‘When we have 20 kids actively vomiting in a school that already has 17% gone we know that we’ve got a problem’: Stomach virus shutters entire Oregon school district

CBS News reports the rapid spread of a stomach virus through the Greater Albany School District has forced the closure of all schools in the district for the rest of the week. The closure comes days after a Colorado school district of about 22,000 students was forced to close after a similar viral outbreak tore through its 46 schools.

CBS Portland affiliate KOIN-TV reported the school district in Linn County, Oregon, was trying to contain the spread of the virus, which causes vomiting and diarrhea.

The district disinfected buildings over the weekend, but kept Periwinkle Elementary School closed Monday after consulting with the Linn County Health Department. On Monday evening, the Greater Albany district said on Facebook that after consulting with state and county health officials — and noting a jump in absences in their other schools — that all schools would close and reopen December 2.

Officials said cleaning teams will continue to disinfect and sanitize throughout the closure.

In Colorado, hundreds of students were sickened by symptoms similar to those of norovirus, a highly-contagious virus that causes vomiting and diarrhea. After the illness jumped quickly from school to school, officials were forced to take the unusual step of closing all 46.

“When we have 20 kids actively vomiting in a school that already has 17% gone we know that we’ve got a problem. We have to stop the exposure,” said Tanya Marvin, the head of nursing for the school district.

Labels: 12 students in Philippines fall sick after eating popcorn

Michael Jaucian of Inquirer.net reports 12 grade 7 students from Polangui General Comprehensive High School were hospitalized on Friday due to food poisoning after mistakenly adding a drying agent they thought was flavoring to popcorn, physicians said Saturday.

Based on diagnosis by the attending physician at Josefina Belmonte Duran Memorial District Hospital in Ligao City where the students were being treated, the patients experienced food poisoning after they ate the popcorn they shared during recess.

Ella Rose Delos Santos, one of the victims, said they mixed what they thought was flavoring with the popcorn their classmate bought from a store in Legazpi City.

“We put some flavor on it. After several minutes eating it, most of us felt bad and started complaining of dizziness and body ache,” Delos Santos said.

Most of the victims felt severe headache, stomachache, and were vomiting after consuming the popcorn.
They were treated and are now in stable condition.

Doctor Ma. Judy Manlangit said the students had mistakenly mixed desiccant with the popcorn.

Arrest after NZ man escaped from Auckland police by pretending to vomit

Police have made an arrest after a man escaped from police custody last Tuesday.

Melanie Earley of Stuff reports 28-year-old Michael Luke Robertson allegedly fled from Avondale Police station on Tuesday morning by pretending he was about to vomit.

On Tuesday, Auckland City district commander Superintendent Karyn Malthus said officers were called to an incident where an unknown man was sleeping in a person’s vehicle.

He was taken back to the Avondale Police Station but fled while being taken from the police car into the station.

“Police gave chase however were unable to catch him and he was last seen running down a driveway on Great North Rd,” Malthus said.

On Thursday, police said a man was arrested about midday in connection to the incident.

What a difference a grade makes

When I was about 10 or 11, playing goal in AAA hockey, I used to vomit before games I knew I was starting, Gump Worsley style.

There was this one time in a 3rd year cell biology class about a century ago, that I totally choked on an exam.

Guess I should have guessed I had anxiety issues back then.

I went to the prof the next day and she let me retake the exam and I aced it.

That’s the thing I’ve learned about anxiety, which is like playing goalie in ice hockey: sometimes you’re good, sometimes not so much (ya let in a goal, gotta get over it and keep your mind in the game).

Amy and I have a lot of shared values, but I can see that my anxiety is causing issues.

She’s going to a conference in the U.S. for a couple of weeks with the kid, and I’m going to a new rehab place (if what you’re doing ain’t working, try something different) with my trusted psychiatrist, beginning last Monday. It gives Amy some peace.

For at least three weeks.

I may write a little.

I may write a lot.

I’ve learned not to make predictions.

Can governments use grades to induce businesses to improve their compliance with regulations? Does public disclosure of compliance with food safety regulations matter for restaurants? Ultimately, this depends on whether grades matter for the bottom line.

Based on 28 months of data on more than 15,000 restaurants in New York City, this article explores the impact of public restaurant grades on economic activity and public resources using rigorous panel data methods, including fixed‐effects models with controls for underlying food safety compliance.

Results show that A grades reduce the probability of restaurant closure and increase revenues while increasing sales taxes remitted and decreasing fines relative to B grades. Conversely, C grades increase the probability of restaurant closure and decrease revenues while decreasing sales taxes remitted relative to B grades. These findings suggest that policy makers can incorporate public information into regulations to more strongly incentivize compliance.

Wiley Online Library

Michah W. Rothbart, Amy Ellen Schwartz, Thad D. Calabrese, Zachary Papper, Todor Mijanovich, Rachel Meltzer, Diana Silver

https://doi.org/10.1111/puar.13091

https://onlinelibrary.wiley.com/doi/abs/10.1111/puar.13091

FDA says wash those avocados

The avocado-based dip was the cause of an aggressive barfing incident that I’ve never been able to push aside, in the same way I wasn’t able to eat muffins for years after a barfing incident when I was a child.

I’m still amazed at the effects sight, sound and smell can have on food preferences.

It was about 33 years ago, and my ex-wife decided to make a batch of her self-proclaimed world-class guac.

We were driving to my relatives in Barrie, Ontario (that’s in Canada) and somewhere on highway 400, we pulled over and too much booze or guac or just being with me caused one of the most violent vomiting incidents I’ve witnessed.

The smell of the guacamole is forged in my memory.

The U.S. Food and Drug Administration has released two reports on its sampling of whole fresh avocados and hot peppers to determine how frequently harmful bacteria are found in each commodity.

For the whole fresh avocado sampling assignment, the FDA collected, tested and analyzed 1,615 domestic and imported avocado samples for Salmonella and Listeria monocytogenes. Of the 1,615 samples, 12 (0.74%) tested positive for Salmonella. As to the Listeria monocytogenes testing, the agency primarily tested the pulp of the avocado samples (as the pulp is the part of the fruit people eat), and some samples of the fruit’s skin. Of the 1,254 avocado pulp samples, 3 (far less than one percent) were positive for Listeria monocytogenes. Of the 361 avocado skin samples, 64 (17.73%) were positive for Listeria monocytogenes. FoodSafety.gov advises consumers to wash all produce before cutting into it or eating.  

Washing doesn’t do much, but with avocadoes it seems the exterior skins are loaded with Listeria, so the opportunities for cross-contamination are huge (think of how you prepare avocado).

CBS News concludes that one-in-five avocados tested positive for Listeria on the outside, so better wash those skins.

Washing won’t do much, but clean the damn cutting board and be the bug, think about where it would go.

Like my ex barfing.

As a comedian in all seriousness: What happens when B. cereus invades human cells

Tegan Taylor of ABC asks, what’s happening inside your body when you have food poisoning?

Research published today has given us a slightly clearer idea, at least for one type of bacteria.

A team from the Australian National University looked at the way the body responds to the bacteria Bacillus cereus, which can cause food poisoning and sometimes lead to serious infections elsewhere in the body, including sepsis, pneumonia and meningitis.

They found a toxin secreted by the bacteria binds directly to cells in the human body and punches holes in the cells to kill them, triggering an immune response.

Understanding the way toxins produced by this bacteria provoke inflammation in the body is a key to understanding how to treat it, said lead researcher Anukriti Mathur.

“Our immune system acts as a double-edged sword in these kinds of cases,” Ms Mathur said.

“In certain cases where you’ve got a bacterial infection it would be really essential to boost our immune system so that it is stronger.

“However in cases such as sepsis, where you’ve got unwanted inflammation happening in your body, you want to dampen the inflammatory responses.

“A very unique balance is required in protecting us against different kinds of infections.”

But what is it about this bacteria punching holes in your cells that leaves you hunched over a toilet bowl?

It has to do with the parts of your nervous system being targeted by the toxins produced by the bacteria, according to Vincent Ho, a University of Western Sydney gastroenterologist and researcher who was not involved in the study.

Bacillus cereus produces more than 12 different toxins. One triggers vomiting and another diarrhea, Dr Ho explained.

The vomit-inducing toxin, called cereulide, binds to serotonin receptors in the stomach and small bowel and stimulates the vagus nerve, which controls muscle movement in the gut.

“That signals back up to the vomiting centres of the brain,” he said.

“And in a very similar way that is how the diarrheal form also works too. It’s causing direct stimulation of the small bowel, and that’s triggering a reactive response of reflex mechanism called the gastro-colic reflex.

“The toxins are stimulating against receptors in the gut lining … triggering a lot more movement of the muscle in the gut and the colon.”

Bacillus cereus can be found in vegetables, rice and pasta, as well as meat and fish, and will grow in these foods if they are stored at the wrong temperature.

Own it: Amy Schumer is still barfing in pregnancy

Amy Schumer‘s ongoing pregnancy with severe nausea is following the comedian into the second trimester of her pregnancy — and she shared it with fans in her second graphic vomiting video on Saturday.

Back in November, Schumer, 37, was hospitalized for hyperemesis gravidarum — a condition marked by persistent sickness and can lead to dehydration and weight loss.

According to People the health crisis caused the I Feel Pretty star to postpone dates on her comedy tour. And though she’s since returned to the stage and powered through, her vomiting hasn’t stopped.

On Saturday, Schumer posted an Instagram video of her getting sick over a toilet. “Hi I thought it might be fun to see me throwing up in a public bathroom,” she said.

Sorta like this food safety asshole (upper right).

Clemson researchers target vomit cleanup methods in new norovirus research

Ever since that time in 2008 when one of Amy’s French students barfed in class, we’ve sorta been obsessed with, what is the proper way to clean up barf?

Especially if norovirus is involved.

The previous story gives an idea of just how infectious this stuff is.

Two Clemson researchers who are working with the federal government to combat stomach bug outbreaks among the elderly are convinced that advancements in this field could be lifesaving. 

Clemson University professors Angela Fraser and Xiuping Jiang catered their new norovirus research project to the needs of residents in long-term care facilities.

“I just think that those of us who are fortunate need to look out for those who are vulnerable,” Fraser said. “And this is a vulnerable population.”

One of the main goals of their new project, which recently received more than $1 million in funding from the federal Agency for Healthcare Research and Quality, is to come up with easy-to-implement, cost-efficient and effective vomit cleanup procedures for soft surfaces. The hope is that this will directly combat the high percentage of norovirus outbreaks in long-term care facilities and places with similar environments. 

The study, which has funding for three years, will be done in partnership with the Centers for Disease Control and Prevention, Emory University and the University of Illinois-Chicago.

In past studies on proper vomit cleanup, Fraser and Jiang learned that there were gaps in the research, particularly when it came to the proper disinfectant to use on soft services to prevent the spread of diseases.

Chlorine bleach, the most commonly used disinfectant, mainly worked on hard surfaces and could rarely be used on soft surfaces like carpets and couches. One of the areas they realized could benefit the most from this information was long-term care facilities. 

“Long-term facilities want to create a very homelike environment, so they have lots of carpet around in comparison to hospitals and other environments,” Jiang said.

They also, of course, tend to have a high number of older adults.

“That’s people’s living environment,” Fraser said. “Do you really want people to be living where everything is just cinder block or smooth walls?”

She said because older patients are more likely to have chronic diseases, their immune systems are typically weakened as well. This means that when these older adults get infected with diseases like the norovirus, there can be a more severe expression of the disease compared to someone younger. Because of all of these factors, some view the study as even more imperative.

 

Multiple modes of transmission during a Thanksgiving Day Norovirus outbreak, 2017

The U.S. Centers for Disease Control reports on November 28, 2017, the manager of restaurant A in Tennessee reported receiving 18 complaints from patrons with gastrointestinal illness who had dined there on Thanksgiving Day, November 23, 2017. Tennessee Department of Health officials conducted an investigation to confirm the outbreak, assess exposures, and recommend measures to prevent continued spread.

On November 23, one patron vomited in a private dining room, and an employee immediately used disinfectant spray labeled as effective against norovirus* to clean the vomitus. After handwashing, the employee served family-style platters of food and cut pecan pie. For the November 23 Thanksgiving Day, restaurant A served 676 patrons a limited menu from 11 a.m. to 8 p.m. The manager provided contact information, seating times, and seating locations for 114 patrons with reservations. All patrons with contact information were telephoned, and a questionnaire was used to assess illness and exposures for anyone living in the household who ate at restaurant A on November 23. Stool specimens were requested from ill patrons. Among the 676 patrons, 137 (20%) were enrolled in a case-control study.

A probable case was defined as diarrhea (three or more loose stools in 24 hours) or vomiting within 72 hours of eating at restaurant A on November 23; probable cases with norovirus RNA detected in a stool specimen by real-time reverse transcription–polymerase-chain reaction (RT-PCR) were considered confirmed. On November 30, environmental swabs for norovirus testing were collected in the restaurant. Patient and environmental samples were tested by real-time RT-PCR and sequenced at the Tennessee State Public Health Laboratory.

Thirty-six (26%) case-patients (two confirmed and 34 probable) and 101 (74%) controls were enrolled in the case-control study. Illness onsets occurred during November 23–25, with 17 of 35 (49%) cases occurring on November 24. The mean incubation period was 31 hours (range = 2.5–54.5 hours), and the mean illness duration was 3 days (range = 0–6 days). Only one case-patient sought medical care. Diarrhea was reported by 33 (94%) case-patients, fatigue by 29 (83%), nausea and abdominal cramps by 28 (80%), vomiting by 24 (69%), and fever by six (17%).

Among menu items, only pecan pie was significantly associated with illness (odds ratio [OR] = 2.6; 95% confidence interval [CI] = 1.1–5.8); however, it was eaten by only 16 (47%) of 34 case-patients. The vomiting event occurred around noon; patrons seated during 11 a.m.–1 p.m. were significantly more likely to become ill than were patrons seated during other times (OR = 6.0; 95% CI = 2.6–15.3). No significant differences between dining locations (i.e., private dining room versus general seating) were identified (OR = 1.4; 95% CI = 0.4–4.3). Logistic regression was used to evaluate the effects of eating pecan pie, seating time, and seating location; only seating time during 11 a.m.–1 p.m. remained statistically significant (OR = 6.0; 95% CI = 2.2–16.5).

Stool specimens from two case-patients identified Norovirus GII.P16-GII.4 Sydney. Norovirus GII was identified in one environmental swab collected from the underside of a table leg adjacent to the vomitus.

A point-source norovirus outbreak occurred after an infected patron vomited in a restaurant. Transmission near the vomiting event likely occurred by aerosol or fomite. Norovirus spread throughout the restaurant could have occurred by aerosol, person-to-person, fomite, or foodborne routes. Inadequate employee handwashing likely facilitated foodborne transmission through servings of pecan pie.

In hospital settings, CDC and the Tennessee Department of Health recommend contact precautions (e.g., gloves and gowns) when personnel have contact with vomitus (1). Similarly, the Food and Drug Administration’s 2017 Food Code recommends restaurants have a written plan detailing when and how employees should use personal protective equipment for cleaning vomitus (2). Reinforcing the need for proper handwashing and performing thorough environmental cleaning with appropriate personal protective equipment in food service establishments can prevent or mitigate future outbreaks.

Acknowledgments

Teresa Vantrease, Jana Tolleson, Tiffany Rugless, Lee Wood, Anita Bryant-Winton, Heather Mendez, Jeannette Dill, Alan Pugh, Jason Pepper, Katie Nixon, Marcy McMillian, Jane Yackley; FoodCORE Interview Team; staff members from restaurant A.

Corresponding author: Julia Brennan, JBrennan@cdc.gov, 615-253-9971.

1Epidemic Intelligence Service, CDC; 2Division of Scientific Education and Professional Development, CDC; 3Communicable and Environmental Diseases and Emergency Preparedness, Tennessee Department of Health; 4Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.

All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest. William Schaffner reports personal fees from Pfizer, Merck, Dynavax, Seqirus, SutroVax, and Shionogi, outside the submitted work. No other potential conflicts of interest were disclosed.

* Active ingredients = n-Alkyl dimethyl benzyl ammonium chlorides and n-Alkyl dimethyl ethylbenzyl ammonium chlorides.

The barf museum in Sweden

Maura Judkis of The Washington Post writes buy a ticket to the Disgusting Food Museum in Malmo, Sweden, and it won’t be printed on a slip of paper.

“Your ticket is a vomit bag with our logo,” said Samuel West, the museum’s founder. It’s a joke, but not really: Somewhere between the exhibit on the world’s stinkiest cheese and the free samples of fermented shark meat, someone’s stomach may turn. But, then again, the noni, an Asian fruit nicknamed the “vomit fruit,” is one of the displays. So visitors will already be acclimated to some pretty terrible smells.

Welcome to the world’s first exhibition devoted to foods that some would call revolting. The museum’s name and its contents are pretty controversial — one culture’s disgusting is another culture’s delicacy. That goes for escamoles, the tree-ant larvae eaten in Mexico, or shirako, the cod sperm eaten in Japan, or bird’s nest soup, a Chinese dish of nests made from bird saliva. The name is meant to grab visitors’ attention, but that’s the point that West says he’s trying to make: Disgust is a cultural construct.

“I want people to question what they find disgusting and realize that disgust is always in the eye of the beholder,” said West. “We usually find things we’re not familiar with disgusting, versus things that we grow up with and are familiar with are not disgusting, regardless of what it is.”

For example: Though the museum is in Sweden, he includes surströmming, an incredibly pungent fermented Swedish herring, and salt licorice, which is found throughout the Nordic nations.