Me teaching Chapman how to golf: Norovirus everywhere

The University of North Carolina-Chapel Hill Panhellenic Council has postponed sorority recruitment due to an outbreak of norovirus-like symptoms for a “significant section of the Greek community,” according to an email sent to students Thursday.

The council said it has taken the recommendation of Campus Health and the Orange County Health Department to cancel at least Thursday and Friday’s planned events.

“Please go to Campus Health immediately if you are showing any symptoms,” the Panhellenic Council said in an email.

In Australia as we welcomed the first day of spring, hundreds of people have been struck down by gastroenteritis with New South Wales Health urging affected people to stay home and follow medical advice.

There were 39 gastro outbreaks in NSW institutions between August 20 and 26, including 22 in childcare centres, 10 in aged-care homes, five in hospitals and two in schools.

NSW Health said at least 348 people were affected by the bug in these outbreaks, which is more than double the previous five-year weekly average number of outbreaks for August.

And the bug finally has a name.

Director Communicable Diseases, NSW Health, Vicky Sheppeard said it appeared the outbreaks were caused by viral gastroenteritis including rotavirus and norovirus which spread easily.

“If your work involves handling food or looking after children, the elderly or patients, do not return to work until 48 hours after symptoms have stopped.

“The best defence against gastroenteritis is to wash your hands thoroughly with soap and running water for at least 10 seconds before handling and eating food, and after using the toilet, changing nappies or assisting someone who has diarrhoea or vomiting.”

10 seconds? In the U.S. it’s 20. How can all these scientists come up with different recommendations when looking at the same data. Values. And I agree with 10.

Winter has been a bad season for gastro in Australia; 1900 people attended NSW emergency departments with the bug in early August.

Brisbane has also been affected by an outbreak, with 51 childcare centres hit in the eight weeks to August 14.

NSW Health said all children should receive the rotavirus vaccine for free as part of the National Immunisation Program.

These figure come after NSW Health data showed there were 35,670 confirmed flu cases in NSW last month, making it the worst month on record for flu cases in NSW.

University students’ hand hygiene practice during a gastrointestinal outbreak in residence: What they say they do and what they actually do
01.sep.09
Journal of Environmental Health Sept. issue 72(2): 24-28
Brae V. Surgeoner, MS, Benjamin J. Chapman, PhD, and Douglas A. Powell, PhD
http://www.neha.org/JEH/2009_abstracts.htm#University_Students%92_Hand_Hygiene_Practice_During_a_Gastrointestinal_Outbreak_in_Residence:_What_They_Say_They_DO_and_What_They_Actually_Do 
Abstract
Published research on outbreaks of gastrointestinal illness has focused primarily on the results of epidemiological and clinical data collected postoutbreak; little research has been done on actual preventative practices during an outbreak.

In this study, the authors observed student compliance with hand hygiene recommendations at the height of a suspected norovirus outbreak in a university residence in Ontario, Canada. Data on observed practices was compared to post-outbreak self-report surveys administered to students to examine their beliefs and perceptions about hand hygiene. Observed compliance with prescribed hand hygiene recommendations occurred 17.4% of the time.

Despite knowledge of hand hygiene protocols and low compliance, 83.0% of students indicated that they practiced correct hand hygiene during the outbreak. To proactively prepare for future outbreaks, a current and thorough crisis communications and management strategy, targeted at a university student audience and supplemented with proper hand washing tools, should be enacted by residence administration.

 

Sick food handlers are a food safety risk

A while back I was awarded a contract to teach food safety in correctional institutions. I clearly remember an incident when I was talking about not going to work when you are ill as this poses a food safety risk and I went to explain why. Then this massive looking dude about the size of Terry Crews jumps out of his seat yelling at me. Apparently he had worked in the food service industry and had to support a family of five without having any sick time. So, when he was sick he went to work. Thereafter it was blur as 5 correctional officers jumped in the room to detain my friend as I soiled myself from fear…

Heather Williams writes

We put a lot of trust in the people who prepare and serve our food. We expect that our food is safe to eat and handled appropriately. In the United States, we have standards for food safety and many regulations in place. Why wouldn’t we trust those who prepare and serve our food? Unfortunately, a significant number of food workers have admitted to working while knowingly being sick. There are many reasons someone might do this. Some do it for financial reasons, others for sense of duty, and then there are some who fear they may lose their job if they do not cover their shift. Could foodborne illness cases dramatically decrease if food workers could have sick leave, which would allow them monetary compensation for identifying their illness and not passing it on to other unsuspecting patrons? Let’s explore this.
Restaurants Are a Primary Source of Foodborne Outbreaks
According to the Center for Disease Control and Prevention (CDC), an estimated 48 million people become ill in the United States each year from foodborne infection. Approximately 128,000 are hospitalized and foodborne illness claims about 3,000 lives each year. Over half of all foodborne outbreaks reported to the CDC can be linked back to eating in restaurants or delicatessens.
In one study, a group of investigators gathered data from FoodNet. This resource is also known as the Foodborne Diseases Active Surveillance Network, a central database where participating sites report information regarding foodborne illness. In a study analyzing 457 foodborne disease outbreaks, 300 were restaurant related. 98% of the 300 had only one contributing factor causing the outbreak. The most common contributing factor resulting in 137 outbreaks was “handling by an infected person or carrier of pathogen.” This is a significant number considering one lapse can have such high statistical repercussions.
The purpose of the study was to identify the contributing factors in restaurant-linked foodborne disease outbreaks. 75% of the outbreaks investigated were linked to Norovirus and Salmonella. These infections were predominately linked back to transmission by food workers. Significant resources are devoted to preventing contamination of food products before they make it to the point of service. Restaurants must ensure that staff have adequate training and understanding for how to handle the food once it becomes in their custody. Food worker health and hygiene were primary factors in contributing to foodborne illness.

The rest of the story can be found be here:

http://www.unsafefoods.com/2017/08/29/sick-leave-reduce-foodborne-illness/

 

Norovirus…again

I have never been on a cruise ship; just the thought of masses of people in close quarters on open water makes me want to barf. Large norovirus outbreaks are associated with settings where people live in close quarters and can easily infect each other, such as cruise ships, dormitories, and hospitals. Contaminated food, water, an infected person are all potential sources of norovirus. Viral contamination of environmental surfaces (fomites) may persist during and after outbreaks and contribute to further illnesses. The source of the Sun princess cruise ship outbreak is currently unknown. 

A norovirus outbreak has struck at least 91 passengers on a Sun Princess cruise ship.
The affected people were treated for gastro after the ship docked in Brisbane on Thursday morning.
A Queensland Health spokesman told Daily Mail Australia: ‘Metro North Public Health Unit is aware of at least 91 cases of gastro on board a cruise ship that berthed in Brisbane this morning.
‘We have been advised that on-board testing has found norovirus to be the cause of the illness.’
It comes after 140 passengers came down with gastro in February after a Sun Princess cruise returned from a 14-day trip around New Zealand.
A fortnight before that, there was another outbreak on the vessel during a previous cruise.

Norovirus, you don’t want it

Norovirus, one of the leading causes of acute gastroenteritis, is highly contagious and attempts to mitigate the bug can be extremely difficult. Moreover, trying to investigate the source of a norovirus outbreak can be frustrating and laborious for public health types.

I can still recall the pain I exhibited when I was infected with norovirus in Mexico, projectile vomiting, diarrhea, and horrible stomach cramps. Being religious, I think I recited the rosary 16 times for the pain to stop.…..then the week after, bit by 2 wild dogs on the resort….nice trip. 

A quickly spreading norovirus outbreak that’s sickened more than 200 people kept a Maumee doughnut shop closed for the third day in a row Thursday.
Initial investigations show patients had similar symptoms and had eaten food from Mama C’s Donuts at 924 Conant St. Illnesses were tracked to patrons who ate there Friday through Monday.
Health officials said at least 214 cases were reported in Lucas County, and Wood County officials said they are investigating if about a dozen norovirus cases were caused by doughnuts the store provides to businesses there.
Toledo-Lucas County Health Department spokesman Shannon Lands said Mama C’s voluntarily closed for cleaning on Tuesday. It was expected to remain closed Thursday.
Many Toledo area residents had stories of how they or family members were affected.
John Pointer of Port Huron, Mich., was one of the lucky ones.
He said he left his granddaughter’s 8th birthday party in Perrysburg before the doughnut cake was served, and so avoided the illness. Fifteen party guests, including the birthday girl, weren’t so lucky, he said.
“Everybody at the party got sick,” he said.
Delray Busch’s 3-year-old daughter Corrigan started vomiting around 12:45 a.m. Tuesday after eating a doughnut Sunday. Corrigan was feeling much better Wednesday, Ms. Busch said, adding she was thankful that the illness was brief and her 2-month-old didn’t show signs of catching it.
The South Toledo resident said she’s been eating at Mama C’s for two years and will be back.
“They are great to our community,” she said. “I will absolutely keep supporting our small businesses.”
A Wood County Health Department spokesman said that the department had confirmed that Grounds for Thought in Bowling Green sells Mama C’s products, and that the department on Wednesday was trying to determine if any other businesses are supplied by the store.
“All of those doughnuts have been taken off the shelf,” said Alex Aspacher, spokesman for the department.
Symptoms of norovirus include vomiting, diarrhea, stomach pain, fever, and body aches.

Noro is serious shit: Hotel housing athletes in world-class fail

As the world seemingly lurches to World War III, I’m reminded it’s the little things that add up.

Especially compensating for little hands.

BBC Sport and CNN report that Botswana’s Isaac Makwala has withdrawn from the 400m final, “due to a medical condition on the instruction of the IAAF Medical Delegate (Rule 113).”

Public Health England says 30 athletes and support staff have been affected by sickness at the Tower Hotel in London.

The International Association of Athletics Federations said Makwala withdrew from Monday’s 200m heats “due to a medical condition on the instruction of the IAAF medical delegate.”

He admitted to vomiting before the heats, but said he was not tested.

“I could have run. I did my warm up well and I was ready to run. I feel ready to run today, tonight,” he said.

Several German and Canadian athletes staying at the Tower Hotel fell ill last week.

A further 30 Germans due to arrive on Tuesday will be moved to other hotels.

German triple jumper Neele Eckhardt collapsed but was well enough to compete on Saturday, and took part in Monday’s final.

The Ireland team, who are also staying at the hotel, have confirmed that one athlete – 400m hurdler Thomas Barr – has been affected.

The Tower Hotel said investigations conducted with environmental health officers and the IAAF had shown the hotel was “not the source of the illness”. That has also been confirmed by Public Health England.

Ireland’s Thomas Barr withdrew from the 400m semifinals, while German and Canadian athletes also staying at The Tower Hotel near Tower Bridge have reportedly been affected too.

In a statement to CNN, Dr Deborah Turbitt, Public Health England (PHE) London deputy director for health protection, said: “We have so far been made aware of approximately 30 people reporting illness and two of these cases have been confirmed as norovirus by laboratory testing.

“PHE has been working closely with British Athletics and the hotel to provide infection control advice to limit the spread of illness.”

Public Health England said most peopled made a full recovery from the illness — often caught through close contact with someone carrying the virus or by touching contaminated surfaces — within one or two days without treatment.

A spokesperson for The Tower Hotel told CNN it was “not the source of the illness,” and that “We have followed strict hygiene protocol, ensuring that those affected are not in contact with other guests and all public areas have been thoroughly sanitized.

Uh-huh.

Chipotle sounds like a John Prine song: Throw front-liners under the bus: Chipotle CEO blames staff for noro outbreak that sickened at least 135

Business Insider reports that last week, news broke that Chipotle had closed a restaurant in Sterling, Virginia, following multiple reports of customers getting sick after eating there. Chipotle’s stock plummeted and more than 130 people claimed they had become ill after eating at the restaurant.

Now, CEO and founder Steve Ells needs to convince customers and investors that the chain has a plan to prevent another food poisoning scandal.

“We have isolated the failure that occurred,” Ells said in a call with investors on Tuesday.

According to Ells, the Sterling, Virginia restaurant had failed to comply with Chipotle’s safety regulations, specifically allowing an employee to work while sick.

“We made it clear to the entire company that we have a zero-tolerance policy” for not following food-safety measures, Ells said. “When followed, they work perfectly.

That’s bullshit.

When biology and humans are involved, nothing is perfect.

Seriously, this dude who runs thousands of restaurants hasn’t looked at the fail-safe measures used by engineering firms for decades?

Another nosestretcher: Ells told reporters on a conference call Tuesday, “We are the only major restaurant to have HACCP.”

That would be news to McDonalds, Disney, and dozens of others.

In describing the norovirus outbreak this past week, Ells placed the blame squarely on the individual restaurant, saying “norovirus is unrelated to our food supply chain.”

How do you know?

Coke-head Mark Crumpacker, chief marketing and development officer at Chipotle, said: “We conducted a thorough investigation and it appears that someone in the restaurant leadership did not adhere to our food safety protocol. We believe someone worked while sick.

The lack of compliance at the Sterling restaurant doesn’t seem to be an isolated incident. According to some Chipotle employees at other locations, store managers have encouraged workers to not to follow certain regulations, forcing them to work while sick and lie when filling out food safety sheets.

To prevent another food poisoning outbreak, Ells said that the chain needs to create a “culture of compliance.”

In light of the Sterling outbreak, Chipotle has made it clear that there will be “severe” consequences when in-store employees do not follow safety procedures. The company is launching additional training and communications efforts to ensure that each location follows national policies, such as sending sick workers home.

“Compliance with our procedures is nonnegotiable,” Ells said.

That’s all nice, and probably because Chipotle Mexican Grill received a follow-up subpoena on July 19, requesting information:

* Chipotle Mexican Grill says follow-up subpoena sought information related to illness incidents associated with a single Chipotle restaurant in Sterling, Virginia

* Chipotle Mexican Grill says it intends to continue to fully cooperate in the investigation

* Chipotle – sales trends in H2 of July 2017 have been adversely impacted by news regarding norovirus incident in co’s restaurant in Sterling, Virginia‍.

But it was just an accident.

Things rarely happen until they do: 4136 sick from Norovirus in bottled water, Spain, 2016

In April 2016, an outbreak of gastrointestinal illness (4,136 cases) occurred in Catalonia, Spain. We detected high levels of norovirus genotypes I and II in office water coolers associated with the outbreak. Infectious viral tiiter estimates were 33–49 genome copies/L for genotype I and 327–660 genome copies/L for genotype II.

During April 11–25, 2016, a total of 4,136 cases of gastroenteritis were reported by the Public Health Agency of Catalonia (ASPCAT; Figure, panel A). A case-patient was defined as an exposed person who had vomiting or diarrhea (3 or more loose stools within 24 hours) and >2 of the following: nausea, abdominal pain, or fever (≥37.8°C). Six patients required hospitalization.

The epidemiologic investigation conducted by the ASPCAT pointed toward an association of the outbreak with drinking bottled spring water from office water coolers; the water had been bottled at a source in Andorra (M. Jané-Checa and A. Martínez-Mateo, Public Health Agency of Catalonia, pers. comm., 2016 Sep 1). Compared with other modes of transmission such as food or person to person, norovirus outbreaks associated with drinking water are rare in developed countries. On April 15, 2016, as a precautionary measure, the company producing the bottled water recalled >6,150 containers of water of suspected quality that had already been distributed to 925 companies. The water complied with all requirements of the European Commission directive on the exploitation and marketing of natural mineral waters, but these requirements do not include any virologic determination.

Norovirus in bottled water associated with gastroenteritis outbreak, Spain, 2016

Emerging Infectious Diseases, Volume 23, Number 9—September 2017

Albert Blanco, Susana Guix, Noemí Fuster, Cristina Fuentes, Rosa Bartolomé, Thais Cornejo, Rosa Maria Pintó, and Albert Bosch

https://wwwnc.cdc.gov/eid/article/23/9/16-1489_article

 

I can’t make this shit up: Chipotle taps Wu-Tang Clan for marketing buzz

I can’t make this shit up: here’s a company with billions invested in it, and Chipotle decides to reach out to the Wu-Tang Clan.

A company that sucks bonding with a band that sucks and hoping that two negatives make a positive?

In April, 2017, Chipotle tapped hey-now Hank Kinsley and some other actors for some spots about how real Chipotle’s food was.

Guess that hasn’t gone so well.

Now, the aptly-named Mark Crumpacker, Chipotle’s chief marketing officer and convicted cokehead, told Bloomberg that Chipotle Mexican Grill Inc., has enlisted rapper RZA from the Wu-Tang Clan to unveil a new website that spotlights Chipotle’s ingredients. The company’s so-called clean menu — free of artificial preservatives and other additives — was a major selling point before a 2015 food-safety crisis sickened hundreds of customers and sent its shares plummeting.

Yup, real hardcore reaching out to the Wu-Tang Clan.

RZA, whose real name is Robert Diggs, helped design Chipotle’s new Savor.Wavs site. The rapper created 51 snippets of music, one for each ingredient on the menu, that lets people hear a audio interpretation of their typical Chipotle order. The new site doesn’t let customers order food, but it’s meant to drive home the simplicity of the chain’s menu.

“That might be lost on some, but people who are into the music will appreciate it,” said Crumpacker.

Crumpacker touted Chipotle’s simple menu at a party in Manhattan on Tuesday that featured a performance by RZA. He noted that fast-food hamburgers can have as many as 47 ingredients.

While the company declined to say how much it spent on the RZA campaign, Chipotle indicated it was less than the $5 million that a Super Bowl ad would have cost.

Chipotle’s stock, which hit a closing high of $757.77 in August 2015, has been battered by the food-safety concerns. The shares had been up for the year until Tuesday, when reports surfaced that customers had been sickened after eating a restaurant in Virginia. That location, which was closed on Monday, was slated to be reopened on Wednesday.

The stock is now trading around $368, about half its peak.

No risk messages are risky: Chipotle still doesn’t get it

I played hockey today, had an early evening nap – my partner is a saint – and then stayed up late so I could be on news radio in San Francisco at 6:20 a.m. their time — KCBS All News 740 and FM 106.9 — trashing Chipotle.

I said I wrote a book 20 years ago – Mad Cows and Mother’s Milk – that concluded no risk messages were really risky.

Yet here’s Chipotle, with their chief-science thingy, saying “Norovirus does not come from our food supply.”

As Chapman noted yesterday, there is on average one outbreak of food-related norovirus every day for all 365 days of the year in the U.S.

And rather than provide supporting statements for their claim, Chipotle took to Twitter to proclaim such insights as, “Why be full of potential when you could be full of burritos?” and “Summertime sadness is when you forget your guac.”

Al Gore had only just invented the Internet for everyone else when Mad Cows and Mother’s Milk was written.

Today, consumers demand data-based assurances, not platitudes.

I miss Phil Hartman (also born in Brantford, Ontario, Canada).

This scene from News Radio reminds me of when Chapman visited Kansas and shit for a couple of days because he had Campylobacter.

British Columbia oysters and norovirus: Another fairytale, as hundreds of cases in months with an “r”

Researchers at the BC Centre for Disease Control report in the British Medical Journal that between November 2016 and March 2017 more than 400 individuals across Canada developed norovirus gastroenteritis associated with the consumption of BC oysters. Over 100 cases occurred mid-November in participants at a Tofino oyster festival. Six cases occurred in persons attending a December oyster barbecue in Victoria. By March over 300 additional cases of norovirus linked to cultivated BC oysters harvested from multiple sites on both the east and west coasts of Vancouver Island were identified in BC, Alberta, and Ontario consumers. 

Norovirus is a highly infectious cause of gastroenteritis typically spread from person to person and is associated with regular community outbreaks in schools, hospitals, day cares, and care facilities. Foodborne outbreaks of norovirus are often linked to ill food handlers. In this recent outbreak, oysters were contaminated in the marine environment where they were farmed. The trace-back of oysters consumed by infected individuals led to the closure of 13 geographically dispersed marine farms in BC and to extensive public outreach.

Genotypic analysis of norovirus isolated from the cases included several variants of genogroup I (GI) early in the outbreak and both genogroups GI and GII later in the outbreak. 

Both GI and GII norovirus were detected in oysters from shellfish farms. This suggests that oysters bind and act as a reservoir for community outbreak strains and disseminate those strains to consumers.[1

Although sewage is often the cause of oyster contamination it remains unclear whether one or many sewage sources contributed to the contamination of shellfish farms. The 2016–17 outbreak was preceded by a wet fall and accompanied an unseasonably cold winter. Wet, cold, and dark winters enhance norovirus survival, allowing for longer retention in ocean sediments and in oysters.[2,3] The infective dose of norovirus is estimated as few as 18 particles.[2] Given the low infective dose and the viability of norovirus in cold water, we postulate that sewage spread by ocean currents may have contaminated geographically dispersed farms. Among potential sources under investigation are sewer overflows, metropolitan and local wastewater treatment plants, municipal raw sewage discharge, and commercial fishing vessels. The BCCDC is leading a collaborative group reviewing pollution sources discharging to BC marine environments that may have contaminated BC oysters. 

In this outbreak, both raw and cooked oysters led to illness; oysters were likely insufficiently cooked to inactivate norovirus. In addition to norovirus, pathogens like Vibrio sp., Salmonella sp., and hepatitis A can be transmitted to oyster consumers; cooking oysters to an internal temperature of 90 °C for at least 90 seconds will reduce this risk. The “rule” that shellfish is safe to eat in months with an “r” (September to April) is false. First, bacteria and viruses persist in cold seawater. Second, marine biotoxins (saxitoxin and domoic acid that cause paralytic and amnesic shellfish poisoning) occur year round. 

Physicians and laboratories play an important role in controlling foodborne disease. In this outbreak, trace-back of oysters linked to cases was used to close shellfish farms. If you see patients with acute gastroenteritis who recently consumed shellfish, inform your local public health office and submit stool samples for testing.[4]

BC oysters and norovirus: Hundreds of cases in months with an “r”

BCMJ, Vol. 59, No. 6, July, August 2017, page(s) 326,327

BC Centre for Disease Control

Lorraine McIntyre, MSc, Eleni Galanis, MD, MPH, FRCPC, Natalie Prystajecky, PhD, Tom Kosatsky, MD

http://www.bcmj.org/bc-centre-disease-control/bc-oysters-and-norovirus-hundreds-cases-months-%E2%80%9Cr%E2%80%9D