Make it mandatory: More evidence that restaurant inspection disclosure matters

This work describes the relationship between compliance with food hygiene law as reflected in food hygiene scores; measures of microbiological contamination of food samples taken from consumer-facing food businesses in England, Northern Ireland and Wales; and outbreaks of foodborne illness.

This paper demonstrates an association between the results of food hygiene inspections done by trained inspectors, using a rigorous and consistent procedure, with microbiological contamination of actual food samples from those premises. A proposed theoretical model further demonstrates the reduction in foodborne illness that would result if there were increased compliance with food hygiene law.

As clean as they look? Food hygiene inspection scores, microbiological contamination, and foodborne illness

Fleetwood, Janet, Shamim Rahman, Darren Holland, David Millson, Laura, Thomson, Guy Poppy. 2019.

Food Control. 96: 76-86

https://doi.org/10.1016/j.foodcont.2018.08.034

https://www.sciencedirect.com/science/article/pii/S0956713518304432

Shiga-toxin E. coli at UK nursery sparks NHS probe

PA reveals a Perthshire school was involved in an E.coli scare last week.

NHS Tayside launched an investigation after a suspected case of the bacteria in a child at Errol Primary School’s nursery.

The nursery will undergo three days of deep cleaning as a “precautionary measure”.

Parents at the school were issued with letters from the health board with information on the infection.

The child was being tested for a non-O157 strain.

Speaking on Friday a spokesperson at NHS Tayside confirmed: “NHS Tayside’s health protection team is aware of and currently investigating a single suspected case of E. coli non O157 infection in a child who attends a nursery in Perthshire.

“As a precaution, a letter has been issued to parents of children at the nursery for information and reassurance.

“The risk to the wider public is very low.”

UK father paralysed after food poisoning issues safety warning to others

ITV news reports a father who became paralysed after contracting a rare illness from food poisoning has issued a warning to others about food safety.

Dai Braham, 40, was left paralysed from the nose down after becoming unwell while watching his six-year-old son play rugby in April.

Within a matter of days, he was in an induced coma.

Father-of-two Dai was a keen bodybuilder and fitness fanatic

It was only later that medical staff discovered the fitness fanatic from Bridgend had been suffering from food poisoning campylobacter – which led to the rare autoimmune disorder Guillian-Barré Syndrome.

At his worst point, he found himself unable to breathe without a ventilator and without a voice.

“It’s the scariest thing in the world. You are basically locked in your own body”, Dai said.

“Your mind is fine and you know what you want your body to do but you just can’t do it.

“It was horrible, I couldn’t communicate with anyone. I could blink to say yes or no or use a letter card. Then I would use words on a board to spell out certain words.”

Dai has spent the last eight months in hospital and has only recently learned to walk again.

What is Guillain-Barré syndrome?

It is thought to be caused by a problem with the immune system, and can be triggered by infections including food poisoning and the flu as well as by vaccinations, surgery or injury.

Symptoms of the condition include numbness, pins and needles, muscle weakness, and problems with balance and co-ordination.

English pub slapped with zero rating after 60 people got food poisoning turned around to get five stars

Heather Pickstock of Bristol Live reports the Old Farmhouse in Nailsea is now under new management and has been issued with a five start rating for its food hygiene.

A pub where dozens of diners suffered food poisoning after eating there on Mothering Sunday has been issued with a five star

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food hygiene rating.

More than 60 people fell ill, suffering from sickness and diarrhoea in March this year after eating at the Old Farmhouse in Nailsea.

The kitchens at the pub, off Trendlewood Way, were temporarily closed while officials from Public Health England and North Somerset Council launched an investigation into the cause. It was given a zero food hygiene rating after an inspection.

Just cook it doesn’t cut it: 283 sick from Salmonella in UK lamb

I’ve been in Australia for 7 years now, and while I once thought it was national duty to eat lamb, I could never get over the smell.

So guess we’re safe from the latest Salmonella outbreak linked to lamb in the UK.

Food Standards AgencyFood Standards ScotlandPublic Health England and Health Protection Scotland are reminding people to take care when handling raw meat and to cook it properly.

This comes as we investigate a rise in cases of a particular strain of Salmonella Typhimurium which have been linked to lamb and mutton. We first saw an increase in cases of this particular type of salmonella in July 2017. A number of control measures were put into place which led to a significant decline in cases at the end of that year. A total of 118 cases were reported up until May 2018.

Since June 2018, a further 165 cases have been reported (up to 19 October), which led us to put control measures in place. These haven’t led to the same decline in cases as in 2017 and so we are now reminding the public about how to cook and handle raw meat.

Nick Phin, Deputy Director, National Infection Service, PHE said:

The likely cause of the increased numbers of this specific strain of Salmonella Typhimurium is considered to be meat or cross-contamination with meat from affected sheep.

People can be infected with Salmonella Typhimurium in a number of ways such as not cooking their meat properly, not washing hands thoroughly after handling raw meat, or through cross-contamination with other food, surfaces, and utensils in the kitchen.

Prior to July 2017 only 2 cases of this strain (Single Nucleotide Polymorphism address 1.43.67.992.2703.3225. %) had been detected in England.

Between July 2017 and November 2017, the first increase in this strain was observed with 95 cases reported in England, Scotland and Wales. Control measures were implemented which resulted in a decline in cases.

Numbers of cases were at low levels from December 2017 to June 2018 (23 cases during this period).

In June 2018, the numbers of cases increased again and since June 2018 165 cases have been reported.

There was a death in which salmonella was thought to be a contributory factor related to this outbreak last year, but we are not aware of any deaths related to this strain in 2018

UK Cyclospora shit fest

TTG reports a judge sitting at Manchester county court has ordered the disclosure of all documentary evidence relating to investigations carried out by Public Health England (PHE) surrounding cyclospora — a parasite spread by food contaminated with infected human faeces.

According to The Times, many customers claimed Tui did not tell them the Riviera Maya region of Mexico was subject to a public health warning due to cyclosporiasis before they booked.

This is in spite of 359 of the 440 British cases reported between June and October 2016 “involving travel to Mexico”, it is claimed.

Others customers allege they were handed a warning letter “only after their plane landed”.

440 sickened: Tui faces legal action from 400 people over Mexico sickness

TTG reports a  judge sitting at Manchester county court has ordered the disclosure of all documentary evidence relating to investigations carried out by Public Health England (PHE) surrounding cyclospora — a parasite spread by food contaminated with infected human faeces.

According to The Times, many customers claimed Tui did not tell them the Riviera Maya region of Mexico was subject to a public health warning due to cyclosporiasis before they booked.

This is in spite of 359 of the 440 British cases reported between June and October 2016 “involving travel to Mexico”, it is claimed.

Others customers allege they were handed a warning letter “only after their plane landed”.

8 in UK sick from Salmonella linked to Dr. Zak’s liquid egg white

‘Dr Zak’s Barn Farmed Liquid Egg White’ has been recalled by the UK Food Standards Agency.

Microbiological testing on a number of batches of the product has indicated contamination with Salmonella bacteria of the same strain as the bacteria causing infection in those affected.

Since mid-August 2018, 3 cases of salmonella have been confirmed in those who consumed the product and a further 5 cases remain under investigation.

Dr Nick Phin, Deputy Director, National Infection Service, Public Health England, said:

Most of those affected have now recovered. However, Salmonella can cause a serious infection in those with weakened immune systems or in vulnerable groups including babies, the elderly or pregnant women.

We’re aware that the high-protein product may be purchased by people for bodybuilding purposes. Symptoms of a Salmonella infection include diarrhoea, stomach cramps and sometimes vomiting and fever.

There are simple steps to stop its spread, including cooking food thoroughly, washing fruit and vegetables and washing your hands after using the bathroom.

It’s oh so simple.

Fairytale.

UK disease detectives: Supermarket loyalty cards to trace an E coli outbreak

Kathie Grant and Lisa Byrne write in Public Health Matters that in November 2017, supermarket loyalty cards were used to trace the source of a large E coli outbreak affecting mainly men in England. Dr Lisa Byrne leads Public Health England’s surveillance of two key bacteria that lead to food poisoning – E Coli and Listeria. Dr Kathie Grant heads the PHE Gastrointestinal Bacteria Reference Laboratory. The two work together as part of a larger team dedicated to reducing foodborne illness and below tell us how they put the pieces of this puzzle together to find the source.

If you’ve ever had food poisoning you’ll know that feeling of mentally going through everything you ate recently, trying to pinpoint what it was that might have made you ill. It’s our job to do that at a national scale.  We bring together lots of different pieces of  information from the community and the lab to try to find  the source of a food poisoning outbreak and then, working alongside other government agencies,  ensure that more people don’t get sick.

We study and monitor many different stomach bugs – some of which you may never have heard of! While stomach bugs are a part of life, PHE works with organisations such as the Food Standards Agency and the Animal and Plant Health Agency to try and prevent them.

Every so often we see a spike in the number of cases.  When this happens it is important that we find the link between the cases and the cause of their illness.  To do this we need to identify the exact strain of a bug to understand if people have got ill from the exact same source.

Whole Genome Sequencing (WGS) ‒ a relatively new process for showing us the makeup of a bacterium or virus’s genes ‒ has changed the way we can find the cause of an outbreak and stop more people getting ill. You can learn more about the process and how it works in our explainer blog.

Before WGS it could take weeks to identify bacteria and sometimes the bacteria could be missed. This slowed down any investigations  as we could not be sure that all the case histories we were taking could be linked to an outbreak – there was a lot of ‘noise’ and false lines of enquiry. With WGS, we can rapidly and accurately identify if bacteria of cases are the same strain and rule out people from our investigation who just happened to be ill at the same time, but with a different illness.

It has also expanded what the word ‘outbreak’ means as we can link cases across several years and different countries, meaning we can more accurately piece together a picture of how something in the food supply chain impacts human health.

Scientists working in the Gastrointestinal Bacteria reference laboratory at Public Health England. The team are processing samples from people who have reported gastrointestinal symptoms, to understand the exact cause of their illness.

Identifying the source of an outbreak is a lot like putting together a jigsaw puzzle, combining multiple pieces of evidence to get the full picture. Sometimes, a common source is obvious, such as when a group of people get ill after eating the same meal, at the same restaurant, on the same day. But other times, we need to use an arsenal of investigative tools, as was the case in a recent E coli outbreak.

In November 2017 our surveillance system alerted us to 12 cases of E coli O157 – (a particular form of E coli), over a six week window. E coliO157 is a relatively rare cause of food poisoning, with only about 700 cases a year, but it can cause a very severe illness. Because of this, any case of E coli O157 identified by doctors and laboratories must be reported to Public Health England.  We monitor the number of cases with our surveillance systems to find any patterns.

Very quickly our reference laboratory used WGS which showed that the cases had the identical genetic “fingerprint” and the work began to trace the source of infection. The majority of people who became ill were men, which was unusual as E coli outbreaks are often linked to salad items ‒ traditionally more likely to be eaten by women.

It took a few rounds of interviews – carried out by colleagues in local authorities – to zero in on the potential source of food poisoning, and a picture started to emerge that implicated burgers from a particular retailer.

We asked the supermarket to analyse the loyalty card records of those who had become ill, to help identify the particular burger product the cases had eaten.  As you can imagine, there were many different types of burgers supplied by the supermarket and it’s often difficult for people to remember exactly what they ate.

Working with the Food Standards Agency we were able to identify that all the cases had bought a particular brand of burger, leading to a product recall to ensure others didn’t get sick. The recall involved removing all the suspected batches of burgers from the supermarket shelves. The supermarket also contacted people who had bought the burgers, advising them not to eat them and return them for a refund.

Sometimes, as in this case, we can rapidly find what is making people ill and quickly remove it from sale. It’s an exciting role and we get a real sense of satisfaction out of using our skills to help people in this way. Other times it can be more frustrating – some outbreaks remain unsolved and it’s a real worry that people will get sick because we can’t eliminate a threat from food distribution.

The role really keeps us on our toes. Our surveillance systems mean that we have a good sense of patterns of illness across the year and how we can intervene to stop people getting unwell – but changes to food habits can catch us by surprise. For instance, raw milk has become more popular recently, bringing with it all the disease risks you would expect from a product that has come straight from a cow without any treatment to kill off bacteria!

In another case, eight people in the UK were affected while on holiday in Germany that was related to seeds.  The seeds were decoratively used as a garnish on salads and were difficult for cases to remember eating. Nearly 1,000 people in Germany got ill in that outbreak and one of the approaches by authorities was to use tourist photos of food to try and identify the common item in meals that could be making people sick.

Solving food borne illness outbreaks can be a real challenge, but by using a variety of the different tools available to us we can quickly intervene to stop people getting ill.

2 children from same UK family die from E. coli

Two children from the same UK family have died after contracting shiga-toxin producing E. coli, health officials have confirmed.

The children, whose ages have not yet been released, were from the Charnwood area of Leicestershire and had been treated for the infection in the last 2 weeks.

Public Health England confirmed the deaths and said it is working with
environmental health officers after 2 cases of hemolytic uremic
syndrome were confirmed in the siblings.

It is not yet known how the children contracted E. coli.

PHE East Midlands said E coli is a relatively rare infection, adding that good hand hygiene and supervised hand hygiene for small children are essential to minimise the risk of developing an infection such as E coli.

Not rare enough for this family and handwashing is never enough.