But what does gastro mean? Outbreak hits University of Queensland students

I don’t know what it is about Australians, whether it’s some pseudo-inherited British culture of hierarchy, or just dumbness, but lately, any outbreak of barfing and pooping is called a gastro outbreak.

As in gastroenteritis.

There are microbiology labs in Australia, so figure it out, and let people know.

Janelle Miles of The Courier Mail reports 20 students at two University of Queensland residential colleges have fallen ill with gastroenteritis in the middle of orientation week.

The students are residents of King’s College and Grace College at UQ’s St Lucia campus in Brisbane’s west.

They have been quarantined separated from other students to avoid the infection spreading.

Was it foodborne? Are there any epidemiologists in Australia? Is anyone investigating?

Australian student who sold monkey skull to ‘people from Pirates of the Caribbean’ fined

A few years ago, one of those Johnny-Depp-pirate movies — it may have been 5 — was filming down the highway at the Gold Coast.

The set was plagued by drama when it was discovered Depp and then wife Amber Heard had illegally brought two dogs into the country.

This prompted deputy premier Banaby-the-bloody-carp Joyce (right, not exactly as shown) to question Depp’s acting ability after the couple apologized, which shows how small Australia is because now Joyce is embroiled in his own scandalous activities, involving humans, not pets.

Behind the sideshow of movie making, divorce and apologies, a Canberra university student was on Thursday fined for illegally possessing and importing exotic animal remains into Australia, in a case that has shed some light on the shadowy world of wildlife trade.

Alexandra Back of the Canberra Times reports that for years, avid collector Brent Philip Counsell, 28, dealt in what a magistrate described as a “macabre” trade of skulls and animal specimens, once selling a primate skull to the people making the Pirates of the Caribbean movie in Brisbane.

In 2016 authorities from the department of environment raided Counsell’s home in Deakin where they found and seized about 100 animal specimens from the living room and bedroom.

Australian environment law makes it illegal to either possess or import protected exotic animal specimens without a permit.

Over several years, Counsell either illegally imported or possessed a small primate skull threaded on a necklace, the skulls of a brown bear and a gibbon, a taxidermy buzzard, water monitor lizard, and teeth from a bear and a hippopotamus tooth.

When he spoke to investigators, Counsell admitted possessing and selling species from his website wulfe.com.au, which he had since shut down.

One of the charges stemmed from an admission Counsell made to authorities after they had searched his home, that he had sold a primate skull to the “people” behind the Pirates of the Caribbean movie that was filming in Brisbane.

He tried to avoid detection, and prosecutors found on his phone articles that offered tips about how to send skulls overseas without being noticed by customs.

Food fraud: UK tourist scam version

Lucia Bohorquez of El Pais writes an investigating judge in Palma de Mallorca has lifted the seal on court records entered in the case of a scheme that may have cheated Spanish hotels out of as much as €60 million through phony food poisoning claims filed since 2014.

British law firms promised clients up to €18,000 and a 98% success rate in claims for gastric illness caused by the hotel food. The lawyers kept 60% of the payout, and the remainder was enough to cover the client’s entire holiday package costs. Clients were sent to them by a ring operating out of Mallorca, where “sales agents” were deployed to hotels in search of targets.

From January 2016 to the end of the summer, one hotel chain received 273 claims requesting compensation for 700 people

The Spanish Civil Guard arrested seven members of this ring, all British nationals, in September of last year. The suspects allegedly exploited lax British legislation by persuading hotel clients to file phony food poisoning claims against their tour operators.

Faced with high legal fees if the cases went to court, the tour operators would accept the claims, then pass on the cost to the Spanish hotels as per their contract, in which the latter accept responsibility for all damages.

The investigation was launched after several hotel groups filed police complaints. These hotels had hired private detectives who found that there was a network of agents sent out to hotels to persuade clients to file claims.

A Civil Guard report that shows up in court records mentions two individuals as the heads of the ring. These men operated out of Britain, where they channeled the claims through law firms “with low professional ethics.”

Back on Mallorca, the local leaders were two women – a mother and daughter – whose job it was to hire agents and train them to persuade hotel clients to simulate gastric illnesses. These agents were always native English speakers who dealt directly with their targets at the hotels.

Civil Guard officers followed the activities of the ring and found that it was also active on the island of Tenerife, where it made around €115 for every successful claim. One of the women would routinely drive to the hotels to supervise her agents, especially in Sa Coma and Puerto de Alcúdia in the north of Mallorca.

The ring was also active in Tenerife, where it made around €115 for every successful claim

All seven arrested ring members kept in touch through a WhatsApp group called “UK Holidays claims,” where they shared their clients’ names and addresses, contact information, holiday reservation number, checkout date and the best time to call the client back in the UK. Each agent added his or her name to the message, to ensure that they would get the commission.

Lettuce grazers rejoice: Consumer Reports says it’s ok to eat romaine lettuce again

Actually, it was the U.S.  Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) who jointly declared an end to the E coli O157 outbreak after nearly two months of investigation. At least 66 people across the U.S and Canada became ill, 22 were hospitalized, and 2 died during November and December, all linked to consumption of romaine lettuce.

Consumer Reports went along for the ride.

What’s been missing is any response from the leafy greens marketing agency types.

Silence – the LGMA cone of silence — is golden, I guess.

CDC announced on January 25, 2018, that this outbreak appears to be over, because the last case became ill on December 12, 2017. This indicates that the food causing illness is no longer available in the marketplace or consumers’ homes.

Although this outbreak appears to be over, the FDA’s outbreak investigation team is continuing to work with federal, state and local partners to determine what leafy greens made people ill, what people ate, where they bought it, and identify the distribution chain — all with the goal of identifying any common food or points where the food might have become contaminated. To date, no common link has been identified.

Because whole genome sequencing showed that the E. coli O157:H7 strain that resulted in the U.S. illnesses was closely related genetically to the strain that caused illnesses in Canada, the FDA and CDC have been in contact with Canadian food safety authorities throughout this outbreak.

 

Food safety: Keep the ego in check

The gap between food safety attitudes and behaviour is well acknowledged. Bridging this gap is critical in controlling foodborne illnesses.

Understanding the basis for behavioural outliers in food safety practices can be vital for persuading and transforming future unfavourable food safety behaviour(s). However, there appears to be limited insights available on this subject. This study investigates the extent to which Khebab vendors relate with the food safety attitude-behaviour gap hypothesis and whether this gap is stratified by education and training exposure. Employing interviews and non-participant observation, data was collected from 50 vendors in the Cape Coast Metropolis in Ghana.

The results indicate a significant gap between food safety attitude and behaviour, irrespective of educational status and training. It was also found that home-based food safety socialisation, customer dissatisfaction and associated consequences and egoistic tendencies accounted for outliers.

There is information in the tails: Outliers in the food safety attitude-behaviour gap

Food Control, 29 December 2017

Susana Moreaux, Charles Adongo, Ishmael Mensah, Francis Amuquandoh

https://doi.org/10.1016/j.foodcont.2017.12.024

https://www.sciencedirect.com/science/article/pii/S0956713517306035

Sexy: Lots of erectile dysfunction in Canadians as Health Canada warns of poppers and sex aides

Health Canada is advising Canadians about unauthorized health products that may pose serious health risks. The table below is updated when Health Canada finds unauthorized health products that are promoted for sexual enhancement, weight loss, as a workout aid, or as “poppers,” and that are labelled to contain or have been tested and found to contain dangerous ingredients.

Unauthorized health products have not been approved by Health Canada, which means that they have not been assessed for safety, effectiveness and quality. Unauthorized health products can pose many health dangers, including:

“Poppers” is a slang term for products that contain alkyl nitrites. Despite being labelled for various uses such as leather cleaners, room odourizers or liquid incense, these products are inhaled or ingested by consumers for recreational purposes. Alkyl nitrites, such as amyl nitrite, butyl nitrite and isobutyl nitrite, are prescription drugs and should be used only under the supervision of a health care professional. Products containing alkyl nitrites may pose serious risks, including death, depending on the amount used, how frequently they are used and how long they are used for, as well as the person’s health and the other medications they may be taking. Since it is difficult to control how much is inhaled, people can accidentally overdose. Swallowing these products can lead to serious medical complications and may be fatal. People with certain medical conditions (including recent head trauma, bleeding into the head, glaucoma, or heart disease) and those taking certain medications (particularly drugs used to treat erectile dysfunction, and other drugs such as high blood pressure medications, certain migraine drugs, and high doses of aspirin) or illicit drugs are at particular risk.

Sildenafil is a prescription drug used to treat erectile dysfunction and should be used only under the supervision of a health care professional. It should not be used by individuals taking any kind of nitrate drug (e.g. nitroglycerine) as it can cause potentially life-threatening low blood pressure. Individuals with heart problems are at increased risk of cardiovascular side effects such as heart attack, stroke, chest pain, high blood pressure and abnormal heartbeat. Other possible side effects include headache, facial flushing, indigestion, dizziness, abnormal vision, and hearing loss.

Tadalafil is a prescription drug used to treat erectile dysfunction and should be used only under the supervision of a health care professional. It should not be used by individuals taking any kind of nitrate drug (e.g. nitroglycerine) as it can cause potentially life-threatening low blood pressure. Individuals with heart problems are at increased risk of cardiovascular side effects such as heart attack, stroke, chest pain, high blood pressure and abnormal heartbeat. Other possible side effects include headache, facial flushing, indigestion, dizziness, abnormal vision, and hearing loss.

Thyroid is a prescription drug ingredient commonly used to treat decreased or absent thyroid function, called hypothyroidism. Products containing thyroid hormone should be used with caution in patients also using medication to treat diabetes and blood clotting. There is also a risk to patients with cardiac conditions such as angina pectoris, high blood pressure and in the elderly as they have a greater likelihood of heart conditions.

Vardenafil is a prescription drug used to treat erectile dysfunction and should be used only under the supervision of a health care professional. It should not be used by individuals taking any kind of nitrate drug (e.g. nitroglycerine) as it can cause potentially life-threatening low blood pressure. Individuals with heart problems are at increased risk of cardiovascular side effects such as heart attack, stroke, chest pain, high blood pressure and abnormal heartbeat. Other possible side effects include headache, facial flushing, indigestion, dizziness, abnormal vision, and hearing loss.

Yohimbine is a prescription drug and should be used only under the supervision of a health care professional. Yohimbine is derived from yohimbe, a bark extract. The use of yohimbine or yohimbe may result in serious adverse reactions, particularly in people with high blood pressure, or heart, kidney or liver disease. Side effects include increased blood pressure and heart rate, anxiety, dizziness, tremors, headache, nausea and sleep disorders. It should not be used by children, or pregnant or nursing women.

Zopiclone is a prescription drug used to treat insomnia. Side effects associated with zopiclone include unpleasant taste, drowsiness, dizziness, memory loss and hallucinations.

Confused consumers: Canadians say E. coli in romaine outbreak is over; U.S. says it’s leafy greens

Outbreaks of foodborne illness are fraught with uncertainties.

It’s OK to admit, to do the best with the info available, and get on with things.

On January 10, 2018, the Public Health Agency of Canada reported that an outbreak of Shiga toxin-producing E. coli O157:H7 infections (STEC O157:H7) they had identified was linked to romaine lettuce appears to be over.

As of January 10, 2018, there were 42 cases of E. coli O157 illness reported in five eastern provinces. Individuals became sick in November and early December 2017. Seventeen individuals were hospitalized. One individual died.

In the United States, the Centers for Disease Control, several states, and the U.S. Food and Drug Administration continue to investigate a multistate outbreak of 24 STEC O157:H7 infections in 15 states. Since CDC’s initial media statement on December 28, seven more illnesses have been added to this investigation. The last reported illness started on December 12, 2017.

The likely source of the outbreak in the United States appears to be leafy greens, but officials have not specifically identified a type of leafy greens eaten by people who became ill.  Leafy greens typically have a short shelf life, and since the last illness started a month ago, it is likely that contaminated leafy greens linked to this outbreak are no longer available for sale. Canada identified romaine lettuce as the source of illnesses there, but the source of the romaine lettuce or where it became contaminated is unknown.

Whole genome sequencing (WGS) showed that the STEC O157:H7 strain from ill people in the United States is closely related genetically to the STEC O157:H7 strain from ill people in Canada. WGS data alone are not sufficient to prove a link; health officials rely on other sources of data, such as interviews from ill people, to support the WGS link. This investigation is ongoing. Because CDC has not identified a specific type of leafy greens linked to the U.S. infections, and because of the short shelf life of leafy greens, CDC is not recommending that U.S. residents avoid any particular food at this time.

In the United States, a total of 24 STEC O157:H7 infections have been reported. Among the 18 ill people for whom CDC has information, nine were hospitalized, including one person in California who died. Two people developed hemolytic uremic syndrome, a type of kidney failure.

The Public Health Agency of Canada identified romaine lettuce as the source of the outbreak in Canada. In the United States, the likely source of the outbreak appears to be leafy greens, but health officials have not identified a specific type of leafy greens that sick people ate in common.

State and local public health officials continue to interview sick people in the United States to determine what they ate in the week before their illness started. Of 13 people interviewed, all 13 reported eating leafy greens. Five (56%) of nine ill people specifically reported eating romaine lettuce. This percentage was not significantly higher than results from a survey of healthy people in which 46% reported eating romaine lettuce in the week before they were interviewed.  Based on this information, U.S. health officials concluded that ill people in this outbreak were not more likely than healthy people to have eaten romaine lettuce.  Ill people also reported eating different types and brands of romaine lettuce. Currently, no common supplier, distributor, or retailer of leafy greens has been identified as a possible source of the outbreak. CDC continues to work with regulatory partners in several states, at the U.S. Food and Drug Administration, and the Canadian Food Inspection Agency to identify the source.

Although the most recent illness started on December 12, there is a delay between when someone gets sick and when the illness is reported to CDC. For STEC O157:H7 infections, this period can be two to three weeks. Holidays can increase this delay. Because of these reporting delays, more time is needed before CDC can say the outbreak in the United Stated is over. This investigation is ongoing.

Going public: FDA leaves tainted foods on shelves too long, report finds

The U.S. Food and Drug Administration is not moving quickly enough to ensure that contaminated food is removed from store shelves, despite being given the necessary authority, federal investigators have concluded.

The inspector general of the Department of Health and Human Services examined 30 of 1,557 food recalls between 2012 and 2015. The investigators found that the F.D.A. did not always evaluate foodborne hazards in a timely manner or ensure that companies initiated recalls promptly, leaving consumers at risk.

Food companies took an average of 57 days to recall items after the F.D.A. was apprised of the potential hazards. One recall did not begin for 303 days, the investigators said.

“Each and every day is important, because every day the product remains on the shelf, consumers are potentially at risk for serious illness or death,’’ said George Nedder, an assistant regional inspector general at Health and Human Services and lead author of the new report.

The F.D.A. has jurisdiction over most of the food supply in the United States, including virtually all processed food. (The Department of Agriculture oversees meat and poultry, and handles recalls of those products.)

About 48 million Americans get sick from food-borne diseases each year, according to the agency. Of those, 128,000 are hospitalized and 3,000 die.

Food recalls are announced frequently, but the vast majority are voluntary. Sometimes a company comes forward to report contamination, adulteration or mislabeling to the F.D.A. Sometimes the agency approaches a manufacturer after learning of a hazard from a state agency or other source.

In the past few months, the F.D.A. has announced recalls of contaminated apple slices (with listeria), biscotti (undeclared nuts) and adobo sauce (salmonella), among other problems.

The report noted numerous failings, among them “deficiencies in F.D.A.’s oversight of recall initiation, monitoring of recalls,” and in collecting and tracking recall data. Investigators also found that the F.D.A. did always not evaluate health hazards in a timely manner.

Many of the problems detailed in the report were the subject of an unusual “early alert memorandum” from the inspector general’s office in June 2016, which warned that “consumers remained at risk of illness or death for several weeks after F.D.A. was aware of a potentially hazardous food in the supply chain.’’

The new report noted that it took the agency 165 days to start a recall of nut butters that may have been tainted with salmonella; 151 days to recall hazelnuts that also suspected of salmonella contamination; 82 days to recall frozen spinach suspected of high levels of cadmium; and 27 days to start a recall of cooked duck eggs carrying the bacteria that cause botulism.

F.D.A. Commissioner Scott Gottlieb said that the agency had taken to heart the inspector general’s earlier warning and had already started to address recall enforcement problems that have persisted for years.

Dr. Gottlieb said that most food recalls occur within four days of a problem being reported, an assertion that Mr. Nedder disputed.

“Delay is deeply concerning to me as well,” Gottlieb, a physician, said in an interview. “I think it’s working a lot better now.”

FDA will also release guidance in the first half of 2018 on what information it can release about where recalled food and diet supplements were sold. A coalition of safety advocates urged Gottlieb in August to release the names of the stores that sell recalled food items, which FDA has claimed is confidential business information. The Agriculture Department releases it, as do other agencies including the Consumer Product Safety Commission.

FDA Commissioner Scott Gottlieb, MD said in a statement (edited below) that, “One of our most important jobs at the U.S. Food and Drug Administration is ensuring the safety of the U.S. food supply. When we learn about a food in the marketplace that may be unsafe, we must act quickly to keep people from getting sick or being harmed. If foodborne illness has already occurred, we also must act quickly to keep more people from becoming ill. The re-issued, final version of the report by the Office of the Inspector General (OIG), which examined our food recall practices over the time period from Oct. 1, 2012 to May 4, 2015, raised some significant concerns for me. While the FDA has addressed many of the findings after the draft version was first released in 2016, we still have more work to do. I take these obligations very seriously. Making sure the FDA has effective recall practices in place, and that we take immediate action to address unsafe foods, are high priorities of mine. Our recall authorities – and how we deploy them – are a cornerstone of our vital, consumer protection mission. …

“Among other steps, the agency will issue guidance on recall communications in the first half of 2018. As one example of the new steps we’re considering, the FDA is examining in what situations it can help consumers get information about the stores and food service locations that may have sold or distributed a potentially unsafe, recalled food, and what company may have supplied the product. If we’re able to disclose this information, consumers would have an easier time knowing if they might have, or have been, exposed to a recalled product that could cause potential risks if it were consumed.”

Here’s some suggestions:

Going public: Early disclosure of food risks for the benefit of public health

Mar.17

NEHA, Volume 79.7, Pages 8-14

Benjamin Chapman, Maria Sol Erdozaim, Douglas Powell

http://www.neha.org/node/58904

Often during an outbreak of foodborne illness, there are health officials who have data indicating that there is a risk prior to notifying the public. During the lag period between the first public health signal and some release of public information, there are decision makers who are weighing evidence with the impacts of going public. Multiple agencies and analysts have lamented that there is not a common playbook or decision tree for how public health agencies determine what information to release and when. Regularly, health authorities suggest that how and when public information is released is evaluated on a case-by-case basis without sharing the steps and criteria used to make decisions. Information provision on its own is not enough. Risk communication, to be effective and grounded in behavior theory, should provide control measure options for risk management decisions. There is no indication in the literature that consumers benefit from paternalistic protection decisions to guard against information overload. A review of the risk communication literature related to outbreaks, as well as case studies of actual incidents, are explored and a blueprint for health authorities to follow is provided.

Fonterra fined $183m over contamination scandal

New Zealand’s Fonterra has been ordered to pay 105 million euros (NZ$183 million) in damages to French food giant Danone as a result of the Fonterra food safety failures of 2013.

Danone had sued Fonterra as a result of the whey protein concentrate contamination scandal in 2013, when Fonterra quarantined several batches over fears it was contaminated with clostridium bacteria. It later turned out to be a false alarm.

Danone launched a legal suit in New Zealand and arbitration proceedings in Singapore, seeking restoration for the costs of recalling the whey protein concentrate.

At the time, Fonterra said it expected any court action would show the Kiwi firm didn’t have any liability in the contract, and it recognised a contingent liability of just $14m over the recall.

In 2014, New Zealand’s Court of Appeal upheld an earlier decision that the Singapore arbitration proceedings should be the first avenue, as provided for in the contract, but refused to permanently stay the legal suit.

The result of the Singapore proceedings was released on Friday, and Danone says it “welcomes” the decision.

Less food poisoning associated with employee paid sick time?

I refer to parenting as hypocrisy disease.

And there’s been more than a few times when Amy has said to me, practice what you preach.

Like barfing and going to work.

People should not work when they are sick.

But in the world of food, people are going to lose their jobs if they don’t show up.

Hsuan et al. write in the American Journal of Preventative Medicine that:

Previous studies suggest an association between paid sick leave (PSL) and better population health, including fewer infectious and nosocomial gastrointestinal disease outbreaks. Yet few studies examine whether laws requiring employers to offer PSL demonstrate a similar association. This mixed-methods study examined whether laws requiring employers to provide PSL are associated with decreased foodborne illness rates, particularly laws that are more supportive of employees taking leave.

Methods:

The four earliest PSL laws were classified by whether they were more or less supportive of employees taking leave. Jurisdictions with PSL were matched to comparison jurisdictions by population size and density. Using difference-in-differences, monthly foodborne illness rates (2000-2014) in implementation and comparison jurisdictions before and after the laws were effective were compared, stratifying by how supportive the laws were of employees taking leave, and then by disease. The empirical analysis was conducted from 2015-2017.

Results:

Foodborne illness rates declined after implementation of the PSL law in jurisdictions with laws more supportive of employees taking leave, but increased in jurisdictions with laws that are less supportive. In adjusted analyses, PSL laws that were more supportive of employees taking sick leave were associated with an adjusted 22% decrease in foodborne illness rates (p=0.005). These results are driven by campylobacteriosis.

Conclusions:

Although the results suggest an association between more supportive PSL laws and decreased foodborne illness rates, they should be interpreted cautiously because the trend is driven by campylobacteriosis, which has low person-to-person transmission.

Association of paid sick leave laws with foodborne illness rates

Am J Prev Med. 2017 Sep 1. pii: S0749-3797(17)30359-8. doi: 10.1016/j.amepre.2017.06.029. [Epub ahead of print]

Hsuan C, Ryan-Ibarra S, DeBurgh K, Jacobson DM

https://www.ncbi.nlm.nih.gov/pubmed/28870665