Roundworm: The parasite on the playground

Amy, Sorenne and I were walking around Nouvea, New Caledonia this morning, and passed a sushi shop.

I said, no, I don’t eat raw fish, I’m not into worms.

If it’s frozen at sea it should control the worms, but that a long supply loop and I got enough problems.

Sorenne said, why would worms live inside us.

I started on an intro microbiology talk, but she soon became more interested in the next shop, despite my efforts to make it sound gross.

Maybe this story from today’s N.Y. Times by Laura Beil will help.

Millions of American children have been exposed to a parasite that could interfere with their breathing, liver function, eyesight and even intelligence. Yet few scientists have studied the infection in the United States, and most doctors are unaware of it.

The parasites, roundworms of the genus Toxocara, live in the intestines of cats and dogs, especially strays. Microscopic eggs from Toxocara are shed in the animals’ feces, contaminating yards, playgrounds and sandboxes.

These infectious particles cling to the hands of children playing outside. Once swallowed, the eggs soon hatch, releasing larvae that wriggle through the body and, evidence suggests, may even reach the brain, compromising learning and cognition.

The Centers for Disease Control and Prevention periodically tracks positive tests for Toxocara through the National Health and Nutrition Examination Survey. The latest report, published in September in the journal Clinical Infectious Diseases, estimated that about 5 percent of the United States population — or about 16 million people — carry Toxocara antibodies in their blood, a sign they have ingested the eggs.

But the risk is not evenly shared: Poor and minority populations are more often exposed. The rate among African Americans was almost 7 percent, according to the C.D.C. Among people living below the poverty line, the infection rate was 10 percent.

The odds of a positive test rise with age, but it’s unknown whether this reflects recent infections or simply an accumulation of antibodies from past encounters.

Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, calls Toxocara both one of the most common parasites in the country and arguably the most neglected.

“We know in some cases it is linked to lower intelligence and epilepsy,” he said. “So if you were to look at disadvantaged kids living in poverty who are also doing lower on tests of school performance, what percentage of that can be attributed to this worm?”

While much is still unknown, “there’s enough here to warrant doing a major study on a large number of children.”

At the moment, research into Toxocara among Americans is so lacking that the National Institutes of Health funding website lists no grants to study it. Even many of the most basic questions are unanswered, including how often ingested eggs progress to full-blown infection.

Among the country’s overlooked parasitic infections, “Toxocara is probably the one that affects the broadest range of people,” said Sue Montgomery, lead of the epidemiology team at the parasitic diseases branch of the C.D.C. “Dogs and cats are everywhere. Many of them may carry the parasites.”

Studies indicate that owned pets who receive regular veterinary care rarely carry Toxocara. Poorer neighborhoods bear a disproportionate share of strays. In one survey, 8,700 unowned dogs were said to be roaming parts of Dallas.

A survey of New York City playgrounds, presented at a medical conference last year, sampled 21 parks across the city. Toxocara eggs were found in nine parks. Three quarters of samples taken in the Bronx contained eggs in the larval stage, which are more infectious. No parks in Manhattan had eggs with larvae.

Don’t spread poop; 71 sick after code brown: NZ playground fells partygoers

At least 70 people fell badly ill after a “fecal incident” on a slide at an indoor playground sparked a norovirus outbreak.

Public health authorities are calling for stricter measures at indoor playgrounds after the “code brown” at Chipmunks Playland and Cafe in Tawa, when children and adults at 10 separate birthday parties were infected.

Regional Public Health is urging parents to keep sick children away from public areas, especially playgrounds and pools, when cases of chipmunk.noro.mar.14accidental diarrhea or vomiting might spread disease.

One parent of two sick children described the outbreak that struck down 71 people – more than half of whom were children – as a nightmare. Victims suffered vomiting, diarrhea and abdominal pain after the busy Saturday session.

Others took to the Chipmunks Facebook page to voice their thoughts.

“Not impressed – our entire children’s party was taken out by this bug,” Melinda Jones wrote.

“Good on Chipmunks for being proactive and also telling people,” Karyn Boyle wrote.

In the latest Public Health Surveillance Report, Wellington public health medical registrar Andrea McDonald and medical officer of health Annette Nesdale said an investigation after the incident in August last year found the facility was clean, and there were no food hygiene concerns.

The outbreak was traced to diarrhea left on a slide by a sick child. However, it was noted the playground had limited ventilation, there was no policy on vomiting or diarrhea incidents, or whose responsibility the cleanup was, and parents were not being advised against bringing in sick children.

The Chipmunks franchise had made changes across its 16 playgrounds in New Zealand, 12 in Australia and nine in Indonesia since the Tawa incident, marketing and communications manager Elaine Russell said.

Don’t play in poop; Penn playground closed due to chicken manure spill

A southwestern Pennsylvania borough has indefinitely closed a playground because of lingering contamination from a chicken manure spill last month.

The manure spilled on a hill above the playground Aug. 23, and water flows onto the playground when it rains, apparently carrying bacteria from the manure. Borough workers treated the area with lime, but say bacteria Empty+Swings+Genericcounts including salmonella haven’t decreased.

Councilman Roger Miller says his own unscientific methods have confirmed those findings saying, “My nose tells me there’s a problem out there.”

Miller asked a borough worker about the results of recent bacteria tests and says he was told, “You don’t want to know.”

1 child ill; Australia’s salmonella playground closed again

In May 2008, children’s playgrounds were closed on Sydney’s Northern Beaches after a rare form of salmonella, paratyphi B var java, normally linked to tropical fish, sickened 23 toddlers. The sand was replaced at a cost of $140,000 but subsequent testing showed the same salmonella had returned.

In Sept. 2011, the park was again closed after 4 children were stricken with gastroenteritis and salmonella java was found in bark. And it was closed again in Dec.

The Manly Daily reports today that Winnererremy Bay’s Flying Fox Park has been closed for a third time in six months after a child fell ill from salmonella.

Pittwater Council temporarily closed the flying fox and climbing net area on advice from NSW Health, resulting from tests coming back positive for salmonella java in the playground’s bark soft fall material.

NSW Health confirmed a child was diagnosed with salmonella java after visiting the playground last month.

According to council, which received the unit’s advice on Tuesday, the child used the playground on January 10.
Testing was conducted in mid-January as a follow-up to bacteria being found at the playground in December.

According to council, two samples of eight were found to have the bacterium in the latest tests. The playground bark will be removed and replaced in the next few days before the area is reopened.

Salmonella reappears at Australian beach playground

In May, 2008, children’s playgrounds were closed on Sydney’s Northern Beaches after a rare form of salmonella, paratyphi B var java, normally linked to tropical fish, sickened 23 toddlers. The sand was replaced at a cost of $140,000 but subsequent testing showed the same Salmonella had returned.??

Over three years later, and once again, part of the popular children’s playground at Winnererremy Bay has been closed after testing revealed the presence of salmonella bacteria in the surface bark.

Pittwater Council general manager Mark Ferguson said the part of the playground that tested positive would remain closed while the bark was replaced.

Dr Michael Staff, of the Public Health Unit, who conducted the testing, said there had been no cases of gastroenteritis linked to the most recent contamination.

Playground source for 2009 E. coli O157 outbreak in Germany; 1 death, 3 ill

In summer 2009, four boys living in the same suburb in Germany developed diarrhea-associated hemolytic uremic syndrome: three were infected by STEC O157:H- and one died.

Writing in Zoonoses and Public Health, researchers screened the stools of 220 persons which led to the identification of only four additional cases: two asymptomatic carriers and two diarrheal cases.

HUS was strongly associated with visiting a local playground in July, particularly on 16th July (odds ratio = 42.7, P = 0.002). No other commonality, including food, was identified, and all environmental samples (n = 24) were negative. In this localized non-foodborne outbreak, the place of likely infection was a local playground.

The complete abstract is available at

Poop in playgrounds: E. coli scare shuts Redwood City Park sandboxes

Two years ago, Christopher Beth, director of the Redwood City Parks, Recreation and Community Services department, received an anonymous tip about a couple of children getting sick after playing in the sandbox at Stafford Park. He decided to order tests.

“We’d never tested the sand before,” Beth said. “Other cities say they don’t test either. There’s no requirement.”

The results showed high levels of E. coli bacteria. Since then, a similar problem was discovered at Maddux Park. The sand play areas at both parks are being replaced with water features, officials said, and the renovations should be done by mid-January.

The sand features at all the other Redwood City parks were tested, and just Maddux came up with an E. coli problem. The source of contamination was feline feces in one case and human feces in the other.

16 hospitalized and 2 deaths now linked to ground beef recall

Following Saturday’s FSIS announcement of Fairbank Farms’ ground beef recall, a CDC spokesperson has been cited as saying that the cluster of illnesses has been expanded to 28. USA Today reports that CDCs Lola Scott Russel released information this afternoon that 16 of the ill have been hospitalized an additional death has been linked to the outbreak.

This week’s food safety infosheet focuses on the outbreak and recall.

Food Safety Infosheet Highlights:
–  Fairbank Farms recalls over 500,000 lbs of ground beef in CT, MD, VA, NC, MA, NY, NJ and PA; NH and NY deaths linked to the beef, at least 26 others ill.
– The meat juices created from thawing a frozen product like ground beef can transfer pathogens to other foods.
– Never place cooked hamburger patties on the unwashed plate that held raw patties; wash hands, counters, and utensils (like forks and spatulas) with hot soapy water after they touch raw meat.
– For a full list of recalled products, visit the FSIS release:

He said, she said: USA Today on E. coli in ground beef

Today’s USA Today offered up its point-counter-point editorial space this morning to the persistent problem of dangerous E. coli in ground beef.

From the newspaper:

Too many Americans get sick and too many die from eating that most all-American of foods, the hamburger. …

The U.S. Department of Agriculture, which has seemed confused as to whether its job is to protect consumers or producers, urges testing by hamburger makers and could require it. But it has not done so, apparently because of industry resistance. It should.

A second problem is that it’s physically impossible and economically unrealistic to test every bit of meat. … Though numerous studies have shown that irradiation is safe and effective, public suspicion has helped prevent its spread. USDA, which has approved irradiation, needs to counter the myths and campaign for its wider use.

Because producers and the USDA admit that they can’t guarantee germ-free meat, they urge consumers to handle ground beef carefully and cook it to 160 degrees, which kills most bacteria. That should be a last line of defense, not a primary one. You shouldn’t be taking your life in your hands if the bun holds an undercooked burger.

From the government, U.S. secretary of Agriculture, Tom Vilsack:

The following are just a few key steps USDA has taken recently:

— Launched an initiative to cut down E. coli contamination, including stepped up meat facility inspections to involve greater use of sampling to monitor the productsgoing into ground beef.

— Appointed a chief medical officer within USDA’s Food Safety Inspection Service to coordinate human health issues within USDA and build bridges with the public health community and senior leaders throughout the federal, state and local sectors to establish a consistent approach and heighten food safety awareness.

— Issued consolidated, more effective field instructions on how to inspect for E. coli O157:H7 contamination.

— Started testing additional components of ground beef, including bench trim, and issued new instructions to our employees asking that they verify that plants follow sanitary practices in processing beef carcasses.

Protecting public health is the sole mission of USDA’s Food Safety and Inspection Service, and we will not rest until we have eliminated food-borne illnesses, hospitalizations and deaths.

If only foodborne illness was as cute as a Kevin Bacon and Elizabeth Perkins movie.

New Food Safety Infosheet:Effects of E. coli O157:H7 linked to grilled burger leaves woman paralyzed

In Sunday’s New York Times, journalist Michael Moss profiled a 2007 outbreak of E. coli O157:H7 linked to ground beef. The tragic story focused on one of the victims, Stephanie Smith, a 22-year-old woman who was in a coma and paralyzed after acquiring the pathogen.

The video (which I can’t seem to embed, but it can be viewed on the Times site) was particularly impactful and shows some of the devastating consequences of foodborne illness.

That story is the focus for this week’s food safety infosheet

Food Safety Infosheet Highlights:
– Ground beef has been linked to at least 16 outbreaks since 2007.
– In 2009, this pathogen led to the recall of beef from nearly 3,000 grocers in 41 states.
– Cook all ground beef to 155°F for 15 seconds or 160°F for an instant kill.
– Clean and sanitize all surfaces (cutting boards, counters) where ground beef items were prepared.

The food safety infosheet can be downloaded here.