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Parallel Clinical Pattern to O104:H4
Source : http://www.foodsafetynews.com/2011/07/a-parallel-clinical-pattern-to-o104h4/
by Daniel B. Cohen (Jul 06, 2011)
The O104:H4 serotype has an unusual clinical pattern for Shiga toxin-producing
E. coli (STEC) pathogens, including bloody diarrhea in adults followed
by a high conversion rate to adult hemolytic uremic syndrome (HUS) or
to severe non-HUS enterohemorrhagic symptoms in adults.
There is another STEC group that parallels the unusual pattern of the
current outbreak in Germany. It as characterized by a form of Shiga
toxin that becomes more deadly after it is attacked by the patient's
body's defense mechanisms.
Most STEC like O147:H7 have a class of Shiga toxin known as Stx2. But
there are a variety of subtypes of Stx2 such as Stx2a, Stx2b, Stx2c
Stx 2d and others. There is a form of Shiga toxin Stx2d that becomes
more virulent following attack by the mucosal enzyme elastase, whether
from mice or humans.
Elastase attacks the toxin by cleaving off two amino acids from one
of its components, at the C-terminal end of the A2 peptide (short protein)
of Stx 2d. In lab tests with mouse models in 2002, as well as other
tests, conducted by Dr. Alison O'Brien's group at the Uniformed Services
University of the Health Sciences (Bethesda, Maryland), these E. coli
with toxins activated by exposure to mucosal preparations or the specific
enzyme elastase, were more virulent than any other (STEC) Stx E.coli
This type of Shiga toxin was then named "Stx 2d activatable"
because instead of damaging the toxin by splitting it, the elastase,
or crude mucosal preparation containing elastase, made it worse -- "activating"
Professor Dr. Helge Karch and associated researchers at the National
Consulting Laboratory on Hemolytic Uremic Syndrome, University of Muenster
and the Interdisciplinary Center for Clinical Research, Muenster, wanted
to study what the clinical implications of this kind of strain were
for humans, rather than mice. They did a stratified analysis of 922
human STEC strains from patients with HUS, bloody or nonbloody diarrhea
and asymptomatic carriers, looking at different kinds of STEC strains
and disease course outcomes.
It takes more than Shiga toxin to have a virulent STEC pathogen. In
particular, in "normal" STEC strains, tissue invasion is aided
by an adhesive protein called intimin, encoded by the eae gene. In most
STEC descriptions, having the eae gene for intimin is a crucial component
The Muenster researchers found that Stx2d activatable strains were also
highly virulent in human cases, not just in mice or the in vitro model
of Vero cells (the basis of calling Shiga toxins "verotoxins"
is based on this kind of test). This was despite being eae (-), lacking
the production of intimin. They also found the unusual pattern of adults
and older patients with bloody diarrhea and HUS, as in the O104:H4 outbreak
There were several alternative hypotheses to explain this. One was that
the increased virulence of the activated toxin was a compensation for
lack of intimin, or that toxin delivery into tissue was actually aided
by the peptide editing caused by human mucosal elastase. A second possibility
was that there was overexpression of the Stx gene to compensate for
lack of intimin. A third possibility was that Stx2d activatable STEC
strains had an unknown virulence factor that replaced the intimin functionality.
The first characterization by the Robert Koch Institute of the German
O104:H4 outbreak strain included the notation that it was also eae (-),
lacking intimin. Rather like the third hypothesis for Stx2d activatable
strains, the outbreak strain had different adhesion genes characteristic
of the entero-aggregative types of pathogenic E. coli, not seen in a
"normal" STEC outbreak, whether in O157:H7 or pathogenic non-O157s.
Here the close parallel ends.
The O104:H4 outbreak strain,
has no need for intimin, one might say, since it has other adhesion
and invasion factors from its enteroaggregative genetic background.
O104:H4 appears to be an enteroaggregative type of E. coli with Shiga
toxin functionality from normal STEC. It is in a sense, a Shiga toxin
containing enteroaggregative strain type. It could be
described as a STEC "armed" enteroaggregative E. coli or as
a hybrid of STEC and enteraggregative types.
Virulence and adult bloody diarrhea and adult HUS at a higher rate of
conversion may be due entirely to these enteroaggregative derived genes,
not due to increased virulence of the Shiga toxin subtype, or increased
virulence due to peptide editing by elastase, or some other enzyme.
The DNA sequence of the toxin from O104:H4 is supposed to be the same
as Stx2, not Stx2d-activatable.
However, the 5-day time course from bloody diarrhea to HUS is somewhat
suggestive of a pathogen-human-pathogen interaction like that of mucosal
elastase and Stx2d activatable strains. Indicators of patient status
slightly improve on the third day, and some patients think they are
recovering just before plunging into a rapid development of HUS.
It is possible that this reflects a similar trigger, where toxin is
functionally enabled for increased virulence and rapidly deployed in
response to the same human defenses that give patients or physicians
the illusion of pos- sible improvement.
STEC strains can change and evolve even during the infection course
of a single patient (3), losing or gaining plasmids and phages, with
their associated functionalities for Shiga toxin or intimin or drug
resistance, for example. The parallel unusual clinical patterns between
the O104:H4 outbreak strain and STEC Stx2d activatable pathogenic strains
-- severity of adult clinical symptoms -- may be an example of convergent
evolution, getting to the same results by completely different mechanisms.
The mechanism could also be analogous or very similar, if not identical.
Regardless of mechanism, two parallel types of cases, with similar clinical
pattern and outcomes, can still give clinicians and researchers sugges-
tions for approaches, context and comparisons for treating the disease
Daniel B. Cohen
Maccabee Seed Company
 Martina Bielaszewska, Alexander W. Friedrich, Thomas Aldick, Robin
Sch?rk-Bulgrin, and Helge Karch Shiga Toxin Activatable by Intestinal
Mucus in Escherichia coli Isolated from Hu- mans: Predictor for a Severe
Clinical Outcome Clin Infect Dis. (2006) 43(9): 1160-1167 doi:10.1086/508195
 "A subset of eae-negative STEC strains (i.e., STEC that produce
Stx2dactivatable) differ from other eae-negative STEC strains by their
strong association with severe disease... By its association with severe
outcome of the infection caused by eae-negative STEC, Stx2dactivatable
parallels the pathogenetic significance of Stx2 among eae-positive STEC
... However, in contrast to Stx2, which is associated with HUS development
in children <5 years old..., most of the patients with HUS from whom
we isolated Stx2dactivatable-producing STEC were adults." From
Bielaszewska et al., next citation.
 Activation of Shiga toxin type 2d (Stx2d) by elastase involves cleavage
of the C-terminal two amino acids of the A2 peptide in the context of
the appropriate B pentamer. Melton-Celsa AR, Kokai-Kun JF, O'Brien AD
Mol Microbiol. 2002 Jan;43(1):207-15.
 Alexander W. Friedrich, Wenlan Zhang, Martina Bielaszewska, Alexander
Mellmann, Robin K?ck, Angelika Fruth, Helmut Tsch?pe, and Helge Karch
Prevalence, Virulence Profiles, and Clinical Significance of Shiga Toxin-Negative
Variants of Enterohemorrhagic Escherichia coli O157 Infection in Humans.
Clin Infect Dis. (2007) 45(1): 39-45 doi:10.1086/518573
Residues Found in New Mexico Dairy Cows
Source : http://www.foodsafetynews.com/2011/07/high-drug-residues-found-at-nms-3v-dairy-farm/
By_ Dan Flynn( Jul 14, 2011)
Dairy cows sold for slaughter in New Mexico were found to have drug
residues, according to the U.S. Food and Drug Administration (FDA).
In a June 24 warning letter to Roswell, NM-based 3V Dairy, FDA said
the dairy operation was found, during a May 10-13 inspection, to be
in violation of the Federal Food, Drug, and Cosmetic Act.
"We found that you offered animals for sale for slaughter as food
that were adulterated, " the warning letter said. FDA explained
that food is "deemed to adulterated if it bears or contains a new
animal drug that is unsafe..."
After 3V Dairy sold one cow that was slaughtered on or about last May
26, tissue sample analysis conducted by USDA's Food Safety and Inspection
Service (FSIS) detected the presence of 0.55 parts per million (ppm)
for penicillin in the kidney tissue, 0.26 ppm for penicillin in the
liver tissue, and 0.141 ppm of flunixin in the liver tissue.
Those results exceed FDA's established tolerance levels for both medications.
Only 0.05 ppm of penicillin in the edible tissues of cattle is allow
by FDA. The tolerance level for flunixin is 0.125 ppm for liver tissues.
A second dairy cow sold at auction on or about Nov. 3 was also subjected
to tissue sample analysis after slaughter. FSIS reported its kidney
tissue contained 0.08 ppm for penicillin, also above the tolerance level.
"Our investigation also found that you hold animals under conditions
that are so inadequate that medicated animals bearing potentially harmful
drug residues are likely to enter the food supply, " the warning
letter said. "For example, you failed to maintain an adequate system
to ensure that animals medicated by you have been withheld from slaughter
for appropriate periods of time to permit complete treatment records
for medicated animals."
FDA said 3V Dairy, as a producer of animals offered for use as food,
is responsible for ensuring that its operation is in compliance with
FDA's Denver district gave the dairy 15 working days to "correct
the violations described in this (warning) letter." If the dairy
fails to do so, FDA said further regulatory steps might be taken without
notice, including product seizures and/or injunctive actions.
Beef Found in Japanese Commerce
Source : http://www.foodproductdesign.com/news/2011/07/radioactive-beef-found-in-japanese-commerce.aspx
(July 12, 2011)
Radioactive cesium levels 4.6 times the legal limit have been detected
in Japanese beef from cattle raised in the nuclear-damaged region of
Fukushima, prompting the government to strengthen its food safety monitoring
of cattle meat in Fukushima, and the nearby prefectures of Miyagi, Yamagata,
Ibaraki, Tochigi, Gunma and Niigata. The government reported some of
the meat had likely been consumed by the public.
Tokyo's metropolitan government reported 11 cows shipped to Tokyo from
a single farm showed levels of radioactive cesium from 1,530-3,200 becquerel
per kilogram, compared to the legal limit of 300 becquerel per kilogram.
The cattle had passed the mandatory screening external test prior to
shipping and slaughter; however the excessive cesium levels were detected
on meat after the cattle were processed in Tokyo.
In March, the Japanese Ministry of Health released a list of 99 food
products produced near the crippled Fukushima Daiichi nuclear power
plant that have tested for unsafe levels of radioactive iodine and cesium.
UK to Seek
'Urgent Specialist Advice' for E. coli
Source : http://www.foodsafetynews.com/2011/07/uk-orders-urgen-specialist-advice-in-e-coli-cases/
By_ Dan Flynn ( Jul 12, 2011)
The United Kingdom's government-run health care system will be taking
verocytotoxin-producing E. coli infection (VTEC) in children more seriously
in the future.
The UK's Health Protection Agency (HPA) Monday said new guidelines will
emphasize the need for primary care clinicians to seek "urgent
specialist advice" whenever a child is reported to have had a single
acute episode of bloody diarrhea.
Primary care clinicians will be required to provide secondary care clinicians
with guidance on assessment and manage referrals to ensure that all
clinical staff are aware of the need for urgent public health action
when E. coli infection is suspected.
In a statement, HPA said the recent outbreak of E. coli O104 in Germany
has demonstrated the need for rapid management and treatment of E. coli
cases and the serious health complications that can result, such as
hemolytic uremic syndrome (HUS).
HUS can damage blood, kidneys and, in severe cases, the entire central
nervous system. It involves about 10 percent of the E. coli cases in
the UK. HUS is the most common cause of acute kidney failure in children.
The new HPA guidelines for managing E. coli cases cover emergency medicine,
pediatrics, and all public health and health protection professional
including both primary care and specialists.
In the UK, like the United States, the most common form of virulent
E. coli is O157. A common cause of such outbreaks in the UK in recent
years has been children visiting so-called open farms. On average, there
are about three outbreaks each year linked to petting farm visits.
Although cases of acute bloody diarrhea in children linked to E. coli
E coli O157:H7 are comparatively rare, according to Dr. Nick Gent, a
health protection consultant at the HPA, between 300 to 500 cases are
reported a year for children 10 or younger, with cases increasing in
the late spring, summer and autumn.
Because some cases can lead to kidney failure and fatalities, urgent
reporting and referral is necessary to ensure children have specialist
assessment and the best chance of recovery, Gent added.
He encouraged parents and children visiting open farms to remember that
hand washing with soap and water is the best way to avoid infections
and that sanitizing hand gels are not a good substitute -- they don't
remove dirt in the same way as running water and soap can.
Wichita meat innovation center set for July 15 debut
Source : http://www.foodnavigator-usa.com/On-your-radar/Food-safety/Cargill-Wichita-meat-innovation-center-set-for-July-15-debut
By _Elaine Watson (Jul, 08, 2011)
A $14.7m innovation center claimed by owner Cargill be "one of
the world's most advanced food R&D facilities" will open next
Friday (July 15) in Wichita, Kansas.
The 75,000-square-foot center, which is focused on meat products, employs
The research and development labs focus on food safety and quality,
while culinary kitchens will be used for the development of new products.
A pilot plant allows operational and technical teams to develop new
products and evaluate new technologies that could potentially be employed
at the company's full-size plants.
There is also a food distribution center for the local area, primarily
serving smaller grocery stores.
Where the art and science of food intersect
Staff at the new center, which is a block away from Cargill's beef,
turkey and pork processing facilities in Wichita, will work closely
with Cargill's salt, egg, dressings, sauces, oils and food ingredients
groups, said vice president of research and development Scott Eilert.
"This is a discovery zone, a place where the art and science of
food intersect to advance food quality, nutrition, meat production,
food safety and packaging, while also employing a creative flair in
the areas of new product development and finding solutions to meet our
customers' needs and expectations.
"This is the crown jewel of meat oriented food innovation centers
currently found in the US. It is where whatever is next in the way of
food innovation is created and, as such, we eagerly look forward to
our customers visiting Wichita to experience this very special place
we built to serve them better."
The Wichita facility comes hot on the heels of the opening of Cargill's
$12.6m innovation center in Campinas, Brazil, which includes laboratories
for flavors, application development and sensory analysis.
Learned' in European Outbreak
Source : http://www.foodsafetynews.com/2011/07/lessons-learned-in-european-outbreak/
By_ Mary Rothschild ( Jul 07, 2011)
The outbreak of E. coli O104:H4 in Europe struck mostly women and men
in their prime who thought they were eating healthy food, the director
of the European Centre for Disease Prevention and Control (ECDC) noted
in a speech July 5 in Sopot, Poland.
"Hundreds of them have been damaged for the rest of their lives,
suffering kidney failure, brain damage and other long term disabilities,"
Dr. Marc Sprenger said in a presentation to the Informal Health Council
titled "Outbreak of EHEC/STEC in Germany: Lessons Learned."
The most obvious lesson, he said regretfully, is that "the EU is
still vulnerable to epidemics."
And while this E. coli outbreak linked to sprouts grown from fenugreek
seeds was unprecedented -- the ECDC's Wednesday update on the outbreak
put the latest toll at 4,236 illnesses, 898 cases of hemolytic uremic
syndrome (HUS) and 50 deaths -- Dr. Sprenger identified three key areas
in which he thought public health authorities made a difference:
-- ECDC's Food and Water Borne Disease network, along with its microbiology
team, reference laboratories and the World Health Organization's collaborating
labs, worked together to analyze the bacterium and publish guidance
on lab tests to confirm infections. This "vital role of microbiology
networks" helped to get an accurate picture of the developing outbreak,
and eventually led to confirmation of contaminated sprouts as its likely
-- The EU's Early Warning and Response System health-threats network
and the European Commission agreed on a common case definition, produced
a standard questionnaire and coordinated the EU-wide investigation.
-- Reference materials describing best practices for treating patients
were developed, discussed with doctors on the frontline and posted on
the ECDC website, something that had never been done before on an EU-wide
To prepare for and face future epidemics, Dr. Sprenger said the EU must
keep investing in microbiology networks, use temporary platforms to
exchange clinical information, foster cross-sector cooperation but keep
"one voice" in giving information to policy makers and citizens
and, finally, to remember that "what looks like a local outbreak
can quickly become an EU-wide event."
by Canada's Food Safety Enforcers
Source : http://www.foodsafetynews.com/2011/07/cfia-enforcement-action-brings-41400-in-june-fines/
by _Dan Flynn (Jul 05, 2011)
Courts in June fined violators of federal laws administrated by the
Canadian Food Inspection Agency (CFIA) a total of $141,400. The largest
fine went to a Canadian company that was illegally importing meat to
the United States.
Courts across Canada were involved in handing down punishments that
went mostly to corporations, including then Cargill Grain Limited, an
Those fined and the amounts included:
-- Ontario Corporation #1325438 (d.b.a. Zadi Foods Inc.), $100,000
-- Chong Lee Market, Vancouver, $2,500.
-- Cargill, $1,000 plus a $400 victim surcharge.
-- City Fresh Market, Richmond, BC, $2,500.
-- North Kee Trading Company, Ontario, $10,000
-- Nieuwland Feed & Supply Limited, Ontario, $8,000
-- Les Distributiuons J.M. Bernatchez Inc., Grand Riviere, Quebec, $3,000
-- Nucci's Bake-a-Deli, Thunder Bay, Ontario, $1,000
-- Rodney Checkowski, Brandon, Manitoba, $4,000
-- Nick Synchyshyn, Brandon, Manitoba, $9,000
Zadi Foods Ltd., which also does business as Casa Italia, pleaded guilty
to one count of violation of the Meat Inspection Regulations and one
count of violation of the Meat Inspection Act, and netted the largest
fine for readmitting a meat product to its establishment that had been
prepared elsewhere and then exported it to the United States.
Nick Synchyshyn was convicted on three counts of violating quarantine-related
provisions of Canada's Health of Animals Act. In November 2009, it was
found he transported and sold 42 beef calves that were under quarantine
on his premises. According to the CFIA, Synchyshyn put other cattle
at risk by putting his quarantined calves in contact with the other
animals. Manitoba Provincial Court Judge Shauna Hewitt-Micta imposed
the fine and gave Synchyshyn nine months to pay it.
Also convicted in Manitoba Provincial Court was Rodney Checkowski, who
was found guilty for offenses related to an incident in which CFIA inspectors
trying to do testing for tuberculosis were blocked from the defendant's
The offenses netted Checkowski a $4,000 fine, including $1,500 he has
not yet paid from an 2010 conviction under the Health of Animals Act.
The Nucci's Bake-a-Deli fine was imposed following a guilty plea for
one count of violation of the Consumer Packing and Labeling Act, and
one count of violation of the Food and Drug Regulations. The company
had failed to label certain meat products and list weights on the package.
The North Kee Trading company pleaded guilty to one court of transporting
meat from its Ontario establishments, which were not federally inspected,
to two retail outets in Alberta. That is a violation of Canada's Meat
Nieuwland Feed was fined because it violated two counts of Canada's
Foods Regulations. It failed to label and register manufactured livestock
Giant Cargill pleaded guilty to violating one count of the Feeds Regulations.
CFIA described it as a "production error" that resulted in
the addition of Tylosin Phosphate to dairy rationed feeds. Tylosin Phosphate
is not approved for use in dairy ration feeds in Canada.
City Fresh Market pleaded guilty to one count of violating Canada's
Food and Drug Act. The market admitted it sold canned dace adulterated
with Enrofloxacin, a veterinary drug not allowed in aquacultured fish.
Chong Lee Market also pleaded guilty to one count of violating the Food
and Drug Act for the same offense as City Fresh Market. Both companies
received the same fine from different British Columbia Provincial Court
Les Distributions J.M. Bernatchez Inc. pleaded guilty to one count of
violating Canada's Fish Inspection Act for shipping mussels to New Brunswick
from Quebec that had not been processed and stored in a federal establishment.
of the E. coli O104:H4 Outbreak Investigation - The German EHEC Task
Force Final Results
Source : http://www.marlerblog.com/legal-cases/chronology-of-the-e-coli-o104h4-outbreak-investigation---the-german-ehec-task-force-final-results/
by _Bill Marler( July 14, 2011)
According to the European Centre for Disease Control and Prevention,
as of today, the cumulative number of probable and confirmed STEC cases
in the EU/EEA is 3,867 (not including six in the United States, including
one death). This includes 762 HUS STEC cases and 3,105 non-HUS STEC
cases. In total, 44 infected persons have died, of which 28 were HUS
STEC cases and 16 were non-HUS STEC cases.
In Germany, since the last update, one HUS STEC case has been excluded,
and 20 non-HUS STEC cases have been reported. Within the last 10 days
(4 July - 13 July), one HUS STEC case and eight non-HUS STEC cases fell
ill. The last known date of illness onset in a patient with confirmed
STEC O104 was 7 July 2011. This was also the last reported date of illness
onset among all cases.
Note: Suspected cases (Germany: 146 HUS STEC (7 deaths), France: 5 non-HUS
STEC) are not included.
Below is a very interesting presentation on the actual investigation
of the outbreak that I received this morning. A couple of things of
note: 1) How long it took from the first illness (first week of May)
until the investigation got fully underway, and 2) The fact that no
food item was never positively identified via test results (either because
food already consumed or destroyed, or tests for E. coli O104:H4 on
food are not yet advanced enough for detection).
Like all outbreak investigations, this is a good read and a cautionary
tale for Untied States public health officials and policy makers.
Reports a Recent Increase in Campylobacter Infections
Source : http://www.foodpoisonjournal.com/food-poisoning-information/wyoming-reports-a-recent-increase-in-campylobacter-infections/
by _Claire Mitchell ( July 14, 2011)
Today, the Wyoming Department of Health issued a press release reporting
that there has been a sharp increase statewide in potentially dangerous
human Campylobacter bacterial infections this summer.
According to the release:
The department has identified 29 cases of Campylobacter infections in
Wyoming residents statewide since June 1, which represents a 4-fold
increase compared to historical data for the same time period. At least
six people have been hospitalized. Nearly three-quarters of the case
patients are male.
Kelly Weidenbach, an epidemiologist with the department's Infectious
Disease Epidemiology Program, observed that "[w]hile the increase
in these infections appears to be sporadic with no single common source,
it's clear that animal-related illness is at least partially driving
Typically, an individual who experiences a Campylobacter infection will
develop diarrhea, nausea, vomiting, stomach cramping, abdominal pain
and fever for about one week. As Weidenbach pointed out, "This
illness can be extremely unpleasant, and can result in medical bills,
missed work and loss of productivity." She added, "In some
people, the effects can be life-threatening."
The Wyoming Department of Health also noted that, in rare cases, people
may develop serious complications such as Guillain-Barr? syndrome, a
disorder in which the body's immune system attacks part of the peripheral
nervous system. It can lead to paralysis and usually requires intensive
The department reports that:
Public health officials attempt to interview each reported case of Campylobacter
infection in state residents. Among patients interviewed to date, exposure
to animals, especially cattle and dogs, has been common. "In many
cases, the animals were noted to be ill with diarrhea when the person
had contact with them," Weidenbach said. "Several have been
ranchers or individuals who recently attended a cattle branding and
who were accidentally exposed to fecal material."
Campylobacter infection is common in farm animals and certain pets.
A single ill calf can shed millions of bacteria in its feces. Campylobacter
bacteria are also common in the feces of ill puppies and kittens. Campylobacter
often causes illness in young animals, but infected older animals often
have no symptoms. Humans are exposed to the bacteria in the fecal material
and then become sick.
In order to prevent further transmission of illness, Weidenbach and
fellow health officials at the Wyoming Department of Health are recommending
certain precautions including:
oWashing hands with soap and water before eating or other hand-to-mouth
oIf ill with diarrhea, wash hands frequently to minimize the chance
of spreading the illness to others. Campylobacter is transmitted in
oThose ill with diarrhea who handle food for other people, work in a
daycare/childcare setting or work as a healthcare provider with direct
patient contact should stay out of work until at least 48 hours after
the last bout of diarrhea or vomiting.
oThose who work or volunteer where they have contact with animals should
wear gloves while working and wash hands before moving to a different
activity. Animals often have fecal material on their bodies. Wash hands
thoroughly before drinking, eating or putting anything in the mouth.
oAvoid consuming unpasteurized milk or products made from unpasteurized
milk. Raw milk is often contaminated with fecal bacteria from the cows.
E. coli Infections Pose New EU Threat
Source : http://www.foodsafetynews.com/2011/07/asymptomatic-e-coli-infections-pose-new-eu-threat/
by _Mary Rothschild (Jul 14, 2011)
After four students in Germany were sickened by E. coli O104:H4 infections,
preliminary tests indicated that 22 out of 30 children at the same school
were also infected with the outbreak strain but had no symptoms, health
officials reported this week.
Asymptomatic E. coli O104:H4 infection was also found in three kitchen
workers at the school in Kreis Paderborn, four child care employees
at four different day-care centers in the district and three workers
at the catering company that supplied school food, the European Centre
for Disease Prevention and Control (ECDC) said in its latest risk-assessment
report on the massive outbreak that began in Germany in May.
The children's infections "resulted most likely from foodborne"
transmission rather than from person-to-person transmission, the ECDC
said, but such a "significant proportion of asymptomatic carriers"
of the pathogen "represent a risk for new foodborne outbreaks,"
in particular if those carriers are food handlers.
"Considering the large number of summer festivals and mass gatherings
in the EU, with sometimes inadequate food hygiene standards, targeted
public health measures for such events could be of value to prevent
further spread," the ECDC suggested, adding " ... information
to the public should stress the need for proper hand washing."
European health authorities have previously noted that the estimated
eight-day incubation period for the O104:H4 strain is longer than the
typical three to eight days for most Shiga toxin-producing E. coli infections,
and that "may indicate a low infectious dose, which may influence
the likelihood of person-to-person and foodborne transmissions by infected
However, so far person-to-person transmission does not appear to have
been a major factor in the spread of the epidemic, the ECDC report stated.
While some secondary infections have been confirmed, there isn't much
evidence of a large occurrence of secondary person-to-person exposure.
In particular, no cases of O104:H4 illness in day-care centers, schools
or nursing homes have been through secondary infection.
"Another important factor in monitoring the future epidemiology
is whether or not the strain has established -- or could establish --
itself within an animal reservoir," the ECDC said.
Although the ECDC reported "a dramatic decline" in the number
of O104 cases in Germany in the last two weeks, it noted that new cases
and clusters are continuing to be reported, despite the identification
of sprouts as the most likely source of the outbreak that has caused
more than 3,800 illnesses and at least 45 deaths.
Since the European Food Safety Authority implicated contaminated fenugreek
seeds imported from Egypt, the European Commission recalled and temporarily
banned the import of certain types of seeds used for sprouting. It also
has warned consumers not to grow their own sprouts for consumption or
to eat sprouts unless they are cooked thoroughly.
While new cases may arise as the result of other contaminated foods
or contaminated seeds still in circulation, the "main reason for
concern at this stage" in the outbreak, the ECDC wrote, is evidence
from clusters like the one at the Kreis Paderborn school of "a
substantial proportion of subclinical infections."
of bacterial infection linked to oysters
Source : http://www.bradenton.com/2011/07/12/3342126/local-case-of-bacterial-infection.html
By_ DAVID GULLIVER (Jul. 12, 2011)
The Manatee County Health Department is investigating a local case of
a bacterial infection contracted from eating oysters.
"We are in contact with the individual that reported it and with
the physician involved with the diagnosis and treatment," said
department spokesman John Burns.
The department's epidemiology and environmental health teams are looking
into the case, he said.
Until the investigation is complete, the department is disclosing little
about the case, including the possible source of the tainted oysters
or even the date of the report.
The department did identify the infection as stemming from the bacteria
species Vibrio vulnificus.
Dr. Roger Danziger, a Bradenton allergist, said V. vulnificus is sometimes
seen in raw or undercooked oysters. Bacterial infections are why restaurant
menus typically caution people against eating raw seafood, he said:
"A raw oyster can be like a petri dish."
A V. vulnificus infection can make the victim seriously ill in 12 to
24 hours with symptoms including vomiting, diarrhea and abdominal pain,
In people with weakened immune systems or liver disease, the infection
can spread to the bloodstream, causing fever, skin lesions and septic
shock. Vibrio infections that spread to the bloodstream are fatal about
half the time, Danziger said.
Doctors recommend treating the infection with antibiotics as soon as
The Centers for Disease Control and Prevention says V. vulnificus, a
relative of the bacteria that causes cholera, is a rare but under-reported
cause of disease.
From 1988 to 2006, the agency received reports of about 100 such infections
each year from Gulf Coast states, where the illness is most common.
Danziger has treated a case of V. vulnificus infection, but was unaware
of any local statistics.
"When they occur they can be quite devastating," he said.
"If a number of severe infections occur in a certain geographic
area, then an intensive investigation for the source is warranted."
by Asymptomatic E. coli O104:H4 Cases
Source : http://www.foodpoisonjournal.com/food-poisoning-watch/ecdc-concerned-by-asymptomatic-e-coli-o104h4-cases/
By_ Claire Mitchell ( July 13, 2011)
According to a report today by the University of Minnesota's Center
for Infectious Disease Research and Policy (CIDRAP) and a risk assessment
statement issued by the European Centre for Disease Control and Prevention
(ECDC), health officials in Germany are now investigating a cluster
of E. coli O104:H4 infections at a German school located in western
Germany's North Rhine-Westphalia state, Kreis Praderborn.
Health authorities reported
that 4 individuals have become infected since late June. Three of those
individuals later developed hemolytic uremic syndrome (HUS). However,
importantly, ECDC noted that after a preliminary screening at the school,
22 of 30 children, 3 kitchen workers, 4 workers in the childcare center,
and 3 staff members of a catering company at the school had asymptomatic
E. coli O104:H4 infections.
According to CIDRAP's report, this development is cause for concern:
The ECDC said the possibility that the strain has a longer incubation
may mean that a low infectious dose is involved, which might increase
the likelihood of person-to-person spread or foodborne transmission
from infected people. Though person-to-person spread of the disease
has occurred in the outbreak, it doesn't seem to be playing an important
role. So far person-to-person spread has not sparked outbreaks at daycare
centers, schools, or nursing homes.
New findings about the asymptomatic infections, along with a lower but
continuing level of new cases and clusters, suggest that Europe's E
coli outbreak is in a transition phase, from a sprout-focused event
to one that is driven by contaminated seeds that may still be on the
market or in households, along with new foodborne transmission vehicles
and person-to-person transmission, the ECDC said.
ECDC is continuously monitoring the E. coli outbreak and publishes a
daily epidemiological update which includes the most recent numbers
of HUS and non-HUS cases reported by EU Member States. So far the ECDC
has received 3,848 reports of E. coli O104:H4 infections, including
763 with HUS and 44 deaths, not including the United States.
at Ukrainian youth summer camp sickens 85
Source : http://www.allheadlinenews.com/articles/90054186?Food poisoning
at Ukrainian youth summer camp sickens 85
By_ Ayinde O. Chase (July 13, 2011)
Poorly prepared food at a Ukrainian summer camp has sickened 85 Russian
children and staff. Health officials revealed the mass food poisoning
took place at the Albatros youth resort near the port city Sevastopol,
in the Black Sea peninsula Crimea.
The Ukrainian Ministry of Emergency Situations said the children, two
of their supervisors and nine Ukrainian Young Pioneer leaders became
sick Tuesday evening.
Most of the victims aged in range from 8 to 16 years and were at the
camp on vacation from their homes in the Russian cities of Moscow, Yekaterinburg,
The condition of one of the children is moderately severe, while the
rest have a mild symptoms, the press service of the Health Ministry
reported on Wednesday.
In the wake of the mass food borne illness Health Minister Oleksandr
Anishchenko announced he plans to fire the public health director in
the city Sevastopol for allowing the summer camps to operate, and for
being negligent in his duties to enforce health regulations.
Additionally officials have also ordered a nationwide investigation
into food preparation safety at summer youth camps.
Other camps in the Chernihiv and Zaporizhia districts also suffered
cases of mass food poisoning in children on summer vacation.
Managers at the camps are also likely to be criminally charged for their
roles. According to reports out of the region inspectors found "massive
health law violations."
The Russian government is now tasked with arranging charter transportation
for the children to return home immediately.
leftovers blamed for food poisoning that sickens 42 children in China
Source : http://english.people.com.cn/90001/90776/90882/7436281.html
(July 12, 2011)
Spoiled leftovers have been identified as the cause in a food poisoning
case that hospitalized 42 kindergartners in east Zhejiang Province,
local authorities said Monday.
The students at an unlicensed kindergarten in the Xiaoshan District
of the provincial capital of Hangzhou suffered vomiting and diarrhea
after eating lunch on July 8 and were rushed to the hospital.
After several days of medical tests and analysis of the lunch samples,
and the children's vomit and excrement, local health authorities confirmed
Monday that Staphylococcus aureus, a coccal bacterium, was found in
the leftovers the children had eaten during lunch.
To date, 36 children have been discharged from the hospital. Six others
remain under medical observation but in stable condition, a publicity
official with the Xiaoshan District government said.
Numbers Continue To Climb
source : http://www.foodsafetynews.com/2011/07/euro-outbreak-numbers-continue-to-climb/
by _News Desk( Jul 12, 2011)
Five more E. coli O104:H4 infections have been confirmed within the
cluster of Bordeaux patients who ate sprouts at an event in early June,
the European Centre for Disease Prevention and Control (ECDC) reported
The University of Minnesota-based Center for Infectious Disease Research
and Policy (CIDRAP) said the additional cases were added by public health
officials in France.
According to CIDRAP, three of the five patients had attended the event
in B?gles. One of them has hemolytic uremic syndrome (HUS), a potentially
fatal kidney complication. The other two patients, one of whom has HUS,
were infected by others who were sick, the ECDC said. The newly reported
infections raise the Bordeaux E. coli O104:H4 cluster to 11 cases, including
8 people with HUS.
Meanwhile, the United Kingdom confirmed another infection, in a visitor
from Germany who had traveled from Hamburg. The UK's Health Protection
Agency (HPA) said in a July 7 statement that one of the patients it
had earlier linked to the outbreak was found to have a different illness,
and the case has been deleted from its total, which the HPA said now
stands at 17, including three with HUS. All of the cases have been microbiologically
confirmed, and all are related to German travel.
Germany reported 18 more E. coli O104:H4 infections, including five
with HUS, according to the ECDC's update. The new cases from France,
the United Kingdom, and Germany push Europe's outbreak total to 3,798,
including 757 with HUS. No new deaths were reported, keeping the fatality
level at 44.
The World Health Organization (WHO) reports slightly different numbers.
In total, it says 16 countries in Europe and North America have reported
3,941 cases of E. coli O104:H4 infection, including 52 fatalities.
Germany extended a ban on fenugreek products to herbal remedies that
contain ground fenugreek seeds.The country's Federal Drugs Institute
recalled specific production lots of powdered fenugreek seeds because
they are in the lots from Egypt that officials suspect may be contaminated
by E. coli, based on product trace-forward investigations. The fenugreek
powder is used as a treatment for ulcers and other digestive problems,
according to the report.
Egypt's agricultural minister has denied that his country's fenugreek
production is responsible for the European outbreak.
One C. difficile death and two new cases at Guelph General Hospital
Source : http://www.guelphmercury.com/news/local/article/561578--one-c-difficile-death-and-two-new-cases-at-guelph-general-hospital
By_ Vik Kirsch, Mercury staff Mon (Jul 11 2011)
GUELPH - A Guelph General Hospital patient died over the weekend with
C. difficile he acquired at the facility. As well, the hospital confirmed
Monday that it has two additional patients with hospital-acquired C.
"The cause of the death is being directly linked to C. difficile,"
said Richard Ernst, the hospital's president and chief executive. He
noted the elderly victim, who tested positive earlier this month, was
in hospital for serious medical conditions unrelated to the bacterium.
"This was a patient who contracted it while in hospital,"
Ernst said, declining further information on the patient because of
It brings to two the number of Guelph General deaths connected to C.
difficile, this year. An elderly patient died in June after contracting
The two new cases reported Monday are in addition to two cases Friday.
Guelph General's incident-management team was to meet Monday over the
developing C. diff outbreak. It was declared a week ago.
Ernst said there is no plan to stop the public from visiting patients
"at this point in time."
Groves Memorial Community Hospital in Fergus remains free of hospital-acquired
C. difficile, president and chief executive Jerome Quenneville said
Guelph General declared an outbreak on July 5. That's after discovering
a combined 11 cases of hospital-acquired C. difficile in May and June,
up from a more typical one or two cases a month. This brings to 15 the
total to date since May.
The gastrointestinal bacterium can cause serious ailments such as severe
diarrhea. It is particularly dangerous for ill or elderly patients.
Meredith Faires, a University of Guelph population medicine doctoral
student who is doing a study on Clorstridium difficile, commended the
local hospital's approach to battling the spore-reproducing bug, which
is generally spread by direct or indirect contact with infected feces.
The General has begun using a process it calls "terminal cleaning,"
which entails double cleaning with sporicidal disinfectants any room
vacated by a C. difficile patient.
Faires, who has probed hospital C. difficile infections since 2008,
said other hospitals have used similar techniques.
"I believe it has helped," Faires said.
C. difficile is a very hardy bacterium that must be physically removed
from the hospital environment or killed, she continued. If not, "it
can be in the environment for months."
Some hospitals have added a third weapon to their anti-C. diff arsenal:
removing any hospital surfaces in which the bacterium can lurk. That
means, for example, discarding message corkboards and specific furniture
that's hard to disinfect, said Faires, who intends to submit her findings
to scientific journals in a couple months.
Guelph is among seven hospitals fighting C. difficile, The Canadian
Press reported Monday. But that's down from 11 reported recently, after
three hospitals were cleared of cases by provincial health authorities.
Ministry Denies Responsibility for E. coli O104:H4 Outbreak
source : http://www.foodpoisonjournal.com/food-poisoning-watch/egyptian-ministry-denies-responsibility-for-e-coli-o104h4-outbreak/
by _Claire Mitchell (July 10, 2011)
After a lengthy trace back investigation, the European Food Safety Authority
(EFSA) issued a press release last week on July 5, 2011 concluding that
one lot of fenugreek seeds imported from Egypt and used to produce sprouts
is the most likely common link between the two outbreaks of E. coli
O104:H4 that occurred in France and Germany. Based on those findings,
EFSA recommended to the European Commission that all efforts be made
to prevent any further consumer exposure to the suspect seeds.
In response to EFSA's press release, European Union (EU) Health Commissioner
John Dalli stated, "The report published today leads us to the
withdrawing of some Egyptian seeds from the EU market and to a temporary
ban on imports of all seeds and beans originating from that country."
Accordingly, the EU has banned imports of Egyptian fenugreek seeds until
October 31, 2011. In addition, the EU directed its member nations to
destroy all seeds from "one Egyptian exporter" received between
2009 and 2011.
However, despite EFSA's report, Egyptian Agriculture Minister Ayman
Abou Hadid maintains that the Egyptian fenugreek seeds were not contaminated.
The minister cited lab tests indicating that the seeds produced by the
Egyptian exporter did not contain the E. coli strain responsible for
the outbreak. Moreover, the EU claimed that the seeds responsible for
the outbreak were imported from Egypt in November 2009. Egyptian officials
argue that the E. coli bacteria could not remain on the surface of dried
seed from 2009 until 2011.
Instead, the Egyptian ministry contends that the contamination could
have occurred during the repackaging process or through contaminated
water used for sprouting the seeds.
The Egyptian fenugreek seeds in question were sent to one large German
distributor, and later sold to 70 different companies, 54 of which are
located in Germany where the most people became ill.
Soup and Botulism: A Cautionary Tale
Source : http://www.foodsafetynews.com/2011/07/unrefrigerated-potato-soup-leads-to-botulism/
by _Mary Rothschild( Jul 08, 2011)
There's good reason the label says "keep refrigerated." And
also good reason not to taste food to see if it's gone bad.
Two people found that out the hard way, and became very sick with botulism
after tasting potato soup left unrefrigerated for weeks, the Centers
for Disease Control and Prevention relates in its current Weekly Morbidity
and Mortality Report.
In "Notes from the Field," the CDC tells the cautionary tale
of a 29-year-old Ohio resident, who sampled potato soup on Jan. 18 from
a "bulging plastic container, noted a bad taste" and discarded
The soup had been purchased on Dec. 7, 2010 from the refrigerated case
at a local grocer, then remained unrefrigerated at home for 42 days,
the CDC said.
After 5 days of progressively worsening dizziness, blurred vision, and
difficulty swallowing and breathing, the man was hospitalized Jan. 28
and required mechanical ventilation and botulism antitoxin. He remained
hospitalized for 57 days and then was moved to a rehabilitation facility
because of residual weakness.
On April 3, a 41-year-old Georgia woman tasted potato soup that had
been purchased from a local grocery store, the CDC said in its second
story. The woman thought the soup tasted sour and threw it away.
Her soup, in a plastic container labeled "keep refrigerated,"
had been purchased on March 16 and left unrefrigerated for 18 days.
After four days of dizziness and trouble swallowing, the woman developed
respiratory distress, required mechanical ventilation and was given
botulism antitoxin. She was hospitalized for 16 days before being transferred
to a rehab facility.
These two cases weren't the first in which improper food storage resulted
in botulism. Although botulism is often associated with home canning
problems, the CDC said that since 1975, 19 U.S. botulism cases have
been linked to commercially produced, chilled foods, implying that in
at least some of these cases, consumer carelessness or ignorance was
responsible for life-threatening illness.
Labels advising refrigeration might be ignored or not noticed, the CDC
noted, and do not warn about the danger of consuming unrefrigerated
The health authority also observed that heating food to a temperature
of 185¡ÆF (85¡ÆC) for 5 minutes inactivates the paralyzing toxin produced
by Clostridium botulinum bacteria, so proper preparation also is an
E. Coli O104:H4 Death in Arizona
Source : http://www.foodsafetynews.com/2011/07/cdc-confirms-e-coli-o104h4-death-in-arizona/
by _Mary Rothschild( Jul 09, 2011)
The first fatality in the United States associated with the outbreak
of E. coli O104:H4 in Europe was an Arizona man who had traveled to
Germany, the Centers for Disease Control and Prevention confirmed Friday.
The CDC had been investigating whether the man's death in June was related
to the outbreak.
In its update on the investigation, the CDC said the sprouts-linked
outbreak centered in Europe includes six cases of O104:H4 infection
in the U.S. Five of the U.S. patients were exposed to the pathogen in
Germany and one had close contact with a patient in Michigan. In addition
to Arizona and Michigan, the illnesses were reported in Massachusetts,
Wisconsin and North Carolina.
Five of the U.S. patients, including the Arizona man who died, developed
the severe kidney-damaging complication, hemolytic uremic syndrome,
European public health authorities have said the likely cause of the
outbreak was a single lot of Egyptian fenugreek seeds imported to Europe
and used to grow sprouts that were consumed in Germany and France. The
European Union has ordered a recall and temporary ban of fenugreek seeds.
"Given the possible severe health impact of exposure to a small
quantity of contaminated material, and in the absence of information
regarding the source and means of contamination and possible cross-contamination,
all lots of fenugreek seeds from the identified exporter should be considered
suspect," the CDC report stated.
The CDC update reinforced earlier reports, which have said the O104:H4
strain of E. coli, while rare, is not unlike various strains of E. coli
in nature. "E. coli, like many other bacteria, exchange genetic
material and there is no evidence to think that this strain has been
modified intentionally," the CDC stated. "Because of minimal
person-to-person transmission associated with this strain, there is
also no evidence to indicate that it will cause a pandemic or spread
around the world."
On Thursday, the European Centre for Disease Prevention and Control
revised its outbreak toll downward, explaining that the EU had adjusted
the numbers to include only probable and confirmed cases. Given that,
the latest total from the World Health Organization was 3,941 illnesses
and 52 deaths in a dozen European countries and North America.
International Conference for
Food Safety and Quality
Holiday Inn Chicago O'Hare Hotel
5615 North Cumberland Avenue, Chicago, Illinois 60631
Major Topic: Detection Methods for
Microbiological/Chemical Hazards for Food Safety and Quality
November 8, 2011
Conference Place: Holiday Inn (Conference Room)
7:00 - 8:30 Registration and Breakfast (Juice, Tea, Coffee) and Poster
(***Exhibitors displaying time : 7:00-9:00 AM***)
- 9:00 Opening Announcement
A. Importance of Detection Methods for Food Safety and Quality
9:00 - 9:50 - The Importance of detection methods for food safety and
University of Georgia
9:50 - 10:40 - Advanced Detection methods for food safety and quality
University of Geulph
Editor of AEM
10:40 - 11:00 - Coffee Break in Exhibitors' Section
11:00 - 11:50 - Current Foodborne Outbreak and legal issues
William D. Marler, Esq.
MarlerClark attorneys at Law
11:50 - 12:00: Exhibitos Presentation and GROUP PICTURE
12:00 - 1:00: Lunch buffet will be supported (Holiday Inn, Dinning
B. Detection methods for Food Allergen Residues
1:50 - Detection of Food Allergen Residues in Processed Foods and Food
University of Nebraska
Director - Food Allergy Research and Resource Program
1:50 - 2:20 - Rapid Testing for Allergen Control Programs
Presentation by Ryan Waters
- 2:30 - Break / Visit Companies' Booth
C. Molecular/Immunoassay methods for Detection of Microbiological and
3:10 - Costco
Way for Food Safety and Quality
Food Safety Quality Manager
3:10 - 3:50 - Novel
biosensor technologies for high throughput screening of pathogens and
Professor, Purdue University
3:50 - 4:10- Innovative detection methods with immunoassay based method
4:10 -4:30 - Novel nucleic acid testing methods for industrial applications
by Roka Bioscience
4:30 - 5:30 - Panel Discussion (All key speakers will be joined)
2008 IAFP President, bioMerieux
5:30 - Adjourn
November 9, 2011
Conference Place: Holiday Inn (Conference Room)
7:00 - 8:30 Registration and Breakfast (Juice, Tea, Coffee) and Poster
8:40 - 9:00 Poster Competition Award
D. Importance of conventional/biochemical detection methods for Food safety
9:00 - 9:40 - Rapid Methods/Automation and a Look into the Future
Daniel Y.C. Fung
Director of Rapid Methods and Automation in Microbiology Workshop (KSU)
Professor, Kansas State University
9:40 - 10:20 - Rapid
Methods and Automation Workshop for 30 years
Director of Rapid Methods and Automation in Microbiology Workshop (UW)
Professor, University of Wisconsin
10:20 - 10:40 - Coffee
Break in Exhibitors' Section
- 10:50 - Presentation Title from Company presentation
- 11:30 - New demands for Rapid and Automative Detection Methods
for Food Safety
2008 IAFP President, bioMerieux
- 12:00 - Rapid methods for monitoring microbial numbers for
Senior Principal Scientist
-12:20 - Innovative methods for detection of microbiological/chemical
hazards for food safety
12:20 - 1:30 -
Lunch buffet will be supported (Holiday Inn, Dinning Room)
Impacts of Advanced/Conventional Detection methods on Food Industries
2:10 - Impact
of detection methods for food industries
2006 AOAC President
2:10 - 2:30 - Application of several detection methods for
- 2:40 -
Coffee Break in Exhibitors' Section
2:40 - 3:10 - The
importance of detection procedures for food safety by 3rd party
4:00 Application of Rapid Methods for Food Industries
IAFP President (2004)
President, AIV Consulting LLC.
4:00 - 4:30 -
Attendees' Certificate / Adjourn
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