Everyone’s got a camera: Netherlands café edition

Janene Pieters of the NL Times reports a video of a mouse munching on a crepe in an Amsterdam cafe, resulted in the business being ordered closed by the Dutch food and consumer product safety authority NVWA. The video was posted on Twitter on Wednesday. NVWA inspectors went to inspect the cafe and found more vermin. Which is why the cafe was ordered closed, RTL Nieuws reports.

“The business can only be reopened if the entrepreneur has thoroughly cleaned everything up and has taken measures to prevent vermin”, the NVWA said. All food supplies currently in the store must also be discarded. The situation in the cafe was unsafe and a public health hazard, an NVWA spokesperson said to the broadcaster.

The NVWA is pleased that consumers report when they see vermin in shops or catering establishments. “With or without a video we take these kinds of complaints seriously. Mice are a direct threat to food safety.”

What foods are most likely to cause illness by shiga toxin-producing Escherichia coli (STEC) and how best to control secondary infections

Two abstracts attempt to provide guidance to these important questions to reduce the toll of STEC.

FAO and WHO conclude shiga toxin-producing Escherichia coli (STEC) infections are a substantial public health issue worldwide, causing more than 1 million illnesses, 128 deaths and nearly 13 000 Disability-Adjusted Life Years (DALYs) annually.

To appropriately target interventions to prevent STEC infections transmitted through food, it is important to determine the specific types of foods leading to these illnesses.

An analysis of data from STEC foodborne outbreak investigations reported globally, and a systematic review and meta-analysis of case-control studies of sporadic STEC infections published for all dates and locations, were conducted. A total of 957 STEC outbreaks from 27 different countries were included in the analysis.

Overall, outbreak data identified that 16% (95% UI, 2-17%) of outbreaks were attributed to beef, 15% (95% UI, 2-15%) to produce (fruits and vegetables) and 6% (95% UI, 1-6%) to dairy products. The food sources involved in 57% of all outbreaks could not be identified. The attribution proportions were calculated by WHO region and the attribution of specific food commodities varied between geographic regions.

In the European and American sub-regions of the WHO, the primary sources of outbreaks were beef and produce (fruits and vegetables). In contrast, produce (fruits and vegetables) and dairy were identified as the primary sources of STEC outbreaks in the WHO Western Pacific sub-region.

The systematic search of the literature identified useable data from 21 publications of case-control studies of sporadic STEC infections. The results of the meta-analysis identified, overall, beef and meat-unspecified as significant risk factors for STEC infection. Geographic region contributed to significant sources of heterogeneity. Generally, empirical data were particularly sparse for certain regions.

Care must be taken in extrapolating data from these regions to other regions for which there are no data. Nevertheless, results from both approaches are complementary, and support the conclusion of beef products being an important source of STEC infections. Prioritizing interventions for control on beef supply chains may provide the largest return on investment when implementing strategies for STEC control.

Second up, in 2016, we reviewed preventive control measures for secondary transmission of Shiga-toxin producing Escherichia coli (STEC) in humans in European Union (EU)/European Free Trade Association (EEA) countries to inform the revision of the respective Norwegian guidelines which at that time did not accommodate for the varying pathogenic potential of STEC.

We interviewed public health experts from EU/EEA institutes, using a semi-structured questionnaire. We revised the Norwegian guidelines using a risk-based approach informed by the new scientific evidence on risk factors for HUS and the survey results.

All 13 (42%) participating countries tested STEC for Shiga toxin (stx) 1, stx2 and eae (encoding intimin). Five countries differentiated their control measures based on clinical and/or microbiological case characteristics, but only Denmark based their measures on routinely conducted stx subtyping. In all countries, but Norway, clearance was obtained with ⩽3 negative STEC specimens. After this review, Norway revised the STEC guidelines and recommended only follow-up of cases infected with high-virulent STEC (determined by microbiological and clinical information); clearance is obtained with three negative specimens.

Implementation of the revised Norwegian guidelines will lead to a decrease of STEC cases needing follow-up and clearance, and will reduce the burden of unnecessary public health measures and the socioeconomic impact on cases. This review of guidelines could assist other countries in adapting their STEC control measures.

Mapping of control measures to prevent secondary transmission of STEC infections in Europe during 2016 and revision of the national guidelines in Norway

Cambridge University Press vol. 147

  1. Veneti(a1)(a2)H. Lange (a1)L. Brandal (a1)K. Danis (a2) (a3) and L. Vold 

DOI: https://doi.org/10.1017/S0950268819001614
https://www.cambridge.org/core/journals/epidemiology-and-infection/article/mapping-of-control-measures-to-prevent-secondary-transmission-of-stec-infections-in-europe-during-2016-and-revision-of-the-national-guidelines-in-norway/1990D2338B220F80F0E683DF6F622A40

British girl, 2, dies from E. coli after holiday in Turkey

A two-year-old British girl has died after contracting E.coli while on holiday in Turkey.

Allie Birchall came down with the severe illness after returning to the UK following a stay at a luxury resort east of the coastal city of Antayla.

Her family were forced to turn off Allie’s life support machine just two weeks after their holiday because of complications caused by the illness.

The family had travelled to Turkey with tour operator Jet2 Holidays on 12 July and said they had concerns about the hygeine of the Turkish resort.

Katie Dawson, Allie’s mother, said her daughter did not start getting ill until five days after getting back to their home in Atherton, Greater Manchester.

According to Ms Dawson, Allie began suffering with stomach cramps, diarrhoea, loss of appetite and lethargy before being admitted to Royal Bolton Hospital on July 30.

The hospital confirmed Allie had contracted Shiga-Toxin producing E.Coli (STEC), which later led to her developing deadly Haemolytic Uraemic Syndrome (HUS) – a life-threatening complication related to the poisoning.

Allie was moved to the Manchester Royal Infirmary and put in an induced coma on August 1.

An MRI scan was carried out, which revealed that she had sustained severe brain trauma and damage. Katie had to make the difficult decision to terminate Allie’s life support following the advice from doctors.

“While nothing will bring her back, we need to know what caused her illness and if anything could have been done to prevent it.

The family have now instructed specialist international serious injury lawyers, Irwin Mitchell, to investigate what happened.

Public Health England is also currently investigating the matter, and an inquest has been opened to examine the circumstances surrounding Allie’s death.

Norovirus most common foodborne pathogen in 2017

This is the CIDRAP summary of the latest CDC number crunching on microorganisms that lead to barfing.

The Centers for Disease Control and Prevention (CDC) late last week released a summary of foodborne illnesses in 2017 based on an annual analysis of data from the Foodborne Disease Outbreak Surveillance System, and norovirus was the most common pathogen reported, responsible for 46% of illnesses. Salmonella and Shiga toxin–producing Escherichia coli were also linked to a substantial number of outbreaks.  

In 2017, the CDC tracked 841 foodborne outbreaks, which included 14,481 illnesses, 827 hospitalizations, 20 deaths, and 14 food product recalls. A single etiologic agent was confirmed in 395 outbreaks (47%), which are defined as two or more related cases.

Tainted seafood and poultry were tied with causing the most outbreaks, with mollusks (41 outbreaks), fish (37), and chicken (23) the specific food items most often implicated. The most outbreak-associated illnesses were from turkey (609 illnesses), fruits (521), and chicken (487), the CDC said.

California had the most outbreaks (107), followed by Ohio (69), and Washington state (67). 

As in past years, restaurants with sit-down dining were the most commonly reported locations for food preparation associated with outbreaks (366).

The complete report is available at: https://www.cdc.gov/fdoss/pdf/2017_FoodBorneOutbreaks_508.pdf

And here:

 

Hydration hype: Fancy bottled drinking water is nonsense, just drink tap

My friend Tim Caulfield, a Canada Research Chair in Health Law and Policy at the University of Alberta, author of “Is Gwyneth Paltrow Wrong About Everything?: How the Famous Sell Us Elixirs of Health, Beauty & Happiness” (Beacon, 2015) and host of “A User’s Guide to Cheating Death” on Netflix (that’s a long bio) writes for NBC News, humans need water but the marketing of water as a detoxifying, energizing, health-enhancing, miracle beverage has become a lucrative business. Over the past few years the booming wellness industry (aka Big Wellness) has coopted this most basic of biological needs to sell products and promises of miraculous improved health. But is there any evidence to support the hydration hype?

Before I dump on the water business, let’s give a nod to the positives. There is growing recognition that sugary beverages are not a good choice, nutrition wise. Evidence suggests that consumption of sugary beverages, especially soft drinks, is associated with a range of health issues, including obesity and heart disease. As a result, there is a broad consensus among nutrition and public health experts about the value of limiting the consumption of these calorie-dense and relatively nutrition-free beverages.

So, in this context, the shift to water is a very good thing. But that doesn’t mean we have to buy what the “premium” water market is selling.

But before we get to the fancy packaging, we need to talk about volume. Do you actually need to drink eight glasses of water a day? In a word: Nope.

This strange and incredibly durable myth seems to have emerged from a misinterpretation of a 1945 US Food and Nutrition Board recommendation. That document suggested a “suitable allowance of water for adults is 2.5 litres daily” (i.e., roughly eight glasses a day). But what is almost always overlooked is that the recommendation — which was not based on a robust body of research — also noted “[m]ost of this quantity is in prepared foods.” In other words, you already get the bulk of your needed water from the food you eat.

In reality, there is no magical amount of water. We do need to stay appropriately hydrated, of course. And as our climate and activities change, so does the amount of water we lose through sweating etc. But our bodies are good at telling us how much and when we should drink. (Thanks, evolution.) And all liquids — coffee, tea, that weird fluid inside hotdogs — count toward your daily consumption of water. My body can’t tell if an H20 molecule came from a fresh-water spring on the side of a remote Himalayan mountain or from a cup of gas station java (which isn’t, despite conventional wisdom to the contrary, dehydrating).

But even if water is found in a lot of foods and beverages, pure bottled water is still better for us, right? Wrong again.

Yes, drinking plain water is almost always a better choice than some other, sugar-infused, beverage. But the water you drink doesn’t need to come out of a plastic, glass, or 24-karat gold (yes, that is a thing) bottle.

The twisted logic behind wellness gadgets like Fitbit isn’t making us healthier

Studies have shown that some people believe bottled water is healthier than tap water. That perception is wrong. In fact, tap water in the U.S. and Canada is almost always the best, cheapest and most environmentally friendly choice. Bottled water can be essential during emergencies that disrupt the supply of clean water. And there have been scary examples of contaminated public water — the Flint, Michigan water crisis being only one recent example.

We also need to be vigilant to ensure our public water supply remains clean. But in most places in the United States and Canada, tap water is tightly regulated and safe. Not only that, but tap water can have less contaminants than bottled waterA study from Canada, for example, found that 70 percent of the tested bottled water brands contained high levels of bacteria and generally had more bacteria than tap water. A 2019 Consumer Report investigation concluded “that in some cases bottled water on store shelves contains more potentially harmful arsenic than tap water.”

But bottled water tastes better, you say! Actually, blind taste tests have consistently found that to be untrue too. To cite just one example, only one-third of the participants in a Boston University study, were able to correctly identify tap water. One third thought it was bottled water and one third couldn’t tell the difference.

But bottled water tastes better, you say! Actually, blind taste tests have consistently found that to be untrue too.

And now we get to what is probably the biggest scam. Wellness wonks have been pushing absurd diets, supplements and potions for decades. Now that same thinking has come to water, with alkaline, hydrogen, gluten and GMO-free water brands hitting the supermarket and health food store shelves near you.

Nope, nope and — sigh — nope.

Alkaline water is part of the larger multimillion-dollar alkaline diet fad embraced by celebrities like New England Patriots quarterback Tom Brady. Proponents claim that humans can become too acidic and, as such, we need to consume foods and beverages that will lower the pH of our bodies. By doing so, we will improve our health and reduce the incidence of disease and cancer, the theory goes.

Problem one: There is little evidence to support the entire premise that adjusting the pH of your food will have an impact on our health. And the studies that have explored the claim have found little benefit to this dietary approach, outside of the diet’s push to eat more fruits and vegetables. (Eating more fruits and vegetables is of course good for you hand can help you stay healthier for longer.)

Problem two: You can’t change the pH of your body through food and beverages. So the entire premise is scientifically absurd. Your body tightly regulated the pH of your blood. It doesn’t need the help of overpriced bottled water.

 

The Crown:: Queen Elizabeth’s staff follows serious (not so much) food poisoning protocol

Queen Elizabeth has a crafty way to avoid getting poisoned at the dinner table. A new documentary called Secrets of the Royal Kitchen explores the ins and outs of Buckingham Palace’s kitchens, including the lengths royal staffers go to keep Elizabeth safe. Here’s a quick look at all the interesting elements that go into a state banquet with the Queen.

During state banquets, Her Majesty’s staff are required to follow a serious protocol to keep her safe – and the lengths they go for her safety might surprise you.

A personal chef at the palace prepares the dishes for all of the guests. According to the New York Post, Elizabeth’s staff members then chose a random plate for her in an effort to prevent someone from poisoning her food.

The only way someone would be able to poison Queen Elizabeth is if they contaminated all of the dishes. This tactic has paid off so far, though we couldn’t imagine why someone would want to poison the Queen.

“After everything is plated up, a page chooses at random one of the plates to be served to her majesty,” Emily Andrews, a correspondent for the royals, shared. “So if anyone did want to poison the monarch they’d have to poison the whole lot.”

The documentary also revealed that banquet guests are required to follow some strict rules while dining with  Elizabeth Queen.

This includes finishing their plates before Her Majesty is done eating. This is an old tradition that used to be more of an issue in the past as guests would race to finish their food. It is unclear if the palace requires visitors to follow this protocol or if they have gotten more flexible in recent years.

There are, of course, plenty of other traditions guests are required to follow whenever they are eating with the Queen.

For starters, nobody sits down until Elizabeth has been seated. You also cannot start eating until she has taken her first bite.

Elizabeth also has a personal menu that has been crafted to her liking. She schedules her meals three days in advance to give the palace chef plenty of time to gather ingredients.

When picking her dining options, Elizabeth crosses out dishes she doesn’t like. She also crosses out entire pages whenever she has a royal event that evening and will not be dining in the palace.

Sounds like me being in psyche jail.

And not a mention of microbiology.

Dumbasses.

TB in deer hunters

For a country that still proclaims, we enjoy the safest food supply in the world in U.S. Department of Agriculture missives, when we’ve been arguing reduced risk is a better message for 25 years and that there are so many countries with the self-proclaimed title of safest food in the world they can’t all be right – it’s alarming that Mycobacterium bovis has been transmitted from deer to a human.

Hello zoonoses.

Deer hunting season in Ontario (that’s in Canada) begins about today.

I never had any interest.

Not a Bambi thing, just thought it was boring.

My dad went a few times but I’m not sure if he enjoyed it or not.

Whatever.

The U.S. Centers for Disease Control reports that in May 2017, the Michigan Department of Health and Human Services was notified of a case of pulmonary tuberculosis caused by Mycobacterium bovis in a man aged 77 years. The patient had rheumatoid arthritis and was taking 5 mg prednisone daily; he had no history of travel to countries with endemic tuberculosis, no known exposure to persons with tuberculosis, and no history of consumption of unpasteurized milk. He resided in the northeastern Lower Peninsula of Michigan, which has a low incidence of human tuberculosis but does have an enzootic focus of M. bovis in free-ranging deer (Odocoileus virginianus). The area includes a four-county region where the majority of M. bovis–positive deer in Michigan have been found.

Statewide surveillance for M. bovis via hunter-harvested deer head submission has been ongoing since 1995; in 2017, 1.4% of deer tested from this four-county region were culture-positive for M. bovis, compared with 0.05% of deer tested elsewhere in Michigan. The patient had regularly hunted and field-dressed deer in the area during the past 20 years. Two earlier hunting-related human infections with M. bovis were reported in Michigan in 2002 and 2004. In each case, the patients had signs and symptoms of active disease and required medical treatment.

Whole-genome sequencing of the patient’s respiratory isolate was performed at the National Veterinary Services Laboratories in Ames, Iowa. The isolate was compared against an extensive M. bovis library, including approximately 900 wildlife and cattle isolates obtained since 1993 and human isolates from the state health department. This 2017 isolate had accumulated one single nucleotide polymorphism compared with a 2007 deer isolate, suggesting that the patient was exposed to a circulating strain of M. bovis at some point through his hunting activities and had reactivation of infection as pulmonary disease in 2017.

Whole-genome sequencing also was performed on archived specimens from two hunting-related human M. bovis infections diagnosed in 2002 (pulmonary) and 2004 (cutaneous) that were epidemiologically and genotypically linked to deer (3). The 2002 human isolate had accumulated one single nucleotide polymorphism since sharing an ancestral genotype isolated from several deer in Alpena County, Michigan, as early as 1997; the 2004 human isolate shared an identical genotype with a grossly lesioned deer harvested by the patient in Alcona County, Michigan, confirming that his infection resulted from a finger injury sustained during field-dressing. The 2002 and 2017 cases of pulmonary disease might have occurred following those patients’ inhalation of aerosols during removal of diseased viscera while field-dressing deer carcasses.

In Michigan, deer serve as maintenance and reservoir hosts for M. bovis, and transmission to other species has been documented. Since 1998, 73 infected cattle herds have been identified in Michigan, resulting in increased testing and restricted movement of cattle outside the four-county zone. Transmission to humans also occurs, as demonstrated by the three cases described in this report; however, the risk for transmission is understudied.

Similar to Mycobacterium tuberculosis, exposure to M. bovis can lead to latent or active infection, with risk for eventual reactivation of latent disease, especially in immunocompromised hosts. To prevent exposure to M. bovis and other diseases, hunters are encouraged to use personal protective equipment while field-dressing deer. In addition, hunters in Michigan who submit deer heads that test positive for M. bovis might be at higher risk for infection, and targeted screening for tuberculosis could be performed. Close collaboration between human and animal health sectors is essential for containing this zoonotic infection.

Notes from the Field: Zoonotic mycobacterium bovis disease in deer hunters—Michigan, 2002-2017

James Sunstrum, MD1; Adenike S hoyinka, MD2; Laura E. Power, MD2,3; Daniel Maxwell, DO4; Mary Grace Stobierski, DVM5; Kim Signs, DVM5; Jennifer L. Sidge, DVM, PhD5; Daniel J. O’Brien, DVM, PhD6; Suelee Robbe-Austerman, DVM, PhD7; Peter Davidson, PhD5

https://www.cdc.gov/mmwr/volumes/68/wr/mm6837a3.htm

Texas meat company execs plead guilty to selling $1 million worth of uninspected, adulterated beef to federal prisons

Prisons are not pleasant places, neither are psych wards.

They’re really just boring, and involve dealing with controlling types – police, prison guards, parole officers, customs officials, psych-types – who expend major effort in defending the small piece of turf they control.

In prison, we’d have road apples at every meal – huge plums or something the size of horse testicles (road apples refers to the frozen version of horse turds, popular for pond hockey).

Jessica Fu of New Food Economy reports that two executives of a now-defunct meatpacking company pleaded guilty to selling more than $1 million worth of adulterated and uninspected beef to the federal prison system, the Department of Justice announced this week.

Jeffrey Neal Smith and Derrick Martinez, president and operations manager of West Texas Provisions, respectively, admitted to contaminating and mislabeling approximately 775,000 pounds of meat that were then distributed to 32 prisons in 18 states. Specifically, Smith and Martinez sold products that they falsely claimed had been inspected by the Department of Agriculture’s (USDA) Food Safety and Inspection Service (FSIS) between October 2016 and August 2017. They also cut ground beef with whole cow hearts, thereby violating USDA food standards.

Though this is one individual case, it falls within a broad spectrum of issues relating to food safety in the prison system.

Smith and Martinez apparently went to great and, sometimes, bizarre lengths to obscure their scheme. Federal law requires all slaughterhouses to undergo FSIS inspection. To that end, after meatpacking facilities report their hours of operation to the agency, they are prohibited from working outside those hours.

According to former employees, Smith and Martinez ordered workers to come in on nights and weekends and process meat without inspectors present. To avoid arousing suspicion, workers were instructed to park off-site and work with the lights off, according to court documents. They were also discouraged from leaving the building to take meal breaks, in order to keep activity around the facility to a minimum. Additionally, Smith and Martinez admitted to hiding uninspected meat in freezers, and distracting inspectors from noticing said meat.

Though this is one individual case, it falls within a broad spectrum of issues relating to food safety in the prison system. In 2014, another Texas meat processor paid nearly $392,000 as part of a settlement with the USDA for mislabeling beef meant for pet food, which was then sold to the Bureau of Prisons. In Arizona, former inmates say they were served chicken from boxes labeled “not for human consumption.” Last year, The New Food Economy reported on the hidden public health crisis in America’s prisons—where incarcerated people were more than six times as likely to get a foodborne illness than the general population.

There are often economic incentives for food service providers to turn a blind eye to quality, such as the right to pocket any money leftover after fulfilling a contract. Infamously, an Alabama prison sheriff bought a beach house partially using “excess” funds meant to feed inmates. Smith and Martinez were also likely financially motivated to shirk federal beef standards.

Attorneys for the executives did not respond to requests for comment. Both defendants are scheduled to be sentenced on February 13, 2020.

Owner of food company responsible for Spain’s worst ever listeriosis outbreak arrested for manslaughter

Eva Saiz of El Pais reports the owners of the food company responsible for the worst-ever listeriosis outbreak in Spain were arrested on Wednesday for manslaughter.

Since August, the outbreak has killed three people, caused seven miscarriages, and infected more than 200 people. The source of the bacterial infection was traced to a Seville-based company called Magrudis, which sold a contaminated pork loin product called carne mechada under the brand name La Mechá. Three more products produced by the company also tested positive for Listeria monocytogenes.

The owners of Magrudis, José Antonio Marín Pince and his two children Sandro and Mario, have been accused, to different degrees, of involuntary manslaughter, crimes against health and causing injury to a fetus.

According to investigators, the three men knew in February that some of their products had been contaminated but did nothing to eliminate the bacteria from their facilities. Instead they continued producing and distributing their products.

“When the crisis broke, we reminded the business by email that one of their samples had been contaminated much earlier. Given that they did nothing, we passed on this information to the courts,” José Antonio Borrás, the owner of the Microal Group laboratory, told EL PAÍS.

The laboratory handed a report to the court in early September, and according to sources close to the investigation, the contents prompted Judge Pilar Ordóñez, who is overseeing the case, to take action on Tuesday.

Neither laboratories nor companies are legally obliged to warn the authorities if a product is found to test positive, but a company does have a duty to adopt measures to correct the problem. Investigators want to find out why the owners of Magrudis did not do this, and why, more importantly they hid the positive test results from health inspectors who visited the factory after the alert was raised. In public appearances, both Marín and his son Sandro claimed that the company had successfully passed all sanitary controls.

Traces of listeria were found in tests carried out on the Magrudis production line, including the oven carts used to transport the meat during the preparation process, and the larding needles used to inject the pork with fat before cooking. The crisis was complicated by the fact that the company’s products had been sold on to another firm and prepared for sale as an own-brand product in a supermarket chain without the proper labelling.

FDA Frank: Digital prompts key to changing food safety behavior

Tom Karst of The Packer writes that teasing the details of a new era of smarter food safety, Food and Drug Administration deputy commissioner for food policy and response Frank Yiannas spoke Sept. 18 at the United Fresh Washington Conference.

Before coming to FDA last December, Yiannas was vice president of food safety at Walmart from 2008 to 2018.

And Disney in Orlando before that.

Yiannas said the FDA’s work on produce safety has been front and central to his work since he joined the agency.

He praised the industry for its contribution to food safety and said the public-private partnership on food safety efforts must strengthen even more in what he called a new era of smarter food safety that is set to begin in 2020.

“I was asked by the Commissioner to continue to lead our efforts on modernization,” Yiannas said. “We’ve come a long way since 2011, but there’s still work to be done.”

Tech-enabled traceability and tech-enabled outbreak response will be one area of focus for the new era of smarter food safety, Yiannas said.

While produce has an impressive safety record overall, he said there are weak points in the supply chain.

“What I have learned over the years, and especially from my vantage point with the world’s largest company, is that I do believe the food system’s Achilles heel is traceability and transparency,” he said.

He noted that in both the spinach-related foodborne illness outbreak in 2006 and the romaine-related outbreak in 2018, traceability was an issue.

“It seems eerily similar almost a decade later,” he said. “And we still are having to do these overly broad consumer advisories.”

Distributed ledger or blockchain technology can be part of the solution, he said, but that isn’t the focus.

“It is not about the technology— it is about solving some of our many public health challenges,” he said.

Helping efforts to create a culture of food safety among growers, food marketers, and consumers is another element of the new era plan, he said.

“What I’ve learned over the years, is that it’s impossible to make progress without changing and influencing behavior,” he said, noting the importance of “digital prompts” to encourage right behavior.

I agree.