Blaming consumers: Cruise ship edition

Jim Walker of Cruise Law News writes the Centers for Disease Control (CDC) reports that there was a gastrointestinal outbreak on the Crown Princess during its recent cruise, from October 25th to November 8, 2017. The Princess cruise ship departed Quebec, Canada on October 25th for a two-week cruise to Canadian and U.S. ports. The cruise ship arrived in Fort Lauderdale, Florida on November 8th and will begin its Caribbean season.

According to the CDC report, 184 passengers and 12 crew members became ill with gastro-like symptoms which included diarrhea.  

During the period from 2010 to the current date, Princess Cruises experienced the most outbreaks on its cruise ships calling on U.S. ports, according to the CDC. Princess reported twenty-one (21) cases to the CDC during this time period.

The Crown Princess alone has suffered through six (6) norovirus outbreaks since 2010 to the present. Before the current GI outbreak, the last norovirus outbreak on the Crown Princess was from January 3 – 18, 2016 and, before that, from October 18 to November 16, 2014. Earlier, there was a norovirus and e-coli outbreak from February 5 to 12, 2014. It also experienced back-to-back norovirus outbreaks from January 29 to February 4, 2012 and February 4 to February 9, 2012.

The cruise line with the second most outbreaks is Holland America Line with 18 cases of GI sicknesses reported to the CDC since 2010. HAL suffered norovirus outbreaks on the Nieuw Amsterdam, and two outbreaks each on the Voendam and the Noordam this year.  

So why is Princess Cruises far more prone to norovirus outbreaks than Carnival cruise lines, for example?

The cruise industry always blames the passengers for bringing the virus aboard, rather than its food handlers, or contaminated food or water. So are Princess Cruises customers the sickest and the least hygienic cruisers around? Are guests of HAL the second most unhygienic cruisers? Do they wash their hands the least of any cruisers? This seems like absurd arguments to make.

Whoever is to blame, the crew members, of course, always pay the price, by having to wipe and scrub and spray everything in sight for long 16+ hour days to try to disinfect a ship longer than three football fields.

Irrespective of the blame-game, don’t call us if you get sick on a cruise. Proving where the virus came from, or that the cruise line was negligent, is virtually impossible to prove, especially since the CDC conducts no epidemiological analysis and sometimes can’t even figure out whether the outbreak is due to norovirus, e-coli or something as exotic as Shigella sonnei or Cyclospora cayetanensis.

For example, The New Zealand Herald reports, a passenger on a cruise ship plagued with a vomiting and diarrhoea bug says he only learnt previous guests had been struck down with the same thing once they set sail.

Sydney man Walter Gibian and his wife Elisabeth left Sydney on October 30 on a 12-day Celebrity Solstice cruise travelling from Sydney to Auckland via the South Island so they could see New Zealand. Gibian had worked in New Zealand in 1980s and loved it so booked the cruise to see the East Coast.

The ship had left Melbourne when the captain announced to guests that passengers on an earlier cruise had norovirus and asked guests to take extra precautions including washing their hands regularly and using hand sanitiser.

any notification before they left and by this time it was too late to do anything about it as they were well on their way to New Zealand.

“It think people should be told and given the option that if you don’t like being exposed to this virus you are allowed to get off. But we found out when we were sea.”

Halfway into the 12-day cruise passengers started falling ill and Elisabeth came down with the bug on Saturday night. She was then isolated to her cabin for 48 hours.

“They (passengers) are sick all right. But of course the ship won’t tell us how many are sick, but my wife got sick on Saturday night. They are taking all sorts of precautions but it is still happening. They keep telling me, they are doing their utmost and they are doing their best but the fact is it is not effective.”

NZ school’s removal of soap from children’s toilets labeled ‘appalling’

Whenever someone tells me of an outbreak at a school, day care, university residence, whatever, the first place I go, or someone more geographically-centered should go, is check out the bathrooms.

It’s easy to preach proper handwashing as a way to reduce the spread of infectious disease.

But proper handwashing requires access to proper tools.

So I check out the bathroom and usually find the tools, uh, missing.

Proper handwashing requires vigorous water flow (temperature doesn’t matter), a vigorous rub with soap, and drying with paper towel.

Garth Bray of TVNZ reports an Auckland primary school has dumped a policy that saw soap and hand towels removed from all children’s toilets.

The school felt the children were wasting those basic items, but failed to follow some of the most basic health advice with its policy.

“I think it’s appalling”, said Dr Michael Baker, who is the University of Otago Professor of Public Health.

“We’ve got good evidence in big trials showing that having handwashing can actually reduce risk of gut infections by about 30 per cent and respiratory infections by about 20 per cent so I think all of our schools need to be part of this,” Dr Baker told Fair Go.

Fair Go was contacted by four parents of children at the school who objected to the school withdrawing soap but had been told by teachers this was the policy.

Some had simply accepted this and started sending their children to school with little bottles of liquid hand soap to use.

However, one took her concerns to the principal and to a school board member.

Fair Go has seen written messages between the board member and the parent which say: “There are no legal requirements from the Ministry of Health and the students were wasting the soap and hand towels so they were taken out but every class has hand sanitiser that they encourage their kids to use regularly.”

That’ll work until the kids start drinking the stuff.

Fair Go spoke with the principal, who disclosed that classrooms were sometimes locked at lunchtimes, meaning children had no access to anything but water for washing before meals and after using toilets.

The principal told Fair Go that the same week our programme had made contact, the school board had decided to reverse the policy and will now stock toilets with soap and hand towels again.

On that basis, Fair Go has decided for now not to name the school publicly as it takes steps to make good its commitment to provide hygienic hand washing facilities for children.

“New Zealand’s got an appalling record of having very high rates of a lot of major childhood diseases – respiratory infections, skin infections and gut infections and these are exactly the things that hand washing can protect our children against,” Dr Baker said.

Fair Go’s advice is for parents to take a look at their own school’s facilities and reassure themselves their children have the essentials on hand at school.

I do.

And the school knows I check.

NZ campy outbreak cost $21m

In Aug. 2016, some 5,500 people in a New Zealand town of 14,000 were sickened with Campylobacter linked to the water supply and three died.

Didn’t chlorinate.

Eric Frykberg of RadioNZ reports the NZ Ministry of Health has found Havelock North’s water contamination cost about $21 million – with residents the worst affected.

The campylobacter infection hit the town last August and afflicted more than 5,000 people with illness, filling the hospital and potentially contributing to three deaths.

The investigators measured the next best thing that people could have been doing if they had not been sick. That and the value of direct costs added up to the total figure of $21,029,288.

A report commissioned by the ministry said some 5088 households were affected by the crisis, and the cost to each household was about $2440.

Those costs included the cost of people getting sick and being unable to go to work or school or carry out other tasks.

Some were unable to look after their children, while others had to drive all over town to visit doctors or to get fresh water or other supplies.

They also had to do far more laundry and cleaning.

This left the households to foot a bill of more than $12,420,000 making up the majority of all costs from the crisis.

The report also said not all consequences of the outbreak could be quantified in monetary terms, with personal stress, loss of public faith in the water supply, and “scarring” of the community adding to the societal bill.

The report said about 25 percent of the population of Havelock North was aged over 65 based on the 2013 Census, and the town also had a large number of school aged children.

Raw is risky: 7 sick from NZ mussels

Hawke’s Bay District Health Board is investigating four confirmed cases of Paratyphoid fever and is following up three suspect cases.

All four confirmed cases have required hospital care at Hawke’s Bay Hospital. At least two of the cases ate mussels gathered from Napier’s Ahuriri area. The district health board is also concerned that mussels from the same area, may have been eaten at a Tangi at the Tangoio Marae 11 days ago, and is following that up.

Medical Officer of Health Nick Jones said, “People with Paratyphoid can carry the (Salmonella Enterica) bacteria in their blood and in their stomach and gut so it is possible for it to be passed on through feces. Hand washing was extremely important to help prevent infecting other people as you can get paratyphoid if you eat or drink things that have been handled by a person who has the bacteria.”

 

Raw milk sucks and is stupid: New Zealand edition

Batches of a brand of raw milk that is delivered in parts of the South Island is being recalled because it might contain Listeria monocytogenes.

The Government’s food safety regulator, the Ministry of Primary Industries, has issued the recall notice on Sept. 1, which applies to certain batches of Go Farming Ltd’s raw – unpasteurised – drinking milk.

The affected products are one litre bottles in baches 32, 33 and 34, with use-by markings of August 18, 20 and 21.

The ministry said the milk is sold online and is collected at the farm or delivered in the Southland and Queenstown regions.

NZ says (not a joke): Have your say on cooking burgers: Until a chef offers a temperature rather than adjectives it’s bullshit

While Australia is being dragged kickin-and-screamin into the thermometer age, New Zealand has decided to put knowledge aside, and ask the people, How do you want your burgers done?

Just because everyone eats doesn’t mean they know anything about microbial food safety.

The NZ Ministry for Primary Industries issued a public notice, stating: Feedback from chefs is that they would like to be able to cook mince (especially minced burger patties) to medium/medium rare (I have no idea what these adjectives mean; some numbers, please) under the template food control plan.

MPI has worked with chefs, environmental health offers and food scientists to develop a specialist section for both official template food control plans.  The specialist page is written in the “Know, Do, Show” format from the Simply Safe & Suitable template. The section will allow red meat mince for medium/medium rare burgers, and other meat specialities like steak tartare, to be safely served lightly cooked or raw. (Carpaccio is already covered in the templates (refer to section 10.6 (Serve) –  Whole cuts and whole joints of meat – and the ‘Cooking food’ page in Simply Safe & Suitable).

We want to know if the specialist section works for you? Have we got it right?  

Please note: Two of the processes included in the consultation are sanitising and blanch-in-a-bag.  The scientific validation for these methods is ongoing.  If there is insufficient evidence for it to be included in this amendment for the official template food control plans, and there is high demand for the process, further research would need to be commissioned so it could be added at a later date.

The consultation opens 25 July and closes on 8 August 2017.

Email your feedback to foodact.2014@mpi.govt.nz

I suggest e-mailing them this blog post and saying, I want a burger cooked safely to a verified 74C.

Poison customers, it’s good for business: Burger row hits the grills in New Zealand; try a thermometer

New Zealand’s oldest licensed premises has pulled a burger that’s been the cornerstone of its menu – blaming it on bureaucratic red tape gone mad.

Dan Fraser, executive chef at the Duke of Marlborough restaurant in the Bay of Islands, was left stewing after a visit from a Ministry of Primary Industries inspector on Thursday. 

Nicole Lawton of The Sunday Star Times reports new food preparation guidelines from MPI state minced meat and liver needs to be cooked at high temperatures for a longer amount of time than previously, to avoid contamination. 

Fraser said the new rules were a raw deal and will now prevent him serving his signature burger The Governor’s Burger which is pink and juicy in the middle. 

The Governor’s Burger features bacon, cheese, pickle, tomato, chipotle mayonnaise and a medium rare beef mince patty.

“It’s a really good burger, we really pride ourselves in presenting it to our customers,” Fraser said.

“Basically, the ministry is telling us how our customers need to eat their food.”

MPI food and beverage manager Sally Johnston, said the new rules didn’t entirely ban medium-rare meat – but chefs would have to change how they cooked it.

“If they do want to serve a medium-rare burger, it is possible, it just might take a little more forethought and planning,” Johnston said.

“It is possible to cook a medium-rare burger safely, it just means that they need to think about the processes that they are using to do that. It might not be necessarily possible to do that on a BBQ or grill.”

She suggest sous vide methods of cooking instead – what people used to call boil-in-the-bag.

“Who the f*** wants a sous vide burger?”, Fraser said.

The new rules state meat should have an internal minimum temperature of 65°C for 15 minutes while cooked, 70°C for three minutes, or 75°C for 30 seconds.

But Fraser said those were rules drawn up by a bureaucrat and not a chef. They meant a beef mince patty would always be “rubbery and devoid of flavour”.

Johnston insists the new rules are necessary. “People have died from under cooked burgers, there is a genuine food safety risk here, we’re not doing this to take the fun out of food. Bugs that have caused people to die (such as E. coli) are frequently found in New Zealand meat.”

The new MPI guidelines detail how restaurants and food businesses should prepare, store and serve their food, and supplement the 2014 Food Act. 

Top chef Ray McVinnie told Stuff NZ that serving a medium-rare burger is “dangerous and dumb” and that any chef who complains about such regulations does not understand basic food safety.

Yesterday, the Ministry for Primary Industries decided they will be talking to chefs about ways they can serve medium rare burgers and still keep food safe for consumers.

“We’re happy to work with chefs wanting to develop a custom Food Control Plan that covers their specific menu items. It might need different methods of sourcing, storing, and handling meat to make sure consumers are still protected.”

The move by MPI to regulate chefs’ kitchens brought howls of outrage and ridicule from those interviewed by the NZ Herald.

Labour’s Damien O’Connor said it was “ridiculous overkill”.

“We’ve got strict controls on how you kill and process meat. To then look at the cooking of it is nanny-state gone mad.

Northland MP Winston Peters, who has eaten at the Duke of Marlborough often over the years, said “paternalistic bureaucrats” were killing New Zealand businesses.

Sick customers ruin biz.

I look forward to the microbiologically-based arguments the talking heads will bring to the public discussion.

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, powellfoodsafety.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.

Bird-flipping welcome for US Secretary of State Rex Tillerson in New Zealand

I’ve always enjoyed the time I spent in New Zealand.

Maybe not as much as U.S. Secretary of State Rex Tillerson​ when he arrived in Wellington.

US media travelling with Tillerson were surprised by the number of people flipping the bird at Tillerson as his motorcade sped through town.

New York Times correspondent Gardiner Harris said he had been in a lot of motorcades but even he was taken back by the negative reaction.

“I’ve been in motorcades for a couple of years now … I’ve never seen so many people flip the bird at an American motorcade as I saw today,” Harris said.

Harris wasn’t the only one who noticed – US protection officers travelling by with Tillerson were overheard joking about the “warm” Wellington welcome.

It’s only water safety but I like it: Chlorine is a friend, multiple failings in NZ campy-in-water outbreak that sickened 5500 and killed 3

On Sunday, May 21, 2000, at 1:30 p.m., the Bruce Grey Owen Sound Health Unit in Ontario (that’s in Canada) posted a notice to hospitals and physicians on their web site to make them aware of a boil water advisory for Walkerton, and that a suspected agent in the increase of diarrheal cases was E. coli O157:H7.

Walkerton Water Tower

Not a lot of people were using RSS feeds, and I don’t know if the health unit web site had must-visit status in 2000. But Walkerton, a town of 5,000, was already rife with rumors that something was making residents sick, and many suspected

the water supply. The first public announcement was also the Sunday of the Victoria Day or May 24 long weekend and received scant media coverage.

It wasn’t until Monday evening that local television and radio began reporting illnesses, stating that at least 300 people in Walkerton were ill.

At 11:00 a.m., on Tuesday May 23, the Walkerton hospital jointly held a media conference with the health unit to inform the public of outbreak, make the public aware of the potential complications of the E. coli O157:H7 infection, and to tell the public to take necessary precautions. This generated a print report in the local paper the next day, which was picked up by the national wire service Tuesday evening, and subsequently appeared in papers across Canada on May 24.

The E. coli was thought to originate on a farm owned by a veterinarian and his family at the edge of town, a cow-calf operation that was the poster farm for Environmental Farm Plans. Heavy rains washed cattle manure into a long discarded well-head which was apparently still connected to the municipal system. The brothers in charge of the municipal water system for Walkerton were found to add chlorine based on smell rather than something like test strips, and were criminally convicted.

Ultimately, 2,300 people were sickened and seven died. All the gory details and mistakes and steps for improvement were outlined in the report of the Walkerton inquiry, available at http://www.attorneygeneral.jus.gov.on.ca/english/about/pubs/walkerton/.

In Aug. 2016, some 5,500 people in a New Zealand town of 14,000 were sickened with Campylobacter linked to the water supply and three died.

Didn’t chlorinate.

Just like Walkerton, where a drunk employee was found to adjust chlorine levels based on smell, Hawke’s Bay, New Zealand also had some lax procedures.

A panel looking into last year’s outbreak made the first stage of its findings public at Hastings District Court on Wednesday.

It identified several failings by the Hastings District Council, Hawke’s Bay Regional Council and drinking water assessors.

The outbreak in August last year made some 5500 of the town’s 14,000 residents ill with campylobacteriosis. It put 45 in hospital and was linked to three deaths.

The contamination was later found to have entered the town’s drinking water bores. Panel chair Lyn Stevens QC said the outbreak “shook public confidence” in this fundamental service of providing safe drinking water and it raised “serious questions” about the safety and security of New Zealand’s drinking water.

The district and regional councils did not directly cause the outbreak, but their “dysfunctional relationship” and their lack of co-operation resulted in a number of missed opportunities that may have prevented it from occurring.

Knowledge and awareness of aquifer and contamination risks near Brookvale Rd fell below “required standards” and it failed to take effective steps to assess the risk, including the management of the many uncapped or disused bores in the vicinity, and the monitoring of the district council’s resource consent to take the water.

Walkerton redux.

The district council “failed to embrace or implement the high standard of care required of a public drinking-water supplier,” particularly in light of a similar outbreak in the district in 1998, from which it appeared to have learned nothing.

The council’s mid-level managers especially failed, Stevens said. They delegated tasks but did not adequately supervise or ensure implementation of requirements. This led to unacceptable delays in developing the council’s water safety plan which would have been “fundamental in addressing the risks of the outbreak.”

That’s a polite way of saying, people care more about their retirement than others, and often fuck up.

Drinking Water Assessors were also at fault, with Stevens finding they were “too hands off” in applying the drinking water standards.

Sounds like food safety auditors.

They should have been stricter in requiring the district council to comply with responsibilities with its water safety plan, he said.

“They failed to address the [council] sufficiently about the lack of risk assessment and the link between the bores and the nearby pond.”

Nicki Harper of Hawkes Bay Today wrote a high number of positive E. coli readings in the Havelock North and Hastings water supplies over the years, dating back to a 1998 water contamination event similar to last year’s Havelock North campylobacter outbreak, caused bureau-types to do, nothing.

It was confirmed yesterday that the most likely source of the contamination was sheep feces that ran off a paddock following heavy rain on August 5 and 6 into the Mangateretere pond near Brookvale Bore 1.

Water from the pond then entered into the aquifer and flowed across to Bore 1 where it was pumped into the reticulation, Mr Stevens said.

The son of an elderly woman who died shortly after contracting Campylobacter during the Havelock North gastro crisis says she had “good innings” despite her death.

Jean Sparksman, 89, was one of three elderly people whose deaths were linked to the outbreak and had been living in the Mary Doyle retirement village at the time of the crisis.

Speaking from the Whangaparaoa Peninsula in Auckland yesterday, Mrs Sparksman’s son, Keith, said her death shouldn’t have happened the way it did.

“She contracted this bug but there were no steps taken to help. That’s probably why she died in the first place.”

The failures are all too familiar: space shuttle Challenger, Bhopal, BP in the Gulf, Listeria in Maple Leaf cold cuts, Walkerton: the tests said things were not good. But a human condition kicked in: Nothing bad happened yesterday so there is a greater chance of nothing bad happening today.

All these people fucked up, and others got sick.

Yet government, industry and academia will trod along, piling up retirement savings, until the next shitfest comes along.

So just watch this stupid Stones video with Keith out of his mind.

Nothing bad will really happen.

Stop handling food: 18 with typhoid in New Zealand

The number of people in Auckland confirmed to have contracted typhoid remains at 18; with one probable case and two others still under investigation.

The Auckland Regional Public Health said this afternoon that of those cases, three people remained in hospitals around the city.

All patients – including children – are connected to the Mt Albert Samoan Assembly of God church congregation which holds its Sunday services at Wesley Primary School in Mt Roskill.

“More cases may come to light as a result of the work ARPHS is doing to trace those who have been in contact with people confirmed as having typhoid,” a statement said.

“Typhoid has a typical incubation period of eight to 14 days, but incubation can be up to 80 days.

This means cases may emerge over the course of several weeks.”

Health officials are urging anyone who has close contacts to those affected by the disease to take extra precautions.

“Public health services have asked close contacts of typhoid patients who are in settings where there is an increased risk of transmission, such as food handlers, to stand down until they’re cleared.”