Rabies (maybe) from bats living in a sorority house, Indiana, 2017

In February 2017, the Indiana State Department of Health (ISDH) was notified of bat exposures at a university sorority house. The initial complaint was made to ISDH because of concerns for food sanitation. Bats had been routinely sighted in shared living areas and hallways. ISDH, in consultation with the U.S. Centers for Disease Control, collaborated with the university and sorority to assess residents and staff members for potential rabies risk. In 2016, 4.3% of all bats tested in Indiana were positive for rabies. The longest incubation period recorded for indigenously acquired bat rabies is 270 days (1); therefore, out of an abundance of caution, ISDH conducted interviews with 140 students and eight employees who resided or worked in the sorority house during the preceding 12 months, all of whom were considered to have possibly been exposed. A web-based survey was administered in February to collect information about bat exposures, which was used to categorize all respondents into having a low, medium, or high risk for rabies exposure per CDC guidance (2).

Persons who reported a bite, scratch, or direct skin contact with a bat were categorized as having a high risk. Persons were categorized as having moderate risk if they reported waking and finding a bat in the same room where they were sleeping. Persons who reported no bat exposure were categorized as having a low risk. Respondents categorized as having a high or moderate risk had follow-up interviews in person or by telephone.

Among the 148 possibly exposed persons, 100 (68%) responded to the questionnaire, including 92 (66%) students and all eight employees; 94 respondents reported ever having seen a bat in the sorority house. Among those 94 persons, 70 (74%) reported having seen a bat within the previous 12 months, and 34 (36%) reported seeing a bat ≤1 month ago. Among respondents who reported ever having seen a bat in the sorority house, 13 (14%) were identified as having a moderate or high risk for rabies exposure, including 11 sorority members, one university employee, and one nonsorority member student. After follow-up interviews, nine of these 13 persons were reclassified as having a low risk for rabies exposure. The remaining four persons were considered to have a high (three persons) or a moderate (one) risk. All four persons received a recommendation for postexposure prophylaxis (PEP), which consists of human rabies immune globulin and a series of 4 doses of rabies vaccine. Two persons completed the PEP series during March 20–April 18, and two declined PEP because of a perceived lack of risk. No respondent had developed clinical rabies as of February 2018.

ISDH learned that bats had been roosting in the building for approximately 30 years. Commercial wildlife operators conducted an environmental investigation in March and identified multiple small openings between the house’s exterior wall and doorframe, which can serve as points of ingress or egress for bats. In addition, certain students reported hearing scratching behind a wall inside the house’s common space. This wall was scheduled to be removed as part of a house remodel during summer 2017. A commercial wildlife control operator repaired the openings and completed building remediation during this time. Students returned to the house in August 2017. No bat sightings have been reported since students returned.

This is the first reported instance of a mass bat exposure in a fraternity or sorority house. Multiple high-risk rabies exposures occurred in this sorority house, attributable to bat colonization of the building. The initial complaint to ISDH related to concerns for food sanitation, rather than rabies, is consistent with previous reports indicating an underappreciation of the health risks associated with indoor bat exposures (3). ISDH communicated the risk for rabies exposure at meetings with students and university housing directors. All bat exposure events should be reported immediately to public health officials, who can provide advice about rabies risk assessments and determination of the need for PEP.

Notes from the Field: Assessment of Rabies Exposure Risk Among Residents of a University Sorority House — Indiana, February 2017

Morbidity and Mortality Weekly Report; February 9, 2018; 67(5);166

Betsy Schroeder, DVM; Alex Boland, MPH; Emily G. Pieracci, DVM; Jesse D. Blanton, PhD; Brett Peterson, MD; Jennifer Brown, DVM

https://www.cdc.gov/mmwr/volumes/67/wr/mm6705a4.htm?s_cid=mm6705a4_e

Corresponding author: Betsy Schroeder, BSchroeder@cdc.gov, 814-248-5774.

1Epidemic Intelligence Service, CDC; 2Indiana State Department of Health; 3Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

References

De Serres G, Dallaire F, Côte M, Skowronski DM. Bat rabies in the United States and Canada from 1950 through 2007: human cases with and without bat contact. Clin Infect Dis 2008;46:1329–37. CrossRef PubMed

CDC. Assessment of risk for exposure to bats in sleeping quarters before and during remediation—Kentucky, 2012. MMWR Morb Mortal Wkly Rep 2013;62:382–4. PubMed

DeMent J, Trevino-Garrison I. Investigation of potential rabies exposure while attending a camp, Barton County, June 2010. Topeka, KS: Kansas Department of Health and Environment; 2010. http://www.kdheks.gov/epi/download/Bats_at_Camp_Final_Report.pdf

Poop baked into a pizza at a Little Caesars restaurant in Indiana

Poop, probably not a pizza topping you would order. An Indiana woman noticed what appeared to be mice poop baked into her pizza at a Little Caesars restaurant.

Fox 4 reports

A Little Caesars restaurant near downtown Indianapolis is back open, after health inspectors shut it down Tuesday after receiving a couple’s complaint of rat or mice droppings baked into their pizza, according to WXIN.
Johnathan McNeil said he and his girlfriend bought a pizza at the establishment near the intersection of 22nd St. and Meridian St., but on the way home she noticed something was amiss.
“She looked at the pizza and realized there was, like, doo-doo looking stuff on the pizza,” said McNeil.
McNeil said he returned to the restaurant to demand an explanation.
“All of them were looking at my pizza dumbfounded as if they didn’t know what’s going on,” said McNeil. “I said ‘That’s mouse doo-doo on the bottom of my pizza.’”
McNeil said he called police who arrived on the scene and suggested he contact the Marion County Health Department.

Not sure why the police were called in.

An inspector initiated an emergency inspection, which resulted in the business license being suspended.
“We did find that there were rodent droppings and violations that warranted us doing a license suspension,” said Janelle Kaufman with the Marion County Health Department.
Upon a follow-up inspection the next morning, Kaufman said the problems had been corrected.
“They cooperated with us, they worked with us … they cleaned everything they needed to do,” said Kaufman.
Inspection reports show the restaurant has been doing battle with mice since at least last August. The store was cited four times since then, before being given the all-clear on October 3, 2017. However, the store was never closed.
Health officials said with only seventeen inspectors to cover about 4600 county restaurants, they rely on diners to be their eyes and ears.
“When they call and let us know what they see, it’s so helpful to us,” said Kaufman, “any restaurant can benefit from another inspection.”
McNeil hopes other diners will learn from his experience.
“I just want people to check their food and be very cautious about what they’re eating,” said McNeil.
Managers at the store declined to comment. WXIN reached out for comment from the restaurant’s corporate franchise owner, but did not immediately heard back.
Restaurant inspection reports are not posted until 10 days after they are conducted, however a restaurant’s cumulative inspection history can be found online.

 

1 dead, 3 sick, 2016 Indiana restaurant: It was the C. perfringens in mystery food (probably sitting on the counter for far too long)

When people die from stupid food safety mistakes, are the rest of restaurant goers supposed to just pass it off, like industry, government and academic associations, or should the families be pissed?

Katie Cox of The Indy Channel writes that Indiana State Department of Health says it is “highly likely” that food from a West Lafayette restaurant was the cause of a man’s death last October.

The health department began their investigation into the Agave Azul on Sagamore Parkway after four people reported becoming sick shortly after eating at the restaurant on October 22, 2016. The four had eaten dishes containing beef, pork or chicken.

One of those four, Alexander Zdravich, 66, was hospitalized because of the severity of his illness. Despite aggressive medical treatment, the health department said Zdravich died on October 26.

Tragic: Indiana mom speaks out after toddler’s sudden E. coli death ‘Misdiagnosed five times’

Less than a week after he woke up feeling ill, 2-year-old Grayson Dunham was dead — the victim of an E. coli infection complication that took a grave turn.

e-coli-graysondunham_family_picture_139d18e7d0c0a23e98ad3c5c74f1d824-today-inline-large2xNow, his grieving mom is sharing his story hoping to spread awareness so that other families don’t have to go through a similar ordeal.

“It is a parent’s worst nightmare,” Kayla Dunham, 25, who lives in Sheridan, Indiana, told A. Pawlowski of Today. “He had never been sick… When you think of things happening, you think of severe illnesses like cancer or car accidents. You don’t think of E. coli.”

The family had been enjoying the summer, visiting a state fair, going to a petting zoo and eating out last month, when Grayson suddenly started vomiting and experiencing diarrhea on the morning of Aug. 10.

Doctors couldn’t settle on an exact cause, Dunham said. At first, the family was told it was stomach flu, then indications that the boy’s intestines may have been folded over each other, then possible problems with his appendix. As time went by, Grayson started having intense abdominal pain and bloody diarrhea.

“We were misdiagnosed five times before they said, yes this is HUS,” she recalled.

HUS, short for hemolytic uremic syndrome, can strike after an E. coli infection of the digestive system, according to the National Institute of Diabetes and Digestive and Kidney Diseases. It destroys red blood cells and clogs the kidneys’ filtering system. HUS is the most common cause of acute kidney injury in kids.

Grayson’s stool sample ultimately tested positive for Shiga toxin-producing E. coli, Dunham said. The family tried to figure out how he could have been infected: Was it the petting zoo? The restaurants they visited? Produce that his mom bought at a supermarket? The local health department told Grayson’s parents they may never know the source.

Grayson finally ended up in the intensive care unit of a children’s hospital in Indianapolis, Dunham said. Doctors told his parents he was stable for the night and urged them to take a nap in a nearby room, but the family was soon jolted by news the boy was deteriorating. His hemoglobin — a protein in red blood cells that carries oxygen — had dropped from the normal range to zero, his mom said.

Doctors were not able to get his heart pumping on its own and performed CPR for an hour and 45 minutes, but to no avail, she recalled. Grayson passed away at 4:30 in the morning on Aug. 15.

“My heart is in shock, I’m numb, and I don’t have words for what even happened,” Dunham wrote on Facebook. Doctors still don’t know why her son deteriorated so suddenly, she said.

Everyone’s got a camera: Indiana mold high-school edition

nobody's.faultNobody’s fault.

Or so they say.
HACCP is short for, CYA – cover your ass.

A photo of food served at Central High School circulating social media has at least one student thinking about bringing his lunch to school for a while.

The photo, posted on Facebook and Twitter Monday, shows a student pulling back the lid of an individually packaged cream cheese to find the top covered in thick, green mold.

Isaiah York, a senior at Central, said it was his friend who found the cheese at breakfast. They took it to the principal, who then talked to the cafeteria staff.

“I was a bit grossed out about it, it made me a bit uneasy,” York said Tuesday. “When we opened it, I was a bit in shock to be honest. … That’s my first time encountering that.”

Dianna Choate, director of food services at MCS, said her staff called the manufacturer as soon as they saw the package. The cheese arrived at the school in individual, sealed packages and was within the expiration date, she said.

She said they opened several other containers and didn’t find another molded one, but threw them all away as a precaution.

The district is in the process of outsourcing its cafeteria staff to a national food service company, Chartwells. MCS spokesperson Ana Pichardo confirmed “this has nothing to do with Chartwells.” The company is set to fully take over operations after spring break.

Jammie Bane, a Delaware County Health department administrator, said the situation was brought to the department’s attention and is being investigated. Although the investigation is ongoing, Bane said he personally felt that it was not the schools’ fault because the product came prepackaged from the manufacturer.

“I feel it’s a shame that MCS is being made out negatively for something that could occur anywhere, at any time, whether a school, business, or personal home,” Bane said via email. “An incident occurring does not point towards a trend, and does not point towards the schools not caring or not taking actions in an effort to ensure it doesn’t occur again. As a matter of fact, our local schools excel at food safety.”

This isn’t the first time pictures of inedible food at Muncie Community Schools have been on social media. During a school board meeting last month, when the board was considering hiring Chartwells, board member Kathy Carey said she was “appalled” at pictures of rotten food that had been shared with her on social media.

4 confirmed E. coli cases in Indiana; 3 more suspected

The State Department of Health says there are now four confirmed E. coli cases with three more being investigated.

Destiny SmithBut, it stresses, there have been no new cases of possible E. coli reported to the agency since the beginning of the month.

The department is still looking into the possible source of exposure.

Nine-year-old Destiny Smith apparently died from E. coli.

Indiana Health investigating E. coli O157 cases in Fulton and Wabash counties after child death

Tonight, Paul and Tracey Schaeffner mourn the loss of their 9-year old daughter, Destiny Smith outside the Rochester courthouse.

8554935_G Destiny Smith“She had a sweet smile, a sweet spirit, and a contagious laugh,” says Destiny’s mom, Tracey.

Smith’s family says she got sick with flu symptoms about ten days ago. Just a week ago today, she went to Riley Hospital for Children in Indianapolis. Family members say she was diagnosed with HUS (hemolytic Uuemic syndrome), and died just two days later.

HUS is a severe result of the bacterial infection: E. coli O157:H7.

Kendra Creighbaum of Rochester is a mother of two twin boys, Hunter and Tucker.  Creighbaum noticed her two boys getting really sick back in May. The boys were both sent to Riley as well, staying there about a month when they were both released in early June.

She and her husband Kyle, say they came close to burying their sons, and can only half imagine the Schaeffner’s pain.

“Nobody deserves that,” says Kyle.

Now, the state department of health is investigating five new E. coli cases in Fulton and Wabash counties. They say two of those cases are confirmed. The Creighbaum and Schaeffner cases aren’t part of the new investigation as far as we know. The health department claims the two confirmed cases might have stemmed from a daycare center, but they’re still investigating that. They will not release the name of the daycare center under investigation.

Earlier reports based on electronic messaging put the number at 10 sick.

Friends and Family of Destiny Smith gathered outside the Rochester courthouse tonight, because they feel the Fulton County authorities haven’t been transparent with them about their investigations.

10 sick, 1 possible death, from E. coli O157 at Indiana daycare

The Fulton County Health Department released a statement Tuesday acknowledging that they are investigating cases of E. coli O157 among children who attend a local daycare, but that “all confirmed cases being investigated with this outbreak are associated with this daycare.”

daycare_children_pictures_242_op_800x533Two children have been hospitalized.

Spend restaurant money at places proud of their inspection results: Indiana investigation highlights problems

State law requires counties inspect Indiana’s nearly 12,000 restaurants twice a year. But even when inspectors find mouse droppings, flies and raw meat stored at the wrong temperature, customers might have a hard time finding out about it, an I-Team 8 investigation found.

jake.gyllenhaal.rest.inspection.disclosureI-Team 8 took a hidden camera into Central Indiana restaurants asking for copies of inspection reports. In four counties, the majority of restaurants wouldn’t provide a report when I-Team 8 asked to see it. Six of eight restaurants refused. One restaurant said, “I don’t have them.”

Even when inspectors have found critical violations, state law mandates counties wait 10 days before making any of those results public.

I-Team 8 took the issue to Indiana State Sen. Vaneta Becker, who was part of the committee that wrote the 10-day rule 20 years ago as a then state representative. She said no one had ever challenged the 10-day rule since, despite most other states not having such a policy.

Some states post letter grades A-F right in the front window. Indiana doesn’t. I-Team 8 checked the policies of all 50 states and Washington, D.C.  Six states require restaurants turn over inspection reports to customers. Many more leave it up to the counties. In South Carolina, grades are posted as a decal in the restaurant immediately after the inspection. Some states like Mississippi you can check restaurant inspections as you walk in on a smartphone app.

Although Indiana doesn’t post grades, I-Team 8 found two restaurants in the metro area that readily handed over their inspections.

“Why make you go through all that work to dig that stuff up when we have it right here?”

The manager at Culver’s in Noblesville immediately said, “I can give you our most recent one, sir,” when I-Team 8 asked for an inspection report.

At Pizza King in Cumberland an employee said, “Yes! They’re supposed to be right here.”

It’s company policy at both Culvers and Pizza King.

“That’s why we have to keep them here,” the Pizza King employee said. “It has to be open to the public, so people can look at it.”

Culvers keeps a copy handy. In fact, the manager said his restaurant helped with Hamilton County Health Department’s online system.

“They post all the health inspections too because we helped them set up the program,” the manager said.

Culver’s owner Jeff Meyer said keeping the inspections on-site is about customer convenience.

“You can log on online and see for yourself, so why make you go through all that work to dig that stuff up when we have it right here?”