Looks like someone picked the wrong week to go to camp, again: 2 confirmed with E. coli in Ohio, others sick

Gates are closed at Plast Camp in Geauga County, Ohio, as the health district begins their investigation to try to figure out why kids at the summer camp suddenly got sick.  

Health District Commissioner Robert Weisdack said there are two confirmed E. coli cases, but a handful of other kids also said they didn’t feel well and more tests are being done to see if other kids have E. coli.

Camp workers handed out E. coli fact sheets to the parents who picked their kids up. Friday night, the health district said about 30 kids were still at the camp. They expect all kids to be out by Saturday so they can go in next week and investigate.

The health district said there is no risk to the community, so people outside the camp shouldn’t worry about getting E. coli.

No risk messages are risky, and so easy to pick apart.

A giant E. coli statue in New York City

John Metcalfe of City Lab writes there is now a giant statue of an E. coli microbe in City Hall Park in Lower Manhattan.

“Earth Potential: E. coli” is based on a 10,000-times magnified electron-microscope image of the fecal bacterium that causes 265,000 infections in the U.S. yearly, with symptoms including cramps and diarrhea. Made from a digital print on cut-out aluminum, it rests in City Hall Park as part of the larger exhibition, “Earth Potential,” by the Estonian artist Katja Novitskova. The show intends to portray “organisms and bodies” that have “significant research value within the scientific community for their potential to advance our understanding of our species and world,” according to the non-profit Public Art Fund. Aside from E. coli, the other pieces in the show include a huge earthworm, a slippery nematode, and a human embryo magnified to resemble a clump of moldy peaches.

Only certain strains of E. coli cause gut-churning maladies; others are beneficial components of the human intestines and boons to science. As the show’s primer explains: “E. coli has been at the center of groundbreaking research: Genetic engineers have used new synthetic biological techniques to recode the bacteria’s genome, potentially changing the organism’s functionality and radically increasing the prospect that humans will have the ability to rewrite the codes for life.”

 

Shiga toxin producing E coli in raw milk products in Norway

The Norwegian Food Safety Authority has detected Shiga toxin producing E. coli (STEC) in four unpasteurized milk products.

Mattilsynet said 82 unpasteurized milk products were examined and STEC was isolated from three products from Norwegian companies and a French cheese. Stx genes were also detected in 20 samples.

E. coli O-, stx2a was found in a Norwegian-produced soft red cheese of cow’s milk and rømme (a type of blue cheese) and E. coli O26, Stx1 and eae was in fresh cheese from goat milk. E. coli O113, stx2d was detected in French chèvre.

Joe Whitworth of Food Quality News reports Mattilsynet took 714 samples of pasteurized and unpasteurized dairy products – mainly cheeses – as part of a monitoring program from 2010 to 2016 – including 184 samples last year.

Samples in 2016 consisted of 102 produced from pasteurized milk and 82 of unpasteurized milk from stores, importers and manufacturers.

These products consisted of cow’s milk (139), goat (33), sheep (11) and a mixture of these (1).

The monitoring program was done to acquire knowledge on hygiene of dairy products on the Norwegian market.

Almost 500 sickened: German pigs and Salmonella

In 2013, raw pork was the suspected vehicle of a large outbreak (n = 203 cases) of Salmonella Muenchen in the German federal state of Saxony. In 2014, we investigated an outbreak (n = 247 cases) caused by the same serovar affecting Saxony and three further federal states in the eastern part of Germany.

Evidence from epidemiological, microbiological and trace-back investigations strongly implicated different raw pork products as outbreak vehicles. Trace-back analysis of S. Muenchen-contaminated raw pork sausages narrowed the possible source down to 54 pig farms, and S. Muenchen was detected in three of them, which traded animals with each other. One of these farms had already been the suspected source of the 2013 outbreak. S. Muenchen isolates from stool of patients in 2013 and 2014 as well as from food and environmental surface swabs of the three pig farms shared indistinguishable pulsed-field gel electrophoresis patterns.

Our results indicate a common source of both outbreaks in the primary production of pigs. Current European regulations do not make provisions for Salmonella control measures on pig farms that have been involved in human disease outbreaks. In order to prevent future outbreaks, legislators should consider tightening regulations for Salmonella control in causative primary production settings.

Two consecutive large outbreaks of salmonella muenchen linked to pig farming in Germany, 2013 to 2014: Is something missing in our regulatory framework?

Eurosurveillance, vol. 22, no. 18, 4 May 2017, A Schielke, W Rabsch, R Prager, S Simon, A Fruth, R Helling, M Schnabel, Siffczyk, S Wieczorek, S Schroeder, B Ahrens, H Oppermann, S Pfeiffer, SS Merbecks, B Rosner, C Frank, AA Weiser, P Luber, A Gilsdorf, K Stark, D Werber

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=22793

Animal poop is everywhere in Bangladesh, and fecal indicator bacteria sorta suck

Fecal-oral pathogens are transmitted through complex, environmentally mediated pathways. Sanitation interventions that isolate human feces from the environment may reduce transmission but have shown limited impact on environmental contamination.

We conducted a study in rural Bangladesh to (1) quantify domestic fecal contamination in settings with high on-site sanitation coverage; (2) determine how domestic animals affect fecal contamination; and (3) assess how each environmental pathway affects others. We collected water, hand rinse, food, soil and fly samples from 608 households. We analyzed samples with IDEXX Quantitray for the most probable number (MPN) of E. coli.

We detected E. coli in source water (25%), stored water (77%), child hands (43%), food (58%), flies (50%), ponds (97%) and soil (95%). Soil had >120,000 mean MPN E. coli per gram. In compounds with vs. without animals, E. coli was higher by 0.54 log10 in soil, 0.40 log10 in stored water and 0.61 log10 in food (p<0.05). E. coli in stored water and food increased with increasing E. coli in soil, ponds, source water and hands.

We provide empirical evidence of fecal transmission in the domestic environment despite on-site sanitation. Animal feces contribute to fecal contamination, and fecal indicator bacteria do not strictly indicate human fecal contamination when animals are present.

Animal feces contribute to domestic fecal contamination: Evidence from E. coli measured in water, hands, food, flies, and soil in Bangladesh

Environmental Science and Technology, July 2017, Ayse Ercumen, Amy Janel Pickering, Laura H. Kwong, Benjamin Arnold, Sarker Masud Parvez, Mahfuja Alam, Debashis Sen, Sharmin Islam, Craig Kullmann, Claire Chase, Rokeya Ahmed, Leanne Unicomb, Stephen Luby, and John M. Colford, DOI: 10.1021/acs.est.7b01710

http://pubs.acs.org/doi/abs/10.1021/acs.est.7b01710?journalCode=esthag

 

Use a thermometer Ireland pt, deux: Growing trend for eating rare burgers could hide deadly bacteria

Gavin White of the Independent follows up on the warning from safefood Ireland that there is “no way of knowing” if rare burger meat is safe.

A leading food safety expert said he was “very surprised” restaurants were offering undercooked burgers and putting their customers at risk.

Professor Martin Cormican, from the school of Medicine in NUI Galway, said small children and pregnant women were at an even higher risk of becoming ill.

“Restaurants need to understand that not every customer is the same and some are at more risk than others. There are liability issues,” Prof Cormican said.

He said that every burger had the potential to have the deadly bacteria, Vtec, which could cause severe illness.

“Although steak can have its bacteria killed on the outside, mince has the potential for the bacteria to end up in the middle where if not cooked properly, has the potential to make you seriously ill,” he said.

Safefood Ireland has launched its Burger Fever campaign as it was revealed 96pc of Irish people consider themselves well informed about food safety, yet 51pc are eating undercooked burgers.

A batch of French mince was recalled last week from French supermarkets over worries for the presence of Vtec, and Prof Cormican said it could easily happen in Ireland.

“Don’t take the risk, and especially if you’re taking medicine for illnesses like rheumatoid arthritis which severely impacts your immune system,” Prof Cormican said.

Dr Linda Gordon, chief specialist in food science at Safefood, said around 2pc of all mince had Vtec in it so the risk was always there for the “growing trend” of burger lovers.

Assessment of risk communication about undercooked hamburgers by restaurant servers

Ellen M. Thomas, RTI International; Andrew Binder, Anne McLaughlin, Lee-Ann Jaykus, Dana Hanson, and Benjamin Chapman, North Carolina State University; and Doug Powell, barfblog.com

Journal of Food Protection

DOI: 10.4315/0362-028X.JFP-16-065

According to the U.S. Food and Drug Administration 2013 Model Food Code, it is the duty of a food establishment to disclose and remind consumers of risk when ordering undercooked food such as ground beef. The purpose of this study was to explore actual risk communication activities of food establishment servers. Secret shoppers visited restaurants (n=265) in seven geographic locations across the U.S., ordered medium rare burgers, and collected and coded risk information from chain and independent restaurant menus and from server responses. The majority of servers reported an unreliable method of doneness (77%) or other incorrect information (66%) related to burger doneness and safety. These results indicate major gaps in server knowledge and risk communication, and the current risk communication language in the Model Food Code does not sufficiently fill these gaps. Furthermore, should servers even be acting as risk communicators? There are numerous challenges associated with this practice including high turnover rates, limited education, and the high stress environment based on pleasing a customer. If it is determined that servers should be risk communicators, food establishment staff should be adequately equipped with consumer advisory messages that are accurate, audience-appropriate, and delivered in a professional manner so as to help their customers make more informed food safety decisions.

 

29 sick: An outbreak of Shiga toxin-producing Escherichia coli O121 infections associated with flour- Canada, 2016-2017

On December 29, 2016, PulseNet Canada identified a cluster of six Escherichia coli non-O157 isolates with a matching pulsed-field gel electrophoresis (PFGE) pattern combination that was new to the PulseNet Canada database. The patients resided in three geographically distinct provinces. In January 2017, the Public Health Agency of Canada (PHAC) initiated an investigation with local, provincial, and federal partners to investigate the source of the outbreak.

A case was defined as isolation of E. coli non-O157 with the outbreak PFGE pattern or closely related by whole genome sequencing (WGS) in a Canadian resident or visitor with onset of symptoms of gastroenteritis on or after November 1, 2016. Patients’ illness onset dates ranged from November 2016 to April 2017 (Figure). As of May 23, 2017, a total of 29 cases were identified in six provinces (Alberta, British Columbia, Newfoundland and Labrador, Ontario, Quebec, and Saskatchewan). One additional case was identified in a U.S. resident who traveled to Canada during the exposure period. Patients’ ages ranged from 2–79 years (median = 23.5 years) and 50% were female. Eight patients were hospitalized, and one developed hemolytic uremic syndrome. Clinical isolates were typed as E. coli O121:H19 (one case was typed as E. coli O121:H undetermined) with Shiga toxin 2–producing genes by in silico toxin testing and had closely related PFGE patterns and WGS.

Initial investigation into the source of the outbreak did not identify any clear hypotheses; common exposures were ground beef, sausage style deli-meats, pizza, and pork, but the data did not converge on any specific products. Patients were reinterviewed by PHAC using an open-ended approach. Knowledge of a recent E. coli O121 flour-associated outbreak prompted interviewers to ask about baking and exposure to raw flour or dough (1). Patients were also asked if any food items of interest, including flour, were available for testing.

In March 2017, E. coli O121 with the outbreak PFGE pattern was isolated from an open flour sample from a patient’s home and a closed sample collected at a retail store, both of the same brand and production date. The clinical and flour isolates grouped together, with only 0–6 whole genome multilocus sequence typing allele differences. As a result of these findings, a product recall was issued. Based on possible connections to the recalled lot of flour, market sampling of flour within certain periods was initiated. The investigation led to additional recalls of flour and many secondary products (2).

As of May 23, 2017, 22 patients had been asked about flour exposure in the 7 days before illness onset; 16 (73%) reported that the implicated brand of flour was used or probably used in the home during the exposure period. Comparison data on the expected proportion with exposure to this brand of flour were not available. Eleven of these sixteen patients reported they ate or probably ate raw dough during their exposure period.

This is the first national outbreak of non-O157 Shiga toxin–producing E. coli infections identified in Canada and the first Canadian outbreak linked to flour. An open-ended interview approach and flour sampling were used to implicate flour as the source. Because of the recent emergence of E. coli outbreaks linked to flour, public health professionals should consider flour as a possible source in E. coli outbreaks and communicate the risk associated with exposure to flour, raw batter, and dough in public health messaging.

Use a fucking thermometer: Ireland says eating undercooked burgers ‘like driving without a seatbelt’

Diners who enjoy a juicy burger have been warned that eating them pink in the middle is “like driving without wearing a seatbelt”.

Fiachradh McDermott of The Irish Times reports that safefood began its new campaign, “Burger Fever”, on Thursday to inform people that eating undercooked burgers could lead to serious or sometimes life-threatening food poisoning.

What she didn’t report is that color is a terrible indicator of safety, and that needle-or-blade-tenderized steaks carry the same risk as mince, so this science-based agency is publishing fairy tales.

But I’ll let the bureaucrats speak for themselves and you judge.

The body advised people to always ask for burgers to be well-cooked in restaurants.

In an online survey conducted by safefood, 96 per cent of people considered themselves well-informed about food safety. However, 51 per cent admitted to eating undercooked burgers.

Two thirds of respondents said they would reconsider their choice if they knew there was a possibility of food poisoning.

Undercooked burgers carry the risk of E. coli, which can have long-term effects. The biggest worry is a type called VTEC, which causes severe diarrhoea.

Dr Linda Gordon, chief specialist in food science at safefood, said it can result in “frequent serious complications.” VTEC can affect the blood and kidneys, and is most serious in older people and children under five. However, it only takes as little as ten E. coli cells to make a person sick, she said.

Dr Gordon said the campaign is intended as a preventative measure, but “emphasising the difference between a burger and a steak” is an important aspect.

According to Dr Gary Kearney, director of food science at safefood, “Mince used in hamburgers is a higher risk as the food poisoning bacteria that live on the surface of the beef (steak) is then mixed through the middle of the burger when the beef is minced – so in effect, the outside is now on the inside.”

Dr Martin Cormican, Professor of Bacteriology at National University of Ireland, Galway (NUIG), emphasised the possibility and danger of contracting VTEC from undercooked meat.

“Eating burgers that are pink in the middle is a bit like driving without a seatbelt; you might get away with it for years but if something goes wrong and you are harmed, will you still think it was worth it?”

No mention of thermometer, cooking temps and hold times, just plain pandering.

Use a fucking thermometer and stick it in.

Assessment of risk communication about undercooked hamburgers by restaurant servers

E. Thomas, E,M,, Binder, A., McLaughlin, A., Jaykus, L., Hanson, D, Powell, D.A., Chapman, B. 2016.

Journal of Food Protection Vol. 79, No. 12, pp. 2113-2118

http://www.jfoodprotection.org/doi/abs/10.4315/0362-028X.JFP-16-065?code=fopr-site

According to the U.S. Food and Drug Administration 2013 Model Food Code, it is the duty of a food establishment to disclose and remind consumers of risk when ordering undercooked food such as ground beef.

The purpose of this study was to explore actual risk communication activities of food establishment servers. Secret shoppers visited restaurants (n=265) in seven geographic locations across the U.S., ordered medium rare burgers, and collected and coded risk information from chain and independent restaurant menus and from server responses.

The majority of servers reported an unreliable method of doneness (77%) or other incorrect information (66%) related to burger doneness and safety. These results indicate major gaps in server knowledge and risk communication, and the current risk communication language in the Model Food Code does not sufficiently fill these gaps. Furthermore, should servers even be acting as risk communicators? There are numerous challenges associated with this practice including high turnover rates, limited education, and the high stress environment based on pleasing a customer. If it is determined that servers should be risk communicators, food establishment staff should be adequately equipped with consumer advisory messages that are accurate, audience-appropriate, and delivered in a professional manner so as to help their customers make more informed food safety decisions.

E. coli O157 is always tragic, but probably not because of the last thing you ate

McDonald’s is a big, semi-popular fast-food chain in the way Semi-Tough (the movie) depicted American professional football as big and semi-popular.

When Shiga-toxin producing E.coli were discovered in 1977 (named verotoxigenic E. coli) and then the first outbreaks were linked to human illness in 1982 at McDonald’s in White City, Ore., and Traverse City, Mich., McDonald’s completely revamped its beef sourcing and cooking procedures.

Over the past three decades, I’ve heard everyone blame McDonald’s for everything, especially on food safety, and especially what used to be known as hamburger disease.

South Korean lawyers are apparently catching up to where North Americans were 25 years ago, but perpetuate semi-stereotypes.

According to The Korea Herald, a mother on Wednesday filed a complaint against McDonalds Korea, claiming her daughter was diagnosed with the “hamburger disease” after eating a burger with an undercooked patty in one of its outlets.

“The 4-year-old victim had no health problems, but caught hemolytic uremic syndrome after eating a McDonald’s hamburger,” lawyer Hwang Da-yeon said at a press conference held in front of the Seoul District Prosecutors Office, before submitting the complaint. 

HUS is serious shit.

McDonald’s has known about it for a long time.

The complaint claims McDonald’s violated local food safety rules by serving contaminated meat that was not fully cooked.

The plaintiff also made a tearful plea, asking state prosecutors to investigate and hold McDonald’s Korea responsible for her daughter, who has suffered irreversible damage to her kidneys and must undergo eight to 10 hours of peritoneal dialysis on a daily basis.

According to the mother, the child ate a hamburger at a McDonald’s outlet in Gyeonggi Province in September and fell ill about three hours afterwards.

HUS is always tragic, and I wouldn’t wish it on anyone.

She was brought to an intensive care unit three days later, where she was diagnosed with HUS, a food-borne disease that can cause acute kidney failure. The child was discharged from the hospital two months later, but had lost 90 percent of her kidney function.

The McDonald’s outlet denied any link between its product and the child’s illness, saying the meat is machined-cooked, eliminating human error.

I’m not sure who’s right, but Shiga-toxin producing E. coli – the kind that lead to HUS – take 2-4 days to develop – not 3 hours.

As Kate Murphy of The New York Times explained last week, when you’re fine one minute and barfing the next – what the U.S. Centers for Disease Control and Prevention calls an acute gastrointestinal event — happens to all of us at least once a year. The bouts, while extremely unpleasant, usually don’t occasion a trip to the doctor or require any medication.

But such events tend to make us spin our gears trying to pinpoint what made us so miserably sick. While it’s hard to know for sure, there are clues that might help you determine the source and reduce your risk in the future.

“People tend to blame the last thing they ate, but it’s probably the thing before the last thing they ate,” said Dr. Deborah Fisher, a gastroenterologist and associate professor at Duke University School of Medicine.

It takes the stomach around four to six hours to empty a full meal, and then the small intestine takes about six to eight hours to squeeze out all the nutrients and empty into the colon. The remains linger there for another one to three days, fermenting and being formed into what ultimately is flushed down the toilet. So-called bowel transit time varies significantly from person to person, but gastroenterologists said you can easily find out what’s normal for you by eating corn and watching for when the indigestible kernels appear in your stool.

Gross, perhaps, but with that baseline, the next time you get sick, you’ll be better able to estimate when you might have eaten the offending meal. For example, if you throw up something and don’t have diarrhea or roiling further down, it could be that what made you ill was something you ate within the last four to six hours. If you wake up in the middle of the night with cramps and diarrhea, it’s more likely something you consumed a good 18 to 48 hours earlier, depending on the results of your corn test.

We stopped at a McDonald’s on the way home from the Glass Mountains yesterday. Quality was semi-OK, but safety was there.

(No McDonald’s money was involved in this blog post; there was no money at all; I just like to write).