The burden of foodborne illness: it’s kind of a big deal

Last week I gave a guest lecture to an undergraduate nutrition class at UNC-Chapel Hill on the burden of foodborne illness as sort of an introduction to how and why folks like small farmers, school garden managers, cafeteria staff address food safety.

In a lot of my talks I get looks of bewilderment when I throw up the details from Elaine Scallan (and lots of her colleagues) papers on the burden of foodborne illness. Same with when I show economic estimates from friend of barfblog and all-around-good-guy-with-hipster-glasses Mike Batz (and colleagues). Foodborne illness, is kind of a big deal (at least to us food safety nerds).

I’m collaborating with Matt Shipman, public information officer at NC State University and curator of The Abstract, on a set of food safety-related posts from other NCSU folks as we roll toward WHO’s World Health Day – which is focused this year on food safety.

Here’s the first post:21d2f2194e7eb6925dac5a428cc518d4398b850316887505b740e8bd0e8ffdd2

Food safety poses a global health problem. According to the World Health Organization, contaminated food can cause more than 200 diseases – and food- and water-borne diseases that cause diarrhea are estimated to kill two million people each year worldwide.

And food safety is not just someone else’s problem.

“Foodborne illnesses are a significant problem in the United States, with massive impacts on public health and the economy,” says Ben Chapman, a food safety expert and researcher at NC State. And the numbers back Chapman up.

According to a 2012 report from researchers at the Emerging Pathogens Institute, Resources For the Future, and the U.S. Department of Agriculture’s Economic Research Service, foodborne illness is estimated to cost the U.S. more than $14 billion annually. (The estimate takes into account factors such as medical costs and productivity losses.)

And a 2011 report from the U.S. Centers for Disease Control and Prevention (CDC) reported an estimated 9.4 million episodes of foodborne illness each year in the U.S. from known pathogens. An additional 38.4 million cases are estimated to come from unspecified or unknown pathogens. In total, foodborne illnesses are thought to contribute to 48 million illnesses annually – resulting in more than 128,000 hospitalizations and 3,000 deaths.

It is, in short, a big deal.

So what are these foodborne illnesses? And how much damage does each of them cause?

In advance of World Health Day, we wanted to explain a handful of the relevant pathogens implicated in foodborne illness.

Campylobacter: Campylobacteris a genus of bacteria, many of which can cause an illness called campylobacteriosis in humans, with symptoms including diarrhea and abdominal pain. People can contract campylobacteriosis from undercooked chicken, from cross-contamination via raw chicken, or from drinking unpasteurized milk.

According to the 2012 paper, campylobacteriosis affects 845,000 people annually in the U.S., costing the nation an estimated $1.747 billion every year and leading to 8,463 hospitalizations.

Listeria monocytogenes: This is a bacterium that causes listeriosis, which is characterized by fever, muscle aches, and sometimes by gastrointestinal problems, such as diarrhea. Listeriosis can be contracted from an incredibly broad range of foods.

According to the 2012 study, listeriosis costs the U.S. $2.577 billion annually, despite the fact that there are only 1,591 illnesses per year. But 1,455 of those illnesses require hospitalization – and 255 result in death.

Norovirus: Noroviruses are the most common cause of foodborne illness in the U.S., affecting an estimated 19-21 million people each year. Symptoms range from vomiting and diarrhea to fever and headache. Transmission comes from ingesting infected feces or vomit particles – for example, by touching a contaminated surface and then touching food or touching your mouth.

According to the 2012 study, noroviruses cost the U.S. $2 billion per year, with more than 14,000 hospitalizations and approximately 150 deaths annually. NC State is a leader in norovirus research, and home to NoroCORE – the Norovirus Collaborative for Outreach, Research, and Education. NoroCORE pulls together norovirus research from 18 institutions, with funding from the U.S. Department of Agriculture.

Salmonella enterica: This is one species of the pathogen that has myriad of subspecies and types – more than 1,400 of which are known to cause human illness. Infection with Salmonella species causes salmonellosis, with symptoms including diarrhea, fever, and cramping. Salmonellosis can be contracted from a variety of sources, ranging from poultry to peanut butter to mangoes.

According to the 2012 study, the subspecies within S. entericaalone costs the U.S. $3.3 billion each year, causing more than one million hospitalizations and almost 400 deaths annually.

What are researchers doing about this?

The four pathogens listed above are just a few of the rogue’s gallery of bacteria and viruses that can cause foodborne illness. But researchers are constantly learning more about these health risks.

“New technology and new research on pathogens, practices and prevention are improving our ability to identify and address foodborne illness,” Chapman says. “The field is really opening up. It’s an exciting time to be involved in food safety research.”

Between now and April 7, we’re planning to publish a series of posts on various aspects of food safety – what we know, what we don’t know, and what we’re working on. We also hope to offer insights to help folks lower the risk of contracting foodborne illnesses. We hope you’ll learn something new.

Note: you can find all of our posts related to food safety here.


Batz, Michael B., Sandra Hoffmann, and J. Glenn Morris, Jr. “Ranking the Disease Burden of 14 Pathogens in Food Sources in the United States Using Attribution Data from Outbreak Investigations and Expert Elicitation” Journal of Food Protection, Vol. 75, No. 7, 2012, Pages 1278–1291. doi:10.4315/0362-028X.JFP-11-418

Scallan, Elaine, et al. “Foodborne Illness Acquired in the United States—Major Pathogens” Emerg Infect Dis, Vol. 17, No. 1, 2011. doi:10.3201/eid1701.P11101

Shopping for safety: What is consumer food safety education?

Now that the annual orgy of food safety advice has subsided until the next holiday (that would be the Super Bowl, and all the bad puns), it’s time to ask: are any of these messages effective? they actually reduce the number of people who get sick? Does anyone test these messages in a scientifically credible way?

Cook-clean-chill-separate has become the mantra of food safety types but there is no evidence — regardless of repetition — these messages work.

Instead, people are picking up sound bites like venereal diseases; I thought we’d gotten past that.

Marty had no reason going to the first food safety educators conference in Washington, D.C. in 1997. He was working as a student life advisor or something but, I had gotten in the habit of taking Marty along on road trips from Guelph – got lost once in some New York mountains in the middle of the night and thought we were going to die – for fun and driving chores.

The 1996 Nissan Quest minivan still had the new car smell, and as a new prof with a carload of students, I decided driving all night was better than dishing out non-existent cash for an extra night of hotel rooms.

We arrived in Georgetown about 7:30 a.m., ate at a dive, and found the on-campus conference room. People looked at us like we had just rolled out of a vehicle and been driving all night.

We had.

pink.floyd.educationMost of us went and changed into fresh clothes, while Marty crashed somewhere until the room was available.

The conference started and we were pumped.

I may have fallen asleep.

There were descriptions of many food safety education programs but the evaluation components were either non-existent or sucked.

I remember going out to a Georgetown bar later that night, watching The Truth About Cats and Dogs in the hotel room while Marty farted, and commenting that student Janis looked like Janeane Garofalo. I remember the drive home.

I don’t remember much about the conference.

Which is why I haven’t gone back.

I’m all for providing food safety information in a compelling, creative and critically sound manner. However education is something people do themselves. Lewis Lapham wrote in Harper’s magazine in the mid-1980s about how individuals can choose to educate themselves about all sorts of interesting things, but the idea of educating someone is doomed to failure. And it’s sorta arrogant to state that shoppers need to be educated; to imply that if only you understood the world as I understand the world, we would agree and dissent would be minimized.

These may be subtle semantics – to communicate with rather than to; to inform rather than educate – but they set an important tone.

With outbreaks in pizza, pot pies, pet food, peanut butter, bagged spinach, lettuce, sprouts, carrot juice, lettuce, tomatoes, canned chili sauce, hot peppers, cookie dough, chia seeds, tuna back scrape, and white pepper, I’m not sure what consumers have to do with it.

This is not to discount the role of consumers in protecting or enhancing the safety of the food they eat. Rather, consumers should be engaged as partners in the management of the farm-to-fork food continuum, and not unduly blamed for failing to recognize and correct errors that other players in this continuum have made.

Forget the blame; focus on shared responsibility; share information. Help people make better decisions. Tell them why what they do is important (if not yourself, try not to make your kids or friends barf).

The World Health Organization recognized this back in 2001 and included a fifth key to safer food: use safe water and raw materials, or, source food from safe sources (

I’m not sure what consumers are supposed to do about Listeria in caramel apples, but that’s another story.

Dr. Douglas Powell is a former professor of food safety who shops, cooks and ferments from his home in Brisbane, Australia.

Disclaimer: The views and opinions expressed in this blog are those of the original creator and do not necessarily represent that of the Texas A&M Center for Food Safety or Texas A&M University.

WHO food safety facts

Food safety according to the World Health Organization:

Access to sufficient amounts of safe and nutritious food is key to sustaining life and promoting good health.

world-healthUnsafe food containing harmful bacteria, viruses, parasites or chemical substances, causes more than 200 diseases – ranging from diarrhoea to cancers.

Foodborne and waterborne diarrhoeal diseases kill an estimated 2 million people annually, mostly children.

Food safety, nutrition and food security are inextricably linked. Unsafe food creates a vicious cycle of disease and malnutrition, particularly affecting infants, young children, elderly and the sick.

Foodborne diseases impede socioeconomic development by straining health care systems, and harming national economies, tourism and trade.

Food supply chains now cross multiple national borders. Good collaboration between governments, producers and consumers helps ensure food safety.

Major foodborne illnesses and causes

Foodborne illnesses are usually infectious or toxic in nature and caused by bacteria, viruses, parasites or chemical substances entering the body through contaminated food or water.

Foodborne pathogens can cause severe diarrhoea or debilitating infections including meningitis. Chemical contamination can lead to acute poisoning or long-term diseases, such as cancer. Foodborne diseases may lead to long-lasting disability and death. Examples of unsafe food include uncooked foods of animal origin, fruits and vegetables contaminated with faeces, and raw shellfish containing marine biotoxins.


Salmonella, Campylobacter, and Enterohaemorrhagic Escherichia coli are among the most common foodborne pathogens that affect millions of people annually – sometimes with severe and fatal outcomes. Symptoms are fever, headache, nausea, vomiting, abdominal pain and diarrhoea. Examples of foods involved in outbreaks of salmonellosis are eggs, poultry and other products of animal origin. Foodborne cases with Campylobacter are mainly caused by raw milk, raw or undercooked poultry and drinking water. Enterohaemorrhagic Escherichia coli is associated with unpasteurized milk, undercooked meat and fresh fruits and vegetables.

Listeria infection leads to unplanned abortions in pregnant women or death of newborn babies. Although disease occurrence is relatively low, listeria’s severe and sometimes fatal health consequences, particularly among infants, children and the elderly, count them among the most serious foodborne infections. Listeria is found in unpasteurised dairy products and various ready-to-eat foods and can grow at refrigeration temperatures.

Vibrio cholerae infects people through contaminated water or food. Symptoms include abdominal pain, vomiting and profuse watery diarrhoea, which may lead to severe dehydration and possibly death. Rice, vegetables, millet gruel and various types of seafood have been implicated in cholera outbreaks.

Antimicrobials, such as antibiotics, are essential to treat infections caused by bacteria. However, their overuse and misuse in veterinary and human medicine has been linked to the emergence and spread of resistant bacteria, rendering the treatment of infectious diseases ineffective in animals and humans. Resistant bacteria enter the food chain through the animals (e.g. Salmonella through chickens). Antimicrobial resistance is one of the main threats to modern medicine.


Norovirus infections are characterized by nausea, explosive vomiting, watery diarrhoea and abdominal pain. Hepatitis A virus can cause long-lasting liver disease and spreads typically through raw or undercooked seafood or contaminated raw produce. Infected food handlers are often the source of food contamination.


Some parasites, such as fish-borne trematodes, are only transmitted through food. Others, for example Echinococcus spp, may infect people through food or direct contact with animals. Other parasites, such as Ascaris, Cryptosporidium, Entamoeba histolytica or Giardia, enter the food chain via water or soil and can contaminate fresh produce.


PRUSINERPrions, infectious agents composed of protein, are unique in that they are associated with specific forms of neurodegenerative disease. Bovine spongiform encephalopathy (BSE, or “mad cow disease”) is a prion disease in cattle, associated with the variant Creutzfeldt-Jakob Disease (vCJD) in humans. Consuming bovine products containing specified risk material, e.g. brain tissue, is the most likely route of transmission of the prion agent to humans.


Of most concern for health are naturally occurring toxins and environmental pollutants.

Naturally occurring toxins include mycotoxins, marine biotoxins, cyanogenic glycosides and toxins occurring in poisonous mushrooms. Staple foods like corn or cereals can contain high levels of mycotoxins, such as aflatoxin and ochratoxin. A long-term exposure can affect the immune system and normal development, or cause cancer.

Persistent organic pollutants (POPs) are compounds that accumulate in the environment and human body. Known examples are dioxins and polychlorinated biphenyls (PCBs), which are unwanted byproducts of industrial processes and waste incineration. They are found worldwide in the environment and accumulate in animal food chains. Dioxins are highly toxic and can cause reproductive and developmental problems, damage the immune system, interfere with hormones and cause cancer.

Heavy metals such as lead, cadmium and mercury cause neurological and kidney damage. Contamination by heavy metal in food occurs mainly through pollution of air, water and soil.

The evolving world and food safety

Safe food supplies support national economies, trade and tourism, contribute to food and nutrition security, and underpin sustainable development.

Urbanization and changes in consumer habits, including travel, have increased the number of people buying and eating food prepared in public places. Globalization has triggered growing consumer demand for a wider variety of foods, resulting in an increasingly complex and longer global food chain.

As the world’s population grows, the intensification and industrialization of agriculture and animal production to meet increasing demand for food creates both opportunities and challenges for food safety. Climate change is also predicted to impact food safety, where temperature changes modify food safety risks associated with food production, storage and distribution.

These challenges put greater responsibility on food producers and handlers to ensure food safety. Local incidents can quickly evolve into international emergencies due to the speed and range of product distribution. Serious foodborne disease outbreaks have occurred on every continent in the past decade, often amplified by globalized trade.

Examples include the contamination of infant formula with melamine in 2008 (affecting 300 000 infants and young children, 6 of whom died, in China alone), and the 2011 Enterohaemorrhagic Escherichia coli outbreak in Germany linked to contaminated fenugreek sprouts, where cases were reported in 8 countries in Europe and North America, leading to 53 deaths. The 2011 E.coli outbreak in Germany caused US$ 1.3 billion in losses for farmers and industries and US$ 236 million in emergency aid payments to 22 European Union Member States.

Food safety: a public health priority

Unsafe food poses global health threats, endangering everyone. Infants, young children, pregnant women, the elderly and those with an underlying illness are particularly vulnerable.

Foodborne and waterborne diarrhoeal disease kill an estimated 2 million people annually, mostly children and particularly in developing countries. Unsafe food creates a vicious cycle of diarrhoea and malnutrition, threatening the nutritional status of the most vulnerable. Where food supplies are insecure, people tend to shift to less healthy diets and consume more “unsafe foods” – in which chemical, microbiological and other hazards pose health risks.

Governments should make food safety a public health priority, as they play a pivotal role in developing policies and regulatory frameworks, establishing and implementing effective food safety systems that ensure that food producers and suppliers along the whole food chain operate responsibly and supply safe food to consumers.

Food can become contaminated at any point of production and distribution, and the primary responsibility lies with food producers. Yet a large proportion of foodborne disease incidents are caused by foods improperly prepared or mishandled at home, in food service establishments or markets. Not all food handlers and consumers understand the roles they must play, such as adopting basic hygienic practices when buying, selling and preparing food to protect their health and that of the wider community.

Everyone can contribute to making food safe. Here are some examples of effective actions:

Policy-makers can:

build and maintain adequate food systems and infrastructures (e.g. laboratories) to respond to and manage food safety risks along the entire food chain, including during emergencies;

foster multi-sectoral collaboration among public health, animal health, agriculture and other sectors for better communication and joint action;

integrate food safety into broader food policies and programmes (e.g. nutrition and food security);

think globally and act locally to ensure the food produce domestically be safe internationally.

Food handlers and consumers can:

know the food they use (read labels on food package, make an informed choice, become familiar with common food hazards);

handle and prepare food safely, practicing the WHO Five Keys to Safer Food at home, or when selling at restaurants or at local markets;

grow fruits and vegetables using the WHO Five Keys to Growing Safer Fruits and Vegetables to decrease microbial contamination.

WHO response

WHO aims to facilitate global prevention, detection and response to public health threats associated with unsafe food. Ensuring consumer trust in their authorities, and confidence in the safe food supply, is an outcome that WHO works to achieve.

To do this, WHO helps Member States build capacity to prevent, detect and manage foodborne risks by:

providing independent scientific assessments on microbiological and chemical hazards that form the basis for international food standards, guidelines and recommendations, known as the Codex Alimentarius, to ensure food is safe wherever it originates;

assessing the safety of new technologies used in food production, such as genetic modification and nanotechnology;

helping improve national food systems and legal frameworks, and implement adequate infrastructure to manage food safety risks. The International Food Safety Authorities Network (INFOSAN) was developed by WHO and the UN Food and Agriculture Organization (FAO) to rapidly share information during food safety emergencies;

promoting safe food handling through systematic disease prevention and awareness programmes, through the WHO Five Keys to Safer Food message and training materials; and

advocating for food safety as an important component of health security and for integrating food safety into national policies and programmes in line with the International Health Regulations (IHR – 2005).

WHO works closely with FAO, the World Organization for Animal Health (OIE) and other international organizations to ensure food safety along the entire food chain from production to consumption.

Top 10 list of foodborne parasites released

A Top 10 list identifying the foodborne parasites of greatest global concern has been released today, and new guidelines are being developed to control them.

parasiteThe parasites affect the health of millions of people every year, infecting muscle tissues and organs, causing epilepsy, anaphylactic shock, amoebic dysentery and other problems. Some can live on in our bodies for decades.

Despite their huge social costs and global impacts, information is generally lacking regarding just where these parasites come from, how they live in the human body, and – most importantly – how they make us sick.

As a first step in tackling the problem, the UN’s Food and Agriculture Organization (FAO) and World Health Organization (WHO) are initially focusing on the ten food borne parasites with the greatest global impact. The rankings contained in today’s FAO-WHO report, Multicriteria-based ranking for risk management of food-borne parasites, are based on the parasites’ burden on human health and other factors, and includes information on where they can be found.

The top ten are:

Taenia solium (pork tapeworm): In pork

Echinococcus granulosus (hydatid worm or dog tapeworm): In fresh produce

Echinococcus multilocularis (a type of tapeworm): In fresh produce

Toxoplasma gondii (protozoa): In meat from small ruminants, pork, beef, game meat (red meat and organs)

Cryptosporidium spp.(protozoa): In fresh produce, fruit juice, milk

Entamoeba histolytica (protozoa): In fresh produce

Trichinella spiralis (pork worm): In pork

Opisthorchiidae (family of flatworms): In freshwater fish

Ascaris spp. (small intestinal roundworms): In fresh produce

Trypanosoma cruzi (protozoa): In fruit juices

small_reportcover.gifThe list and supporting report were developed following a request by the global food standards body, the Codex Alimentarius Commission (Codex), for FAO and WHO to review the current status of knowledge on parasites in food and their public health and trade impacts.

The Codex Committee on Food Hygiene is now developing new guidelines for the control of these parasites. FAO and WHO are supporting the process by providing scientific and technical information.

The aim is to develop new standards for the global food trade that will help countries control the presence of these parasites in the food chain.

Food safety a habit: Indonesia

Chef Vindex Tengker told the Jakarta Post that Indonesians have so far been lucky that, despite a lack of awareness on food safety, things have been going rather well, adding, “I have spent 24 years working around kitchens around the globe. I’ve been in the US, Spain, Turkey, Japan and Vindex TengkerMexico; food safety is a problem everywhere. Food safety is attitude; it takes time to develop an attitude. You have to do it each and every day.” 

Wasis Gunarto, a general manager of a well-known cafe and restaurant franchise in Jakarta, said food businesspeople were in the dark about food safety standards and certification.

“We don’t have much knowledge on food safety standards from the government and which body is in charge of the certification,” Wasis said.
He said his company opted to cooperate with an international hotel chain and have their restaurant employees trained under international hotel standards.

“I think the government has a lot of homework to do in this food safety standards issue. They should not only focus on restaurant operators but also apply food safety standards on produce distributors and suppliers,” Wasis said.

The story notes the World Health Organization has devised five keys to safer food: clean; separate; cook; keep food at safe temperatures; and use safe water and raw materials.

As in source food from safe sources. FightBac folks, are you listening?

WHO: the global view of Campylobacteriosis

From July 9-11, 2012, the World Health Organization (WHO), in collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (OIE), convened an Expert Consultation on The Global View of Campylobacteriosis, in Utrecht, Netherlands.

Below are the general conclusions:

 Considerable new evidence, data, and analytical tools have emerged in the ten chicken.campy.vaccineyears since the previous WHO consultations on Campylobacter.

 In terms of public health actions, there is already a sufficient evidence base to address the burden of disease from C. jejuni and C. coli. The importance of other species in terms of burden of disease is still unclear, but is considered unlikely to eclipse these two species.

 Public health surveillance can provide important basic information to policy-makers about the frequency of infection, who is affected, and the success of specific prevention strategies. Surveillance is the starting point for studies of burden of disease and source attribution.

 There is a need for standardization and validation of laboratory methods.

 Burden of disease studies provide the evidence base that drives the need for control measures across all outcomes of Campylobacteriosis while taking into consideration its underestimation.

 There is considerable potential for the identification of new sequelae from acute infection. However, decision criteria are needed on the level of evidence required to add outcomes to burden estimates. This applies to all sequelae, and may increase burden estimates considerably.

 In order to reduce exposure countries should be encouraged to adopt the recently developed Codex Guidelines for the Control of Campylobacter and Salmonella in chicken meat which promote a risk based approach to the management of Campylobacter in chicken meat traded internationally. campy.who.jul.12Consideration should be given to the development of additional guidance and recommendations for the management of Campylobacter in other potential food vehicles that are traded internationally.

 Source attribution studies should adopt a holistic attitude, considering multiple sources and pathways of exposure. Where possible attribution estimates should combine both molecular tying and epidemiological data and include measures of uncertainty.

 Although poultry is the dominant source of infection in many countries, controlling Campylobacter in poultry meat will not completely eliminate the disease in humans. Options are available to control other pathways which are based on general hygiene, generic control measures including biosecurity and sanitation.

 Reducing the load of Campylobacter in poultry to a level with a low probability of causing illness is unlikely to be achieved by any single pre-harvest or post-harvest intervention. Success will most likely occur through use of multiple stepwise interventions to lower the load of Campylobacter on or in each bird on the farm and in the processing facility.

 The epidemiology of Campylobacteriosis is likely to be different in high-income countries versus LMIC. This will affect control options.

 GFN, as an international training and capacity development network, will play a key role in promoting better and more consistent methodologies and quality assurance for work with Campylobacter. Where possible, GFN should link with other international networks, such as FERG, which is promoting capacity development in estimation of burden of foodborne disease.

The complete report is available at

Lend a hand for food safety on World Hand Hygiene Day

The World Health Organization’s World Hand Hygiene Day is on Sunday May 5.

CEO Polly Bennett said the New South Wales Food Authority’s Name and Shame website, which allows consumers to view businesses that have failed to meet handwash_south_park(2)food safety standards, had a number of businesses on the register for handwashing offences.

“While the vast majority of businesses do the right thing, there are a few who need to lift their game, and this includes those who have failed to implement correct hand washing measures.

“Hand washing offences are up there in the top five most common food safety breaches under the Food Act, accounting for 13% of breaches in 2010-11.

“In addition to the Name and Shame register that provides the public with information about those businesses who have breached food safety laws, the Authority is also committed to encouraging and promoting training and learning through programs like Food Safety Supervisor.”

Food Safety Supervisor is a training initiative designed to improve skills and knowledge in the industry – with close to 50,000 people in NSW having completed the training.

“I encourage everyone to use today’s World Hand Hygiene Day as a reminder to ensure they are following the rules and keeping themselves, their family and for business – their customers, safe.”

handwash_infosht-2-7-08 copy

Outbreaks associated to large open air festivals, including music festivals, 1980 to 2012

I’ve been to my share of open-air music festivals or, as we called them, concerts, outside: The Who, Toronto, 1980; Rolling Stones, Buffalo, 1981; Grateful Dead, Toronto, 1987; Tragically Hip, Toronto, a few times; Jimmy Buffet, Toronto, a few times; Blue Rodeo, Guelph, 2000; Lyle Lovett, 2002, lyle.hairToronto, John Prine, Toronto, a few times, Jerry Reid, Barrie, 1986, Neil Young, Toronto, many times, and Neil Young, Brisbane, 2013, oops not, stuck in an airport, and many more I can’t remember.

Sometimes we got wet.

Researchers in Marseille, writing in Eurosurveillance, state that in the minds of many, large scale open air festivals have become associated with spring and summer, attracting many people, and in the case of music festivals, thousands of music fans. These festivals share the usual health risks
associated with large mass gatherings, including transmission of communicable diseases and risk of outbreaks. Large scale open air festivals have however specific characteristics, including outdoor settings, on-site housing and food supply and the generally young age of the participants. Outbreaks at large scale open air festivals have been caused by neil-acl_std.originalCryptosporium parvum, Campylobacter spp., Escherichia coli, Salmonella enterica, Shigella sonnei, Staphylococcus aureus, hepatitis A virus, influenza virus, measles virus, mumps virus and norovirus. Faecal-oral and respiratory transmissions of pathogens result from non-compliance with hygiene rules, inadequate sanitation and insufficient vaccination coverage. Sexual transmission of infectious diseases may also occur and is likely to be underestimated and underreported. Enhanced surveillance during and after festivals is essential. Preventive measures such as immunisations of participants and advice on-site and via social networks should be considered to reduce outbreaks at these large scale open air festivals.

Who are you? Seizures to avoid restaurant bills

I saw The Who in the summer of 1980, just before the first of their never-ending farewell tours, at Toronto’s Exhibition stadium. We’d stayed up most of the night before crashing on a friend’s lawn, went to the show early to get good seats on lawn, and sat through several opening bands, including Heart.

But by the time Pete and Roger and John hit the stage (Keith was dead), we were weary. And the band sucked. You can tell from these clips they were sorta bored, and Pete was doing his solo thing. Our great seats, however, had morphed into a sea of people, and we couldn’t move. It was hot, and we wanted to back off.

My friend Dave told me to roll my eyes in the back of my head, and he managed to make the people part by yelling “seizure, seizure,” as he dragged me towards the back of the stadium. It worked.

According to The Eater, police in Baltimore are warning restaurants that a notorious scammer — who would "fake seizures to avoid paying the check" — has been released from prison. The Baltimore Sun explains: "Unable to rouse him, the restaurant staff would call 911, and the scammer was limoed off by paramedics to the nearest emergency room. From there, depending on whether the restaurant was pressing charges, [he’d] either quietly absconded or was arrested by the police." 

Beware the botulism at Euro 2012

Headed to Poland to watch some footy in June? The World Health Organisation has some advice: beware the botulism.

The 2012 UEFA European Football Championship, commonly referred to as Euro 2012, will be hosted by Poland and Ukraine between June 8 and July, 1 2012.

WHO warns that Poland has a particularly high incidence of botulism, which can be foodborne if the dish is improperly canned or preserved.