Listeria Monocytogenes Recall in Australian Fried Rice: No Ending

Posted on October 27, 2015 by | 7 comments

In Australia, there was a recall on September 3, 2015 due to pre-packaged fried rice from the company JL King & Co due to Listeria monocytogenes. Both packagings of 1kg and 450g were on the recall. As of now, there is still no information about the source of contamination, how many or if there were any consumers who got sick. The best before date for this product was September 15, 2015, which was only 12 days from the date the recall was announced. (Australian Competition Consumer Commission, 2015)

Similar to most other ready to eat foods that Listeria monocytogenes like to grow in, the shelf life is quite short and some consumers consume the ready to eat products right after purchasing. Other products such as canned foods that Clostridium botulinum can grow in, the shelf life can be up to 2 years which gives plenty of time for recalls as those consumers may not consume them immediately after purchase. The recalls for ready to eat foods such as the pre-packaged fried rice can serve the purpose of taking the food off store shelves to prevent future consumers from getting sick. However for the consumers who have consumed contaminated products before any recall notification, some of them may not even get sick due to the natural microflora present on their intestinal surfaces.

The ones who are most susceptible to falling ill from Listeria monocytogenes are pregnant women and their unborn or newborn children, seniors and the immunocompromised. For pregnant women in the first three months of pregnancy, being sick with Listeria monocytogenes can cause a miscarriage. If the bacteria is contracted later on in the pregnancy, premature birth, stillbirth or the birth of a severely ill child may happen. The immunocompromised are much more likely to get sick but according to the Public Health Agency of Canada, people suffering from AIDS are 300 times more susceptible to being infected by Listeria monocytogenes compared to healthy individuals. (Public Health Agency of Canada, 2012)

Listeria Monocytogenes luckily cannot grow in all ready to eat food products as long as the food product falls under one of the following three criteria according to Australia’s Food Standards (Food Standards, 2014):
1. pH less than 4.4, no matter the water activity value
2. Water activity less than 0.92, no matter the pH value
3. pH less than 5.0 and water activity less than 0.94

However, if Listeria monocytogenes is present it can survive in acid conditions and in products with low water activity for a long period of time, especially for refrigerated products. Even if the product has gone through a drying process, Listeria monocytogenes may survive. (Lawley, 2013)

If the ready to eat food product is frozen and is consumed frozen, thawed but still eaten cold or heated before consumption then it is most likely safe from Listeria Monocytogenes. (Food Standards, 2014) If the ready to eat food product does not fit with the above criteria, then heating to an internal temperature of 74°C before eating can help in minimizing the chance of Listeria monocytogenes surviving in the food. (Public Health Agency of Canada, 2012)

With all the conditions Listeria monocytogenes can grow or survive in ready to eat products, I feel that one of the better ways to minimize the risks of getting ill from Listeria monocytogenes is to heat ready to eat products except for frozen products before consuming. Although this might be difficult for ready to eat foods that are generally eaten at room temperature such as sandwiches.

Are there any other methods that you think are sufficient in eliminating Listeria monocytogenes?

References:

Andersen, L. (2015) Listeria and Bacteriocin-Producing Starter Culture. Retrieved from http://www.foodsafetynews.com/2015/08/listeria-and-bacteriocin-producing-starter-cultures/#.Vi3XUmSrToB

Australian Competition Consumer Commission. (2015). Product Safety Recalls Australia. Retrieved from http://www.recalls.gov.au/content/index.phtml/itemId/1076441

Food Standards. (2014). Supporting document 1 – Guidance On the Application of Microbiological Criteria for Listeria Monocytogenes. Retrieved from
http://www.foodstandards.gov.au/code/proposals/Documents/P1017-MicroAppR-SD1.pdf

Lawley, R. (2013). Food Safety Watch. Retrieved from http://www.foodsafetywatch.org/factsheets/listeria/

Public Health Agency of Canada. (2012). Listeria. Retrieved from
http://www.phac-aspc.gc.ca/fs-sa/fs-fi/listerios-eng.php

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Listeria Outbreak Associated with Blue Bell Ice Cream

Posted on October 25, 2015 by | 9 comments

Blue Bell Creameries recently did product recall for the first time in their 108 years of company’s history caused by an outbreak of Listeria monocytogenes. There were in total 10 cases in 4 states & 3 deaths affected by the outbreak. They have 3 production facilities and all of them were contaminated with Lm: one in Texas (which is the headquarters), and two auxiliary production lines in Oklahoma and Alabama. In this post, I’m focusing on what happened in the Oklahoma facility.

The first 5 Listeriosis cases that were reported in Kansas early March 2015. They were all hospital inpatients and immunocompromised, and 3 of them actually died, which made up the total deaths for this outbreak. In late March 2015, using PFGE and Whole Genome Sequencing, Kansas Department of Health and Environment found out that the same strains of Lm found in the patients were traced back to unopened Blue Bell Creameries’ 3 oz. Institutional/Food Service Chocolate Ice Cream cups served in the hospital, which were manufactured in the Oklahoma production facility. Interestingly, this product was distributed to 23 states and only sold in schools, nursing homes, and hospitals, which mainly accomodate individuals at risk. This suggests that there were probably unreported cases of listeriosis linked to the Blue Bell Creameries’ products.

 

In May 7, 2015, the FDA released findings from Blue Bell Creameries’ production facility in Oklahoma. In this report, there are 12 observations being made but I’m only going to outline several points.

 

This report mentions that the Oklahoma Department of Agriculture, Food, and Forestry established a requirement of 20 CFU/mL of Lm or less in finished products of frozen dairy desserts. In March 2015, 275 CFU/mL Lm was found in the finished product half-gallon Dutch Chocolate Ice Cream, more than thirteen times the recommended levels. Now, if we assume that there is 275 CFU/mL of Lm in a 3 oz. (88mL) Institutional/Food Service Chocolate Ice Cream cup, then there is in total 24,200 CFU of Lm in one cup. However, several hospital patients fell ill after consuming the particular product, which means that the amount of Lm in that product is at least at an infectious dose of 0.1 to 10 million CFU for at risk individuals. Based on these assumptions, Lm might continue to grow under freezing temperatures, but more research needs to be done on this subject. Another possibility is that some finished products of the chocolate ice cream already had enough Lm in it to infect at risk individuals, therefore any more Lm growth would not make any impact.

 

This report also mentions that the plant’s production line is not designed to prevent cross-contamination from drippings and condensate from pipes and tank lids. The lids on top of the tanks containing post-pasteurized Dutch Chocolate Ice Cream were not closed tightly, hence condensate from another product line installed horizontally right above it drips into the tanks, which makes a potential source of Lm contamination. Additionally, a worker was observed spraying the top of the lids and switching lids between other post-pasteurized Dutch Chocolate Ice Cream tanks, which may contribute to Lm cross-contamination in the tanks. The rest of the report states that lack of employee hygiene and inadequate facilities for cleaning and sanitizing equipments might be some contributing factors to the growth of Lm in their products.

 

Now, if you were to be part of Blue Bell Creameries’ quality control team at the Oklahoma production facility, what would you do? What recommendations would you offer to make the production line safer?

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Europe: Salmonella Stanley Strikes Again! Find out why S. Stanley keeps refusing to back down.

Posted on October 23, 2015 by | 3 comments

SalmonellaTurkeys Stanley, as friendly as this particular strain of salmonella may sound, is no friend to the European member states at all. S.Stanley may as well be a multi-national celebrity as it has been making headlines across Europe for various food-borne outbreaks since 2011.

After a string of salmonella outbreaks that affected 7 European states and more than 400 patients, the European Centre for Disease Prevention and Control (ECDC) and other authorities finally initiated investigations on the source of the culprit strain in 2012. Evidence from the investigations led to a suggested source of turkey meat and without slowing down, the notorious S.Stanley continued to make various headlines up until 2014. Now, S.Stanley has re-emerged in clusters throughout 2015 and is taking over a new wave of Austrian turkey supply.

Between 1 January and 8 October 2015, 141 cases of non-travel related infection with S. Stanley were identified in eight of the nine Austrian provinces. At least 36 of these cases have been traced back to turkey kebabs made with turkey meat supplied by a single retailer located in Slovakia. More trace back by National authorities indicate that the Slovakian retailer sources its turkey meat from a facility in Hungary. This same facility was linked to a S.Stanley cluster back in 2014. Furthermore, recent investigations using pulsed-field gel electrophoresis (PFGE) molecular typing indicate that the 2015 salmonella isolates have the same unique pattern as S.Stanley from the 2011 to 2014 outbreaks.

So what is the secret to S.Stanley’s everlasting presence?

Antimicrobial Resistance.

Since the early 1990s, antimicrobial resistant salmonella strains have emerged and become serious public health concerns. Antimicrobial resistance occurs when pathogenic cases are routinely treated with antimicrobial therapy but result in not eliminating the more resistant bacteria strains. The subsequent result is resistant bacteria strains reproducing, and the antimicrobial treatment becoming ineffective.

The same strain of Salmonella Stanley has consistently been recognized from 2011-2014 due to its pattern of resistance to nalidixic acid antibiotics. That was up until now, where the 2015 strain of S.Stanley has been identified as having low-level resistance to ciprofloxacin in addition to nalidixic acid antibiotics.

To prevent further cases of antimicrobial resistance cases, the single most important action is to change the way antibiotics are used. Mostly, the use of antibiotics in people and animals are unnecessary especially in mild cases of infection. Treatment guidelines should be reviewed regularly while considering bacterial resistance patterns.

Here are some simple tips to prevent Salmonella from spreading in your home:

  • Clean surfaces regularly and wash your hands often especially after coming into contact with animals and animal products.
  • Separate raw and cooked, ready-to-eat foods to prevent cross contamination.
  • Cook food to the right temperature. Checking the colour and texture of meat is not enough to ensure it is safe. Instead, use a food thermometer to check internal food temperatures.
  • Refrigerate foods below 4°C. Germs can grow in many foods within 2 hours and even quicker during the summer.

 

Works Cited

CDC. (2014). Antibiotic Resistance and Food Safety. Available at: http://www.cdc.gov/foodsafety/antibiotic-resistance.html

CDC. (2015). About Antimicrobial Resistance. Available at: http://www.cdc.gov/drugresistance/about.html

ECDC. (2015). CDTR Week 41, 4-10 October 2015. . COMMUNICABLE DISEASE THREATS REPORT. Available at: http://ecdc.europa.eu/en/publications/Publications/communicable-disease-threats-report-10-oct-2015.pdf

Whitworth, J. (13 October 2015). New Cases reported in multi-year, multi-country Salmonella outbreak. Food Quality News. Available at: http://www.foodqualitynews.com/Food-Outbreaks/Turkey-production-chain-at-centre-of-Salmonella-concerns

WHO. (2013). Salmonella (non-typhoidal). Available at: http://www.who.int/mediacentre/factsheets/fs139/en/

WHO. (2015). Antimicrobial resistance. Available at: http://www.who.int/mediacentre/factsheets/fs194/en/

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Posted in Week 3

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“Banh mi” in Vietnam

Posted on October 23, 2015 by | 12 comments

 

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Recently, on Oct. 20th 2015, there was a Salmonella outbreak in the Quang Binh province, which located in the north- central coast of Vietnam. The outbreak affected 224 local people, who showed symptoms such as stomach ache, vomiting, fever and diarrhea. The Salmonella bacteria were found in “Banh mi” supplied by the “Vuong Tien Thanh Bakery”. “Banh mi” is a Vietnamese snack introduce by the French during the Colonial Period. It consisted of a baguette, usually filled with variety of meats, pickled vegetables and chili peppers.

 

According to the Quang Binh province Hygiene and Food Safety department, samples taken from the bakery and the contents of the victims’ stomach both tested positive for the bacteria Salmonella. Most of the consumer infected with Salmonella developed symptoms within 72 hours and rushed to the local hospital. This was the biggest case of food poisoning seen in the province.

 

About a week prior to the detection of Salmonella bacteria in “Banh mi”, the bakery had supplied bread to “Tan Phat Sport Company”. 20 of the worker. who consumed the bread suffered from vomiting and diarrhea.  “Vuong Tien Thanh Bakery” had five branches, which 3 were suspended after the incident.

 

A little background in Vietnamese food culture and the snack food item “Banh mi”. “Banh mi” from the journal article “An Outbreak of Foodborne Salmonellosis Linked to Bread Takeaway Shop in Ben Tre City, Vietnam” was referred as stuff bread. In the article it was mention that in 2013 media reported multiple incidents where people had been hospitalized with acute gastroenteritis due to consumption of stuffed bread. They found that “Banh mi” usually included the ingredients pork bologna, pork pate, salted and dried pork and raw egg mayonnaise. Many of these items were found to have Salmonella species as well as E. coli growing.  Most of the stuff breads were brought from street food stalls and vendors. At these vendors poor hygiene was found: some had cooked food and raw food place very close together, some had cooked food kept at room temperature for long period of time.

 

Vietnam is a lower middle income country, where development and industrialization are still taken place. The food culture there is still very traditional, which comprised of traditional foods with traditional methods of making the food. Traditional practices of preparing the food are not necessary food safe or hygienic. Vietnam is also one of the Asian countries known for its delicious and inexpensive street food. To regulate and improve food safety laws for street food vendors in Vietnam, in 2011 laws were passed providing guidelines on operating street food stalls.

 

The guidelines are:street-food-vendor

  1. Stall must be away from polluted place.
  2. Clean water must be used to cook and clean kitchen utensils
  3. Origin of the produce used to make food must be clear
  4. Vendors must have a waste collection system in place
  5. Vendors can only make use of a specific list of additives

 

Many other Asian countries are also known for the inexpensive and impressive variety street foods. What would be your opinion on regulation on street food? How can we blend traditional practices with modern implications?

 

Thank you so much for your time.

Emily L. 

 

Reference links:

http://www.vietnambreakingnews.com/2015/10/224-banh-my-eaters-stricken-with-salmonella-poisoning/

http://www.who.int/features/2015/food-safety-interview/en/

http://www.vietnambreakingnews.com/2015/10/suspected-food-poisoning-affects-48-workers/

http://www.sciencedirect.com.ezproxy.library.ubc.ca/science/article/pii/S1201971214015513

 

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Posted in Week 3

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An Outbreak of Salmonella Poona Infections: Think Twice Before Eating That Cucumber

Posted on October 19, 2015 by | 13 comments

The Centers for Disease Control and Prevention (CDC) and US Food and Drug Administration (FDA) are investigating a very serious strain of salmonella called Salmonella Poona, which has affected 767 people as reported until October 14, 2015 by consuming contaminated cucumbers. Among 36 states, 205 cases reported from California, which has the highest number of infected people in this salmonella outbreak. Four deaths have been reported from California, Arizona, Texas, and Oklahoma. More than gettyimages-175696368half of the infected people are children younger than 18 years old. FDA investigations have identified that the contaminated cucumbers were imported from state of Baja California in Mexico and distributed by Andrew & Williamson Fresh Produce. The company has issued a recall of all cucumbers sold under its Limited Edition label, which are those Slicer cucumbers imported from Mexico, during the period from August 1, 2015 to September 3, 2015. However, the shelf life of this type of cucumber is 14 days and some customers may store the cucumbers and do not notice the recall of these contaminated cucumbers. Moreover, it usually takes 2 to 4 weeks for the case actually reported as part of the outbreak since the person is exposed to salmonella, which means there will be more illnesses reported later on. CRbPX0_VAAA47iN

Children, elderlies, and people with suppressed immune systems are more likely to get salmonella
infections and the infection can be fatal. Salmonellosis causes abdominal cramping, vomiting, nausea, and diarrhea. According to CDC, 8% of reported infections had long-term impact, such as chronic gastroenteritis, osteomyelitis, and septic arthritis.

People mostly hear about salmonella when it comes to poultry, egg and beef, not vegetables, but any type of food might be contaminated by salmonella bacteria. Research shows that 13% of the source attribution of salmonellosis is vine vegetables, fruits, and nuts. Cucumber, as a delicious and refreshing vegetable, is usually eaten raw, which increases the risk of getting infected by salmonella. Salmonella grows optimally at 37 °C and pH of 6.5 to 7.5. However, most salmonella serotypes can grow in the range of 7 to 48 °C and are able to survive under freezing for a relatively long period of time. They can also survive under very acidic and dry condition. An efficient way to eliminate salmonella in the food is heating to an internal temperature of 72 °C for at least ten minutes.

Nevertheless, going back to the salmonella outbreak linked to cucumbers in US since September 2015, fresh cucumbers are usually not cooked before consumption, which means it would not go through the heating process, so it is very difficult to eliminate the pathogens during the preparation. The question is: how to safely prepare your produce? According to FDA, there are some precautions to take each time before eating the produce:

  1. Clean your hands by washing them for at least 20 seconds with soap and warm water before and after preparation.

  2. Wash your produce thoroughly under running water before eating, cutting or cooking — home-grown veggies included.

  3. Scrub firm produce like cucumbers with a clean produce brush.

  4. Dry produce with a clean towel to further reduce bacteria from spreading.

Furthermore, avoiding cross-contamination is also very critical. Raw meat, poultry, and produce need to be separated in the grocery shopping cart and the refrigerator. For the preparation, different cutting boards can be used for different types of food, especially for separating cooked and raw food.

Eating raw food always links to high risk of getting infected by the foodborne pathogens. Personally, I always eat cucumbers raw, since produce is not a very big concern for salmonella infection. As I heard this outbreak, I started to re-consider if I should cook them before eating. I feel like cooking is the safest way to prevent from getting infected.

Suggestions by FDA – “how to safely handle raw produce and fresh-squeezed fruit and vegetable juices”

 

What do you think? How would you prevent yourself from being harmed by eating raw produce?

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Posted in Week 3

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A Canada Exclusive: Salmonella Across the Country, Majority on the East-side!

Posted on October 19, 2015 by | Leave a comment

Just last Friday on October 16th, news outlets have published an article about a recent outbreak on Salmonella, with reports starting from June 12, 2015. The Salmonella outbreak has spread over the country in 8 provinces by the 20th of September with the most cases reported in Ontario. Other provinces include British Columbia, Alberta, Saskatchewan, Manitoba, Nova Scotia, New Brunswick, and Quebec. Luckily, there has been no reported deaths.

The source of outbreak is still unknown as of today, however many common food carriers of Salmonella pathogens include: poultry and poultry products (ex. eggs), beef, pork, nuts, and produce (ex. fruits and vegetables.

A Study has shown that Salmonella can be a tricky pathogen as it can become resistant to standard sterilization procedures in food industries through cross-protection. Cross-protection occurs when a pathogen experiences sub-lethal conditions—in which it develops resistance to harsh environments—followed by conditions that would have otherwise killed it (Fong, 2015). In the case of Salmonella, lethal conditions include but are not limited to: pH <6.5, temperature>70 degrees Celsius, and water activity <0.93.

This means that Salmonella can be found not only on food sources, but surviving on surfaces that have come into contact with the contaminated products! It is a very versatile pathogen, which means that the source of outbreak could be identified in any step of the food chain:

  1. Agricultural Sector
  2. Manufacturing/processing Sector
  3. Distribution and Transportation Sector
  4. Retail Sector
  5. At home/restaurants in which the foods are prepared and consumed

2Salmonella can cause symptoms within 6-72 hours of ingestion. Common symptoms include: fever, chills, diarrhea, abdominal cramps, headache, nausea, and vomiting which can last 4-7 days. In more severe cases, such as for those with compromised immune systems, are elderly, or are children, may have to be hospitalized and in the worst case scenario, death may occur. In some cases, people may be asymptomatic and spread the bacteria onto others by not practicing hygienic procedures (handwashing, keeping equipment clean, etc.). (Public Health Agency of Canada, 2015).

This outbreak is a very curious incident as it has spread so far across the country, yet the source(s) is/are not pinpointed to exact foods or modes of process/transportation. With the largest cases found in Ontario and incidences tapering off towards the west, it would seem that the source of outbreak would be from the east. However there may also be a chance that the outbreaks are due to improper food handling methods at home. Another interesting finding is that over half of the effected are female.

With such a large difference of outbreaks between the east and west, could there be a difference between provinces for public education in food handling procedures? Could there be any meaning behind why half of those affected were women?

Before this reported outbreak, there had been another in January 2015. These incidents have been identified rather quickly. However there is an ongoing debate about whether inspection has become quicker and well executed, or if the increased frequency in outbreaks is due to recent cuts in finance for CFIA. More about the cuts can be read on from this article.

What other underlying factors contribute to outbreaks?

How should industry procedures change in order to minimize the effect of cross-protection?

In addition, this link is very helpful with explaining the bacteria and names some organizations involved in food safety for those of you who are looking at the policies currently in place for protecting consumers.

Any related and passionate comment is welcome!

 

Works cited:

Public Health Agency of Canada. 2015. http://www.phac-aspc.gc.ca/fs-sa/phn-asp/2015/salm-0628-eng.php

Image obtained on October 19, 2015 from http://thumbs.dreamstime.com/thumblarge_1666/16666999.jpg

Fong, K. 2015. Environmental adaptation and stress response of Salmonella enterica in peanut oil, peanuts, and chia seeds. University of British Columbia.

 

 

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Australia: Unresolved egg problem

Posted on October 17, 2015 by | 10 comments

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In the past week, a Salmonella outbreak was reported at the South Bank Surf Club in Brisbane, Australia where the restaurant was inspected after receiving some complaints from consumers who felt sick. After further investigation, it was found out that it was due to a bad batch of eggs which was provided by the supplier and the eggs were used in the sauces in seafood platter. As a major egg lover myself, it will be a terrible nightmare to know that you will end up sick eating your favorite food and not knowing the cause of it.

In Australia, despite an overall decline in the national rate of foodborne illness cases each year, the number of Salmonella– related food-poisoning cases continues to increase drastically, posing a health threat to the local community. According to the statistics shown by the Victoria’s Department of Health Figures, there has been a 50% increase in Salmonella-related food poisoning since 2012 along with a doubling of Salmonella poisoning cases occurring in the past 12 months in Queensland with 1895 reported cases so far. A table of past raw eggs related outbreak in Australia was carefully tabulated which shows recurring food outbreaks occurring year by year revolving around eggs. This also indirectly implies the fact that the existing intervention strategies to combat against Salmonella were not as efficient in the prevention of raw egg contamination.

For your information, Salmonella food-poisoning is one of the most common food-borne illnesses reported which is often associated with contaminated poultry products such as eggs. Salmonella can be naturally found in soil and water and contamination of Salmonella is prone to occur with unsanitary food handling and improper cooking of raw food items. Besides, ingestion of food contaminated with Salmonella can lead to salmonellosis which shows symptoms such as abdominal cramping, vomiting and diarrhea.

In conjunction to the recent outbreak which points upstream to the reservoir, studies have shown that some Salmonella serovars, especially Salmonella enterica serovar have the capacity of infecting developing eggs within the oviduct. Therefore, contaminated eggs which serve as an ecological amplifier could then facilitate the dissemination of Salmonella into the food chain and further leads to human transmission.

Besides the possibility of initial product contamination, it is also undeniable that proper food handling techniques are mandatory when it comes to the prevention of food contamination. To properly address that issue, new guidelines have been released by the Fresh Produce Safety Centre Australia New Zealand to spread more awareness and knowledge about the importance of proper food safety standards. In conclusion, I personally think that the Australian Government should properly educate the public about the importance of proper food handling techniques and how does it relate to foodborne illnesses. Also, strict policies in regard to proper food handling practices and maintenance of hygienic standards should be further enforced from farm to fork to minimize the occurrence of foodborne illnesses in Australia.

Please leave some comments on your thoughts on the increasing Salmonella outbreak cases in Australia. Thanks.

Yi Chen Teh

 

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Posted in Week 3

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No Surprises in E. coli Outbreaks of Eastern and Central Canada: The Usual Food-Source, and PHAC’s Anticipated Race against Time!

Posted on October 16, 2015 by | 6 comments

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The Public Health Agency of Canada (PHAC) , the institute in charge of responding to public health emergencies and infectious disease outbreaks, published a final update on the E. coli outbreak that occurred between July 6 and September 4, 2015, in Alberta, Ontario, Quebec and Nova Scotia. Of the 29 cases reported, seven were hospitalized.

According to PHAC, investigators identified E. coli O157 to be responsible for this outbreak, “with the use of enhanced techniques”, that enabled them to rule out 2 other reported cases with similar gastrointestinal symptoms, as not being related to the outbreak strain. The food-source associated with the outbreak has not been identified yet, but further investigations are underway.

This is the second E. coli outbreak of 2015 in Eastern Canada, with the first occurring between March 13 and March 31 in Alberta, Saskatchewan, Ontario, and Newfoundland and Labrador; all the 13 cases that were reported had a matching genetic fingerprint of E. coli O157:H7.
According to PHAC report, exposure to contaminated leafy greens (including all varieties of lettuces, in addition to other green leafy vegetables such as kale, spinach, arugula, or chard) was identified as the possible source of the outbreak. However, CFIA could not identify a specific food product as the single source of the pathogen, which illustrates the challenges associated with food-source attribution in outbreaks.

Escherichia coli O157:H7, a Shiga toxin–producing E. coli (STEC) is the strain most commonly associated with outbreaks of bacterial gastrointestinal disease in the North America. The subpopulation most severely affected by the outbreaks have historically been young children, and the elderly, whereas in the latest Canadian outbreak discussed in this report, the majority of patients were young males (average age of 23); however, the report does not disclose the age distribution of the patients who were hospitalized due to the severity of their condition.

The most common routs of transmission of E. coli pathogen, leading to outbreaks are generally identified to be contaminated food, water (drinking, irrigation or swimming), and environment, as well as person-to person and animal-to-person contact (Turabelidze et al. 2013).

Analysis of outbreak data suggest that foods most frequently implicated in outbreaks in North America are ground beef, leafy green vegetables, and unpasteurized dairy products, as well as sprouts, unpasteurized apple cider, melons and other fruits, and salami (Neil et al. 2009). Therefore, the suggested association of the earlier outbreak to leafy green vegetables, is in line with the characteristics of outbreak food-sources in general.

guiltyNumerous studies have specifically examined the survival and growth of E. coli on leafy vegetables. For instance, Parker et al. (2011) demonstrated E. coli’s “ability to multiply in the phyllosphere of whole lettuce plants” on shredded and intact harvested lettuce leaves, due to an up-regulation of genes involved in oxidative and osmotic stress, which also make the bacteria more resistant to antimicrobials commonly used in the fresh-cut produce industry. Therefore, the food industry needs to implement more effective strategies in handling raw vegetables.

Examining the timeline of PHAC’s report on E. coli outbreaks, reveals that in both occasions, it took the agency over two months from the time of the first reported case, to come to a final conclusion about the strain and possible food source. A similar timeline can be observed in E. coli outbreaks from previous years as well (2012 and 2013). The use of new and improved methods, such as Matrix-Assisted Laser Desorption/Ionization Time-of-Flight (MALDI-TOF)-Based Peptide Mass Fingerprinting, as suggested by Chui et al.(2015) can contribute to a more rapid identification and fingerprinting of the pathogen, which can in turn, reduce the burden of outbreaks by early targeting of the attributed food source.

How can we, as consumers, prevent outbreaks from happening? How do you evaluate the effectiveness of communication methods, and timeliness of response to outbreaks by PHAC?

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Works Cited:

Neil, K. P., Biggerstaff, G., MacDonald, J. K., Trees, E., Medus, C., Musser, K. A., … & Sotir, M. J. (2012). A novel vehicle for transmission of Escherichia coli O157: H7 to humans: multistate outbreak of E. coli O157: H7 infections associated with consumption of ready-to-bake commercial prepackaged cookie dough—United States, 2009. Clinical infectious diseases, 54(4), 511-518.

Parker, C. T., Kyle, J. L., Huynh, S., Carter, M. Q., Brandl, M. T., & Mandrell, R. E. (2012). Distinct transcriptional profiles and phenotypes exhibited by Escherichia coli O157: H7 isolates related to the 2006 spinach-associated outbreak. Applied and environmental microbiology, 78(2), 455-463.

Turabelidze, G., Lawrence, S. J., Gao, H., Sodergren, E., Weinstock, G. M., Abubucker, S., … & Tarr, P. I. (2013). Precise dissection of an Escherichia coli O157: H7 outbreak by single nucleotide polymorphism analysis. Journal of clinical microbiology, 51(12), 3950-3954.

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Posted in Week 2

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E. coli found in South Africa drinking water

Posted on October 16, 2015 by | 4 comments

South Africa drinking water

In March 2015, AfriForum, a South African civil-right organization, found E. coli in the drinking water of four local South Africa municipalities: Molteno-Inkwanca, Tarkastad-Tsolwana, Coligny-Ditsobotla and Vryheid-Abaqulusi. Under the South African National Standard for Drinking Water (SANS 241:2011) and the World Health Organization (WHO) guidelines, E. coli must not be detected (count per 100 ml) in any drinking water samples. Local communities were notified not to drink the water. The non-compliance municipalities’ water authority was told to investigate the source of contamination and implement corrective actions. Follow-up samples were taken and tested clean.

E. coli is found in the intestines of human and animal. While most E. coli strains are harmless, some are pathogenic and can cause severe human illnesses. According to the study undertaken by WHO’s Foodborne Disease Burden Epidemiology Reference Group (FERG),enteropathogenic E. coli was one of the top three enteric disease agents responsible for most deaths globally in 2010. Enteropathogenic E. coli associates with infantile diarrhea and it is the major cause of infant mortality in developing countries. Enterotoxigenic Escherichia coli (ETEC), the most common cause of travel-associated diarrhea, can be found in less-developed countries. ETEC can also cause mortality for children under the age of 5.

In Inkwanca Municipality: Integrated Development Plan 2012-2017, one of the remarks made on Molteno water supply concern was the need to upgrade the monthly raw water treatment system. Molteno raw water source is abstracted from Molteno Dam, the Jubilee Dam and a borehole in Denekruin Township. As the dams are open water sources, it may carry more of a risk for E. coli contamination than closed water sources. Precautionary measures such as restricting domestic, livestock or wild animals access to these dams should be taken. Surface water should also be in adequate distance from untreated manure and human sewage waste system. Borehole water can also be contaminated by agricultural livestocks effluent. It is important for the municipality to maintain and upgrade the raw water source treatment and purification work as recommended in the development plan.

Both Ditsobotla and Abaqulusi have experienced water shortages due to the growth demand outstripping the water supply. The National Treasury advises that all municipalities should ensure that the water tariffs can cover the cost of maintenance and renewal of purification plants, water networks and water infrastructure expansion. To prevent low income households from opting for unsafe water sources due to the water tariffs, Free Basic Water Policy and water subsidies are implemented in some municipalities. To prevent reoccurrence of E. coli detection in drinking water, South African municipalities must put in a sustainable water supply budget plan in order to supply high quality potable water for households of all income levels.

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E. coli 0121 Outbreak Naha, Japan

Posted on October 16, 2015 by | 9 comments

E. coliOn October 2nd, an E. coli outbreak was reported at a childcare facility in Naha, Japan. The strain implicated in the infection was Enterohemorrhagic E. coli 0121. The first case identified was from a nurse who worked at the childcare center. Ten people in total became ill with mild gastrointestinal symptoms. Seven of the cases were children. The source of the infection is still unknown.

Japan may be particularly sensitive when it comes to E. coli outbreaks, especially among school-aged children. Back in 1996, one of the worst E. coli outbreaks ever seen worldwide occurred in Sakai City Japan. Ultimately, an astonishing 9,451 people became ill from the bacteria, and 12 people died. Most of those affected by the outbreak were school children.

The causative strain was identified as E. coli O157:H7; however, the source of E. coli was not identified until three years later when scientists conducted studies aimed at tracing the source. In their report they concluded that radish sprouts from a single farm were responsible for the outbreak. The sprouts had been shipped to various schools to be included in the children’s lunches.radish sprout

This extreme example, and the more recent outbreak show the difficulties in attributing an E. coli outbreak to a particular source. Without knowing the origin of an outbreak, it is more difficult to get it under control, and can quickly get out of hand as seen in 1996 incident. This is an important idea to consider as last year alone Japan experienced 4153 cases of EHEC (according to the National Institute of Infectious Disease).

Despite current conditions, there may be good news for future improvements to Japan’s E. coli testing. According to a study reported in Food Safety News, the global market for E. coli testing is predicted to increase by nearly one billion dollars by 2022, with Asia being the region expected to see the most growth. Technologies are being developed to make E. coli testing quicker and more cost effective.

It will be interesting to see if faster, and more frequent testing can have any significant impact in preventing or minimizing future outbreaks. It is easy to wonder if Japan had had more funding or technology devoted to testing for E. coli back in 1996 if the outbreak would have reached the staggering number of cases that it did. Even now, this recent outbreak shows the continued difficulty in tracking the spread of E. coli infections. Luckily, this time the outbreak stopped at 10 cases.

 

What do you think?

Could faster and more effective methods of testing help prevent infections and stop major outbreaks?

Also, even though the market is showing an increasing demand for E. coli testing should resources go to developing these technologies, or should money go to other areas along the food safety/disease prevention chain?

 

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