. Interesting stuff.
The World Health Organization has sent a food safety expert to South Africa to assist in identifying the cause of the Listeria outbreak. Apparently, it has been recommended that South Africa should have approximately 5000 environmental health practitioners; currently they only have 2000 to safeguard public health, clearly not enough.

Wendy Knowler of Times Live reports

Would you be able to list every single thing you’ve eaten in the past month?
That’s what victims of South Africa’s massive listeriosis outbreak – the biggest on record globally – are being asked to do by the National Institute for Communicable Diseases (NICD) in an attempt to pinpoint the source.
The number of confirmed listeriosis cases is now 872, and 164 of those have died – up from 107 last week. The current mortality rate is a staggering 27%.
Of those confirmed cases, 43% were babies of less than a month old – pregnant women being 20 times more likely to get listeriosis than other healthy adults.
Contracted by eating food containing the listeria pathogen, listeriosis is by far the most deadly of food-borne diseases. Given the scale of our mystery outbreak, it has led to what one delegate termed “listeria hysteria”, at a listeriosis workshop hosted by the South African Association of Food Science and Technology (SAAFoST) in Johannesburg on Wednesday.
While patés, soft cheeses and guacamole have been found to be the source in listeriosis outbreaks in other countries, our outbreak is unlikely to be a “high-end luxury food item”, said the NICD’s Dr Juno Thomas at the workshop.
“So far, our epidemiological investigation team has interviewed about 60 listeriosis victims to find out what they ate, day by day, during the month before they became symptomatic, in an attempt to identify patterns of consumption and indicate what we can eliminate,” Thomas said. “None had eaten smoked fish, for example.”
Food safety expert and SAAFoST president Lucia Anelich said given that a single, unique “homegrown” strain of listeriosis was identified in more than 90% of the confirmed cases, it was likely that the source was a single food product or range of food products consumed often and by both rich and poor across South Africa.
“Cold meats, for example, range from viennas and polony to more expensive slices of ham,” she said.
As listeria is killed during the cooking process, the culprit is thought to be a ready-to-eat food, fruit, or vegetables.
Attorney Janus Luterek told workshop delegates that his work had led him to believe that the offending product would be traced back to irrigation water that was not properly treated. A few food scientists in the room agreed with him.
“Keep your insurance up to date,” Luterek told the attending food producers, “because when the claims come they will be huge, as in a Boeing 737 crashing and everyone on board dying.”
The World Health Organisation (WHO) has sent a food safety expert, an epidemiologist with listeriosis experience and a communication specialist to South Africa to help identify the source of the outbreak.
A WHO spokesman was quoted in industry publications this week as saying the body was working on a “strong lead”, with laboratory results pending.
Speaking at the workshop, Dr Thomas said food safety legislation was fragmented, outdated and inappropriate for South Africa.
“We need a dramatic overhaul of our legislation and the entire food safety system,” she said.
For example, she said, there were fewer than 2,000 environmental health practitioners, responsible for monitoring all food outlets from restaurants to informal vendors, but the WHO recommended that South Africa needed 5,000 of them.
Several presenters mentioned the need for better cooperation between the government departments and organisations responsible for food safety – including health; agriculture, forestry and fisheries; trade and industry; and the Consumer Goods Council.

 

17 sick from hepA in Denmark linked to dates

Since the end of January, the State Serum Institute has investigated a disease outbreak of contagious hepatitis caused by hepatitis A virus infections. This indicates that the source of infection may be dates, and the case is further investigated in collaboration with the Danish Veterinary and Food Administration and the DTU Food Institute. The outbreak is the second national food-borne outbreak of hepatitis A in Denmark.

The outbreak thus includes 17 patients, nine women and eight men aged 17 years. Patients have become ill from December 2017 onwards. Patients are resident throughout the country and 16 have been hospitalized. Virus from seven of the patients has been type-approved for type 3A, and for the time being, genetic studies have shown that four of these are identical, which supports the suspicion of a common source of infection. It is still expected that more patients will come, as about four weeks from eating the contaminated dates until you get sick with hepatitis A.

To investigate the source of infection for the outbreak, the State Serum Institute has conducted extensive interviews with patients and made a so-called case-control study. During the initial interviews, dates, as several of the patients indicated to have eaten, were suspected. The correlation between dates and disease risk was then investigated in the case-control study. Here you compare how often patients have eaten a number of specific foods with similar information from a comparable group of healthy Danes. 

The results have shown that the source of infection was most likely to have been dates since patients had far more eaten this food than the comparable group of healthy Danes. The dates are described by most patients as soft dark stones with stones purchased in Rema1000. The results were handed over to the Danish Veterinary and Food Administration, The importer and Rema1000 chose to withdraw the dates on 6 February .

The likelihood of infectious hepatitis infection caused by infection with Hepatitis A virus by eating dates from Rema1000 is considered very small. Therefore, there is no need to consult a doctor if you have no symptoms of hepatitis A infection.

If you have eaten Rema1000 dadels after 1 December 2017 and develop symptoms of hepatitis such as nausea, madness, abdominal pain, vomiting, diarrhea or fever without any other obvious causes or yellowing of the skin and the whites of the eyes, light colored dye and / or dark , porter-colored urine, consult your own doctor.