The investigation included open-ended interviews of ill persons, traceback, product testing, facility inspections, and trace forward.
Ninety-four persons infected with outbreak strains from 16 states and four provinces were identified; 21% were hospitalized and none died. Fifty-four (96%) of 56 persons who consumed chia seed powder, reported 13 different brands that traced back to a single Canadian firm, distributed by four US and eight Canadian companies.
Laboratory testing yielded outbreak strains from leftover and intact product. Contaminated product was recalled. Although chia seed powder is a novel outbreak vehicle, sprouted seeds are recognized as an important cause of foodborne illness; firms should follow available guidance to reduce the risk of bacterial contamination during sprouting.
A favorite line in the ice hockey linesman course I take every year to be recertified is, “that player exhibited a special kind of stupid”
Cooks and purveyors of food porn exhibit their own special kind of stupid, especially around raw beef.
The N.Y. Times continues its long history of bad food porn-based advice because, they’re New Yorkers, and they are their own special kind of stupid: at least the uppity ones.
Gabrielle Hamilton writes in the New York Times Cooking section that a hand-chopped mound of cold raw beef, seasoned perfectly, at around 3 o’clock in the afternoon on New Year’s Day, with a cold glass of the hair of the Champagne dog that bit you the night before, will make a new man out of you.
Hamilton writes the recipe calls for 8-10 ounces highest-quality beef tenderloin … and to nestle each yolk, still in its half shell if using raw, into the mound, and let each guest turn the yolk out onto the tartare before eating.
Nary a mention of Shiga-toxin producing E. coli or Salmonella or Campylobacter.
The salmonella outbreak shut down the City Center, DC location for six days in Sept. 2015. The Food and Drug Administration and local health authorities never definitively determined the exact source of the salmonella, but truffle mushroom croquettes were a common denominator among Fig & Olive diners who got sick. Components of the dish were pre-prepared at a Long Island City commissary that supplied Fig & Olive’s restaurants around the country with already-made sauces, dressings, and more, and has since been closed.
Six months and a round of layoffs later, one former mid-level executive told Jessica Sidman of Washington City Paper, “They’re an image conscious-first company. They don’t care about the guest. They care about their image, and they care about the bottom line … It’s just not a good company.”
During July–September 2015, a total of 159 patrons reported gastrointestinal illness after eating at a single District of Columbia restaurant. Forty-one persons (40 restaurant patrons and one employee) were infected with an indistinguishable Salmonella Enteritidis strain on the basis of pulsed-field gel electrophoresis (XbaI pattern JEGX01.0008). Results from a case-control study using restaurant patron data identified a novel food vehicle, truffle oil, as the likely source of Salmonella Enteritidis infection in this outbreak. Approximately 89% of case-patients reported eating truffle oil–containing items, compared with 57% of patrons who did not report gastrointestinal illness (p<0.001).
Public health officials and consumers should be aware that truffle oil has been implicated as the likely source of a Salmonella Enteritidis outbreak and could possibly harbor this pathogen. Timely engagement of the public, health care providers, and local and federal public health officials, is particularly critical for early recognition of outbreaks involving common foodborne pathogens, such as Salmonella Enteritidis.
Earlier this month Doug and I had a paper published in the Journal of Environmental Health about the need for public health folks (especially at the local and state levels) who are dealing with an outbreak to have a plan on when to go public. The plan should include what info the release; how they release it; and, what triggers release.
There are a bunch of great folks in these agencies who are often understaffed, overworked and dealing with political pressures – but often don’t look to the risk communication world for tips on this stuff.
The FDA does not specify, however, which stores, centers or schools — because that would violate its interpretation of an obscure trade secret rule.
This interpretation differs from that of other agencies in the federal food safety system, an overlapping and often illogical network of regulatory fiefdoms. The system, which is responsible for keeping food free of bacteria and other pathogens, frequently has to weigh the very real interests of private food companies against potential risks to the public. In the case of releasing retailer lists during major outbreaks, the FDA has historically sided with business, ruling that such lists constitute “confidential commercial information” and thus should not be available for public consumption.
Critics say that the agency’s unwillingness to share this information poses a clear danger to public health, particularly in cases like the current E. coli outbreak, where parents may not know if their child consumed the recalled product. According to the Centers for Disease Control and Prevention, 14 of the 16 people who have fallen ill were children.
It could also prove relevant in incidents like last year’s multistate hepatitis A outbreak, which was traced to frozen strawberries imported from Egypt and sold at several Tropical Smoothie Cafes. The FDA did not specifically reveal which locations, however — a measure that some experts say would have gotten the news to ill consumers faster. That’s important in the case of an illness like hepatitis A, which can be treated with a vaccine for a limited period after exposure.
Doug and I argue that public health agencies (like FDA) should be in the business of sharing the info they have, the info they don’t have and all the uncertainties. This includes distribution data. There are lots of ways that folks get food safety and recall information. Sometimes it’s directly from their retailer of choice; or maybe it comes from a local media source. Or someone shared something on Facebook.
Bill Hallman and colleagues at Rutgers conducted a survey of consumers and their self-reported behaviors following 2008’s Salmonella saintpaul in tomatoes, er, peppers outbreak and found that lots of people (81%) say they they share recall info when they see it. 38% believe that the food they purchase is less likely to be recalled than their neighbors. And less than 60% report checking their fridges and pantries for the food.
Releasing retailer/distribution information might increase the chance individuals will say to themselves ‘I’ve bought some soynut butter recently, and I got it at that grocery store’ and they go check.
But I could just be optimistic.
A food safety Facebook friend posted a couple of days ago about a Listeria monocytogenes-linked recall. It was so important to him that he posted the info twice once on Feb 17 and again March 11, ‘I want to again stress that you should check any production codes immediately and if you have any of these products, either throw them away or return them to your grocery store. I just checked my cheese stash and had the pepperjack slices that are included.’
But, like Hallman and colleagues found, while he shared the info, he wasn’t motivated to actually go to his fridge to look for it the first time he posted. Maybe the distribution information would have triggered a behavioral response.
At 4:23 p.m. AET on Friday, March 3, 8-year-old Sorenne’s school issued a notice to some parents that said:
“Hepatitis A has been reported at school. Hepatitis A is a viral disease that affects the liver. Anyone can be infected with hepatitis A if they come into direct contact with food, drunks, or objects contaminated by faeces of an infected person.”
I’m not sure they meant drunks, but that’s what it said.
Amy got the e-mail.
I got notification of the e-mail at 5:30 p.m. AET
I immediately called the school.
I e-mailed all the school contacts to say, “Hepatitis A is a serious disease for those who are unvaccinated. It passes fecal-oral, and can be acquired by drinks with straws, but usually not drunks (as your note says).”
Standard procedure in the U.S is vaccination clinics for anyone who has the potential to be exposed, but is only useful if done within a few days.:
So then I called Queensland Health, the state health agency.
Being after 5 p.m. on a Friday, there wasn’t no one around, except for a nice man who said he would investigate.
I e-mailed my questions:
“What is standard vaccination clinic procedure in the event of a positive case?
“What is the vaccination policy for hep A in Australia? Queensland?
“What was the timeline for detection and public notification?”
He said he would do the best he could and call me back.
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.
There’s an outbreak of Salmonella in Canberra (that’s Australia’s capital, on a swamp, like Washington, DC), and there’s an outbreak in Brisbane.
They are not related, other than no one will say something in public.
The whole idea of risk communication is to let people know when there is a problem, what they can do to avoid the problem, and stop making things worse by refusing to ID the source or the food implicated.
It’s OK, social media will fix that for the bureaucrats, but why spend taxpayer money on agencies that won’t tell the public shit?
I called Queensland Health a week ago, to ask them about the Chinese New Year Salmonella outbreak in Brisbane, and the media thingy said, e-mail your question, which I did, and still, no answer.
Which is why I always tell private sector types to expect nothing from the government.
If there’s an outbreak, the government types will still have their job and super: you won’t.
According to ABC News two weeks ago – and there’s been nothing public since — an outbreak of salmonella has forced two popular Canberra cafes to close their doors while they are investigated by health inspectors.
The ACT Government Health Protection Services (HPS) has served prohibition orders on the two cafes linked to the outbreak, located in Belconnen and Gungahlin.
The cafes are Ricardo’s in Jamison and the Central Cafe in Gungahlin.
In a statement, HPS said health inspectors had uncovered problems “related with food handling processes and procedures” at both stores.
“The cafes will be closed until such time as the identified issues have been rectified,” the statement said.
“This action means that there is no ongoing risk to the health of the ACT population from these events”.
The health directorate refused to comment on how many people had been affected by the outbreak while the investigation was in process.
Though there were a number of posts on social media from those claiming to have eaten at Ricardo’s before falling ill.
“I know someone who was in hospital last week, for four days, with a truly awesome bout of salmonella after eating there,” one person wrote on Facebook.
“My partner and I are both in hospital,” wrote another.
“Bought cake from there Monday last week, was shivering in bed with fever and food poisoning with girlfriend until Friday, she’s fine I’m still not over it,” a user said on Reddit.
“Ugh ate there Wednesday last week. Friday, got sick/gastro for 5 days. Guess I have an idea where it came from now…”
I was so sick for two weeks, although I did manage to crawl out of bed for a Neil Young show in Toronto (part of the International Harvesters tour) but then felt so sick afterwards I went home to Brantford.
One of my parent’s neighbours was my evy doctor, so I was in for a regular check-up and he detected it immediately.
Put me on some Acyclovir, which had just come out, and I was cured in no time.
Or temporarily. Viruses don’t go away.
We’re all hosts on a viral planet.
Mine has come back, in the form of a cold sore, probably because of the stress of buying a new house in an over-heated real-estate market and not selling ours.
I went to the chemist, got some drugs that aren’t really working, but at least I had that option.
Imagine 600 years ago, when Cortez from Spain dances across the water to what is now Mexico and there’s no chemist down the road.
Ewen Callaway of Nature writes one of the worst epidemics in human history, a sixteenth-century pestilence that devastated Mexico’s native population, may have been caused by a deadly form of salmonella from Europe, a pair of studies suggest.
In one study, researchers say they have recovered DNA of the stomach bacterium from burials in Mexico linked to a 1540s epidemic that killed up to 80% of the country’s native inhabitants. The team reports its findings in a preprint posted on the bioRxiv server on 8 February.
This is potentially the first genetic evidence of the pathogen that caused the massive decline in native populations after European colonization, says Hannes Schroeder, an ancient-DNA researcher at the Natural History Museum of Denmark in Copenhagen who was not involved in the work. “It’s a super-cool study.”
In 1519, when forces led by Spanish conquistador Hernando Cortés arrived in Mexico, the native population was estimated at about 25 million. A century later, after a Spanish victory and a series of epidemics, numbers had plunged to around 1 million.
The largest of these disease outbreaks were known as cocoliztli (from the word for ‘pestilence’ in Nahuatl, the Aztec language). Two major cocoliztli, beginning in 1545 and 1576, killed an estimated 7 million to 18 million people living in Mexico’s highland regions.
“In the cities and large towns, big ditches were dug, and from morning to sunset the priests did nothing else but carry the dead bodies and throw them into the ditches,” noted a Franciscan historian who witnessed the 1576 outbreak.
There has been little consensus on the cause of cocoliztli — although measles, smallpox and typhus have all been mooted. In 2002, researchers at the National Autonomous University of Mexico (UNAM) in Mexico City proposed that a viral haemorrhagic fever, exacerbated by a catastrophic drought, was behind the carnage2. They compared the magnitude of the 1545 outbreak to that of the Black Death in fourteenth-century Europe.
In an attempt to settle the question, a team led by evolutionary geneticist Johannes Krause at the Max Planck Institute for the Science of Human History in Jena, Germany, extracted and sequenced DNA from the teeth of 29 people buried in the Oaxacan highlands of southern Mexico. All but five were linked to a cocoliztli that researchers think ran from 1545 to 1550.
Ancient bacterial DNA recovered from several of the people matched that of Salmonella, based on comparisons with a database of more than 2,700 modern bacterial genomes.
Further sequencing of short, damaged DNA fragments from the remains allowed the team to reconstruct two genomes of a Salmonella enterica strain known as Paratyphi C. Today, this bacterium causes enteric fever, a typhus-like illness, that occurs mostly in developing countries. If left untreated, it kills 10–15% of infected people.
It’s perfectly reasonable that the bacterium could have caused this epidemic, says Schroeder. “They make a really good case.” But María Ávila-Arcos, an evolutionary geneticist at UNAM, isn’t convinced. She notes that some people suggest that a virus caused the cocoliztli, and that wouldn’t have been picked up by the team’s method.
Krause and his colleagues’ proposal is helped by another study posted on bioRxiv last week, which raises the possibility that Salmonella Paratyphi C arrived in Mexico from Europe.
A team led by Mark Achtman, a microbiologist at the University of Warwick in Coventry, UK, collected and sequenced the genome of the bacterial strain from the remains of a young woman buried around 1200 in a cemetery in Trondheim, Norway. It is the earliest evidence for the now-rare Salmonella strain, and proof that it was circulating in Europe, according to the study. (Both teams declined to comment on their research because their papers have been submitted to a peer-reviewed journal – good for them, dp).
“Really, what we’d like to do is look at both strains together,” says Hendrik Poinar, an evolutionary biologist at McMaster University in Hamilton, Canada. And if more ancient genomes can be collected from Europe and the Americas, it should be possible to find out more conclusively whether deadly pathogens such as Salmonella arrived in the New World from Europe.
Deep-fried ice cream sounds like something from a U.S. state fair, where everything is deep-fried, but in times of relative truths, decreasing skepticism and declining media coverage, the idea that over 100 people in Brisbane are sick from Salmonella, and that I found out about it from a hockey parent rather than public-health types is disturbing.
Or the new normal.
We have a paper coming out in April about the importance of going public with health information, so fewer people barf, but that lesson is increasingly lost.
There has been no public reporting that I can find, but at some time, public-health types and bureaucrats will realize they are paid by taxpayers, their job is to prevent people barf, not cover and hide.
According to a hockey parent, 15 teachers are out at their son’s school after dining on deep-fried ice cream in the Sunnybank suburb of Brisbane a week or so ago.
The diagnosis is Salmonella and over 100 are believed to be sickened.
Or maybe it’s just fake news, but everyone has a camera and social media, so these stories spread.
Maybe our public health types, or their bosses, with their supers (RSP) can take some steps to protect public health, rather than their own asses.
Joe Whitworth of Food Navigator reports Germany has seen a significant increase in Salmonella Stourbridge infection that has not been identified but a past outbreak was linked to unpasteurized goat cheese.
The first case was in July and the most recent had disease onset in late October.
Nine of the 13 cases with available information have been hospitalised and two males have died.
In earlier studies, the UTMB researchers developed potential vaccines from three genetically mutated versions of the salmonella bacteria, that is Salmonella Typhimurium, that were shown to protect mice against a lethal dose of salmonella. In these studies, the vaccines were given as an injection.
However, oral vaccination is simplest and least invasive way to protect people against salmonella infection. Taking this vaccine by mouth also has the added advantage of using the same pathway that salmonella uses to wreak havoc on the digestive system.
“In the current study, we analyzed the immune responses of mice that received the vaccination by mouth as well as how they responded to a lethal dose of salmonella, said Ashok Chopra, UTMB professor of microbiology and immunology. “We found that the orally administered vaccines produced strong immunity against salmonella, showing their potential for future use in people.”
There is no vaccine currently available for salmonella poisoning. Antibiotics are the first choice in treating salmonella infections, but the fact that some strains of salmonella are quickly developing antibiotic resistance is a serious concern. Another dangerous aspect of salmonella is that it can be used as a bioweapon — this happened in Oregon when a religious cult intentionally contaminated restaurant salad bars and sickened 1,000 people.
Salmonella is responsible for one of the most common food-borne illnesses in the world. In the US alone, the Centers for Disease Control and Prevention estimates that there are about 1.4 million cases with 15,000 hospitalizations and 400 deaths each year. It is thought that for every reported case, there are approximately 39 undiagnosed infections. Overall, the number of salmonella cases in the US has not changed since 1996.
Salmonella infection in people with compromised immune systems and children under the age of three are at increased risk of invasive non-typhoidal salmonellosis, which causes systemic infection. There are about one million cases globally per year, with a 25 percent fatality rate.
Other authors include UTMB’s Tatiana Erova, Michelle Kirtley, Eric Fitts, Duraisamy Ponnusamy, Jourdan Andersson, Yingzi Cong, Bethany Tiner and Jian Sha as well as Wallace Baze from the University of Texas M.D. Anderson Cancer Center. The study was supported by UTMB and The National Institutes of Health.