Food safety is not simple

Winnipeg, Manitoba, Canada correspondent, Rob Mancini, writes:

I’ve been told many times from various sources that Mancini’s always a cheerful guy, you can’t upset him… this is only because I find happiness with my family. I have an amazing wife and 2 incredible kids (6 years old and 19 months), all healthy.  What more can I ask for: nothing.

But when I read stories of kids dying from hemolytic uremic syndrome due to an E. coli infection, in particular when it could have been prevented, I get mad.

“We can’t hold him. We can’t love on him. All we can do is just stand at the bedside,” Lindsey Montgomery, Huston’s mom, told WFAA.

Heartbreaking.

Fox News reports A 2-year-old boy is on life support after contracting an E. coli infection from an unknown source while on vacation in Oklahoma with his family. Landon Huston, of Ennis, Texas, was experiencing stomach virus-like symptoms when a fecal sample tested positive for E. coli, WFAA reported.

Huston was taken to Children’s Medical Center Dallas where doctors discovered the infection had progressed to Hemolytic Uremic Syndrome (HUS), an abnormal destruction of red blood cells that leads to kidney failure, WFAA reported.

Huston underwent the first of two surgeries on June 14 and has had a blood transfusion. He was placed on life support after doctors discovered fluid in his lungs, a post on the family’s GoFundMe page said.

The Texas Department of Health Services is investigating any potential source of the bacteria. E. coli can be found in the environment, foods, and intestines of people and animals, according to the Centers for Disease Control and Prevention (CDC).

“Most parents like us had no idea, you know, the dangers of something like this,” Montgomery told WFAA. “And it’s everywhere. E. coli is something that’s everywhere.”

While most strains of the bacteria are harmless, others can cause diarrhea, urinary tract infections, respiratory illness and pneumonia. About 5-10 percent of patients who contract E. coli will develop (HUS), which could present as decreased frequency of urination, feeling tired and losing color in cheeks and inside the lower eyelids. Patients can recover in a few weeks but others may suffer permanent damage or die.

“I have faith he’s going to come out on top,” John Huston, the toddler’s dad, told WFAA.

I’ve taught many food safety courses and have lectured on the importance of food safety to many. I’ve used different techniques in teaching, heavily based on behavioral science amongst other antics, to stress the importance of certain food safety principles. Even did a TV show on the subject.  All of this doesn’t matter if your inherent belief system is contrary to the information provided.  Need to be compelling and understand how human behavior operates. At times I wish I know more psychology but it’s never too late.

Food safety is not simple, it is hard and anyone who says otherwise is clueless.

I always try to share personal stories and current relevant food safety stories in an attempt to connect with my audience or readers and gauge their interest. Doug taught me this and it works.

 

Norovirus in frozen raspberries: Quebecers sick

My grandfather, Homer the Canadian asparagus baron, always said if it wasn’t asparagus, he figured raspberries would be a good cash crop.

He had a patch out front and as a child I could often be found in the raspberry patch, picking a few and eating many.

So I’m disappointed (how Canadian) whenever cheap raspberries are the culprit in transmitting norovirus or hepatitis A.

I’m even more disappointed when taypayer-funded bureaucrats in government and public journalism fail to ask basic questions or provide basic information so consumers can make actual food choices, away from the hucksterism.

CBC News reports the Ministry of Agriculture, Fisheries and Food (MAPAQ) has issued a warning list of raspberry and raspberry products that may have been contaminated by norovirus.

Several cases of illness have already been reported to the ministry.

Those who have products on the list are asked to avoid consuming them and return them to the facility where they were purchased, or discard them.

Media coverage notes the bad batch of raspberries that is the likely culprit has been recalled by the Canadian Food Inspection Agency.

Oddly, the only recall on the CFIA website involving norovirus and frozen raspberries happened on June 20, 2017, with almost no supporting information, other than, media should call.

Gelsius brand IQF Whole Raspberries were recalled due to norovirus,and were distributed by Farinex (113712 Canada Inc.), a Quebec-based distributor of all things food.

Here’s some questions to ask:

Where were the frozen berries grown?

Were they covered in human shit?

Why so little info from CFIA?

Montreal locations affected by the recall:

Crémerie Gélato Cielo (10414 Gouin Blvd. W.)

Raspberry gelato

Raspberry sorbet

Berry sorbet

C’Chô-Colat Inc. (1255 Bishop St.)

Raspberry gelato

Raspberry sorbet

Berry sorbet

Les Délices Lafrenaie Inc. (8405 Lafrenaie St.)

Frutti di bosco

Heavenly berry

Les gourmandises de Marie-Antoinette (4317 Ontario St. E.)

Marie-Antoinette cake

Glaces et Sorbets Kem Coba inc. (60 Fairmont Ave. W.)

Raspberry sorbet

Boulangerie Et Pâtisserie Lasalle R.D.P. Inc. (8591 Maurice-Duplessis Blvd.)

Berry cake

Gourmet Bazar inc. (9051 Charles-de-la-Tour St.)

Whole raspberries

Me thinks something is going on here.

Homer would be ashamed that raspberries got a bad name.

Lunar module to control that E. coli

Escherichia coli O157:H7 is an important foodborne pathogen that causes severe bloody diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome.

Ruminant manure is a primary source of E. coli O157:H7 contaminating the environment and food sources. Therefore, effective interventions targeted at reducing the prevalence of fecal excretion of E. coli O157:H7 by cattle and sheep and the elimination of E. coli O157:H7 contamination of meat products as well as fruits and vegetables are required.

Bacteriophages offer the prospect of sustainable alternative approaches against bacterial pathogens with the flexibility of being applied therapeutically or for biological control purposes.

This article reviews the use of phages administered orally or rectally to ruminants and by spraying or immersion of fruits and vegetables as an antimicrobial strategy for controlling E. coli O157:H7. The few reports available demonstrate the potential of phage therapy to reduce E. coli O157:H7 carriage in cattle and sheep, and preparation of commercial phage products was recently launched into commercial markets.

However, a better ecological understanding of the phage E. coli O157:H7 will improve antimicrobial effectiveness of phages for elimination of E. coli O157:H7 in vivo.

Use of bacteriophages to control Escherichia coli O157:H7 in domestic ruminants, meat products, and fruit and vegetables

Foodborne Pathogens and Disease, June 2017, ahead of print, Wang Lili, Qu Kunli, Li Xiaoyu, Cao Zhenhui, Wang Xitao, Li Zhen, Song Yaxiong, and Xu Yongping, https://doi.org/10.1089/fpd.2016.2266

http://online.liebertpub.com/doi/abs/10.1089/fpd.2016.2266

Cockles warmed: E. coli O157 strikes UK child, school says wasn’t us

Parents have been warned to be alert for signs of a “very infectious” strain of E. coli after a pupil from Thurnby Lodge Primary, in Leicester, contracted the O157 strain of the bug.

The source of the infection, caught over the half-term holidays, is not known, the school said. The severity of the illness has not been disclosed, but pupils in the same
class were sent letters by Public Heath England.

A spokeswoman for the school said, in her best British bureaucratese, “Thurnby Lodge Primary has received no further notifications of such incidents and it is deemed likely that the child was infected outside of school during the holidays. The letters from Public Health England came via the academy and were just a precautionary measure.”

The cockles of the parents were warmed.

And what kind of school is named, Thumby?

NZ parents warned about dangerous E. coli

According to the New Zealand Herald, Taranaki District Health Board medical officer of health Dr Jonathan Jarman has started to raise awareness about Shiga toxin-producing E.coli (STEC) after research found the number of cases in the area was increasing but few people knew about it.

The research, by a medical student last year, found most cases were in children under the age of five who had been exposed to farm animals in the week prior to the onset of illness, Jarman said. Almost half the people affected were hospitalised and one in 10 people developed a life-threatening complication – hemolytic uremic syndrome.

Jarman said STEC, also known as verotoxin E.coli, was an organism carried in the intestines of cattle and other farm animals but the study found that virtually no one in the farming sector had heard about it.

“STEC is twice as common as leptospirosis which everyone knows about,” he said. “It’s a type of E.coli that produces a toxin and it can be quite serious in humans.”

It caused a severe gastrointestinal illness and was mainly a problem in areas where there was a lot of dairy farming and was most common around calving season.

The strain was first detected in humans in New Zealand in 1993, Jarman said. Last year there were 14 cases in Taranaki and so far this year there had been six.

No one had died from it in Taranaki but there had been deaths in other parts of the country.

ESR public health physician Jill Sherwood said there had been no increase in the number of STEC cases nationally. There were 205 reported last year and 125 so far this year.

Jarman distributed information to local organisations as well as a couple of national ones such as the Ministry for Primary Industries in his mission to raise awareness. The message had gone out to early learning centre in Taranaki and spread to other centres including some in Auckland.

“It is a very contagious disease. It’s quite easy to pick up. For that reason when we are notified about cases

The food safety world has lost two champions

I never met Dave Theno. I saw him speak a few times at IAFP, and other places; he had a fantastic story to tell – he had the experience of cleaning up after a tragic food safety mess. Stories like that are compelling – especially when the storyteller is earnest an candid (and Dave was). There’s a lot to learn from folks like that. Dave was a food safety rock star. Everyone knew him.

Sadly, Dave passed away on Monday.

The food safety world lost another star, albeit quietly.

My introduction to the real food and agriculture world was driving around Ontario (that’s in Canada) with Doug and Amber Bailey.

In the summer of 2001, we went on a trip to Leamington, Ontario to spend some time in vegetable greenhouses where Amber was collecting wash water and tomato samples for analysis and talking to the growers about hazards and risk reduction.

These trips were part of a program that Doug, Amber and Denton Hoffman, then General Manager of the Ontario Greenhouse Vegetable Growers, had created. On that trip, Denton told me that what kept him up at night was the thought of a customer in Pittsburgh or Cleveland getting sick from one of his industry’s 200+ members products.

That one incident could close the border to the hundreds of thousands of pounds of tomatoes and cucumbers that were being shipped all over the Eastern U.S.

I think the story is that Denton approached Doug sometime after following a Cyclospora outbreak linked to Guatemalan raspberries. Initially California strawberries were fingered for the illnesses. Denton saw how an outbreak, even if the industry wasn’t the source, could cost millions. So he wanted a robust, science-based and defendable food safety program to protect his members.

I took over Amber’s role as food safety coordinator and worked alongside Denton from 2001-2005. After declining health over the past few years and a stroke in 2015, Denton passed away last week.

I can’t find the words to describe how my experience with Denton shaped me. I have to steal Doug’s words, ‘This guy was a champion of on-farm food safety, long before it was fashionable.’ Yep.

31 sickened by E. coli O55 in Dorset: 3 years later, health-types’ report remains a secret

In Dec. 2014, an outbreak of E. coli O55 was identified in Dorset, U.K. with at least 31 sickened. Public Health England (PHE) and local environmental health officials investigated and found nothing, other than cats were also being affected.

Tara Russell of Bournemouth Echo reports again this week that a review into the outbreak in Dorset was carried out, health chiefs have insisted – but the report is not available to the public.

Public Health England (PHE) says the public can only request to see the report detailing exactly what happened when 31 people contracted the O55 strain between July 2014 and November 2015 through a Freedom of Information request.

Families including some whose children have been left with lifelong health complications say they did not know the review existed and have branded it ‘disappointing and disgusting’ they have been kept in the dark.

The Daily Echo has lodged an official FOI request on behalf of the affected families and will receive a response in July.

Nurse Jessica Archer, who today suffers crippling head pains, fatigue and depression while her nephew Isaac Mortlock (right) endures severe seizures, must be peg fed every night and will need a kidney transplant as a result of the outbreak, said: “Without the Daily Echo we wouldn’t even know this report even existed and we are very interested to see it and we have the right to know. The families affected have so many unanswered questions and have to live with the effects of this outbreak forever but yet again we feel Public Health England are trying to sweep it under the carpet and hope that it will just go away.

“It is disappointing and disgusting this report has not already been made public let alone having to wait and wait still. We feel there have been a series of failures and this is the latest.”

The news comes after Jessica last month called for PHE to be held to account telling how her and her five-year-old nephew’s Isaac Mortlock’s lives have changed irreversibly, and accused the organisation of ‘a cover up.’

In response, PHE told the Daily Echo it carries out ‘routine outbreak reviews once investigations have ended’, adding it is ‘a learning organisation and reflects on outbreaks to identify lessons learnt and to continually improve our response.’

However at the time, the organisation refused to tell the Daily Echo exactly which lessons were learned.

It was only following a further request from this newspaper, PHE said a report was compiled however it has not been available to the public.

A spokesman said: “This report was not intended for external publication – it’s not standard procedure to publish outbreak reports externally due to patient confidentiality – however if interested parties would like to request a copy they can do this via our Freedom of Information portal.”

That’s bullshit.

Outbreak investigations are routinely published while ensuring patient confidentiality.

Families say it is the latest in a string of ‘failures’ by Public Health England.

A spokesman from PHE added: “As with all outbreaks, PHE Health Protection Team ensured throughout their investigation that those affected were kept informed of any information that was uncovered at that time.”

That’s also bullshit.

And why UK health types feature prominently in our paper on when to go public for the benefit of public health.

Three years seems a bit long.

Going public: Early disclosure of food risks for the benefit of public health

Mar.17

NEHA, Volume 79.7, Pages 8-14

Benjamin Chapman, Maria Sol Erdozaim, Douglas Powell

http://www.neha.org/node/58904

Often during an outbreak of foodborne illness, there are health officials who have data indicating that there is a risk prior to notifying the public. During the lag period between the first public health signal and some release of public information, there are decision makers who are weighing evidence with the impacts of going public.

Multiple agencies and analysts have lamented that there is not a common playbook or decision tree for how public health agencies determine what information to release and when. Regularly, health authorities suggest that how and when public information is released is evaluated on a case-by-case basis without sharing the steps and criteria used to make decisions.

Information provision on its own is not enough. Risk communication, to be effective and grounded in behavior theory, should provide control measure options for risk management decisions. There is no indication in the literature that consumers benefit from paternalistic protection decisions to guard against information overload. A review of the risk communication literature related to outbreaks, as well as case studies of actual incidents, are explored and a blueprint for health authorities to follow is provided.

Handwashing is never enough: Texas family says sons infected with E. coli at petting zoo

An Azle family wants to warn others after both their young boys were hospitalized with E. coli earlier this year.

“It’s awful. You can’t do anything but just sit there and watch your child hurt,” Emily Miller told WFAA.

Miller’s sons Brayden, 7, and Dylan, 5, were both diagnosed with an E. coli infection, and Dylan’s case impacted his kidneys. Miller said he required dialysis, and he was hospitalized for 27 days, including several nights in the ICU.

“It’s such a crazy thought that this could happen,” Miller said.

She was surprised by the intensity of the illness, but also by where her boys may have come into contact with E. coli. She said doctors believe they were likely contaminated while the family was visiting a petting zoo.

“I wasn’t aware that you could get it from animals and livestock,” Miller said.

She took the boys to the petting zoo back in January, and four days later her oldest was in the hospital.

Both brothers are now doing well, though Dylan is still on blood pressure medicine due to the illness, Miller said.

The Centers for Disease Control says petting zoos do pose risks, as livestock can carry E. coli bacteria. The CDC’s advice is to wash hands with soap and water immediately after being near animals, whether you touch them or not.

The CDC also says that soap and water is more effective than instant hand sanitizers, and if sanitizers are the only option, go ahead and use them but follow up with soap and water as soon as possible.

A table of petting zoo outbreaks is available at http://barfblog.com/wp-content/uploads/2014/04/Petting-Zoo-Outbreaks-Table-4-8-14.xlsx.

Erdozain G, Kukanich K, Chapman B, Powell D. 2012. Observation of public health risk behaviours, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011. Zoonoses Public Health. 2012 Jul 30. doi: 10.1111/j.1863-2378.2012.01531.x. [Epub ahead of print]

Abstract below:

Observation of public health risk behaviors, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011Outbreaks of human illness have been linked to visiting settings with animal contact throughout developed countries. This paper details an observational study of hand hygiene tool availability and recommendations; frequency of risky behavior; and, handwashing attempts by visitors in Kansas (9) and Missouri (4), U.S., petting zoos. Handwashing signs and hand hygiene stations were available at the exit of animal-contact areas in 10/13 and 8/13 petting zoos respectively. Risky behaviors were observed being performed at all petting zoos by at least one visitor. Frequently observed behaviors were: children (10/13 petting zoos) and adults (9/13 petting zoos) touching hands to face within animal-contact areas; animals licking children’s and adults’ hands (7/13 and 4/13 petting zoos, respectively); and children and adults drinking within animal-contact areas (5/13 petting zoos each). Of 574 visitors observed for hand hygiene when exiting animal-contact areas, 37% (n=214) of individuals attempted some type of hand hygiene, with male adults, female adults, and children attempting at similar rates (32%, 40%, and 37% respectively). Visitors were 4.8x more likely to wash their hands when a staff member was present within or at the exit to the animal-contact area (136/231, 59%) than when no staff member was present (78/343, 23%; p<0.001, OR=4.863, 95% C.I.=3.380-6.998). Visitors at zoos with a fence as a partial barrier to human-animal contact were 2.3x more likely to wash their hands (188/460, 40.9%) than visitors allowed to enter the animals’ yard for contact (26/114, 22.8%; p<0.001, OR= 2.339, 95% CI= 1.454-3.763). Inconsistencies existed in tool availability, signage, and supervision of animal-contact. Risk communication was poor, with few petting zoos outlining risks associated with animal-contact, or providing recommendations for precautions to be taken to reduce these risks.

Best practices for planning events encouraging human-animal interactions

Zoonoses and Public Health 62:90-99, 2015

G. Erdozain , K. KuKanich , B. Chapman  and D. Powell

http://onlinelibrary.wiley.com/doi/10.1111/zph.12117/abstract?deniedAccess

Educational events encouraging human–animal interaction include the risk of zoonotic disease transmission. It is estimated that 14% of all disease in the US caused by Campylobacter spp., Cryptosporidium spp., Shiga toxin-producing Escherichia coli (STEC) O157, non-O157 STECs, Listeria monocytogenes, nontyphoidal Salmonella enterica and Yersinia enterocolitica were attributable to animal contact. This article reviews best practices for organizing events where human–animal interactions are encouraged, with the objective of lowering the risk of zoonotic disease transmission.

petting1-791x1024

petting2-791x1024 

2-year-old on life support in Texas after contracting E. coli

An Ennis family says the CDC is investigating after their 2-year-old was exposed to a dangerous strain of E.coli.

Landon Huston is now on life support at Children’s Medical Center Dallas.

“He’s usually up, rambunctious, running around,” said his mother, Lindsey Montgomery. “I’m ready for my little boy to be back.”

The family took a trip to Oklahoma two weeks ago, cooling down in a hotel pool and at a natural spring.

“I’d never heard of people swimming and get E. oli,” said his father, John Huston.

Unfortunately, many, many people have been identified as getting sick with Shiga-toxin producing E. coli from swimming, water parks, or water supplies.

“Three, four days later, Landon’s got fever, diarrhea, really sick,” said Montgomery.

But by the time a test confirmed E.coli, his kidneys were shutting down. Montgomery said the CDC interviewed her trying to determine the source of the infection.

“They asked me where he had been, what food he had ate, any restaurants,” she said.

Dr. Jeffrey Kahn, Children’s Health Chief of Pediatric Infections Diseases, said it’s normal for a case like this to trigger a public health investigation.

“That suggests that there’s some contamination somewhere. It’s usually water or food and typically that means it’s not just one individual who’s been exposed,” he said.

Color sucks: Use a thermometer and stick it in for food safety

safefood Ireland has joined the UK Food Standards Agency in providing terrible advice about how to cook burgers.

A recipe for summer beef burgers (may a fine solstice greet our Northern and Southern friends) endorsed by safefood says:

“Before serving, ensure that the burgers are cooked thoroughly. Cut into them with a clean knife and check that they are piping hot all the way through, there is no pink meat remaining and that the juices run clear.”

Meanwhile, FSA issued a Safe Summer Food guide as UK picnickers head out in the sun (there’s sun in the UK?). The guidelines were in part based results of a self-reported survey, which is largely meaningless but something FSA likes to do.

The Morning Advertiser has more details on the hoops FSA seems willing to jump through to ensure the safety of rare burgers including:

  • sourcing the meat only from establishments which have specific controls in place to minimise the risk of contamination of meat intended to be eaten raw or lightly cooked;
  • ensuring that the supplier carries out appropriate testing of raw meat to check that their procedures for minimising contamination are working;
  • Strict temperature control to prevent growth of any bugs and appropriate preparation and cooking procedures;
  • notifying their local authority that burgers that aren’t thoroughly cooked are being served by the business; and,
  • providing advice to consumers, for example on menus, regarding the additional risk.

The advice from these self-proclaimed science-based agencies is at odds with, uh, science.

It has been known for over two decades that color is a lousy indicator of safety in hamburger.

The latest addition to this work comes from Djimsa et al. in the Dept. of Animal Science at Oklahoma State Univ., who wrote in the Journal of Food Science earlier this year that:

Premature browning is a condition wherein ground beef exhibits a well-done appearance before reaching the USDA recommended internal cooked meat temperature of 71.1 °C; however, the mechanism is unclear.

The objectives of this study were: (1) to determine the effects of packaging and temperature on metmyoglobin reducing activity (MRA) of cooked ground beef patties and (2) to assess the effects of temperature and pH on thermal stability of NADH-dependent reductase, lactate dehydrogenase (LDH), and oxymyoglobin (OxyMb) in-vitro.

Beef patties (lean: fat = 85:15) were packaged in high-oxygen modified atmosphere (HiOX-MAP) or vacuum (VP) and cooked to either 65 or 71 °C. Internal meat color and MRA of both raw and cooked patties were determined. Purified NADH-dependent reductase and LDH were used to determine the effects of pH and temperature on enzyme activity. MRA of cooked patties was temperature and packaging dependent (P < 0.05). Vacuum packaged patties cooked to 71 °C had greater (P < 0.05) MRA than HiOX-MAP counterparts.

Thermal stability of OxyMb, NADH-dependent reductase, and LDH were different and pH-dependent. LDH was able to generate NADH at 84 °C; whereas NADH-dependent reductase was least stable to heat.

The results suggest that patties have MRA at cooking temperatures, which can influence cooked meat color.

Effects of metmyoglobin reducing activity and thermal stability of NADH-dependent reductase and lactate dehydrogenase on premature browning in ground beef

Journal of Food Science, 2017 Feb, 82(2):304-313, doi: 10.1111/1750-3841.13606. Epub 2017 Jan 18.

https://www.ncbi.nlm.nih.gov/pubmed/28099768