Hepatitis A virus can cause Hepatitis A, which is a potentially serious form of liver disease by attacking the liver. Non-travel-related hepatitis A infection is rare in North America as the virus is usually found in developing countries with very poor sanitary conditions and hygiene practices.

It often takes a long time to recognize that a food-borne disease outbreak is underway because cases can be dispersed geographically. Taking into consideration that the incubation period of hepatitis A is usually 14 to 28 days, it can be difficult to find the source since people cannot recall with precision what they ate weeks earlier.

An example of successful investigation is the recall of hepatitis A contaminated pomegranate seeds in British Columbia in early 2012 by comparing the foods the infected people had bought in previous months. Those food purchasing histories were compiled from their crockery story loyalty cards, pomegranate seeds in a frozen fruit mix were eventually identified as the source of the infection. At a very early stage, with only six cases, the investigators were able to see that the infected people had purchased the same brand of a frozen fruit mix containing blueberries, strawberries, cherries and pomegranate seeds. The following test eventually showed that on e lot of pomegranate seeds from the supplier was contaminated with hepatitis A and a recall was ordered.

“It certainly did make it easier and it allowed us to identify, to really land on a specific product really very early in the outbreak,” Dr. Helena Swinkels of Fraser Health Authority says of the access to the patients’ purchasing history through their loyalty card data, “Loyalty cards are one tool that definitely can help investigations of food-borne outbreaks.”

Although hepatitis A is rare in Canada and the few cases recorded each year generally are in people travelling in or returning from countries where the virus circulates, occasionally someone who becomes infected will transmit it to others in Canada. Therefore, it is necessary for the public to understand its transmission pathway and the prevention methods.

Transmission:
-Faecal-oral route
-Waterborne outbreaks, infrequent, usually associated with sewage-contaminated or inadequately treated water.
-Close physical contact with an infectious person, although casual contact among people does not spread the virus.

Prevention:
-Improved sanitation, food safety and immunization are the most effective ways to combat hepatitis A.
-Several hepatitis A vaccines are available internationally.
http://www.streamingwell.com/how-do-you-get-hepatitis-a-video.html

Sources:
http://www.liver.ca/liver-disease/types/viral_hepatitis/Hepatitis_A.aspx
http://o.canada.com/health-2/grocery-store-loyalty-cards-help-b-c-disease-detectives-trace-hepatitis-a-outbreak
http://www.who.int/mediacentre/factsheets/fs328/en/

Did you know that China has a zero pathogen standard that needs to be met for meat imports? Whether raw or cooked, meat and poultry from Canada shipped to China must contain no amounts of Listeria monocytogenes. How would this affect China’s food market and food availability?

Listeria monocytogenes is a facultative anaerobe, meaning that this bacterium is able to survive in environments absent of oxygen. It also has the capability of growing in temperatures ranging from 0 to 40 degrees Celsius. This allows Listeria monocytogenes to grow and to survive on refrigerated and frozen foods respectively. In Canada, presence of the bacteria on food is permitted as long as the detected amount is below 125 CFU/g for category 1 RTE foods and less than 100 CFU/g for categories 2A and 2B. These values were established because foods with less than these detected amounts of L. monocytogenes have low risk of causing illness. In fact, most foods consumed in Canada are usually tainted with L. monocytogenes. According to Health Canada, there is a 0-10% frequency of L. monocytogenes found in RTE foods.

Food from Canada that is exported must comply with the regulations of the country receiving the food, in this case, China. According to the China National Standards (GB 29921-2013), meat products cannot contain any amount of Listeria monocytogenes for every 5 samples tested. If meat and ready-to-eat (RTE) food producers want to export their products to China, they need to apply procedures that would completely eliminate L. monocytogenes from the food. To ensure that cross contamination does not occur, exporters need to follow proper equipment maintenance, sanitation, and handling procedures; however, this may be difficult for Canadian producers to achieve if we export our meat to countries with such requirements because meat can be contaminated through packaging and shipment processes. In addition, there is difficulty in eliminating the bacteria from foods due to the resistant qualities of L. monocytogenes such as sanitizer, acid, and desiccation tolerance, as well as its ability to attach and remain on surfaces.

China’s zero tolerance policy for the presence of L. monocytogenes in meat poses as an issue for other countries wanting to import their meat into China. If China buys meat from Canada and the meat gets tainted during exportation, China destroys the meat. This waste and reduction in food imports is not only harmful to both economies, but also to the food supply in China. Moreover, implementation and regulation of stricter laws is costly.

Compared to previous years, the presence of L. monocytogenes in foods has been increasing. The number of incidences of foodborne infection due to L. monocytogenes reported in China is similar to the numbers from different countries. Since China’s food market is rapidly developing, along with an increase in the population, there is a demand for pre-made, RTE foods. This increased consumption may also mean that there is more risk of infection, but there may also be a lack of supply due to the restrictions on imports. According to the WHO, the likelihood of developing listeriosis depends on multiple factors including how the food is stored, how many times contaminated food is consumed, and the amount of pathogen on the food. Rather than having the zero tolerance policy, perhaps China can consider educating consumers on basic food safety principles.

Considering the risk of infection and the loss of trade, do you think the zero tolerance policy is necessary?

Works Cited

China National Standards (26 Dec 2013). Food Safety National Standard Limit of Pathogens in Food Products. Retrieved from http://cexgan.magrama.es/MODULOS05/Documentos/GB29921-2013-PatogenosEnAlimentos.pdf

Feng, Y., Wu, S., Varma, J. K., Klena, J. D., Angulo, F. J., & Ran, L. (2013). Systematic review of human listeriosis in china, 1964–2010. Tropical Medicine & International Health, 18(10), 1248-1256. doi:10.1111/tmi.12173

Health Canada (1 Apr 2011). Policy on Listeria monocytogenes in Ready-to-Eat Foods. Retrieved from http://www.hc-sc.gc.ca/fn-an/alt_formats/pdf/legislation/pol/policy_listeria_monocytogenes_2011-eng.pdf

Wu, S., Wu, Q., Zhang, J., Chen, M., Yan, Z. A., & Hu, H. (2015). Listeria monocytogenes prevalence and characteristics in retail raw foods in china. PloS One, 10(8), e0136682. doi:10.1371/journal.pone.0136682

September 24, 2014: At least 22 members of the football team were reported sick, some hospitalized, after the team potluck at the Durand High School in Wisconsin. Lab tests have confirmed suspicions of the pathogen to be Campylobacter Jejuni. Wisconsin Department of Health said that unpasteurized milk served at the dinner was the cause of the outbreak. More than 50 Durand High school students were forced to stay home due symptoms that included Diarrhea, cramps, fever, and stomach pain.

Read more about the news break here: http://www.weau.com/home/headlines/NEW-INFORMATION-Campylobacter-infection-found-in-one-Durand-patient-276958321.html

The potluck is a yearly tradition at the high school usually held at the nearby school. Dinner included Chicken Alfredo, Kool-Aid, water, and raw milk with chocolate syrup added.

The Wisconsin Department of Health (DHS) interviewed all players and coaches of the football team (ill and unwell) in order to assess symptoms, as well as find the root of the problem. Consumption of raw milk appeared to be the isolated as the only food item associated with the illness. Symptoms lasted for about a week and ranged from mild to severe. Other complications include meningitis, urnary tract infection, arthritis, and sometimes, Guillian –Barre syndrome.

One of the students, Brianna, reported unusual pain in her hips and knees, limb weakness, as well as numbness for which she was hospitalized.

Reportedly, other students were hit hard by the symptoms as well, many suffered from bloody diarrhea and noticeable weight loss.

More about the investigation:
http://www.jsonline.com/business/raw-milk-blamed-as-38-at-durand-high-football-potluck-are-sickened-b99390272z1-282848161.html

According to the Health Canada website, people infected with C.jejuni can experience an array of symptoms. Some may not get sick at all, but still be able to spread the disease. Others may experience a severe flu, while some may be hospitalized.

The outbreak affected the football team so much so that the high school cancelled the Sept 27th football game against Amery High School.

Campylobacter Jejuni, the pathogen identified as the cause of this outbreak, is found in digestive systems of cattle, poultry, and animal feces. The DHS collected samples of manure from the farm where the raw milk was produced, and the bacteria strain was found positively correlating the bacteria to the illeness. People with weakened immune systems are at a greater risk of complication including arthiritis, meningitis etc.

Public Health Canada website:
http://www.phac-aspc.gc.ca/fs-sa/fs-fi/campylo-eng.php

The state-law prohibits sale of unpasteurized milk products to the public to contain bacteria that may promote food borne illnesses. Moving forward, the school recommends fewer dinners like potlucks, as the food quality is difficult to control. The effects of this have been particularly eminent to the student population.