Efforts to prevent Clostridioides difficile infection continue to expand across the health care spectrum in the United States. Whether these efforts are reducing the national burden of C. difficile infection is unclear.
The Emerging Infections Program identified cases of C. difficile infection (stool specimens positive for C. difficile in a person ≥1 year of age with no positive test in the previous 8 weeks) in 10 U.S. sites. We used case and census sampling weights to estimate the national burden of C. difficile infection, first recurrences, hospitalizations, and in-hospital deaths from 2011 through 2017. Health care–associated infections were defined as those with onset in a health care facility or associated with recent admission to a health care facility; all others were classified as community-associated infections. For trend analyses, we used weighted random-intercept models with negative binomial distribution and logistic-regression models to adjust for the higher sensitivity of nucleic acid amplification tests (NAATs) as compared with other test types.
The number of cases of C. difficile infection in the 10 U.S. sites was 15,461 in 2011 (10,177 health care–associated and 5284 community-associated cases) and 15,512 in 2017 (7973 health care–associated and 7539 community-associated cases). The estimated national burden of C. difficile infection was 476,400 cases (95% confidence interval [CI], 419,900 to 532,900) in 2011 and 462,100 cases (95% CI, 428,600 to 495,600) in 2017. With accounting for NAAT use, the adjusted estimate of the total burden of C. difficile infection decreased by 24% (95% CI, 6 to 36) from 2011 through 2017; the adjusted estimate of the national burden of health care–associated C. difficileinfection decreased by 36% (95% CI, 24 to 54), whereas the adjusted estimate of the national burden of community-associated C. difficile infection was unchanged. The adjusted estimate of the burden of hospitalizations for C. difficile infection decreased by 24% (95% CI, 0 to 48), whereas the adjusted estimates of the burden of first recurrences and in-hospital deaths did not change significantly.
The estimated national burden of C. difficile infection and associated hospitalizations decreased from 2011 through 2017, owing to a decline in health care–associated infections. (Funded by the Centers for Disease Control and Prevention.)
Trends in US burden of clostridioides difficile infection and outcomes, 02 April 2020
New England Journal of Medicine
Alice Y. Guh, M.D., M.P.H., Yi Mu, Ph.D., Lisa G. Winston, M.D., Helen Johnston, M.P.H., Danyel Olson, M.S., M.P.H., Monica M. Farley, M.D., Lucy E. Wilson, M.D., Stacy M. Holzbauer, D.V.M., M.P.H., Erin C. Phipps, D.V.M., M.P.H., Ghinwa K. Dumyati, M.D., Zintars G. Beldavs, M.S., Marion A. Kainer, M.B., B.S., M.P.H., Maria Karlsson, Ph.D., Dale N. Gerding, M.D., and L. Clifford McDonald, M.D.
Almost 10 years ago, I, full professor who had been tenured since 2000, was fired by Kansas State University for bad attendance because I did want to be the spouse who crushed his partner’s dreams and not move to Australia (she has lots of other ways to be disappointed in me, join the line).
I said, why not run a distance course.
That didn’t work out so well.
Now all the unis are trying to develop distance courses as they face shutdowns in response to Coronavirus.
Nick Hall of Franchise Business reports fast food chain Red Rooster has made the drastic decision to shut two Perth outlets after leaked photos raised concerns over food safety.
Images posted on Facebook appear to show cooked chickens piled into the back of a Red Rooster delivery vehicle; unwrapped, unrefrigerated and in seemingly unsanitary condition.
Furthermore, reports suggest the chickens were being transported on day when the Perth sun was at its deadliest.
Social media users slammed the outlet for its unsanitary practices, with many questioning why the chickens were placed in the back of the car in the first place.
“To me this looks like a store has ran out of chicken and someone has transferred these from one store to another,” one user speculated.
In response to the alleged food safety breaches, Red Rooster quickly moved to close Forrestfield store, along with another in Waypoint also under the same franchisee’s direction.
In a statement, Red Rooster confirmed that the stores would remained closed until investigations were finalised.
“These stores will remain closed while detailed investigations are conducted, required actions are taken and we are satisfied that the operating standards of these locations meet the high expectations of our strict brand standards,” the brand said.
“We have alerted the relevant authorities and are working with them closely while our local staff on the ground undertake the investigation and actions required to meet our brand standards.”
In a previous life I was the scientific advisor for the Canadian Council of Grocery Distributors.
We would meet a couple of times a year, and I would provide my food safety thoughts on what was going on at retail, but what struck me was that the first three hours of every meeting were like a self-help therapy session.
These heads of food safety at major Canadian retailers would bemoan their diminishing status at the corporate level: No one cares about food safety until there’s an outbreak. Twenty years later, the song remains the same.
Alexis Morillo of Delish writes that Chipotle workers claim that food safety practices are at risk at the fast casual restaurant due to managerial procedures that cause workers to “cut corners.”
A total of 47 current and former Chipotle workers from New York City locations came forward about the malpractice in a report to Business Insider. This news follows recent allegations that the company has been violating child labor laws.
In the report obtained by Business Insider, workers outlined concerns about the way things are done behind the scenes at Chipotle. It said that many incentives like pay bonuses let other responsibilities like cleanliness audits and food safety fall to the wayside.
Workers said in the report that working at Chipotle is “highly pressurized environment” with goals that include “minimizing labor costs.”
It was also said that managers are often told in advance when a restaurant will be inspected for cleanliness so they can be prepared. Meanwhile, when an inspection isn’t taking place the cleanliness standard is much more laid back. In the past, people have questioned Chipotle’s safety standards because of the E. Coli outbreak a couple years back. The chain also has an interesting sick day policy, where there are on call nurses for workers to check if they’re actually sick.
Chipotle said in a statement to Delish that the company is committed to safe food and a safe work environment and that the pay bonuses actually incentivize workers to be even more precise when following company policies.
The topic of food safety culture and climate is growing attention from industry, researchers, standards owners and certification bodies. Authors use the terms food safety culture and climate, however, there are no unified definitions to provide clarity on the meaning of these terms.
The objective of this study is to analyse the similarities and differences in current definitions and statements of Food Safety Culture and Food Safety Climate, and provide suggested clarifying definitions for both concepts, to bring a consistent approach to the field. The study evaluates the types of organisational cultures, climates and employees’ behaviours which provide important differences and further insights into each of these.
Looking back at the origins of safety culture following the Chernobyl accident in the 1980’s provides an understanding of how this laid the foundation for safety culture and climate in the UK. Reflecting on the increasing trend in Hazard Analysis and Critical Control Point (HACCP) breaches due to the increasing number of incidents reported to authorities, the study suggests an increased focus is needed on culture, climate, and behaviour in food businesses. A critical analysis of previous definitions, statements and common words currently used to describe culture and climate in published definitions is provided. New definitions for food safety culture and climate based on factors shown to be important and are recommended for use by industry and researchers are proposed. The study assesses different types of culture, climate and employees, and suggests different employee behaviours impact the culture and climate of an organisation.
Terminology and the understanding of culture, climate, and behavioural change—impact of organizational and human factors on food safety management
Trends in Food Science and Technology, vol. 96, pg. 13-20
I started working when I was 9-years-old, biking out to the Brantford private golf course on weekends and weekdays during the summer and carrying a heavy bag of clubs around a 5-mile-course.documented my time in the bullpen, where we would wait for our name to be called.
The 1980 movie, Caddyshack, perfectly and accurately captured me in 1973.
By the time I was 13, I had a couple of regular gigs so I didn’t have to wait around, and was caddying for the club pro around Ontario (that’s in Canada) who would give me an extra $10 for every stroke under par.
In high school I often worked the graveyard shift at the gas station, pumping petrol in the middle of the night, trying not to get robbed and then going off to fall asleep in grade 12 math and French.
I’ve always worked and have concluded after years of therapy I need to work.
“Chipotle is a major national restaurant chain that employs thousands of young people across the country and it has a duty to ensure minors are safe working in its restaurants,” Healey said in a statement.
“We hope these citations send a message to other fast food chains and restaurants that they cannot violate our child labour laws and put young people at risk.”
The fine detailed that Chipotle had employees under the age of 18 working past midnight and for more than 48 hours a week.
Teenagers told investigators their hours of work were so long that it was preventing them from keeping up with their schoolwork. The company also regularly hired minors without work permits.
The settlement total is closer to $US2 million, including penalties for earned sick time violations in which managers granted employees paid time off only for certain illnesses.
I’m sure those tired kids have Chipotle food safety at the top of their priority list.
Every day I see jobs being advertised for communications and marketing types that I know I am qualified for and it would be nice to have a paycheck, but then I look at what is produced and realize I would have to check my brain at the door.
Not my style.
Someone from the OIE writes, we hear about health challenges at the human-animal-environment interface. Zoonotic diseases such as avian influenza, rabies, Ebola, and Rift Valley fever continue to have major impacts on health, livelihoods, and economies. These health threats cannot be effectively addressed by one sector alone. Multidisciplinary and multisectoral collaboration is needed to tackle them and to reduce their impacts.
As a way to support countries in taking a One Health approach to address zoonotic diseases, the guide: “Taking a Multisectoral, One Health Approach: A Tripartite Guide to Addressing Zoonotic Diseases in Countries” has been jointly developed by the Tripartite organizations (FAO, OIE, and WHO). This Guide, referred to as the Tripartite Zoonotic Guide (TZG) is flexible enough to be used for other health threats at the human-animal-environment interface; for example, food safety and antimicrobial resistance (AMR).
I won’t go into anymore. If you’re interested, click on the url.
Food contamination during air travel presents unique risks to those affected. Foodborne pathogens can cause serious illness among all on board, and potentially jeopardize flight safety. These risks are likely to increase with current trends of “densification” and a predicted massive expansion of air travel. While aircraft are being equipped with ever newer designs with a focus on efficiency and comfort, regulations remained largely unmodified in terms of basic hygiene requirements.
Strict guidelines for food hygiene exist for on-ground food settings and catering kitchens. There is uncertainty about hygiene standards on board commercial aircraft, and little regulatory oversight of what happens to food in-flight. In two hypothetical scenarios we indicate the potential risks associated with poor food handling practice onboard aircraft, with the ultimate aim of bringing aviation food safety in line with on-ground regulations. Changes in cabin design alongside adequate training in safe food handling have the potential to increase public health protection. We urge a review of existing in-flight hygiene protocols to better direct the development of regulation, prevention, and intervention measures for aviation food safety.
In-flight transmission of foodborne disease: How can airlines improve?
Several types of mettwurst, manufactured by a South Australian Company, have been recalled after it was discovered the products may be contaminated with harmful bacteria.
Wintulichs, based in Gawler, recalled their Metwurst Garlic 300g, 375g, 500g, 700g, Mettwurst Plain 700g and Mettwurst Pepperoni 375g products.
Food Standards Australia New Zealand say the products have been sold at Woolworths, IGA and independent stores across SA.
The recall is due to incorrect pH and water activity levels, which may lead to microbial contamination and could cause illness if consumed.
Customers should return the products to the place of purchase for a full refund.
In Australia and around the world, the incidence of reported foodborne illness is on the increase. Regularly cited estimates suggest that Australia is plagued with over two million cases of foodborne illness each year, costing the community in excess of $1 billion annually.
Based on the case studies cited here and a thorough examination of a variety of documents disseminated for public consumption, government and industry in Australia are well aware of the challenges posed by greater public awareness of foodborne illness. They are also well aware of risk communication basics and seem eager to enter the public fray on contentious issues. The primary challenge for government and industry will be to provide evidence that approaches to managing microbial foodborne risks are indeed mitigating and reducing levels of risk; that actions are matching words.
There is a further challenge in impressing upon all producers and processors the importance of food safety vigilance, as well as the need for a comprehensive crisis management plan for critical food safety issues.
On Feb. 1, 1995, the first report of a food poisoning outbreak in Australia involving the death of a child from hemolytic uremic syndrome (HUS) after eating contaminated mettwurst reached the national press. The next day, the causative organism was identified in news stories as E. coli 0111, a Shiga-toxin E. coli (STEC) which was previously thought to be destroyed by the acidity in fermented sausage products like mettwurst, an uncooked, semi-dry fermented sausage. By Feb. 3, 1995, the child was identified as a four-year-old girl and the number sickened in the outbreak was estimated at 21.
The manager of the company that allegedly produced the contaminated mettwurst had to hire security guards to protect his family home as threats continued to be made on his life, and the social actors began jockeying for position in the public discourse. The company, Garibaldi, blamed a slaughterhouse for providing the contaminated product, while the State’s chief meat hygiene officer insisted that meat inspections and slaughtering techniques in Australian abattoirs were “top class and only getting better.”
On Feb. 4, just three days after the initial, national report, the South Australian state government announced it was implementing new food regulations effective March 1, 1995. The federal government followed suit the next day, announcing intentions to bolster food processing standards and launching a full inquiry. Even the coroner investigating the death of the girl said on Feb. 9 that investigations relating to inquests usually took about three months to complete, but he would start the hearing the next day if possible.
By Feb. 6, 1995, Garibaldi Smallgoods declared bankruptcy. Sales of smallgoods like mettwurst were down anywhere from 50 to 100 per cent according to the National Smallgoods Council.
The outbreak of E. coli O111 and the reverberations fundamentally changed the public discussion of foodborne illness in Australia, much as similar outbreaks of STEC in Japan, the U.K. and the U.S. subsequently altered public perception, regulatory efforts and industry pronouncements in those countries. The pattern of public reporting and response followed a similar pattern of reporting on the medical implications of the illness, attempts to determine causation and finger pointing. Such patterns of reporting are valid; when people are sick and in some cases dying from the food they consume, people want to know why. The results altered both the scientific and public landscapes regarding microbial foodborne illness, and can inform future risk communication and management efforts.
In all, 173 people were stricken by foodborne illness linked to consumption of mettwurst manufactured by Garibaldi smallgoods. Twenty-three people, mainly children, developed HUS, and one died. Although sporadic cases of HUS had been previously reported, this was the first outbreak of this condition recognized in Australia.
Once public attention focused on Garibaldi as the source of the offending foodstuff, the company quickly deflected criticism, blaming an unnamed Victorian-based company of supplying contaminated raw meat, and citing historical precedent as proof of safety. Garibaldi’s administration manager Neville Mead was quoted as saying that he was confident hygiene and processing at the plant were up to standard, adding, “We stand by our processing. We’ve done this process now for 24 years and it’s proved successful.” Such blind faith in tradition, even in the face of changing science-based recommendations, even in the face of tragedy, is often a hallmark of outbreaks of foodborne illness, reflecting the deep cultural and social mythologies that are associated with food.
However, given the uncertainties at the time, a spokesman with the Australian Meat and Livestock Association appropriately rejected such allegations, saying, “I believe it is irresponsible of them (Garibaldi) to make that statement when there is absolutely no evidence of that at all.” Likewise, Victorian Meat Authority chairman John Watson said his officers were investigating Garibaldi’s claims, but that even if the raw meat had come from
Victoria, the supplier may not necessarily be the source of the disease, but rather it could be based in Garibaldi’s processing techniques.
Similarly, when Garibaldi accused the watchdog South Australian Health Commission of dragging its feet with investigations, Health Minister, Dr. Michael Armitage responded by publicly stating that, “They indicated to us that they wanted their lawyers first to be involved before they provided us with information (concerning the mettwurst). It was only (after) earlier this week, under the Food Act, we issued a demand for that information, that we got it. So indeed, I would put it to Garibaldi that the boot is completely on the other foot.”
Likewise, South Australia’s chief meat hygiene officer, Robin Van de Graaff rejected such claims, saying that, “These organisms are part of a large family of bugs that are normal inhabitants of the gut of farm animals … If a tragedy like this occurs it is usually because, and it no doubt is in this case, not because of a small amount of contamination at the point of slaughter but because of the method of handling and processing after that.” The statements of government regulators would be subsequently validated.
If the animals are hanging out in trees when they’re stunned, they lose their grip and fall to the ground below.
When temperatures warm up, most of the iguanas that were stunned are expected to wake up. Because iguanas are cold-blooded, the cold weather causes their metabolism to slow down. The reptiles become lethargic as temperatures drop from the warm weather they’re used to.
Iguanas, or “chicken of the trees,” are considered an “economical source of protein” by the University of Florida’s Institute of Food and Agricultural Sciences.