New fathers older than ever

Today is father’s day in Australia.

 

It’s all a bit confusing between North America and the southern hemisphere, so I just say, no formality, nothing, just ignore it. Researchers at Stanford University reviewed data on 168,867,480 live births from 1972 to 2015, making statistical adjustments for missing paternal records. The average age of the father of a newborn in the United States, the investigators found, has risen to 30.9 from 27.4 in 1972.

 

Paternal age increased across the country: the oldest fathers lived in the Northeast, and the youngest in the South. There were average age increases across all educational levels, races and ethnicities. The report appears in the journal Human Reproduction.

 

In 2015, fathers with college degrees were 33.3 years old on average, compared with 29.2 for those with only a high school diploma. Asian fathers were the oldest on average by ethnicity, and blacks and Hispanics the youngest.

 

My first kid was born when I was 24.

 

I’m 54 and have an 8-year-old.

 

I get to go watch my daughter play hockey this afternoon, and will sit in the stands and enjoy the moment – mindfully.

Me teaching Chapman how to golf: Norovirus everywhere

The University of North Carolina-Chapel Hill Panhellenic Council has postponed sorority recruitment due to an outbreak of norovirus-like symptoms for a “significant section of the Greek community,” according to an email sent to students Thursday.

The council said it has taken the recommendation of Campus Health and the Orange County Health Department to cancel at least Thursday and Friday’s planned events.

“Please go to Campus Health immediately if you are showing any symptoms,” the Panhellenic Council said in an email.

In Australia as we welcomed the first day of spring, hundreds of people have been struck down by gastroenteritis with New South Wales Health urging affected people to stay home and follow medical advice.

There were 39 gastro outbreaks in NSW institutions between August 20 and 26, including 22 in childcare centres, 10 in aged-care homes, five in hospitals and two in schools.

NSW Health said at least 348 people were affected by the bug in these outbreaks, which is more than double the previous five-year weekly average number of outbreaks for August.

And the bug finally has a name.

Director Communicable Diseases, NSW Health, Vicky Sheppeard said it appeared the outbreaks were caused by viral gastroenteritis including rotavirus and norovirus which spread easily.

“If your work involves handling food or looking after children, the elderly or patients, do not return to work until 48 hours after symptoms have stopped.

“The best defence against gastroenteritis is to wash your hands thoroughly with soap and running water for at least 10 seconds before handling and eating food, and after using the toilet, changing nappies or assisting someone who has diarrhoea or vomiting.”

10 seconds? In the U.S. it’s 20. How can all these scientists come up with different recommendations when looking at the same data. Values. And I agree with 10.

Winter has been a bad season for gastro in Australia; 1900 people attended NSW emergency departments with the bug in early August.

Brisbane has also been affected by an outbreak, with 51 childcare centres hit in the eight weeks to August 14.

NSW Health said all children should receive the rotavirus vaccine for free as part of the National Immunisation Program.

These figure come after NSW Health data showed there were 35,670 confirmed flu cases in NSW last month, making it the worst month on record for flu cases in NSW.

University students’ hand hygiene practice during a gastrointestinal outbreak in residence: What they say they do and what they actually do
01.sep.09
Journal of Environmental Health Sept. issue 72(2): 24-28
Brae V. Surgeoner, MS, Benjamin J. Chapman, PhD, and Douglas A. Powell, PhD
http://www.neha.org/JEH/2009_abstracts.htm#University_Students%92_Hand_Hygiene_Practice_During_a_Gastrointestinal_Outbreak_in_Residence:_What_They_Say_They_DO_and_What_They_Actually_Do 
Abstract
Published research on outbreaks of gastrointestinal illness has focused primarily on the results of epidemiological and clinical data collected postoutbreak; little research has been done on actual preventative practices during an outbreak.

In this study, the authors observed student compliance with hand hygiene recommendations at the height of a suspected norovirus outbreak in a university residence in Ontario, Canada. Data on observed practices was compared to post-outbreak self-report surveys administered to students to examine their beliefs and perceptions about hand hygiene. Observed compliance with prescribed hand hygiene recommendations occurred 17.4% of the time.

Despite knowledge of hand hygiene protocols and low compliance, 83.0% of students indicated that they practiced correct hand hygiene during the outbreak. To proactively prepare for future outbreaks, a current and thorough crisis communications and management strategy, targeted at a university student audience and supplemented with proper hand washing tools, should be enacted by residence administration.

 

Handwashing is never enough, bureaucrats have no spine: E. coli O157 from animals at Ekka edition

The EKKA, Queensland’s agricultural showpiece, concluded last week in Brisbane, about the same time an uncomfortable memory was finally published in the peer-reviewed cyber-sphere.

In Aug. 2013, 56 people became sick with E. coli O157 after contact with animals, or hanging out in the animal facility at the EKKA.

No child, or family, should have to go through grief and anguish because they took the kids to a petting zoo at the local fair.

Being repeatedly told they failed because they didn’t wash their hands is condescending. And ignores the science.

Handwashing is never enough.

At the time, a Biosecurity Australia dude said, “This highlights the importance of people practising sound hygiene measures following all contact with animals, their body fluids and excretions.”

How many want bureaucrats talking about body secretions?

As Anderson and Weese found in 2011 at a temporary petting zoo in Guelph (that’s in Canada) using video observation, 58 per cent of visitors performed some form of hand hygiene (either using water, soap and water, or hand sanitizer), and two interventions (improved signage while offering hand sanitizer, and verbal hand hygiene reminders by venue staff) were associated with increased hand hygiene compliance. U.K. health officials currently recommend handwashing stations with soap and water only (no wipes or sanitizers).

And while some studies suggest inadequate handwashing facilities may have contributed to enteric disease outbreaks or washing hands was protective against illness, others suggest relevant infectious agents may be aerosolized and inhaled.

In the fall of 2009, an E. coli O157:H7 outbreak at Godstone Petting Farm in the U.K resulted in 93 illnesses – primarily little kids.

The investigation into the Godstone outbreak identified evidence of environmental contamination outside the main barn, indicating acquisition of illness through both direct animal or fecal contact, and indirect environmental contact (e.g. contacting railings or soiled footwear).

Aerosolization of potential pathogens is also possible, as suggested in an E. coli O157:H7 outbreak at a county fair in Oregon, in which 60 people fell ill.

As part of the response to the Godstone outbreak, U.K. health types recommended handwashing stations with soap and water only (no wipes or sanitizers, because they don’t work that well under certain conditions).

Ihekweazu et al. subsequently concluded that in the Godstone outbreak, “handwashing conferred no demonstrable protective effect. …

“Moreover, from the findings of many previous published studies, it must be assumed that all petting or open farms are potentially high-risk environments for the acquisition of VTEC O157 infection (an STEC).”

This is what the Ekka folks had to say about the 2013 outbreak (which no one in Brisbane seems to know about).

The 2013 Ekka agricultural show displayed >10,000 animals and included sections where direct contact between visitors and animals could occur. The animal boulevard included a large animal nursery where visitors could pat and feed farm animals, including goats, lambs, calves, piglets, chicks, ducklings, donkeys, and turkeys. A milking demonstration took place in an area adjacent to the animal nursery and visitors were invited to milk a cow. Unpasteurized milk was not served. Visitors could also view the birth of lambs that took place in an enclosed booth. The birthed lambs were available for supervised petting after >24 h after veterinary clearance. Other animals displayed in the animal boulevard and other pavilions were less accessible to the public for direct contact. 

The number of visitors in the animal nursery was not restricted. Limited unsupervised handwashing facilities were available opposite the exit of the animal nursery. Hand sanitizers were available in other areas. Signs in animal contact areas encouraged visitors to wash their hands. Staff at the agricultural show regularly removed animal waste from animal contact areas. 

Stool samples from 56 of 57 case-patients showed identical virulence gene profiles, consisting of stx1, stx2, eaeA, and ehxA . The virulence gene profile of the remaining probable primary case-patient was only stx2 and ehxA. Twenty bovine, 4 ovine, and 2 caprine fecal samples were tested from animals traced to other properties after the show had ended. Serotype O157:H- was confirmed from 51 of the human cases, and also from ovine, caprine, and bovine feces, and the animal bedding sample. All O157:H- isolated from animal and environmental sources displayed the same MLVA profiles (6_8_2_9_4_7_8_2_3_8 and 11–7-13–4-5–6-4–9) (Technical Appendix Table 2), stx1a and stx2c subtypes, and sequence type ST11, and 2/51 of human isolates differed by 1 allele in 1 of the MLVA profiles. Although E. coli O157 has frequently been reported to belong to sequence type 11 (13), the MLVA profiles were novel to the Queensland collection of previously typed STEC isolates (n = 112). 

A table of petting zoo outbreaks is available at http://www.barfblog.com/wp-content/uploads/2017/08/Petting-Zoo-Outbreaks-Table-7-26-17.xlsx

Mild illness during outbreak of shiga toxin-producing Escherichia coli O157 infections associated with agricultural show, Australia

Emerging Infectious Diseases, vol. 23, no 10, October 2017, Bhakti R. Vasant, Russell J. Stafford, Amy V. Jennison, Sonya M. Bennett, Robert J. Bell, Christine J. Doyle, Jeannette R. Young, Susan A. Vlack, Paul Titmus, Debra El Saadi, Kari A.J. Jarvinen, Patricia Coward, Janine Barrett, Megan Staples, Rikki M.A. Graham, Helen V. Smith, and Stephen B. Lambert

https://wwwnc.cdc.gov/eid/article/23/10/16-1836_article

During a large outbreak of Shiga toxin−producing Escherichia coli illness associated with an agricultural show in Australia, we used whole-genome sequencing to detect an IS1203v insertion in the Shiga toxin 2c subunit A gene of Shiga toxin−producing E. coli. Our study showed that clinical illness was mild, and hemolytic uremic syndrome was not detected.

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

Outbreaks 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.

Whole genome sequencing PR in Australia

In a press release story that oozes with promotional fanfare, foodborne illnesses caused by bugs such as salmonella could be cut by a third in NSW within five years, with food and health authorities adding a “revolutionary” tool to their arsenal.

NSW Health and NSW Food Authority have started using whole genome sequencing technology to more quickly identify a foodborne outbreak and connect it with its source, which could reduce illnesses and even deaths.

“[It’s] a significant breakthrough that could help revolutionise how food-borne illnesses are identified, understood, tracked and managed,” said Dr Craig Shadbolt, the Food Authority’s acting chief executive.

“This will be invaluable in terms of achieving the NSW Government’s Food Safety Strategy goal of reducing foodborne illnesses caused by salmonella, campylobacter and listeria by 30 per cent by 2021.”

That sounds nice, but some practical steps, like not using raw eggs in mayo, aoili, or baked Chinese ice cream, would go farther. In Australia, rates of foodborne salmonella poisoning have climbed from 38 per 100,000 people in 2004 to 76 per 100,000 in 2016, with a record-breaking 18,170 cases last year, according to the National Notifiable Diseases Surveillance System.

A table of raw-egg-based outbreaks in Australia is available at: http://barfblog.com/wp-content/uploads/2017/05/raw-egg-related-outbreaks-australia-5-1-17.xlsx-

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.

Barnaby-the-bloody-carp Joyce caught out in citizenship drama

Ancestry is all the rage.

And we all have bare-knuckle boxing champs in our past.

My 30-year-old daughter e-mailed me this morning to ask about our family. She said she had a DNA test.

I took the don’t-ask-a-question-unless-you-want-an-answer route – and told her it’s all on ancestry.com, go look it up, but you may have to like your step-sister.

I’ve got three passports: Canadian, American, Australian.

It’s homogenized white, but at least I can remember them.

Sorenne is about to get her third, once we find her Canadian thingy under my name.

Australian politicians are apparently brain-dead.

Barnaby Joyce (right, not exactly as shown), the Donald Trump of Australia, deputy Prime Minister and Agricrlture Minister, didn’t know he was born a kiwi (like Russell Crowe)

Section 44 of the Australian Constitution says

Any person who –

(i.) Is under any acknowledgement of allegiance, obedience, or adherence to a foreign power, or is a subject or a citizen or entitled to the rights or privileges of a subject or citizen of a foreign power: or

(ii.) Is attainted of treason, or has been convicted and is under sentence, or subject to be sentenced, for any offence punishable under the law of the Commonwealth or of a State by imprisonment for one year or longer: or

(iii.) Is an undischarged bankrupt or insolvent: or

(iv.) Holds any office of profit under the Crown, or any pension payable during the pleasure of the Crown out of any of the revenues of the Commonwealth: or

(v.) Has any direct or indirect pecuniary interest in any agreement with the Public Service of the Commonwealth otherwise than as a member and in common with the other members of an incorporated company consisting of more than twenty-five persons:

shall be incapable of being chosen or of sitting as a senator or a member of the House of Representatives.

Australian politics is as awfull as the country’s ability to hook up decent Internet.

Australian swim star Ariarne Titmus reveals food poisoning setback before world titles

Tasmanian teenager Ariarne Titmus has revealed her world championship swimming success came off the back of a bout of food poisoning.

The 16-year-old represented Australia at the FINA World Swimming Championships in Budapest last week, winning a bronze medal with the 4 x 200m freestyle relay team.

Her performance in Budapest also ranked her fourth in the world for the 400 metres freestyle, behind record holder Katie Ledecky.

Titmus said she contracted food poisoning just days before her world championship debut, which heightened pre-race nerves.

“I didn’t really know how I was going to race because a week out from the competition I got food poisoning and I was actually vomiting the weekend before racing started,” she told ABC Hobart.

“But I was positioned next to Katie Ledecky, which was really exciting.

Despite her 400-metre result, Titmus cited her relay performance when she reeled in a Russian competitor as the highlight.

“I definitely felt really fast, I was mowing her down and it was a really really good swim,” she said.

“It was so cool to be standing up on the dais, because the dais was looking over the whole stadium you can see everything. It was really amazing, unlike any other medal ceremony I’ve ever had before.”

Shock and shame: Science behind getting people to wash their hands

Gimmie shelter from the ravages of time.

I’d largely forgotten about my lab’s handwashing phase, probably because I was leaving the safety (shurley not) of Kansas and heading to Australia.

But was reminded from this excerpt in The New Yorker from Nate Dern’s “Not Quite a Genius,” to be published by Simon & Schuster:

Employees must wash hands.

Employees must wash their own hands.

Employees must wash their own hands after they use the restroom.

Employees of this restaurant must wash their own hands after they use the restroom.

Employees of this restaurant must wash their own hands (literally, not metaphorically) after they use the restroom.

Employees of this restaurant must wash their own hands (literally, not metaphorically) after they use the restroom, or else they are in violation of the health code.

Employees of this restaurant must wash their own hands (literally, not metaphorically) after they use the restroom, or else they are in violation of the health code, and, no, there is no practical way to regulate or enforce this rule.

Employees of this restaurant must wash their own hands (literally, not metaphorically) after they use the restroom, or else they are in violation of the health code, and, no, there is no practical way to regulate or enforce this rule, but, yes, we still ask, and trust that you will comply.

Employees of this restaurant must wash their own hands (literally, not metaphorically) after they use the restroom, or else they are in violation of the health code, and, no, there is no practical way to regulate or enforce this rule, but, yes, we still ask, and trust that you will comply, and, O.K., we apologize for the condescending tone of the posting of this rule, which seems to imply that without such a sign we would assume that our employees are disgusting children with no regard for their own hygiene.

Employees must wash hands. Greg has been fired.

Filion, K., KuKanich, K.S., Chapman, B., Hardigree, M.K., and Powell, D.A. 2011. Observation-based evaluation of hand hygiene practices and the effects of an intervention at a public hospital cafeteria. American Journal of Infection Control 39(6): 464-470.

Background

Hand hygiene is important before meals, especially in a hospital cafeteria where patrons may have had recent contact with infectious agents. Few interventions to improve hand hygiene have had measureable success. This study was designed to use a poster intervention to encourage hand hygiene among health care workers (HCWs) and hospital visitors (HVs) upon entry to a hospital cafeteria.

Methods

Over a 5-week period, a poster intervention with an accessible hand sanitizer unit was deployed to improve hand hygiene in a hospital cafeteria. The dependent variable observed was hand hygiene attempts. Study phases included a baseline, intervention, and follow-up phase, with each consisting of 3 randomized days of observation for 3 hours during lunch.

Results

During the 27 hours of observation, 5,551 participants were observed, and overall hand hygiene frequency was 4.79%. Hygiene attempts occurred more frequently by HCWs than HVs (P = .0008) and females than males (P = .0281). Hygiene attempts occurred more frequently after poster introduction than baseline (P = .0050), and this improvement was because of an increase in frequency of HV hand hygiene rather than HCW hand hygiene.

Conclusion

The poster intervention tool with easily accessible hand sanitizer can improve overall hand hygiene performance in a US hospital cafeteria.

Wilson, S.M., Jacob, C.J. and Powell, D.A. 2011. Behavior-change interventions to improve hand hygiene practice: A review. Critical Public Health 21: 119-127.

http://www.informaworld.com/smpp/content~content=a934338802~db=all~jumptype=rss

Despite the role of hand hygiene in preventing infectious disease, compliance remains low. Education and training are often cited as essential to developing and maintaining hand-hygiene compliance, but generally have not produced sustained improvements. Consequently, this literature review was conducted to identify alternative interventions for compelling change in hand-hygiene behavior. Of those, interventions employing social pressures have demonstrated varying influence on an individual’s behavior, while interventions that focus on organizational culture have demonstrated positive results. However, recent research indicates that handwashing is a ritualized behavior mainly performed for self-protection. Therefore, interventions that provoke emotive sensations (e.g., discomfort, disgust) or use social marketing may be the most effective.

21 sickened with Salmonella from duck prosciutto at Australian restaurant, 2015

In June 2015, an outbreak of salmonellosis occurred among people who had eaten at a restaurant in Darwin, Northern Territory, Australia over 2 consecutive nights.

We conducted a retrospective cohort study of diners who ate at the restaurant on 19 and 20 June 2015. Diners were telephoned and a questionnaire recorded symptoms and menu items consumed. An outbreak case was defined as anyone with laboratory confirmed Salmonella Typhimurium PT9 (STm9) or a clinically compatible illness after eating at the restaurant.

Environmental health officers inspected the premises and collected food samples. We contacted 79/83 of the cohort (response rate 95%); 21 were cases (attack rate 27%), and 9 had laboratory confirmed STm9 infection. The most commonly reported symptoms were diarrhoea (100%), abdominal pain (95%), fever (95%) and nausea (95%). Fifteen people sought medical attention and 7 presented to hospital.

The outbreak was most likely caused by consumption of duck prosciutto, which was consumed by all cases (OR 18.6, CI 3.0–∞, P<0.01) and was prepared on site.

Salmonella was not detected in any food samples but a standard plate count of 2×107 col- ony forming units per gram on samples of duck prosciutto demonstrated bacterial contamination. The restaurant used inappropriate methodology for curing the duck prosciutto. Restaurants should consider purchasing pre-made cured meats, or if preparing them on site, ensure that they adhere to safe methods of production.

An outbreak of salmonellosis associated with duck prosciutto at a Northern Territory restaurant

CDI, vol 41, no 1, 2017, Anthony DK Draper, Claire N Morton, Joshua NI Heath, Justin A Lim, Anninka I Schiek, Stephanie Davis, Vicki L Krause, Peter G Markey

https://www.health.gov.au/internet/main/publishing.nsf/Content/cda-cdi4101-pdf-cnt.htm/$FILE/cdi4101d.pdf

Commun Dis Intell 2017;41(1):E16 – E20.