Zoonoses in Minnesota

Prospective, population-based surveillance to systematically ascertain exposures to food production animals or their environments among Minnesota residents with sporadic, domestically acquired, laboratory-confirmed enteric zoonotic pathogen infections was conducted from 2012 through 2016.

Twenty-three percent (n = 1708) of the 7560 enteric disease cases in the study reported an animal agriculture exposure in their incubation period, including 60% (344/571) of Cryptosporidium parvum cases, 28% (934/3391) of Campylobacter cases, 22% (85/383) of Shiga toxin-producing Escherichia coli (STEC) O157 cases, 16% (83/521) of non-O157 STEC cases, 10% (253/2575) of non-typhoidal Salmonella enterica cases and 8% (9/119) of Yersinia enterocolitica cases. Living and/or working on a farm accounted for 61% of cases with an agricultural exposure, followed by visiting a private farm (29% of cases) and visiting a public animal agriculture venue (10% of cases). Cattle were the most common animal type in agricultural exposures, reported by 72% of cases.

The estimated cumulative incidence of zoonotic enteric infections for people who live and/or work on farms with food production animals in Minnesota during 2012–2016 was 147 per 10 000 population, vs. 18.5 per 10 000 for other Minnesotans. The burden of enteric zoonoses among people with animal agriculture exposures appears to be far greater than previously appreciated.

Animal agriculture exposures among Minnesota residents with zoonotic enteric infections, 2012-2016, 17 December 2019

Epidemiology and Infection

CA Klumb, JM Scheftel and KE Smith

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/2F76B12833C41C4F63153CC4315C22F0/S0950268819002309a.pdf/animal_agriculture_exposures_among_minnesota_residents_with_zoonotic_enteric_infections_20122016.pdf

The Tripartite Zoonotic Guide (TZG): Worst catchphrase ever, but important

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.

Here’s a tripartite (below).

Predicting zoonotic Salmonella from livestock

Increasingly, routine surveillance and monitoring of foodborne pathogens using whole-genome sequencing is creating opportunities to study foodborne illness epidemiology beyond routine outbreak investigations and case–control studies.

Using a global phylogeny of Salmonella entericaserotype Typhimurium, we found that major livestock sources of the pathogen in the United States can be predicted through whole-genome sequencing data. Relatively steady rates of sequence divergence in livestock lineages enabled the inference of their recent origins. Elevated accumulation of lineage-specific pseudogenes after divergence from generalist populations and possible metabolic acclimation in a representative swine isolate indicates possible emergence of host adaptation.

We developed and retrospectively applied a machine learning Random Forest classifier for genomic source prediction of Salmonella Typhimurium that correctly attributed 7 of 8 major zoonotic outbreaks in the United States during 1998–2013. We further identified 50 key genetic features that were sufficient for robust livestock source prediction.

Zoonotic source attribution of Salmonella Enterica serotype typhimurium using genomic surveillance data, United States

January 2019

Emerging Infectious Diseases vol. 25 no. 1

Shaokang Zhang, Shaoting Li, Weidong Gu, Henk den Bakker, Dave Boxrud, Angie Taylor, Chandler Roe, Elizabeth Driebe, David M. Engelthaler, Marc Allard, Eric Brown, Patrick McDermott, Shaohua Zhao, Beau B. Bruce, Eija Trees, Patricia I. Fields, and Xiangyu Deng 

https://wwwnc.cdc.gov/eid/article/25/1/18-0835_article

 

How can you have your pudding if you don’t eat your meat? Pink Floyd figured out educating don’t mean much in 1979

Compelling stories are what get people to pay attention.

The U.S Centers for Disease Control in 2011, when an outbreak of variant virus infections* in people was linked to exposure to pigs at agricultural fairs, public health officials quickly recognized the need to support states in using a One Health approach to respond effectively to novel influenza A and other zoonotic disease outbreaks in rural areas. The approach would need to involve organizations focused in animal and human health, as well as members of the communities most at risk. In the United States, there are around 7.2 million youth actively involved in 4-H and FFA combined1. CDC and USDA saw that working with these youth groups could be an effective way to reach rural Americans with important influenza and zoonoses prevention education to protect the 150 million people who visit agricultural fairs each year, as well as the animals shown and exhibited in these venues

To improve influenza education and communication efforts around youth in agriculture, several government and non-governmental organizations partnered to launch a pilot program called Influenza Education among Youth in Agriculture. The program has since taken off, reaching hundreds of thousands of youth and their families across rural America and has expanded to include other zoonotic diseases caused by infections such as E. coli and Salmonella. The program is a joint effort of federal government (CDC and USDA), the Council for State and Territorial Epidemiologists (CSTE), several state health departments, land-grant universities and the 4-H programs run out of them, and state departments of agriculture. These One Health partners work together to develop hands-on activities for youth, zoonotic disease curricula and lesson plans, educational workshops, biosecurity and handwashing posters, and also hold meetings to foster relationships, build networks, and achieve project goals to protect human and animal health.</em

Wild boars and zoonoses

Maria Fredriksson-Ahomaa writes in Foodborne Pathogens and Disease that wild boar populations around the world have increased dramatically over past decades. Climate change, generating milder winters with less snow, may affect their spread into northern regions. Wild boars can serve as reservoirs for a number of bacteria, viruses, and parasites, which are transmissible to humans and domestic animals through direct interaction with wild boars, through contaminated food or indirectly through contaminated environment. Disease transmission between wild boars, domestic animals, and humans is an increasing threat to human and animal health, especially in areas with high wild boar densities.

This article reviews important foodborne zoonoses, including bacterial diseases (brucellosis, salmonellosis, tuberculosis, and yersiniosis), parasitic diseases (toxoplasmosis and trichinellosis), and the viral hepatitis E. The focus is on the prevalence of these diseases and the causative microbes in wild boars. The role of wild boars in transmitting these pathogens to humans and livestock is also briefly discussed.

barfblog and a song; 118 sick from campy in puppies

We have escaped to Coff’s Harbour, about five hours south of Brisbane, for our annual hockey tournament at the Big Banana, which has a small ice rink so we play 3-on-3, and where Russell Crowe apparently learned to skate for his role in the 1999 movie, Mystery, Alaska (a great hockey movie).

Amy is involved in all kinds of things, I coached for a few years and am now a happy spectator.

JFK of NSA Hockey, who played junior in Michigan, runs a day-long hockey camp for kids who are interested, so it’s a couple of days of writing and chilling for me and the Hubbell.

I’m going to catch up on some blog posts, fit each with one of my favorite songs, and then get on with that book.

I laid in bed and figured out the first half the other night.

We have Ted, the Wonder Dog, with us (he’s a wonder because how can such a little thing shit so much).

According to the U.S Centers for Disease Control, dogs, especially puppies, are a known source of sporadic Campylobacter infections in humans, but are uncommonly reported to cause outbreaks.

Investigation of a multistate, multidrug-resistant outbreak of Campylobacter jejuni infections implicated puppies from breeders and distributors sold through pet stores as the outbreak source. Outbreak strains were resistant to all antibiotics commonly used to treat Campylobacter infections.

Campylobacter causes an estimated 1.3 million diarrheal illnesses in the United States annually (1). In August 2017, the Florida Department of Health notified CDC of six Campylobacter jejuni infections linked to company A, a national pet store chain based in Ohio. CDC examined whole-genome sequencing (WGS) data and identified six isolates from company A puppies in Florida that were highly related to an isolate from a company A customer in Ohio. This information prompted a multistate investigation by local and state health and agriculture departments and CDC to identify the outbreak source and prevent additional illness. Health officials from six states visited pet stores to collect puppy fecal samples, antibiotic records, and traceback information.

Nationally, 118 persons, including 29 pet store employees, in 18 states were identified with illness onset during January 5, 2016–February 4, 2018. In total, six pet store companies were linked to the outbreak. Outbreak isolates were resistant by antibiotic susceptibility testing to all antibiotics commonly used to treat Campylobacter infections, including macrolides and quinolones. Store record reviews revealed that among 149 investigated puppies, 142 (95%) received one or more courses of antibiotics, raising concern that antibiotic use might have led to development of resistance. Public health authorities issued infection prevention recommendations to affected pet stores and recommendations for testing puppies to veterinarians. This outbreak demonstrates that puppies can be a source of multidrug-resistant Campylobacter infections in humans, warranting a closer look at antimicrobial use in the commercial dog industry.

If you’re a stray cat, Ted the Wonder Dog will make friends.

Multidrug-resistant campylobacter jejuni outbreak linked to puppy exposure- United States, 2016-2018

https://www.cdc.gov/mmwr/volumes/67/wr/mm6737a3.htm?s_cid=mm6737a3_e

‘You could make animals sick’

Gonzalo and Kate, after all those farm/petting zoo/animal experience visits, have you ever seen a sign like this:

It’s accurate, zoonoses go both or lots of other ways.

Many thanks to the barfblog.com subscriber who sent it along.

Going to a petting zoo? People need to be a lot more careful than they thought

 https://barfblog.com/2012/09/going-to-a-petting-zoo-people-need-to-be-a-lot-more-careful-than-they-thought/

The other parents hate me.

Even Amy changed her phone ring to the Debbie Downer noise from Saturday Night Live.

I’m Dougie Downer.

Every time there’s a sausage sizzle, I don’t complain, I cook for the kids and their families, and use a thermometer.

People think I’m weird.

The chicken coop at the daycare is still empty. And while no one will say it, I’m sure they blame me for depriving their little ones of chick interaction (and Salmonella).

This is nothing new; I’ve been causing angst or disgust for about 20 years, going with my kids on those field trips to the farm (the oldest of five daughters is 25; I’m ancient).

Besides, Gonzalo Erdozain did most of the work on this petting zoo paper, and he’s got a little one, so he can torment the parents of Roman’s future classmates.

Kansas State University came out with their version of our petting zoo paper and quoted me, as saying “People have to be careful — a lot more careful than they thought.”

Powell is co-author of the paper “Observation of Public Health Risk Behaviors, Risk Communication and Hand Hygiene at Kansas and Missouri Petting Zoos – 2010-2011″ that was published recently in the journal Zoonoses and Public Health.

courtlynn.petting.zooThe paper’s main author is Gonzalo Erdozain, a master of public health student at the Kansas State University who works with Powell. Erdozain, Manhattan, visited numerous petting zoos and fairs in Kansas and Missouri in 2010 and 2011 and found many sanitary problems at the facilities. Article co-authors include Katherine KuKanich, assistant professor of clinical sciences at Kansas State University, and Ben Chapman of North Carolina State University.

When visiting petting zoos, Powell said parents need to be vigilant in watching their children and they need to put a health plan in effect for the visit. In Erdozain’s study, he observed children touching their faces after petting the animals, eating or drinking in the petting zoo, eating petting zoo food and sucking on a pacifier while at the zoo. Children were also seen picking up animal feces.

Another factor to watch for is the presence of high-risk animals — those most associated with zoonotic diseases, including chicks, young ruminants like goats, sheep and cattle.

Zoonotic diseases can be passed from animal to human, or vice versa.

Washing hands before and after encountering animals and the animal feed is one of the most recommended method to fight germs and bacteria from the animals and surrounding area of animal pens, Powell said.

“Hand-washing tool selection may also contribute to the success of hand hygiene as a preventive measure, as some outbreak investigations have reported alcohol-based hand sanitizer was not protective against illness, especially when hands are soiled,” Powell said.

Powell said Erdozain’s study found that visitors were five times as likely to wash their hands when a staff member was present. This observation, Powell said, is consistent with a study published last year that showed the importance of a little encouragement.

To help maintain a safe and healthy environment, Powell said petting zoos should constantly remind visitors to wash their hands when exiting the pens. Keeping clean and useful sinks near the exits of all facilities with a stand by attendant would help decrease the likeliness of a widespread illness due to forgetful hygiene, he said.

Strict governmental regulation and enforcement would be one way to ensure this happens but is an unlikely solution. Powell said that it is up to the zoos to help keep watch on what is happening within their pens and to make sure that the proper facilities are in place and are noticeable to visitors — children and adults alike.

“Providing hand hygiene stations, putting up some good signs, having staff supervise, avoiding high-risk animals and logical facility design are easy and inexpensive — and not doing so is inexcusable,” Powell said.

I’m fine with animal interactions; but people, and organizers, should be a lot more careful than they thought. That’s what I told my 3-year-old’s daycare as they prepared for a chicken coop. They hate me.

A table of petting zoo outbreaks is available at http://bites.ksu.edu/petting-zoos-outbreaks.

Erdozain G, Kukanich K, Chapman B, Powell D. 2012. Observation of public health risk behaviours, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011. Zoonoses Public Health. 2012 Jul 30. doi: 10.1111/j.1863-2378.2012.01531.x. [Epub ahead of print]

Abstract below:

Observation of public health risk behaviors, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011Outbreaks of human illness have been linked to visiting settings with animal contact throughout developed countries. This paper details an observational study of hand hygiene tool availability and recommendations; frequency of risky behavior; and, handwashing attempts by visitors in Kansas (9) and Missouri (4), U.S., petting zoos. Handwashing signs and hand hygiene stations were available at the exit of animal-contact areas in 10/13 and 8/13 petting zoos respectively. Risky behaviors were observed being performed at all petting zoos by at least one visitor. Frequently observed behaviors were: children (10/13 petting zoos) and adults (9/13 petting zoos) touching hands to face within animal-contact areas; animals licking children’s and adults’ hands (7/13 and 4/13 petting zoos, respectively); and children and adults drinking within animal-contact areas (5/13 petting zoos each). Of 574 visitors observed for hand hygiene when exiting animal-contact areas, 37% (n=214) of individuals attempted some type of hand hygiene, with male adults, female adults, and children attempting at similar rates (32%, 40%, and 37% respectively). Visitors were 4.8x more likely to wash their hands when a staff member was present within or at the exit to the animal-contact area (136/231, 59%) than when no staff member was present (78/343, 23%; p<0.001, OR=4.863, 95% C.I.=3.380-6.998). Visitors at zoos with a fence as a partial barrier to human-animal contact were 2.3x more likely to wash their hands (188/460, 40.9%) than visitors allowed to enter the animals’ yard for contact (26/114, 22.8%; p<0.001, OR= 2.339, 95% CI= 1.454-3.763). Inconsistencies existed in tool availability, signage, and supervision of animal-contact. Risk communication was poor, with few petting zoos outlining risks associated with animal-contact, or providing recommendations for precautions to be taken to reduce these risks.

Kansas veterinarian says the same food safety rules that apply to humans also apply to pets

When I got fired as a full professor from Kansas State University in 2013, my department chair actually kept a straight face as he said, if I didn’t show up on campus, he would have no choice, and that “I didn’t work well with others.”

Bureaucratic BS.

They wanted my salary, didn’t like what I said to cattle folks, and started a whole on-line thingy I had proposed after getting dumped.

Best and brightest get promoted.

There were several colleagues in the college of veterinary medicine I worked quite well with.

One was Kate KuKanich, associate professor of clinical sciences in Kansas State University’s College of Veterinary Medicine.

We hit the road and did handwashing studies in hospitals, co-supervized vet students who did cool investigative work on petting zoos, and she brought us duck eggs.

Kate made K-State’s Thanksgiving of PR, and full kudos for going through the process.

“Thanksgiving is a time when a lot of people think that giving tidbits of the food to pets it thoughtful. A small piece of turkey breast, which is low in fat and salt, is OK for a dog or cat in moderation. But, because we love our pets, we can often overdo it and ignore food safety rules that affect both our health and the health of our pets.”

Each year around Thanksgiving, KuKanich and colleagues at Kansas State University’s Small Animal Hospital treat multiple cats and dogs that have pancreatitis — an inflammation of the pancreas. The condition often manifests in pets that have eaten fatty human foods, such as meat trimmings and bacon, rather than their normal diet. Foods high in salt can be hazardous to pets with heart disease.

I thought it was drunks that got pancreatitis.

KuKanich advises pet owners to keep pets’ meals and treats as normal as possible during the holidays in order to avoid a recipe for disaster. She also said that the same food safety rules that apply to humans also apply to pets. These include:

  • Turkey and other meats must be cooked to 165 degrees Fahrenheit before dogs, cats and humans eat it. Raw and undercooked meats as well as their juices can contain germs that can cause serious illness in both people and animals.

“Sometimes people think that it’s OK to give a pet raw or undercooked meat because pets’ ancestors come from the wild,” KuKanich said. “Any raw meat, such as the gizzard of the turkey, can make our pets sick because they can be contaminated with bacteria. A meat thermometer is best way to know our meats are food safe and cooked to the proper temperature for everyone’s safety.”

  • Bones, such as a hambone, drumstick or rib, also can be dangerous because they can become lodged in the esophagus of dogs, requiring emergency endoscopy or surgical removal.
  • Pet owners should wash their hands in warm, sudsy water before and after feeding their pet. Pets’ food and water bowls and measuring cups used to dispense their food also should be cleaned regularly.

“Handwashing prior to cooking, eating and food storage is important to keep food and family members safe,” KuKanich said. “It also is a good idea to either avoid petting our furry friends during food prep and meals or to wash hands frequently so that we keep both the food and the pets safe.”

  • Juices from raw turkey and other meats will contaminate anything it touches in the kitchen, including counter space, utensils, other food and pet dishes.
  • Pets and people should not eat cooked and dairy-based food that has been sitting at room temperature for longer than 2 hours. Two hours is the longest food should sit at room temperature before it is refrigerated or frozen, according to a food safety specialist at Kansas State University Olathe.

Additionally, while sweets and deserts may affect our waistline, they can be hazardous to an animal.

Kate’s got the basics right.

Kansas State is fortunate to have her.

Our publications can be found on-line.

Almost 500 sickened: German pigs and Salmonella

In 2013, raw pork was the suspected vehicle of a large outbreak (n = 203 cases) of Salmonella Muenchen in the German federal state of Saxony. In 2014, we investigated an outbreak (n = 247 cases) caused by the same serovar affecting Saxony and three further federal states in the eastern part of Germany.

Evidence from epidemiological, microbiological and trace-back investigations strongly implicated different raw pork products as outbreak vehicles. Trace-back analysis of S. Muenchen-contaminated raw pork sausages narrowed the possible source down to 54 pig farms, and S. Muenchen was detected in three of them, which traded animals with each other. One of these farms had already been the suspected source of the 2013 outbreak. S. Muenchen isolates from stool of patients in 2013 and 2014 as well as from food and environmental surface swabs of the three pig farms shared indistinguishable pulsed-field gel electrophoresis patterns.

Our results indicate a common source of both outbreaks in the primary production of pigs. Current European regulations do not make provisions for Salmonella control measures on pig farms that have been involved in human disease outbreaks. In order to prevent future outbreaks, legislators should consider tightening regulations for Salmonella control in causative primary production settings.

Two consecutive large outbreaks of salmonella muenchen linked to pig farming in Germany, 2013 to 2014: Is something missing in our regulatory framework?

Eurosurveillance, vol. 22, no. 18, 4 May 2017, A Schielke, W Rabsch, R Prager, S Simon, A Fruth, R Helling, M Schnabel, Siffczyk, S Wieczorek, S Schroeder, B Ahrens, H Oppermann, S Pfeiffer, SS Merbecks, B Rosner, C Frank, AA Weiser, P Luber, A Gilsdorf, K Stark, D Werber

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=22793

First we take Manhattan, then Berlin: Zoonoses in the food chain

I may have spoken at this in 1998.

quote-first-we-take-manhattan-then-we-take-berlin-leonard-cohen-87-88-65Or something else.

My parents warned me Germans would not get my sense of humor, and I hobbled around Berlin with my first affliction of what I later understood to be familial-associated gout.

The beer probably didn’t help.

Regardless, the occurrence of zoonotic pathogens and toxigenic bacteria in the food chain and the associated risk for humans were the focus of the4th Symposium for Zoonoses and Food Safety” at the Federal Institute for Risk Assessment (BfR) in Berlin.

Around 250 participants were discussing strategies to combat zoonotic pathogens in livestock, their occurrence in foods of animal origin and the role of toxigenic bacteria for food safety.

“The sharp decline of salmonellosis in humans in recent years can be seen as a success of the measures taken to combat this pathogen in poultry flocks,” says BfR President Professor Dr. Dr. Andreas Hensel. “Accordingly, there is now more focus on other sources of human infection”. This includes the occurrence of Salmonella in pig farming and in reptiles kept as pets.

For this reason, the symposium also focused on how to reduce the spread of salmonella in pig herds and pork meat. To do so, the food chain was examined from feedstuffs all the way through to food retail. New goals and initiatives of the federal states were presented too. The possible role of household pets as a source of infection for humans was also thematised using the example of reptiles.

The risk posed to humans by other zoonotic pathogens was also looked at. New laboratory methods play an important role in estimating these risks and assessing possible infection chains. This was illustrated by describing the investigation of a listeriosis outbreak. Another current example is the appraisal of the gut bacteria Clostridium difficile as a zoonotic pathogen.

one-healthA second main focus of the symposium was toxigenic bacteria. These are bacteria whose metabolites can trigger illnesses known as food intoxications (poisonings) that can sometimes be severe. It is not the bacterium but rather the toxin produced by it that is the cause of the health impairment.

The number of cases of foodborne diseases through toxigenic bacteria reported on EU level is increasing continuously. With approx. 16%, overall food intoxications took third place in reported cases of foodborne disease outbreaks after viruses and salmonella in 2014.

The main focus of the symposium was on the significance, occurrence and detection of toxigenic Staphylococci, Bacilli and Clostridia. The results of outbreak investigations in Germany were presented among other things, along with suitable examination methods for detecting toxigenic bacteria in prepared foods. The experts also picked up on the question of whether more efforts have to be made to better estimate and minimise the risk posed by toxigenic bacteria in the future.