61 sick in 7 states from Cyclospora in new outbreak linked to McDonald’s; 3000 locations removing salads

At least 61 people in seven Midwestern States have been sickened with Cyclospora possibly linked to salads served at McDonald’s restaurants.

The U.S. Food and Drug Administration and the Centers for Disease Control and Prevention (CDC) report that two people have been hospitalized and to date, no deaths have been reported.

Ashley Nickle of The Packer reports that health authorities in Illinois and Iowa have reported 105 recent cases of cyclosporiasis and have linked some of them to McDonald’s salads.

“Out of an abundance of caution, we decided to voluntarily stop selling salads at impacted restaurants until we can switch to another lettuce blend supplier,” McDonald’s said in a statement. “We are in the process of removing existing salad blends from identified restaurants and distribution centers, which includes approximately 3,000 of our U.S. restaurants, primarily located in the Midwest.”

McDonald’s spokeswoman Terri Hickey said, “McDonald’s is committed to the highest standards of food safety and quality control. We are closely monitoring this situation and cooperating with state and federal public health authorities as they further investigate”

In June, federal agencies investigated cyclosporiasis cases that were linked to Del Monte vegetable trays. More than 225 illnesses have been reported in that outbreak. At this time, no link has been made by health authorities between the outbreak linked to McDonald’s salads and the outbreak linked to Del Monte vegetable trays, which included broccoli, cauliflower, carrots and dip.

Father of Tennessee E. coli victim ‘Nutritionist recommended raw milk’

James Zenker never imagined his young son would battle for his life at just two-years-old.

“It’s affected his kidneys; they shut down,” Zenker said. “It affected his intestines; he couldn’t digest any of his food and its affected his brain — he has a substantial brain injury.”

His son William got E. coli after drinking raw milk linked to French Broad Farm. Zenker said a nutritionist recommended the raw milk to help William fight allergies.

“He’s not able to speak and not able to do the same activities as before he was ill,” Zenker said.

The vast majority of nutritionists, dieticians and physicians I encounter – and it’s frequent with my brain status and trips to emergency – know shit about microbial food safety.

The odd ones do, and they are food safety heros.

But when hospitals continue to serve raw sprouts to immunocompromised people, when they won’t be sold at WalMart in the U.S., I gotta question their food safety credibility.

To reiterate, I stared the Food Safety Network (the original FSN) over 25 years ago as an incoming graduate student in 1993 in the wake of the Jack-in-the-Box outbreak, combining my science and journalism learnings, and because a constant refrain I observed was, I never knew foodborne illness could be so serious.

That’s why I continue to do it as a form of community service (I haven’t been paid since 2016).

Of the 15 children sick with E. coli in Tennessee that has now been linked to consumption of raw milk and contact with ruminants from French Broad Farm, William is the last one left in the hospital. His father said East Tennessee Children’s Hospital saved his son’s life.

The Knox County Health Department said an investigation concluded that the outbreak was caused by two separate sources, the exposure to farm animals and exposure to raw milk.

“While it is rare, it appears we had two sets of children sickened by two different strains of E. coli O157 at the same time. The epidemiological evidence overwhelmingly supported the two-source theory: consumption of raw milk and some type of contact, most likely indirect, with ruminant animals,” said KCHD Director Dr. Martha Buchanan.

William has had several blood transfusions during his recovery and still needs more. His home church Temple Baptist in Powell (no relation – dp) hosted a replacement drive Tuesday for William and the community.

“It’s so encouraging to see people take time out of their busy day and donate from their own life to help Will and others affected by E. coli,” Zenker said.

If you would like more information about future blood drives click here: 
Blood drives scheduled to help children infected with E. coli.

Food fraud: Crab meat from Venezuela linked to 9 cases of vibrio in Maryland

While Maryland Blue Crabs are a staple in the DMV, many places do sell crabs, packaged crab meat, and crab cakes with crab from elsewhere.

Anne Cutler of Fox 26 says the National Aquarium in Baltimore reports that due to environmental degradation and years of overfishing, there’s not enough blue crab in the region to support demand, and grocery stores and restaurants often resort to selling imported crab.

According to ocean conservancy organization Oceana, 33 percent of the seafood purchased in the United States is actually mislabeled.

The National Aquarium reports that under current law, crab meat can be imported from around the world, pasteurized in-state and relabeled as “Maryland crabmeat.”

Nine people have contracted dangerous Vibrio infections in Maryland alone. The state’s Department of Health is warning residents to not eat crab meat from Venezuela.

“We’re selling a lot of crab meat, shrimp, lobster, whatever you want. We’re steaming it for you. And as far as this crab meat, we gotta get it from the eastern shore now, because we heard from the media what’s going on,” said Clarence Goodman, with Jessie Taylor Seafood.

Goodman says the company is not taking any chances — sticking with products almost exclusively from the eastern seaboard. 

The crab in question comes in the little plastic tubs. Consumers should look for a label on the side of the container that says where the meat is from. If it comes from Venezuela, you don’t want to get it.

Diners should also pay attention when buying crab cakes as well.A 2015 study from Oceana found that 38 percent of crab cakes being advertised as having locally sourced Chesapeake blue crab were actually made of imported meat.

In the state of Maryland, only a few dozen restaurants in the state reliably make their crab cakes from local crabmeat and the state does not require restaurants to identify the specific source of the meat.

The state has a listing of “True Blue” local restaurants that serve Maryland blue crab.

Night soil: Kenyans feeding on Sukuma wiki grown in raw sewage

While some city residents have become farmers either by design or default depending on the residential area one resides in, cheap is proving to be life threatening as farmers are now using raw sewage for farming. This means much of the vegetables especially sukuma wiki (kales) on sale in Nairobi are highly contaminated and pose a serious health risk to consumers.

A visit to the sewage collection point in Njiru, Nairobi by Linda Shiundu of TUKO.co.ke revealed the effluence deposited there is always tapped and used for farming by farmers living. The farmers who wished to remain anonymous said instead of waiting for the rains, they would rather take advantage of the 75,000 liters of untreated sewage disposed daily to water their crops. They do so by digging trenches from the deposit site channeling the semi solid human waste into their farms which they use to water the crops and as manure. They mainly grow vegetables like sukuma wiki, spinach and other crops like bananas. Sewage deposited at the sewage collection point around Njiru area is always trapped by farmers living around the collection center and use for planting. The vegetables later on find their way into the market and in to the plates and stomachs of many unsuspecting residents. The vegetables later on find their way into the market.

Despite the health risks posed by the exposed raw sewage including, diarrhea, abdominal pain, vomiting and even death, open food kiosks are also run next to the disposal site. The kiosks are normally flooded with drivers who bring in the hundreds of lorries daily to deposit the sewage.

Victims blame FDA for food-recall failures

I don’t blame any regulatory type for going early or going late in a foodborne disease outbreak.

There’s lots of armchair quarterbacks out there, and we’ve tried to present the various viewpoints on many an outbreak.

There’s also a lot people out there with nothing but a personal agenda, based on profit rather than peer review.

Christine Haughney of Politico reports that people had been getting sick from eating I.M. Healthy Original Creamy SoyNut Butter for more than two months when Peter Ebb, a 59-year-old Boston lawyer and health enthusiast, went for a run and then ate his usual gluten-free English muffin smeared with soy nut butter.

Later that morning — March 6, 2017 — Ebb saw a message from Amazon, which had sold him the nut butter, that the manufacturer had recalled it for contamination by E. coli bacteria. Ebb threw away a protein drink he had made with the soy nut butter, but didn’t worry too much. The Food and Drug Administration warning that was linked to the email was worded very cautiously: Though serious illnesses might result, even potentially leading to death, “most healthy adults can recover completely within a week.”

Six days later, Ebb was hospitalized and developed a deadly type of kidney failure. Within days, doctors told his wife to send for their children in case they needed to bid him a last goodbye. He survived, but remains unable to work full time and has trouble climbing the stairs. Now, he’s joining with 18 other victims to file claims against the companies responsible and call attention to the inadequacy of the nation’s recall system.

“If I had heard about the problem even one week earlier and stopped then, I might have been able to avoid the disease completely, and life today would be very different,” Ebb said.

A POLITICO investigation found that the I.M. Healthy SoyNut Butter case — which officials at the FDA and the Centers for Disease Control and Prevention have hailed as an improvement over past failures — was nonetheless emblematic of persistent weaknesses in the nation’s food-safety system, some of which haven’t been corrected for two years after being flagged by the agency’s inspector general.

Two months elapsed between the first person sickened by eating I.M. Healthy SoyNut Butter on Jan. 4 and the recall orders that began on March 3 and expanded three more times until March 10. The FDA, working through a national network of labs that identifies outbreaks, pinpointed the contamination on Feb. 22. The nine-day lag time in persuading the manufacturer to begin recalling the tainted products was a significant improvement over previous lag times — which were as high as 165 days in one infamous case, according to the inspector general. But victims maintain that the FDA should have ordered a recall on its own authority, given that a few days or even hours can make a difference in a deadly outbreak.

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.

Vets have the best drugs: Minneapolis investigates police use of ketamine on suspects

The veterinarian’s choice of drug – the horse sedative, ketamine – has been used by Minnesota police types to sedate people in custody, according to NPR.

I was married to a vet for 16 years and she had lots of tales about ketamine, but no evidence she used it herself, but I’ve met a few vets in rehab, and they liked their ketamine.

Ketamine, a powerful sedative is used in hospitals as an anesthetic and more recently, to treat depression. It’s also been called the date-rape drug. And now, city investigators in Minneapolis have found that police officers there directed paramedics to inject the drug into people on the street to subdue them. This, according to a draft report that was obtained by the Star Tribune. Andy Mannix is the reporter at the Star Tribune who broke the story, and he’s with us now. Andy Mannix, welcome. Thanks so much for speaking to us

MARTIN: What did we find from this report? I mean, for example, how do we know that the police were directing the paramedics to use the powerful sedative? And were there some other patterns that emerged when they reviewed all this information?

MANNIX: One of the issues that’s been alarming to a lot of people is just like how casually police and paramedics talk about this drug. So, we have one example where there’s a person who’s sort of being combative. The police officer is talking about ketamine. Give him a shot of ketamine – stuff like that. And then they give him two shots and then the guy sort of starts coming out of it and so they give him another shot. And the police officer – he says, he just hit the K-hole. So, they’re talking about in a way that’s almost like joking about it. There’s other examples of people saying, you know, calling a paramedic and saying bring ketamine, bring ketamine.

MARTIN: So tell us, who was being injected with this drug and what happened to them?

MANNIX: So most of the time they are – they’re calls dealing with someone who may be intoxicated or in a mental health crisis, you know, sort of like a minor nuisance crime – if a crime has been committed. So, in terms of what happens to these people, almost all of them – actually I think all of them get taken to the hospital.

MARTIN: The reports suggest that there was a large increase in the use of ketamine in recent years. There were reported of 3 incidents in 2012 and then there were 62 last year. Does the report offer any insight into why?

MANNIX: We have, in interviews with medical staff, asked that question many times and they say that there are more – there’s been a record amount of incidents involving severely agitated people. Paramedics and doctors would say that’s when someone is so agitated that they may hurt themselves or hurt somebody else. So they’re saying they’re running into more examples of this kind of behavior on the street.

MARTIN: On the other hand, though, the county hospital where the EMTs work was conducting studies on ketamine. The question arises, were they being sort of pressured?

MANNIX: You know, the scope of the oversight report is mostly police, but they do touch on this a little bit. There’s one case in particular where someone, you know, being recorded on police body camera asks why they sedated somebody and the paramedic talks about the study and says well, you know, we’re doing this study and so we needed to give them ketamine. There was one woman we talked to who had relapsed on alcohol and she was in her apartment and her sponsor, an AA, called and said can you just do a welfare check on my friend. I just want to make sure she’s OK. They ended up coming into her apartment – said she didn’t want this drug, they gave it to her anyway.

She wakes up 24 hours later with a breathing tube down her throat. And then on her way out, they hand her this form that says, by the way, you know, you’re enrolled in this study. And that’s pretty common, that’s a pretty typical story. There are several investigations going on right now including one with former acting U.S. Attorney General Sally Yates. She’s been appointed by the mayor, here, to come in and do an independent investigation. So obviously they’re very concerned.

MARTIN: That’s Andy Mannix. He’s a reporter at the Star Tribune in Minneapolis. Andy, thanks so much for speaking to us.

MANNIX: Hey, thanks for having me.

Defense matters

The head coach of the Australian state of Queensland , a fellow Canadian, told us parents and coaches earlier this year, anyone can play defense, it’s easy, offense is hard.

I disagree.

But that’s just my opinion.

Defense wins Stanley Cups and Super Bowls.

Defense takes discipline.

Defense is hard.

I played four years as a linebacker in football and would crush anybody who tried to cross the line.

Any food company knows this, because they do not want to be tomorrow’s headline, just because someone messed up.

This is a picture of my daughter playing defense in practice (thanks Julie). Look at how the goalie is ideally placed, with his foot up against the post and his stick outside the post. Look at the angling Sorenne is using on her teammate.

Those are boring things but they win games.

And help people not barf from food.

This is Sorenne protecting the blue-line last week (thanks again, Julie).

Defense matters.

Petting zoos as a source of shiga-toxin producing E. coli in Austria

Hey Gonzo, they cited us.

Too bad your soccer teams suck, and I don’t care.

But I do care when others cite the gumshoe work we put into our research activities.

And I especially care when every year, I tell our public school or the local shopping mall that petting farms around kids can lead to heartache.

They call me crazy, just like they continue to top salads with raw alfalfa sprouts at Brisbane Private Hospital, despite my protestations.

I do what I can.

These others are microbiological idiots.

There, I’m done.

Despite their general low incidence, Shiga toxin-producing Escherichia (E.) coli (STEC) infections are considered an important public health issue due to the severity of illness that can develop, particularly in young children.

 We report on two Austrian petting zoos, one in Tyrol (2015) and one in Vorarlberg (2016), which were identified as highly likely infection sources of STEC infections. The petting zoo related cases involved a case of hemolytic uremic syndrome (HUS) due to STEC O157:HNM in 2015 and an outbreak of STEC O157:H7 infections affecting five young children and two adults in 2016. The HUS case accounted for 2.8% of the 36 STEC O157:HNM/H7 infections notified in Austria in 2015 (5,9% of 17 HUS cases). The seven cases described for 2016 accounted for 4.0% of the 177 human STEC infections documented for Austria in 2016, and for 19% of the 36 STEC O157:HNM/H7 infections notified that year.

The evaluation of the STEC infections described here clearly underlines the potential of sequence-based typing methods to offer suitable resolutions for public health applications. Furthermore, we give a state-of-the-art mini-review on the risks of petting zoos concerning exposure to the zoonotic hazard STEC and on proper measures of risk-prevention.

A table of petting zoo outbreaks is available at http://www.barfblog.com/wp-content/uploads/2017/08/Petting-Zoo-Outbreaks-Table-7-26-17.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]

Outbreaks 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.

Petting zoos as sources of shiga toxin-producing Escherichia coli (STEC) infections

27.june.18

International Journal of Medical Microbiology, DOI: 10.1016/j.ijmm.2018.06.008 

Sabine Schlager, Sarah Lepuschitz, Werner Ruppitsch, Oksana Ableitner, Ariane Pietzka, Sabine Neubauer, Anna Stöger, Heimo Lassnig, Claudia Mikula, Burkhard Springer, Franz Allerberger
http://www.x-mol.com/paper/721663

Reducing food waste is good, but is it safe?

Organizations dedicated to hunger relief have grown in recent years to increase their capacity to reach more food insecure populations for example, Feeding America served 11% more meals in 2016 than in 2015.

One barrier to ensuring food safety during the diversion and donation of food is lack of effective training for volunteers. Some programs are affiliated with universities and as such rely on student volunteers. Students have been shown to have risky practices in food-handling environments and can create situations in which food distributed by hunger-relief organizations can be at risk for unintentional contamination.

Using a food recovery program at a large, land-grant university, food-handling behaviors of student volunteers were observed in-person and compared to self-reported behaviors and self-identified training needs gathered via a survey.

Commonly observe behaviors were improper handwashing, inconsistent record keeping, and the use of unclean or contaminated equipment for example, during deliveries only 13% of volunteers were observed washing their hands at least once, while 69% self-reported doing so.

Training volunteers is necessary in view of the vulnerability to foodborne illness of those receiving recovered food. Trainings specifically for this audience should include unique handling scenarios adapted to food handler best practices.

Food-handling behaviors of student volunteers in a university food recovery program

Food Protection Trends, Volume 38, Issue 4, Pages 284-294, 2018

Lester Schonberger, Renee R. Boyer, Melissa W. Chase

http://staging.nxtbook.com/nxtbooks/trilix/fpt_20180708/stage.php#/44

42: Tea towels a source of bacteria in kitchen

I was never a paper towel kinda guy.

I have about 30 tea towels, including one with images of all of Sorenne’s prep (kindergarten) pals and teachers.

They are my go-to sweat rags, hand wipes and kitchen cleaner-uppers.

As advised by The Hitchhikers’ Guide to the Galaxy, never leave home without a towel.

About five go into the laundry every day.

According to a study published by the University of Mauritius, and presented recently at the annual meeting of the American Society for Microbiology, your kitchen towels may be the leading culprit of pathogen advancement.

“Our study demonstrates that the family composition and hygienic practices in the kitchen affected the microbial load of kitchen towels,” said Dr. Biranjia-Hurdoyal. “We also found that diet, type of use and moist kitchen towels could be very important in promoting the growth of potential pathogens responsible for food poisoning,” she said.

Researchers collected a total of 100 kitchen towels after one month of use. Using standard biochemical tests, they concluded that 49% of the kitchen towels collected in the study had bacterial growth. The bacterial growth increased in number with family size—whether by extended family, or the presence of children.

Experts discourage using kitchen towels for multiple purposes (wiping utensils, drying hands, holding hot utensils, wiping/cleaning surfaces) because they had a higher bacterial count than single-use towels. They also warn against using humid towels because they too showed higher bacterial count than dry ones. Pathogens on kitchen towels would indicate that they could bear some responsibility for cross-contamination in the kitchen and, ultimately, food poisoning. Households with children, older adults or others with immunosuppression should be especially vigilant about hygiene in the kitchen.

But, like other studies of sponges and things, the researchers don’t account for the level of cleaning in a particular household. Five a day, into the laundry.

And rather than blame consumers, have a look at bacterial loads on chef aprons.