Blame the kids: 20 sick at Hong Kong kindergarten

The Centre for Health Protection (CHP) of the Department of Health is investigating an outbreak of acute gastroenteritis (AGE) at a kindergarten in Tseung Kwan O, and hence reminded the public and management of institutions to maintain personal and environmental hygiene against AGE.
The outbreak involves 20 students, comprising 13 boys and seven girls aged 2 to 5, as well as two female staff members, who have developed vomiting, diarrhea and fever since November 4. Among them, seven students and one staff member sought medical attention, while one was discharged upon hospitalisation. All affected persons have been in a stable condition.

Officers of the CHP conducted a site visit and provided health advice to the staff of the school concerning proper and thorough disinfection, the disposal of vomit, and personal and environmental hygiene.

75 sick: Blame the consumer, Hong Kong: edition

It’s an institution serving food, but the public is to manage the risk.

blame_canadaThat’s the message from the Centre for Health Protection (CHP) of the Department of Health today (August 4) as it reported its investigation into an outbreak of suspected food poisoning at an institution in Tseung Kwan O, and hence reminded the public to maintain personal, food and environmental hygiene to prevent foodborne diseases.

“Upon notification from the department concerned yesterday afternoon (August 3), our Outbreak Team immediately commenced epidemiological investigations. We have alerted the Food and Environmental Hygiene Department to the incident and will work with relevant departments on the investigation,” a spokesman for the CHP said.

The outbreak at this stage involved 75 persons, comprising 74 men and one woman aged from 20 to 33, who developed diarrhoea and abdominal pain about one to 28 hours after dinner on August 2 at the institution. All affected persons did not seek medical attention and required no hospitalisation.
They are now in a stable condition.
To prevent food-borne diseases, institutions are advised to:

Choose and monitor food suppliers carefully; and

Hot foods should be kept at above 60 degrees Celsius while cold foods should be kept at four degrees Celsius or below.
The CHP reminded members of the public to maintain personal, food and environmental hygiene at all times. When dining out:

Eat thoroughly cooked food;

Proper handling, storage and thorough cooking of all food-stuff derived from animal sources, in particular meat, poultry, eggs and their products;

Food handlers should immediately stop handling food if they develop gastrointestinal symptoms such as diarrhoea or vomiting;

Do not leave cooked food at room temperature for more than two hours;

Patronise only reliable and licensed restaurants;

Do not patronise illegal food hawkers;

Drink boiled water;

Always wash hands before eating and after going to the toilet;

Avoid eating raw seafood;

Be a discerning consumer in choosing cold dishes, including sashimi, sushi and raw oysters, at a buffet;

Use two sets of chopsticks and eating utensils to handle raw and cooked food; and

Do not try to use salt, vinegar, wine and wasabi to kill bacteria as they are not effective.

Salmonella from same processor stalks Seattle cook-outs

On July 15, 2015, the Washington State Department of Health notified the feds of an investigation of Salmonella I 4,[5],12:i:- illnesses. The U.S. Department of Agriculture’s Food Safety Inspection Service (FSIS) determined there was a link between whole hogs for barbeque and pork products from Kapowsin Meats of Pierce County and those illnesses.

pig.sex_In the end, at least 192 were sickened by the oddly named Salmonella I 4,[5],12:i:-.

It has now emerged that the Salmonella that sickened at least 11 people at a Seattle luau in July is the same type — and possibly from the same source — as the July 2015 outbreak.

JoNel Aleccia of The Seattle Times cited Washington state epidemiologist Dr. Scott Lindquist as saying they all ate whole roast pork served either at the Good Vibe Tribe Luau at Golden Gardens Park in Seattle on July 3, or at a private event in Pierce County,. The meat in both cases came from Kapowsin, which reopened with approval from the U.S. Department of Agriculture (USDA) on June 13.

“This is very concerning to me,” said Lindquist.

The genetic fingerprints of the bacteria match those from the outbreak that caused 22 clusters of illnesses in June and July 2015 in Washington, Oregon, Idaho, California and Alaska, Lindquist said.

When reached by phone, John Anderson, chief executive of Kapowsin Meats in Graham, Pierce County, declined to answer questions Tuesday. He referred calls to the USDA’s Food Safety and Inspection Service (FSIS).

FSIS officials said Kapowsin had implemented new cleaning, processing and bacterial-sampling protocols, including running whole hog carcasses through a steam intervention to kill bacteria. Federal inspectors were at the plant when it reopened in June and have been there every day that slaughter occurred.

The plant remained open Tuesday, FSIS officials said. Officials with the Centers for Disease Control and Prevention said they were monitoring the outbreak closely.

Health officials urge consumers to use care when cooking whole roast pig to avoid getting sick. Consumers should make sure the meat is clean, avoid cross-contamination of utensils and surfaces, cook the meat to a minimum temperature of 145 degrees Fahrenheit, and quickly refrigerate cooked meat after meals.

But this doesn’t sound so much like a consumer problem as a slaughterhouse problem.

Blame consumers: Hong Kong case of E. coli O157:H7

The Centre for Health Protection (CHP) of the Department of Health is today (June 20) investigating a case of Shiga toxin-producing Escherichia coli (STEC) O157:H7 infection, and hence reminded the public to maintain good personal, food and environmental hygiene against intestinal infections.

blame_canadaBecause in the absence of any details, it’s PR strategy to blame consumers.

The boy, aged 3 with good past health, has developed fever, vomiting, diarrhoea, cough and runny nose since June 10, and was admitted to a private hospital for management on June 12. He has been in a stable condition all along and was discharged on June 15.

His stool specimen tested positive for STEC O157:H7 upon laboratory testing by the CHP’s Public Health Laboratory Services Branch.

Initial enquiries revealed that the patient had no recent travel history. He had contact with animals during the incubation period, but did not consume unpasteurised milk or raw food.

Blame consumers, Guyana edition: Health ministry says gastro outbreaks possible because of unhygienic practices

While a reoccurrence of an outbreak of gastroenteritis is not unlikely, deliberate efforts have been advanced by the Ministry of Public Health to reduce this possibility. This state of affairs has been vocalised by both Ministers within the Public Health Ministry, Dr. George Norton and Dr. Karen Cummings.

SAMSUNG CAMERA PICTURES

SAMSUNG CAMERA PICTURES

Sporadic outbreaks of gastroenteritis in some hinterland sections of the country over the years have been deemed a challenge to the Ministry. It is, however, one that the Ministry has grown accustomed to.

Nothing speaks government action like, “we’re accustomed to this.”

An outbreak in Region One reported on earlier this year came as no surprise to the Public Health Ministry, said Minister Norton. In January the public health sector reported an outbreak which sickened scores of residents in Baramita, Region One.

Minister Norton in revealing that the outbreak has been linked to contaminated water said, “We know that over the years, usually at the start of some years, we have had gastroenteritis outbreaks. A few years ago we had a few deaths as a result but this time around we had doctors on the ground and medications including rehydration solutions and so on because we were looking out for it. So when it started out in Baramita we managed to control it from the initial stages.”

Prior to the outbreak reported earlier this year, the public health sector was faced with an outbreak in 2013. During that time more than 200 residents in various Region One communities became ill. At least three children died.

According to Minister Cummings, the most recent gastroenteritis outbreak was reported from Baramita and its surrounding settlements. Between December 3, 2015 and January 16, 2016, a total of 102 cases were documented by the Ministry.

However, by January 20, 2016 the cases had mounted to 122 based on data received from the Senior Environmental Officer in Region One, Minister Cummings informed. The Minister shared too that at least one death was linked to the outbreak. The reported death was that of an 11-month-old child on December 27, 2015 who manifested symptoms including malnutrition, diarrhoea and vomiting, consistent with gastroenteritis.

Minister Cummings disclosed that while follow up visits to the Region One villages revealed that the majority of villagers are adhering to the use of purification tablets or chlorine and some had even erected ventilated pit latrines, the fact that there are some who are not adhering suggest that a repeat outbreak is not unlikely.

“The possibility exists because villagers are not 100 per cent compliant in maintaining hygienic standards, despite sensitization efforts, because of health behaviour and cultural practices,” Minister Cummings said.

UK E. coli infections ‘rise by 1,000’

The UK has a long history, like many countries, of blaming the consumer when  foodborne illness is involved.

give.blood.townsendMaybe those who are sick are in the wrong class.

The number of people infected with E. coli across England rose by more than 1,000 last year, figures have shown.

Dorset and North, East and West Devon were the worst hit for the infection with 629 and 612 cases each between September 2014 and September 2015.

Public Health England figures show there were 39,604 from September 2014 to September 2015, compared with 38,291 for the same period the year before.

The health authority said it was working to reduce the rate.

That’s a lot of E. coli infections.

Consumers are apparently supposed to:

  • Wash hands thoroughly after using the toilet, before and after handling food and after handling animals
  • Remove any loose soil before storing vegetables and salads
  • Wash all vegetables and fruits that will be eaten raw
  • Store and prepare raw meat and unwashed vegetables away from ready-to-eat foods
  • Do not prepare raw vegetables with utensils that have also been used for raw meat
  • Cook all minced meat products, such as burgers and meat balls, thoroughly
  • People who have been ill should not prepare food for others for at least 48 hours after they have recovered.

The UK health types really do treat people as if they are dense. Wrong social class, I guess.

Blame consumers: How to handle an egg edition

Less than half of adults, only 48 percent, wash their hands with soap and water after cracking eggs, and over 25 percent eat cookie dough or cake batter containing raw eggs, according to a study published last month in the Journal of Food Protection. Both activities put a person at serious risk for food poisoning.

raw.egg.mayo“It’s shocking,” says lead author Katherine Kosa, a research analyst in food and nutrition policy at RTI International, a nonprofit research organization based in North Carolina. In an earlier study, her team found that 98 percent of people wash their hands after handling raw poultry, but somehow that same logic hasn’t extended to eggs, she says.

She and collaborators surveyed 1,504 US grocery shoppers about their food-handling habits. The researchers were happy to find that 99 percent of people purchased refrigerated eggs and kept them refrigerated. Keeping eggs adequately cool prevents any salmonella present in the eggs from growing to dangerous levels.

Foodborne outbreaks: Learning opportunities, regardless of uncertainty, and should not be hidden

My latest column for Texas A&M’s Center for Food Safety:

powell.food.safety.going.publicThere was this one time, about 32 years ago, I was sitting in the kitchen with the mother of my university girlfriend.

She was peeling potatoes for boiling and mashing, and I smugly asked, why are you wasting so much potato?

“Because I don’t have all bloody day and if you’re so concerned, get off your bloody ass and bloody-well help.”

I’ve cooked ever since.

But what the mom and I didn’t know was that those potato skins could be contaminated with nasties like E. coli O157.

Potatoes, carrots, leeks, they’re grown in soil, and poop has various ways of getting into soil, so peeling potatoes should be like handling raw meat – you never bloody-well know what is contaminated and what isn’t.

Be the bug, follow the bug.

The folks at the U.K. Food Standards Agency, whose idea of science-based verification is to cook meat until it is piping hot, have apparently decided that E. coli O157:H7 – the dangerous kind – found on or in leeks, is the consumers’ responsibility.

Almost two months after revealing 250 people were sickened and one died with E. coli O157:H7 phage-type 8 over the previous eight months in 2011, linked to people handling loose raw leeks and potatoes in their homes, FSA decided to launch a campaign reminding people to wash raw vegetables to help minimize the risk of food poisoning.

leek_washNo information on how those 250 became sick and no information on farming and packing practices that may have led to such a massive contamination that so many people got sick, no information on anything: just advice to wash things thoroughly so that contamination can be spread throughout the kitchen.

This outbreak combines two of the central themes of conflict and public trust in all things food: when to go public, and blaming consumers.

Often during an outbreak of foodborne illness there are health officials who have data indicating that there is a risk, prior to the public (although social media is changing that equation).

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.

On June 2, 2008, the U.S. Centers for Disease Control and Prevention (CDC) announced that it was investigating an ongoing multistate outbreak of human Salmonella serotype Saintpaul infections. CDC identified the consumption of raw tomatoes as the likely source of the illnesses in at least two states. By the time the outbreak was officially declared over on August 28, 2008, 1,442 people had been reported infected, at least 286 people had been hospitalized, and the infection may have contributed to two deaths. Despite the early identification of tomatoes as a potential pathogen source, jalapeño peppers were subsequently identified as the major source, with some implication of serrano peppers as well.

Was the public advisory to avoid raw tomatoes issued too early in the outbreak investigation, despite its intent as a control measure?  Some, including the Florida Tomato Committee may believe so, considering the outcome of the investigation and the substantial impact on the agriculture sector. The estimated economic cost to the tomato industry was more than $100 million in Florida and close to $14 million in Georgia.

In a 1999 news article about a Listeria monocytogenes outbreak, CDC foodborne illness epidemiologist Paul Mead summed up the conundrum that health officials face when reviewing preliminary data during an outbreak investigation: “Food safety recalls are always either too early or too late. If you’re right, it’s always too late. If you’re wrong, it’s always too early.”  Go public too early, and make a mistake, and a corporation or industry’s reputation could unduly suffer. Go public too late, and individuals and businesses may be denied critical information they could use to protect public health.

This balancing act was most recently on display in New Zealand, following 170 confirmed cases of Yersinia pseudotuberculosis and a further 59 suspected but not confirmed cases of infection, apparently linked to lettuce.

By early Oct. 2014, enough people were sick that Food Safety Minister Jo Goodhew was compelled to finger Pams Fresh Mesclun Salad Lettuce and Pams Fresh Express Lettuce, while stressing the list was not initially released because it showed no definitive cause for the illness.

This is a disturbing trend, in that people are demanding microbiological proof when none exists – epidemiology remains a powerful and preventative public health tool.

Canterbury medical officer of health Dr Alistair Humphrey said a draft report from Environmental Science and Research (ESR) made available the previous week identified lettuce and carrots from a particular supermarket chain as the source.

“Everybody involved in this work, including MPI, ESR, all the public health units and the Ministry of Health, have seen the results of the ESR study, which is quite clear. It is unequivocal and it does name the types of food that have led to this problem and it also names one particular product,” Humphrey told Radio New Zealand.

He claimed MPI asked public health officials to keep the name of the supermarket and the products involved a secret, but he decided to name the vegetables to protect the public.

“[MPI] felt they should work with the industry rather than naming the foods but, of course, that leaves the New Zealand public slightly at risk, in my view.”

Bureaucrats are terrified of discussions of risk.

Within days of the public announcement, dozens of N.Z. Herald readers affected by the illness sent in messages describing what they went through, with many saying they were left bedridden, drowsy and debilitated.

But then the backpedaling started, portraying Living Farms, the producers of Pam’s greens, as victims of a zealous media, and by Nov., epidemiology was dumped in favor of “no Yersinia pseudotuberculosis was detected in any samples.”

Yet internal e-mails under the Official Information Act show the Ministry for Primary Industries (MPI) was mindful of balancing the risk of further illness against the risk of panicking the public and a loss of trust in the food supply chain.

An email from MPI, dated 1 October, said it considered “there will be greater ongoing positive effect and influence, with lesser risk of negative results, by managing the food safety hazard at the most likely source, ie: with industry.”

public.healthMPI had been visiting farms and retailers to try and pinpoint the source of the bug.

The documents also showed MPI believed the best it could do was inform the public to wash all fruit and vegetables as a precaution.

But, in an email dated 1 October, MPI said it was likely that the suspected vegetables were contaminated with the bacteria internally, rather than just on the surface: “Meaning that washing of the produce by consumers will not afford protection from illness.” This information was not passed on to consumers.

I don’t envy anyone facing bloody accusations. Growers and others would be better served if there were clear, publicly available guidelines for when to go public about foodborne illness. And don’t bloody-well blame consumers unless it is warranted.

Dr. Douglas Powell is a former professor of food safety who shops, cooks and ferments from his home in Brisbane, Australia.

 DISCLAIMER: The views and opinions expressed in this blog are those of the original creator and do not necessarily represent that of the Texas A&M Center for Food Safety or Texas A&M University. 

Blaming consumers, Australia edition

Australians are equally able to blame consumers for foodborne illness.

And equally dumb about it.

Within chapter 5 of the National Food Plan for the Commonwealth of Australia is the assertion that most other countries proclaim — although they can’t all be correct – that “Australia has one of the safest food supplies in the tourism-australia-3world, with a world-class system to manage safety across the food supply chain.”

The report says ”by 2025 we would like to see Australia as one of the top three countries in the world for food safety, improving the wellbeing of Australians and increasing the already good reputation of our exports.”

Kansas State University has one of those 2025 plans and why I tell my 4-year-old, less talk, more action.

Within the bureaucratic rhetoric, the authors felt it necessary to remind readers that “about a third of all food poisonings come from food handling mistakes in the home.”

No reference. No data. No special mention of what causes the other 70 per cent.

 

UK blame game; where is food contaminated? Everywhere, not just home

The blame game lives on in the UK.

Haringey Borough Council says “the authority’s food safety teams, part of the Food Standards Agency, investigated 210 complaints of food poisoning michael.douglasbut found no evidence to link them to eating out.”

Where’s Michael Douglas when needed?

The Haringey Independent reports most cases of food poisoning happen when cooking at home, and this suggested that most incidents were a result of poor food hygiene while cooking at home.”

Food safety is a farm-to-fork thing, and lowering loads limits cross-contamination.