Your vomit and diarrhea is our bread and butter: Portland’s outbreak museum

I still miss Bill.

I never really knew him, but we all have our demons.

Everyone has problems, especially the ones who think they don’t.

He was awkward in a way I found familiar

Thing is, Bill could nail an outbreak in a heartbeat.

Emily Smith of Atlas Obscura writes about the home-canned beets killed someone.  The freezer-aisle pot pies (there’s about 50 in Phebus’ freezer from 2007). The cheese, breakfast cereal, frozen pizza, tampons, tattoo ink and plastic bags have victims of their own.

These are a handful of the exhibits on display at the International Outbreak Museum in Portland, Oregon, which curators say is the world’s only museum of its kind. It features objects collected from outbreaks of infectious diseases that took place in Oregon and around the globe.

The museum is a single windowless room in a state office building that’s home to the Oregon Health Authority. This room was once the office of Bill Keene, an internationally respected disease investigator for the State of Oregon who assisted on cases around the world. He officially began collecting the mementos for a museum in 1993, though he started holding onto items a decade or more earlier. After his unexpected death in 2013, his colleagues have continued his efforts.

The small room is crammed with more than 100 exhibits that fill tall glass-encased cabinets and cover every surface. The beets and the box of Rely tampons are authentic. Others, like the papier-mache cantaloupes in a net that hangs from the ceiling, are carefully handcrafted representations.

Not every item in the collection represents a fatal outbreak. But every item hints at ailment: stomach cramps, fevers, chills, rashes—the often-agonizing symptoms that accompany an outbreak. And each exhibit hints at investigators’ quiet, crucial work to unravel the mystery of their cause.

On a shelf along the back wall, some tarot cards and mugs bearing the image of cult leader Bhagwan Shree Rajneesh mark a dark chapter for disease detectives, when a cult in rural Antelope, Oregon, perpetrated the largest bioterrorism attack in U.S. history. The goal was to suppress voter turnout in Wasco County, ensuring that cult members, known as Rajneeshees, could overtake locals in the November 1984 elections. They slipped liquid tainted with salmonella into salad-bar offerings at 10 restaurants and several other public places. The attack sickened 751 people, who ranged in age from newborn to 87.

The plastic milk jugs contained in a red plastic crate recall a yearlong case that stumped investigators as they pondered 25 cases of salmonella spread across Oregon, over the course of 12 months, with no clear link. The only detail the cases had in common was milk, which perplexed investigators because the milk was pasteurized. However, a trip to a beloved local dairy in Roseburg, southern Oregon revealed that while the milk itself was fine, a crate-washing machine at the facility was contaminated with salmonella bacteria. So, as crates of milk cartons moved through the facility, they were doused with a salmonella-infused solution. A thorough cleaning of the facility ended the yearlong outbreak.

The Outbreak Museum’s peanut-laced products including granola bars, cookies, and crackers serve as a reminder of Stewart Parnell, a corporate peanut peddler who was sentenced to 28 years in prison for knowingly selling contaminated products. Parnell, the CEO of the Peanut Corporation of America, famously wrote in an email, “Just ship it,” when he learned a shipment had been delayed pending salmonella testing. The shipped peanut-butter paste was linked to a 2008 outbreak that killed nine people and sickened more than 700 others.

In isolation, the stuff that fills this one-room museum is the same ordinary stuff that fills trash and recycling bins. It’s waxy paper boxes printed with company slogans and plastic wrappers bearing logos and nutrition facts. In some cases it’s convincing reproductions of raw meat you’d find shrink-wrapped and refrigerated in the grocery store or fresh strawberries you’d buy from a farmer’s market.

But in Bill Keene’s world, each exhibit stands for a smoking gun. This museum is the evidence of real, everyday items that harmed or killed—and that could have gone on to hurt more, if not for the scientists who solved these mysteries. Even before it was a museum, this room was a place where other investigators drew inspiration.

“You could come in here when you needed a break from your work, sit here and ask him about anything,” epidemiologist Tasha Poissant says.

Keene wanted this museum to commemorate the successes, remember the failures and demonstrate the importance of this work, Poissant says. He understood that outbreaks affect people’s lives in intimate and powerful ways, which means they also have the power to educate, to influence public opinion and change policy.

“When Bill passed away, we all wondered what are we going to do with this museum?” epidemiologist Hillary Booth says. “He didn’t get a chance to make it into the proper museum he wanted to.”

So his colleagues and family stepped in to bring some order to the collection he’d amassed. They installed the display cabinets in his office and catalogued exhibits on the museum website. They continue to collect artifacts, from their own work as well as from cases around the world. While the museum isn’t open to the general public, the curators show it off whenever the opportunity arises—when a public health conference comes to town or guests visit the office.

Memorabilia from Keene’s work spills out of the museum and covers the walls leading to its door. Newspaper clippings, photos from his field work and quotes from Keene (Keene-isms) decorate the cubicle walls just outside.

“Your diarrhea is our bread and butter,” one quote reads.

Poissant offers a correction: What Keene actually said was, “Your vomit and diarrhea is our bread and butter.”

Either way, Keene’s words capture a genuine passion for this line of work that in some cases saves lives but almost always remains invisible.

Why quarterbacks should stick to football: New Oregon QB commit Cale Millen celebrates by chugging raw eggs with head coach Mario Cristobal

There’s nothing worse than athletes trying to speak.

Bull Durham captured it (below).

This ain’t Rocky, this is Salmonella.

Apparently, it was representative of Cale Millen’s dedication to the University of Oregon. The newest Ducks commit, a Mount Si (Wash.) three-star junior, announced his college decision on Sunday and celebrated by chugging a glass of three raw eggs with his future head coach, Mario Cristobal, as captured by The Oregonian Oregon beat writer Andrew Nemec.

If that sounds unhealthy, well, it is. Sure, raw eggs pack plenty of protein, but they also pack a risk of salmonella. Not a huge risk of salmonella, mind you (there’s actually a greater risk of salmonella on contaminated egg shells than eggs), but the risk is there.

Cut means increased risk: 18 sick in Salmonella outbreak in Oregon, Washington linked to pre-cut fruit

Brad Schmidt of The Oregonian reports that 18 people in Washington and Oregon have been diagnosed with Salmonella after eating pre-cut fruit purchased from local grocery stores, prompting a review by state and federal health authorities.

Officials in both states have traced the outbreak to pre-cut watermelon, cantaloupe and fruit mixes containing those fruits. The products were purchased from Fred Meyer, QFC, Rosauers and Central Market.

Anyone who bought those products from those stores between Oct. 25 and Dec. 1 is urged to throw out the fruit.

“They should not eat it,” said Jonathan Modie, a spokesman for the Oregon Health Authority.

Just two of the 18 confirmed cases happened in Oregon, Modie said, with one in Multnomah County and one in Wasco County. Both people ate fruit purchased from Fred Meyer, he said, and the products carried Fred Meyer labels.

A spokesman for Fred Meyer, Jeffrey Temple, said the grocer pulled pre-cut watermelon and cantaloupe from store shelves in response to Friday’s advisory by the state of Washington.

Customers can return items to local stores for a full refund.

“Our highest priority is our customer’s safety and the safety of our food,” Temple said in a statement. “We will continue to work closely with state and federal health officials on their investigation to determine the source of this outbreak.” 

Uh-huh.

 

Raw is risky and a drain on public health

A protracted outbreak of Escherichia coli O157:H7 infections was caused by consumption of unpasteurized (“raw”) milk sold at Oregon grocery stores. Although it never caused a noticeable increase in reported infections, the outbreak was recognized because of routine follow-up interviews.

Six of 16 Portland-area cases reported between December 1992 and April 1993 involved people who drank raw milk from dairy A. By pulsed-field gel electrophoresis (PFGE), E. coli O157:H7 isolates from these cases and from the dairy A herd were homologous (initially, 4 of 132 animals were E. coliO157:H7-positive).

Despite public warnings, new labeling requirements, and increased monitoring of dairy A, retail sales and dairy-associated infections continued until June 1994 (a total of 14 primary cases). Seven distinguishable PFGE patterns in 3 homology groups were identified among patient and dairy herd E. coli O157:H7 isolates. Without restrictions on distribution, E. coli O157:H7 outbreaks caused by raw milk consumption can continue indefinitely, with infections occurring intermittently and unpredictably.

A prolonged outbreak of Escherichia coli O157:H7 infections caused by commercially distributed raw milk

1.sep.2017

The Journal of Infectious Diseases

Keene et al.

https://academic.oup.com/jid/article/176/3/815/872141

Beware the Shiga-toxin producing E. coli in sheep shit: Goat yoga is a thing in Oregon

I’m really glad the folks in Portland, Oregon have stopped demonstrating about Dump-a-Trump, and are going back to their old ways – like having yoga with goats.

goat-yoga-portlandThe No Regrets Farm in Albany, Oregon, is offering what it calls Goat Yoga classes.

The sessions take place outside. While participants stretch and pose, the animals wander around or sit on mats and wait to be pet, said Lainey Morse, who owns and lives on the farm.

Morse launched the program last month, and it was an instant hit, she told The Huffington Post. The remaining two classes of the season have filled up already, and her waiting list for next year is more than 500 people long, she added.

Though people have been taking the class for a suggested donation of $10, that price will likely change in the future due to demand.

To sign up for a class, people can visit the Goat Yoga Facebook page, where the class schedule and updates are posted.

“They are gentle and peaceful and just want attention,” the farm owner told HuffPost of the goats.

People seem to enjoy their experiences with the class. In fact, one participant, a cancer patient, was flooded with emotion when taking it, according to Morse.

What’s behind Oregon’s Marionberry mania?

I love the berries, especially the tart blackberries.

marion-barry-1They grew voraciously in my aunt’s backwoods where as kids, we’d pick them by the bucketful. She also made great pies.

According to Tove Danovich of NPR, blackberries also grow voraciously in the Pacific Northwest and it’s not rare to stumble across rural barns or abandoned homes that have been completely consumed by the thorny vine. Let them grow too close to a window, and they’ll break the glass. They’re common — easy to forage and hard to get too excited about. At least compared to the marionberry, a type of blackberry that has become an Oregon obsession.

One of the reasons the marionberry is so beloved is because it is entirely a product of Oregon. It’s “born and raised” in state, so to speak.

The marionberry, a cross between Chehalem and Olallie blackberries, was bred at Oregon State University as part of a berry-developing partnership with the U.S. Department of Agriculture that dates back to the early 1900s. It’s named for Marion County in the Willamette Valley, where most of the field trials took place (not for former D.C. Mayor Marion Barry, right, exactly as shown).

marionberryWhen the berry was introduced in the 1950s, it was widely hailed as the most delicious blackberry commercial cultivar around. Even today, people rave over its tart-yet-sweet flavor — think of a cross between raspberries and blackberries. (Though there is some raspberry in its DNA, the red fruits are more like a genetic great-great grandparent to the marionberry.)

MNA fighter’s Listeria death shines light on illness

Amy Frazier of KOIN 6 reports the death last week of MMA fighter Chael Sonnen‘s newborn daughter from a listeria infection shined a spotlight on the foodborne illness.

Brittany-Smith-Chael-Sonnen-girlfriend-pictures1Sonnen, a West Linn native described as “one of the most polarizing figures in MMA,” talked about his baby, Blauna, on his podcast. She was born 10 weeks prematurely, and both she and his wife, Brittany, were diagnosed with listeriosis, said MMA official Jeff Meyer.

The CDC said listeriosis is usually caused by eating contaminated food and primarily affects older adults, pregnant women, newborns and adults with weakened immune systems.

“It is worrisome in pregnancy because there is the chance a pregnant woman can pass the infection on to her fetus and that can cause potentially serious complications like miscarriage, still birth, preterm labor. So it can be serious in pregnancy,” said Dr. Jennifer Vines, the Deputy Health Officer for the Multnomah County Health Department.

“It’s an illness that would be hard to distinguish from others, so we talk about flu-like symptoms,” she said — fever, muscle aches, feeling tired, vomiting and diarrhea.

Vines said listeria is rare among pregnant women. Over the past 5 years, she said there’s been about 10 cases of listeria, “and of those, only 2 of those have been pregnant women.”

She suggested pregnant women steam hot dogs or deli meats, avoid unpasteurized cheeses and avoid cross-contamination from the water in the package to any other foods, like a salad.

“You’d want to avoid any unpasteurized milk and then any unpasteurized milk that’s used to make cheese,” Vines said.

Handwashing is never enough: E. coli outbreak suspected at Oregon fair

Washington County health officials are investigating after cases of Shiga-toxin producing E. coli were reported after some attendants at the Washington County Fair became ill.

Microbiologist Mi Kang works to identify a strain of E. coli from a specimen in a lab at the Washington State Dept. of Health Tuesday, Nov. 3, 2015, in Shoreline, Wash. Chipotle's industry-leading commitment to tracking its ingredients from farm to table is being put to the test by an E. coli outbreak that has sickened at least 37 people as of Tuesday, nearly all of whom ate recently at one of the chain's restaurants in Washington state or Oregon. Scientists also said that they identified the specific microorganism responsible, which they believe was carried on fresh produce such as lettuce or tomatoes. (AP Photo/Elaine Thompson)

No sources has been identified, but public health officials said that livestock at the Washington County Fair may have been a cause, as well as food items brought to the fair from outside.

According to Washington County, anyone who attended the Washington County Fair and has had, or develops, symptoms of stomach cramps, diarrhea, vomiting or fever, should call their health care provider.

“The best way to prevent getting STEC infection is by washing hands well with soap and water,” Baumann said. “It’s very important to wash your hands after using the bathroom or changing diapers, before preparing or eating food, and after contact with animals or their environments at farms, petting zoos and fairs.”

A table of petting zoo outbreaks is available at https://barfblog.com/wp-content/uploads/2016/05/Petting-Zoo-Outbreaks-Table-5-5-16.xlsx

Best practices for planning events encouraging human-animal interations

Zoonoses and Public Health 62:90-99

Erdozain , K. KuKanich , B. Chapman and D. Powell, 2015

http://onlinelibrary.wiley.com/doi/10.1111/zph.12117/abstract?deniedAccess

 Educational events encouraging human–animal interaction include the risk of zoonotic disease transmission. ‘It is estimated that 14% of all disease in the USA caused by Campylobacter spp., Cryptosporidium spp., Shiga toxin-producing Escherichia coli (STEC) O157, non-O157 STECs, Listeria monocytogenes, nontyphoidal Salmonella enterica and Yersinia enterocolitica were attributable to animal contact. This article reviews best practices for organizing events where human–animal interactions are encouraged, with the objective of lowering the risk of zoonotic disease transmission.

Nuts to you: Organic raw macadamia nuts recalled because of Salmonella

Ashland Food Co-op of Oregon is recalling Organic Raw Macadamia nuts because it has the potential to be contaminated with Salmonella.

macadamia.organic.salmAshland Food Co-op (AFC) sold affected Organic Raw Macadamia nuts in random weight bags between January 5th, 2016 and February 4th, 2016. The nuts have a one month shelf life if refrigerated and were packaged in clear cellophane bags of random weights with an AFC bulk label.

No illnesses have been reported to date in connection with AFC product. We initiated this recall because we were notified by our supplier, Hummingbird, of the bulk Organic Raw Macadamia nuts recall.

Oregon public health employee faked 56 infection case reports

A former employee in the public health division of the Oregon Health Authority committed misconduct in 56 case reports about Clostridium difficile infections in Klamath County, Oregon, as well as in a manuscript submitted to JAMA Internal Medicine and a published report in the Morbidity and Mortality Weekly Report in March, 2012.

faking.itRyan Asherin, previously a Surveillance Officer and Principal Investigator at the OHA,

falsified and/or fabricated fifty-six (56) case report forms (CRFs) while acquiring data on the incidence of Clostridium difficile infections in Klamath County, Oregon. Specifically, the Respondent (1) fabricated responses to multiple questions on the CRFs for patient demographic data, patient health information, and Clostridium difficile infection data, including the diagnoses of toxic megacolon and ileus and the performance of a colectomy, with no evidence in patient medical records to support the responses; and (2) falsified the CRFs by omitting data on the CRFs that clearly were included in patient medical records.

In addition, Asherin was found guilty of “falsifying and/or fabricating data” that appeared in the research record of the U.S. Centers for Disease Control and Prevention, a manuscript sent to JAMA Internal Medicine in January 2013, and a paper about C. diff that appeared in the CDC’s MMWR journal. The paper — about a potentially deadly infection that’s a common feature of healthcare settings — has been cited 75 times, according to Thomson Scientific’s Web of Knowledge.

Some of these messy data also made their way into 2012 presentations to the CDC and the 11th Biennial Congress of the Anaerobe Society, according to the ORI report.

The OHA told us Asherin no longer works there.