The stories of ill children are never easy to read

The holidays always remind me that I’m pretty lucky. Neither of my kids has ever been really sick. A few stitches and ear infections are about all we’ve had to deal with. Between skating, playing road hockey, Drake-inspired dance parties and multiple The Force Awakens viewing this week I’ve thought about how good things are.

During non-family, non-hockey times I’m immersed in food safety.2F987B5E00000578-3373030-Nicola_Jackson_39_donated_a_kidney_to_save_her_three_year_old_so-m-17_1450950567932

Reading about the seriousness of the issues and how illnesses happen shouldn’t be a surprise to anyone who works with food – farmers, processors, food handlers (commercial or domestic).

A decade or so into things and you start seeing the same stories and mistakes repeated.

But the narrative is still emotional and shocking when you read about a kid getting sick, like three year-old Reuben Jackson. He picked up E. coli O157 during a visit to a farm, developed HUS and required a kidney transplant. The Daily Mail writes that his mother, according to  Nicola, gave him one of hers.

For Reuben, the infection triggered haemolytic uraemic syndrome (HUS), where blood cells begin destroyed, and start to clog up the filtering system in the kidneys.

Mrs Jackson said: ‘It was a living nightmare. Reuben was in intensive care and then had to have his large intestine removed and a stoma pouch fitted.’

He spent time on dialysis, where a machine filters the blood, and regained around 25 per cent of kidney function, but earlier this year they began to fail again.

The mother-of-two was tested to see if she would be a match to donate a kidney to her son.

When Mrs Jackson received the news that she would be able to donate a kidney, she describes the moment as sheer relief.

She said: ‘I remember thinking at the last test, please let this one be okay, each positive result felt like one step closer.

Mrs Jackson spent four days in hospital, and said Reuben was instantly better after the operation.

She said: ‘It was remarkable to see him. He was instantly better.

‘He was running around the ward and was back to his old, bright self, laughing and being cheeky.’

Now, Reuben has been selected as a Little Hero by the baby and toddler swim school Water Babies as – with the agreement of doctors – he swam throughout his treatment.

‘Reuben’s time in the pool is his fun time, he just loves it,’ Mrs Jackson said.

That’s a good end to a terrifying story.

5 sick; help animals on Isle of Man, get Campylobacter

About five cases of Cryptosporidium and Campylobacter have been reported on the island during the past three months.

It is thought some of those affected may have been involved in helping snow-cow_1216616ifarmers to rescue livestock after heavy snow last month.

Food Safety Manager Ivan Bratty told BBC that  simple precautions must be taken.

“These recent cases serve as a timely reminder of the importance of thorough hand washing after handling livestock and before preparing or handling food to prevent infection and the spread of disease in the community,” he said.

“It is also important for anyone suffering from diarrhoea to avoid swimming pools as Cryptosporidium can survive in chlorinated water.”

Food safety is never simple.

Two outbreaks of diarrhea in nurseries in Norway after farm visits, April to May 2009

As the parents of two young children file a lawsuit against the Cleveland County Fair, part of the 106 sickened and one death from E. coli O157, Eurosurveillance reports on two separate outbreaks of shiga-toxin producing E. coli in two nurseries where the children had recently visited farms  in Norway in 2009. The nursery outbreaks probably wouldn’t have been noticed except for the increased awareness in Norway at the time due to an on-going outbreak of E coli O157 that sickened 13 children and led to one death.

A table of petting zoo outbreaks is available at

Abstract below.

During a 2009 nationwide outbreak of sorbitol-fermenting Escherichia coli O157 in Norway, the Norwegian Institute of Public Health was notified of diarrhea outbreaks in two nurseries. A link to the nationwide outbreak was suspected and investigated, including retrospective cohort studies. Both nurseries had recently visited farms.

Fecal specimens were obtained from symptomatic children as well as from the farm animals and tested for Campylobacter, Salmonella, Yersinia, Shigella and pathogenic E. coli, and isolates were further characterized.  Nursery A had 12 symptomatic children, and we found the same strain of C. jejuni in feces from children and lambs. Nursery B had nine symptomatic children, including one child with bloody diarrhoea carrying enterohaemorrhagic E. coli (EHEC) O26. EHEC O26 with a similar multiple-locus variable number tandem repeat analysis (MLVA)-profile was found in sheep.  Five children had enteropathogenic E. coli (EPEC) O76. 

Animals were not tested for EPEC O76. We found no significant association between illness and risk factors for either nursery. The isolated pathogens differed from the one involved in the nationwide outbreak. In each nursery outbreak, the pathogens isolated from children matched those found in farm animals, implicating animal feces as the source. Hygiene messages are important to prevent similar outbreaks.

Don’t kiss animals and avoid poop: child hospitalised by E coli from cowpat in park, 6 others infected

A child has been taken to hospital after cowpats in a park caused an E. coli O157 outbreak.

Seven people, including five children under eight, have been infected with E. coli O157 from the same park in Birmingham in recent weeks.

The Health Protection Agency said the likely cause was cowpats and rabbit droppings.

Sutton Park, in Sutton Coldfield, covers around 2,400 acres and is thought to attract around two million visitors annually.

Cows are free to roam around the park – sharing space with the public.

Designated a National Nature Reserve, the former royal deer park is included in English Heritage’s list of historic parks and gardens, and includes sites of archaeological interest.

HPA’s Dr Roger Gajraj said, “The council is increasing hand-washing facilities at the park and the city council and HPA are issuing leaflets and displaying posters to warn visitors of the risks and advise on preventative measures. …  I would also advise cyclists and walkers to wash their tyres, footwear and their hands after visiting Sutton Park as an extra precaution.

Darren Share, Birmingham City Council’s head of parks said, “… we feel it is appropriate at this stage to warn parents and families of the potential risks. There are signs throughout the park.” 

7 sick with E. coli O157 linked to UK park

Seven people have been infected with E. coli O157 at Sutton Park in Sutton Coldfield over July and August.

Five of the cases involved children under eight years old, according to the Health Protection Agency. All patients have since recovered.

BBC News reports posters and leaflets have been issued, but the HPA said parents may want to use other parks for the time being.

Dr Roger Gajraj, a consultant with the HPA’s West Midlands East Health, said extra hand washing facilities had been set up in the park.

Posters issued by Birmingham City Council in Sutton Park recommended keeping children and pets away from grazing animals and washing hands, particularly before eating or drinking.

They also advised washing shoes and bicycle and pushchair wheels after a visit to the park.

Challenges, opportunities, needs in animal agriculture

 A new report concludes decision makers must understand the relationship between animal health and food safety, which the authors say is sorta complex.

The Council for Agricultural Science and Technology (CAST) has published a review of research titled, “The Direct Relationship between Animal Health and Food Safety Outcomes” and is available at

Developed by the National Institute for Animal Agriculture, the White Paper synthesizes information 50-plus experts presented at NIAA’s recent Annual Conference, five species committees?bovine, equine, poultry, small ruminant and swine?and six councils?Animal Care; Animal Health, Emergency Management; Animal Identification and Information Systems; Antibiotics; Emerging Diseases; and Global Animal Health, Food Security and Trade.

177 died from E. coli O157:H7 in a 1999 outbreak in China

 Who knew?

The largest, most-fatal outbreak of E. coli O157 or other shiga-toxin producing E. coli wasn’t sprouts in Germany in 2011, wasn’t roast beef in Scotland in 1996 or Ontario in 1985, wasn’t Japan in 1996 in radish sprouts.

It was in Xuzhou, China, in 1999: 177 dead, 195 hospitalized with hemolytic uremic syndrome. An estimate of the number sickened was not available.

A new paper by Chinese researchers examining the E. coli O157:H7 virulence factors involved in the outbreak strain dryly notes, “A less well known massive outbreak of O157:H7 occurred in, China, in 1999 … which has only been reported in Chinese journals.”

Those extra languages could really come in handy.

The authors write in PLoS ONE today that,

“The O157:H7 outbreak occurred between April and September and peaked in June, 1999 with 195 HUS cases and 177 deaths from 52 villages of seven counties in Jiangsu and neighboring Anhui province. Of the 195 cases, 167 (85.6%) were over 50 years old with only two less than 20 years old and 121 (62.1%) were female. The National Institute for Communicable Disease Control and Prevention, China CDC, commenced the outbreak investigation on June 28, 1999.

“Three and two strains of O157:H7 were isolated in Xuzhou city from fecal screening of 30 HUS and 25 diarrhea patients respectively. Thirty six sera collected from 42 HUS patients (85.7%) tested positive for IgG against EHEC-hemolysin or O157 lipopolysaccharide. Thus both bacterial and serological data confirmed that the outbreak was caused by O157:H7. The source of the infection was investigated using a case-control sample of 146 HUS patients and 840 healthy individuals, matched in age, sex and residence. No hand-washing before eating, consumption of fruits or vegetables without washing, consumption of leftover foods without heating, no fly-net cover for foods and high density of flies in kitchen were found to be statistically associated with infected patients. Using magnetic beads coated with antibodies against the O antigen, O157:H7 was isolated from six of 67 (9.0%) fly specimens, four of 74 (5.4%) raw meats and three of 83 (3.6%) cooked meats. O157:H7 was also isolated from live animals including 32 of 189 (16.9%) cattle, 50 of 605 (8.3%) pigs, 91 of 590 (15.4%) goats and 52 of 604 (8.6%) chickens raised in courtyards of families with and without HUS patients in the same villages.

“From the epidemiological investigations, the outbreak was mainly associated with peasants living with animals carrying O157:H7 in the household, including goats, pigs, chickens and cattle. Courtyard animals carrying O157:H7 contaminated the surrounding environment through fecal shedding and persons who had poor personal and kitchen hygiene practice were more likely to be infected. It is well established that farm animals are carriers of O157:H7. Additionally we found that 9% of the flies tested were positive for O157:H7 and thus they are important carriers in this outbreak. Flies may not just be mechanical vectors as O157:H7 can multiply inside the fly’s mouth and be excreted through fly fecal matter. Therefore poor hygiene and multiple routes of transmission may be the major contributing factors to the massive outbreak. However, increased transmission would have expected to increase number of infections but not higher number of HUS rate and high mortality rate. Host factors may contribute to higher mortality with a disproportional number of HUS cases and deaths in the older age groups. We showed that the outbreak was caused by a new sequence type, ST96.”

Abstract below:

A novel Escherichia coli O157:H7 clone causing a major hemolytic uremic syndrome outbreak in China***
PLoS ONE 7(4): e36144.
Yanwen Xiong, Ping Wang, Ruiting Lan, Changyun Ye, Hua Wang, Jun Ren, Huaiqi Jing, Yiting Wang, Zhemin Zhou, Xuemei Bai, Zhigang Cui, Xia Luo, Ailan Zhao, Yan Wang, Shaomin Zhang, Hui Sun,Lei Wang, Jianguo Xu
An Escherichia coli O157:H7 outbreak in China in 1999 caused 177 deaths due to hemolytic uremic syndrome. Sixteen outbreak associated isolates were found to belong to a new clone, sequence type 96 (ST96), based on multilocus sequence typing of 15 housekeeping genes. Whole genome sequencing of an outbreak isolate, Xuzhou21, showed that the isolate is phylogenetically closely related to the Japan 1996 outbreak isolate Sakai, both of which share the most recent common ancestor with the US outbreak isolate EDL933. The levels of IL-6 and IL-8 of peripheral blood mononuclear cells induced by Xuzhou21 and Sakai were significantly higher than that induced by EDL933. Xuzhou21 also induced a significantly higher level of IL-8 than Sakai while both induced similar levels of IL-6. The expression level of Shiga toxin 2 in Xuzhou21 induced by mitomycin C was 68.6 times of that under non-inducing conditions, twice of that induced in Sakai (32.7 times) and 15 times higher than that induced in EDL933 (4.5 times). Our study shows that ST96 is a novel clone and provided significant new insights into the evolution of virulence of E. coli O157:H7.

Four more cases of cryptosporidium on Welsh farm

itv News reports four more people have been diagnosed with cryptosporidiosis linked to the outbreak at Greenmeadow Community farm in Cwmbran, Wales.

It brings the total number of cases to eight. All were either members of staff or volunteers who bottle fed unwell animals. The animals have now been removed from the farm.

Public Health Wales say extra control measures are in place to ensure that risks to farm visitors and staff are kept to a minimum.

Man tries to smuggle live baby bear, panthers, leopards and monkeys in suitcase at Thailand airport

Students travelling home to live in your parent’s basement after graduation today – don’t try this.

Noor Mahmoodr, a 36-year-old citizen of the United Arab Emirates, was detained soon after midnight by undercover officers at a Bangkok airport with a baby bear, a pair of panthers, two leopards and some monkeys – all aged under two months – in his cases.

The man, who was trying to get the creatures onto a first-class flight to Dubai from Suvarnabhumi airport, was charged with smuggling endangered species out of Thailand, according to Colonel Kiattipong Khawsamang of the Nature Crime Police.

He said one of the bags had been abandoned in an airport lounge because the animals were being too noisy.

The animals were taken into the care of local veterinarians.

Measures to prevent disease associated with animals in public settings, 2011

Run a petting zoo? A state fair? Farm visits? Then this is the most comprehensive summary of everything to be done so people don’t barf.

It’s a tad more than signs that say, “Wash your hands.”

The National Association of State Public Health Veterinarians, Inc. (NASPHV) along with the U.S. Centers for Disease Control and a bunch of other public and animal health groups have updated guidelines for interacting with animals. The summary is below. The complete report is available at

Our table of petting zoo outbreaks is available at

Certain venues encourage or permit the public to be in contact with animals, resulting in millions of human-animal interactions each year. These settings include county or state fairs, petting zoos, animal swap meets, pet stores, feed stores, zoologic institutions, circuses, carnivals, educational farms, livestock-birthing exhibits, educational exhibits at schools and child-care facilities, and wildlife photo opportunities. Although human-animal contact has many benefits, human health problems are associated with these settings, including infectious diseases, exposure to rabies, and injuries. Infectious disease outbreaks have been caused by Escherichia coli O157:H7, Salmonella species, Cryptosporidium species, Coxiella burnetii, Mycobacterium tuberculosis, ringworm, and other pathogens. Such outbreaks have substantial medical, public health, legal, and economic effects.

This report provides recommendations for public health officials, veterinarians, animal venue staff members, animal exhibitors, visitors to animal venues, physicians, and others concerned with minimizing risks associated with animals in public settings. The recommendation to wash hands is the most important for reducing the risk for disease transmission associated with animals in public settings. Other important recommendations are that venues prohibit food in animal areas and include transition areas between animal areas and nonanimal areas, visitors receive information about disease risk and prevention procedures, and animals be properly cared for and managed. These updated 2011 guidelines provide new information on the risks associated with amphibians and with animals in day camp settings, as well as the protective role of zoonotic disease education.