Lettuce is overrated: STEC in Finland

Escherichia coli are Gram-negative rod-shaped bacteria and part of the normal bacterial flora in the gastrointestinal tract, while diarrhoeagenic E. colipathotypes such as Shiga toxin-producing E. coli (STEC) and enteropathogenic E. coli (EPEC) are able to cause gastrointestinal infections [1]. STEC can lead to a severe disease, such as haemolytic-uraemic syndrome (HUS) [2]. The risk of HUS has been related especially to children under 5 years and to elderly people. HUS is characterised by acute onset of microangiopathic haemolytic anaemia, renal injury and low platelet count.

More than 400 STEC serotypes have been recognised, of which the best-known serotype is O157:H7 [1]. The most common non-O157:H7 serotypes causing human infections are O26, O103, O111 and O145 [3]. The virulence of STEC is largely based on the production of Shiga toxin 1 or 2 and is identified by detecting the presence of stx1 or stx2 genes [1,4]. The virulence of EPEC is caused by its capability to form attaching and effacing (A/E) lesions in the small intestine. This capability requires the presence of virulence genes called the locus of enterocyte effacement (LEE) in a pathogenity island (PAI) that encodes intimin [4]. Unlike STEC, EPEC do not produce Shiga toxin. EPEC are divided into two distinct groups by the presence of EPEC adherence factor plasmid (pEAF) expressing bundle-forming pili (BFP), which is a virulence determinant of typical EPEC (tEPEC) [5]. Thus atypical EPEC (aEPEC) are defined as E. coli that produce A/E lesions but do not express BFP. Typical EPEC are best known as a cause of infantile diarrhoea, especially in developing countries [6]. Diarrhoea-causing aEPEC have been shown to be separate group without a close relation to tEPEC, but some serotypes are genetically related to STEC [5]. The pathogenity of aEPEC has been questioned but their involvement with diarrhoeal outbreaks supports the idea that certain strains are diarrhoeagenic [1,7].

Both STEC and EPEC are transmitted through the faecal-oral route, and outbreaks caused by STEC and aEPEC have been described after ingestion of contaminated food or water [7,8]. STEC is common in ruminants and can be found in foods contaminated by ruminant faeces [9]. Most studies on STEC have focused on the serotype O157:H7, but infections and outbreaks caused by non-O157 strains are increasingly reported in Europe and elsewhere [1013]. Atypical EPEC strains are found in animals used for food production, such as cattle, sheep, goat, pig and poultry, in contrast to tEPEC that has been found only in humans [1,14].

Since 1995, clinicians and clinical microbiology laboratories have been obliged to report culture-confirmed STEC infections to the Finnish Infectious Disease Registry (FIDR) maintained by the National Institute for Health and Welfare (THL) in Finland. EPEC infections are not reportable. Since PCR instead of culture became the standard for screening of diarrhoeal patients in 2013, the incidence of reported STEC infections has increased in Finland to 1.2–1.8 per 100,000 population between 2013 and 2015 compared with 0.2–0.6 per 100,000 between 2000 and 2012. From 1997 to 2015, six food- or waterborne STEC outbreaks were detected in Finland (Table 1).

Outbreak of multiple strains of non-O157 Shiga toxin-producing and enteropathogenic Escherichia coli associated with rocket salad, Finland, autumn 2016

15.may.18

Eurosurvelliance, Volume 23, Issue 35, https://doi.org/10.2807/1560-7917.ES.2018.23.35.1700666

Sohvi KinnulaKaisa HemminkiHannele KotilainenEeva RuotsalainenEveliina Tarkka,Saara SalmenlinnaSaija HallanvuoElina LeinonenOllgren JukkaRuska Rimhanen-Finne

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2018.23.35.170066

Sometimes if you’re nice to grad students, they are nice back – Chapman edition

Chapman bailed me out of jail on a bogus charge, and all grad students should go through the hell that must feel like: Oh, and because you’ve got a key, I can find a bright kid to pick the lock. It’s the basis of cryptography.

So me and Chapman and this student had a chat this morning about how she wants to do more work for us over the summer.

Don’t know if she’ll work out, I always figured the kids are moldable until about 5, after that it’s a crap shoot (mine have all turned out exceedingly well, despite their despicable parents).

For the first year Chapman worked in my lab, I didn’t know he existed, and now he’s the golden ginger boy of food safety.

The university may shut this idea down, so wat?

I always thought being a uni prof was to come up with novel ideas and be at home while raising kids.

Now it’s lotsa  talk about research excellence, while spending your time on bureaucrat bullshit.

If I had to spend another weekly faculty meeting with 30 or more profs making 6 figures arguing the merits of a 25K per year admin type , I wouldn’t go postal, I’d turn the gun on myself.

I’m still an optimist, despite all my bullshit negativity to the contrary, and will always be there for a student, or anyone else who wants to learn.

Well played, Chapman.

Beware the canal waters (I’m looking at you Holland Marsh, Ontario, that’s in Canada): Canal irrigation water likely source of E. coli O157 outbreak linked to romaine lettuce 5 dead, 218 sick

The U.S. Food and Drug Administration, along with the Centers for Disease Control and Prevention (CDC) and state and local partners, are investigating a multistate outbreak of E. coli O157:H7 illnesses linked to romaine lettuce from the Yuma, Arizona, growing region.

The FDA, along with CDC and state partners, initiated an environmental assessment in the Yuma growing region to further investigate potential sources of contamination linked to this outbreak.

Samples have been collected from environmental sources in the region, including water, soil, and cow manure. Evaluation of these samples is ongoing.

To date, CDC analysis of samples taken from canal water in the region has identified the presence of E. coli O157:H7 with the same genetic finger print as the outbreak strain. We have identified additional strains of Shiga-toxin producing E. coli in water and soil samples, but at this time, the samples from the canal water are the only matches to the outbreak strain.

Analysis of additional samples is still ongoing, and any new matches to the outbreak strain will be communicated publicly and with industry in the region.

Identification of the outbreak strain in the environment should prove valuable in our analysis of potential routes of contamination, and we are continuing our investigation in an effort to learn more about how the outbreak strain could have entered the water and ways that this water could have come into contact with and contaminated romaine lettuce in the region.

As of June 27, the CDC reports that 218 people in 36 states and Canada have become ill. These people reported becoming ill in the time period of March 13, 2018 to June 6, 2018. There have been 96 hospitalizations and five deaths.

The traceback investigation indicates that the illnesses associated with this outbreak cannot be explained by a single grower, harvester, processor, or distributor. While traceback continues, the FDA will focus on trying to identify factors that contributed to contamination of romaine across multiple supply chains.  The agency is examining all possibilities, including that contamination may have occurred at any point along the growing, harvesting, packaging, and distribution chain before reaching consumers. 

The FDA, along with CDC and state partners, initiated an environmental assessment in the Yuma growing region to further investigate potential sources of contamination linked to this outbreak. To date, CDC analysis of samples taken from canal water in the region has identified the presence of E. coli O157:H7 with the same genetic finger print as the outbreak strain. We have identified additional strains of E. coli in water and soil samples, but at this time, the samples from the canal water are the only matches to the outbreak strain.

The FDA is continuing to investigate this outbreak and will share more information as it becomes available.

“More work needs to be done to determine just how and why this strain of E. coli O157:H7 could have gotten into this body of water and how that led to contamination of romaine lettuce from multiple farms,” said Dr. Scott Gottlieb, commissioner of the U.S. Food and Drug Administration, in a statement.

Study says: Communication is most important skill for public-health types

The professional development of environmental public health professionals in Canada is guided by a set of 133 discipline-specific competencies. Given the diversity of practice in environmental public health, certain competencies may be more important to job effectiveness depending on a practitioner’s context. However, the most important competencies to job effectiveness by context are unknown. Thus, the objectives of this study were to prioritize the discipline-specific competencies according to their importance to job effectiveness, and determine if importance varied by demographic variables.

A quantitative discrete-choice method termed best–worst scaling was used to determine the relative importance of competencies. Discrete choice information was electronically collected and analyzed using Hierarchical Bayesian analysis.

Our analysis indicates that communication was most important to job effectiveness relative to the other categories. Competency statements within each category differed in their importance to job effectiveness. Further, management and front-line practitioners differed in the importance placed on five of the eight categories.

This information can be used to guide new training opportunities, thereby investing in the capacity of environmental health professionals to better protect population health.

Prioritizing professional competencies in environmental public health: A best-worst scaling experiment

Aug. 2018

Environmental Health Review, vol. 61 no. 2, pg 50-63

Lauren E. Wallar,* Scott A. McEwen,* Jan M. Sargeant,* Nicola J. Mercer, Andrew Papadopoulos*

 https://doi.org/10.5864/d2018-014

http://pubs.ciphi.ca/doi/abs/10.5864/d2018-014

How produce gets contaminated in the field: A review

Foodborne illness resulting from the consumption of contaminated fresh produce is a common phenomenon and has severe effects on human health together with severe economic and social impacts.

The implications of foodborne diseases associated with fresh produce have urged research into the numerous ways and mechanisms through which pathogens may gain access to produce, thereby compromising microbiological safety.

This review provides a background on the various sources and pathways through which pathogenic bacteria contaminate fresh produce; the survival and proliferation of pathogens on fresh produce while growing and potential methods to reduce microbial contamination before harvest.

Some of the established bacterial contamination sources include contaminated manure, irrigation water, soil, livestock/ wildlife, and numerous factors influence the incidence, fate, transport, survival and proliferation of pathogens in the wide variety of sources where they are found. Once pathogenic bacteria have been introduced into the growing environment, they can colonize and persist on fresh produce using a variety of mechanisms.

Overall, microbiological hazards are significant; therefore, ways to reduce sources of contamination and a deeper understanding of pathogen survival and growth on fresh produce in the field are required to reduce risk to human health and the associated economic consequences.

 

Sources and contamination routes of microbial pathogens to fresh produce during field cultivation: A review

Food Microbiology, vol. 73, pg. 177-208

Oluwadara Alegbeleye, Ian Singleton and Anderson Sant’Ana

https://doi.org/10.1016/j.fm.2018.01.003

https://www.sciencedirect.com/science/article/pii/S0740002017310158?via%3Dihub

Will it mean fewer sick people? Trump’s plan to consolidate federal food safety efforts won’t work

Timothy D. Lytton, Associate Dean for Research & Faculty Development and Distinguished University Professor & Professor of Law at Georgia State University College of Law writes in this contributed op-ed that:

The Trump administration on June 21 unveiled an ambitious plan to consolidate federal food safety efforts within the U.S. Department of Agriculture.

Currently, 15 agencies throughout the federal government administer 35 different laws related to food safety under the oversight of nine congressional committees.

The administration calls this system “illogical” and “fragmented.”

“While [the USDA’s Food Safety Inspection Service] has regulatory responsibility for the safety of liquid eggs, [the Food and Drug Administration in the Department of Health and Human Services] has regulatory responsibility for the safety of eggs while they are inside of their shells,” the document explains. “FDA regulates cheese pizza, but if there is pepperoni on top, it falls under the jurisdiction of FSIS; FDA regulates closed-faced meat sandwiches, while FSIS regulates open-faced meat sandwiches.”

Concern about this state of affairs has been fueling similar consolidation proposals for decades.

But my research for a forthcoming book on the U.S. food safety system suggests that the Trump administration plan faces a number of challenges that make a major reorganization of federal food safety regulation both impractical and undesirable.

The curious division of labor between the U.S. Department of Agriculture and the Food and Drug Administration dates back to the passage of two laws enacted in 1906.

The Meat Inspection Act mandated inspection of all beef carcasses. The Pure Food and Drug Act prohibited the sale of adulterated food in interstate commerce.

Initially, both laws were implemented by officials at the USDA. Its Bureau of Animal Industry placed inspectors trained in veterinary science at every meat plant. Meanwhile, its Bureau of Chemistry employed laboratory scientists to test foods for adulteration.

In 1940, Franklin Roosevelt moved the Bureau of Chemistry, by then renamed the Food and Drug Administration, out of the USDA and into the Federal Security Agency, which later became the Department of Health and Human Services. Today, the FDA is responsible for overseeing the production of most foods other than meat and poultry.

Separately, the Bureau of Animal Industry was renamed the Food Safety Inspection Service, which is still responsible for all meat and poultry inspections.

Concerns about regulatory fragmentation grew as Congress assigned new tasks related to food safety to a variety of other agencies.

For example, Congress instructed the Federal Trade Commission to regulate food advertising, the Environmental Protection Agency to set pesticide tolerances and the National Marine Fisheries Service to inspect seafood.

Proponents of putting food safety under the roof of a single agency have argued that the current system causes confusion because different agencies produce inconsistent standards.

They further allege that overlapping jurisdictions create inefficiencies and that inadequate coordination leaves gaps in coverage. They also worry that the involvement of so many different actors diffuses political accountability.

The first high-profile proposal to consolidate federal food safety regulation was made in 1949, during the Truman administration, when a presidential commission recommended transferring food safety oversight to the USDA, just as the Trump administration has.

In 1972, consumer activist Ralph Nader advocated creating a new consumer safety agency to oversee food safety. And a few years later, a Senate committee recommended moving the USDA’s food safety responsibilities to the FDA.

Those are just three examples of more than 20 such proposals from both sides of the political aisle, including one by President Barack Obama in 2015.

None of these consolidation efforts succeeded for the same reasons the current one is unlikely to work now.

First of all, the many congressional committees that currently oversee agencies that regulate food safety are unlikely to support any reorganization that would reduce their power. Congressional oversight affords lawmakers who serve on committees opportunities to help interest groups and constituents in exchange for political support.

Similarly, industry associations are unlikely to support a reorganization that would disrupt their relationships with existing agencies. Consolidation threatens to reduce their access and influence over agency decisions.

In addition to the political obstacles to consolidation, there are practical problems. Merely merging the 5,000 food safety officials in the FDA and the 9,200 officials in the FSIS under the oversight of a single administrator would not eliminate the differences in jurisdiction, powers and expertise responsible for the current bureaucratic fragmentation. Meaningful consolidation would require a complete overhaul of federal food safety laws and regulations, a task of extraordinary legal and political complexity.

Moreover, consolidating food safety efforts in a single agency might create new forms of fragmentation. For example, transferring the FDA Center for Veterinary Medicine’s program for regulating drug residues in beef and poultry to the USDA would separate it from the FDA’s veterinary drug approval program.

And finally, reorganization is costly and would take years for the different agency teams newly working together to develop bonds of trust and cooperation. And these costs would have to be paid upfront, without a clear idea of whether the expected gains will ever pay off.

Consolidation need not be all or nothing.

For example, some have proposed more modest consolidation of inspection services, policy planning and communications that would be less costly and not so difficult.

Nonetheless, Congress has shown little interest in considering any bureaucratic reorganization of federal food safety regulation, even a partial consolidation.

In other words, the Trump administration may have to settle for the less ambitious goal of better interagency coordination, which offers an alternative way to address concerns about duplication and coverage gaps. This more modest approach would not, however, address the persistent problem of fragmentation.

In food safety, as in other regulatory reform arenas, it may turn out that half a loaf is better than none.

Another Cyclospora outbreak IDed in Minnesota

The Minnesota Department of Health (MDH) is investigating an increase in Cyclospora infections within the last month. To date, state health officials have identified two outbreaks together involving at least three dozen Minnesotans.

One outbreak has been identified among people who ate at Sonora Grill in Minneapolis in mid-May. To date, 17 patrons have reported illness. The restaurant is fully cooperating with the investigation, and investigators say they do not have any indication that there is an ongoing risk to patrons.

To better identify the source of infection, MDH investigators want to speak with people who ate at Sonora Grill over the weekend of May 18-May 20, regardless of whether they became ill.

“Even if you have not been sick, your information can help us identify what may have caused these illnesses and prevent future illnesses,” said Trisha Robinson, an epidemiologist supervisor with MDH. “If you ate at Sonora Grill during that weekend of May 18-20, please contact the Minnesota Department of Health Waterborne Diseases Unit at 651-201-4891.”

Infection with Cyclospora, known as cyclosporiasis, is caused by the parasite Cyclospora and is spread through consumption of imported fresh produce; it is not spread person-to-person. Washing of imported produce, or routine chemical disinfection or sanitizing methods, are unlikely to kill Cyclospora. Symptoms typically include watery diarrhea, stomach cramps, nausea, loss of appetite and weight loss. People typically become ill about a week after exposure, but this period can range from 2-14 days. Diarrhea can last several weeks or longer if not treated.

A second outbreak has been linked to Del Monte vegetable trays purchased at Kwik Trip locations. To date, 20 cases have been identified among Minnesotans in this outbreak. Cases report purchasing the vegetable trays at various Kwik Trip locations around the state. Kwik Trip is cooperating with the investigation and voluntarily removed the vegetable trays from their shelves. Consumers should not eat the following products:

Del Monte Vegetable Tray, containing broccoli, cauliflower, carrots and dill dip, 6 oz.

Del Monte Vegetable Tray, containing broccoli, cauliflower, carrots and dill dip, 12 oz.

MDH investigators are working with the Minneapolis Health Department and the Minnesota Department of Agriculture (MDA) on the Sonora Grill outbreak and with MDA and other states on the Kwik Trip outbreak.

“We do not have any indication at this time that the two outbreaks are related,” Robinson said. “Besides these outbreak cases, there are other cases of cyclosporiasis that do not appear to be related to either of these outbreaks, which is not unexpected for this time of year. We typically see increases in Cyclospora infections from May through August.”

Money talks: Safety interventions in Dutch vegetable production

Surveys still suck, but the results of this one generally correlate to what we have found doing 20 years of on-farm food safety with fresh produce growers.

Outbreaks and crisis drive grower food safety concerns, prevention is a hard sell, but we’ve shown it can be done.

Understanding growers’ preferences regarding interventions to improve the microbiological safety of their produce could help to design more effective strategies for the adoption of such food safety measures by growers.

The objective of this survey study was to obtain insights for the design of interventions that could stimulate growers to increase the frequency of irrigation water sampling and water testing to reduce possible microbiological contamination of their fresh produce.

The results showed that price intervention, referring to making the intervention less costly by reducing the price via discounts, is the most effective strategy to change growers’ intentions to increase their frequency of irrigation water testing. Moreover, a sense of urgency affects their intentions to increase the frequency of irrigation water testing.

The findings of this survey support the hypothesis that, to date, safety is not perceived as a quality control issue under normal circumstances, but safety becomes an overriding attribute in a food crisis.

Understanding preferences for interventions to reduce microbiological contamination in Dutch vegetable production

June 2018, Journal of Food Protection vol. 81 no. 6

A. P. M. VAN ASSELDONK,1*L. MALAGUTI,2M. L. H. BREUKERS,1 and H. J. van der FELS-KLERX2,3

https://doi.org/10.4315/0362-028X.JFP-17-106

http://jfoodprotection.org/doi/abs/10.4315/0362-028X.JFP-17-106

Does chlorine make pathogens harder to detect in fresh produce?

The microbiological safety of fresh produce is monitored almost exclusively by culture-based detection methods. However, bacterial foodborne pathogens are known to enter a viable-but-nonculturable (VBNC) state in response to environmental stresses such as chlorine, which is commonly used for fresh produce decontamination.

Here, complete VBNC induction of green fluorescent protein-tagged Listeria monocytogenes and Salmonella enterica serovar Thompson was achieved by exposure to 12 and 3 ppm chlorine, respectively. The pathogens were subjected to chlorine washing following incubation on spinach leaves. Culture data revealed that total viable L. monocytogenes and Salmonella Thompson populations became VBNC by 50 and 100 ppm chlorine, respectively, while enumeration by direct viable counting found that chlorine caused a <1-log reduction in viability. The pathogenicity of chlorine-induced VBNC L. monocytogenes and Salmonella Thompson was assessed by using Caenorhabditis elegans. Ingestion of VBNC pathogens by C. elegans resulted in a significant life span reduction (P = 0.0064 and P < 0.0001), and no significant difference between the life span reductions caused by the VBNC and culturable L. monocytogenes treatments was observed. L. monocytogenes was visualized beyond the nematode intestinal lumen, indicating resuscitation and cell invasion. These data emphasize the risk that VBNC food-borne pathogens could pose to public health should they continue to go undetected.

IMPORTANCE Many bacteria are known to enter a viable-but-nonculturable (VBNC) state in response to environmental stresses. VBNC cells cannot be detected by standard laboratory culture techniques, presenting a problem for the food industry, which uses these techniques to detect pathogen contaminants. This study found that chlorine, a sanitizer commonly used for fresh produce, induces a VBNC state in the foodborne pathogens Listeria monocytogenes and Salmonella enterica. It was also found that chlorine is ineffective at killing total populations of the pathogens. A life span reduction was observed in Caenorhabditis elegans that ingested these VBNC pathogens, with VBNC L. monocytogenes as infectious as its culturable counterpart. These data show that VBNC foodborne pathogens can both be generated and avoid detection by industrial practices while potentially retaining the ability to cause disease.

Viable-but-nonculturable listeria monocytogenes and Salmonella enterica serovar Thompson induced by chlorine stress remain infectious

17 April 2018

American Society for Microbiology, vol. 9 no. 2

Callum J. HighmoreaJennifer C. Warnera*Steve D. Rothwellb, Sandra A. Wilksa, C. William Keevila

doi: 10.1128/mBio.00540-18

http://mbio.asm.org/content/9/2/e00540-18

Wasn’t there a Food Safety Authority before this? NZ food safety for a foodie nation

I used to go there a lot, but probably won’t get invited anytime soon.

I get it that politicians have a short life-span, that things change, but New Zealand used to have the New Zealand Food Safety Authority, and then it got sucked into the Ministry of Primary Industries, and now you’re creating New Zealand Food Safety.

The printers of business cards will be pleased with the work.

Food Safety Minister Damien O’Connor says the establishment of New Zealand Food Safety will help raise the profile of food safety for all New Zealanders.

It is one of four new business units created within the Ministry for Primary Industries to create a stronger focus on keys areas of work, along with Biosecurity New Zealand, Fisheries New Zealand and Forestry New Zealand.

“In the spirit of manaakitanga, our food safety system cares for the people producing and processing food, as well as those consuming it. It protects consumers at home and abroad by ensuring that food grown, harvested, imported, processed, transported, stored, exported and sold is safe to eat,” Damien O’Connor says.

“The integrity of the food safety system is particularly important to New Zealand because we are a nation of food producers and exporters, and we are trusted across the globe.

“New Zealand Food Safety brings together about 390 people from MPI’s food standard setting, verification and assurance teams into one strong and visible business unit.