Dozens of guests at Ibiza hotel struck down by gastroenteritis amid fears dirty rainwater seeped into water tanks

One of my fondest childhood memories was the rain barrels my grandparents used to collect water.

I have no idea why, other than a foreshadowing of somewhat of a career in microbiology, but the memories remain vivid.

Now we live in Australia, which has 10 years of drought followed by a 1-in-500-year downpour, so we have these bloody big rain water collection tanks that look nothing like my grandparents.’

Around 50 guests at an Ibiza hotel popular with British holidaymakers have fallen ill with suspected gastroenteritis.

A pregnant woman needed hospital treatment and doctors were made available for 49 other guests following the outbreak at the four-star Hotel Algarb in Playa d’en Bossa,

A probe is now underway to establish the cause, although it has been initially linked to rainwater from midweek storms on the island filtering into hotel water tanks and ending up being used to make ice.

The mum-to-be who was hospitalised with “light gastroenteritis” has now been discharged.

Cole Hansberger fights botulism

Every day after work I look forward to playing and hugging my 2 kids, it’s what keeps me going and motivated to enjoy life to its’ fullest. The following story is heartbreaking to read…

Cole Hansberger has been in the Intensive Care Unit at Banner Thunderbird Medical Center in Glendale since Aug. 6, his first birthday.
The day before he turned 1, Cole’s mother, Jackie Hansberger, noticed his head was drooping as he crawled.
By 5 p.m., that evening, Cole could no longer crawl.
At 3 a.m., the next morning, he could no longer sit up, she said.
The Peoria woman took her son to an emergency room, after which he was then transferred to Banner Thunderbird to be further evaluated.
Cole eventually was diagnosed with botulism, a rare condition that affects about 110 people per year in the United States, 72 percent of them infants, according to Banner officials.
Botulism is caused by ingesting spores of bacteria found in dirt, soil, dusty areas and certain foods.
These spores produce toxins that can lead to paralysis, said Dr. Rahul Chawla, pediatric critical-care physician at Thunderbird Medical Center who is treating Cole.
Jackie Hansberger said she hasn’t been home since Cole was admitted to intensive care.
“I refuse to leave his bedside,” she told The Arizona Republic on Wednesday. “Every day I sit, stare at the monitor all day, just to make sure my son’s breathing and he’s OK.
“Sometimes you get frustrated with your children, but I would pay a million dollars just to hear my son cry right now. I haven’t held him in over a week.”
Hansberger described Cole as rambunctious and amazing. His eyes and smile light up the room, she said.
She also has a 4-year-old son who is at home with her husband.
Chawla works 24-hour shifts and said he often gets close with a patient’s parents.
“Cole’s mom’s a rock,” he said. “I don’t think she’s left the unit.”
Hansberger has been told Cole faces a long recovery, but doctors offer a hopeful prognosis.
According to Chawla, Cole is still critically ill. He is on a ventilator and has minimal movement in his arms and legs. He will remain in intensive care for the next week to 10 days.
Cole will have to learn muscle memory again and undergo physical therapy sessions, which could last months. But Chawla said Cole should be able to return to a normal life.
Chawla said people should know the symptoms of botulism so they can seek medical attention immediately.
He said Cole’s symptoms were a classic indicator: muscle weakness, often starting with the nerves in the face and moving downward to the legs.
Chawla said people should avoid ingesting or being exposed to dirt, and washing fruits and vegetables to reduce the chances of botulism.
Hansberger wants all parents to be aware of botulism, although it is extremely rare.
“As a parent, you never expect it,” she said. “It’s a very scary experience. It humbles you as a person. Nothing else matters except in the moment.”
A GoFundMe account has been set up for Cole and his family

Not Paradise: Brucellosis linked to raw milk consumption in Texas

The Texas Department of State Health Services reports in the course of diagnosing the cause of fever, muscle and joint pain, and fatigue in a Texas resident, blood culture results revealed that the patient was infected with Brucella. Through investigation by DSHS, the most probable source of the infection was determined to be raw cow’s milk which the person had been consuming. The source of the milk was K-Bar Dairy, a licensed raw milk dairy in Paradise, Texas.

DSHS is concerned that other people who consumed raw milk from K-Bar Dairy may also have been exposed to Brucella and became infected. Brucellosis may cause short-term and long-term disease. Without specific testing, this disease may elude correct diagnosis, and without appropriate antibiotic therapy, illness may persist.

Health care providers should consider Brucellosis among differential diagnoses when a patient presents with a clinically-compatible constellation of signs and symptoms. The patient should be asked about risk factors for Brucellosis. A key question affecting the level of suspicion of Brucellosis in this scenario is the patient’s consumption of raw milk or raw milk products from K-Bar Dairy in Paradise Texas in Wise County since June 1, 2017. These individuals are considered to be at high risk of contracting brucellosis. Consumers are advised not to consume any raw milk or raw milk products from K-Bar Dairy that are still in their possession and to discard it.

At this time, it is uncertain how long Brucella may have been present in the raw milk from this dairy. Testing is ongoing in an attempt to answer that question. If a patient seeks consultation because they consumed raw milk or raw milk products from this dairy between January and June, 2017 they should be advised to be watchful for signs of chronic Brucellosis and clinically evaluated as appropriate.

Toxo: You don’t want it

Toxoplasmosis is a foodborne zoonosis transmitted by Toxoplasma gondii, a cosmopolitan protozoan that infects humans through exposure to different parasite stages, in particular by ingestion of tissue cysts or tachyzoites contained in meat, primary offal (viscera), and meat-derived products or ingestion of environmental sporulated oocysts in contaminated food or water.

The pig is an important species for infection: raw or undercooked pork consumption not subject to treatment able to inactivate the parasite represents a risk to consumers’ health. Broadening knowledge of transmission ways and prevalence concerning this important pathogen in swine, together with a thorough acquaintance with hazard management are key elements to avoid T. gondii spreading within the swine production chain.

This review aims to illustrate why toxoplasmosis should be regarded as a veterinary public health issue through a careful description of the parasite, routes of infection, and inactivation treatments, highlighting the main prevention lines from pig breeding to pork consumption.

Toxoplasma gongii, a foodborne pathogen in the swine production chain form a European perspective

Foodborne Pathogens and Disease, ahead of print, July 2017,  De Berardinis Alberto, Paludi Domenico, Pennisi Luca, and Vergara Alberto, https://doi.org/10.1089/fpd.2017.2305

http://online.liebertpub.com/doi/abs/10.1089/fpd.2017.2305

Cyclospora: Back to the future

During the summers of 2015 and 2016, the United Kingdom experienced large outbreaks of cyclosporiasis in travellers returning from Mexico. As the source of the outbreaks was not identified, there is the potential for a similar outbreak to occur in 2017; indeed 78 cases had already been reported as at 27 July 2017. Early communication and international collaboration is essential to provide a better understanding of the source and extent of this recurring situation.

Cyclosporiasis in travellers returning to the United Kingdom from Mexico in Summer 2017: Lessons from the recent past to inform the future

Eurosurveillance, vol. 22, issue 32, 10 August 2017, DFP Marques, CL Alexander, RM Chalmers, R Elson, J Freedman, G Hawkins, J Lo, G Robinson, K Russell, A Smith-Palmer, H Kirkbride, DOI: http://dx.doi.org/10.2807/1560-7917.ES.2017.22.32.30592

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=22854

206 sick: CDC notes increase of Cyclospora cayetanensis infection, United Sates, Summer 2017

Another North American summer, another Cyclospra-induced shit-fest.

The U.S. Centers for Disease Control and Prevention (CDC), State and Local Health Departments, and the Food and Drug Administration (FDA) are investigating an increase in reported cases of cyclosporiasis. The purpose of this HAN Advisory is to notify public health departments and healthcare facilities and to provide guidance to healthcare providers of the increase in reported cases. Please disseminate this information to healthcare providers in hospitals and emergency rooms, to primary care providers, and to microbiology laboratories.

Healthcare providers should consider a diagnosis of cyclosporiasis in patients with prolonged or remitting-relapsing diarrheal illness. Testing for Cyclospora is not routinely done in most U.S. laboratories, even when stool is tested for parasites. Healthcare providers must specifically order testing for Cyclospora, whether testing is requested by ova and parasite (O&P) examination, by molecular methods, or by a gastrointestinal pathogen panel test. Cyclosporiasis is a nationally notifiable disease; healthcare providers should report suspect and confirmed cases of infection to public health authorities.

As of August 2, 2017, 206 cases of Cyclospora infections have been reported to CDC in persons who became infected in the United States and became ill on or after May 1, 2017. These cases have been reported from 27 states, most of which have reported relatively few cases. Eighteen cases reported hospitalization; no deaths have been reported. At this time, no specific vehicle of interest has been identified, and investigations to identify a potential source of infection are ongoing. It is too early to say whether cases of Cyclospora infection in different states are related to each other and/or to the same food item(s).

The number of cases (206) reported in 2017, is higher than the number of cases reported by this date in 2016. As of August 3, 2016, 88 Cyclospora infections had been reported in persons who became infected in the United States and became ill on or after May 1, 2016.

4 sick with campy linked to raw milk served at Royal Welsh Show

In 2013, at least 50 people, mainly children, became ill with E coli O157 at the Ekka, Queensland, Australia’s version of the state fair.

It starts again on Friday, and because organizers have done little except to encourage people to wash their hands, we won’t be going.

Handwashing is never enough.

Manure from ruminants is easily aerosolized in these environments, and I’ve been to many human-animal interaction events for research, and there is shit everywhere.

Although ostensibly designed to promote understanding of food production, these agricultural celebrations rarely discuss risk – until an outbreak happens.

The motto seems to be: It’d be better for us if you don’t understand.

Now, four people have been sickened with Campylobacter linked to unpasteurised or raw cow’s milk from Penlan y Môr farm near New Quay, Ceredigion and sold at the Royal Welsh Show.

Public Health Wales says the four cases all consumed or bought the milk at Aberystwyth Farmer’s Market after June 1.

But visitors to the Royal Welsh Show in Builth Wells may also have sampled or bought the milk which was available there on Wednesday, 26 July.

A table of animal-human-interaction 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]

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

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.

There’s a lot of botulism in Ukraine this year

According to MiceTimes of Asia (great name) there have been 90 illnesses and nine deaths in 2017 from foodborne botulism in Ukraine this year. Seems like a lot. Home canned foods and dried fish have been linked to many of the illnesses. Dried fish and botulism seem to go together. Five bot cases in Germany and Spain were linked to dried fish in 2016.

To prevent botulism, you must carefully follow the canning of vegetables, fruits, meat, fish and mushrooms. Before the use of canned foods should be warmed to a temperature of 100°C for 30 minutes to destroy botulinum toxin.

In no case can not eat canned meat and fish, if the iron Bank is inflated or deformed.

Something may be lost in translation.

The attack of the kitchen sponge

This brings me back to my Kitchen Crimes days when we analyzed dishcloths and sponges from 13 Winnipeg homes and confirmed the presence of pathogenic microorganisms. Given that bacteria are all around us and providing a medium that is moist, porous and contains food particles left at room temperature, the following is not surprising.

Peter Dockrill of Science Alert writes

Scientists in Germany have conducted what they say is the world’s first comprehensive study of contamination in used kitchen sponges, and it backs up we already feared: these soggy, porous ‘cleaning products’ are positively teeming with living bacteria.
Researchers led by Furtwangen University ran genetic sequencing on samples from 14 different used kitchen sponges and ended up finding 362 different types of bacteria happily lounging within all that comfortable, springy foam.
Fortunately for you and me, the majority of this bacteria was in fact not harmful – but some of it was.
“What surprised us was that five of the ten [types] which we most commonly found, belong to the so-called risk group 2 (RG2),” says lead researcher, microbiologist Markus Egert, “which means they are potential pathogens.”
These included Acinetobacter johnsonii, Moraxella osloensis, and Chryseobacterium hominis – which the researchers say can lead to infections – plus Acinetobacter pittii and Acinetobacter ursingii.
Of these, bacteria in the family Moraxellaceae was the most dominant kind found, backing up previous research on sponges.
Since Moraxellaceae is also common on human skin, the researchers speculate that it might be people touching sponges that introduces this particular contamination.
It’s also that we insist on then wiping these dense bug-ridden colonies over other, potentially clean surfaces in the house, including bench tops, appliances, and kitchen sinks.

What I would find more interesting is how much of what is on the sponge actually transfers over to a dish after the application of a detergent followed by a warm water rinse.

In addition to the sequencing, the team was able to visualise the presence of bacteria in the samples in 3D using a technique called fluorescence in situ hybridisation coupled with confocal laser scanning microscopy (FISH–CLSM).
The visualisations reveal how the large surface area, moist foam, and scattered food matter within the sponge provide the perfect, incubating habitat for bacteria.
So much so, in fact, that it’s almost hard to differentiate where the sponge (blue) stops and the bugs (red) start:
“Sometimes the bacteria achieved a concentration of more than five times 1010 cells per cubic centimetre,” says Egert.
“Those are concentrations which one would normally only find in faecal samples. And levels which should never be reached in a kitchen.”

The authors recommend changing the sponge on a weekly basis. Dischloths are no better.

Levine writes: Investigating shoppers’ perceptions of risk

Katrina Levine, extension associate and lead author of Consumer perceptions of the safety of ready-to-eat foods in retail food store settings writes,

While I was grocery shopping one day at my regular store, I noticed that one of the doors to the dairy refrigerator case was missing. There was no sign or notice to explain the gaping hole where the door should have been in front of the shredded cheese, nor was any attempt made to compensate for the absent door, such as by relocating the items in that section or putting up a temporary covering.

After first being a bit confused when trying to reach for a non-existent handle, these questions popped into my head:

• how can the food in this section be at a safe temperature, as well as the foods on either side of it? and,

• doesn’t this missing door affect the ability of the case to maintain its temperature?

I’m a food safety nerd. Most people just want to shop and get on with whatever they are doing, but I’m subconsciously always looking for food safety behaviors. The person standing behind me was probably more interested in which brand was the least expensive or which package looked the freshest, or just wanted me to get out the way so they could buy their cheese and leave.

Does the lack of a door on a normally enclosed refrigerator case pose a food safety risk for dairy the products in that case? Depends on whom you ask. The average consumer (interpret this as you choose) often doesn’t see the same food safety risks when shopping in grocery stores compared to food safety folks.

Our group from North Carolina State teamed up with John Luchansky and Anna Porto-Fett at the U.S. Department of Agriculture’s Agricultural Research Service to investigate this difference between consumers and food safety folks in food safety risk perception when shopping at grocery stores.  We conducted a national survey and several focus groups where, instead of just describing a situation, we showed pictures of a food safety situation someone could actually encounter while shopping. In addition to asking questions about whether each photo was safe or unsafe, we wanted to know about the actions, if any, people would take to do something about a situation they thought was unsafe. We prodded them further with questions about how their perceptions of safety would affect their shopping behaviors.

We found that consumers and food safety folks don’t always see the same food safety risks. There were some situations consumers perceived as risky but that weren’t actually risks, like seeing an insect on the floor. There were also some risks that food safety folks saw but consumers missed, like food not properly stored within the refrigerated area.

I was explaining our study to a friend the other day, and she flat out told me, “I look for food quality when I’m shopping – is it fresh, is there mold or signs of damage, does it look ok?” This is exactly what we found. Consumers are looking for those quality aspects, but aren’t always seeing the warning signs that the safety of the food could be at risk. The viruses, bacteria, and other things that cause foodborne illness such as Listeria monocytogenes, might be present on foods in the grocery store at high levels by not storing soft cheeses at the proper temperature, allowing bacteria to grow more quickly.

Our research team will be taking this one step further to better understand the mind of the shopper and see things through their eyes. Everyday consumers will become our secret shoppers, and we plan to arm them with the information they need to be food safety detectives every time they shop. #citizenscience for the win.

Consumer perceptions of the safety of ready-to-eat foods in retail food store settings

Katrina Levine, Mary Yavelak, John B. Luchansky, Anna C. S. Porto-Fett, and Benjamin Chapman

Journal of Food Protection

August 2017, Vol. 80, No. 8, pp. 1364-1377

DOI: doi.org/10.4315/0362-028X.JFP-16-417

Abstract:

To better understand how consumers perceive food safety risks in retail food store settings, a survey was administered to 1,041 nationally representative participants who evaluated possible food safety risks depicted in selected photographs and self-reported their perceptions, attitudes, and behaviors. Participants were shown 12 photographs taken at retail stores portraying either commonly perceived or actual food safety contributing factors, such as cross-contamination, product and equipment temperatures, worker hygiene, and/or store sanitation practices. Participants were then asked to specifically identify what they saw, comment as to whether what they saw was safe or unsafe, and articulate what actions they would take in response to these situations. In addition to the survey, focus groups were employed to supplement survey findings with qualitative data. Survey respondents identified risk factors for six of nine actual contributing factor photographs >50% of the time: poor produce storage sanitation (86%, n = 899), cross-contamination during meat slicing (72%, n = 750), bare-hand contact of ready-to-eat food in the deli area (67%, n = 698), separation of raw and ready-to-eat food in the seafood case (63%, n = 660), cross-contamination from serving utensils in the deli case (62%, n = 644), and incorrect product storage temperature (51%, n = 528). On a scale of 1 to 5, where 1 was very unsafe and 5 was very safe, a significant difference was found between average risk perception scores for photographs of actual contributing factors (score of ca. 2.5) and scores for photographs of perceived contributing factors (score of ca. 2.0). Themes from the focus groups supported the results of the survey and provided additional insight into consumer food safety risk perceptions. The results of this study inform communication interventions for consumers and retail food safety professionals aimed at improving hazard identification.