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7/15
2011
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A 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 strains [1].
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" it.
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 for pathogenicity.
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 [2,3].
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 course.
Daniel B. Cohen
Maccabee Seed Company
Davis, CA
[1] 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
[2] "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.
[3] 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.
[4] 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

Drug 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 the law.
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.

Radioactive 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.

Cargill 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 70 staff.
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.

'Lessons 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 source.
-- 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 level.
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."

Fines Imposed 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 industry giant.
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 premises.
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 Inspection Act.
Nieuwland Feed was fined because it violated two counts of Canada's Foods Regulations. It failed to label and register manufactured livestock feed.
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 judges.
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.

Chronology 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.

Wyoming 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 the increase."
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 care.

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 contact.
oIf ill with diarrhea, wash hands frequently to minimize the chance of spreading the illness to others. Campylobacter is transmitted in feces.
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.

Asymptomatic 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 persons."
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."

Local case 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, he said.
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 possible.
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."

ECDC Concerned 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.

Food poisoning 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, and Orekhovo-Zuevo.
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.

Spoiled 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.

Euro Outbreak 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 Monday.
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.

Recommend 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. difficile.
"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 confidentiality.
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 illness.
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 Monday.
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.

Egyptian 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.

Potato 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 rest.
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 food.
The health authority also observed that heating food to a temperature of 185F (85C) for 5 minutes inactivates the paralyzing toxin produced by Clostridium botulinum bacteria, so proper preparation also is an important safeguard.

CDC Confirms 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, or HUS.
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.




6th
International Conference for
Food Safety and Quality

November 8-9, 2011
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


Registration

Tuesday, November 8, 2011
Conference Place: Holiday Inn (Conference Room)

7:00 - 8:30 Registration and Breakfast (Juice, Tea, Coffee) and Poster Display
(***Exhibitors displaying time : 7:00-9:00 AM***)

8:40 - 9:00 Opening Announcement


Program
Section A. Importance of Detection Methods for Food Safety and Quality

9:00 - 9:50 - The Importance of detection methods for food safety and quality

Michael Doyle
University of Georgia



9:50 - 10:40 - Advanced Detection methods for food safety and quality


Mansel Griffiths
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 Room)


Section B. Detection methods for Food Allergen Residues

1:00 - 1:50 - Detection of Food Allergen Residues in Processed Foods and Food Processing Facilities

Stephen Taylor
University of Nebraska
Director - Food Allergy Research and Resource Program



1:50 - 2:20 - Rapid Testing for Allergen Control Programs
Presentation by Ryan Waters
Charm Science

2:20 - 2:30 - Break / Visit Companies' Booth


Section C. Molecular/Immunoassay methods for Detection of Microbiological and Chemical hazards

2:30 - 3:10 - Costco Way for Food Safety and Quality

Robin Forgey
Food Safety Quality Manager
Costco



3:10 - 3:50 -
Novel biosensor technologies for high throughput screening of pathogens and toxins

A. Bhurnia
Professor, Purdue University

 


3:50 - 4:10- Innovative detection methods with immunoassay based method
Presented by SDI




4:10 -4:30 - Novel nucleic acid testing methods for industrial applications
Presented by Roka Bioscience



4:30 - 5:30 - Panel Discussion (All key speakers will be joined)

Stan Bailey
2008 IAFP President, bioMerieux





5:30
- Adjourn



Wed. November 9, 2011
Conference Place: Holiday Inn (Conference Room)

7:00 - 8:30 Registration and Breakfast (Juice, Tea, Coffee) and Poster Display
8:40 - 9:00 Poster Competition Award



Section D. Importance of conventional/biochemical detection methods for Food safety and Quality

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

P.C. Vasavada
Director of Rapid Methods and Automation in Microbiology Workshop (UW)
Professor, University of Wisconsin



10:20 - 10:40 - Coffee Break in Exhibitors' Section

10:40 - 10:50 - Presentation Title from Company presentation

bioMerieux

11:00 - 11:30 - New demands for Rapid and Automative Detection Methods for Food Safety

Stan Bailey
2008 IAFP President, bioMerieux

 

11:30 - 12:00 - Rapid methods for monitoring microbial numbers for food industries

Gregory Siragusa
Senior Principal Scientist
Danisco USA

 

12:00 -12:20 - Innovative methods for detection of microbiological/chemical hazards for food safety

Dupont Qualicon


12:20 - 1:30
- Lunch buffet will be supported (Holiday Inn, Dinning Room)


Section E. Impacts of Advanced/Conventional Detection methods on Food Industries

1:30 - 2:10 - Impact of detection methods for food industries

Robert Koeritzer
2006 AOAC President




2:10 - 2:30 - Application of several detection methods for Food industries

remel

2:30 - 2:40 - Coffee Break in Exhibitors' Section

2:40 - 3:10 - The importance of detection procedures for food safety by 3rd party

Erdogan Ceylan
Director, Silliker



3:10 - 4:00 Application of Rapid Methods for Food Industries

Paul Hall
IAFP President (2004)
President, AIV Consulting LLC.


4:00 - 4:30 - Attendees' Certificate / Adjourn







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