But I’ve already been threatened with one lawsuit, and will not indulge further, other than the facts.
The Public Health Agency of Canada is collaborating with provincial public health partners, the Canadian Food Inspection Agency and Health Canada to investigate an outbreak of Salmonella infections involving five provinces: British Columbia, Alberta, Saskatchewan, Manitoba, and Quebec. The illness reported in Quebec was related to travel to British Columbia. At this time, there is no evidence to suggest that residents in eastern Canada are affected by this outbreak.
Based on the investigation findings to date, exposure to long English cucumbers has been identified as the likely source of the outbreak. Many of the individuals who became sick reported eating long English cucumbers before their illness.
(Those would be the ones grown in greenhouses, but I’m just speculating, rather than inviting a lawsuit from the Ontario Greenhouse Vegetable Growers who like to intimidate with threats of lawsuits, but know shit about growing up in Southern Ontario; bring it on).
As of November 27, 2018, there have been 55 laboratory-confirmed cases of Salmonella Infantis illness investigated in the following provinces: British Columbia (47), Alberta (5), Saskatchewan (1), Manitoba (1), and Quebec (1). The individual from Quebec reported traveling to British Columbia before becoming ill. Individuals became sick between mid-June and late-October 2018. Eleven individuals have been hospitalized. No deaths have been reported. Individuals who became ill are between 1 and 92 years of age. The majority of cases (60%) are female.
Between January 16 and April 10, 22 cases of listeriosis occurred across New South Wales, Victoria, Queensland and Tasmania, which led to seven deaths and a miscarriage.
The investigation found the farm that was the source of the outbreak had hygiene and sanitary procedures on par with or better than most rockmelon-growing operations
Dust storms that covered the farm’s paddocks significantly increased the amount of listeria on the fruit
There were other peripheral issues found in the packing facility that were not considered to be major underlying causes
A report released on Thursday by the NSW Department of Primary Industries confirmed those cases were all linked to consumption of rockmelon packed at Rombola Family Farms in Nericon, NSW.
The report said the farm’s hygiene and sanitary procedures were “on par with or better than most other rockmelon-growing operations across Australia”.
Despite this, heavy rains in December and dust storms that followed covered the farm’s paddocks in dust, and “significantly increased” the amount of listeria on the fruit.
Rockmelons on the farm were washed in a chlorine solution and scrubbed prior to packing.
“The wash water was not recirculated, sanitiser was constantly monitored and applied through an auto-dosing system, and all water coming into the facility was treated and considered potable,” the report said.
“The netted skin of rockmelons makes this fruit particularly hard to clean and sanitise.”
The report said there were other peripheral issues noted in the packing facility during the investigation.
These included some dirty fans that were used to reduce the level of moisture on melons after washing, and some spongy material on packing tables that was not able to be easily cleaned.
These may have been contributing factors to the outbreak but were not considered to be the major underlying causes.
The report said the outbreak highlighted the need for better control measures and awareness of external threats to food safety in the rockmelon indstury.
As more cases of listeriosis emerged, sales of rockmelon plummeted and failed to recover.
Fourteen students were transported to St. Olavs Hospital in Trondheim after the hazing incident at NTNU.
This still goes on?
Marit Kvikne, communication director at St. Olavs Hospital says the students “have taken a mixture of vinegar and water, and have had an eternal damage in the oral cavity. There are 14 patients who have come to the emergency room, 10 of which were sent to the hospital. Three are for observation and one receives intensive care.”
Both the vegetables were targeted by the agency’s proactive testing because of their role in previous outbreaks. Because cucumbers are often eaten raw, bacteria on them are more likely to make it into food; raw cucumbers have been blamed in five outbreaks of illness from 1996 to 2014.
Hot peppers, such as jalapeño and serrano peppers, on the other hand, are often cooked but can be a “stealth component” of multi-ingredient dishes, the FDA said. In 2008, hot peppers were implicated in an outbreak that caused 1,500 illnesses, 308 hospitalizations, and two deaths.
The FDA’s proactive sampling program began testing for disease-causing microbes in certain foods in 2014 to learn more about the prevalence of disease-causing bacteria and to help the agency identify patterns that may help predict and prevent future contamination.
The latest findings, released lastThursday, included results from 1,050 cucumber samples and 1,130 hot pepper samples. Eventually 1,600 of each will be sampled.
Of the cucumber samples, 15 tested positive for salmonella. None tested positive for E. coli. Of the hot pepper samples, 35 tested positive for salmonella, and one tested positive for a strain of Shiga toxin-producing E. coli that was determined to be incapable of causing severe illness.
The samples were collected at ports, packing houses, manufacturers, and distributors across the US.
The agency may take enforcement action, such as a recall, on foods that test positive.
In 2014, the FDA started a sampling program for a variety of commodities to learn more about the prevalence of disease-causing bacteria on the commodities.
The microbiological sampling assignments were designed to collect a statistically determined number of samples of certain commodities over 12 to 18 months and test them for certain types of bacteria that can cause foodborne illnesses.
Carlo Nicholson, who was made to drink from a paddling pool full of urine and vomit, said he was left feeling suicidal following the “joining run” event – watched by 80 drunken men – and carried out by 45 Commando, based at Royal Marine Condor in Arbroath in May 2014.
Marine Ian Tennet, 22, Lance Corporal Scott Simm, 26, and James Taylor, 27, who is now a lance corporal in the Royal Marines Reserves, were all sentenced for a charge of ill-treatment of a subordinate.
Tennet was sentenced to 11 months and two weeks’ detention, while Simm and Taylor were both sentenced to eight months.
A fourth defendant, former Marine Ryan Logan, 25, was sentenced to 220 hours of unpaid community work for battery and disgraceful conduct of a cruel kind.
Sentencing the defendants at Portsmouth Naval Base’s court martial centre, Judge Advocate Robert Hill said the event had been “40 minutes of depravity and naked humiliation”.
He said: “The suggestion has been made it was nothing more than a rite of passage, and its purpose was not to humiliate, harm or distress but to harness bonding, and is something all Royal Marines Commandos have gone through – but it’s no more than conduct that brings disgrace on the Commandos involved.”
He said the defendants had been described during the court hearing as “scapegoats” and added: “It is not the purpose of this court to set itself up as a board of inquiry. It has been noted with considerable concern that more senior non-commissioned officers haven’t found their way to the court martial system. Had they done so the likely position they would face is a starting point of a term of imprisonment.”
Military training: During the initiation event, described in court as a “rite of passage”, Mr Nicholson, along with other newcomers to the unit, was forced to run naked around the camp with bottles and milk and lemonade taped to his arms.
He was made to lie down in the paddling pool containing urine and vomit while eggs were thrown at him, as well as to fight other marines while naked and covered in cooking oil.
He was also made to eat dessert spoons of chill, cinnamon and curry powder, eat dog food out of a mess tin while on all fours, eat lard and swallow liquid through a funnel as well as made to consume the contents of a mess tin filled from the paddling pool which also contained a rollmop herring, lard and cider.
I started the Food Safety Network (FSnet) in Jan. 1993.
Lots of people have stolen or borrowed the idea since, but they don’t have a good origin story.
They’re just copycats.
I was a lost genetics graduate student/journalist who happened along to Mansel who let me do what I wanted to do to get a PhD.
And I am forever grateful to him for that.
Back then, the U.S. Centers for Disease Control Morbidity and Mortality Weekly would take about six months to arrive by mail.
I started doing things electronically, because I had e-mail at the University of Waterloo previously.
It would be another three years until Al Gore invented the Internet.
Now, it’s been 20 years since the inauguration of FoodNet.
That the CDC annual data has become so common and is no longer worthy of mention in what remains of the media is an outstanding scientific and policy accomplishment.
The heros of wars – as we gear up for ANZAC Day here in Australia – are usually the grunts and the public folks who toil in obscurity.
I retrieved my grandfather’s medals from WW1 and II when we gathered our final belongings from Kansas last month, not because I thought he was a great person – he wasn’t – but he served, and so much of public health is about serving.
Out of all my professoring moments, the ones that stick with me are positively influencing students – who knew Chapman would stand out, I thought he was Stork in Animal House when I met him – and the folks who serve: public health, military, whatever.
I don’t want to deal with your bureaucracy, but I can respect what you do.
It’s all about service.
To evaluate progress toward prevention of enteric and foodborne illnesses in the United States, the Foodborne Diseases Active Surveillance Network (FoodNet) monitors the incidence of laboratory-confirmed infections caused by nine pathogens transmitted commonly through food in 10 U.S. sites.* This report summarizes preliminary 2015 data and describes trends since 2012.
In 2015, FoodNet reported 20,107 confirmed cases (defined as culture-confirmed bacterial infections and laboratory-confirmed parasitic infections), 4,531 hospitalizations, and 77 deaths. FoodNet also received reports of 3,112 positive culture-independent diagnostic tests (CIDTs) without culture-confirmation, a number that has markedly increased since 2012 (1). Diagnostic testing practices for enteric pathogens are rapidly moving away from culture-based methods. The continued shift from culture-based methods to CIDTs that do not produce the isolates needed to distinguish between strains and subtypes affects the interpretation of public health surveillance data and ability to monitor progress toward prevention efforts. Expanded case definitions and strategies for obtaining bacterial isolates are crucial during this transition period.
FoodNet is a collaboration among CDC, 10 state health departments, the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS), and the Food and Drug Administration (FDA).
FoodNet conducts active, population-based surveillance for laboratory-confirmed infections caused by Campylobacter, Cryptosporidium, Cyclospora, Listeria, Salmonella, Shiga toxin–producing Escherichia coli (STEC), Shigella, Vibrio, and Yersinia in 10 sites covering approximately 15% of the U.S. population (an estimated 49 million persons in 2014). Confirmed infections are defined as culture-confirmed bacterial infections and laboratory-confirmed parasitic infections (e.g., identified by enzyme immunoassay). Positive CIDT results are defined as the detection of antigen or nucleic acid sequences of the pathogen, or for STEC, Shiga toxin or the genes that encode a Shiga toxin, in a stool specimen or enrichment broth using a CIDT.† Positive CIDT results that were confirmed by culture are included only among the confirmed infections. For this analysis, the term “positive CIDT report” refers to positive CIDT results that were not confirmed by culture (either because the specimen was not cultured at the clinical or public health laboratory or because a culture did not yield the pathogen). Hospitalizations occurring within 7 days of specimen collection are recorded. The patient’s vital status at hospital discharge, or 7 days after specimen collection if the patient was not hospitalized, is also captured. Hospitalizations and deaths that occur within 7 days of specimen collection are attributed to the infection.
Incidence of confirmed infections is reported for all FoodNet pathogens and calculated by dividing the number of confirmed infections in 2015 by U.S. Census estimates of the surveillance area population for 2014. A second incidence measurement, calculated by adding positive CIDT reports to confirmed infections, is also reported for Campylobacter, Salmonella, Shigella, and STEC.§ A negative binomial model with 95% confidence intervals (CIs) was used to estimate changes in incidence of infections in 2015 compared with 2012–2014. To describe changes in testing practices, percentage difference in number of positive CIDT reports was calculated for 2015 compared with 2012–2014, by pathogen.
Surveillance for physician-diagnosed postdiarrheal hemolytic uremic syndrome (HUS), a complication of STEC infection, is conducted through a network of nephrologists and infection preventionists and by hospital discharge data review. This report includes HUS data for persons aged <18 years for 2014, the most recent year for which data are available, and compares 2014 incidence with 2011–2013 incidence.
Cases of Infection, Incidence, and Trends
In 2015, FoodNet identified 20,107 confirmed cases of infection, 4,531 hospitalizations, and 77 deaths (Table 1). The number and incidence of confirmed infections per 100,000 population were reported for Salmonella (n = 7,728 [incidence = 15.89]), Campylobacter (6,309 [12.97]), Shigella (2,688 [5.53]), Cryptosporidium (1,612 [3.31]), STEC non-O157 (796 [1.64]), STEC O157 (463 [0.95]), Vibrio (192 [0.39]), Yersinia (139 [0.29]), Listeria (116 [0.24]), and Cyclospora (64 [0.13]). Among confirmed infections, the vast majority were diagnosed only by culture; the exception is STEC, for which most were identified by a CIDT (Table 2).
Among 6,827 (88%) serotyped Salmonella isolates, the top serotypes were Enteritidis, 1,358 (20%); Newport, 816 (12%); and Typhimurium, 739 (11%). Among 175 (91%) speciated Vibrio isolates, 113 (65%) were V. parahaemolyticus, 27 (15%) were V. alginolyticus, and 12 (7%) were V. vulnificus. Among 606 (76%) serogrouped STEC non-O157 isolates, the top serogroups were O26 (32%), O103 (27%), and O111 (18%).
Compared with incidence in 2012–2014, the 2015 incidence of confirmed infections was significantly higher for STEC non-O157 (40% increase; CI = 21%–62%), and Cryptosporidium (57% increase; CI = 20%–106%). No significant changes were observed in 2015 for other pathogens compared with the previous 3-year averages. Among the top three most commonly identified Salmonella serotypes, the incidence in 2015 compared with 2012–2014 was significantly lower for Typhimurium (15% decrease; CI = 4%–25%) and unchanged for Enteritidis and Newport.
FoodNet identified 55 cases of postdiarrheal HUS in children (0.50 cases per 100,000) in 2014; 30 (55%) occurred among children aged <5 years (1.01 cases per 100,000). Compared with 2011–2013, the incidence was significantly lower for all children (27% decrease; CI = 1%–46%) but no change for children aged <5 years was observed.
FoodNet also received 3,112 positive CIDT reports. The number of positive CIDT reports, by pathogen, were Campylobacter (2,021), Shigella (454), Salmonella (361), and STEC (254). These numbers represent an increase in positive CIDT reports in 2015 of 92% for Campylobacter, 284% for Shigella, 247% for Salmonella, and 120% for STEC, when compared with the 2012–2014 averages; the overall increase in CIDT reports for these four pathogens was 122%. Adding positive CIDT reports to confirmed cases resulted in the following incidence rates per 100,000 population: 17.12 for Campylobacter, 16.63 for Salmonella, 6.46 for Shigella, and 3.12 for STEC (Figure). Compared with 2012–2014, the 2015 incidence of confirmed infections plus positive CIDT reports was significantly higher for STEC but not for any other pathogen.
Use of CIDTs is finding cases that were not being previously diagnosed. Among confirmed cases, the incidence of Cryptosporidium and STEC non-O157 infections in 2015 was significantly higher than the average for the previous 3 years. The increase in incidence of STEC non-O157 infections is attributable, in part or in full, to increases in diagnostic testing (2). The proportion of laboratories testing for STEC non-O157 increased to 74% in 2015, compared with 55% in 2012 (FoodNet, unpublished data). The increase in Cryptosporidium follows the pattern observed in national data since 2005 and is likely also driven by increases in diagnostic testing (3,4).
The incidence of Salmonella serotype Typhimurium infections continues to decline, and it has dropped to the third most commonly reported serotype. The use of a live attenuated Typhimurium vaccine in poultry (5), in addition to more stringent performance standards for Salmonella contamination of poultry carcasses (6) might have contributed to this decline. The significant decrease in HUS incidence in 2014 compared with the preceding 3 years (2011–2013) mirrors significant decreases in STEC O157 incidence observed during the same period (7). Efforts are still needed to decrease contamination of produce, beef, and other foods to achieve the Healthy People 2020 goal for STEC O157 of 0.6 cases per 100,000 population.¶
The percentage of infections diagnosed only by CIDTs markedly increased in 2015. Diagnostic testing practices for enteric pathogens are rapidly moving away from culture-based methods, and the impact of this change varies by pathogen. Although CIDTs are still most commonly being used for Campylobacter and STEC, the highest percentage increase in use compared with the previous 3-year average was observed for Shigella and Salmonella, most likely due to laboratories using the newly available DNA-based syndrome panels (FoodNet, unpublished data)
In FoodNet, current methods to assess trends in the incidence of illness caused by bacterial pathogens are based only on culture-confirmed infections. The ability to assess and interpret change is impeded as the number of positive CIDT reports continues to rise because of important limitations in the understanding of CIDTs and possible changes in clinician and laboratory practices surrounding them. For example, analyses need to consider the likelihood of false-positive CIDTs and of CIDTs that are more sensitive than routine culture methods; such characteristics vary among CIDTs. The availability of CIDTs might also increase testing for some pathogens. Surveillance systems need to adapt to these changes by expanding case definitions to include positive CIDT reports. Isolates are still needed for antimicrobial susceptibility testing, serotyping, subtyping, and whole genome sequencing (1); these data are critical for monitoring trends, detecting clusters of illness, and investigating outbreaks. For Salmonella, with serotypes diverse in reservoirs and sources, the inability to distinguish serotypes will prevent tracking of important changes in incidence by serotype, and markedly limit detection and investigation of outbreaks. For STEC, because identification of serogroups requires culture, it is not known which STEC-positive CIDT reports represent O157 versus non-O157.
The findings in this report are subject to at least five limitations. First, increasing use of CIDTs by clinical laboratories might affect the number of culture-confirmed infections reported; use of CIDTs might result in an increase (as seen for STEC non-O157 infections) or decrease (as fewer cases might be diagnosed by traditional methods) in reported incidence. Second, the sensitivity and specificity of CIDTs vary by test type, brand, and other factors; some CIDT reports could be false positives (1). Third, health care–seeking behaviors, access to health services, and other characteristics of the population in the surveillance area might affect the generalizability of the findings. Fourth, the proportion of illnesses transmitted by non-food routes differs by pathogen; data provided in this report are not limited to infections from food.** Finally, changes in incidence between periods can reflect year-to-year variation during those periods rather than sustained trends, and the number of infections and patterns observed might change as final data become available.
The use of CIDTs in clinical laboratories has many advantages. Illnesses can be diagnosed much faster than when culture is required. Also, some CIDTs are becoming available to detect infections caused by pathogens not routinely sought by standard laboratory methods. One of these is enterotoxigenic E. coli, an important cause of travelers’ diarrhea (8).
More work is needed to extend the benefits of CIDT to the public health sector. During this initial period when clinical laboratories are transitioning to the use of CIDTs, reflex culturing†† of specimens with positive CIDT reports should be considered for bacterial pathogens to obtain isolates needed for public health practice. For the future, expedited research and development are needed to create methods to detect the genetic sequences of pathogens directly and rapidly from stool specimens, which has the potential to benefit both clinical and public health practice, because subtype, resistance profile, and other features can be obtained from the genetic sequence.
Infection with Pathogens Transmitted Commonly Through Food and the Effect of Increasing Use of Culture-Independent Diagnostic Tests on Surveillance — Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2012–2015
Weekly / April 15, 2016 / 65(14);368–371
Jennifer Y. Huang, MPH; Olga L. Henao, PhD; Patricia M. Griffin, MD; Duc J. Vugia, MD; Alicia B. Cronquist, MPH; Sharon Hurd, MPH; Melissa Tobin-D’Angelo, MD; Patricia Ryan, MD; Kirk Smith, DVM; Sarah Lathrop, PhD; Shelley Zansky, PhD; Paul R. Cieslak, MD; John Dunn, DVM; Kristin G. Holt, DVM; Beverly J. Wolpert, PhD1; Mary E. Patrick, MPH
Tan Sri Lee Lam Thye (lower left, not exactly as shown), chairman of the National Institute for Occupational Safety and Health (NIOSH), writes that media reports on cases of food poisoning in Malaysia, especially involving students, seem to be on the rise lately.
NIOSH views the matter seriously and would like to urge everyone involved, including the relevant authorities, school administrators, owners of eateries, caterers, food handlers and parents to take appropriate steps to prevent food contamination from becoming a serious health threat.
We do not want to see a repeat of the recent food poisoning case in Batu Gajah, Perak which claimed one life and left several others needing hospital care.
Less than a month after the incident in Batu Gajah, where victims consumed pesticide-contaminated food bought at a stall there, another food poisoning episode took place at Sekolah Menengah Sains Tapah in Perak. In this incident, 43 students and a teacher fell sick after eating roti jala with chicken curry at the hostel. It was later found that the chicken used in the curry was contaminated by salmonella bacteria.
It was the second case of food poisoning reported in the school in the past three years. In October 2013, more than 270 students suffered food poisoning from a chicken dish served at the school’s dining hall.
Students must be protected from not only accidents and crime within the school compound but they should also have access to safe and hygienic food in the canteen or dining hall.
As for food outlets and restaurants, the owners must ensure that people whom they hire must be qualified and practise hygienic and safe food preparation and handling.
In the wake of the recent food poisoning incidents, there should be close monitoring on food preparation and handling as well as frequent checks on eateries and school canteens throughout the country.
In Malaysia, roadside food stalls are mushrooming and frequented by the public who seem to be unsure whether these stall owners have certificates from the Health Ministry or permits from local authorities.
Furthermore, many restaurants, cafes and outlets at food courts today hire foreigners to cook and prepare food.
Tan believes that random checks and on-the-spot compound issued by the ministry and local authorities will help improve the cleanliness of the eateries and ensure safe and hygienic food preparation and handling.
The Health Ministry has to conduct more frequent inspections at all eateries as compared to the current practice of once a year, or when there are food poisoning cases or customer complaints. Local authorities also have to step up their inspection at eateries in their jurisdiction and focus on the roadside stalls to weed out the unlicensed ones.
As for primary school pupils, teachers and parents have to teach them food safety and how to spot spoiled food by using senses like sight, smell and taste.
School administrators or parent-teacher associations have to ensure that sinks in school canteens are properly maintained and soap is provided for the students to clean their hands before and after meals. Consumers have to be conscious of food safety and avoid dirty eateries.
How would consumers know? Foodborne organisms that cause illness cannot be seen. Carrots and sticks, shock and shame, rather than just military-like intervention. Go for full restaurant inspection disclosure.
According to the U.S. Centers for Disease Control, in August 2014, PulseNet, the national molecular subtyping network for foodborne disease surveillance, detected a multistate cluster of Salmonella enterica serotype Newport infections with an indistinguishable pulse-field gel electrophoresis (PFGE) pattern (XbaI PFGE pattern JJPX01.0061).
Outbreaks of illnesses associated with this PFGE pattern have previously been linked to consumption of tomatoes harvested from Virginia’s Eastern Shore in the Delmarva region and have not been linked to cucumbers or other produce items.
To identify the contaminated food and find the source of the contamination, CDC, state and local health and agriculture departments and laboratories, and the Food and Drug Administration (FDA) conducted epidemiologic, traceback, and laboratory investigations. A total of 275 patients in 29 states and the District of Columbia were identified, with illness onsets occurring during May 20–September 30, 2014.
Whole genome sequencing (WGS), a highly discriminating subtyping method, was used to further characterize PFGE pattern JJPX01.0061 isolates. Epidemiologic, microbiologic, and product traceback evidence suggests that cucumbers were a source of Salmonella Newport infections in this outbreak. The epidemiologic link to a novel outbreak vehicle suggests an environmental reservoir for Salmonella in the Delmarva region that should be identified and mitigated to prevent future outbreaks.
Outbreak of Salmonella Newport infections linked to cucumbers — United States, 2014
CDC MMWR 64(06);144-147
Kristina M. Angelo, Alvina Chu, Madhu Anand, Thai-An Nguyen, Lyndsay Bottichio, Matthew Wise, Ian Williams, Sharon Seelman, Rebecca Bell, Marianne Fatica, Susan Lance, Deanna Baldwin, Kyle Shannon, Hannah Lee, Eija Trees, Errol Strain, Laura Gieraltowski,