What’s in your weed?

In Hawaii, one of the testing labs certified by the state to check the quality of medical marijuana said they found contamination in more than half of the samples from the black market.   

The lab, Steep Hill Hawaii, says over 50 percent of the black market product had contaminants that included mold, yeast, and pesticides. 

The lab says that doesn’t mean all homegrown products are bad, but patients should be aware of what’s in their medicine. 

“I personally was shocked to find out how much stuff was in black market cannabis that you would never expect. E. coli, which comes from fecal matter. Salmonella, which comes from raw egg and chicken. We found that on product we tested,” said Michael Covington, of Steep Hill Hawaii. 

In Canada, CannaDrinks may be all the rage in some parts of the world, but there are some serious health concerns surrounding new products being formulated.

Sure it sounds cool, to order some cannabis-infused drinks at the bar for you and your buddies. However, a leading food safety expert is warning that these cool drinks may be dangerous, and the public (apparently) needs to take note.

While a $245 million deal was penned between Constellation Brands and Canopy Growth last week, for a 10 percent stake of CP, Canada’s largest cannabis producer, to produce the new CannaDrinks, Rick Holley claims the drinks are problematic, “[Producers] could screw this all up if they don’t get into the mechanics of how to safely prepare and develop new food products,” he said, adding, “They could kill people!”

BNN reported that Constellation Brands told them via email that the company, “has a long-standing commitment to producing products with the highest quality standards and that comply with all regulations.”

According to Lawrence Goodridge, a McGill University food safety expert (Larry, you’re an expert), alcohol has the advantage of killing bacteria and toxins in sealed bottles or cans, whereas cannabis-infused products may not, “Because cannabis is a plant, there are certain concerns — like the possibility of pesticides used in production, or the type of fertilizer used, or the potential presence of heavy metals that could be toxic to humans,” said Goodridge, adding that, “Bacteria like e-coli or listeria that could be on the plant and that could make it onto the food, whether it is drinks or edibles, the risk is the same — but alcohol is special because we know that helps to kill some of those toxins.”

Also, Sikora et al. identified a case of Hepatitis A associated with cannabis use.

We identified a case of acute Hepatitis A virus (HAV) infection linked to cannabis use. The local Public Health department received report of a man in his mid-20s with a classic presentation of hepatitis – jaundice, abdominal pain, vomiting, general malaise, and dark urine – as well as elevated serum aminotransferase levels and a positive anti-HAV IgM. Upon questioning, he reported no contact with ill individuals, or travel outside his metropolitan area. His exclusive source of water was the local municipal supply. He reported consuming mainly pre-packaged lower risk foods from large chain-style supermarket stores and eating at several local restaurants. While administering the questionnaire, the investigator identified that the patient smoked cannabis. Upon request, the patient agreed to provide a sample of cannabis for testing purposes. A viral elution of fresh cannabis leaves was completed. The sequences derived from the patient’s serum sample and the eluate from the cannabis leaves were identical, but did not match any other HAV sub-genotype 1B sequences from Canadian isolates within the National Microbiology Laboratory database. Hepatitis A virus can survive >60 days when dried and kept at room temperature and low humidity; HAV can remain infectious in water at room temperature for 300 days. It cannot be concluded with certainty that the cannabis was the source of the hepatitis A; however, as other sources were excluded, or were of lesser probability, the association of cannabis with his disease acquisition remains strong.

 

Ready-to-eat meals may be popular but have risks

Eugene Boisvert of Au News writes that more than 40 per cent of ready-to-eat meals tested by South Australian health types contained an unsatisfactory level of bacteria, according to survey results published in the Eastern Health Authority’s annual report this month.

The SA Health survey said one of the tested meals contained 310 times the safe level of Bacillus cereus, and another had almost 13 times the safe level of E. coli, which comes from feces.

Out of 98 meals bought at local supermarkets and shops with a shelf life of 10 or more days, 42 had an unsatisfactory microorganism count.

Eastern Health Authority chief executive Michael Livori said more small businesses were trying to capitalise on the growing popularity of ready-to-eat meals without understanding the health risks involved.

“Most manufacturers who are normally in this business will (understand the risks) but there’s an increase in small businesses or retailers getting into this realm but not without risk,” Mr Livori said.

The SA Health survey and subsequent report, published in June, was sparked by Eastern Health Authority concerns about the standard of manufacturing processes of ready-to-eat meals.

The SA Health report recommended measures to prevent bacteria growing in ready-to-eat meals, including that they be heated to at least 90C for 10 minutes when being cooked.

Meanwhile, the Eastern Health Authority issued 10 businesses with prohibition orders in 2016/17, banning them from preparing, selling or transporting food until they cleaned up their act, compared with three in the previous two financial years.

85 sick with shiga-toxin E. coli at Marines base

About 85 U.S. Marines-in-training remained ill last week after an apparent shiga-toxin producing E. coli outbreak at Marine Corps Recruit Depot San Diego and Camp Pendleton amid a week-old outbreak of diarrheal illnesses at the military installations, authorities reported.

Among the medical cases were 19 new ones diagnosed since Oct. 31, 2017, according to MCRD public affairs. In all, 16 recruits were receiving treatment at an off-base hospital, with the remainder being cared for at military medical facilities.

Base officials initially announced a total of about 300 cases of intestinal ailments at the 2 San Diego-area installations on Oct. 30, 2017.

 That tally was down to roughly 215 a day later. The cause or causes of the debilitating bacterial exposure remain under investigation.

12-year-old Oklahoma girl lives with constant reminder of E. coli outbreak nine years ago

In Aug. 2008, 26-year-old Chad Ingle had a meal at the Country Cottage in Locust Grove, Oklahoma, a popular family-owned buffet-style restaurant.

Nine days later, Chad was dead from E. coli O111.

By the end of the outbreak, 341 people had been sickened with E. coli O111, all from eating at the country diner in a town of 1,423 people.

A paper describing the investigation was published in 2011 in Epidemiology and Infection and concluded from epidemiological evidence the outbreak resulted from cross-contamination of restaurant food from food preparation equipment or surfaces, or from an unidentified infected food handler.

Ethan Hutchins of ABC News writes that at first glance Machaela Ybarra is a typical 12-year-old going through the struggles any pre-teen faces. But like the words on the pages of her textbooks, Machaela has a story to tell, a story she only wishes was fiction.

“Whenever I understood what happened to me, I couldn’t believe it,” said Ybarra.

Machaela was just 2 when she contracted E. coli. It happened at Country Cottage restaurant in Locust Grove.

A Sunday afternoon lunch nine years ago changed Machaela’s life forever.

“It sounds scary even though I don’t remember much,” said Ybarra.

Her mother will never forget that day. Christina Ybarra still knows what her daughter ate: Fried chicken, meatloaf, green beans, mashed potatoes and gravy.

“It was a buffet so we went and got one plate, her and I both ate off of it and I didn’t get sick at all,” said Christina Ybarra.

It’s a miracle, she says, since Christina was seven months pregnant at the time with Machaela’s little sister.

Of the hundreds who got sick from E. coli, one person died. The restaurant closed, but was back in business two months later, and now years later Country Cottage remains open. Folks here in town say they still eat here, not blaming the restaurant for those dark days years ago.

No one in Locust Grove at the restaurant or even with the city likes to talk about the outbreak. It’s fair to say, it’s a bad time most people there would like to forget.

But for Machaela, there are daily reminders.

“I’m on seizure medication because I can just stare sometimes and just be unconscious,” said Ybarra.

 

UK woman critically ill with E.coli O55

A young woman from Guildford has been left in a critical condition in hospital after she contracted E.coli O55.

Alexander Brock of Get Surrey writes the victim and her sister, whose family have asked us not to name, both fell ill within hours of each other on Saturday September 16.

Public Health England (PHE) confirmed it was investigating “a confirmed case of E.coli O55 in Surrey.”

The eldest of the two sisters, aged 22, recovered after a few days of having symptoms such as diarrhoea and abdominal pain.

However, the health of the younger sister, 19, quickly deteriorated and she was rushed to Royal Surrey County Hospital in Guildford a few days after becoming ill.

She then suffered kidney failure, which developed into hemolytic uremic syndrome.

This led to several of her organs failing, including her heart. The woman has been in critical condition at St Bartholomew’s Hospital in London since September 27.

The strain has been confirmed as E.coli O55, which 31 people contracted in an outbreak in Dorset between July 2014 and November 2015.

In a statement, PHE added there had been other recorded E.coli cases in children in neighbouring areas which have been “identified as being potentially linked.”

 

South Korea McDonald’s offices raided after outbreak of HUS

The UK Daily Mail reports investigators have raided McDonald’s offices in Seoul, South Korea after allegations that several children fell ill after eating the U.S. chain.

At least five children have allegedly suffered life-threatening kidney disease as a result of an infection, after being served under-cooked hamburger patties at McDonald’s.

The raid on Wednesday saw the Seoul central district prosecutors’ office confiscated documents and evidence local news reports said.

Investigators also carried out raids at three other companies, including an ingredient supplier.

A spokeswoman at McDonald’s Seoul office confirmed the raid to Reuters, but gave no reason or further details.

In July, a consumer filed a complaint against the U.S. firm, saying her daughter was diagnosed with hemolytic uremic syndrome – also known as hamburger disease – following the consumption of a McDonald’s hamburger last year.

The parent said that the four-year-old girl had been left with irreversible kidney damage.

Complaints were also filed by parents of four more children who became sick after eating McDonald’s burgers.

Fancy food ain’t safe food: UK E. coli cheesemaker edition

Jane Bradley of the Scotsman reports an artisan cheesemaker which is embroiled in a court case with food hygiene authorities after being forced to withdraw its products amid an outbreak of E.coli which killed a three year old girl, has been named one of Britain’s top cheese producers in an industry awards ceremony.

Errington Cheeses, which is awaiting a court date against South Lanarkshire Council, which ordered the manufacturer to stop production of its raw milk cheeses amid an investigation following the outbreak of the food poisoning bug last summer, was given runner up in the Best Artisan Producer category at the Great British Cheese Awards. The Lanarkshire-based business also came runner up in the category of Best Blue Cheese for its Lanark Blue cheese, at the awards at Marcus Wareing’s Gilbert Scott restaurant in London, hosted by food website Great British Chefs.

The company is currently only making one type of cheese – made from ewe’s milk – pending its court case against South Lanarkshire Council. Owner Humphrey Errington, who launched the firm in 1985, has insisted that his cheese is not the source of the food poisoning outbreak – which saw 19 people hospitalised – and has claimed that the authorities, including Food Standards Scotland, are trying to curb production of raw milk cheese. A Just Giving campaign launched to help Errington cover its legal costs, raised £34,000 from supporters. Twitter user Artisan Food wrote: “Chefs vote of confidence @ErringtonCheese Resilience in face of harassment/bias/ignorance.” In March, an official report from Health Protection Scotland into the E.coli outbreak claimed that Errington’s Dunsyre Blue was the source of the bacteria.

You’re such a cute bunny; yes you are; and you can carry dangerous bacteria

Antimicrobial resistance (AMR) in zoonotic (e.g. Salmonella spp.), pathogenic, and opportunistic (e.g. E. coli) bacteria in animals represents a potential reservoir of antimicrobial resistant bacteria and resistance genes to bacteria infecting humans and other animals. This study evaluated the prevalence of E. coli and Salmonella enterica, and the presence of associated AMR in commercial meat, companion, research, and shelter rabbits in Canada. Associations between antimicrobial usage and prevalence of AMR in bacterial isolates were also examined in commercial meat rabbits.

Culture and susceptibility testing was conducted on pooled fecal samples from weanling and adult commercial meat rabbits taken during both summer and winter months (n = 100, 27 farms), and from pooled laboratory (n = 14, 8 laboratory facilities), companion (n = 53), and shelter (n = 15, 4 shelters) rabbit fecal samples.

At the facility level, E. coli was identified in samples from each commercial rabbit farm, laboratory facility, and 3 of 4 shelters, and in 6 of 53 companion rabbit fecal samples. Seventy-nine of 314 (25.2%; CI: 20.7-30.2%) E. coli isolates demonstrated resistance to >1 antimicrobial agent. At least one E. coli isolate resistant to at least one antimicrobial agent was present in samples from 55.6% of commercial farms, and from 25% of each laboratory and shelter facilities, with resistance to tetracycline being most common; no resistance was identified in companion animal samples. Salmonella enterica subsp. was identified exclusively in pooled fecal samples from commercial rabbit farms; Salmonella enterica serovar London from one farm and Salmonella enterica serovar Kentucky from another. The S. Kentucky isolate was resistant to amoxicillin/clavulanic acid, ampicillin, cefoxitin, ceftiofur, ceftriaxone, streptomycin, and tetracycline, whereas the S. London isolate was pansusceptible. Routine use of antimicrobials on commercial meat rabbit farms was not significantly associated with the presence of antimicrobial resistant E. coli or S. enterica on farms; trends towards resistance were present when resistance to specific antimicrobial classes was examined. E. coli was widely prevalent in many Canadian domestic rabbit populations, while S. enterica was rare. The prevalence of AMR in isolated bacteria was variable and most common in isolates from commercial meat rabbits (96% of the AMR isolates were from commercial meat rabbit fecal samples).

Our results highlight that domestic rabbits, and particularly meat rabbits, may be carriers of phenotypically antimicrobial-resistant bacteria and AMR genes, possibly contributing to transmission of these bacteria and their genes to bacteria in humans through food or direct contact, as well as to other co-housed animal species.

Prevalence of antimicrobial resistance in fecal Escherchia coli and Salmonella Enterica in Canadian commercial meat, companion, laboratory, and shelter rabbits (Oryctolagus cuniculus) ad its association with routine antimicrobial use in commercial meat rabbits

Preventative Veterinary Medicine, vol 147, 1 November 2017, Pages 53-57, Jennifer Kylie, Scott A. McEwen, Patrick Boerlin, Richard J. Reid-Smith, J. Scott Weese, Patricia V. Turner, https://doi.org/10.1016/j.prevetmed.2017.09.004

http://www.sciencedirect.com/science/article/pii/S0167587716305062

Was it the bulgogi burger? HUS outbreak in S. Korea linked to McDonald’s

Bulgogi is literally “fire meat,” a Korean-style grilled or roasted dish made of thin, marinated slices of beef or pork, grilled on a barbecue or on a stove-top griddle. It is also often stir-fried in a pan in home cooking

A Bulgogi burger is the same idea.

Korea Centers for Disease Control and Prevention is conducting an epidemiological investigation into a case of 7 children and 1 adult who showed symptoms of food poisoning with vomiting and diarrhea after eating McDonald’s hamburgers on 25 Aug 2017 at a Jeonju branch in North Jeolla.

Authorities are not ruling out the possibility that the 8 individuals contracted hemolytic-uremic syndrome (HUS), widely known as “hamburger disease,” a bacterial infection that can leave the renal system severely damaged.

On 25 Aug 2017, a group of 15 adults and elementary school students from the same church in Jeonju visited McDonald’s Jeonju branch and ate bulgogi burgers together. A day later, 7 children and 1 adult experienced diarrhea and vomiting. The authorities declared an epidemiological probe into the case on Sat 2 Sep 2017.

As the case was publicized, McDonald’s Korea halted selling bulgogi burgers nationwide starting on Sat 2 Sep 2017. On its website, a notice says, “We have decided to stop selling bulgogi burgers pending the outcome of the ongoing investigation by authorities,” adding that the multinational company’s Korean branch was taking the issue seriously. It also said the company will do its best to help patients recover, though without elaborating on how or when.

The outcome of the ongoing probe is expected to be made public around Wed 6 Sep 2017.

ProMED-mail reports classic bulgogi recipes use a marinade of soy, ginger, garlic, and gochujang (Korean chili paste) to flavor and tenderize strips of meat. Because combining a marinade into ground beef would change the consistency of the hamburger, making it more of a “sloppy-joe”, usually a bulgogi inspired sauce is used on top of the burger although a Korean inspired spice combination can be added to the ground beef.

31 sickened by E. coli O55 in Dorset: Almost 4 years later, health-types’ report is public

In Dec. 2014, an outbreak of E. coli O55 was identified in Dorset, UK with at least 31 sickened. Public Health England (PHE) and local environmental health officials investigated and found nothing, other than cats were also being affected.

There was a protracted battle between local residents affected by the outbreak, and the lack of disclosure by PHE, documented in June, 2017.

But now, the health-types have gone public, in a report in the current issue of Eurosurveillance.

The first documented British outbreak of Shiga toxin-producing Escherichia coli (STEC) O55:H7 began in the county of Dorset, England, in July 2014. Since then, there have been a total of 31 cases of which 13 presented with haemolytic uraemic syndrome (HUS). The outbreak strain had Shiga toxin (Stx) subtype 2a associated with an elevated risk of HUS. This strain had not previously been isolated from humans or animals in England. The only epidemiological link was living in or having close links to two areas in Dorset.

Extensive investigations included testing of animals and household pets. Control measures included extended screening, iterative interviewing and exclusion of cases and high-risk contacts. Whole genome sequencing (WGS) confirmed that all the cases were infected with similar strains. A specific source could not be identified. The combination of epidemiological investigation and WGS indicated, however, that this outbreak was possibly caused by recurrent introductions from a local endemic zoonotic source, that a highly similar endemic reservoir appears to exist in the Republic of Ireland but has not been identified elsewhere, and that a subset of cases was associated with human-to-human transmission in a nursery.

Recurrent seasonal outbreak of an emerging serotype of shiga toxin producing Escherichia coli (STEC O55:H7 STX2A) in the South West of England, July 2014 to September 2015

Eurosurveillance, vol 22, issue 36, 07 September 2017, N McFarland, N Bundle, C Jenkins, G Godbole, A Mikhail, T Dallman, C O’Connor, N McCarthy, E O’Connell, J Treacy, G Dabke, J Mapstone, Y Landy, J Moore, R Partridge, F Jorgensen, C Willis, P Mook, C Rawlings, R Acornley, C Featherstone, S Gayle, J Edge, E McNamara, J Hawker, Balasegaram, DOI: http://dx.doi.org/10.2807/1560-7917.ES.2017.22.36.30610,

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=22872

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.