165 sick from norovirus at Canadian student journalism conference up from 75

The Victoria Times Colonist (that’s in British Columbia, in Canada) reports 147 delegates are believed to have contracted norovirus during the final night of a four-day university journalism conference at the Harbour Towers Hotel and Suites, and the final tally has yet to come.

More than one- third of the 370 delegates attending the Canadian University Press national conference went down with severe nausea, vomiting and diarrhea.

Eighteen hotel staff also contracted the virus about 24 hours after the first few students showed symptoms, according to hotel management.

"That’s a really significant outbreak," said Dr. Murray Fyfe, chief medical health officer for the Vancouver Island Health Authority. "And the fact that we had people who were perfectly well and then became ill after coming into contact with others or got sick when they got home, that’s really typical of norovirus."

The highly contagious virus kept some delegates isolated in their hotel rooms for days before they could check out.

Handwashing for nerds: Are those Dysan jet dryers better than paper towel?

Amy, Sorenne and I spent a long last weekend in San Francisco, where Amy conferenced, I had some meetings, but mainly just hung out with the kid (three pirates and a little girl, right).

The washrooms at the San Francisco airport featured the Dysan airblade, billed as the “fastest, most hygienic hand dryer.” Says so right on the machine. And it’s certified by NSF as “tested, certified, hygienic.” Says so right on the machine.

My bowels are in a state of flux when traveling so I had several opportunities to try out the newfangled machinery, that sounds like an airplane is taking off below your fingertips.

We have maintained, based on our reading of the available literature, that proper handwashing, entails:

• wet hands with water;
• use enough soap to build a good lather;
• scrub hands vigorously, creating friction and reaching all areas of the fingers and hands for at least 10 seconds to loosen pathogens on the fingers and hands;
• rinse hands with thorough amounts of water while continuing to rub hands; and,
• dry hands with paper towel.

Water temperature is not a critical factor — water hot enough to kill dangerous bacteria and viruses would scald hands — so use whatever is comfortable.

The friction from rubbing hands with paper towels helps remove additional bacteria and viruses.

I did a cursory search to find some data on the Dysan thingy, and found a study comparing paper towel, regular blow dryers, and a Dysan-type jet dryer that was published in 2008.

Those authors state:

“The jet air dryer showed that there were significant differences (although not as great as for the fingerpads) between the towels and both types of dryer. Again, the superior performance of the towels in reducing bacterial numbers was confirmed. As for the fingerpads, the jet air dryer performed better than the warm air dryer in not increasing mean bacterial count on the palms as much but this difference was not significant.

“Therefore, the manufacturer’s claim that the tested JAD is the “most hygienic hand dryer” is confirmed, especially for fingerpads and assuming that the term “hand dryer” refers to electric devices only because its performance in terms of the numbers of all types of bacteria remaining on the hands of users compared to paper towels was significantly worse. …

“It is well known to microbiologists that air movements encourage the dispersal and transmission of microorganisms and increase the chances of the contamination of materials or persons in any situation. This makes paper towels, where little air movement is generated, the most hygienic option tested in this respect followed by the warm air dryer and, lastly, the jet air dryer.”

The friction from rubbing with paper towel is particularly effective at reducing microbial populations; yet many of these public bathrooms have signs proclaiming that electric dryers of whatever kind are better, and save the trees. Oh, and I should hear from someone at Dysan or NSF – public claims need to be backed with public data.

Maybe I’ll just stay at home.

Shoot, shovel and shut up – the wrong approach for animal and zoonotic diseases

Daughter Sorenne woke up around 6:15 a.m. after a big Halloween night (thanks for the costume, Katie). Then the clocks on the computer changed and I realized it was 5:15 a.m.

Damn you daylight savings.

So while Sorenne plays on the floor and fills her diaper, I’m looking at a poignant release from the France-based World Organization for Animal Health, inexplicably referred to as OIE (it’s a French thing) reiterating the importance of animal health rules to control human disease.

When the first case of bovine spongiform encephalopathy or mad cow disease was discovered in Canada in May, 2003, Alberta premier Ralph Klein famously declared that any

"self-respecting rancher would have shot, shovelled and shut up."

In 1184, city leaders in Toulouse, France, introduced some of the first documented measures to oversee the sale of meat: profit for butchers was limited to eight per cent; the partnership between two butchers was forbidden; and, selling the meat of sick animals was forbidden unless the buyer was warned.

By 1394, the Toulouse charter on butchering contained 60 articles, 19 of which were devoted to health and safety.

As outlined by Madeleine Ferrières, a professor of social history at the University of Avignon, in her 2002 book, Sacred Cow, Mad Cow: A History of Food Fears, the goal of regulations at butcher shops — the forerunners of today’s slaughterhouse — was to safeguard consumers and increase tax revenues. Animals from the surrounding countryside were consolidated at a single spot — the evolving slaughterhouse, originally inside city walls — so taxes could be more easily gathered, and so animals could be physically examined for signs of disease.

It’s no different today: slaughterhouses are common collection points to examine animals for signs of disease and to collect various levies. And like medieval times, one of the most basic rules is animals that cannot walk are forbidden from entering (the slaughterhouse or city).

Bernard Vallat, Director General of the World Organisation for Animal Health (OIE), reminded the world this morning that veterinary legislation is the foundation of any efficient animal health policy.

Veterinary legislation is a critical infrastructure element for all countries. In many OIE Member countries, the veterinary legislation has not been updated for many years and is obsolete or inadequate in structure and content for the challenges facing veterinary services in today’s world.

Dr Vallat says that it is important that the veterinary services have the authority to enter livestock premises and other establishments and take the actions needed for early detection, reporting and rapid and effective management of any animal diseases as soon as they are detected. Such actions include the capacity to seize animals and products, to impose standstills, quarantine, testing and other procedures; to control animals and products at frontiers; and to require the destruction and safe disposal of animals and all articles considered to present a risk of disease transmission and to public health. These activities represent the core activities of veterinary services in the field of animal health control and veterinary public health and the legislation must provide the necessary authority as a minimum.

64 UK kids now sick from Godstone petting zoo; 3 other farms closed; is telling people to wash their hands really enough?

With 64 kids now stricken with E. coli O157 related to visits at the Godstone farm in Surrey, the responses from the folks who run petting zoos could be a little more sympathetic, a little more reflective.

Instead, as reported by the Guardian tonight (tomorrow in the U.K.), Geoff Ford, who runs Docker Park farm in Lancashire, where children can feed pygmy goats (see 1999 Ontario Western Fair outbreak, below) by hand and stroke rabbits, said any ban would affect "children’s environmental education” stating,

"It’s going to get hyped up out of all proportion. It does away with children’s environmental education. It’s important that children realise what a chicken is, what a calf is – often they come here and ask ‘is that a horse?’… We have run our farm for 20 years with no problems. But there is only so much you can do if people don’t listen. The farm at the source of the outbreak in Surrey had big signs all over the place telling people to wash their hands, but some people don’t give a damn."

The U.K. Department of Health responded today by announcing that the advisory committee on dangerous pathogens would be reviewing the current guidance on open farms and will advise on the need for additional precautions "in the light of the current outbreaks of E coli O157."

A Department of Health spokesman told the Telegraph,

“The risk of infection from E-coli O157 through petting farm animals can be prevented by following everyday good hand hygiene measures.”

All of these statements have serious problems.

• 64 kids sick with E. coli O157 is not hysteria, it sucks;

• anyone who says, “we have run our farm for 20 years with no problems” is unwilling to learn and a hazard to public health;

• telling people to wash their hands is insufficient – proper handwashing requires access to proper tools;

• even with proper tools, signs are not enough, as we showed with our recent handwashing compliance study at a university residence when everyone was barfing and awareness was high; and,

• the best handwashing may not be enough — the E. coli O157:H7 that sickened 82 people in 2002 at the Lane County Fair in Oregon appears to have spread through the air inside the goat and sheep expo hall.

Scott Weese, a clinical studies professor at the University of Guelph (Canada) and colleagues reported in the July 2007 edition of Clinical Infectious Diseases that in a study of 36 petting zoos in Ontario between May and October of 2006, they observed infrequent hand washing, food sold and consumed near the animals, and children being allowed to drink bottles or suck on pacifiers in the petting area.

He observed similar failures yesterday.

So after 159 people, mainly children, were thought to be sickened with E. coli O157:H7 traced to a goat and a sheep at the 1999 Western Fair in London, Ontario, and eight years after all Canadian fairs were urged to adopt 46 recommendations to enhance petting zoo safety, many are still doing a lousy job.

Bill Marler has compiled a list of outbreaks related to petting zoos. We’ve previously reported at least 29 petting zoo related outbreaks in North America alone.

These petting zoo experiences raise questions: how best to motivate fair managers to provide petting zoos that are microbiologically safe? Should the urban public be allowed to interact with livestock at all? Should petting zoos be inspected, as restaurants are, and the results displayed?

If 64 sick kids is hysteria, conversation is useless and regulation required.

Salad Smackdown at Food Micro ’08

The press releases were fast and furious and the excitement non-stop  today in response to some new research about Salmonella sticking to salad greens that was presented at Food Micro ’08 in Aberdeen.

Professor Gadi “Flagella” Frankel of Imperial College London was first into the ring yesterday with a press release containing tragically cliché headline, How Salmonella bacteria contaminate salad leaves — it’s not rocket science, and produced by his own Imperial Colleague that said,

"In their efforts to eat healthily, people are eating more salad products, choosing to buy organic brands, and preferring the ease of ‘pre-washed’ bagged salads from supermarkets, then ever before. All of these factors, together with the globalisation of the food market, mean that cases of Salmonella and E. coli poisoning caused by salads are likely to rise in the future. This is why it’s important to get a head start with understanding how contamination occurs now.”

U.K. media outlets rose to the challenge, with the Horrible Herald inverting the order of the press release to lede with,

“The growing popularity of pre-packed salads is likely to lead to an increase in food poisoning cases, scientists warned yesterday.

“They said the increased uptake in the salads in particular, but also in fruit and vegetables, is likely to be reflected in a future rise in food poisoning.

Professor Gadi Frankel, from Imperial College, said a greater understanding of how salads are contaminated is important because cases of food poisoning caused by salads are "likely to rise in the future."

The Fresh Prepared Salads Producer Group – really, that’s the association name, how about Big Salad – today, “completely refutes suggestions in the press that prepared salads are unsafe to eat," and tag teamed with Prof. Bill “Critical” Keevil, professor of environmental health care at the University of Southampton, who was at the conference in Aberdeen where the salad research which sparked the stories was presented, and said,

"I was extremely disappointed by the quality of the data presented and its interpretation. We have known for a long time the various mechanisms that bacteria can use to attach itself to a range of surfaces, including plants. This is not new."

Big Salad said in a statement:,

"Our products sold as ‘washed and ready to eat’ are just that. We have long recognised that to produce a safe-to-eat salad one needs safe-to-eat produce off the field. To achieve that, we strive to ensure that dangerous microbes do not get the opportunity to contact our crops – such that hypotheses as to how they initially adhere are irrelevant. The UK prepared salads sector has an unrivalled safety record and employs stringent controls, described as ‘excellent’ by the FSA – not necessarily the case elsewhere in the world. There has not been a confirmed outbreak associated with prepared salad since 2001 in the UK. … There is absolutely no evidence to suggest that re-washing a prepared salad will do any good at all – and it’s even possible that exposing the salad leaf to the ‘kitchen sink’ will increase the food safety risk. Indeed, the Advisory Committee on the Microbiological Safety of Food (FSA) has recently determined that re-washing is unlikely to remove any contamination remaining on the produce after the manufacturing process.”

To further muddle things, Judith “Hey Now” Hilton wrote on a U.K. Food Standards Agency blog that,

“In fact, while we advise that it’s a good idea to wash salad items in general, there is no need for consumers to rewash ready-to-eat bagged salads unless it says otherwise on the packet.  You can best help yourself by following good food hygiene practice at home – it’s important to follow the 4Cs – cooking, cleaning, chilling, avoiding cross contamination.”

Smackdown. Consumers, if you get sick from ready-to-eat salads, it’s your fault.

Should bagged salads be washed at home?

Yes, says one of Britain’s leading microbiologists, Professor John Threlfall, of the government’s Health Protection Agency (HPA).

The Scotsman reports today that Threlfall said prepared salads and other "ready-to-eat" foods pose a salmonella threat and he urged consumers to disregard assurances on packaging and wash the contents again before eating.

The U.K. Food Standards Agency (FSA) also agreed that extra precautions may be necessary with pre-washed products, with a spokesman quoted as saying,

"Our advice is to wash all lettuce, including bagged lettuce, when you get it home. We will review this advice if we receive extra evidence and reassurances from the industry about their cleaning processes."

No, says the industry, some government agencies and some academics. The products are sufficiently washed at the processing facility, are ready-to-eat, and there is a potential for cross-contamination.

David Barney of the Fresh Prepared Salads Producer Group, which represents UK salad companies, was quoted as saying,

"I am very puzzled by this advice. I don’t understand why he is saying this and we would strongly argue against it. Our cleaning processes are robust and well-managed. The wash the salad gets is as good as any wash you would give in the home, and washing it again at home is not going to make a substantive difference to the safety of the product. … There is almost no food-borne illness directly associated with retail prepared salads, because the washing systems have been particularly good. … It’s widely known that kitchens – and particularly kitchen sinks – are the source of much cross-contamination."

What’s missing in all of this is data to support either recommendation. And the question is the wrong one, focusing on what consumers can do. Washing of fresh produce, particularly leafy greens like spinach and lettuce, is of limited use in removing dangerous microorganisms. The contamination, especially with E. coli O157 and Salmonella, must be prevented on the farm. A  2005 article from the Atlanta Journal-Constitution discussing some aspects of the issue is available here.

A table of known outbreaks of verotoxigenic E. coli — including but not limited to E. coli O157:H7 — associated with fresh spinach and lettuce is available at http://foodsafety.ksu.edu/en/article-details.php?a=3&c=32&sc=419&id=903.

I thought it was football?

The bi-annual congress of the South African Association for Food Science and Technology in Durban was told on Wednesday that many of South Africa’s food manufacturers are failing to meet basic hygiene standards with the management often scrambling to ensure a spotless factory only when standard certification inspections are imminent.

And with the 2010 soccer World Cup just around the corner, it is high time that local food producers improved food safety levels in their factories to avert possible food poisoning disasters.

Rolf Uys, Manager of AIB International, was cited as saying that 45 percent of the factories his company had inspected over the past year had not met basic international food safety requirements, and 70 percent had less than desirable levels of food safety standards, adding,

"Some of the things I have seen this year were live insect activity in seven out of 10 silos inspected; cat droppings in a warehouse; urine in a fruit juice container; slime and psocids (tiny insects ) in water feed; the same buckets used for waste product and cleaning; and rodents blissfully living in warehouse wall panels.

"Factories are being cleaned once every three years just in time for the audit inspection. There is good preparation for the audit, but the attention is not on an entrenched food safety programme. … There is an attitude in the factory of ‘we’ll clean when we feel like it because the legislation is only providing a guideline’, and of ‘let’s see what we can get away with.’ A lot of factories are saying ‘we’ll just take our chances’ and dish out vouchers to customers who complain, but this is not working any more."

If this is what the auditors are willing to say publicly, wonder what they really find?