Raw is risky: Meghan Markle had to give up eating favourite food after marrying Harry

Australia has this weird love of everything royal – at least on the news.

If Harry farts, it’s reported; if one of the kids picks their nose, it’s reported.

And now, Meghan Markle, the Duchess of Sussex, has been told by Royal Butler Grant Harold, she will have to stop eating her most adored cuisine – seafood.

Mr Harold explained this is because the Royal Family don’t eat it due to food poisoning fears.

He told Express.co.uk: “It is a very sensible move to abandon having seafood when out and about on public duties.

“We don’t want a member of the Royal family having a serious reaction to food poisoning, especially if she is on an overseas tour.”

In 2013, Meghan revealed her “ideal food day” would consist of a “dinner of seafood and pasta” with a Negroni cap it all off.

But this isn’t the only fancy food off the table for the newest addition to the family.

The butler added: “As well as shellfish, it would also be quite appropriate for foods such as foie gras to be avoided.”

Prince Charles is said to have banned the delicacy from the palace in 2008 over animal rights concerns.

Another Cyclospora outbreak IDed in Minnesota

The Minnesota Department of Health (MDH) is investigating an increase in Cyclospora infections within the last month. To date, state health officials have identified two outbreaks together involving at least three dozen Minnesotans.

One outbreak has been identified among people who ate at Sonora Grill in Minneapolis in mid-May. To date, 17 patrons have reported illness. The restaurant is fully cooperating with the investigation, and investigators say they do not have any indication that there is an ongoing risk to patrons.

To better identify the source of infection, MDH investigators want to speak with people who ate at Sonora Grill over the weekend of May 18-May 20, regardless of whether they became ill.

“Even if you have not been sick, your information can help us identify what may have caused these illnesses and prevent future illnesses,” said Trisha Robinson, an epidemiologist supervisor with MDH. “If you ate at Sonora Grill during that weekend of May 18-20, please contact the Minnesota Department of Health Waterborne Diseases Unit at 651-201-4891.”

Infection with Cyclospora, known as cyclosporiasis, is caused by the parasite Cyclospora and is spread through consumption of imported fresh produce; it is not spread person-to-person. Washing of imported produce, or routine chemical disinfection or sanitizing methods, are unlikely to kill Cyclospora. Symptoms typically include watery diarrhea, stomach cramps, nausea, loss of appetite and weight loss. People typically become ill about a week after exposure, but this period can range from 2-14 days. Diarrhea can last several weeks or longer if not treated.

A second outbreak has been linked to Del Monte vegetable trays purchased at Kwik Trip locations. To date, 20 cases have been identified among Minnesotans in this outbreak. Cases report purchasing the vegetable trays at various Kwik Trip locations around the state. Kwik Trip is cooperating with the investigation and voluntarily removed the vegetable trays from their shelves. Consumers should not eat the following products:

Del Monte Vegetable Tray, containing broccoli, cauliflower, carrots and dill dip, 6 oz.

Del Monte Vegetable Tray, containing broccoli, cauliflower, carrots and dill dip, 12 oz.

MDH investigators are working with the Minneapolis Health Department and the Minnesota Department of Agriculture (MDA) on the Sonora Grill outbreak and with MDA and other states on the Kwik Trip outbreak.

“We do not have any indication at this time that the two outbreaks are related,” Robinson said. “Besides these outbreak cases, there are other cases of cyclosporiasis that do not appear to be related to either of these outbreaks, which is not unexpected for this time of year. We typically see increases in Cyclospora infections from May through August.”

The global burden of crypto in children under 5

The protozoan Cryptosporidium is a leading cause of diarrhoea morbidity and mortality in children younger than 5 years. However, the true global burden of Cryptosporidium infection in children younger than 5 years might have been underestimated in previous quantifications because it only took account of the acute effects of diarrhoea. We aimed to demonstrate whether there is a causal relation between Cryptosporidium and childhood growth and, if so, to quantify the associated additional burden.

Methods

The Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2016 was a systematic and scientific effort to quantify the morbidity and mortality associated with more than 300 causes of death and disability, including diarrhoea caused by Cryptosporidium infection. We supplemented estimates on the burden of Cryptosporidium in GBD 2016 with findings from a systematic review of published and unpublished cohort studies and a meta-analysis of the effect of childhood diarrhoea caused by Cryptosporidium infection on physical growth.

Findings

In 2016, Cryptosporidium infection was the fifth leading diarrhoeal aetiology in children younger than 5 years, and acute infection caused more than 48 000 deaths (95% uncertainty interval [UI] 24 600–81 900) and more than 4·2 million disability-adjusted life-years lost (95% UI 2·2 million–7·2 million). We identified seven data sources from the scientific literature and six individual-level data sources describing the relation between Cryptosporidium and childhood growth. Each episode of diarrhoea caused by Cryptosporidium infection was associated with a decrease in height-for-age Z score (0·049, 95% CI 0·014–0·080), weight-for-age Z score (0·095, 0·055–0·134), and weight-for-height Z score (0·126, 0·057–0·194). We estimated that diarrhoea from Cryptosporidium infection caused an additional 7·85 million disability-adjusted life-years (95% UI 5·42 million–10·11 million) after we accounted for its effect on growth faltering—153% more than that estimated from acute effects alone.

Interpretation

Our findings show that the substantial short-term burden of diarrhoea from Cryptosporidium infection on childhood growth and wellbeing is an underestimate of the true burden. Interventions designed to prevent and effectively treat infection in children younger than 5 years will have enormous public health and social development impacts.

Morbidity, mortality, and long-term consequences associated with diarrhoea from cryptosporidium infection in children younger than 5 years: A meta-analyses study

The Lancet Global Health, DOI: https://doi.org/10.1016/S2214-109X(18)30283-3

Ibrahim A Khalil, Christopher Troeger, Puja C Rao…

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30283-3/abstract#.WyQRPA3swGY.twitter

Funding

The Bill & Melinda Gates Foundation.

Cyclospora infections linked to vegetable trays sold at Kwik Trip stores

Rick Barrett of the Journal Sentinel reports that Wisconsin and Minnesota health officials are investigating an increase of Cyclospora infections that may be linked to Del Monte vegetable trays purchased from Kwik Trip stores.

Eleven people in Wisconsin and three in Minnesota have reported becoming ill after eating vegetables from the trays that contained broccoli, cauliflower, carrots and dill dip, according to the Wisconsin Department of Health Services.

Kwik Trip has removed the 6-ounce and 12-ounce trays from its stores and is cooperating with state officials. The trays may also have been available from other businesses, health officials said.

PMA: Research on produce safety priorities

Bob Whitaker, Ph.D., chief science and technology officer for Produce Marketing Association (PMA), writes that because it provides inherently healthy, nutritious foods, the fresh produce industry is uniquely positioned to help solve the nation’s obesity epidemic. To do so, consumers must have confidence in the safety of the fresh fruits, vegetables, and nuts they eat and feed their families.

A green row celery field is watered and sprayed by irrigation equipment in the Salinas Valley, California USA

Following a large and deadly outbreak of foodborne illness linked to fresh spinach in 2006, the U.S. produce industry couldn’t wait for government or other direction. After finding significant knowledge gaps and a lack of data needed to build risk- and science-based produce safety programs, the industry created the Center for Produce Safety (CPS) in 2007.

CPS works to identify produce safety hazards, then funds research that develops that data as well as potential science-based solutions that the produce supply chain can use to manage those hazards. While two foodborne illness outbreaks in the first half of 2018 associated with leafy greens demonstrate the industry still has challenges to meet, CPS has grown into a unique public-private partnership that moves most of the research it funds from concept to real-world answers in about a year.

Each June, CPS hosts a symposium to report its latest research results to industry, policy makers, regulators, academia, and other produce safety stakeholders. Key learnings from the 2017 symposium have just been released on topics including water quality, cross-contamination, and prevention. A few highlights from those key learnings are summarized here, and for the full details, you can download the Key Learnings report from CPS’s website.

Know Your Water (we were doing that in 2002, long before youtube existed)
Irrigation water is a potentially significant contamination hazard for fresh produce while it is still in the field. While CPS research has revealed many learnings about agricultural water safety in its 10 years, many questions still remain. Meanwhile, the U.S. Food and Drug Administration (FDA)’s proposed Food Safety Modernization Act (FSMA) water testing requirements—which offers some challenges for producers in specific production regions—recently raised even more questions.

New CPS research illustrates the risks of irrigating with “tail water” from runoff collection ponds. With water becoming a precious resource in drought-stricken areas, the objective was to learn if tail water might be recovered and used for irrigation.  We learned that differences among pond sites—for example, water sources, climate, ag management practices—can strongly influence the chemistry and microbiology of the water. Further, water pH can influence disinfection treatment strategies.[1]

CPS research continues to investigate tools for irrigation water testing, looking specifically at sample volumes,[2] and searching for better water quality indicators and indexing organisms including harnessing next-generation DNA sequencing.[3] Following a CPS-organized colloquium on ag water testing in late 2017, FDA subsequently announced it would revisit FSMA’s ag water requirements, and postponed compliance.

Bottom line, CPS research demonstrates that growers must thoroughly understand their irrigation water before they can accurately assess cross-contamination risk. CPS’s findings clearly point to the need to take a systems approach, to understand and control the entire water system to help achieve produce safety. Long term, this may mean prioritizing research into ag water disinfection systems to better manage contamination hazards that can also operate at rates needed for field production.
Cross-Contamination Can Happen across the Supply Chain
While conceptually and anecdotally the fresh produce industry knows that food safety is a supply chain responsibility, research is needed that documents the role of the entire supply chain to keep fresh produce clean and safe from field to fork. At the 2017 CPS Research Symposium, research reports were presented focusing on cross-contamination risks from the packinghouse to retail store display.

In the packinghouse, CPS-funded research found that wash systems can effectively control cross-contamination on fruit, when proper system practices are implemented.[4] Post-wash, CPS research involving fresh-cut mangos also demonstrated that maintaining the cold chain is critical to controlling pathogen populations.[5] Across the cantaloupe supply chain, CPS studies show food contact surfaces—for example, foam padding—are potential points of cross-contamination.[6] See the full 2017 Key Learnings report for details, as these brief descriptions only scratch the surface of this research.

CPS studies clearly demonstrate that food safety is a supply chain responsibility—a message that must be internalized from growers and packers to transporters, storages, and retailers to commercial, institutional, and home kitchens. While translating this research into reality will present engineering and operational challenges, our new understanding of produce safety demands it.
Verifying Preventive Controls
The produce industry must know that its preventive controls are in fact effective. That said, validation can be tricky. If validation research doesn’t mimic the real world, industry ends up fooling itself about whether its food safety processes work—and the human consequences are real.

Numerous scientists presented research at the 2017 CPS Research Symposium that validates various preventive controls, from heat treating poultry litter[7] to pasteurizing pistachios[8] to validating chlorine levels in wash water systems.[9] Some researchers effectively used nonpathogenic bacteria as a surrogate in their validation studies, while another is working to develop an avirulent salmonella surrogate, and another. Wang used actual Escherichia coliO157:H7 (albeit in a laboratory).

Importantly, CPS research finds that the physiological state of a pathogen or surrogate, and pathogen growth conditions themselves, are critically important to validation studies.[10] Meanwhile, suitable surrogates have been identified for some applications, the search continues for many others.

The research findings described here are just some of the real world-applicable results to emerge from CPS’s research program. To learn more, download the 2017 and other annual Key Learnings reports from the CPS website > Resources > Key Learnings page at www.centerforproducesafety.org.

We were doing these videos in the early 2000s, long before youtube.com existed, and weren’t quite sure what to do with them. But we had fun.

 

The produce problem: Ingredient analysis at restaurants in Cyclospora outbreaks

By Sept. 2017, the U.S. Centers for Disease Control reported that almost 1,000 people had laboratory-confirmed cases of cyclosporiasis for the year.

Another banner year for the parasite famously associated with Guatemalan raspberries in 1996.

During July 21–August 8, 2017, the Texas Department of State Health Services (DSHS) was notified of 20 cases of cyclosporiasis among persons who dined at a Mediterranean-style restaurant chain (chain A) in the Houston area. On August 10, 2017, DSHS requested assistance from CDC to support ongoing investigations by the City of Houston Health Department, Harris County Public Health, Fort Bend County Health and Human Services, and Brazoria County Health Department. The objectives of this investigation were to determine the source of the illnesses in the Houston area and to generate hypotheses about the source of the national increase in cyclosporiasis in 2017.

Chain A has four locations in the Houston area and a central kitchen where many dishes are prepared. A case-control study was performed using a menu-specific questionnaire focusing on items containing fresh produce. A confirmed case was defined as laboratory-confirmed Cyclospora infection and clinically compatible illness in a person who ate at any location of chain A during May 28–July 15, 2017. A probable case was defined as diarrhea and at least one additional sign or symptom compatible with cyclosporiasis (e.g., anorexia, abdominal cramping, bloating, myalgia, fatigue, vomiting, or low-grade fever) in a person within 2 weeks after dining at chain A during May 28–July 15, 2017. Controls were identified as either dining companions of case-patients who had no illness or patrons who dined at the same chain A location within 2 days of a case-patient visit and who had no illness. For controls identified by the latter method, contact information was obtained using commercially available databases used by local health agencies in Texas. Three controls per case-patient were recruited.

A total of 22 case-patients (16 confirmed and six probable) and 66 controls were enrolled in the study. Case-patients had a median age of 52 years (range = 29–79 years); 50% were female. Analysis compared menu items consumed by case-patients and controls, followed by ingredient-level analysis. The following ingredients were identified as being significantly associated with illness: green onions (matched odds ratio = 11.3; 95% confidence interval = 2.55–104.68), tomatoes (5.5; 1.2–51.7), red onions (4.7; 1.3–21.0), and cabbage (4.0; 1.1–15.9). When analysis was limited to the 16 confirmed case-patients and their corresponding 48 controls, only green onions remained significantly associated with illness (17.6; 2.5–775.7). Restaurant invoices from chain A were collected for all items identified during the epidemiologic investigation, but efforts to trace any food item to its source were inconclusive. Although the current study identified potential foods associated with illness in Texas, investigators were not able to identify the illness source or confirm whether the patients within the chain A subcluster had consumed a product reported by other ill persons in the United States.

Cyclosporiasis is an intestinal illness caused by the parasite Cyclospora cayetanensis. Since 2013, the United States has experienced annual increases in the incidence of cyclosporiasis incidence during the summer months, with some illnesses linked to imported produce (1–3). Molecular subtyping of Cyclospora is not currently available; therefore, identification of an ingredient associated with a particular illness subcluster might provide information about a source contributing to other cyclosporiasis illnesses. Previous U.S. outbreaks of cyclosporiasis have been linked to fresh produce, such as prepackaged salad mix, raspberries, and cilantro (3,4). Identification of a vehicle for Cyclospora is complicated by the short shelf life of fresh produce as well as the use of potential vehicles such as garnishes or mixtures with other items that could also harbor the parasite. Ingredient-level analysis within restaurant clusters and subclusters therefore remains critical in Cyclospora outbreak investigations.

Notes from the field: Cyclosporiasis cases associated with dining at a Mediterranean-style restaurant chain- Texas 2017

1.jun.18 CDC

Amelia A. Keaton, MD1,2; Noemi Borsay Hall, PhD2,3; Rebecca J. Chancey, MD2,4; Vivienne Heines, MPH3; Venessa Cantu, MPH3; Varsha Vakil, MPH5; Stephen Long, MD5; Kirstin Short, MPH5; Elya Franciscus, MPH6; Natasha Wahab, MPH6; Aisha Haynie, MD6; Laura Gieraltowski, PhD2; Anne Straily, DVM4

https://www.cdc.gov/mmwr/volumes/67/wr/mm6721a5.htm

Electrolyzed water: a pretty good review

An old friend of the blog emailed today looking for some info for someone he was working with who wanted to know about whether electrolyzed water, on it’s own, was a good replacement for sanitizers.

I came across this 2016 review paper in Comprehensive Reviews in Food Science and Food Safety.

Electrolyzed Water as a Novel Sanitizer in the Food Industry: Current Trends and Future Perspectives

SME Rahman, Imran Khan, and Deog-Hwan Oh

Abstract:

Electrolyzed water (EW) has gained immense popularity over the last few decades as a novel broad-spectrum sanitizer. EW can be produced using tap water with table salt as the singular chemical additive. The application of EW is a sustainable and green concept and has several advantages over traditional cleaning systems including cost effectiveness, ease of application, effective disinfection, on-the-spot production, and safety for human beings and the environment. These features make it an appropriate sanitizing and cleaning system for use in high-risk settings such as in hospitals and other healthcare facilities as well as in food processing environments. EW also has the potential for use in educational building, offices, and entertainment venues. However, there have been a number of issues related to the use of EW in various sectors including limited knowledge on the sanitizing mechanism. AEW, in particular, has shown limited efficacy on utensils, food products, and surfaces owing to various factors, the most important of which include the type of surface, presence of organic matter, and type of tape water used. The present review article highlights recent developments and offers new perspectives related to the use of EW in various areas, with particular focus on the food industry.

It’s Not the Mayonnaise: Food Safety Myths & Summertime Food

Matt Shipman, Research Communications Lead at NC State News Services (and all-around great guy) writes,

When folks get sick after a picnic, people often blame the potato salad. Or the chicken salad. Or whatever other side dish was made with mayonnaise. But that’s usually not the culprit.

“It’s not always the potato salad…except when it’s the potato salad,” says Ben Chapman, a food safety researcher at NC State University. “There are lots of other foods at a cookout that can also lead to illnesses.”

Potato Salad

When it is the potato salad, the culprits are usually Staphylococcus aureus or Clostridium perfringens. And a combination of factors can lead to problems. In most “salads” of this type, low-acid potatoes, chicken, pasta or hard-boiled eggs are added to the mayonnaise. The mayonnaise is acidified to make it safe, but the low acidity of the potatoes (or foods) offsets the acidity of the mayonnaise, creating an environment where bacteria can thrive.

That sets the stage. Then poor hygiene comes into play. S. aureus, for example, can often be found on our faces, particularly around the eyes or nose. So, S. aureus can be introduced to salads when people touch their face and then – without washing their hands – touch the food.

However, in order for bacteria to become a problem, there also has to be “temperature abuse,” meaning that the potato salad isn’t kept below 41°F.

“For example, above 90°F, foodborne pathogens in potato salad increase tenfold in as quickly as an hour,” Chapman says. “In ideal temperatures for bacteria, such as body temperature, bacterial populations can double in less than 20 minutes.”

So, it’s rarely the mayonnaise. Instead, it’s the combination of mayonnaise and other salad ingredients, plus poor hygiene and poor temperature control.

But, in rare cases, it can be the potatoes. An outbreak of botulism poisoning in 2015 stemmed from potato salad made using potatoes that had been canned improperly by a home cook.

“Potatoes need to be ‘pressure canned,’ using a boiling water bath,” Chapman says. “These potatoes weren’t, which led to 29 illnesses and two deaths – the largest botulism poisoning in 40 years.”

Why It’s Not the Mayonnaise (And When It Could Be)

A big reason that mayonnaise rarely causes foodborne illness these days is that most people buy their mayonnaise, rather than making it from scratch.

“Commercially produced mayonnaise is acidified to reduce spoilage and kill off human pathogens,” Chapman says. “It’s really low risk on its own.”

However, many mayo recipes for the home cook don’t include acid, which makes it possible for pathogens – like S. aureus, C. perfringens and Salmonella – to grow and become a health risk.

“So, if you’re making mayonnaise at home, pick a recipe that uses pasteurized egg products and incorporates acid – such as vinegar or lemon juice – to reduce risk” Chapman says. “And refrigeration is still incredibly important, as recipes may not incorporate enough acid to address risks.”

More Likely Culprits

If it’s probably not the mayonnaise salad, what are the more likely culprits behind foodborne illness? The answer may surprise you.

“Fresh fruits and vegetables are responsible for more outbreaks of foodborne illness than any other type of food; they’ve been linked to 46 percent of foodborne illnesses between 1998 and 2008,” Chapman says.

That does not mean that you shouldn’t eat your fruits and veggies. Just beware of risks.

Unfortunately, in most cases, contaminated produce was contaminated before the consumer bought it – at any point between the field where it was grown and the shelf where the consumer picked it up.

That said, you can still take steps to reduce risk

First, you really want to avoid cross contamination, which is when pathogens from uncooked food (like raw meat) are transferred to food that’s ready to eat. That can happen if you don’t wash your hands, for instance, or if you use the same cutting board for cutting chicken and preparing salad.

You can also reduce risk by washing your produce – though that won’t eliminate risk altogether.

And, if you are growing your own fruits and vegetables, make sure you’re that you are following some fundamental food safety guidelines for gardeners: using a clean water source (not your rain barrel); keeping wildlife from contaminating your garden; keeping your hands and gardening gear clean; and not using uncomposted manure.

As for grilling, check out our “5 Things You Should Know About Grilling Burgers (To Avoid Getting Sick).” There are good tips in there!

Bon appétit!

‘I thought I had mono, but was just really bored’ Ohio hockey player, 20, finds a 25-inch tapeworm in his poop

Mary Kekatos of the Daily Mail reports that Carson Meyer had been feeling perpetually tired for almost a year.

The 20-year-old, who had recently been drafted by the Columbus Blue Jackets hockey team, had been experiencing relentless lethargy along with pale skin and a loss of appetite.

Doctors, psychiatrists and trainers thought the Powell, Ohio, native might have depression, mononucleosis, and even cancer.

It wasn’t until a trip to the bathroom that Meyer figured out why he was sick – a 25-inch tapeworm had been living in his small intestine. ‘’