From the duh files: Ordinary people key resources in outbreaks

The case study is part of a wider project done by ECDC within the context of EU Decision 1082/2013/EU on serious cross-border threats to health. It is part of a multi-country case study project that investigates the synergies between communities affected by serious public health threats and the institutions (both health- and non-health-related) mandated to prepare for and respond to them.

The premise for the project is that affected communities are increasingly recognised as key resources in public health emergencies, and that the concerns and experiences of ordinary people should be harnessed as an important part of the response.

Community engagement and institutional collaboration in Iceland during a norovirus outbreak at an outdoor/scout centre (10-15 August 2017)


16 sick: Farm visits can be risky: E. coli outbreak in Iceland raises worries about infection spreading further

Andie Fontaine of Grapevine writes that 16 children have been diagnosed with E. coli, and concerns have been raised that tourists may spread it further, RÚV reports.

The outbreak is purported to have originated in Efstadal 2, a farm and restaurant near Laugarvatn, after a group of school children visited the place, with some of them contracting E. coli. To be clear: none of the food nor any of the employees tested positive for E. coli. Rather, it is all but certain the bacteria originated from the faecal matter of calves on the farm.

Health authorities have pointed out that there are many rural restaurants in Iceland that are located near farms, prompting a more thorough investigation into stopping the infection’s spread. Further, these locations are visited by many tourists, which could potentially increase the risk of spreading E. coli.

Iceland reports 4 STEC infections in Arnessysla county children

Outbreak News Today reports Iceland health officials have reported four pediatric Shiga-toxin-producing E. coli (STEC) cases. Officials say all the children are from the capital of Reykjavik; however, all have probably been infected in Árnessýsla county or, more specifically, in Bláskógabyggð.

The source of the infection is unknown at this time. The Icelandic Food and Veterinary Authority and the South Iceland Health Inspectorate are now working to analyze the origin of the infections and stop further spread.

E. coli found in Icelandic meat

Keeping with all things Icelandic, E. coli was found in 30% of lamb samples and 11.5% of beef samples in a test carried out by the Icelandic Food and Veterinary Authority (MAST). The particular strain discovered is known as STEC, or shiga-toxin producing E. coli. This is the first time lamb and beef have been screened for STEC in Iceland.

The testing was carried out on around 600 samples of lamb, beef, pork, and chicken of both Icelandic and foreign origin between March and December 2018. The purpose of the testing was to determine the prevalence of pathogenic micro-organisms in products when they reach the consumer, and for this reason the samples were taken from shops.

Campylobacter and salmonella were not detected in pork or chicken samples, with the exception of a single sample of pork from Spain. MAST attributes this to improved preventative measures in slaughterhouses.

MAST points to several ways consumers can reduce the risk of infection from salmonella, campylobacter, and E. coli, including cooking meat all the way through and taking care to avoid cross-contamination. Most E. coli is found on the surface of meat, and therefore is killed by frying or grilling, but when meat is ground, the bacteria is distributed throughout. Therefore, hamburgers and other types of ground meat should be cooked through.

But what does that mean?

Use a tip-sensitive digital thermometer.

100 sick: Ice-maker in Iceland: stops sales to suppliers

E. coli was found in a water pool that is close to the infected area on Askøy. Nearly 100 primary school students have been sick Friday, and several have been admitted to hospital.

Later on Friday, Haukeland Hospital reported that it is campylobacter bacteria that cause intestinal infection, which has been detected in admitted from Askøy. Campylobacter is a bacterium that E-coli often finds along with.

Isbjørn Is has used the water in the municipality both in the products and for cleaning equipment. Kolseth explains that all the products in which it enters water are heat treated – so that no pathogenic bacteria can survive. However, they use lower temperature water for rinsing and cleaning parts and smaller equipment.

– This means that there can potentially be poor quality water on parts of our equipment when production starts. We have to have full control of this, says Kolseth.

48 sick: Raw is risky: Icelandic oysters cause noro at top notch restaurant

There’s nothing like people forking over huge coin only to end up barfing.

Irony is sometimes ironic.

The Iceland Monitor reports infected Icelandic oysters caused food poisoning for 48 individuals at Skelfisksmarkaðurinn, a relatively new restaurant owned by succcessful tv chef and restaurant owner Hrefna Sætran. Icelandic oysters are a novelty in Iceland as all oysters on menus until now have been imported from Ireland or other countries. 

The oysters were imported as youngsters and raised in Skjálfandaflói bay by company Víkurskel. This is the first time that the noro virus is confirmed in oysters in Iceland. 

Forty-four individuals ate oysters at the restaurant from November 8th to November 13th and four further individuals ate oysters between October 29th and November 4th. Oysters infected by the noro virus were on the menu during this period of time, confirms the Icelandid food and veterinary authority. According to the health authorities they found that the restaurant complied to all regulations and standards with regards to food safety and hygiene. 


Toxo imported meat might alter nation’s behavior, warns Iceland’s PM

Contrary to the claims of The Reykjavík Grapevin, toxoplasmosis is not a virus; it’s a parasite.

Prime Minister Sigmundur Davíð GunnlaugssonBut according to Iceland’s Prime Minister Sigmundur Davíð Gunnlaugsson, “Because this is such an interesting topic, maybe I will get one more minute to cover it, because it is extremely important that we, precisely, protect the wholesomeness of Icelandic products, that we don’t use additives, steroids and hormones and such in the production of Icelandic meat,’ Sigmundur Davíð pleaded in a live interview on radio-station Bylgjan on Thursday. … Another thing, no less important, is that we remain free of all sorts of infections which are, unfortunately, all to common in very many places. These are not just harmful to the animals but can be very detrimental to people. For example, there is a virus that causes people’s behavior to change. If they eat, for instance, meat in other countries, that has not been cooked particularly well, then people are at risk of ingesting this infection. And it can lead to changes in behavioral patterns. People have even posed the question, and researched, if this might be changing the behavior of whole nations. This sounds like science fiction, but …’

At this point the radio host intervened to ask: Where has this come up?

‘This is very common,’ Sigmundur Davíð replied, ‘for example widely in East-Europe, France, not least Belgium. Actually all over the world. The prevalence is variable, but there are some countries that stand out, where this toxoplasma is rare. That’s Iceland. And Norway. And the UK, actually. Remarkably. There, people are rather safe against this critter.’

The Prime Minister then recommended that the radio hosts interview a scientist or a doctor about this ‘extremely interesting’ phenomenon.

100 sick from Campylobacter in Iceland over past year

It wasn’t virtual, it was real (messy).

campy.chickenThe Directorate of Health says it has had to deal with a virtual explosion of diarrhea cases caused by Campylobacter.

The Icelandic Food and Veterinary Authority (MAST) said that they could not definitively draw a connection between Icelandic chickens and the outbreak, nor could they rule it out. They pointed out that according to their findings, the incidence of Campylobacter in chickens has not significantly spiked upwards.

The Directorate of Health cautions the public to cook all meat thoroughly and to keep surfaces and hands clean during and after cooking, as well as to use clean water.

Mice droppings found in Belfast food shop

Food safety inspectors have confirmed mice droppings and bread for sale, which had been gnawed by rodents, were both found at an Iceland store in west Belfast.

Belfast City Council staff carried out an inspection of the premises on 19 September, 2008 which uncovered "a number of serious breaches of food hygiene legislation.

"Officers observed mouse droppings on and under shelving, and bread which was displayed for sale had been gnawed by mice."

The store was fined £400 plus £66 costs after the inspection.

In a statement, Iceland Foods Limited claimed it "was not charged for or fined for any pest-related issues".

But the council said the firm had been fined for "food safety offences."

Could credit card receipts save children’s lives?

The Norwegian Institute of Public Health has confirmed a genetic match for an infection of E. coli O157 among three children who developed hemolytic uremic syndrome (HUS) this year.

The Institute reported this week,

“The first child became ill in January, the second in February and the third in March. In addition, a sibling of one of the children has also developed HUS, but it has not yet been confirmed whether this is the same bacterial strain.”

One of the four children—all of which are under the age of ten—has died.

The source of the outbreak has yet to be determined. County food safety officials are currently questioning the families of victims on the children’s meals and testing leftover food, while federal officials are seeking information on any further possible cases (i.e. persons, and particularly children, with bloody diarrhea who test positive for enterohemorrhagic E. coli).

I wonder if they’ve looked into the families’ grocery store receipts?

A peer-reviewed article in the April 15 issue of Clinical Infectious Diseases reports that the source of a 2007 outbreak of E. coli in Denmark was found using credit card information.

Investigators had struggled to determine the source of a strain of E. coli O26 that infected 20 Danish children between February and May of 2007.

Flesh and Stone reports that when interviews failed to yield any likely suspect foods, investigators turned to shopping lists.

“Parents in seven families provided their credit card information and a list of supermarkets where they had shopped. The two supermarket chains that the parents had used most often agreed to help with the investigation. The stores searched their central computers for the precise amount paid and the date and the location of the shop.

“From there, investigators determined that five families had purchased the same brand of fermented, organic beef sausage. A sixth family was linked to the same sausage brand through shopping records provided by the kindergarten attended by two children who became infected with the same E. coli strain, STEC O26. An unopened sample of the sausage also tested positive for the strain.”

Authors of the CID article acknowledged that relying on memory to identify similarities among the diets of outbreak victims diets is often unsuccessful and found credit card information to be “a strong tool in the [current] investigation.”

Investigation of a similar outbreak of E. coli O157 in Iceland successfully used the same method some months later. It could be worth a try for Norway.