Over 100 ill with noro at USC

Norovirus kind of sucks, unless you are a virologist. The perfect human pathogen (a term coined by my NoroCORE colleague and all-around good guy, Aron Hall) is shed at a crazy high rate of virus particles per gram of vomit or feces and sticks around in the environment for a long time. So outbreaks tend to persist and hit college campuses where lots of people live and eat together.

Like USC, where, according to LAist, a lot of students are sick.la-sp-usc-recruiting-update-20141021

The Los Angeles County Department of Public Health has confirmed that they are currently investigating a norovirus outbreak at the University of Southern California. A representative from the Department of Public Health told LAist that 103 cases have been reported since October 26, which is when the university reached out to the department about the situation. 

The university has asked students to remain home from classes or social events until they’ve been symptom free for at least 24 hours, according to a post on the USC Engemann Student Health Center website. This isn’t the first time the student body has been struck down by the virus—in 2008 hundreds of cases were reported in 2008, and there were a number of outbreaks around the L.A. area last year, as well.

Brae Surgeoner, Doug and I had a paper published in the Journal of Environmental Health about some research we conducted in the Winter of 2006. The study came about because a whole bunch of kids in the University of Guelph’s residence system started puking from an apparent norovirus outbreak. There were lots of handwashing signs up and we wanted to know whether they changed hygiene behavior (especially if kids were using the tools available when entering the cafeteria). Turns out that students weren’t doing as good of a job at hand hygiene as they reported to us.

Norovirus confirmed in PA university outbreak

There’s a lot of norovirus on campuses this time of year. A bunch of Virginia colleges dealt with the pathogen a couple of weeks ago, and it looks like N.C. State did too. According to mcall.com, the virus caused over 150 illnesses at East Stroudsburg University in Pennsylvania.

The vomiting, diarrhea and stomach pain that affected 154 students at East Stroudsburg University last week was the result of a highly contagious virus, the state Health Department said Thursday.

The Department of Health has determined that there is now enough accumulated evidence to say the recent ESU outbreak is due to norovirus,” department spokesman Wes Culp said.

The illnesses swept through the campus so fast that doctors and medical staffs could not identify its cause with certainty, though doctors did suspect norovirus. The outbreak affected 2.5 percent of ESU students.

Here are some campus-specific food safety infosheets. Click on the pics to download.

Risk management decision: Norovirus outbreak closes Hampden-Sydney College

Norovirus kind of sucks, unless you are a virologist. The perfect human pathogen (a term coined by my NoroCORE colleague and all-around good guy, Aron Hall) is shed at a crazy high rate of virus particles per gram of vomit or feces and sticks around in the environment for a long time. So outbreaks tend to persist.10849902_719581291471357_3442145704847569295_n1-300x300

Risk managers are faced with a  tough decision – shut down a place (school, amusement park, hotel, restaurant) for a deep clean/sanitize (with high concentrations of chlorine) or risk the chance that an outbreak stretches out over weeks. According to NBC 12, a Virginia college chose the former and will be closed until Wednesday as sanitation staff do their thing, while ill students stay isolated (and out of the classroom).

Hampden-Sydney College announced Sunday that it will remain closed through Wednesday, Feb. 4.

An update on the college’s website reads, “The Virginia Department of Health has determined that the illness on campus is norovirus. Norovirus spreads quickly person to person and causes nausea, vomiting, diarrhea, and a low grade fever. The virus is contracted by contact with infected persons or contaminated surfaces and items. The virus can remain vital for as long as two weeks.

Classes are suspended until Wednesday, February 4.

Athletic practices and competitions, extracurricular activities, and fraternity social events are suspended until Wednesday, February 4.

Administrative departments will resume normal hours on Tuesday, February 3.

It may have taken three days, but sophomore Tre Briggs just got over the norovirus. He is one of more than 300 students who fell ill after the outbreak on campus last week. “I just knew something was wrong and then that night I went to sleep and I was just vomiting all night,” Briggs said.

Managing behavior through messaging doesn’t always work, as we saw 7 years ago at Guelph:

University students’ hand hygiene practice during a gastrointestinal outbreak in residence: What they say they do and what they actually do
Journal of Environmental Health Sept. issue 72(2): 24-28
Brae V. Surgeoner, MS, Benjamin J. Chapman, PhD, and Douglas A. Powell, PhD

Published research on outbreaks of gastrointestinal illness has focused primarily on the results of epidemiological and clinical data collected postoutbreak; little research has been done on actual preventative practices during an outbreak. In this study, the authors observed student compliance with hand hygiene recommendations at the height of a suspected norovirus outbreak in a university residence in Ontario, Canada. Data on observed practices was compared to post-outbreak self-report surveys administered to students to examine their beliefs and perceptions about hand hygiene. Observed compliance with prescribed hand hygiene recommendations occurred 17.4% of the time. Despite knowledge of hand hygiene protocols and low compliance, 83.0% of students indicated that they practiced correct hand hygiene during the outbreak. To proactively prepare for future outbreaks, a current and thorough crisis communications and management strategy, targeted at a university student audience and supplemented with proper hand washing tools, should be enacted by residence administration.

Is college still worth it?

My two eldest daughters graduated university with $30,000 in debt, each. For Canada, with its exclusively public system, that’s a lot.

backtoschool-01I only became aware of this about five months ago.

But it dovetails with my observations and own experiences of the intransigence of the university system.

When it makes The Daily Show, which most American university kids go to for news, even though it’s a fake news show, it’s not just me going on about something.

The system is broken.


Food porn, NY Times college cafeteria edition; blowing rhetorical chunks

Why do people no longer read newspapers? Because despite flashes of brilliance, the quality control just isn’t there anymore with all the slashed budgets and too few people.

The New York Times today published a blog entitled, That cafeteria cheese steak might be antibiotic-free, a supposed reflection on college admissions by some mom, Caren Osten Gerszberg.

Antibiotic-free is a bogus claim.

Last month, Gerszberg apparently spent the day at the University of Pennsylvania with her daughter, and her “ ears immediately perked up when our tour guide mentioned the school’s new, sustainable-minded, organic-leaning dining service provider. …

On the Penn Web site, (new provider) Bon Appétit’s food is described as follows: “made from scratch; purchasing practices are seasonal, local and sustainable; meat and dairy antibiotic free, rGBH free milk, featuring cage free eggs; unique menus per cafe; vegetarian, vegan & international options; following Monterey Bay Aquarium’s Seafood Watch guidelines.” Without being able to comment on taste at this point, it definitely sounds like a much better direction along nutritional lines — and is so unlike my days of college dining.”

Those claims have little or nothing to do with nutrition. And absolutely nothing to do with microbial food safety – the things that make students barf every week at some campus across America.

CDC investigators to lead study into E. coli O145 coutbreak; at least 47 sick in 3 states

Misti Crane of the Columbus Dispatch reports this morning that federal health officials will investigate an outbreak of E. coli O145 with cases involving college students in Michigan, New York and Ohio.

Because E. coli O145, a relative of the more common shiga-toxin producing E. coli O157:H7, is not routinely tested for, health types hope an epidemiological investigation will help pinpoint the suspected food vehicle.

In Feb. 1995, E. coli O111 took the life of a 4-year-old in Australia as part of an outbreak linked to fermented sausage. And in Aug. 2008, E. coli O111 was responsible for hundreds of illnesses and the death of 26-year-old Chad Ingle (right) who had all dined at the Country Cottage restaurant in Locust Grove, Oklahoma.

Herpes, hepatitis A, swine flu — beer pong transmits disease?

No beer pong? What is college life without beer pong?

Last year, some publication at the University of California at Los Angeles – UCLA – warned students that beer pong, a communal drinking game, could be a source of infectious disease like herpes.

The N.Y Times reports tomorrow that students at Rensselaer Polytechnic Institute in Troy, N.Y., are being asked to refrain from playing beer pong after an outbreak of illness that officials feared might be swine flu.

The story notes that what used to be O.K. is not anymore, as the flu has ushered in new standards of etiquette that can be, in turns, mundane, absurd and heartbreaking.

Heartbreaking and beer pong. College life is tragic.

First years and foodborne illness

Julie, my youngest sister, started her first year at Fanshawe College in London (Ontario) this fall. Like many first years she’s staying in residence, and like many first years she’s having a great drunken time – likely followed by painful mornings hovered over the toilet.

Although many a pukey morning could be attributed to alcohol overconsumption, Courier-Journal reports ways to avoid foodborne illness while living in dorms (or residence halls).

Food-related illnesses, such as E. coli and salmonella infection, can creep into a dorm — or any setting where people gather. But students aren’t always alert to the risks…

The article identifies a few problem areas for this demographic.

Eating pizza that’s been left out all night: In general, perishable food shouldn’t be left out more than two hours at room temperature or no more than one hour in 90-degree weather, according to the U.S. Department of Agriculture.

But as Doug explains, there are exceptions,

“If it’s the kind of pizza that most people usually get, which is like cardboard and completely dry, it’s probably going to be all right. But when in doubt, throw it out.”

Relying solely on a food’s color or smell to tell whether it’s safe to eat:

“If something smells gross, toss it,” said Doug Powell.

But while your nose and eyes may lead you right sometimes, they’re not foolproof. For example, that hamburger or chicken you just cooked may look done, but you won’t know for sure whether it’s safe to eat unless you stick a food thermometer in it to check the temperature. You can pick one up at the nearest big-box store.

Your tongue can mislead you, too. A product can be contaminated with bacteria, such as salmonella, without tasting or looking odd.

That’s Julie, right, with the college staple food pizza.

The Dirt on Mold

When was the last time you opened your fridge and saw this- the mold monster?  Hopefully never, but if you have, you’ve probably experienced some sort of sickness related to eating the food from the fridge.  Mold grows from decomposing organic material, and in addition to a foul order and slime, mold is a great indicator of food going bad.  But food can be decidedly “bad” before the mold fully appears.

Unfortunately the busy life of student has led me to find the mold monster lurking in my fridge on more than one occasion.  CNNHealth gives some great advice to college students this week: “Don’t eat mold.”  Not only is it unappetizing, but molds can cause allergic reactions and respiratory problems as well as produce mycotoxins, poisonous substances that can make you sick.

I’ve definitely never gone as far to intentionally consume mold.  I believe in labeling my leftovers with the date and smelling foods before eating them.  It’s not a foolproof way to avoid food-borne illness from moldy foods, but it’s better than eating leftovers blindly.

CNNHealth goes on to offer additional tips to enjoy a meal from the fridge: The U.S. Department of Agriculture Food Safety and Inspection Service recommends discarding moldy bread and baked goods, because of their porous texture.
Creamy dairy products like yogurt can easily spread mold and should be discarded. So
ft cheeses with high moisture content — including those that are shredded, sliced, or crumbled — can be contaminated with both mold and bacteria. So throw those away, experts advise.
Hard cheeses can be saved, as long as the mold is cut 1 inch around the spot. Because of the cheese’s hardness, the mold generally cannot penetrate deep into the product.

Mom taught me well, to throw away any bread with the slightest bit of mold, and to keep moldy hard cheese but to cut away the mold. (Within reason of course, I’m talking about cutting off a dime-sized piece of mold, not eating a furry piece of cheese.)  I also try to disinfect my fridge at least every six months.

What if the fridge doesn’t belong to you?  Office or community fridges can be hot spots for spoiled food and moldy surfaces.  The Pittsburg Post-Gazette cites a survey by the American Dietetic Association and ConAgra Foods which “found that 44 percent of office refrigerators are cleaned once a month and 22 percent are cleaned only once or twice a year.”

Clean out your fridge at home with a household kitchen cleaner – preferably something with bleach.  Institute a bi-weekly cleanup day for the office fridge.  These are two terrific ways to lower your risk of contracting a food-borne illness from fridge food.  You can also reference the USDA’s guide on moldy food when deciding what to trash or save.

Also, don’t forget to wash your hands after touching all that mold.