Zoe Drewett of Metro wrote in August that a man from South Korea became infected with a potentially deadly flesh-eating bacteria which caused painful black ulcers to grow across his skin 12 hours after indulging in the raw seafood. The infection was so bad that he had to have his hand and forearm amputated 25 days later.
The 71-year-old man went to hospital after two days of fever and excruciating pain in his left hand that had developed 12 hours after eating raw seafood Medics drained the blisters before deciding his limb could not be saved because the unnamed man’s skin had started rotting so badly. The pensioner visited doctors in Jeonju, South Korea, after experiencing excruciating pain in his hand for two days. His story, published in the New England Journal of Medicine, took a turn when a blister on the palm of his hand grew to 3.5cm by 4.5cm – approximately the size of a golf ball.
Whole genome sequencing (WGS) has been widely used in traceability of foodborne outbreaks. Here, an interesting connection between Cronobacter sakazakii and foodborne gastroenteritis (AGE) was noticed. In October 2016, an acute AGE outbreak affecting 156 cases occurred in a local senior high school.
Case-control study including 70 case-patients and 295 controls indicated a strong association between eating supper at school canteen of the outbreak onset and AGE, as revealed by the Odds Ratio (OR: 95.32). Six recovered Cronobacter strains were evaluated and compared using pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and WGS. A phylogenetic tree of whole genomic single nucleotide polymorphisms (wgSNPs) were generated to traceback the potential contamination source in this outbreak. C. sakazakii isolates S2 from a patient’s rectal swab and S4 from leftover food sample shared identical PFGE pattern and sequence type (ST73), and clustered tightly together in the SNP phylogenetic tree. C. sakazakii isolates S5 and S6 from food delivery containers were both ST4 but with different PFGE patterns. Cronobacter isolates S1 and S3 from two patients’ rectal swab were sequenced to be C. malonaticus and shared another same PFGE pattern with the same ST567.
The interesting feature of this study was the implication of C. sakazakii as a causative agent in foodborne AGE occurring in healthy adults, although C. sakazakii is considered as an opportunistic pathogen and generally affects neonates, infants and immuno-compromised adults.
An investigation of an acute gastroenteritis outbreak: Cronobacter sakazakii, a potential cause of foodborne illness
Frontiers in Microbiology, doi: 10.3389/fmicb.2018.02549
Shannon M. Casillas, Carolyne Bennett and Anne Straily of the U.S. Centers for Disease Control write in Morbidity and Mortality Weekly that cyclosporiasis is an intestinal illness caused by the parasite Cyclospora cayetanensis through ingestion of fecally contaminated food or water.
Symptoms of cyclosporiasis might include watery diarrhea (most common), loss of appetite, weight loss, cramping, bloating, increased gas, nausea, and fatigue. Typically, increased numbers of cases are reported in the United States during spring and summer; since the mid-1990s, outbreaks have been identified and investigated almost every year. Past outbreaks have been associated with various types of imported fresh produce (e.g., basil, cilantro, and raspberries) (1). There are currently no validated molecular typing tools* to facilitate linking cases to each other, to food vehicles, or their sources. Therefore, cyclosporiasis outbreak investigations rely primarily on epidemiologic data.
The 2018 outbreak season is noteworthy for multiple outbreaks associated with different fresh produce items and the large number of reported cases. Two multistate outbreaks resulted in 761 laboratory-confirmed illnesses. The first outbreak, identified in June, was associated with prepackaged vegetable trays (containing broccoli, cauliflower, and carrots) sold at a convenience store chain in the Midwest; 250 laboratory-confirmed cases were reported in persons with exposures in three states (illness onset mid-May–mid-June) (2). The supplier voluntarily recalled the vegetable trays (3).
The second multistate outbreak, identified in July, was associated with salads (containing carrots, romaine, and other leafy greens) sold at a fast food chain in the Midwest; 511 laboratory-confirmed cases during May–July occurred in persons with exposures in 11 states who reported consuming salads (4). The fast food chain voluntarily stopped selling salads at approximately 3,000 stores in 14 Midwest states that received the implicated salad mix from a common processing facility (5).
The traceback investigation conducted by the Food and Drug Administration (FDA) did not identify a single source or potential point of contamination for either outbreak.
In addition to the multistate outbreaks, state public health authorities, CDC, and FDA investigated cyclosporiasis clusters associated with other types of fresh produce, including basil and cilantro. Two basil-associated clusters (eight confirmed cases each) were identified among persons in two different states who became ill during June. Investigation of one cluster, for which the state health department conducted an ingredient-specific case-control study, found consumption of basil to be significantly associated with illness. A formal analytic study was not conducted for the other cluster, but all patients reported consuming basil. Three clusters associated with Mexican-style restaurants in the Midwest have resulted in reports of 53 confirmed cases in persons who became ill during May–August. Analytic studies were conducted for two clusters; consumption of cilantro was found to be significantly associated with illness in both. Although a formal analytic study was not possible for the third cluster, all 32 identified patients reported consuming cilantro at the restaurant. FDA traceback of the basil and cilantro from these clusters is ongoing. Additional clusters associated with Mexican-style restaurants were identified in multiple states; but investigations to determine a single vehicle of infection were unsuccessful because of small case counts, limited exposure information, or because fresh produce items (including cilantro) were served as components of other dishes (e.g., in salsa).
Many cases could not be directly linked to an outbreak, in part because of the lack of validated molecular typing tools for C. cayetanensis. As of October 1, 2018, a total of 2,299 laboratory-confirmed cyclosporiasis cases† have been reported by 33 states in persons who became ill during May 1–August 30 and did not have a history of international travel during the 14 days preceding illness onset. Approximately one third of these cases were associated with either the convenience store chain outbreak or the fast food chain outbreak.
The median patient age was 49 years (range = <1–103 years) and 56% were female (1,288 of 2,285). At least 160 patients were hospitalized; no deaths have been reported.
The 2,299 domestically acquired, laboratory-confirmed cases reported in persons who became ill during May–August 2018 are markedly higher than the numbers of cases reported for the same period in 2016 (174) and 2017 (623). This increase might be due, in part, to changes in diagnostic testing practices, including increased use of gastrointestinal molecular testing panels. CDC is working with state public health partners to determine whether and to what extent changes in testing practices might have contributed to increased case detection and reporting.
Consumers should continue to enjoy fresh produce as part of a well-balanced diet. To reduce risk from most causes of foodborne illness and other contaminants, CDC recommends washing fresh fruits and vegetables with clean running water; however, washing, including use of routine chemical disinfection or sanitizing methods, is unlikely to kill C. cayetanensis. Persons with diarrheal illness that lasts >3 days or who have any other concerning symptoms should see a health care provider if they think they might have become ill from eating contaminated food.
Contributing state and local public health department personnel; Food and Drug Administration
Nearly one dozen customers reached out to Pasha Mediterranean Grill in the 9300 block of Wurzbach Road and reported getting sick after dining at the restaurant, according to an inspection report from the San Antonio Metropolitan Health Department.
The restaurant’s managers also stated at least two employees had been sick with and reported symptoms of fever and diarrhea.
The manager told Metro Health that raw chicken and beef were discarded as a precaution after it was prepared by food handlers.
According to Food Safety Magazine, since 2014, the U.S. Food and Drug Administration (FDA) has been trying a new approach to produce sampling to assess microbial contamination in food commodities. The approach involves collecting a statistically-valid number of samples of targeted foods over a 12-18 month period, then identifying common microbial factors among them.
For fiscal year 2018, FDA had already been sampling fresh herbs, specifically basil, parsley, and cilantro, along with processed avocado and guacamole–all from both domestic and imported sources. The fresh herbs were chosen for sampling because they are eaten without having gone through any type of kill step (ie. cooking) to reduce or eliminate pathogens. Also, these items are grown low to the ground, which makes them susceptible to contamination. Initially, the sampling was to measure the prevalence of Salmonella and Shiga toxin-producing E. coli (STEC) in these herbs.
Recently, FDA added a new test to this sampling group: Cyclospora cayetanensis. The agency has a new analytical testing method for this parasite.
And my kid is really into this song; also no explanation.
Mariam Nabbout of Step Feed reports 103 wedding guests got food poisoning from meals they were served at a marriage ceremony. Before the arrests, the incident was reported to Al Zakazik Police Station, who then launched an investigation into the matter.
Samples of the meal were sent to a lab for testing
Police have since obtained samples of the food served at the wedding from leftovers stored at the groom’s house. The rice and meat dish that was served to the guests will now be tested for suspected contamination.
Crypto, which commonly refers to both the parasite and the diarrheal disease that it causes, cryptosporidiosis, infects humans and animals. It is a serious problem in developing countries, where it is a leading cause of life-threatening diarrhea in children under two. Now cases reported in the U.S. are increasing.
Swallowing one mouthful of crypto-contaminated water can cause illness. While most people recover after a few weeks of significant gastrointestinal upset, young children, the elderly, and the immunosuppressed can face chronic infection, wasting, cognitive impairment, and even death.
No vaccine exists, and the sole FDA-approved drug for crypto is, paradoxically, ineffective in people with weakened immune systems.
A major roadblock to developing drugs is the fact that crypto oocysts—the infectious form of the parasite that thrives in the small intestine—are impossible to cultivate under laboratory conditions, explained Saul Tzipori, distinguished professor of microbiology and infectious diseases at Cummings School, who has made the study of crypto and other intestinal diseases his life’s work.
To produce oocysts for scientific investigation, crypto must therefore be grown in host animals. The process is expensive, time-consuming, and cumbersome.
“To evaluate and optimize prototype vaccines and test them in humans we need to use the same source, age, viability, quality, and quantity of oocysts. This is impossible with available methods, which necessarily involve variation,” said Tzipori, who is also the Agnes Varis Chair in Science and Society and chair of the Department of Infectious Disease and Global Health.
Now Tzipori and his team, in collaboration with researchers at Massachusetts General Hospital, have developed a way to rapidly freeze crypto oocysts, preserve their infectiousness indefinitely, and thaw them as needed for study. The researchers recently published their discovery, which was supported by the Bill & Melinda Gates Foundation, in Nature Communications.
For the past forty years, scientists have tried to keep crypto oocysts for later use by freezing them—a process called cryopreservation—using slow cooling, “but those methods didn’t yield infectious oocysts,” explained the paper’s co-first author, Justyna Jaskiewicz, a veterinarian who is pursuing a Ph.D. in biomedical sciences as a member of Tzipori’s lab. The group discovered that the oocysts’ impermeable walls kept out cryoprotective agents—chemicals that are typically used to prevent formation of harmful ice crystals by replacing intracellular water. As a result, sharp ice crystals formed, which punctured and damaged the oocysts’ infectious interior.
To help tackle this problem, Tzipori’s team tapped the expertise of Massachusetts General’s Center for Engineering in Medicine, whose co-founder, Mehmet Toner, is widely known for advances in low-temperature biology and tissue stabilization.
The solution turned out to be bleaching the oocysts to make their walls permeable before soaking them in protective chemical agents.
Oocysts in solution were then loaded into cylindrical glass microcapillaries about three inches long and 200 microns in diameter—the diameter of about four human hairs—and plunged into liquid nitrogen at -196 degrees Celsius (about -320 Fahrenheit). Almost immediately, the oocyst solution morphed into a glasslike solid free of ice crystals.
“Unlike standard cryopreservation, where cells are slowly cooled, our technique vitrified the oocysts almost instantaneously. Vitrification is an ice-free method that cools cells so rapidly that crystals don’t form,” said Rebecca Sandlin, an investigator at the Center for Engineering in Medicine and co-first author on the paper.
Oocysts thawed three months later were 50 to 80 percent viable and still infectious in mice. The researchers believe such cryopreservation will last indefinitely. They hope to increase the volume of oocysts frozen and test the methodology with other strains of the parasite.
The discovery is just the latest from Tzipori’s far-ranging research on a host of globally important infectious diseases, from E. coli to dengue fever.
Tzipori believes ultrafast cooling will benefit scientists worldwide in addition to advancing his own work on crypto drug discovery and vaccine development.
“For the first time, we can produce the crypto parasite—including unique or genetically modified strains—in large quantities, without need for constant passage through animals, uniformly cryopreserved, and ship it to other investigators in liquid nitrogen that can be stored indefinitely and used at any time,” he said. “This capability has existed for other pathogens, but never for crypto.”
I wonder about prion diseases because I watched my grandfather degenerate from Alzheimers, and carried my suicidal grandmother into the Barrie, Ontario (that’s in Canada) hospital when I was 20 (that’s her, right, when I was a kid)
It sucked, and has scared me for 35 years.
But after years of therapy, I may be learning to deal with it.
My first book in 1997 was called Mad Cows and Mothers Milk for a reason.
A very personal reason.
A new study has shed light on the mechanisms underlying the progression of prion diseases and identified a potential target for treatment.
Prion diseases are a group of fatal neurological disorders that includes Creutzfeldt-Jakob disease and bovine spongiform encephalopathy (“mad cow disease”). They are caused by the spread of “prions”, which are altered forms of normal cellular proteins. These abnormal molecules then interact with normal proteins to promote misfolding. While we understand that this process of converting normal to abnormal protein is what causes the symptoms of prion disease (including rapidly progressive dementia, seizures and personality changes), the exact mechanism of damage to the neuronal connections in the brain and spinal cord has been poorly understood.
Researchers from Boston University School of Medicine (BUSM) used a method they previously described for culturing nerve cells from the hippocampal region of the brain, and then exposing them to prions, to illustrate the damage to nerve cell connections usually seen in these diseases. They then added a number of different chemical compounds with known inhibitory effects on cellular responses to stressful stimuli, with the objective of identifying which pathways may be involved.
They found that inhibition of p38 MAPKα (an enzyme that typically responds to stress, such as ultraviolet radiation and heat shock) prevented injury to nerve connections and promoted recovery from the initial damage. Hippocampal nerve cells that had a mutation preventing normal function of p38 MAPKα were also protected, seeming to confirm the role the enzyme plays in this disease process.
David. A. Harris, MD, PhD, professor and chair of the Department of Biochemistry at Boston University School of Medicine and corresponding author of the study, sees these findings as a major breakthrough in trying to understand and treat these diseases. “Our results provide new insights into the pathogenesis of prion diseases, they uncover new drug targets for treating these diseases, and they allow us to compare prion diseases to other, more common neurodegenerative disorders like Alzheimer’s disease.”
The Virginia and Georgia departments of health are investigating a multistate outbreak of psittacosis occurring at two poultry slaughter plants owned by a single corporation. The U.S. Centers for Disease Control (CDC) and the U.S. Department of Agriculture (USDA) are assisting with the investigation.
Contact a healthcare professional if you have fever, cough, headache, or muscle aches after working at a poultry slaughter plant involved in the outbreak. Tell your healthcare professional that you may have been exposed to psittacosis. Healthcare professionals can treat psittacosis with antibiotics.
During August–September 2018, psittacosis cases were reported among workers at two poultry slaughter plants in Virginia and Georgia. A single corporation owns both plants.
Chlamydia psittaci, the type of bacteria that causes psittacosis, was detected by a laboratory test in 10 people. Additional illnesses in workers at the two plants have been identified, although have not been confirmed by the laboratory.
No deaths have been reported.
Virginia and Georgia departments of health are conducting an investigation, and the number of cases is likely to change.
Current evidence indicates that all of the people who have psittacosis work at poultry slaughter plants in two states: Virginia and Georgia. Investigators are still working to understand why the outbreak occurred.
The affected plants in Virginia and Georgia voluntarily suspended operations for cleaning.
On September 8, 2018, the affected plant in Virginia suspended operations. The plant reopened on September 18, 2018.
On September 15, 2018, the affected plant in Georgia suspended operations. The plant reopened on September 19, 2018.
Plant management held town hall meetings in both plants to inform their workers about the outbreak.
CDC will provide updates when more information is available.
The most common way someone gets infected with the bacteria that cause psittacosis (Chlamydia psittaci) is by breathing in dust containing dried secretions (e.g., droppings, respiratory) from infected birds. There is no evidence that these bacteria can spread by preparing or eating chicken meat.
It is rare for psittacosis to spread from person to person. In this outbreak, infection among family members who are not workers at the affected plants has not been reported.