Ben Chapman

About Ben Chapman

Dr. Ben Chapman is a professor and food safety extension specialist at North Carolina State University. As a teenager, a Saturday afternoon viewing of the classic cable movie, Outbreak, sparked his interest in pathogens and public health. With the goal of less foodborne illness, his group designs, implements, and evaluates food safety strategies, messages, and media from farm-to-fork. Through reality-based research, Chapman investigates behaviors and creates interventions aimed at amateur and professional food handlers, managers, and organizational decision-makers; the gate keepers of safe food. Ben co-hosts a biweekly podcast called Food Safety Talk and tries to further engage folks online through Instagram, Twitter, Facebook, YouTube and, maybe not surprisingly, Pinterest. Follow on Twitter @benjaminchapman.

Papayas linked to outbreak of salmonellosis; over 60 ill

I really like fruits and berries. All kinds of fruits are my go-to snacks and over the past few years I’ve discovered how much I like tropical fruits like mango and papaya.

My favs aren’t immune from outbreaks. In 2017, an outbreak of Salmonella Anatum was linked to papaya.

And today CDC and FDA announced another outbreak of Salmonella (this time Uganda) traced to the fruit, causing at least 62 illnesses to date (with 23 hospitalizations).

According to the CDC release, there’s some notable stuff:

  • Of 33 ill people with available information, 22 reported being of Hispanic ethnicity.
  • The hospitalization rate in this outbreak is 66 percent among people with information available. The hospitalization rate in Salmonella outbreaks is usually around 20 percent.
  • Most of the sick people in this outbreak are adults over 60.

5 dead, 9 sick from Listeria in sandwiches to UK hospitals: Going public: Hugh Pennington on the shameful secrecy over the hospital sandwich scandal

I wonder if Dr. Hugh Pennington feels he’s in a Groundhog Day situation.

I know I often do.

The man who led the investigation into the 2005 E. coli O157 outbreak in the UK that killed Mason Jones and sickened about 160 children wrote in the Daily Mail the other day that,

almost two weeks have passed since news emerged of a listeria outbreak linked to ready-made sandwiches provided to patients in hospitals.

Yet until yesterday we had been told absolutely nothing beyond the names of four hospital trusts where some of the patients died or where others had fallen ill.

Last night, we learned that one of the victims was Ian Hitchcock, 52, a businessman and father of twins, from Crich in Derbyshire.

Our thoughts must go to his grieving family. But as a scientist I also have to ask why it has taken so long for even this sliver of information to be shared?

The health authorities have a duty to ensure no more people are put at risk of death. And to try to ensure that we — as doctors, scientists and indeed the wider public — all need to know more about those who got sick and recovered, or who succumbed to listeriosis, a potentially fatal form of food poisoning. This is not out of prurience, but to better safeguard the health of others.

Listeria can present in various ways — which is why diagnosis is so difficult — but among the complications are sepsis and meningitis, two of the nastiest and hardest illnesses to treat. Anyone at risk should know about it sooner rather than later.

Remarkably, and in my view wrongly, the information needed is largely being denied to us. It is only after pressure from the Daily Mail that any details at all have been released.

Tory MP Nadine Dorries, a former nurse, this week called for ‘full transparency and openness about those who have died’.

She added: ‘I don’t understand why they don’t tell us the age or sex — or what conditions they were in hospital for. All these would be relevant.’

She is right. It is in the public interest that the age, gender and reason why the victims were originally admitted to hospital are released as a matter of urgency.

If, for example, a high percentage of victims in the latest outbreak were aged over 80, then that would be helpful to know, allowing doctors and nurses to pay close attention to that demographic.

If more men than women have died — and listeria infections are generally more common in men — that would be highly relevant, too.

I’m old enough to remember the Aberdeen typhoid outbreak of 1964. In that case the names and addresses of the 400 or so infected people, who had all eaten corned beef from Argentina, were printed in the local paper almost before they’d seen a doctor. Miraculously, none of them died.

I’m not, of course, advocating a return to that level of media scrutiny. But as a bacteriologist who has spent much of his career investigating the medical consequences of poor food hygiene, I do know that — now, and for some time to come — it will be to the wider community’s benefit if there is full disclosure of facts relevant to protecting the public’s health.

In the course of my career, I’ve headed two public inquiries into outbreaks of illness caused by the better-known bacterial infection, E. coli. In both cases the public received far more information than has been released this time. One was an outbreak at schools in South Wales in 2005. This was rapidly traced back to a single butcher.

The other, which turned out to be the deadliest outbreak of this particular form of E. coli in recent British history, hit central Scotland in 1996 and was again linked to one meat supplier. A hospital, an old people’s home and a pub were all affected.

Some 21 people died in that outbreak. Thanks to strategic and considered release of information, however, doctors knew that although some children as young as 10 were infected and became seriously ill, the elderly were at the highest risk of dying. Treatment was adjusted accordingly.

Yet Public Health England (PHE) has restricted itself to a mealy-mouthed statement, saying: ‘We never confirm any information about patients affected unless there is a risk to the public’s health. Confirmation of those details is a matter for families and their doctors.’

But hang on a minute. This is an outbreak of a potentially fatal bacterial disease that has already claimed five lives in hospitals across England. We know the company at the centre of the outbreak, the Good Food Chain, supplied 43 NHS trusts, and other patients have been infected by sandwiches or salads contaminated by listeria. And we know the bacterium has a long incubation period.

So how can PHE be so certain there is no further ‘risk to the public’s health’?

The first inquests into the deaths of victims — Ian Hitchcock, who was treated at the Royal Derby Hospital, and another patient treated at Manchester Royal Infirmary where two other patients died — open tomorrow.

It is likely there will be inquests into the deaths of the other three victims, too.

But if PHE took responsibility for aggregating the information of all those who have died, stripping it of anything that could identify individuals (a particularly rare illness, for example), I believe that would safely balance confidentiality concerns with the very real need for more information.

The fact is that mounting public unease would be hugely reduced if patients, together with their concerned families, knew what the dangers were and their level of risk.

A small minority would then know they had valid concerns and could seek advice from their doctor accordingly.

The sandwiches linked to the outbreak have now been removed from the food chain, but a threat of infection remains — and will continue to do so for a few weeks yet.

We need to know who is at the highest risk — and we need that information now. Without it, there is a real danger that more people will die needlessly as a result of the authorities’ shameful silence.

Food Safety Talk 185: Hot Diapers

Don and Ben are joined by friend, listener and co-host of Do By Friday, Max Temkin. The show starts when Don surprises Ben with our special guest. Max brings the guys a bunch of great food safety questions about tomato paste and the nuances of expiration dates, sous vide, jerky and grinding your own meat. They talk about frozen berries, what triggers recalls and what they look for in a company or industry that is doing good food safety things. The episode ends on a story on how Cards Against Humanity became a food processor (sort of).

Show notes so you can follow along at home:

Food safety in popular culture: Scripps Spelling Bee edition

Last night I was watching the Toronto Raptors play in their first NBA finals so I missed my annual viewing of the Scripps Spelling Bee. I’ve been hooked on the spelling drama since watching Spellbound in 2002.

Campylobacter was one of the words in this year’s competition. One of my food safety nerd friends sent me the below screenshot from Instagram.

I had campy back in 2009. It sucked.

Beware of the plume: Flour linked E. coli O26 outbreak, Aldi brands recalled

I used to be a lick-the-batter-off-the-spoon kind of guy. I stopped doing that a few years ago. I don’t eat raw cookie dough, or let my kids eat it. I’m probably not the most fun dad, but outbreaks like what is going on right now is why.

Courtesy of the Safe Plates Information Center and NC State Extension

According to CDC,

As of May 24, 2019, 17 people infected with the outbreak strain of E. coli O26 have been reported from 8 states. A list of the states and the number of cases in each can be found on the Map of Reported Cases page.

Illnesses started on dates ranging from December 11, 2018 to April 18, 2019. Ill people range in age from 7 to 86 years, with a median age of 23. Sixty-five percent of ill people are female. Of 17 people with information available, 3 have been hospitalized. No deaths have been reported.

Epidemiologic and laboratory evidence indicates that flour is a likely source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Of seven people who were interviewed, four (57%) reported eating, licking, or tasting raw, homemade dough or batter. Two people with detailed information reported eating raw dough or batter made with flour or baking mixes from ALDI.

Investigators with the Rhode Island Department of Health collected records and flour samples at a bakery where an ill person reported eating raw dough. Records indicated that the bakery used Baker’s Corner All Purpose Flour from ALDI. The outbreak strain was isolated from an unopened bag of Baker’s Corner All Purpose Flour collected at the bakery.

WGS results showed that the E. coli O26 strain identified in the Baker’s Corner All Purpose Flour sample was closely related genetically to the E. coli O26 strain identified in ill people. These results provide additional evidence that people in this outbreak got sick from eating flour.

On May 23, 2019, ADM Milling Co. and Aldi recalled pdf icon[PDF – 142 KB]external icon 5 lb. bags of Baker’s Corner All Purpose Flour sold at retail locations in the following states because they may be contaminated with E. coli: Connecticut, Delaware, Massachussetts, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont, and West Virginia

I talked to Korin Miller at whattoexpect.com about this outbreak too, and the hidden risk factor in all of this might be cross-contamination.

It’s a good idea to take care when handling raw flour the same way as you would if you were preparing raw meat. That means washing your hands well after you touch it, sanitizing your countertops after you use it and not eating flour products until they’re thoroughly cooked, Chapman says.

Overall, you should definitely take this seriously. “It’s really, really risky to eat raw flour products,” Chapman says.

And I think about this every time I squeeze and plop down a bag of flour in my kitchen. The pathogens, if they are in there, get spread around like shrapnel.

Food Safety Talk 183: Raw Raw Raw Almonds

Image from PIRO4D at Pixabay

Don and Ben are joined by longtime friend and colleague, podcast downloader (and sometimes listener) Linda Harris. The three nerds talk about other podcasts, Kardashian indices, Erdos numbers, berries, and the long and progressive food safety story of raw almonds. The almond story touches on what should happen when an industry has a major outbreak, how working with extension and research academics can lead to solutions and ripples of managing food safety risks.

You can download Food Safety Talk 183 here or at iTunes.

Show notes so you can follow along at home:

At the intersection of food safety and hockey: Is drinking/eating out of the Stanley Cup risky?

For almost 20 years I’ve tried to connect the things I know about. Today it worked.

Matt Shipman and Chris Liotta, my buddies and colleagues in NC State Communications and our college communications independently hit me up with a question about if we could connect food safety and hockey as Raleigh was in the midst of NHL playoff fever.

Here’s what we came up with:

A lot of traditions have developed around the Stanley Cup since it was first awarded to hockey champions in 1893. One of those traditions is for members of the winning team to drink from the Cup, which raises the question: could the Stanley Cup spread disease?

To get at that question, we should discuss the history of the “common cup.”

Shared Cups and Public Health

In the early years of train travel in the United States, travelers were expected to share a common cup, or a dipper, when getting water in their train cars. This eventually raised public health concerns, which led to a spate of state and federal laws barring the use of common cups in train travel.

“We now know that whenever someone places their hands or mouth on a cup, or other eating utensil, that person can deposit bacteria or viruses on the surface,” says Ben Chapman, a food safety researcher at NC State University (and avid hockey fan). “The next person to use that utensil may then ingest the bacteria or virus.

“This form of cross-contamination is well established, and has been identified as a vector for disease since studies of diphtheria and tuberculosis in the early 20th century – which is what led to the common cup laws in the first place.”

That’s good general background, but what about the Stanley Cup in particular?

Drinking From Lord Stanley’s Cup

The bowl part of the Cup, which is what people actually drink from, is made of silver – not dissimilar to a silver chalice your grandparents might own, if your grandparents own a silver chalice that’s been photographed with Wayne Gretzky. And the fact that it’s made of silver actually matters.

Silver is inert. That means it won’t react chemically with most of the substances you put into it, like the acidic fruit juices. Silver also has antimicrobial properties. However, given the circumstances we’re talking about (a bunch of hockey players drinking out of the Cup), those antimicrobial properties won’t reduce the risk of cross-contamination in any meaningful way.

What About Booze?

Everyone knows alcohol is a disinfectant. But does the presence of alcohol eliminate the risk of disease transmission for people drinking out of the Cup? No.

“There are two big factors here,” Chapman says. “One factor is the amount of alcohol in the beverage. For example, beer has a lower percentage of alcohol than champagne, which has less alcohol than hard liquor.

“An alcohol percentage of about 3% appears to be the threshold for making a difference in regard to contamination. And the higher the alcohol percentage, the more effective the beverage will be as an antimicrobial agent.”

However, this first factor is largely irrelevant, because of the second factor: time.

“In order to kill off pathogens, the alcohol has to be in contact with the pathogens for a specific period of time,” Chapman says. “The higher the alcohol content, the shorter the contact time needs to be.

“But, as we’ve noted in the past with eggnog, even strong liquor won’t significantly reduce microbial contamination in an hour or less. And nobody’s waiting an hour between sips when it comes to the Stanley Cup.”

What Increases Risk?

People have put all sorts of things into the Stanley Cup, from dogs to caviar. But the riskiest behavior comes when people put things in the Cup that are likely to be contaminated, such as raw eggs (that’s happened) or babies that are about to poop (that’s happened too).

Beyond that, basic health guidelines suggest that any time someone is drinking from the Cup, you want to make sure they’ve washed their hands first and haven’t thrown up recently. Players who are playing through an illness, for example, could potentially pass it on to the rest of the team. (Players who barfed due solely to athletic exertion likely don’t pose an increased health risk.)

What Is The Biggest Risk?

“If someone is going to contract a disease by drinking out of the Cup, my best guess would be norovirus,” Chapman says. “There are more than 19 million cases of norovirus each year in the U.S., and it is incredibly hardy. In addition, it only takes a little bit to make you sick – on average only a few virus particles are necessary to cause an illness.

“If norovirus got onto the Cup, it could survive there for months. What’s more, you have to take very specific steps to sanitize a surface contaminated with noro.”

However, it’s important to note that cross-contamination can only occur if one of the people handling the Cup is a disease carrier.

So, can drinking out of the Cup spread disease?

“Absolutely,” Chapman says. “But it’s really unlikely.”

Editor’s note regarding the video: Special thanks to Raleigh Center Ice for the ice time, and to the Washington Capitals for providing footage.

FDA announces tattoo ink recalls due to microorganism contamination

There have been a few times in my life that I thought about getting a tattoo. When I was doing my undergrad in molecular biology and genetics, I often talked about getting a double helix on my shoulder. I didn’t.

More recently I’ve thought about getting a digital thermometer on each of my forearms. I haven’t yet.

FDA’s announcement of multiple tattoo inks contaminated with microbes has caused me to take pause again. But, like with food recalls I’m left with as many questions than answers: what microbes? How did they get contaminated? Is this a GMP issue? 

The FDA has become aware of contaminated tattoo inks through its FY2018-2019 inspections of distributors and manufacturers, routine surveys of marketed tattoo inks, and subsequent microbiological analysis of sampled tattoo inks. The FDA has identified 6 tattoo inks contaminated with bacteria harmful to human health. The tattoo inks were manufactured or distributed by 4 firms inspected under an ongoing assignment.

The following tattoo inks have been recalled because they are contaminated with microorganisms:

Scalpaink SC, Scalpaink PA, and Scalpaink AL basic black tattoo inks manufactured by Scalp Aesthetics (all lots)
Dynamic Color – Black tattoo ink manufactured by Dynamic Color Inc  (lots 12024090 and 12026090)
Solid Ink-Diablo (red) tattoo ink manufactured by Color Art Inc. (dba Solid Ink) (dba Antone’s Ink) (lot 10.19.18)

 

Food Safety Talk 181: Hot Pants!

In this super long episode (sort of a double album) Ben and Don talk about their recent travels, PowerPoint as a performance and river cruising. The conversation takes a food safety turn into raw milk goat cheese, bull pizzles and veggie washes. They talk through some listener questions on surviving in the wild, foods they eat (and avoid) and pet food bowls. The show ends with some quick hits on phone cleaning, deli slicer-linked illnesses and geographical differences in pathogen exposure (and how the demise of the Aztec population is like Ontario beef farming).They answer the age-old question of what to do when there’s no paper towels in the restroom. They don’t talk about how the Toronto Maple Leafs are out of the Stanley Cup playoffs.

Food Safety Talk 181:Hot Pants! is available on iTunes and here.

Show notes so you can follow along at home: