Rubber ducky you’re the one, who makes bacterial interactions so much fun

It’s a gotcha story, lots of bugs, nothing that would really make anyone sick, but familiarity with a child and a bathtub (or an adult).

Ceylan Yeginsu of The New York Times reports there’s an ugly truth about the rubber duck, the popular bathroom toy that children put in their mouths and use to squeeze bath water into their siblings’ faces.

Something yucky is likely to be inside, scientists say: “potentially pathogenic bacteria” that can cause eye, ear and stomach infections.

A study by American and Swiss researchers found that toy ducks appeared to be a breeding ground for microbes. The murky water released from four out of every five ducks tested included Legionella along with Pseudomonas aeruginosa bacteria, often associated with infections acquired in hospitals, the authors of the study said.

So don’t play with a rubber duck in a hospital.

The study, conducted by the Swiss Federal Institute of Aquatic Science and Technology, ETH Zurich and the University of Illinois, was published on Tuesday in the journal N.P.J. Biofilms and Microbiomes.

The researchers tested a range of bath toys, 19 different ones, and found 75 million cells of bacteria per square centimeter in the ducks — a strikingly high level that scientists say was a result of their polymer material releasing carbon, which acts as a nutrient for bacteria.

 “In addition to the nutrient supply, dirty bath water also serves as a further source of microbial seeding for the bath toys,” the researchers noted.

They suggested that using a higher-quality polymer to make the rubber ducks might prevent bacterial and fungal growth.

The study, which received funding from the Swiss government, is part of broader research into bacteria on household objects.

UK health officials finger C. perfringens as source of over 60 illnesses at pub

Those 60-plus diners that got sick at the Old Farmhouse pub on Mother’s Day in Somerset, UK, were stricken with Clostridium perfringens.

PHE South West Consultant in Health Protection Dr Bayad Nozad said: “C. perfringens live normally in the human and animal intestine and in the environment.

“The illness is usually caused by eating food contaminated with large numbers of C. perfringens bacteria that produce enough toxin in the intestines to cause illness.”

The Old Farmhouse, owned by brewery chain Hall and Woodhouse, temporarily closed its kitchen while investigations were underway.

Samples were then taken in order to identify the cause of the sickness outbreak.

Dr Nozad said: “It is good news that the majority of affected individuals appear to have recovered quickly.

“Our advice for anyone else affected is to drink plenty of water to avoid dehydration.

“We are currently working with Environmental Health Officers from North Somerset Council to ensure that the venue have appropriate precautions and procedures in place.”

North Somerset Council environmental health officers have say the venue is now operating under their guidance.

Tests show NZ beef sector so far free of M. bovis

Emma left this morning.

Emma has always been a special person in our lives, and especially Sorenne’s.

When Amy was pregnant almost 10 years ago at Kansas State University, we talked about getting some early childhood education students to help out, so I could work and Amy could write.

Never had to post the ad.

Emma was a student in one of Dr. Amy’s French classes, noticed she was pregnant, and asked, are you going to need help with that baby?

Emma became one of our helpers.

This was in the U.S., with six weeks maternity leave, rather than Canada, with six months maternity leave (plus a whole bunch more parental leave, in Canada).

Emma now lives in New Zealand with her partner, the veterinarian, and took advantage of the long weekend to have a visit.

To watch Emma and her partner experiment and flourish over the past 10 years has been a delight.

But this story is for the dude, since he works at MPI in New Zealand, whose $3 billion beef export sector seems to be free so far of the serious new cattle disease Mycoplasma bovis.

The Ministry for Primary Industries, which is attempting to contain an outbreak of the disease in dairy cattle by a mass slaughter of more than 22,000 dairy cattle before the beginning of June, said there had been no positive results from its testing of beef animals.

The beef and dairy sectors work closely in New Zealand through dairy calf rearing and dairy grazing with about 80 per cent of premium beef cattle production originating from the dairy herd.

In response to a Herald inquiry, an MPI spokeswoman said the risk profile for M. bovis in beef farming was very different to that of dairying because of how beef is raised in New Zealand.

“Generally beef cattle are farmed extensively in pasture and are not fed risky discarded calf milk.

“We looked into this carefully and determined the beef stock at greatest risk were those that were raised in feed lots – not that common in New Zealand.”

With the support of industry good organisation Beef+Lamb, MPI had carried out some surveillance of cattle in feed lots, mostly in the South Island, the epicentre of the M. bovis outbreak.

“The animals were tested at slaughter in order to take samples … there were no positive results,” the spokeswoman said.

“We also consider that many dairy beef animals were tested in the response as part of our tests on neighbouring farms to infected properties. Again, no positives were found.”
Meanwhile, newly released MPI reports on M. bovis investigations since the first outbreak last July said “confluence of multiple rare events” could have allowed the bacterial disease into New Zealand, possibly as long ago as 2015.

One of the three released reports identifies seven potential pathways for the disease but finds all “improbable – yet one of them resulted in entry”.

The risk pathways investigated were imported embyros, imported frozen bull semen, imported live cattle, imported feed, imported used farm equipment, and other imported live animals. A seventh pathway was redacted from the reports along with all discussion about it, but the Herald can confirm it was imported veterinary medicines and biological products.

MPI has opted to try to contain the disease with a mass cull of cattle on 28 quarantined properties, all but one in the South Island, because it believes it is not yet well established in New Zealand. The first outbreak of the disease was on a large-scale dairying business in the South Island. However, the MPI reports suggest it may have been introduced in mid-2016 or even earlier.

Vibrio cholerae on Vancouver Island linked to herring eggs

Island Health says it is investigating confirmed cases of Vibrio cholerae infection contracted by people who ate herring eggs on Vancouver Island.

The health authority is now warning the public not to consume herring eggs found on kelp, seaweed or other surfaces that have been harvested from the French Creek to Qualicum Bay area, as they could be tainted.

Island Health did not specify how many people fell ill from eating the herring eggs or how severe their symptoms were.

Vibrio cholerae is a bacterium found in water that can cause intestinal illness including the disease cholera. 

It called the situation “unique” and said it will release more information as it becomes available.

Still waiting.

Raw is risky: Brucellosis from unpasteurized milk in Texas

In July 2017, the Texas Department of State Health Services (DSHS) Region 2/3 office reported a human case of brucellosis associated with the consumption of raw (unpasteurized) cow’s milk purchased from a dairy in Paradise, Texas. CDC’s Bacterial Special Pathogens Branch (BSPB) confirmed the isolate as Brucella abortus vaccine strain RB51 (RB51).

Brucellosis is a zoonotic bacterial disease that affects humans and many animal species. In humans, the disease is characterized by fever and nonspecific influenza-like symptoms that frequently include myalgia, arthralgia, and night sweats. Without appropriate treatment, brucellosis can become chronic, and life-threatening complications can arise. Human brucellosis transmitted by cattle was once common in the United States. Control strategies have focused on elimination of brucellosis through vaccination and surveillance of cattle herds, in addition to milk pasteurization. Because of these measures, domestically acquired human cases are now rare (1).

RB51, a live-attenuated vaccine used to prevent B. abortus infection in cattle, has been documented to cause human disease, most commonly through occupational exposures such as needle sticks (2). Importantly, unlike wild strains of B. abortus, RB51 does not stimulate an antibody response detectable by routine serological assays, requiring culture for confirmation. Additionally, RB51 is resistant to rifampin, a common treatment choice for human brucellosis (2,3). This case represents the first documented instance of human brucellosis caused by RB51 through consumption of raw milk acquired in the United States.

Following isolation of RB51 from the patient’s blood, bulk milk tank samples from the farm tested positive for RB51 by polymerase chain reaction and bacterial culture. Culture of individual milk samples from all 43 cows in the herd identified two RB51 culture-positive cows. Subsequent whole genome sequencing indicated genetic relatedness between the cow and human isolate.

In Texas, farm sales of raw milk products to the public are legal with a “Grade ‘A’ Raw for Retail” license, regulated by the DSHS Milk and Dairy Group. By the end of August, through correspondence with the dairy, DSHS had identified approximately 800 persons who might have visited the farm during June 1–August 7. On September 1, Texas DSHS and BSPB began notification calls to these households, recommending that all exposed persons (i.e., those who consumed raw milk products from the farm during June 1–August 7) seek medical attention and begin 3 weeks of postexposure prophylaxis, even if asymptomatic (4).

Contact information was available for 582 households. The notification was issued successfully to 397 (68.2%) households. Among these notified households, 324 (81.6%) identified at least one exposed household member. Contacted persons referred 34 additional potentially exposed households, including households from seven other states.* A nationwide press release and Health Alert Network Health Advisory were issued in September to facilitate further identification of exposed persons (5).

To date, there are no other confirmed cases associated with this investigation. CDC and Texas DSHS continue measures to increase awareness among health care providers and the public regarding unique challenges associated with treatment and diagnosis of RB51 in humans and the risks of consuming raw milk.

Notes from the Field: Brucella abortus vaccine strain RB51 infection and exposures associated with raw milk consumption

09.mar.18

CDC

Caitlin Cossaboom

https://www.cdc.gov/mmwr/volumes/67/wr/mm6709a4.htm?s_cid=mm6709a4_w

Raw is risky: Kitten death and recall

I’d somehow dropped off the Worms & Germs Blog, hosted by my former hockey friend-buddy-guy Scott Weese at the University of Guelph, in the same way people lose barfblog.com.

We’re both still here (he’s in the back row, third from left, I’m the goalie in black, 13 years ago).

Resubscribe.

Scott writes about recent raw pet food outbreaks that, I haven’t written much lately about recalls of raw pet food because of Salmonella contamination. In large part that’s because it’s an expected event. There’s a reason we cook food…to kill things that can make us sick. We assume that raw meat intended for our consumption is contaminated with bacteria like Campylobacter and Salmonella (because it often is). Therefore, we similarly expect raw meat for pet consumption to be frequently contaminated. Various research studies have confirmed that.

A recent recall highlights the issues and risks. The recall involves Blue Ridge Beef of Eatontown, Georgia. They are recalling “Kitten grind” (an unfortunate name, in my opinion…but that’s a different story) after consumer complaints of deaths of two kittens. One death was confirmed to have been the result of Salmonella. Salmonella and Listeria were identified in the food (although it’s not clear to me whether it was the same strain and the same lot). Regardless, it’s not too surprising. Salmonella contamination of raw meat is common and while disease in animals is fortunately rare, it can happen, sometimes with fatal consequences.

This should be a reminder that handling and feeding raw meat is a risk for acquisition of pathogens such as Salmonella. My main recommendation is ‘don’t feed raw’. That’s particularly true in households where there are high-risk people (e.g. young kids, elderly individuals, pregnant women, immunocompromised individuals) or high-risk animals (same types as for people). If someone’s determined to feed raw, it’s important to reduce the risk as much as possible.

Soup sold at Belleville, Ontario farmers’ market recalled

When I was a teenager my mom would drag me out of bed a couple of Saturday’s every year and we’d go to the farmers’ market in Peterborough. Depending on the season, she’d shop for peaches, apples, strawberries or cucumbers. The goal was to freeze or pickle these foods for winter consumption. I don’t remember seeing much else at the market beyond produce, eggs or the local butcher. This was before I had embraced my food safety nerddom. Or knew what that was.

There probably was soup and other canned stuff floating around. I see canned stuff like pickles, jams and sauces that at the farmers’ markets I frequent. I don’t see a lot of low acid canned goods like mushroom soup. Stuff like that is tough to make commercially without a retort. And by tough I mean, against most local and federal laws.

In Belleville, Ontario (that’s in Canada, former home of the OHL’s Belleville Bulls) someone was selling some homemade mushroom soup. According to CFIA’s website, regulatory folks conducted a few tests (I read that as ‘tested the pH’) and now there’s a recall.

This stuff doesn’t look sketchy at all (right, exactly as shown).

Raw meat does not confer ‘strength’ 12 sick with trichinellosis from wild boar, 2017

The U.S. Centers for Disease Control reports on January 15, 2017, a hospital physician notified the Alameda County Public Health Department (ACPHD) in California of a patient with a suspected diagnosis of trichinellosis, a roundworm disease transmitted by the consumption of raw or undercooked meat containing Trichinella spp. larvae (1).

A family member of the initial patient reported that at least three other friends and family members had been evaluated at area hospitals for fever, myalgia, abdominal pain, diarrhea, and vomiting. The patients had attended a celebration on December 28, 2016, at which several pork dishes were served, including larb, a traditional Laotian raw pork dish, leading the hospital physician to suspect a diagnosis of trichinellosis. Although the event hosts did not know the exact number of attendees, ACPHD identified 29 persons who attended the event and seven persons who did not attend the event, but consumed pork taken home from the event by attendees. The event hosts reported that the meat had come from a domesticated wild boar raised and slaughtered on their private family farm in northern California. ACPHD conducted a case investigation that included identification of additional cases, testing of leftover raw meat, and a retrospective cohort study to identify risk factors for infection.

Investigation and Findings

Contact information for additional attendees and exposed persons was obtained during interviews with confirmed attendees. Reports of suspected diagnoses of trichinellosis among event attendees were requested from hospital infection prevention specialists, outpatient clinic providers, and local health jurisdictions where event attendees lived.

Exposure to Trichinella was defined as consumption of pork in which Trichinella spiralis larvae were identified. Thirty-six potentially exposed persons were identified, including 29 who attended the event and seven who consumed food taken home from the event by attendees. Among the potentially exposed persons, 20 (56%) were interviewed, 16 for whom professional language interpreters were used. Fourteen potentially exposed persons were not interviewed because contact information was unavailable, and two persons could not be reached. Clinical and exposure information from all 20 persons who were interviewed was collected using a structured questionnaire administered by telephone 28–92 days after the December 28 event. Medical records for patients with a suspected diagnosis of trichinellosis were requested from hospitals and outpatient providers and abstracted. In consultation with the California Department of Public Health and CDC, ACPHD recommended serologic testing for Trichinella for all persons with a suspected diagnosis of trichinellosis using a commercial laboratory’s enzyme-linked immunosorbent assay* to detect immunoglobulin G (IgG) directed against a Trichinella excretory-secretory antigen.

An illness that was clinically compatible with trichinellosis was defined as the occurrence of 1) myalgia and fever; or 2) periorbital edema; or 3) eosinophilia (≥6% eosinophils), with or without gastrointestinal symptoms (e.g., diarrhea, vomiting, or abdominal pain) in an attendee or someone who had consumed food brought home by an attendee. A probable case was defined as clinically compatible illness in a patient with exposure to Trichinella. Confirmed cases were defined as laboratory-confirmed Trichinella infection (i.e., a positive serologic test for Trichinella IgG antibodies) in a patient with history of exposure and clinically compatible illness.

Ten confirmed and two probable cases of trichinellosis were identified; 11 occurred in men. Eleven patients self-identified as Asian, and one identified as Asian and white. The median age was 58 years (range = 39–71 years). Onset dates ranged from December 28, 2016, to January 23, 2017. Nine patients were hospitalized, two of whom were admitted to the intensive care unit; nine had sepsis, seven had acute kidney injury, and two had gastrointestinal bleeding, one case of which was attributed to nonsteroidal antiinflammatory drug use. Eight patients had elevated peak creatine phosphokinase levels indicating skeletal muscle damage (median = 2,821 μg/L; range = 566–25,467 [normal <200 μg/L]), and seven had elevated peak lactic acid levels, which is an indicator of sepsis (median = 3.1 mmol/L; range = 2.3–5.3 [normal = 0.5–2.2 mmol/L]). Six had elevated peak troponin levels indicating damage to the myocardium (median = 0.76 μg/L; range = 0.23–2.02 [normal <0.10 μg/L]). Ten cases were confirmed by a positive Trichinella serological test; two patients were not tested (Table).

Several event attendees had also assisted with food preparation. The three pork-containing dishes reported to have been served at the event included pork stew, grilled pork, and raw larb. Attendees were interviewed about preparation and consumption of the three pork dishes served at or taken home from the event, as well as consumption of any other pork-containing dishes served at the event and other sources of wild boar or bear meat. Attack rates and relative risks were calculated. Leftover raw pork from the implicated meal was obtained from the event hosts.

Larvae in an unstained touch preparation from the raw pork were verified as Trichinella spp. from a photomicroscopic image (Figure); samples were sent to CDC’s Division of Parasitic Diseases and Malaria diagnostic laboratory and identified as Trichinella spiralis through sequencing of the polymerase chain reaction–amplified ITS1-ITS2 region. Consumption of larb was significantly associated with trichinellosis, with an attack rate of 100% and a relative risk of 3.33 (95% confidence interval = 1.29–8.59). No other meat dishes were associated with an increased relative risk.

Public Health Response

The caretaker of the source farm could not be reached, but the event host who owns the farm reported that the caretaker purchased the pig from a private farm at age 5 weeks, raised it in an outdoor, fenced pen, and slaughtered it with the farm owner at age 2.5 years. The farm owner stated there are several pigs being raised on the farm, and the swine are only given commercial feed and never cooked or uncooked meat, offal, or garbage. The farm owner denied any rodent infestation issues on the farm but did state that small animals such as chicks had occasionally gotten into the fenced pen and been eaten by the pigs, indicating that small mammals infected with Trichinella could have entered the pen and been consumed by the swine. The event host has slaughtered pigs and served the fresh raw pork dish at previous celebrations; no illnesses had been reported before this event. Health education regarding safe food handling practices and avoiding consumption of raw meat was provided during interviews with potentially exposed persons and patients. The host was educated about reducing the risk for trichinellosis when consuming pigs from his farm by freezing raw meat for 30 days and cooking meat to a minimum internal temperature of 160°F (71.1°C) to kill Trichinella larvae (2). Although the host did not indicate that he would employ these risk reduction techniques, he did state that he would not serve raw pork from pigs from his farm in the future. Some patients said they would no longer eat raw meat; one patient reported he would continue to eat raw meat from animals that he hunts, believing that raw meat confers strength.

Discussion

Historically, most cases of trichinellosis were associated with the consumption of raw or undercooked Trichinella-infected pork (median = 360 cases reported to CDC per year during 1947–1956); however, largely owing to improvements in agricultural and food processing standards (3), many fewer cases are currently reported (median = 14.5 cases reported per year during 2006–2015) (4). Whereas trichinellosis is rare in the United States, it remains a public health threat, especially among populations that consume raw or undercooked wild game meat or pork from noncommercial sources (5). Recent outbreaks of trichinellosis have been associated with wild boar, bear, walrus, and unspecified pork (4,6). The outbreak described in this report was linked to consumption of a privately raised boar, yet surveillance data during 2008–2012 identified just one case of trichinellosis linked to the consumption of home-raised swine (4), suggesting that this might be an underrecognized risk factor for trichinellosis. Home-raised and home-slaughtered swine produced for personal consumption typically are not subject to the same safety and inspection standards as are commercially produced swine and might be outside the purview of inspections by the state agriculture department or animal health board. Home-raised swine with access to the outdoors are also at risk for acquiring other zoonotic parasites, including toxoplasmosis and Ascaris suum (large roundworm of pigs). Educating persons who raise swine for personal consumption about these safety concerns by public health or agriculture authorities might mitigate the risks.

Clinical disease associated with trichinellosis can be severe and might include sepsis, which has rarely been reported in the English-language scientific literature. This outbreak investigation indicates that high-risk meat preparation and consumption practices might be part of valued cultural traditions. Public health, agriculture, and wildlife authorities should strengthen efforts to provide culturally competent education about trichinellosis prevention to private farmers, hunters, and communities whose cultural practices include raw meat consumption.

Acknowledgments

Marcos de Almeida, Henry Bishop, Kathleen Breen, Jeffrey Jones, Division of Parasitic Diseases and Malaria, CDC; Edward Powers, Infectious Diseases Branch, California Department of Public Health; Barbara Gregory, City of Berkeley Public Health Department, California; Susan Farley, Ileen Quimora, Contra Costa Public Health, Martinez, California.

Conflict of Interest

No conflicts of interest were reported.

Trichinellosis Outbreak Linked to Consumption of Privately Raised Raw Boar Meat — California, 2017

Morbidity and Mortality Weekly Report; March 2, 2018; 67(8);247–249

Dustin Heaton, MSN; Sandra Huang, MD; Rita Shiau, MPH; Shannon Casillas, MPH; Anne Straily, DVM; Li Kuo Kong, MD; Valerie Ng, MD, PhD; Viviana Petru, MD

https://www.cdc.gov/mmwr/volumes/67/wr/mm6708a3.htm?s_cid=mm6708a3_e

Vietnamese sandwich downs more than 300 in Bataan

More than 300 people were treated for suspected food poisoning after they ate Banh Mi, a Vietnamese sandwich.

Morong municipal health officer, Dr. Emma Bugay, said Friday that 160 were admitted to the municipal health center while 160 others were treated in dispensaries.

“They were vomiting and experiencing diarrhea. All of them ate Banh Mi. Some victims who came from remote areas were feeling so weak,” the doctor said.

Banh Mi, Vietnamese for bread, consists of a baguette with tomato, cucumber, onion, homemade liver, pork and butter, among others. It is Vietnam’s most recognized food after “pho”.

Bugay said Morong is noted for the sandwich and not only visitors but even local folks patronize the stores selling it.

Morong Mayor Cynthia Estanislao ordered the closure of Banh-Mian ni Raven, a store near the municipal hall, where all the victims bought the sandwich from, while an investigation was ongoing.

Attempt by the Philippine News Agency (PNA) to contact the owners in their house in Morong failed.

Bugay, however, said that according to the store owner, the 300 sandwiches they prepared for the day were all sold out.

She said Banh Mi is big and is often shared by two persons so she estimated that not only 300 persons were affected.

23 sick: Cryptosporidiosis outbreak in Illinois linked to 4-H projects

The Clark and Champaign county health departments say they’re investigating 23 possible cases of cryptosporidiosis linked to dairy calves brought to the region for youth 4-H projects. 

The calves were sold to children.  A Clark County epidemiologist says hydrogen peroxide is the only known disinfectant for killing the parasite. No other information has been released.