Listeria hysteria in South Africa

My wife and I were discussing this morning the horror that is occurring in South Africa regarding the Listeria outbreak. My wife is a professional dancer for an African modern dance group-NAfro in Winnipeg (Canada) and very interested in African culture. I have had the pleasure of speaking with her choreographer a number of times regarding issues in Africa (his home) which are primarily political in nature. Interesting stuff.
The World Health Organization has sent a food safety expert to South Africa to assist in identifying the cause of the Listeria outbreak. Apparently, it has been recommended that South Africa should have approximately 5000 environmental health practitioners; currently they only have 2000 to safeguard public health, clearly not enough.

Wendy Knowler of Times Live reports

Would you be able to list every single thing you’ve eaten in the past month?
That’s what victims of South Africa’s massive listeriosis outbreak – the biggest on record globally – are being asked to do by the National Institute for Communicable Diseases (NICD) in an attempt to pinpoint the source.
The number of confirmed listeriosis cases is now 872, and 164 of those have died – up from 107 last week. The current mortality rate is a staggering 27%.
Of those confirmed cases, 43% were babies of less than a month old – pregnant women being 20 times more likely to get listeriosis than other healthy adults.
Contracted by eating food containing the listeria pathogen, listeriosis is by far the most deadly of food-borne diseases. Given the scale of our mystery outbreak, it has led to what one delegate termed “listeria hysteria”, at a listeriosis workshop hosted by the South African Association of Food Science and Technology (SAAFoST) in Johannesburg on Wednesday.
While patés, soft cheeses and guacamole have been found to be the source in listeriosis outbreaks in other countries, our outbreak is unlikely to be a “high-end luxury food item”, said the NICD’s Dr Juno Thomas at the workshop.
“So far, our epidemiological investigation team has interviewed about 60 listeriosis victims to find out what they ate, day by day, during the month before they became symptomatic, in an attempt to identify patterns of consumption and indicate what we can eliminate,” Thomas said. “None had eaten smoked fish, for example.”
Food safety expert and SAAFoST president Lucia Anelich said given that a single, unique “homegrown” strain of listeriosis was identified in more than 90% of the confirmed cases, it was likely that the source was a single food product or range of food products consumed often and by both rich and poor across South Africa.
“Cold meats, for example, range from viennas and polony to more expensive slices of ham,” she said.
As listeria is killed during the cooking process, the culprit is thought to be a ready-to-eat food, fruit, or vegetables.
Attorney Janus Luterek told workshop delegates that his work had led him to believe that the offending product would be traced back to irrigation water that was not properly treated. A few food scientists in the room agreed with him.
“Keep your insurance up to date,” Luterek told the attending food producers, “because when the claims come they will be huge, as in a Boeing 737 crashing and everyone on board dying.”
The World Health Organisation (WHO) has sent a food safety expert, an epidemiologist with listeriosis experience and a communication specialist to South Africa to help identify the source of the outbreak.
A WHO spokesman was quoted in industry publications this week as saying the body was working on a “strong lead”, with laboratory results pending.
Speaking at the workshop, Dr Thomas said food safety legislation was fragmented, outdated and inappropriate for South Africa.
“We need a dramatic overhaul of our legislation and the entire food safety system,” she said.
For example, she said, there were fewer than 2,000 environmental health practitioners, responsible for monitoring all food outlets from restaurants to informal vendors, but the WHO recommended that South Africa needed 5,000 of them.
Several presenters mentioned the need for better cooperation between the government departments and organisations responsible for food safety – including health; agriculture, forestry and fisheries; trade and industry; and the Consumer Goods Council.

 

Raw is risky, for pets and humans

I have never fed any of my dogs or cats raw pet food.

They may eat each other’s poop, but I control what I can control.

The U.S. Food and Drug Administration is alerting pet owners to a history of four recalls of and multiple complaints associated with Darwin’s Natural and ZooLogics pet foods, manufactured by Arrow Reliance Inc., dba Darwin’s Natural Pet Products, over the period from October 17, 2016 to February 10, 2018. In each instance, the company recalled these products after being alerted to positive findings of Salmonella and/or Listeria monocytogenes in samples of their raw pet food products.

In its most recent recall, on February 10, 2018, Arrow Reliance/Darwin’s Natural recalled ZooLogics Duck with Vegetable Meals for Dogs (Lot #41957) and ZooLogics Chicken with Vegetable Meals for Dogs (Lot #41567) because the products may be contaminated with Salmonella and therefore have the potential to cause salmonellosis in humans and animals. The company states that it only sells its products online through direct-to-consumer sales.

The FDA has investigated six complaints of illness and death in animals that have eaten the recalled products.

Arrow Reliance/Darwin’s Natural has notified its customers directly of the recalls, but has so far not issued any public notification announcing this or any of the previous recalls.

This issue is of particular public health importance because Salmonella can make both people and animals sick.

As part of an ongoing investigation into complaints associated with products manufactured by Arrow Reliance/Darwin’s Natural of Tukwila, WA, the FDA has confirmed that new samples of Darwin’s Natural Pet Products raw pet foods have tested positive for Salmonella. These raw pet foods include ZooLogics Duck with Vegetable Meals for Dogs Lot #41957 and ZooLogics Chicken with Vegetable Meals for Dogs Lot #41567.

The latest recall was triggered by a complaint of an adult dog that had recurring diarrhea over a nine-month period. The dog tested positive for Salmonella from initial testing by the veterinarian and by follow-up testing by the FDA’s Veterinary Laboratory Investigation and Response Network (Vet-LIRN). The Darwin’s Natural raw pet food that the dog had been fed was also positive for Salmonella.

Arrow Reliance/Darwin’s Natural is aware of the dog’s illness and the positive results and initiated a recall on February 10, 2018 by directly notifying its customers via email. The firm has not issued a public recall notice.

Since October 2016, Arrow Reliance/Darwin’s Natural has initiated four recalls and had six reported complaints (some referring to more than one animal) associated with their raw pet food products, including the death of one kitten from a severe systemic Salmonella infection. The Salmonella isolated from the kitten was analyzed using whole genome sequencing and found to be indistinguishable from the Salmonella isolated from a closed package from the same lot of Darwin’s Natural cat food that the kitten ate.

In addition to reports of illnesses associated with Salmonella contamination in the products, the FDA is aware of complaints of at least three animals who were reportedly injured by bone shards in the Darwin’s Natural raw pet food products.

107 dead, 852 sick from Listeria in South Africa: Suspects unknown

The National Institute for Communicable Diseases (NICD), in Johannesburg, South Africa, reported 107 case patients have died from Listeria monocytogenes.

The agency, which is a division of the National Health Dept., said 852 listeriosis cases were confirmed between Jan. 1, 2017 and Feb. 5,2018, but so far, the source of the outbreak is not known. “Presently no food sources that are contaminated with the outbreak strain have been found, including amongst poultry and poultry products,” the agency said in a statement.

1 sick from Listeria linked to raw sheep milk cheeses from Spain

On February 5 the Spanish Agency for Consumer Affairs, Food Safety and Nutrition has learned through the Coordinated System of Rapid Information Exchange (SCIRI) of the existence of an affected by meningitis in the Community of Madrid, as a result of intoxication food by Listeria monocytogenes presumably associated with the consumption of soft milk sheep cheese made by the company Ohian Txiki Koop located in the Basque Country. The affected one evolves favorably.

The cheeses allegedly involved are the following:

Gutizia, raw sheep milk cheese. 

Txuria , soft cheese from raw sheep’s milk. 

Beltza,  lactic cheese-curl of raw sheep’s milk.

These products have been distributed from the manufacturer to the Autonomous Communities of Madrid, Catalonia and the Basque Country. On February 7 there is evidence that from Madrid, there has been a small redistribution to Andalusia, Castilla-La Mancha, Castilla y León, Extremadura, Galicia, Valencia and Portugal, few units.

The removal of all batches of raw soft-ewe sheep milk cheese is being carried out. 

This information has been communicated through the system of the national alert network to the competent Authorities of the Autonomous Communities that are carrying out the appropriate actions, as well as to the competent Portuguese Authorities through the Rapid Alert Network System for Food and Feed. European.

As a precautionary measure, people who have some packaging of these products at home are advised, refrain from consuming them and if they have consumed them and if they present any unusual symptoms, it is recommended to go to a health center.

Europe models: Listeria monocytogenes contamination of ready-to-eat foods and the risk for human health in the EU

Here’s an idea: don’t serve cold cuts and raw sprouts to old people.

Duh.

The European Food Safety Authority reports that food safety criteria for Listeria monocytogenes in ready-to-eat (RTE) foods have been applied from 2006 onwards (Commission Regulation (EC) 2073/2005). Still, human invasive listeriosis was reported to increase over the period 2009–2013 in the European Union and European Economic Area (EU/EEA). Time series analysis for the 2008–2015 period in the EU/EEA indicated an increasing trend of the monthly notified incidence rate of confirmed human invasive listeriosis of the over 75 age groups and female age group between 25 and 44 years old (probably related to pregnancies).

A conceptual model was used to identify factors in the food chain as potential drivers for L. monocytogenes contamination of RTE foods and listeriosis. Factors were related to the host (i. population size of the elderly and/or susceptible people; ii. underlying condition rate), the food (iii. L. monocytogenes prevalence in RTE food at retail; iv. L. monocytogenes concentration in RTE food at retail; v. storage conditions after retail; vi. consumption), the national surveillance systems (vii. improved surveillance), and/or the bacterium (viii. virulence).

Factors considered likely to be responsible for the increasing trend in cases are the increased population size of the elderly and susceptible population except for the 25–44 female age group. For the increased incidence rates and cases, the likely factor is the increased proportion of susceptible persons in the age groups over 45 years old for both genders. Quantitative modelling suggests that more than 90% of invasive listeriosis is caused by ingestion of RTE food containing > 2,000 colony forming units (CFU)/g, and that one-third of cases are due to growth in the consumer phase. Awareness should be increased among stakeholders, especially in relation to susceptible risk groups. Innovative methodologies including whole genome sequencing (WGS) for strain identification and monitoring of trends are recommended.

61 dead from listeriosis in South Africa as fatalities double in a month

Wendy Knowler of Business Day reports the death toll from the listeriosis outbreak plaguing SA has nearly doubled in the past month, to 61 from 36, as SA grapples with an outbreak that experts say is the worst on record, worldwide.

The origin of the outbreak remains a mystery, though researchers have confirmed it probably has a single source.

Nonetheless, a Sovereign Foods abattoir has been closed, after listeria bacteria were found there.

Sovereign Foods, which is based in the Eastern Cape‚ is one of the major poultry producers in Africa. The company delisted from the JSE on November 22, concluding a management buyout funded by private equity firm Capitalworks.

But Health Minister Aaron Motsoaledi said the strain found at the abattoir was not the ST6 strain responsible for the deadly outbreak.

He told a briefing in Pretoria on Monday that a chicken sample collected from the fridge at a patient’s home tested positive for Listeria monocytogenes.

This chicken was traced back to the store and then traced back to the abattoir. It was sourced from Sovereign Foods‚ he said.

However‚ all samples collected from the abattoir have so far failed to pick up the ST6 strain of the outbreak that the country is experiencing.

As a consequence‚ authorities cannot yet link clinical isolates obtained from patients to particular foodstuffs or a food production site.

Motsoaledi said that the number of cases of listeriosis confirmed via lab testing had increased from 557 in early December to 727 at the latest count.

Food scientists are now calling it the worst documented listeriosis outbreak in global history.

The minister said 91% of the isolates were ST6 type isolates, a finding that supported the hypothesis that a single source of food contamination may have caused the outbreak from one or more food products at a single facility.

Dr Lucia Anelich‚ a prominent South African food microbiologist and food safety expert, said “I concur with my colleagues from business‚ academia and governments‚ in Europe‚ Australia‚ Canada and the US‚ that this is the worst documented listeriosis outbreak in global history.”

1 dead, 5 sick from Listeria in cold-smoked salmon, 2017, Denmark

In Denmark, on 23 August 2017, Statens Serum Institut (SSI) identified a genetic cluster of four human Listeria monocytogenes sequence type (ST) 8 isolates by core genome multilocus sequence typing (cgMLST) [1]. The allele calling was performed in BioNumerics (v7.6.2, Applied Maths, Belgium). We initiated an epidemiological investigation and notified the Danish Central Outbreak Management Group (collaboration between the Danish Veterinary and Food Administration (DVFA), the National Food Institute at the Technical University of Denmark (DTU) and SSI). On 25 August, two additional human isolates were found to belong to the same genetic cluster.

Lox 014

A confirmed case was defined as a person clinically diagnosed with listeriosis after 1 January 2017 with laboratory-confirmed L. monocytogenes ST8 clustering using cgMLST (≤ 5 allelic distance, single linkage). Cases diagnosed before 1 January 2017 with an isolate belonging to this cluster were defined as probable cases.

As of 25 August 2017, the genetic cluster comprised six cases; five confirmed and one probable. Laboratory sample dates ranged from 25 October 2015 to 21 August 2017. The age of the cases ranged from 59 to 96 years (median 80 years) and four were women. All patients had underlying illness and no travel history. One patient died within 30 days of diagnosis. Epidemiological investigations including a standard questionnaire on exposures showed that all five confirmed cases had consumed cold-smoked and/or cured salmon in the 30 days before disease onset. Four cases had bought the salmon in retail chain X. No other food-item was reported as consumed in high frequencies among cases. Epidemiological follow-up for the probable case did not include information on fish consumption.

Cross-border outbreak of listeriosis cause by cold-smoked salmon, revealed by integrated surveillance and whole genome sequencing (WGS), Denmark and France, 2015 to 2017

Eurosurveillance, 2017, Susanne SchjørringSofie Gillesberg LassenTenna JensenAlexandra MouraJette S Kjeldgaard, Luise MüllerStine ThielkeAlexandre LeclercqMylene M MauryMathieu Tourdjman ,Marie-Pierre DonguyMarc LecuitSteen EthelbergEva M Nielsen, https://doi.org/10.2807/1560-7917.ES.2017.22.50.17-00762

http://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2017.22.50.17-00762

647 sick, 60 dead from Listeria in South Africa

As of 19 December 2017, a total of 647 laboratory-confirmed listeriosis cases have been reported to the National Institute for Communicable Diseases (NICD) since 01 January 2017.

Diagnosis was based most commonly on the isolation of Listeria monocytogenes in blood culture (71%, 459/647), followed by CSF (24%, 156/647). Where age was reported (n=620), ages range from birth to 93 years (median 26 years) and 39% (241/620) are neonates aged ≤28 days . Of neonatal cases, 96% (232/241) had early-onset disease (birth to ≤6 days). Females account for 55% (341/623) of cases where gender is reported.

As of 19 December 2017, case investigation forms (CIFs) of variable completeness have been received for 229 (35%) cases. Apart from neonates (≤28 days) and the elderly (>65 years), additional risk factors for listeriosis reported include pregnancy (11/47 females aged 15-49 years) and HIV infection status. In non-neonatal cases where HIV status was known (n=117), 37% (43/117) were HIV positive. Maternal HIV status is known for 57 neonatal cases, of which 22/57 (38%) were HIV positive. Final outcome data is available for 20% (131/640) of cases, of which 46% (60/131) died.

To date, whole genome sequencing has been performed on 206 clinical L. monocytogenes isolates. Fifteen sequence types (STs) have been identified; however, 74% (153/206) belong to a single ST (ST6). Isolates in this ST6 cluster are very closely related, showing <20 single nucleotide polymorphism (SNP) differences. This suggests that most cases in this outbreak have had exposure to a widely available, common food type/source

Clinical listeriosis management guidelines are available on the website (www.nicd.ac.za). Where clinicians suspect listeriosis but specimens (including CSF and blood) are culture negative, a polymerase chain reaction (PCR)-based test can be performed at the NICD.

Whole genome sequencing is being performed on all clinical isolates and food/environmental isolates received from the NHLS Infection Control Laboratory in Johannesburg.

 

Does Europe have an egg problem? Salmonella cases no longer falling in the EU

The declining trend of salmonellosis cases in the EU has levelled off according to the annual report on zoonotic diseases published today.

The European Centre for Disease Prevention and Control reports that cases of Salmonella Enteritiis acquired in the EU have increased in humans by 3% since 2014. In laying hens, the prevalence increased from 0.7% to 1.21% over the same period. 

“The increase shown by our surveillance data is worrying and a reminder that we have to stay vigilant,” said Mike Catchpole, ECDC’s Chief Scientist. “Even in a state of high awareness and with national control programmes for S. Enteritidis in place, there is a need for continuing risk management actions at the Member State and EU level,” he added. 

Marta Hugas, EFSA’s Chief Scientist, said: “The decrease of Salmonella has been a success story in the EU food safety system in the last 10 years. Recent S. Enteritidis outbreaks contributed to a change in this trend in humans and poultry. Further investigations by competent authorities in the field of public health and food safety will be crucial to understand the reasons behind the increase.” 

There were 94 530 human cases of salmonellosis reported in the EU in 2016. S. Enteritidis – the most widespread type of Salmonella, accounted for 59% of all salmonellosis cases originating in the EU and is mostly associated with the consumption of eggs, egg products and poultry meat. 

Campylobacter and Listeria

Campylobacter, the most reported food-borne pathogen in humans, was detected in 246 307 people, an increase of 6.1% compared with 2015. Despite the high number of cases, fatalities were low (0.03%). Levels of Campylobacter are high in chicken meat.

Listeria infections, which are generally more severe, led to hospitalisation in 97% of reported cases. In 2016, listeriosis continued to rise, with 2 536 cases (a 9.3% increase) and 247 deaths reported. Most deaths occur in people aged over 64 (fatality rate of 18.9%). People over 84 are particularly at risk (fatality rate of 26.1%). Listeria seldom exceeded legal safety limits in ready-to-eat foods.

Salmonella food-borne outbreaks increasing 

The 4 786 food-borne disease outbreaks reported in 2016 represent a slight increase in comparison with 2015 (4 362 outbreaks), but the figure is similar to the average number of outbreaks in the EU during 2010–2016. 

Outbreaks due to Salmonella are on the rise, with S. Enteritidis causing one in six food-borne disease outbreaks in 2016. Salmonella bacteria were the most common cause of food-borne outbreaks (22.3%), an increase of 11.5% compared to 2015. They caused the highest burden in terms of numbers of hospitalisations (1,766; 45.6% of all hospitalised cases) and of deaths (10; 50% of all deaths among outbreak cases).

Salmonella in eggs caused the highest number of outbreak cases (1 882).

Steam with your melons? If it makes produce safer, why not

Abstract

The purpose of this study was evaluation of the effectiveness of superheated steam (SHS) on inactivation of foodborne pathogens on cantaloupes and watermelons.

Saturated steam (SS) treatment was performed at 100 °C and that of SHS at 150 and 200 °C. Escherichia coli O157:H7, Salmonella Typhimurium and Listeria monocytogenes-inoculated cantaloupes and watermelons were exposed for a maximum of 30 s and 10 s, respectively. Populations of the three pathogens on cantaloupes and watermelons were reduced by more than 5 log after 200 °C steam treatment for 30 s and 10 s, respectively. After SHS treatment of cantaloupes and watermelons for each maximum treatment time, color and maximum load values were not significantly different from those of untreated controls. By using a noncontact 3D surface profiler, we found that surface characteristics, especially surface roughness, is the main reason for differences in microbial inactivation between cantaloupes and watermelons. The results of this study suggest that SHS treatment can be used as an antimicrobial intervention for cantaloupes and watermelons without inducing quality deterioration.

Comparison of the effect of saturated and superheated steam on the inactivation of Escherichia coli O157:H7, Salmonella Typhimurium and Listeria monocytogenes on cantaloupe and watermelon surfaces, Korea, April 2017 to October 2017, Food Microbiology, Volume 72

Sun-Ah Kwon, Won-Jae Song, Dong-Hyun Kang

http://www.sciencedirect.com/science/article/pii/S0740002017303805?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb&ccp=y