Party on: It’s Global Handwashing Day- October 15

Kids, kids. It’s global handwashing day.

Join CDC expert, Dr. Vincent Hill for a Facebook Live handwashing demonstration on October 15 at 11:00 AM EDT in observance of Global Handwashing Day. Global Handwashing Day is an occasion to support a global and local culture of handwashing with soap, and promote handwashing with soap as an easy and affordable way to prevent disease in communities around the world.

The Facebook Live presentation will feature a handwashing contest between two volunteers to help viewers understand the importance of proper handwashing techniques. Tune in via CDC Facebook at www.facebook.com/cdcgov

I don’t do hashtags.

2299 confirmed sick from Cyclospora in US from multiple outbreaks May 1-Aug. 30, 2018

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.

Acknowledgments

Contributing state and local public health department personnel; Food and Drug Administration

14 sick from Salmonella linked to Gravel Ridge Farms Shell Eggs

On September 8, 2018, Gravel Ridge Farms recalled cage-free large eggs because they might be contaminated with Salmonella.

Do not eat, sell, or serve recalled Gravel Ridge Farms cage-free large eggs.

Gravel Ridge Farms recalled packages of a dozen and 2.5 dozen eggs in cardboard containers with UPC code 7-06970-38444-6.

Recalled eggs have “best if used by” dates of July 25, 2018 through October 3, 2018.

Recalled eggs were sold in grocery stores and to restaurants in Alabama, Georgia, and Tennessee. For a full list of locations where recalled eggs were sold, visit the FDA website.

Return any Gravel Ridge Farms eggs to the store for a refund or throw them away, regardless of the “best if used by” date. Even if some eggs were eaten and no one got sick, do not eat them.

Wash and sanitize drawers or shelves in refrigerators where recalled eggs were stored. Follow these five steps to clean your refrigerator.

Contact a healthcare provider if you think you got sick from eating recalled Gravel Ridge Farms shell eggs.

Consumers and restaurants should always handle and cook eggs safely to avoid foodborne illness from raw eggs. It is important to handle and prepare all fresh eggs and egg products carefully.

Eggs should be cooked until both the yolk and white are firm. Scrambled eggs should not be runny. Egg dishes such as casseroles and quiches should be cooked to an internal temperature of 160°F or hotter.

Make sure that foods that contain raw or lightly cooked eggs, such as eggs over easy or hollandaise sauce, are made only with pasteurized eggs. Pasteurization kills disease-causing germs.

Wash hands and items that came into contact with raw eggs—including countertops, utensils, dishes, and cutting boards—with soap and water.

And a song dedicated to my high school girlfriend, Susie.

Multistate outbreak of Vibrio parahaemolyticus infections linked to fresh crab meat imported from Venezuela

The U.S. Centers for Disease Control (CDC), is getting in on the vibrio outbreak linked to crab meat imported from Venezuela – often posing as Maryland crab – along with state and local health officials, and the U.S. Food and Drug Administration.

CDC recommends that consumers not eat, restaurants not serve, and retailers not sell fresh crab meat imported from Venezuela at this time.

How would consumers know? Ask questions?

Consumers are not the critical control point of this food safety system.

Yet my 9-year-old knew enough to ask if the aioli that was served with her chips at a hockey tournament in Newcastle, Australia, this was weekend, contained raw egg.

I wasn’t around, but a shiver of pride went through my body.

This type of product may be labeled as fresh or precooked. It’s commonly found in plastic containers.

Food contaminated with Vibrio parahaemolyticus usually looks, smells, and tastes normal.

Steamed crab meat from blue crab (close up)

If you buy crab meat and do not know whether it is from Venezuela, do not eat, serve, or sell it. Throw it away.

CDC, state and local health officials, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Vibrio parahaemolyticus infections linked to eating fresh crab meat imported from Venezuela.

Epidemiologic evidence indicates that precooked fresh crab meat imported from Venezuela is the likely source of this outbreak.

Twelve people infected with Vibrio parahaemolyticus who ate fresh crab meat have been reported from Maryland, Louisiana, Pennsylvania, and the District of Columbia.

Four people (33%) have been hospitalized. No deaths have been reported.

Illnesses started on dates ranging from April 1, 2018 to July 3, 2018.

100 sick from Salmonella in 33 states: Kellogg’s Honey Smacks Cereal still suck and still being sold

The U.S. Food and Drug Administration (FDA) has become aware that recalled Kellogg’s Honey Smacks cereal are still being offered for sale. All Honey Smacks cereal was recalled in June 2018.

Retailers cannot legally offer the cereal for sale and consumers should not purchase Kellogg’s Honey Smacks cereal.

The FDA has learned that some retailers are still selling this product. The FDA will continue to monitor this situation closely and follow up with retailers as we become aware of recalled products being offered for sale. Additionally, the public is urged to report any product being offered for sale to the FDA Consumer Complaint Coordinator in their region. More information about the recall can be found at FDA.gov.

The FDA, CDC, along with state and local officials are investigating a multi-state outbreak of Salmonella Mbandaka infections linked to Kellogg’s Honey Smacks sweetened puffed wheat cereal.

The CDC reports that 100 people in 33 states have become ill. There have been 30 hospitalizations and no deaths.

Following discussion with FDA, CDC, and state partners, the Kellogg Company voluntarily recalled Kellogg’s Honey Smacks cereal. The recalled products were distributed across the United States including Guam and Saipan and internationally. Consumers should not eat any Honey Smacks cereal.

As this is an ongoing investigation, the FDA will update this page as more information becomes available, such as product information, epidemiological results, and recalls.

The FDA provided a more detailed a list of foreign countries to which the Kellogg’s Honey Smacks cereal was distributed.. Here is the list of the foreign countries: Aruba/Curaçao/Saint Maarten (Netherlands Antilles), the Bahamas, Barbados, Tortola (British Virgin Islands), Costa Rica, Guatemala, Haiti, Mexico, Panama, and Tahiti (French Polynesia).

The FDA is advising consumers to not eat and to discard any Kellogg’s Honey Smacks cereal. This is regardless of size or “best if used by” dates. The recall notice accounts for all of the product that is on the market within the cereal’s estimated one year shelf-life. However, Honey Smacks products with earlier dates could also potentially be contaminated.  

The FDA quickly initiated an inspection at the contract facility where Kellogg’s Honey Smacks is manufactured. As part of the inspection, investigators collected environmental and product samples. Analysis of the environmental samples is now complete, and they were found to be a match to the outbreak strain. In addition, product samples collected and analyzed by state partners were positive for the outbreak strain of Salmonella Mbandaka. As of June 12, 2018, the manufacturing facility is no longer producing product. The FDA continues to work with the firm to address corrective actions.

When the Miami Herald filed a Freedom of Information Act request for the inspection of the facility, the FDA denied the request. The agency claimed two exemptions: “disclosure could reasonably be expected to interfere with enforcement proceedings” and possible disclosure of “trade secret and confidential commercial information.”

61 sick in 7 states from Cyclospora in new outbreak linked to McDonald’s; 3000 locations removing salads

At least 61 people in seven Midwestern States have been sickened with Cyclospora possibly linked to salads served at McDonald’s restaurants.

The U.S. Food and Drug Administration and the Centers for Disease Control and Prevention (CDC) report that two people have been hospitalized and to date, no deaths have been reported.

Ashley Nickle of The Packer reports that health authorities in Illinois and Iowa have reported 105 recent cases of cyclosporiasis and have linked some of them to McDonald’s salads.

“Out of an abundance of caution, we decided to voluntarily stop selling salads at impacted restaurants until we can switch to another lettuce blend supplier,” McDonald’s said in a statement. “We are in the process of removing existing salad blends from identified restaurants and distribution centers, which includes approximately 3,000 of our U.S. restaurants, primarily located in the Midwest.”

McDonald’s spokeswoman Terri Hickey said, “McDonald’s is committed to the highest standards of food safety and quality control. We are closely monitoring this situation and cooperating with state and federal public health authorities as they further investigate”

In June, federal agencies investigated cyclosporiasis cases that were linked to Del Monte vegetable trays. More than 225 illnesses have been reported in that outbreak. At this time, no link has been made by health authorities between the outbreak linked to McDonald’s salads and the outbreak linked to Del Monte vegetable trays, which included broccoli, cauliflower, carrots and dip.

212 sick: Multistate outbreak of cyclosporiasis linked to Del Monte Fresh produce vegetable tray

The U.S. Centers for Disease Control and Prevention (CDC) reports that Cyclospora cayetanensis is a single-celled parasite that causes an intestinal infection called cyclosporiasis.

As of July 5, 2018 (9am EDT), CDC has been notified of 212 laboratory-confirmed cases of cyclosporiasis in persons who reportedly consumed pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip. The reports have come from four states.

Seven (7) of these people have been hospitalized, and no deaths have been reported.

Epidemiologic evidence indicates that pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip are the likely source of these infections.

Most ill people reported eating pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip.

Most ill people reported buying pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip in the Midwest. Most people reported buying the trays at Kwik Trip convenience stores.

The investigation is ongoing. CDC will provide updates when more information is available.

General advice for consumers about prevention of cyclosporiasis can be found here.

On June 15, 2018, Del Monte Fresh Produce recalled 6 oz., 12 oz., and 28 oz. vegetable trays containing fresh broccoli, cauliflower, celery sticks, carrots, and dill dip. Recalled products were sold in clear, plastic clamshell containers.

Recalled products were distributed to the following stores: Kwik Trip, Kwik Star, Demond’s, Sentry, Potash, Meehan’s, Country Market, FoodMax Supermarket, and Peapod.

185 sick: Cyclosporiasis in Del Monte veggie trays

As of June 28, 2018 (11am EDT), the U.S Centers for Disease Control (CDC) has been notified of 185 laboratory-confirmed cases of cyclosporiasis in persons who reportedly consumed pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip. The reports have come from four states.

Seven (7) of these people have been hospitalized, and no deaths have been reported.

  • Epidemiologic evidenceindicates that pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip are the likely source of these infections.
    • Most ill people reported eating pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip.
    • Most ill people reported buying pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip in the Midwest. Most people reported buying the trays at Kwik Trip convenience stores.
    • The investigation is ongoing. CDC will provide updates when more information is available.

The median illness onset date among patients is May 31, 2018 (range: May 14 to June 9).  Ill people range in age from 13 to 79 years old, with a median age of 47. Fifty-seven percent (57%) are female and 7 people have been hospitalized. No deaths have been reported.

Illnesses that began after May 17, 2018 might not have been reported yet due to the time it takes between when a person becomes ill and when the illness is reported.

That ole swimmin’ hole got lotsa bugs in it

Untreated recreational water–associated outbreaks can be caused by pathogens, toxins, or chemicals in freshwater (e.g., lakes) or marine water (e.g., ocean).

During 2000–2014, 140 untreated recreational water–associated outbreaks that caused at least 4,958 illnesses and two deaths were reported; 80 outbreaks were caused by enteric pathogens.

Swimmers should heed posted advisories closing the beach to swimming; not swim in discolored, smelly, foamy, or scummy water; not swim while sick with diarrhea; and limit water entering the nose when swimming in warm freshwater.

Outbreaks associated with untreated recreational water can be caused by pathogens, toxins, or chemicals in fresh water (e.g., lakes, rivers) or marine water (e.g., ocean). During 2000–2014, public health officials from 35 states and Guam voluntarily reported 140 untreated recreational water–associated outbreaks to CDC. These outbreaks resulted in at least 4,958 cases of disease and two deaths. Among the 95 outbreaks with a confirmed infectious etiology, enteric pathogens caused 80 (84%); 21 (22%) were caused by norovirus, 19 (20%) by Escherichia coli, 14 (15%) by Shigella, and 12 (13%) by Cryptosporidium. Investigations of these 95 outbreaks identified 3,125 cases; 2,704 (87%) were caused by enteric pathogens, including 1,459 (47%) by norovirus, 362 (12%) by Shigella, 314 (10%) by Cryptosporidium, and 155 (5%) by E. coli. Avian schistosomes were identified as the cause in 345 (11%) of the 3,125 cases. The two deaths were in persons affected by a single outbreak (two cases) caused by Naegleria fowleri. Public parks (50 [36%]) and beaches (45 [32%]) were the leading settings associated with the 140 outbreaks. Overall, the majority of outbreaks started during June–August (113 [81%]); 65 (58%) started in July. Swimmers and parents of young swimmers can take steps to minimize the risk for exposure to pathogens, toxins, and chemicals in untreated recreational water by heeding posted advisories closing the beach to swimming; not swimming in discolored, smelly, foamy, or scummy water; not swimming while sick with diarrhea; and limiting water entering the nose when swimming in warm freshwater.

Outbreaks associated with untreated recreational water-United States, 2000-2014

29.jun.18

CDC

Daniel S. Graciaa, MD1; Jennifer R. Cope, MD2; Virginia A. Roberts, MSPH2; Bryanna L. Cikesh, MPH2,3; Amy M. Kahler, MS2; Marissa Vigar, MPH2; Elizabeth D. Hilborn, DVM4; Timothy J. Wade, PhD4; Lorraine C. Backer, PhD5; Susan P. Montgomery, DVM6; W. Evan Secor, PhD6; Vincent R. Hill, PhD2; Michael J. Beach, PhD2; Kathleen E. Fullerton, MPH2; Jonathan S. Yoder, MPH2; Michele C. Hlavsa, MPH2

https://www.cdc.gov/mmwr/volumes/67/wr/mm6725a1.htm?s_cid=mm6725a1_e

On Salmonella, go with science or rapper who craves Honey Smacks?

Joshua Espinoza of Complex writes that Boosie Badazz is in disbelief over the 2018 Honey Smacks recall.

Just days after it was announced that the beloved cereal was linked to 73 salmonella outbreaks in 31 states, the Baton Rouge rapper went to social media demanding further proof of the reported contamination.

“I just got home and my kids told me some shit about Honey Smacks are no longer available. I don’t if this true, but I’m pissed. I need proof,” he said in an Instagram video. “I think somebody might be tryin’ to fuck with me […] They say it’s full of salmonella, they were sayin’ something—well I’m full of salmonella!”

Boosie’s love for Honey Smacks has been well documented over the years. There are a number of videos of the rapper doing nothing more than grubbing on the puffed wheat breakfast cereal.

“I need proof, man. Fuck that. They just can’t take them off the market,” he goes on in the video. “I need proof. Somebody DM proof. The scientists, somebody, DM me some proof.”

How badazz is it to eat a kid’s cereal?