It was the ice: 144 students sickened in Taiwan, 2015

On 5 March 2015, Taiwan Centers for Disease Control was notified of more than 200 students with gastroenteritis at a senior high school during excursion to Kenting. We conducted an outbreak investigation to identify the causative agent and possible vehicle of the pathogen.

Methods

We conducted a retrospective cohort study by using a structured questionnaire to interview all students for consumed food items during their stay at the resort. Students were defined as a gastroenteritis case while having vomiting or diarrhea after the breakfast on 4 March. We inspected the environment to identify possible contamination route. We collected stool or vomitus samples from ill students, food handlers and environmental specimens for bacterial culture for common enteropathogens, reverse transcription polymerase chain reaction (RT-PCR) for norovirus and enzyme-linked immunosorbent assay (ELISA) for rotavirus. Norovirus PCR-positive products were then sequenced and genotyped.

Results

Of 267 students enrolled, 144 (54%) met our case definition. Regression analysis revealed elevated risk associated with iced tea, which was made from tea powder mixed with hot water and self-made ice (risk ratio 1.54, 95% confidence interval 1.22–1.98). Ice used for beverages, water before and after water filter of the ice machine and 16 stool and vomitus samples from ill students were tested positive for norovirus; Multiple genotypes were identified including GI.2, GI.4 and GII.17. GII.17 was the predominant genotype and phylogenetic analyses showed that noroviruses identified in ice, water and human samples were clustered into the same genotypes. Environmental investigation revealed the ice was made by inadequate-filtered and un-boiled water.

Conclusions

We identified the ice made by norovirus-contaminated un-boiled water caused the outbreak and the predominant genotype was GII.17. Adequately filtered or boiled water should be strongly recommended for making ice to avoid possible contamination.

Ice-associated norovirus outbreak predominantly caused by GII.17 in Taiwan, 2015

BNC Public Health, 2017, 17:870, Hao-Yuan Cheng, Min-Nan Hung, Wan-Chin Chen, Yi-Chun Lo, Ying-Shih Su, Hsin-Yi Wei, Meng-Yu Chen, Yen-Chang Tuan, Hui-Chen Lin, Hsu-Yang Lin, Tsung-Yen Liu, Yu-Ying Wang, Fang-Tzy Wu https://doi.org/10.1186/s12889-017-4869-4

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4869-4

143 sickened from Salmonella-in-duck in Taiwan

Lee I-chia of the Taipei Times reports that a 15-year-old shop selling roast duck in Miaoli County’s Toufen Township (頭份) has been fined and temporarily shut after more than 140 people fell ill last week after consuming duck bought from the shop.

roast-duck-taiwanThe Miaoli County Public Health Bureau said that more than 140 people visited local hospitals after developing symptoms of food poisoning, including vomiting, diarrhea or a fever, after consuming roast duck bought from the store on Sept. 10 and last week.

The hospital where some of the people were hospitalized found salmonella bacteria in their stool samples and reported the cases to the health bureau.

The bureau on Tuesday last week sent investigators to collect samples from the shop.

As of Monday evening, the bureau said it had received 13 case reports concerning 143 people — including several family groups — who had allegedly developed food poisoning after eating duck meat from the shop and had notified the Ministry of Health and Welfare.

Lab test results received on Monday confirmed the shop’s duck meat was contaminated by salmonella bacteria and a sample collected from the shop’s cutting board had Bacillus cereus bacterium.

Food fraud: 22 tons of expired food ingredients, 250 kg of seafood uncovered in Taiwan

Prosecutors uncovered 22 tons of expired food ingredients, some of which were seven years past their due date, in Taichung, while 250 kilograms of seafood, including frozen shrimp which expired three years ago, was found in New Taipei Tuesday.

taiwan.food.fraudThe discovery triggered a new round of alarm over food safety in this country, which is still reeling from a spate of food scandals involving plasticizers and adulterated edible oils over the past few years.

Taichung City’s health officials said Hsiung Hsun Co. Ltd., based in the city’s Dali District, is suspected of selling expired black tea powder, ham seasoning, garlic powder, rosemary spice, soy milk powder and other raw materials to downstream manufacturers since 2014.

A big customer of Hsiung Hsun’s expired products is the Nantou factory of food giant CP Taiwan, where local health officials have cordoned off more than 7,608 boxes with a combined weight of 10,959 kg that had been used in seven products.

Officials from CP Taiwan, also known as Charoen Pokphand Enterprise (Taiwan) Co., said they have asked their downstream sellers to remove the affected products from shelves as a precaution. The recalled products will be destroyed, according to Natou County’s Department of Health.

Some of Hsiung Hsun products have been sold to a company in Kaohsiung City, whose health officials have demanded that the company recall all products made from the expired ingredients.

Taichung prosecutors and police said Hsiung Hsun Co. is suspected of committing forgery by changing the expiry dates of its products to make illicit profits.

In New Taipei, health and prosecution officials said they have cordoned off 250 kg of sea food at Ocean International Co. Ltd., which is also suspected of forging the expiry dates of its frozen products before selling them to restaurants and eateries.

Simplicity may mean ‘deliciousness’ but not safetiness

Deliciouness is a subjective thing. Microbiologically safe is more of a data-driven thing, or a does-it-make-you-barf thing.

lost.in.foodThe China Post reports 100 renowned local chefs gathered at Four Four South Village (四四南村) on May 1, vowing unanimously to be the safeguards of food safety, as part of the promotion for the Taiwan Culinary Exhibition (台灣美食展) that is to kick off in August this year.

Thirty of them displayed onsite how to prepare dishes that are low in sugar, salt and oil, all with seasonal foods, which manifests their determination to protect the health of the more than 70 percent of the people in Taiwan who eat out on a regular basis.

Janice Lai (賴瑟珍), chairwoman of Taiwan Visitors Association (台灣觀光協會), stated during the event that one of the reasons why the association holds the exhibition is that it hopes to bring visitors back to a time when simplicity meant deliciousness. In addition, it is also hopes that the exhibition will be a platform for restaurant-goers, chefs, farmers and government to exchange ideas and suggestions, added Lai.

Shu-TiChiou (邱淑媞), director-general of the Health Promotion Administration (國民健康署), complimented the event, saying “Tourists can now eat without worrying about food safety.”

Does that mean that up until May 1, 2016, tourists dined in justified fear?

Raw is risky: Taiwan regulators warn of food poisoning from shellfish

The Taiwan Food and Drug Administration (FDA) yesterday urged people not to eat raw shellfish to avoid food poisoning, such as norovirus infection, as several recently reported cases of food poisoning were all caused by eating raw shellfish.

raw.clamsRaw shellfish, including raw clams and oysters, can easily be contaminated by norovirus or Vibrio parahaemolyticus in their growing environment, the agency said, adding that norovirus is one of the most common viruses that cause viral gastroenteritis.

The transmission of norovirus is primarily fecal-oral, and as few as 10 or less viral particles can cause an infection, Division of Food Safety official Hsu Chao-kai (許朝凱) said, adding that norovirus infection can cause an infected person to exhibit symptoms such as vomiting, stomach pain, watery diarrhea and, in some cases, a fever.

The agency said people should not risk their health to enjoy the taste of raw shellfish and urged the public to wash and cook shellfish thoroughly before eating.

Duck blood? 13 food products fail safety checks in Taiwan

The Health Bureau of Taichung City Government implemented food safety checks recently and found 13 out of 322 products to be violating regulations.

Jellied-Duck-BloodAhead of Chinese New Year, the city’s health authorities have stepped up inspections on traditional holiday food products.

The Health Bureau announced that it found 13 products – including duck blood, noodles and snow fungus – that violated food safety regulations.

Health officials also found pepper powder made from non-food grade magnesium carbonate; tea leaves that contained pesticide residue; and steamed spring roll that contained rongalite, a banned bleaching agent.

All products were either taken off the shelf right away or destroyed, according to the local health bureau.

Raw still risky: 102 sickened with Norovirus in oysters at Taiwan restaurant

A recent diarrhea outbreak among 102 tourists on Green Island off Taitung was caused by a norovirus infection at a local seafood restaurant that had served contaminated raw oysters imported from South Korea, Taiwan’s Food and Drug Administration (FDA) reported Thursday.

SUN0705N-Oyster7Taitung health authorities have received seven suspected food poisoning cases between June 26-30 which involved 102 tourists in six tour groups who displayed symptoms of diarrhea, with 76 of whom having been hospitalized.

After an investigation, Taitung County’s Public Health Bureau found that all the 120 people had eaten raw oysters at a seafood restaurant on Green Island and directed that all restaurants around the island to stop serving raw oysters.

In addition, two raw oyster samples have been found with the presence of norovirus, while two travelers who visited local hospitals tested positive for the norovirus, according to a report from the FDA on July 8.

The FDA then traced the sources of the contaminated products and found they were among a total of 16,447.5 kilograms of raw oysters imported by two aquaculture companies in New Taipei and Kaohsiung from South Korea, a FDA official said Thursday.

 

Over 240 students in Taiwan ill with Norovirus

There’s a lot of Norovirus going around Taiwan resulting in hotel closures, waivers and according to the Want China Times, the latest group hit by the vomit-inducing pathogen are students on graduation trips.

About 140 students and teachers out of a 285-person group from New Taipei Municipal An Kang High School reported diarrhea and vomiting during their trip to southern Taiwan, according to the CDC.10849902_719581291471357_3442145704847569295_n1-300x300

The symptoms appeared after the group ate breakfast at their hotel in the scenic Kenting area on Thursday morning and again after eating dinner at another restaurant on Thursday night, the agency said.

The patients were sent to numerous hospitals and most of them have been discharged, the agency said.

Likewise, 100 students from Ming Hu Elementary School in Taipei have reported vomiting during their trip to Chiayi county since Thursday morning.

The CDC said it is investigating if any staff members of the hotels and restaurants the group visited have contracted the disease.

CDC probing strain of Taiwan Norovirus

Whether last week’s norovirus outbreak in Taichung’s Hoya Resort Hotel Wuling (武陵富野渡假村) was caused by norovirus GII.17 — a genotype common in certain African nations — has not been determined, the Centers for Disease Control (CDC) said yesterday.

norovirusThe agency made the remarks after a norovirus outbreak at the hotel over the Lunar New Year holiday affected more than 200 guests and employees.

Norovirus infections cause rapid onset of vomiting and diarrhea. The virus is transmitted through the fecal-oral route, primarily via contaminated food or water.

CDC Deputy Director-General Chuang Jen-hsiang (莊人祥) said there are many genotypes of norovirus and that local cases last year were caused mostly by GII.4 and GII.6 strains.

“GII.17 genotype was first detected in Taiwan in October 2013, before disappearing shortly later. However, it re-emerged in the nation late last year and has since been the most predominant genotype circulating in the country,” Chuang said.

Chuang said the world’s knowledge about the GII.17 strain’s pathogenicity and level of communicability is still limited, except that it caused a cluster of infections in Africa and Brazil in 2005 and 2006 respectively, and affected a few individuals in the US and Japan in recent years.

Maybe it should be for Americans in America? Food safety top concern for American businesspeople in Taiwan

Food safety is the biggest anxiety for U.S. businesspeople living in Taiwan, according to an annual survey released Thursday by the American Chamber of Commerce (AmCham) in Taipei.

Taiwan_street_food_t658Among the least favorite aspects of living in Taiwan, the poll listed food safety as the major concern, followed by lack of an English-friendly environment. AmCham Chairman Thomas Fann noted that despite the food safety concerns, the business leaders at AmCham companies praised the high quality of life in Taiwan, describing Taiwan as “a safe and friendly environment in which to live and work.”