Raw is risky: Salmonella growth on sprouts and microgreens

Microgreens, like sprouts, are relatively fast-growing products and are generally consumed raw. Moreover, as observed for sprouts, microbial contamination from preharvest sources may also be present in the production of microgreens.

In this study, two Salmonella enterica serovars (Hartford and Cubana), applied at multiple inoculation levels, were evaluated for survival and growth on alfalfa sprouts and Swiss chard microgreens by using the most-probable-number (MPN) method. Various abiotic factors were also examined for their effects on Salmonella survival and growth on sprouts and microgreens. Community-level physiological profiles (CLPPs) of sprout/microgreen rhizospheres with different levels of S. enterica inoculation at different growth stages were characterized by use of Biolog EcoPlates. In the seed contamination group, the ability of S. enterica to grow on sprouting alfalfa seeds was affected by both seed storage time and inoculation level but not by serovar. However, the growth of S. enterica on Swiss chard microgreens was affected by serovar and inoculation level. Seed storage time had little effect on the average level of Salmonella populations in microgreens. In the irrigation water contamination group, the growth of Salmonella on both alfalfa sprouts and microgreens was largely affected by inoculation level. Surprisingly, the growth medium was found to play an important role in Salmonella survival and growth on microgreens. CLPP analysis showed significant changes in the microbial community metabolic diversity during sprouting for alfalfa sprouts, but few temporal changes were seen with microgreens. The data suggest that the change in rhizosphere bacterial functional diversity was dependent on the host but independent of Salmonella contamination.

Sprouts and microgreens are considered “functional foods,” i.e., foods containing health-promoting or disease-preventing properties in addition to normal nutritional values. However, the microbial risk associated with microgreens has not been well studied. This study evaluated Salmonella survival and growth on microgreens compared to those on sprouts, as well as other abiotic factors that could affect Salmonella survival and growth on microgreens. This work provides baseline data for risk assessment of microbial contamination of sprouts and microgreens. Understanding the risks of Salmonella contamination and its effects on rhizosphere microbial communities enables a better understanding of host-pathogen dynamics in sprouts and microgreens. The data also contribute to innovative preventive control strategies for Salmonella contamination of sprouts and microgreens.

Plant-microbe and abiotic factors influencing salmonella survival and growth on alfalfa sprouts and Swiss chard microgreens

16 February 2018

Applied and Environmental Microbiology, vol 84 no 9

Elizabeth ReedaChristina M. Ferreiraa, Rebecca BellaEric W. Browna and Jie Zhenga

doi:10.1128/AEM.02814-17

http://aem.asm.org/content/84/9/e02814-17.abstract?etoc

Raw is risky: Norovirus outbreak linked to raw oysters rises to 126 in BC

In a follow-up on the norovirus outbreak linked to the consumption of British Columbia raw oysters, The Public Health Agency of Canada has reported that a total of 126 cases of gastrointestinal illness linked to oyster consumption have been reported in three provinces: British Columbia (92), Alberta (9), and Ontario (25). No deaths have been reported.

Ensure oysters are fully cooked before consuming them. Lightly cooking oysters does not kill norovirus. Oysters need to be cooked to an internal temperature of 90° Celsius (194° Fahrenheit) for a minimum of 90 seconds in order to kill norovirus.

35 in 11 states sick with E. coli from Romaine lettuce grown in Arizona

It’s time to end the leafy greens cone of silence.

Top view of romaine lettuce that has been sliced on a wood cutting board.

This time it has made people unnecessarily sick.

I wouldn’t touch their product.

But how would I know?

On Sept. 14, 2006, the U.S. Food and Drug Administration announced that an outbreak of E. coli O157: H7 had killed a 77-year-old woman and sickened 49 others. The FDA learned from the Centers for Disease Control and Wisconsin health officials that the outbreak may have been linked to the consumption of produce and identified bagged fresh spinach as a possible cause.

Eventually, four would die and at least 200 sickened.

One of the responses was to form the Leafy Greens Marketing Agreement (LGMA) which apparently overseas most of the leafy greens production in the U.S.

They are known primarily for self-aggrandizing press releases.

And lots of rumors about how they inhibit epidemiological investigations into outbreaks of foodborne illness linked to their products (search ‘cone of silence’ on barfblog.com for plenty of examples)

According to the U.S. Centers for Disease Control, since the last update on April 10, 2018, 18 more people from 9 states were added to this outbreak.

How many of those could have been prevented if CDC or State health types fingered chopped Romaine lettuce when rumors started circulating? Is the goal of LGMA really to forego epi and demand absolute proof before going public?

As of April 12, 2018, 35 people infected with the outbreak strain of E. coli O157:H7 have been reported from 11 states. Illnesses started on dates ranging from March 22, 2018 to March 31, 2018. Ill people range in age from 12 to 84 years, with a median age of 29. Sixty-nine percent of ill people are female. Twenty-two ill people have been hospitalized, including three people who developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

Illnesses that occurred after March 27, 2018, might not yet be reported due to the time it takes between when a person becomes ill with E. coli and when the illness is reported. This takes an average of two to three weeks.

Epidemiologic evidence collected to date indicates that chopped romaine lettuce is the likely source of this outbreak. Twenty-six (93%) of 28 people interviewed reported consuming romaine lettuce in the week before their illness started. This percentage is significantly higher than results from a survey[787 KB] of healthy people in which 46% reported eating romaine lettuce in the week before they were interviewed. Most people reported eating a salad at a restaurant, and romaine lettuce was the only common ingredient identified among the salads eaten. The restaurants reported using bagged, chopped romaine lettuce to make salads. At this time, ill people are not reporting whole heads or hearts of romaine.

Traceback investigations are ongoing to determine the source of chopped romaine lettuce supplied to restaurant locations where ill people ate. At this time, no common grower, supplier, distributor, or brand has been identified. However, preliminary information indicates that the chopped romaine lettuce was from the Yuma, Arizona growing region.

Information collected to date indicates that chopped romaine lettuce from the Yuma, Arizona growing region could be contaminated with E. coli O157:H7 and could make people sick.

Advice to Restaurants and Retailers:

  • Restaurants and retailers should not serve or sell any chopped romaine lettuce, including salads and salad mixes containing chopped romaine lettuce, from the Yuma, Arizona growing region.
  • Restaurants and retailers should ask their suppliers about the source of their chopped romaine lettuce.

That’s right, consumers, it’s up to you.

It should be up to the restaurant or retailer, who markets food safety at point-of-purchase.

And LGMA, which covers Yuma growing, should be forthcoming about risks, rather than blowing themselves in nonsensical tweets.

Going public, Salmonella-in-French-cheese-style: Morbier and Mont d’Or cheese behind 10 deaths in France, 2015-16

In a country where reporting foodborne illness is deemed unpatriotic an investigation by France Inter radio revealed that at least 10 people died in the Franche-Comté region in the east of France linked to two cheeses made from unpasteurized milk  in late 2015 and early 2016.

The investigation produced a document which showed that in January 2016 national health authorities had discovered an unusually high number of salmonella contaminations in France that was centred on Franche-Comté.

Five cheese making companies in the region, between them making 60 different brands, were later identified as being at the source of the contaminations that began in November 2015 and continued until April the following year.

In a way that is truly French in its description, those who died in the outbreak were old people who were physically weak or who suffered from another illness.

Jean-Yves Mano, the president of the CLCV consumer association, said he was surprised that a product recall had not been ordered of products that might have been infected with salmonella.

“We do not understand why a general alert was not issued by state officials, or at least information given on what precautions to take,” he told France Inter.

The state food agency, the Direction générale de l’alimentation (DGAL), said there were two reasons why a recall was not ordered.

The first was that it would have allegedly been very difficult to identify which exact brand of the cheeses were contaminated because there were a total of 60 that were produced in the cheese-making firms where the outbreak originated.

The second was that by the time the authorities found out where the outbreak had come from, the contaminated cheeses had already been consumed and the new batches in the cheesemakers’ premises were not infected.

“It is perhaps due to these two factors that this contamination was not in the media, even though all the data was public nothing was hidden,” said Fany Molin of the DGAL food agency.

That’s French-bureau-speak.

Go public: Further illnesses may be prevented; others learn; citizens may not come with torches demanding change; and it’s the right thing to do.

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.

Again, 11 sick: Blame the consumer Hong Kong edition

The Centre for Health Protection (CHP) of the Department of Health is today (January 19) investigating an outbreak of food poisoning affecting 11 persons, and reminded the public to maintain personal, food and environmental hygiene to prevent food-borne diseases.

The patients, comprising one man and 10 women aged 63 to 76, developed abdominal pain, nausea, vomiting, diarrhoea and fever about 12 to 26 hours after having lunch at a restaurant at Lau Fau Shan in Yuen Long on January 7.

Five of them sought medical attention, of whom one required hospitalisation but was discharged upon treatment. The stool specimen of that patient tested positive for Vibrio parahaemolyticus. All affected persons are now in stable condition.

Cilantro has a history of shits: Produce risk modelling in India

This study estimates illness (diarrhea) risks from fecal pathogens that can be transmitted via fecal-contaminated fresh produce. To do this, a quantitative microbial risk assessment (QMRA) framework was developed in National Capital Region, India based on bacterial indicator and pathogen data from fresh produce wash samples collected at local markets.

Produce wash samples were analyzed for fecal indicator bacteria (Escherichia coli, total Bacteroidales) and pathogens (Salmonella, Shiga-toxin producing E. coli (STEC), enterohemorrhagic E. coli (EHEC)). Based on the E. coli data and on literature values for Cryptosporidium and norovirus, the annual mean diarrhea risk posed by ingestion of fresh produce ranged from 18% in cucumbers to 59% in cilantro for E. coli O157:H7, and was <0.0001% for Cryptosporidium; for norovirus the risk was 11% for cucumbers and up to 46% for cilantro. The risks were drastically reduced, from 59% to 4% for E. coli O157:H7, and from 46% to 2% for norovirus for cilantro in post-harvest washing and disinfection scenario.

The present QMRA study revealed the potential hazards of eating raw produce and how post-harvest practices can reduce the risk of illness. The results may lead to better food safety surveillance systems and use of hygienic practices pre- and post-harvest.

Quantitative microbial risk assessment to estimate the risk of diarrheal diseases from fresh produce consumption in India

Food Microbiology, January 2018

Arti Kundu, Stefan Wuertz, Woutrina Smith

DOI: 10.1016/j.fm.2018.01.017 

http://www.x-mol.com/paper/530702

Eating sushi can be risky

I dry heaved when I read this…..

Michelle Robertson of SF Gate reports

A Fresno man with a daily sushi habit had a 5.5-foot tapeworm lodged in his intestines. He pulled it out himself, wrapped it around a cardboard toilet paper tube and carried the creature into Fresno’s Community Regional Medical Center.
Kenny Bahn was the lucky doc on shift at the time. He recounted his experience on a recent episode of the podcast “This Won’t Hurt A Bit.”
Bahn said the patient complained of “bloody diarrhea” and expressed a desire to get treated for tapeworms.
“I get asked this a lot,” the doctor said. “Truthfully, a lot of times I don’t think they have it.”
This man had it, which he proved to Bahn by opening a plastic grocery bag and pulling out the worm-wrapped toilet paper tube.
Bahn then asked some questions, starting with: “That came out of your bottom?”
“Yes.” 
According to the doctor’s retelling, the patient was using the restroom when he noticed what looked like a piece of intestine hanging out of his body.
Doctors in Taiwan extracted an 8-and-a-half foot tapeworm from a girl’s intestine and believe she contracted the parasite through raw, contaminated fish.
“He grabs it, and he pulls on it, and it keeps coming out,” Bahn recounted. He then picks the thing up, “looks at it, and what does it do? It starts moving.” (Note: At this point in the podcast, the hosts audibly gasp.)
That’s when the man realized he had a tapeworm stuck in his insides. He headed to the emergency room shortly thereafter, where Bahn treated him with an anthelmintic, a single-treatment deworming medication used on humans and dogs alike.
Bahn also took it upon himself to measure the specimen on the floor of the hospital. It stretched a whopping 5 feet, 6 inches — “my height,” noted the doctor.
Tapeworms can be contracted in a variety of ways, but Bahn said his patient hadn’t traveled out of the country or engaged in any out-of-the-ordinary behavior. The man also professed his love of sushi, specifically raw salmon sashimi, which he confessed to eating daily.
Fresno is located an ample 150 miles from coastline and is not exactly famed for its sushi. The Centers for Disease Control and Prevention warned last February that the rise in popularity of raw fish consumption has likely spurred a recent increase of tapeworm infections.

 

Raw is risky: Oysters strike down victims in Louisiana, Hong Kong

A Texas woman who spent a day along the Louisiana coast crabbing with friends and enjoying oysters found herself fighting for her life just 36 hours later, KLFY-TV reported.

Jeanette LeBlanc contracted a deadly flesh-eating bacteria called Vibrio that day, resulting in her death a few weeks later.

LeBlanc’s symptoms started out similar to an allergic reaction. In fact, that’s what she suspected it was before doctors told her otherwise. She had red patches of a rash on her legs and experienced respiratory issues before the symptoms worsened, KLFY reported.

The Centers for Disease Control and Prevention said the bacteria that causes Vibriosis creates 80,000 cases of illness in the United States each year and 100 deaths. The Vibrio bacteria live in coastal waters, those where oysters also live. The oysters contract the bacteria by filtering water to feed and the bacteria ends up in the tissues of the oyster, then when someone like LeBlanc eats it raw, they also contract the bacteria.

In Hong Kong, the Centre for Health Protection (CHP) of the Department of Health today (December 29) reported its investigations into three food poisoning outbreaks suspected to be related to the consumption of raw oysters in three different restaurants.

They involve:

  1. One man and two women, aged from 25 to 39, who have developed abdominal pain, diarrhea and vomiting about 11 to 50 hours after having lunch (including raw oysters) in a restaurant in Yau Ma Tei on December 17. All sought medical attention;

2.Two women, aged from 36 to 37, who have developed similar symptoms about 30 to 33 hours after having dinner (including raw oysters) in a restaurant in Kowloon Bay on December 19. Both sought medical attention; and

  1. One man and three women, aged from 22 to 24, who have developed similar symptoms about 16 to 59 hours after having dinner (including raw oysters) in a restaurant in Tsim Sha Tsui on December 25.

One sought medical attention.

Raw water: It’s a thing

In Australia, communities at the suburb level have the power to decide whether to fluoridate water or not.

Every time I go to the dentist, he tells me the same story: I can tell where you’re from by your teeth, no fluoride means more business for me.

In an America dominated by indulgence, privilege and the nonsensical, raw water is a thing.

Nellie Bowles of the New York Times writes at Rainbow Grocery, a cooperative in Culver, Oregon, one brand of water is so popular that it’s often out of stock. But one recent evening, there was a glittering rack of it: glass orbs containing 2.5 gallons of what is billed as “raw water” — unfiltered, untreated, unsterilized spring water, $36.99 each and $14.99 per refill, bottled and marketed by a small company called Live Water.

“It has a vaguely mild sweetness, a nice smooth mouth feel, nothing that overwhelms the flavor profile,” said Kevin Freeman, a shift manager at the store. “Bottled water’s controversial. We’ve curtailed our water selection. But this is totally outside that whole realm.”

Here on the West Coast and in other pockets around the country, many people are looking to get off the water grid.

Start-ups like Live Water in Oregon and Tourmaline Spring in Maine have emerged in the last few years to deliver untreated water on demand. An Arizona company, Zero Mass Water, which installs systems allowing people to collect water directly from the atmosphere around their homes, began taking orders in November from across the United States. It has raised $24 million in venture capital.

And Liquid Eden, a water store that opened in San Diego three years ago, offers a variety of options, including fluoride-free, chlorine-free and a “mineral electrolyte alkaline” drinking water that goes for $2.50 a gallon.

What adherents share is a wariness of tap water, particularly the fluoride added to it and the lead pipes that some of it passes through. They contend that the wrong kind of filtration removes beneficial minerals. Even traditional bottled spring water is treated with ultraviolet light or ozone gas and passed through filters to remove algae. That, they say, kills healthful bacteria — “probiotics” in raw-water parlance.

The quest for pure water is hardly new; people have been drinking from natural springs and collecting rainwater from time immemorial. The crusade against adding fluoride to public water began in the 1950s among Americans who saw danger in the protective measures that had been adopted over decades to protect the populace from disease and contamination.

But the off-grid water movement has become more than the fringe phenomenon it once was, with sophisticated marketing, cultural cachet, millions of dollars in funding and influential supporters from Silicon Valley.

Food safety in hospitals: Chemotherapy patients may be ill because they aren’t aware of the food poisoning risks (and neither are the food service types)

It’s no secret I have my share of demons, but I’ve always shared them publicly, (whether you wanted to know or not; if you don’t, go start your own blog and stop reading mine).

Every Friday, on average, I am fortunate enough to go to a place called Damascus at the Brisbane Private Hospital, where a group of 10-15 of us sit and tell stories and get better.

Some people have been sober for 10 years.

Some are straight out of the detox ward upstairs.

I’m somewhere in between.

But I value this community of lawyers, doctors, vets – both the military and animal kind – financial planners and people who just got lost along the way.

When Bill Leiss asked me to write a second edition of my first book, Mad Cows and Mothers Milk, I quoted a Neil Young line: “Heart of Gold put me in the middle of the road. Traveling there soon became a bore so I headed for the ditch.”

The ditch trilogy stands up strong 45 years later, and was featured during Neil’s solo show in Omemee, Ontario (that’s in Canada) a few weeks ago.

To add insult to injury, his next studio recording was the harrowing “Tonight’s The Night”, though with a perversity that was becoming typical of him the latter wasn’t released until after the subsequently-cut “On The Beach”. Both albums stand up strongly to this day. Both use the rock format as a means of redemption and rejuvenation, the very act of recording (no overdubs) serving as therapy. “Tonight’s The Night” and “On The Beach” were pretty free records,” Young pondered, lighting another unfiltered Pall Mall. 

“I was pretty down I guess at the time, but I just did what I wanted to do, at that time. I think if everybody looks back at their own lives they’ll realise that they went through something like that. There’s periods of depression, periods of elation, optimism and scepticism, the whole thing is…. it just keeps coming in waves. 

You go down to the beach and watch the same thing, just imagine every wave is a different set of emotions coming in. Just keep coming. As long as you don’t ignore it, it’ll still be there. If you start shutting yourself off and not letting yourself live through the things that are coming through you, I think that’s when people start getting old really fast, that’s when they really age. 

‘Cause they decide that, they’re happy to be what they were at a certain time in their lives when they were the happiest, and they say ‘that’s where I’m gonna be for the rest of my life’. From that minute on they’re dead, y’know, just walking around. I try to avoid that.”

I can’t swim, but the quote above encapsulates why I like being near the beach.

I’m no Neil Young, but I do have my passions, like safe food, so when Brisbane Private Hospital keeps serving funeral home sandwiches loaded with raw sprouts, I say something.

No change, though the hospital is serving an immunocompromised population.

As Ellen W. Evans, junior research fellow, Cardiff Metropolitan University, writes in The Conversation, chemotherapy treatment can reduce immune function and the body’s ability to defend against opportunistic pathogens. It is well documented that people undergoing chemotherapy are at an increased risk of infection, including those transmitted via food.

This is not just about suffering through a tummy bug. People who are already undergoing the gruelling side effects of chemotherapy can be made seriously ill simply because the food they are eating isn’t being handled properly at home. Added to that is the fact that foodborne infection could cause delays in treatment, and potentially increase patient mortality.

But the problem is not down to patients’ laziness. In our newly published research, we have found that they are not being given consistent information, nor do they recognise the serious risks that food can pose.

In our study, we investigated the availability and adequacy of food safety information available to UK cancer patients. We looked at online food-related resources, and conducted in-depth interviews with patients and their families on their food experiences during chemotherapy treatment.

Although some food safety information exists for chemotherapy patients, their access to it is limited. In total, we found just 45 resources online that related to food safety. These included 35 from the 154 NHS chemotherapy providers in England, Scotland and Wales, the Department of Health, and three from 184 identified UK cancer charities.

Looking at the content, 67% of the food-related information resources we identified included food safety advice – for example, “ensure eggs are thoroughly cooked”. Guidance on hand decontamination routines, such as hand washing, was most frequently included (49%). But information on how to reduce the risk of listeriosis, or safe alternatives to particular foods – such as unpasteurised dairy products, and raw or under-cooked meat – were lacking.

Most worryingly, we found that some of the online advice actually promoted potentially unsafe practices. For example, some suggested eating lukewarm food, when this temperature range can encourage bacteria growth.

The most comprehensive food safety resources that we found were tailored to the needs of neutropenic patients – those that have very low levels of white blood cells – but these are unlikely to be given to, or accessed by, all people undergoing chemotherapy.

An assessment of food safety information provision for UK chemotherapy patients to reduce the risk od foodborne infection

Public Health, December 2017, vol. 153, pg 25-35, E.W. Evans, E.C. Redmond, DOI: http://dx.doi.org/10.1016/j.puhe.2017.06.017

http://www.publichealthjrnl.com/article/S0033-3506(17)30220-2/fulltext

Objectives

Given the increased risk of foodborne infection to cancer patients receiving chemotherapy treatment, and the risk of listeriosis reportedly five-times greater to this immunocompromised patient group, there is a need to ensure the implementation of domestic food safety practices among chemotherapy patients and their family caregivers. However, information regarding the adequacy of resources to inform and enable patients to implement domestic food safety practices to reduce the risk of foodborne infection is limited. Consequently, this study aimed to evaluate the provision of food safety information available to UK chemotherapy patients.

Study design

In-depth semi-structured interviews and content analysis of online patient information resources.

Methods

Interviews with patients and family caregivers (n = 15) were conducted to explore food-related experiences during chemotherapy treatment. Online food-related information resources for chemotherapy patients (n = 45) were obtained from 35 of 154 National Health Service chemotherapy providers in England, Scotland, and Wales, the Department of Health (DoH) and three of 184 identified UK cancer charities. Identified food-related information resources were reviewed using a content-analysis approach to assess the inclusion of food safety information for chemotherapy patients.

Results

In-depth interviews established that many patients indicated awareness of immunosuppression during treatment. Although patients reported practicing caution to reduce the risk of communicable diseases by avoiding crowded spaces/public transport, food safety was reported to be of minimal concern during treatment and the risk of foodborne infection was often underestimated. The review of online food-related patient information resources established that many resources failed to highlight the increased risk of foodborne infection and emphasize the importance of food safety for patients during chemotherapy treatment. Considerable information gaps exist, particularly in relation to listeriosis prevention practices. Cumulatively, information was inconsistent, insufficient, and varied between resources.

Conclusion

The study has identified the need for an effective, standardized food safety resource specifically targeting chemotherapy patients and family caregivers. Such intervention is essential to assist efforts in reducing the risks associated with foodborne infection among chemotherapy patients.

Neil Young – 2017-12-01 Coronation Hall, Omemee, Ontario, Canada [720p] from JoeRay Skrha on Vimeo.