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.”

 

Norway: 7 infected with rare Salmonella

Ida Louise Rostad of NRK Finnmark reports seven people in Norway have been stricken with a rare form of Salmonella.

The samples of the patients were taken at the end of August, and all are thought to be infected in Norway. Bacteria with similar DNA profiles have been detected in all seven people, says senior adviser Heidi Lange at the Public Health Institute in a press release.

The people who are infected are between 19 and 60 years old. Two people live in Finnmark, but also people from Møre og Romsdal, Sogn og Fjordane, Akershus and Oslo are infected.

The DNA profile of the bacterium has never been seen before in Norway, either in humans, animals or in foods.

“There are no symptoms beyond what we usually see, such as diarrhea, fever and abdominal pain. So it does not look like this is more serious,” says Director of the Department of Public Health Institute, Line Violence to NRK.

“Now we are working on common routines for outbreaks. We have a little work to do to get out and we know this is work that can take time, “she says.

Now the institute cooperates with the municipal health service, the Norwegian Food Safety Authority and the Veterinary Institute to investigate whether patients can have a common source of infection.

The bacterium is a rare variant of the bacterium Salmonella Typhimurium.

The Norwegian Institute of Public Health does not want to provide information on whether patients are in hospital or have been with the GP to detect infection.

Chlorine works: Reducing Salmonella outbreaks in mangoes

The new crop of Australian mangoes is starting to arrive in spring-like Brisbane (because it’s more like summer with temps expected to hit 40 C this weekend), and they are delicious.

A team in one University of Connecticut lab recently processed 4,000 mangoes and water samples to test the efficacy of three disinfectants commonly used by the industry to avoid contamination.

To the utter surprise of researcher Mary Anne Amalaradjou, they found an unlikely candidate was extremely effective: chlorine. “When I saw the results, I didn’t believe it. So we re-ran the test ten times,” says the assistant professor in the Department of Animal Science.

Amalaradjou will present her findings at a meeting of the National Mango Board.

Salmonella is a frequent culprit for outbreaks in mangoes because it makes its way into the water used to wash the fruit in processing plants. According to the Centers for Disease Control and Prevention Salmonella leads to approximately 1.2 million cases of Salmonellosis each year in the United States and around 23,000 hospitalizations and 450 deaths.

“We had several outbreaks of people getting sick. The worrying part was the illnesses were not from cut mangoes, these were from mangoes they bought whole,” says Amalaradjou, whose work focuses on food safety and in finding new approaches to control or prevent foodborne illnesses.

In mango processing plants, the wash water is housed in gigantic tanks and once the water is contaminated, the bacteria are able to attach to the fruit’s skin and then enter the fruit’s pulp. Once bacteria make their way into the fruit, no amount of washing can remove them. With so many mangoes washed at once, the number of contaminated mangoes can be numerous, potentially causing many cases of Salmonellosis.

mango tropical fruit with male hand picking fruit from tree

Recognizing the danger, the Center for Produce Safety and the National Mango Board funded Amalaradjou’s study.  After taking on the project, Amalaradjou traveled to a mango processing plant to see the source of the contamination, the big wash water tanks, for herself in order to learn the processes so she could adapt them to a smaller-scale laboratory set up.

Amalaradjou was surprised by the results because chlorine is not very effective in the wash step for most produce. For one reason or another, from lettuce, to tomatoes to apples, chlorine simply doesn’t reliably kill Salmonella.

With mangoes, Amalaradjou found, chlorine cleaned the wash water and also helped prevent cross-contamination by cleaning the mangoes themselves.

One of the other challenges the research group had to tackle was not only effective Salmonella killing, but doing so with affordable and easily implementable measures on a large scale. Because chlorine is already used in the wash water, all that the processing plants need to do is to monitor the levels frequently to keep it at an effective concentration.

1 dead, over 200 sick: Salmonella Anatum infections linked to imported maradol papayas

This outbreak is one of four separate outbreaks currently under investigation that are linked to imported Maradol papayas from Mexico.

The Centers for Disease Control, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Salmonella Anatum infections.

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. PulseNet is the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC. DNA fingerprinting is performed on Salmonella bacteria isolated from ill people by using techniques called pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS). CDC PulseNet manages a national database of these DNA fingerprints to identify possible outbreaks. WGS gives a more detailed DNA fingerprint than PFGE.

This past spring, CDC investigated a multistate outbreak of Salmonella Anatum infections. Fourteen people infected with the outbreak strain of Salmonella Anatum were reported from three states. A list of the states and the number of cases in each can be found on the Case Count Map page. WGS showed that isolates from people infected with Salmonella Anatum were closely related genetically. This close genetic relationship meant that people in this outbreak were more likely to share a common source of infection.

Illnesses started on dates ranging from December 20, 2016, to April 8, 2017. Ill people ranged in age from less than 1 year to 85, with a median age of 38. Ninety-two percent were female. Among 11 people with available information, 10 (91%) were of Hispanic ethnicity. Among those 11 people, 5 (45%) were hospitalized. One death was reported from California.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Seven (88%) of eight people interviewed reported eating papayas. This proportion was significantly higher than results from a survey of healthy Hispanic people in which 22% reported eating papayas in the week before they were interviewed. In addition, four of these seven people reported buying papayas from the same grocery store chain.

While the epidemiologic information indicated that papayas were the likely source of this outbreak at the time, investigators could not determine the specific source of contaminated papayas and the outbreak investigation ended after illnesses stopped.

FDA informed CDC that a sample from an imported papaya identified Salmonella Anatum on September 4, 2017. This sample came from a papaya from a grower in Mexico named Productores y Exportadores de Carica Papaya  de Tecomán y Costa Alegre in Tijuana, Mexico. WGS showed that the isolate from the papaya and the isolates from the 14 people infected with Salmonella Anatum this past spring were closely related. Bravo Produce Inc. was a supplier of Maradol papayas to the grocery store chain where four of seven ill people reported buying papayas. After receiving FDA’s recent Salmonella isolate from papayas, CDC reviewed the PulseNet database to look for matching DNA fingerprints in bacteria from people who got sick after the investigation closed in the spring of 2017. Six more ill people have been identified and CDC is investigating to determine if these more recent illnesses are also linked to Maradol papayas imported by Bravo Produce Inc.

On September 10, 2017, Bravo Produce Inc. recalled Maradol papayas packed by Frutas Selectas de Tijuana, S. de RL de CV. The grower of the recalled Maradol papayas is Productores y Exportadores de Carica Papaya de Tecoman y Costa Alegre in Tijuana, Mexico. The papayas were distributed to California from August 10 to August 29, 2017. The recalled papayas can be identified by the label on the fruit from the packing company, Frutas Selectas de Tijuana.

This investigation is ongoing. CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill people and to interview them. FDA continues testing papayas from Mexico to see if other papayas from other farms are contaminated with Salmonella. Investigations are ongoing to determine if additional consumer warnings are needed beyond the advice not to eat papayas from specific importers or farms. Updates will be provided when more information is available.

You’re such a cute bunny; yes you are; and you can carry dangerous bacteria

Antimicrobial resistance (AMR) in zoonotic (e.g. Salmonella spp.), pathogenic, and opportunistic (e.g. E. coli) bacteria in animals represents a potential reservoir of antimicrobial resistant bacteria and resistance genes to bacteria infecting humans and other animals. This study evaluated the prevalence of E. coli and Salmonella enterica, and the presence of associated AMR in commercial meat, companion, research, and shelter rabbits in Canada. Associations between antimicrobial usage and prevalence of AMR in bacterial isolates were also examined in commercial meat rabbits.

Culture and susceptibility testing was conducted on pooled fecal samples from weanling and adult commercial meat rabbits taken during both summer and winter months (n = 100, 27 farms), and from pooled laboratory (n = 14, 8 laboratory facilities), companion (n = 53), and shelter (n = 15, 4 shelters) rabbit fecal samples.

At the facility level, E. coli was identified in samples from each commercial rabbit farm, laboratory facility, and 3 of 4 shelters, and in 6 of 53 companion rabbit fecal samples. Seventy-nine of 314 (25.2%; CI: 20.7-30.2%) E. coli isolates demonstrated resistance to >1 antimicrobial agent. At least one E. coli isolate resistant to at least one antimicrobial agent was present in samples from 55.6% of commercial farms, and from 25% of each laboratory and shelter facilities, with resistance to tetracycline being most common; no resistance was identified in companion animal samples. Salmonella enterica subsp. was identified exclusively in pooled fecal samples from commercial rabbit farms; Salmonella enterica serovar London from one farm and Salmonella enterica serovar Kentucky from another. The S. Kentucky isolate was resistant to amoxicillin/clavulanic acid, ampicillin, cefoxitin, ceftiofur, ceftriaxone, streptomycin, and tetracycline, whereas the S. London isolate was pansusceptible. Routine use of antimicrobials on commercial meat rabbit farms was not significantly associated with the presence of antimicrobial resistant E. coli or S. enterica on farms; trends towards resistance were present when resistance to specific antimicrobial classes was examined. E. coli was widely prevalent in many Canadian domestic rabbit populations, while S. enterica was rare. The prevalence of AMR in isolated bacteria was variable and most common in isolates from commercial meat rabbits (96% of the AMR isolates were from commercial meat rabbit fecal samples).

Our results highlight that domestic rabbits, and particularly meat rabbits, may be carriers of phenotypically antimicrobial-resistant bacteria and AMR genes, possibly contributing to transmission of these bacteria and their genes to bacteria in humans through food or direct contact, as well as to other co-housed animal species.

Prevalence of antimicrobial resistance in fecal Escherchia coli and Salmonella Enterica in Canadian commercial meat, companion, laboratory, and shelter rabbits (Oryctolagus cuniculus) ad its association with routine antimicrobial use in commercial meat rabbits

Preventative Veterinary Medicine, vol 147, 1 November 2017, Pages 53-57, Jennifer Kylie, Scott A. McEwen, Patrick Boerlin, Richard J. Reid-Smith, J. Scott Weese, Patricia V. Turner, https://doi.org/10.1016/j.prevetmed.2017.09.004

http://www.sciencedirect.com/science/article/pii/S0167587716305062

Raw milk is risky

I have friends who grew up on the farm their entire lives and insist on drinking raw milk as they feel that pasteurization completing devoid the milk of nutrients. I can preach about the dangers of consuming raw milk supported with scientific facts but that’s not going to change their minds. They’re adults, they can make their own choices; just don’t impose your choice on a child. When I was younger I was courting a girl who lived on a dairy farm in rural Manitoba (Canada). She insisted on drinking raw milk and offered some to me. I was aware that raw milk was risky but this way before my food safety days. So like many boys courting women, you sometimes make foolish mistakes and so I drank the milk. Puked it up. Not because of microbial reasons, just tasted horrible, maybe it was that batch, not sure.

Kristi Rosa reports
The Centers for Disease Control and Prevention (CDC) have issued an official health advisory regarding a rifampin/penicillin-resistant strain of RB51 Brucella that has been linked with the consumption of raw milk; this follows a alert issued by the Texas Department of State Health Services (DSHS) that was issued back in mid-August.

The DSHS defines raw milk as “milk from cows or other animals that has not been pasteurized to kill harmful bacteria.” Raw milk can be contaminated with several different bacteria, including Listeria, Salmonella, Escherichia coli, and Campylobacter—all bacteria that are known to be responsible for countless disease outbreaks.

The individual who contracted brucellosis is a Texas resident who was exhibiting fever, muscle and joint pain, as well as fatigue. The DSHS reports that blood culture revealed the bacteria responsible for these symptoms was, in fact, Brucella. Further investigation tracked the infection back to a potential source: a licensed raw milk dairy based in Paradise, Texas, called K-Bar Dairy.

The CDC stresses that any individuals who have consumed raw milk from this dairy between June 1, 2017 and August 7, 2017 should “receive appropriate post-exposure prophylaxis (PEP).” These individuals are thus at increased risk for infection and should contact their healthcare providers to inquire about PEP and undergo potential diagnostic testing.

K-Bar Dairy has fully cooperated with the CDC’s investigation and has contacted customers and advised them to dispose of any milk that may be contaminated. However, the dairy does not have a record of all customers, therefore, the DSHS alerted the public about the recall on August 14, 2017.

The rest of the story can be found here.

11M eggs destroyed: Health types in Israel warn of Salmonella threat

Baltimore Jewish Life, one of my must-reads in the tub, reports the Israeli Health Ministry has called on the general public not to buy “Yesh Maohf” eggs with a ‘last date of sale’ of 20 October. Officials are also calling on the tzibur at large to destroy 11 million eggs.

 Officials do not want the eggs returned, for this will spread the infection. Consumers are instructed to take the loss and destroy eggs.

The Ministries of Health and Agriculture emphasize that it is forbidden to consume eggs that have already been purchased and that they must be destroyed by throwing them into the garbage can.

ProMed followed up on this, and was provided with a report from Israeli health types:

The Israeli Ministry of Health is investigating a recent increase in laboratory notifications of _Salmonella enterica_ serovar Enteritidis infections. During May-July 2017 at least 848 patients infected with _S._ Enteritidis were reported, compared with 294 cases in the same period in 2016 (2.9-fold increase). During this period _S._ Enteritidis accounted for 58 percent of salmonellosis cases in Israel which marks a major increase in this serovar. Salmonellosis cases were reported nationwide, with case clusters reported mainly from the Jerusalem and the Southern districts. About 2 percent of cases involved invasive infection.

Several outbreak clusters were reported and investigated during this period in kindergartens, hostels, and restaurants across the country. Epidemiology, trace back, and laboratory data have linked several of the outbreak clusters to eggs with hen farms and egg distributors identified as possible sources. PFGE [pulsed-field gel electrophoresis] analysis of isolates from most reported clusters revealed a shared pulsotype. Further analysis by whole genome sequencing and whole genome MLST (wgMLST) [whole genome multi locus sequence typing] identified several sub-clones. Of particular interest is the identification of a clone from geographically distinct salmonellosis clusters that were temporally linked with a common egg distributor (“Yesh Maof”). This clone has also been detected in the context of a kindergarten outbreak in Southern Israel in 2016. Notably, several disease clusters are associated with _S._ Enteritidis strains belonging to the same pulsotype but accounting for distantly related WGS-types [whole-genome-sequencing types]. Laboratory investigation is still ongoing. It is noteworthy that there have not been any reports of _S._ Enteritidis in any foodstuffs routinely inspected for _Salmonella_ in Israel during the respective period.

An outbreak control team has been set up by the Ministry of Health and Ministry of Agriculture. Joint trace back and trace forward investigations are being carried out in order to identify the source of infection. The Ministry of Agriculture has recently inaugurated a monitoring program for _S._ Enteritidis control in laying hen farms.

In the context of this investigation, enhanced environmental sampling of traced laying hen flocks and farms is being carried out. These activities have led to the detection of _S._ Enteritidis in flocks supplying the above-mentioned distributor and a subsequent egg recall and planned culling of implicated flocks. Additional public health actions include continued risk management and source control in farms or flocks that will be implicated in human infection and/or found to be contaminated, enhanced epidemiological investigations for salmonellosis cases or case clusters of gastrointestinal infection, intensified inspections by the National Food Service and risk communication to the public, with emphasis on the safe handling and consumption of eggs and egg-containing foods.

 

14 sick after Salmonella outbreak linked to Chicago restaurant

The Chicago Department of Public Health announced a salmonella outbreak linked to a Morgan Park barbecue restaurant on Chicago’s Far South Side.

CDPH said at least 14 people are sick and six of them had to be hospitalized.

Best BBQ, located in the 1600 block of 115th Street, voluntarily closed Friday.

The CDPH said the outbreak was detected after reviews of lab reports revealed an uptick in salmonella cases.

After contacting patients, officials determined several of them ate at Best BBQ recently.

According to Best BBQ’s website the restaurant has been in business for 30 years, and customers said the outbreak is very surprising.

“This place is quality food. They’re very clean. The service is great. I’m super shocked, actually,” said Joshua Keys.

‘Woman loses appendix after Salmonella poisoning at Edmonton Folk Fest’

It’s not like she went to the mall and lost her appendix.

She was poisoned.

Talia Johnson is one of 19 salmonella cases linked with food exposure from the Haweli Restaurant food booth at the Edmonton Folk Festival. Johnson ate food from Haweli on Friday, and started to feel sick on Monday.

“I started feeling very, very sick and I didn’t feel better until August 25, so it was quite a long time,” Johnson told CTV News.

Alberta Health Services said symptoms flare up within six to 72 hours.

The 18-year-old decided to go to the hospital the following Wednesday in the Barrhead area – where she works at a kids camp – and was told to go back to Edmonton.

“When I went to the Grey Nuns on Saturday, they got the results back and said it was salmonella from those tests,” Johnson said. “It was weird that day in the hospital – I was feeling more pain in my abominable area that I didn’t feel before.”

The medical staff noticed elevated enzymes in her pancreas, so Johnson had an ultrasound to determine what was causing the abdominal pain.

“A doctor came up to me while I was in bed and said that I had appendicitis and that I would need surgery in a couple of hours, and they said it was from the salmonella,” Johnson said. “The fact that not only I went to the hospital but had to get surgery as a result of eating at a food place at Folk Fest is just kind of insane.”

Johnson missed two weeks of camp, and an additional two weeks from her restaurant job in Edmonton, because salmonella is a foodborne illness.

She received a letter on behalf of the Medical Officer of Health prohibiting her from working at a restaurant to limit the spread of infectious diseases.

“You are therefore prohibited from working in any occupation involving food handling, patient care or the care of young children, elderly or dependent people until your stool pattern has been normal for at least 48 hours,” part of the letter read.

Folk Music Festival producer Terry Wickham has been a part of the event for 29 years, and said he has never seen an outbreak this big before.

“My concern would be that it doesn’t happen again,” Wickham said. “The patrons can have my guarantee that we’ll go to the ends of the earth to make sure it doesn’t happen again.”

Uh-huh.

19 sick with Salmonella at Edmonton folk fest

When I think of folk festivals, I think of Arlo Guthrie.

Public health officials are investigating an outbreak of salmonella linked to food served at one restaurant booth during the recent Edmonton Folk Music Festival.

Nineteen lab-confirmed cases of salmonella have been linked to exposure to food bought at the Haweli Restaurant booth at the festival last month.