The Bachelor’s Tim Robards suffers a bad case of food poisoning in Italy ahead of wedding to Anna Heinrich

This may make sense to people who watch The Bachelor.

Tim Robards has suffered a bad case of food poisoning ahead of his wedding to Anna Heinrich.

The Bachelor star fell ill while the couple were travelling up and down the coast of Italy this week.

In an Instagram video posted on Wednesday, the 35-year-old revealed he had been sick for ’24 hours’.

A little flat today. Food poisoning knocked me out for 24 hours,’ he informed his fans.

But the buff reality star ensured he was on the mend, feeling better after a dip in the healing ocean with his bride-to-be Anna. 

He took a selfie of the couple soaking up the sun at popular tourist spot Grotta Della Poesia in Roca, writing in the caption ‘slowly coming alive again’.  

How should restaurants be inspected in Italy?

The purpose of this study was to elaborate a checklist with an inspection scoring system at national level in order to assess compliance with sanitary hygiene requirements of food services.

The inspection scoring system was elaborated taking into account the guidelines drawn up by NYC Department of Food Safety and Mental Hygiene. Moreover the checklist was used simultaneously with the standard inspection protocol adopted by Servizio Igiene Alimenti Nutrizione (Servizio Igiene Alimenti Nutrizione – Ss. I.A.N) and defined by D.G.R 6 March 2017 – n. X/6299 Lombardy Region. Ss. I.A.N protocol consists of a qualitative response according to which we have generated a new protocol with three different grading: A, B and C.

The designed checklist was divided into 17 sections. Each section corresponds to prerequisites to be verified during the inspection. Every section includes the type of conformity to check and the type of violation: critical or general. Moreover, the failure to respect the expected compliance generates 4 severity levels that correspond to score classes.

A total of 7 food services were checked with the two different inspection methods. The checklist results generated a food safety score for each food service that ranged from 0.0 (no flaws observed) to 187.2, and generates three grading class: A (0.0-28.0); B (29.0 – 70.0) and C (>71.00). The results from the Ss. I. A. N grading method and the checklist show positive correlation (r=0.94, P>0.01) suggesting that the methods are comparable. Moreover, our scoring checklist is an easy and unique method compared to standard and allows also managers to perform effective surveillance programs in food service

Food safety in food services in Lombardy: proposal for an inspection-scoring model, 2017

Italian Journal of Food Safety vol. 6:6915

Claudia Balzaretti, Katia Razzini, Silvia Ziviani, Sabrina Ratti, Vexna Millicevic, Luca Chiesa, Sara Panseri, Marta Castrica


Careful with that Italian water fountain: An entire orchestra is rushed to hospital

Norman Lebrecht of Slippedisc reports all 80 members of the European Spirit of Youth Orchestra were rushed to the Santa Chiara Emergency Room in Trento, Italy, suffering from dehydration after an outbreak of vomiting and diarrhea.

About 20 young musicians received prolonged treatment and two were detained in hospital overnight.

The problem was traced to a picturesque fountain in the small town of Belluno, where the orchestra had stopped for a drink of water. Officials say this was due to current repairs to the aqueduct.

The orchestra aims to continue its tour with conductor Igor Coretti-Kuret.


1 dead from botulism linked to olives in Rome

Thanks to my Italian food safety friend for forwarding this and, as usual, something may be lost in translation.

olives-2Il Messaggero reports the ordeal for the victim began one evening in late August when Mrs. Anna C. decided to put on the table one of the three packages of olives purchased a month earlier in a supermarket. The husband shortly feels the onset of illness, and Mrs C. has severe pain in the belly.

Within a day and a half the couple rush to the closest hospital. The prognosis in the emergency room is clear: “Food poisoning from botulism.” The first investigations focus on the olives. The woman appears in serious condition. The doctors noted in the medical record that this is a case of “sepsis staphylococcal pneumonia with pleural effusion.” She is transfered to an immediate resuscitation room. The husband is held for five days for foodborne botulism, recovers and is discharged.

Anna remains in a coma for almost a month, then her state of health improves. On October 8, after 40 days of hospitalization, the patient is invited to go home in a system of protected discharge. The doctors write down that she had “had a steady improvement that had been weaned from the ventilator ” and then continued clinical monitoring for persistent pericardial effusion share.”

Ten days later, on October 18, the family members of the woman call an ambulance to rush back to the hospital. She died on October 21.

The hospital has an initial autopsy. Yesterday, an order was added for a new autopsy and further toxicological investigations, prepared by the prosecutor. The cremation scheduled for November 9 is suspended. A few hours after receipt of the legal complaint of the family, the lawyer Armando Fergola, the deputy prosecutor Antonio Clemente, ordered the appointment of a medical examiner to determine the cause of death. And at the same entry in the register of suspects for the health personnel who assisted and discharged the patient. A duty, in the first steps of the investigation, also to ensure the people involved in the affair to appoint professional advisers.

“The case is alarming,” said the lawyer Fergola, “We found ourselves in a botulism infection and then to a possible case of medical malpractice. A family now awaits answers. ” The victim left her husband and two children.

Salami, fermented sausage and risk in Italy

Sorenne loves her salami  — or smallgoods as they are sometimes called in Australia.

soppresseNow its gone all artsy or artisanal but there’s still a microbiological risk.

As of the start of the 21st century, consumers have developed a growing interest in so called “traditional or artisanal” food. The renewed interest in this type of food is explained by consumers’ perception of these products. In fact, traditional food has a general positive image across Europe, and European consumers trade off the relative expense and time required for preparation of traditional food for its specific taste, quality, appearance, nutritional value, healthiness and safety (Almli et al., 2011 and Guerrero et al., 2009). Such food is often produced by small farms, and so the rural economy benefits from the increase in activity and profits through direct sales at local food markets (Berlin et al., 2009 and Carey et al., 2011).

Although the term “traditional foods” is widely used, the concept of traditional food products embraces different dimensions and there are hardly any definitions that clearly define traditional foods. In order to identify “traditional” foods, the EU legislation (EC, 2006a, EC, 2006b and EC, 2012) has defined criteria based on product designations that are linked to geographical origin or traditional production methods. In addition, the EuroFIR FP6 Network of Excellence provided a definition of traditional foods which includes statements about traditional ingredients, traditional composition and traditional type of production and/or processing method (Weichselbaum et al., 2009).

Among European countries, Italy is the lead producer of traditional foods and products such as foods with Protected Designation of Origin (PDO) or Protected Geographical Indication (PGI), followed by France, Spain, Portugal and Greece (ISMEA, 2013). Additionally, it is estimated that Italy has around 5000 traditional local food products without any certification (CIA, 2015), which could represent an important resource contributing to the development and sustainability of rural areas, providing ample variety in food choice for the consumer and a remarkable income for the economy. With its 371 typical products, Veneto Region is the fourth Italian Region according to number of traditional food products after Toscana, Campania and Lazio (Mipaaf, 2014). In addition, since 2007, Veneto Region has implemented regional legislation which defines a simplified procedure to sell small quantities of traditional food products at local level directly from the producer to the consumer (DGR, 2007 and DGR, 2008). In Veneto Region, many typical fermented sausages such as salami and soppresse are produced with traditional technologies, and so the legislation has been focused firstly on these products and subsequently on other types of meat products (poultry and rabbit meat) and products of non-animal origin (canned food; fruit juices; flour and dried vegetables; bread and bakery products; extra virgin olive oil).

In relation to fermented sausages, the legislation defines the production season, the maximum number of animals that can be reared and the minimum rearing period for pigs on the production farm as well as the minimum hygienic pre-requisites of the work areas used for processing pork meat into fermented sausages. Since these sausages are mainly produced following traditional practice in small processing units, starter cultures are not added to the minced pork meat and ripening is carried out in rooms with less temperature and relative humidity control than that used by industrial manufacturers. Therefore, deviations in temperature and/or humidity can result in insufficient fermentation-drying processes, meaning the absence of pathogens in the final products is not assured. The presence of food-borne pathogens such as Listeria monocytogenes, Escherichia coli O157, and Salmonella spp. in fermented sausages has been reported.

salamiConcerning L. monocytogenes, the pathogen was detected at the end of ripening in 40% of “Salsiccia Sarda” (a traditional Italian fermented sausage) with contamination levels always lower than 100 cfu/g ( Meloni et al., 2012), while a prevalence of 15% was reported in fermented sausages produced in northern Italy (De Cesare et al., 2007). Other studies conducted on traditional fermented sausages at the end of the ripening period showed a L. monocytogenes prevalence of 10% in France ( Thevenot et al., 2005), 16% in Spain (Martin et al., 2011), 42% in Greece (Gounadaki et al., 2008) and 60% in Portugal (Ferreira et al., 2007). The prevalence of Salmonella spp. in traditional fermented sausages is lower than Listeria: the presence of Salmonella was reported in two out of 38 batches of traditional Portuguese sausages (alheiras) ( Ferreira et al., 2007) and in three out of 21 (14%) batter samples of traditional Greek fermented sausages but not in the final products (ready to be sold) (Gounadaki et al., 2008). In relation to verocytotoxin-producing E. coli (VTEC), including E. coli serotype O157:H7, for which meat and meat products are considered the main source of infection for humans, an overall VTEC prevalence of 16% was found in fresh pork sausages collected in the southern part of Italy ( Villani et al., 2005).

In addition, food-borne outbreaks associated with the consumption of fermented meats are reported in the literature. In Veneto Region of Italy, in January 2004, a family outbreak of E. coli O157 infection caused by a dry-fermented traditional salami made with pork meat and produced in a local plant occurred ( Conedera et al., 2007). In Norway, an outbreak caused by E. coli O103:H25 involving 17 patients was attributed to the consumption of fermented sausages ( Sekse et al., 2009). Concerning Salmonella, an outbreak of Salmonella Typhimurium DT104A involving 63 cases associated with the consumption of traditional pork salami was reported in Lazio Region of Italy ( Luzzi et al., 2007). Another outbreak of Salmonella Typhimurium associated with the consumption of unripened salami was reported in Lombardia Region of Italy ( Pontello et al., 1998). L. monocytogenes outbreaks associated with the consumption of fermented sausages have not been reported, to our knowledge, even though L. monocytogenes has been implicated in several listeriosis outbreaks linked to the consumption of pre-sliced ready-to-eat deli meats ( Thevenot et al., 2006). The infective doses of the above-mentioned micro-organisms can vary widely according to several factors such as the strain, the susceptibility of the host, and the food matrix involved. In case of L. monocytogenes in susceptible individuals, it is unlikely that fewer than 1000 cells may cause disease ( EFSA, 2007). Concerning Salmonella the infective dose is variable but often low numbers of cells (between 10 and 1000) are sufficient to cause disease, the same for EHEC which is known for its low infective dose ( Strachan et al., 2005 and Teunis et al., 2010). The difference in dose-response relationship between the three pathogens may also, to some extent, explain the difference in stringency in surveillance. In European Regulation 2073/2005 (EC, 2005), tolerance of up to 100 cfu/g of L. monocytogenes in ready-to-eat meat products is accepted at the end of shelf life, whereas usually action limits of absence of Salmonella and EHEC per 25 g are applicable.

In order to avoid the marketing of potentially hazardous traditional fermented pork sausages (Italian salami and soppresse) produced within the Veneto region, this study was initiated by the regional competent authorities in collaboration with the small-scale producers with the following aims: a) investigate the production process of traditional salami and soppresse in Veneto Region of Italy; b) identify the microbiological hazards associated with this type of food, and finally; c) identify control measures easily applicable directly by the Food Business Operator (FBO) with the supervision and control of the regional Competent Authority (CA) in order to manage the hazards associated with this type of traditional meat product.

Artisanal Italian salami and soppresse: Identification of control strategies to manage microbiological hazards

Journal of Food Microbiology

Volume 61, February 2017, p. 5-13

Roccato, Anna. Et al.

20 children sickened: E. coli O26 in Italy, 2013

In summer 2013, an excess of pediatric cases of haemolytic uraemic syndrome (HUS) in a southern region of Italy prompted the investigation of a community-wide outbreak of Shiga toxin 2-producing Escherichia coli (STEC) O26:H11 infections. Case finding was based on testing patients with HUS or bloody diarrhoea for STEC infection by microbiological and serological methods.

bobby-crosier-e-coli_-sep_-15A case–control study was conducted to identify the source of the outbreak. STEC O26 infection was identified in 20 children (median age 17 months) with HUS, two of whom reported severe neurological sequelae. No cases in adults were detected. Molecular typing showed that two distinct STEC O26:H11 strains were involved. The case–control study showed an association between STEC O26 infection and consumption of dairy products from two local plants, but not with specific ready-to-eat products. E.coli O26:H11 strains lacking the stx genes were isolated from bulk milk and curd samples, but their PFGE profiles did not match those of the outbreak isolates.

This outbreak supports the view that infections with Stx2-producing E. coli O26 in children have a high probability of progressing to HUS and represent an emerging public health problem in Europe.

Community-wide outbreak of hemolytic uraemic syndrome associated with Shiga toxin 2-producing Escherichia coli O26:H11 in southern Italy, summer 2013

Eurosurveillance, Volume 21, Issue 38, 22 September 2016

C Germinario, A Caprioli, M Giordano, et al.

Pathogens in raw sheep’s milk cheese

Italy is one of the main producers and exporters of cheese made from unpasteurized sheep milk. Since raw milk and its derived products are known sources of human infections, cheese produced from raw sheep milk could pose a microbiological threat to public health. Hence, the objectives of the study were: to characterize the potential risk of the presence of pathogens Escherichia coli O157, Listeria monocytogenes, and Salmonella in raw ovine milk destined for cheese production obtained from all the sheep farms (n = 24) in the Marches region (Central Italy) that directly transform raw milk into cheeses and to evaluate the equivalence between the analytical methods applied.

gene-wilder-sheepA three-step molecular method (simultaneous culture enrichment, species-specific DNA magnetic isolation, and multiplex real-time polymerase chain reaction) was used for milk (n = 143) and cheese (n = 5) analysis over a 3-year period. L. monocytogenes was not detected on any of the farms, while E. coli O157 was found on three farms, although only using the molecular method. Four farms tested positive for Salmonella spp., and Salmonella enterica subsp. diarizonae serovar 61:k:1,5,7 was isolated in one of those cases.

This information highlights the need to develop preventative measures to guarantee a high level of consumer safety for this specific product line, and the molecular method could be a time-saving and sensitive tool to be used in routine diagnosis.

Presence of Escherichia coli O157, Salmonella spp., and Listeria monocytogenes in raw ovine milk destined for cheese production and evaluation of the equivalence between the analytical methods applied

Foodborne Pathogens and Disease, ahead of print. doi:10.1089/fpd.2016.2159.

G Amagliani, A Petruzzelli, E Carloni, F Tonucci, M Foglini, E Micci, M Ricci, S di Lullo, L Rotundo, G Brandi

Food fraud: EU warns Italy to stop treating squid with hydrogen peroxide

Michael Ramsingh of reports European trade officials have warned Italy to stop soaking its squid in hydrogen peroxide (H2O2) and shipping it to markets around the EU.

squid-fish-marketItalian officials were notified by the EU Commission’s Ministry of Health that soaking squid in H2O2 currently violates specific food safety regulations.  The practice is legal in the Italian market but is not approved in other member countries.

“The use of this substance as a food additive, therefore, is not authorized in the EU,” the Commission said in a statement. “The Member States have the responsibility to enforce effectively the Union legislation concerning the food chain, which also includes rules applicable to the use of food additives.”

H2O2 is used to treat squid to increase its marketability since it whitens the product on display. The treatment does not pose a health risk for consumers. However, the practice is considered dubious since it is nearly impossible to tell a treated squid product with a non-treated item, which makes it difficult to verify the actual freshness of the item.

When it’s not the potato salad, it’s the ham

I used to eat a lot of ham sandwiches. It was the only lunch meat I’d take to school from about age 8 until I finished high school.

It’s still my preferred quick-service deli sandwich meat.

And we bake one at home a couple of times a year, making one large enough to have a few days of leftovers.

Photo Courtesy- National Pork Board

Ham can be risky though. In 1997 Neil Young missed a bunch of shows after cutting his finger while making a ham sandwich.

According to a paper by Huedo and colleagues in Food Pathogens and Disease, a couple of years ago over 40 Italian school kids got sick with salmonellosis linked to ham.

A multischool outbreak of salmonellosis caused by Salmonella enterica serovar Napoli was investigated in the province of Milan from October to November 2014, following an increase in school absenteeism coinciding with two positive cases. Epidemiological studies detected 47 cases in four primary schools: 46 children and 1 adult woman (51.4% males and 48.6% females, median age 8.9). From these, 14 cases (29.8%) were severe and resulted in hospitalization, including 6 children (12.8%) who developed an invasive salmonellosis. The epidemic curve revealed an abnormally long incubation period, peaking 1 week after the first confirmed case. Twenty-five available isolates were typed by pulsed-field gel electrophoresis showing an identical pattern. The isolate belongs to ST474, an ST composed exclusively of Salmonella Napoli human strains isolated in France and Italy. Antibiotic resistance analysis showed resistance to aminoglycosides, correlating with the presence of the aminoglycoside resistance gene aadA25 in its genome. Trace-back investigations strongly suggested contaminated ham as the most likely food vehicle, which was delivered by a common food center on 21 October. Nevertheless, this ingredient could not be retrospectively investigated since it was no longer available at the repository. This represents the largest Salmonella Napoli outbreak ever reported in Italy and provides a unique scenario for studying the outcome of salmonellosis caused by this emerging and potentially invasive nontyphoidal serotype.

Listeria in Italy: An on-going outbreak

In the first seven weeks of 2016, six cases of invasive listeriosis were recorded in Ancona province, Italy. Five strains of Listeria monocytogenes serotype 1/2a were isolated and typed by enterobacterial repetitive intergenic consensus (ERIC)-PCR and PFGE, indicating clonality. In addition, seven serotype 1/2a L. monocytogenes strains from cases of invasive listeriosis recorded in the same area in 2015 were also typed and showed relatedness. Here we provide details of the ongoing outbreak.

listeria4From 4 January to 15 February 2016, six L. monocytogenes strains (3 from blood, 3 from cerebrospinal fluid (CSF)) were isolated from six patients diagnosed with invasive listeriosis at the Clinical Microbiology Laboratory of Ancona Regional Hospital (eastern Italy) of Area Vasta 2 (AV2) which encompasses Ancona, Fabriano, Senigallia, and Jesi.

Patients had been admitted to four different departments: emergency room (ER) (n=2), oncology (n=2), infectious diseases (n=1), and intensive care unit (ICU) (n=1). Four of the six patients were women and the most common risk factors/underlying conditions were: age (n=5; >71 years), cancer (n=2), and diabetes (n=1). Clinical manifestations included septicaemia (n=3), meningitis (n=2) and meningoencephalitis (n=1).

In addition to the cases detected in 2016, eight L. monocytogenes strains (5 from blood and 3 from CSF) had been isolated in AV2 (from 7 cases) and nearby Ascoli Piceno (from 1 case) in 2015 (Figure 1); clinical samples came from six hospital departments: ER (n=1), general medicine (n=3), nephrology (n=1), vascular surgery (n=1), infectious diseases (n=1), and ICU (n=1). Five patients were men and the mean patient age was 73.6 years (range: 55–84; median: 75); a 77 year-old man died.

The 2015 and 2016 isolates were identified as L. monocytogenes by Gram staining and the Vitek MS system (bioMérieux Italia SpA, Firenze, Italy). Susceptibility to ampicillin, meropenem, erythromycin, and sulphamethoxazole-trimethoprim was tested by the E-Test (Liofilchem, Teramo, Italy) according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines [1]. All strains were susceptible to all the antibiotics tested.

The incidence of listeriosis has been rising since the early 2000s in several European countries, mainly in immunocompromised patients older than 65 years [7-9]. In particular, a statistically significant increase was reported in Austria, Denmark, Hungary, Italy, France, Spain, and Sweden from 2005 to 2009 [10]. In the past 30 years, outbreaks of listeriosis have been mostly linked to serotype 1/2a and 4b clones [8]. A shift to serotype 1/2a has been observed in Europe and North America in the last decade [8]. In Italy, surveillance of invasive listeriosis has found an increase in serotype 1/2a isolates over the same period, mainly in the central and northern regions (about 80% of cases) [10-14].

Listeriosis is an infection of great concern to public health due its clinical severity and high case fatality rate, despite its low incidence compared with other foodborne diseases such as salmonellosis or campylobacteriosis. The present data suggest an ongoing outbreak of listeriosis due to serotype 1/2a L. monocytogenes in AV2 that most probably started in 2015, since the strain was already present in the area in 2015. As in other European countries, most cases were associated with an underlying condition and involved elderly people [8,9].

Local authorities are working with the Italian national public health institute (the Istituto Superiore di Sanità, Rome) and the regional Istituto Zooprofilattico Umbria and Marche to identify the sources of food contamination. A recent press release [15] points out that there are findings which suggest contamination of a pork product as a possible vehicle of infection for at least one human case. At present, however, no clear link can be established between the contaminated pork product and the infections. Investigation into the source of infection in AV2 is still in progress.


Ongoing outbreak of invasive listeriosis due to serotype 1/2a Listeria monocytogenes, Ancona Province, Italy, January 2015 To February 2016

28 April 2016

Eurosurveillance, Volume 21, Issue 17

E Marini, G Magi, C Vincenzi, E Manso, B Facinelli