09/10,2012
ISSUE:512

                                                    
Additional Courses
November 12 - Food Safety Microbiology Short Course
November 13-14 - 7th International Conference for Food Safety/Quality (Detection Methods)
November 15-16 - Control Methods to Kill pathogens and spoilage bacteria
November 15-16 - HACCP

Comprehensive News List
General Food Safety News/ Outbreak News/ Recall News/ New Methods News/
USDA/FDA News
/ On-Line Slides/ Job Information/Internet Journal of Food Safety


Salmonella Cases Linked to Cantaloupe and Mangoes Hold Steady at 330 – California and Kentucky Hardest Hit
Source : http://www.marlerblog.com/legal-cases/salmonella-cases-linked-to-cantaloupe-and-mangoes-hold-steady-at-330-california-and-kentucky-hardest-hit/
By Bill Marler (Sep 08, 2012)
We got through the week with no increase in Salmonella cases.
The CDC and FDA have reported that a total of 204 persons infected with the outbreak strain of Salmonella Typhimurium have been reported from 22 states linked to cantaloupe grown in Indiana. The number of ill persons identified in each state is as follows: Alabama (13), Arkansas (5), California (2), Florida (1), Georgia (4), Illinois (24), Indiana (22), Iowa (8), Kentucky (63), Massachusetts (2), Michigan (6), Minnesota (5), Mississippi (5), Missouri (13), New Jersey (2), North Carolina (5), Ohio (5), Pennsylvania (2), South Carolina (3), Tennessee (8), Texas (2), and Wisconsin (4). 78 ill persons have been hospitalized. Two deaths have been reported in Kentucky.
The CDC, FDA and Canadian Health Authorities have reported that a total of 126 persons infected with the outbreak strain of Salmonella Braenderup have been reported from 16 states and Canada linked to mangoes grown in Mexico. The number of ill persons identified in each state is as follows: California (80), Delaware (1), Hawaii (3), Idaho (1), Illinois (1), Louisiana (1), Maine (1), Michigan (1), Montana (1), Nebraska (1), New Jersey (1), New York (3), Oregon (1), Texas (2), Washington (6), and Wisconsin (1). 21 people in Canada have been reported ill. 25 ill persons have been hospitalized. No deaths have been reported.
The states with Salmonella illnesses caused by both cantaloupes and mangoes are in purple and are: Illinois (25), Wisconsin (5), New Jersey (3), Texas (4), California (82) and Michigan (7).

2012 Salmonella Outbreaks and Lawsuits - Marler Clark Update
Source : http://www.foodpoisonjournal.com/foodborne-illness-outbreaks/2012-salmonella-outbreaks-and-lawsuits---marler-clark-update/
By Bill Marler (Sep 09, 2012)
Taco Bell (a.k.a., Nationwide Mexican Fast Food Restaurant A)
A widely distributed contaminated food product might cause illnesses in a specific region and across the United States. As of January 19, 2012, a total of 68 individuals infected with the outbreak strain of Salmonella Enteritidis have been reported from 10 states. The number of ill persons identified in each state with the outbreak strain was as follows: Texas (43), Oklahoma (16), Kansas (2), Iowa (1), Michigan (1), Missouri (1), Nebraska (1), New Mexico (1), Ohio (1), and Tennessee (1).
Moon Marine Raw Scraped Tuna
A total of 425 individuals infected with the outbreak strains of Salmonella Bareilly or Salmonella Nchanga were reported from 28 states and the District of Columbia. Four hundred and ten persons infected with the outbreak strain of Salmonella Bareilly were reported from 28 states and the District of Columbia. The number of ill persons infected with the outbreak strain of Salmonella Bareilly identified in each state was as follows: Alabama (5), Arkansas (1), California (8), Colorado (1), Connecticut (11), District of Columbia (3), Florida (1), Georgia (20), Illinois (30) Indiana (1), Kansas (1), Louisiana (6), Massachusetts (36), Maryland (39), Missouri (4), Mississippi (2), Nebraska (2), New Hampshire (2), New Jersey (39), New York (62), North Carolina (12), Pennsylvania (37), Rhode Island (6), South Carolina (5), Tennessee (4), Texas (14), Virginia (33), Vermont (1), and Wisconsin (24). Fifteen persons infected with the outbreak strain of Salmonella Nchanga were reported from 7 states. The number of ill persons infected with the outbreak strain of Salmonella Nchanga identified in each state was as follows: Georgia (2), Maryland (1), New Jersey (3), New York (6), Texas (1), Virginia (1), and Wisconsin (1).
Cargill Ground Beef
A total of 40 persons infected with the outbreak strain of Salmonella Enteritidis have been reported from 8 states. The number of ill persons identified in each state is as follows: Maine (1), Massachusetts (3), New Hampshire (2), New York (18), Rhode Island (2), Vermont (11), Virginia (2), and West Virginia (1).
Chamberlain Farms Cantaloupe
A total of 204 persons infected with the outbreak strain of Salmonella Typhimurium have been reported from 22 states. The number of ill persons identified in each state is as follows: Alabama (13), Arkansas (5), California (2), Florida (1), Georgia (4), Illinois (24), Indiana (22), Iowa (8), Kentucky (63), Massachusetts (2), Michigan (6), Minnesota (5), Mississippi (5), Missouri (13), New Jersey (2), North Carolina (5), Ohio (5), Pennsylvania (2), South Carolina (3), Tennessee (8), Texas (2), and Wisconsin (4).
Daniella Mangoes
A total of 105 persons infected with the outbreak strain of Salmonella Braenderup have been reported to PulseNet from 16 states since July 1, 2012. The number of ill persons identified in each state is as follows: California (80), Delaware (1), Hawaii (3), Idaho (1), Illinois (1), Louisiana (1), Maine (1), Michigan (1), Montana (1), Nebraska (1), New Jersey (1), New York (3), Oregon (1), Texas (2), Washington (6), and Wisconsin (1).

Organic Pastures Raw Milk Recall Retail Distribution List Released
Source : http://foodpoisoningbulletin.com/2012/organic-pastures-raw-milk-recall-retail-distribution-list-released/
By Carla Gillespie (Sep 09, 2012)
The California Department of Health has released the list of retailers that received Organic Pastures raw milk products  being recalled for possible contamination with Campylobacter.  A recall of raw milk, raw skim milk (non-fat) and raw cream produced by the Fresno County diary was announced by the California Department of Agriculture on September 6 after Campylobacter was detected in a sample of raw cream during routine testing.
The recalled products have a code date of  ”SEP 13.”  No illnesses have been reported at this time.
The lengthy retail distribution list includes Mollie Stones, Mothers Market, New Leaf and Sprouts stores. Consumers who have purchased these products should not consume them. Laws governing the sale of raw milk vary from state to state. In California, retail sales of raw milk are legal as long as producers are regularly tested.
Campylobacter is a pathogen that can cause serious, sometimes life-threatening illness. Symptoms of a Campylobacter infection, called campylobacteriosis, include diarrhea, cramping and fever developing two to five days after exposure and lasting up to a week. In some cases there can be serious complications. For example, if the infection spreads to the bloodstream it can be life-threatening. And, in some cases, a condition called Guillain-Barre syndrome can develop. Campylobacteriosis is the leading trigger of Guillain-Barre which causes paralysis that is usually short term.
This is the second recall for Organic Pastures this year.  A May recall of raw milk products from the farm was linked to a Campylobacter outbreak that sickened 10 people, most of whom were children. Organic Pastures is  the nation’s largest producer of raw milk products.

McDonald's Employee at Walmart in San Diego Diagnosed with Hepatitis A
Source : http://foodpoisoningbulletin.com/2012/mcdonalds-employee-at-walmart-in-san-diego-diagnosed-with-hepatitis-a/
By Linda Larsen (Sep 08, 2012)
The San Diego County News Center is reporting that an employee at the McDonald’s restaurant inside the Walmart store at 3412 College Avenue in San Diego has tested positive for Hepatitis A. Anyone who ate there on August 25, 26, 27, and 30, 2012 between 10:00 am and 11:00 pm may have been exposed to the virus.
Dr. Wilma Wooten, County Public Health office, said, “we encourage anyone who has not had the Hepatitis A vaccine and those who may have been exposed to contact their healthcare provider.” Walmart shoppers who did not eat at the restaurant are not at risk for exposure to the virus. Anyone who has been immunized with the Hepatitis A vaccine or has had the disease is protected from the virus.
The early signs of the disease appear two to seven weeks after exposure. They include mild fever, loss of appetite, nausea, vomiting, diarrhea, dark urine, light color stools, pain in the upper right abdomen, and yellowness of the skin and eyes.
Anyone who may have been exposed should get the vaccination within two weeks of exposure. The Hepatitis A vaccine is the preventative treatment for healthy people who are 12 months to 40 years old. Immune globulin is used for people 41 to 59 years old, anyone over the age of 60, is less than 12 months old, and anyone with chronic liver disease.
If you think you were exposed to the virus and don’t have medical insurance, you can go to the HHSA Central Region Public Health Center at 5202 University Avenue in San Diego to get a vaccination for minimal or no cost. For more information, call the HHSA Epidemiology Program at 619-692-8499.

Norovirus Outbreak on Princess Cruise Line Ship Dawn Princess
Source : http://foodpoisoningbulletin.com/2012/norovirus-outbreak-on-princess-cruise-line-ship-dawn-princess/
By  Linda Larsen (Sep 09, 2012)
The Centers for Disease Control and Prevention (CDC) has issued an investigation update on the Norovirus outbreak on the Dawn Princess cruise ship. The ship of part of the Princess Cruises cruise line.
Voyage dates were August 21 to September 13, 2012. The number of passengers on the ship is 1,778, and crew members is 851. The passengers who reported being ill numbered 114, or 6.41%, and the number of crew who reported being ill numbered 11, or 1.29%. The symptoms of vomiting and diarrhea are consistent with Norovirus infection.
The crew on the ship have taken preventative action according to their outbreak prevention and response plan. They have increased cleaning and disinfection procedures, made announcements to notify passengers of the outbreak, and encouraged reporting and hygiene. They have also collected stool specimens from the ill persons, tested them using a rapid Norovirus test, and made reports to the VSP two times a day.
Norovirus, also known as Norwalk Virus, causes viral gastroenteritis. The only more common virus is the common cold. Any place where people are confined, such as nursing homes, hospitals, and cruise ships, are the most common places for Norovirus infections. Person-to-person transmission is very easy and any ill person who doesn’t wash their hands can touch a surface and contaminate it.
Two CDC Vessel Sanitation Program environmental health officers will board the ship when it arrives in Juneau, Alaska on September 7, 2012 to conduct an environmental health assessment. They will also evaluate the outbreak and the crew’s response to it. The ship will most likely be “super sanitized” in Seward, Alaska.

Texas Issues Fish Consumption Advisory for Mercury
Source : http://foodpoisoningbulletin.com/2012/texas-issues-fish-consumption-advisory-for-mercury/
By Linda Larsen (Sep 07, 2012)
The Texas Department of State Health Services has issued an advisory warning consumers not to consume blue marlin caught in all waters off the Texas coast. And they said that women of childbearing age and children under the age of 12 should not eat swordfish caught off the Texas coast. The fish have unsafe levels of mercury.
Testing revealed that the fish from the northwestern Gulf of Mexico had mercury at concentrations above the DSHS health guidelines of no more than 0.7 mg/kg. The blue marlin mercury levels were 12.9 mg/kg, more than 18 times the recommended limit. The levels in swordfish were 1.18 mg/kg, more than 1.6 times the recommended levels.
Mercury is a naturally occurring element that can cause birth defects and harm to the central nervous system. Symptoms of prolonged exposure include tingling of the skin, loss of coordination, visual and hearing impairment and slurred speech.
Most recreational fishermen catch and release these fish, but some is eaten. In addition to this advisory, public health officials have said that kind mackerel greater than 43 inches in length not be eaten. For king mackerel between 37 to 43 inches, women of childbearing age and children under the age of 12 should eat it no more than once a month. One serving is 8 ounces of fish.

Salmonella, Irritable bowel syndrome (IBS) and Reactive Arthritis Sites Updated
Source : http://www.marlerblog.com/case-news/salmonella-irritable-bowel-syndrome-ibs-and-reactive-arthritis-sites-updated/
By Bill Marler (Sep 07, 2012)
As I said last week, shortly after I resolved the 1996 Odwalla E. coli O157:H7 outbreak on behalf of five kids that suffered Hemolytic Uremic Syndrome (HUS), and long before Google became synonymous with searching on the Internet, we had compiled more information about that nasty bug and a few others, and their frightening and potentially deadly impact, than anyone outside a few major teaching hospitals.
After I started Marler Clark in 1998 along with Bruce Clark, Denis Stearns and Andy Weisbecker, E. coli O157:H7 cases, along with Salmonella cases, both arrived at our offices at a far too frequent rate.
For those who do not recall Prodigy or Netscape, in 1998 few could envision that the Internet would be more than a place to park what in essence were online Word documents.  So, in 2000 we placed everything we knew about Salmonella on www.about-salmonella.com and two of the infection’s complications – Irritable bowel syndrome (IBS), www.about-irritablebowelsyndrome.com and Reactive Arthritis, www.about-reactive-arthritis.com on the web.
The idea was when someone called you would direct them to the site to read for themselves about the dangers of Salmonella, IBS and RA.  I think few at the time – certainly not me – thought that people would search for these things for themselves by using “search terms.”
Over the years the sites have gone through substantive changes – both in content quality and look.  We have had the opportunity and honor to work with the best infectious disease experts in the world, and the patients they cared for.  In the last month both sites have undergone edited content and an updated look – here are the highlights:
Salmonella
Salmonella is a bacterium that causes one of the most common enteric (intestinal) infections in the United States – salmonellosis.  It has long been said that, in 1885, pioneering American veterinary scientist, Daniel E. Salmon, discovered the first strain of Salmonella.   Actually, Theobald Smith, research-assistant to Dr. Salmon, discovered the first strain of Salmonella–Salmonella cholerae suis.  But, being the person in charge, Dr. Salmon received credit for the discovery.  In any case, today the number of known strains of the bacteria totals over two thousand.
The term Salmonella refers to a group or family of bacteria that variously cause illness in humans. Salmonella serotype typhimurium and Salmonella serotype Enteritidis are the most common in the United States.  Salmonella javiana is the fifth most common serotype in the United States and accounted for 3.4% of Salmonella isolates reported to the CDC during 2002.
•An Introduction to Salmonella Bacteria
•The Incidence of Salmonella Infections
•The Prevalence of Salmonella in Food and Elsewhere
•Transmission of Salmonella Bacteria
•Symptoms of Salmonella Infection
•Complications of Salmonella Infection
•Diagnosis of Salmonella Infection
•Treatment for Salmonella Infection
•Antimicrobial Resistance in Salmonella Bacteria
•The Economic Impact of Salmonella Infections
•Real Life Impact of Salmonella Infection
•Preventing Salmonella Infection
•Salmonella Outbreaks
•Foods Recalled for Salmonella Contamination
•Consumer Resources for Salmonella
•References
Reactive Arthritis – Reiter’s Syndrome
Reactive Arthritis refers to a group of arthritic diseases that includes a subset formally known as “Reiter’s Syndrome.”  The old term Reiter’s syndrome has fallen into disfavor.  In recent medical literature Reiter’s Syndrome is simply referred to as Reactive Arthritis which may or may not be accompanied by extraintestinal manifestations.
•An Introduction to Reactive Arthritis
•Symptoms of Reactive Arthritis
•Diagnosis of Reactive Arthritis
•Treatment for Reactive Arthritis
•Preventing Reactive Arthritis
•References
Irritable bowel syndrome (IBS)
Irritable bowel syndrome (IBS) is one disorder in a spectrum of common functional gastrointestinal disorders. Symptoms of IBS can include constipation, diarrhea, alternating diarrhea and constipation, abdominal pain, urgency, bloating, straining at stools, and a sense of incomplete evacuation.
•An Introduction to Irritable Bowel Syndrome
•What Causes IBS?
•Post-Infectious IBS
•Dyspepsia & Gastroparesis
•How is IBS Diagnosed?
•Treatment for IBS
•References
Readers, I would love your feedback.  Also, feel free to use the information on all our “about” sites – a link back would be nice.

CDC Releases Cryptosporidiosis Surveillance Report
Source : http://foodpoisoningbulletin.com/2012/cdc-releases-cryptosporidiosis-surveillance-report/
By Kathy Will (Sep 06, 2012)
The Centers for Disease Control and Prevention (CDC) has released its 2009 – 2010 surveillance summary for Cryptosporidium in the United States. The Cryptosporidium protozoa causes the gastrointestinal illness cryptosporidiosis. During the reporting period, fifty state and two metropolitan public health agencies (District of Columbia and New York City) reported cases of the disease through the CDC’s National Notifiable Diseases Surveillance System.
In 2009, 7,656 confirmed and probable cases were reported. That increased to 8,951 confirmed and probable cases in 2010. The cases were most frequently reported in children aged 1 to 9 years, followed by adults aged 25 to 29 years. The cryptosporidiosis rate in the Midwest was 1.3 to 2.9 times greater than other regions in 2009 and 1.8 to 4.6 times greater than other regions in 2010. The peak illness onset is in early summer through early fall, which coincide with the summer recreational water season. The increase in cases may reflect the increased use of swimming pools, water parks, and interactive fountains by young children.
Transmission is from fecal contamination in the water, by contact with infected animals, and by ingesting contaminated food. The infectious dose is very low. Swimmers can swallow water that contains the parasite or the oocyst, which is infectious immediately after excretion in feces. For instance, there was an outbreak of Cryptosporidium at two Minnesota water parks in April 2012.
The parasite is evolving, with multiple species that can infect human beings. C. hominis exists in a human-t0-human transmission cycle, while C. parvum infects humans and rumaninants (cows). Multiple subtypes of those species can infect humans.
Cryptosporidiosis is characterized by weight loss, abdominal pain, diarrhea, anorexia, fatigue, joint pain, headache, fever, and vomiting. Young children, pregnant women, and those with severely weakened immune systems can develop dehydration and other serious or life-threatening diseases.
The oocyst is very tolerant to chlorine, which means that swimmers must practice healthy behavior to control the spread of this disease. Do not swim if you have diarrhea and, if you are diagnosed with cryptosporidiosis, stay out of the water and avoid serving food to others for at least 2 weeks following recovery.

USDA Challenges Back to School Safety Smarts
Source : http://foodpoisoningbulletin.com/2012/usda-challenges-back-to-school-safety-smarts/
By Kathy Will (Sep 05, 2012)
The USDA is challenging consumers to a quiz on food safety as part of its back to school initiative. The quiz is based on actual calls to the USDA’s Meat and Poultry Hotline. The hotline, 1-888-674-6854, is open Monday through Friday from 10:00 am to 4:00 pm and is staffed by specialists.
Under Secretary for Food Safety Elisabeth Hagen said, “preventing foodborne illness is part of USDA’s public health mission, but one in six Americans is still expected to get sick from the food they eat this year. Back to school time provides an excellent opportunity for the whole family to brush up on food safety steps.”
One of the questions is about microwave safety. Many consumers don’t know about “standing time” in microwave cooking directions. That’s not a direction you can ignore, because food continues to cook after the microwave stops cooking. Standing time lets food come up to a safe internal temperature to destroy any bacteria that may be present. Plus, eating food the second it comes out of the microwave oven can lead to burns, since the food continues to heat for a few minutes.
Do you like to eat leftover pizza? Another question is about refrigerating foods. Even if it isn’t topped with perishable meats or cheeses, any leftover pizza must still be refrigerated. Bacteria grow easily in foods that are rich in carbohydrates, such as pizza crust, cooked pasta, and cooked rice. So these and any other leftover foods should be refrigerated within two hours after cooking. Uncooked vegetables are the only food safe to leave at room temperature for more than two hours.
Take the quiz on the USDA site and learn more. And check out more information at Food Safe Families, the first-even national multimedia food safety campaign launched by the government to reduce food poisoning in this country. Graphic courtesy of FoodSafety.gov.

Mango Salmonella Recall Expands
Source : http://www.foodproductdesign.com/news/2012/08/mangoes-recalled-over-salmonella-fears.aspx
By Food Product Design (Sep 04, 2012)
California Department of Public Health officials are investigating 73 illnesses potentially linked to mangoes that may be contaminated with Salmonella Braenderup bacteria, according to Food Safety News. The investigation comes just days after the Canadian Food Inspection Agency (CFIA) and North American Produce Sales announced a recall of Daniella brand mangoes imported from Mexico after several illnesses were linked to consuming the fruit.
"Preliminary data indicate that mango consumption is associated with an increase in the number of Salmonella Braenderup cases in California," said CDPH spokesman Matt Conens. "As of today, there are 73 cases with this outbreak strain that have been confirmed."
On Aug. 24, CFIA recalled Daniella brand mangoes from Mexico that were sold as individual fruit with a sticker bearing PLU# 4959. The mangoes were sold at various retail stores between July 12 and Aug. 24, 2012. The mangoes may have been distributed in British Columbia, Alberta, Saskatchewan, Manitoba, Northwest Territories, Nunavut and Yukon. The mangoes also sold to U.S. retailers.
On Aug. 28, Splendid Products issued a recall of Daniella brand mangoes from Mexico distributed throughout the United States. Specific retailers, including Giant Foods in Delaware, Maryland, Virginia and Washington D.C.; Stop & Shop in Connecticut, Massachusetts, New Hampshire, New Jersey, New York, and Rhode Island; and Food Lion, Harveys and Reid’s across the Southeast and Mid-Atlantic states, followed with their own recalls.
Update
•9/1: F&S Produce Co., Inc. issued a recall of Delish!, Garden Highway, Garden Pure, Signature Café, Trader Joe’s, and generic products, distributed to Connecticut, Delaware, Florida, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Virginia and Washington D.C. retailers, including Genuardi’s, Safeway, Trader Joe’s and Wal-Mart.
•8/31: Winn-Dixie issued a voluntary recall of Tropical Salsa, Fruit Burst and Island Medley cut fruit produced by Renaissance Food Group and sold in stores in central and south Florida.
•8/31: Ready Pac announced a voluntary recall of fresh-cut fruit products containing mangoes distributed to Alaska, Alabama, Arkansas, Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Iowa, Idaho, Illinois, Indiana, Kentucky, Louisiana, Massachusetts, Maryland, Michigan, Minnesota, Missouri, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Vermont, Washington, Washington D.C., Wisconsin, Wyoming and Canada, including products distributed to Starbucks, Wal-Mart and Wawa.
•8/31: Pacific Coast Fruit Company issued a recall of deli-style fruit salads distributed to retailers in retailer groceries in Oregon, Washington, Idaho and Alaska.
•8/30: World Foods initiated a voluntary recall of cut-fruit and salsa products distributed to retailers in central and south Florida.
•8/30: Taylor Farms New Jersey issued a recall of various mango products distributed to Delaware, New Jersey, Maryland and Pennsylvania.
•8/29: Spokane Produce Inc. initiated a voluntarily recall of pineapple/mango pico de gallo products distributed to Idaho, Montana and Washington.

Job openings

09/07. Food Safety Specialist 1 - Ohio
09/07. Food Safety Manager – Jessup, MD
09/07. Food Safety- Hygienist – Itasca, IL
09/06. Food Safety Specialist – Salisbury, NC
09/06. Food Safety Security Training Coordinator – UC Davis
09/06. HACCP Technician - Jessup, MD
09/04. Sanitation/Food Safety – New Orleans, LA
09/04. Food Safety Specialist - Harahan, LA
09/04. Microbial Food Safety Of Hort. Foods – UC Davis

Cholera in Sierra Leone – update
Source : http://www.who.int/csr/don/2012_09_08/en/index.html
By WHO(Sep 08, 2012)
The Ministry of Health and Sanitation (MOHS) is closely working with partners at the national and international levels to step up response to the cholera outbreak that has affected Sierra Leone since the beginning of the year.
As of 5 September 2012, a total of 16,360 cases including 255 deaths with a case fatality rate (CFR) of 1.6% have been reported from 12 out of 13 districts. The Western area of the country where the capital city of Freetown is located, reported more than 60% of all new cases.
The President of Sierra Leone has declared the cholera epidemic a ‘’humanitarian crisis’’. A high level Presidential Cholera Task Force was established to oversee coordination, mobilization of resources and guide the response. A multi-sectoral approach to the response has been adopted involving the MOHS and other line ministries such as Finance, Information and Communication, and local governments together with partners and stakeholders.
With support from national and international partners and donors, including UNICEF, Oxfam, British Red Cross, Save the Children, Care, Concern MSF, DFID, OCHA, IRC, and WHO, the MOHS is scaling up the response particularly in the areas of coordination of the overall response, surveillance and case management.
A Cholera Control and Command Center (C4) has been established at the WHO Country Office in Freetown to strengthen the coordination, and support the MOHS and other health providers to implement activities related to Cholera Preparedness and Response Operation Plan (CPROP), in order to bring the epidemic under control as soon as possible. The C4 will also provide information to guide the decision-making of the national task force.
Emphasis is being placed on early detection of cases and timely provision of treatment at the district levels, in order to reduce deaths. Cholera cases are managed in Cholera treatment units (CTUs) and where there are no established CTUs, emphasis is placed on designating specific areas within the health facilities for isolation purposes.
WHO through the Global Outbreak Alert and Response Network (GOARN) has provided experienced case management and laboratory experts from the International Center for Diarrheal Disease Research, Bangladesh (ICDDR,B) to build capacity among health care workers and laboratory technicians in case management and laboratory diagnosis.
Laboratories at the national level are being supplied with appropriate materials and reagents to collect, transport and analyze laboratory specimens. Laboratory confirmation is important, particularly in new areas experiencing the cholera outbreak.
There are ongoing community interventions on cholera prevention and control activities. More than 200 traditional healers have been oriented on cholera. Community meetings are organized in Freetown to raise awareness to avoid drinking water from unprotected water sources. Text messages are also being used to channel information to the public by telephone companies. UNICEF and other partners are supporting water, sanitation and hygiene activities.
With respect to this event, WHO does not recommend that any travel or trade restrictions be applied to Sierra Leone.

Salmonella Outbreak Linked To Pet Hedgehogs
Source : http://foodpoisoningbulletin.com/2012/salmonella-outbreak-linked-to-pet-hedgehogs/
By Carla Gillespie (Sep 07, 2012)
A trend in keeping African pygmy hedgehogs, which are about the size of hamsters, as pets is the likely driver of a multi-state Salmonella outbreak, according to the Centers for Disease Control and Prevention (CDC). Fourteen people in six states have become ill after having contact with hedgehogs. Three people have been hospitalized.
Most of the case patients interviewed so far specifically mentioned contact with the tiny animals in the week before becoming ill. And most of them are children under the age of 10. By state the case count is as follows: Alabama (1), Indiana (1), Michigan (3), Minnesota (2), Ohio (2), and Washington (5).
The CDC is collaborating with state public health and agriculture officials and the U.S. Department of Agriculture’s Animal and Plant Health Inspection Service, Animal Care Program (USDA-APHIS-AC) to investigate this outbreak of a rare strain of SalmonellaTyphimurium. Those who became ill purchase the hedgehogs from multiple breeders in different states.
Salmonella is a bacteria that causes illness when ingested. Hedgehogs and other animals shed these germs in their droppings which can contaminate their bodies spreading the germs where they live and roam. Thoroughly washing hands with soap and water right after touching hedgehogs or anything they touched is the best way to prevent illness. The CDC recommends that adults supervise hand washing for young children.
Symptoms of Salmonella include abdominal cramps diarrhea and fever which usually develop 12 to 72 hours after exposure and last up to a week. Anyone who develops these symptoms after handling a hedgehog should see a health care provider.

E. coli Outbreak at Saginaw Correctional Facility in Michigan
Source : http://foodpoisoningbulletin.com/2012/e-coli-outbreak-at-saginaw-correctional-facility-in-michigan/
By Linda Larsen (Sep 06, 2012)
John C. Cordell, Public Information Specialist with the Michigan Department of Corrections told Food Poisoning Bulletin that there is an outbreak of STEC, or Shiga toxin-producing E. coli, at the Saginaw Correctional Facility. The facility is quarantined with no prisoner transfers, no group programming or prisoner visitation.
So far, 89 prisoners and seven staff have been confirmed ill with the E. coli bacteria. Four prisoners have been hospitalized, but there are no cases of hemolytic uremic syndrome. The hospitalizations have been for dehydration.
Most cases occurred from August 27 to August 30, 2012. The outbreak may be over, since no cases were identified on September 3 or 4, 2012. The facility may be able to return to normal operations at the end of this week, since the incubation period for this type of bacteria is 3 to 10 days. The facility is also monitoring prisoners who transferred out of the prison to other correctional facilities in the days before the outbreak.
Public health officials are looking at all avenues of transmission, focusing on food and food preparation. The Saginaw County Health Department, the Michigan Department of Community Health, and the Michigan Department of Agriculture are assisting with the investigation.
STEC bacteria produce Shiga toxins, which go into the bloodstream and destroy red blood cells, causing anemia. The toxins can target the kidneys, which causes hemolytic uremic syndrome that can destroy that organ. The central nervous system can also be affected by Shiga toxins.

Cholera in West Africa, food safety center in Minnesota
Source : http://www.cidrap.umn.edu/cidrap/content/fs/food-disease/news/sep0612foodscan.html
By CDIRAP(Sep 06, 2012)
Groups warn rains will worsen West Africa's cholera outbreak
A cholera epidemic in West Africa will worsen as rains and flooding promote the spread of the disease, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) warned yesterday in a statement. So far 55,289 cholera cases in 15 countries have been reported, with the disease spreading fast in Mano River Basin countries of Guinea and Sierra Leone, those along the Congo River, and western Niger. The groups said 1,109 deaths have been reported. Some of the hardest hit countries are experiencing unusually heavy rains, which have flooded shantytowns in some urban areas and contributed to the spread of the disease. The number of cases in West and Central Africa this year is 34% higher than in the same period last year, and health officials expect cases to climb during the rainy season. Luis Sambo, MD, the WHO's regional director for Africa, said in the statement, "Governments need to declare an emergency early so as to benefit from the necessary technical and other support of partners. Just as crucial are better surveillance and cross-border collaboration between health authorities."
Sep 5 UNICEF press release
CDC picks Minnesota for regional Food Safety Center of Excellence
The Centers for Disease Control and Prevention (CDC) has chosen the Minnesota Department of Health (MDH) and the University of Minnesota's School of Public Health (SPH) to set up one of five regional Food Safety Centers of Excellence for detecting and responding to foodborne disease outbreaks, Sen. Amy Klobuchar, D-Minn., announced yesterday. The CDC awarded the MDH $199,970 to help set up the center, which will provide other states with support and training for conducting food safety surveillance and outbreak investigations, Klobuchar said in a press release. "Minnesota has been a leader in the effort to improve food safety, and today's announcement means that our state will continue to be on the front lines in the fight to keep consumers safe," Klobuchar said in the release. She and Sen. Saxby Chambliss, R-Ga., authored the portion of the FDA Food Safety Modernization Act, enacted in 2011, that established the Food Safety Centers of Excellence. Since then, Klobuchar said, she has worked with CDC Director Thomas Frieden, MD, MPH, to ensure that the five centers receive funds to begin operating. "Because outbreak investigations are the only way to identify new food safety hazards, the Centers will have an important role to play in rapidly identifying and effectively responding to these new threats," Craig Hedberg, PhD, of the SPH's Division of Environmental Health Sciences, commented in the press release.
Sep 5 Klobuchar press release

E. coli Outbreak In New York Expands
Source : http://foodpoisoningbulletin.com/2012/e-coli-outbreak-in-new-york-expands/
By Carla Gillespie (Sep 05, 2012)
The source of an unusual E. coli outbreak that has sickened 10 people in the Finger Lakes region of New York since early August has yet to be identified, Joan Ellison, Livingston County’s director of public health told Food Poisoning Bulletin today.
Nine Livingston County residents and one person from Onondaga County have developed E. coli infections over the last month. Three of them had cases so severe that they were hospitalized, but have since been released. Lab tests that use a genetic “fingerprinting” method called pulsed field gel electrophoresis (PFGE)  have confirmed that eight of the cases patients were sickened by the same strain of  E.coli 0157:H7. Test results for two case patients from Livingston County are pending.
While public health authorities have been able to identify the outbreak strain, they have not yet been able to identify a specific source of the outbreak. “There is a thread that connects them, but not a rope that ties them all together,” Ellison said. “It’s really hard to say where it’s coming from.”
The outbreak began in early August with a cluster of seven cases in Livingston County. Then, last week, new cases popped up, including one in a second county. “It’s kind of odd that we’re adding them sporadically,” Ellison said.
Symptoms of an E. coli infection include vomiting, bloody diarrhea and abdominal cramps which  usually develop three to four days after exposure and last up to a week.  Those most at risk are young children, seniors, people who take antacids on a regular basis and anyone whose immune system is compromised. The victims of this outbreak range in age from 10 to 75.

Ebola outbreak in Democratic Republic of Congo – update
Source : http://www.who.int/csr/don/2012_09_05/en/index.html
By WHO(Sep 05, 2012)
The Ministry of Health (MoH) of the Democratic Republic of Congo (DRC) continues to work with partners to control the outbreak of Ebola haemorrhagic fever. As of 3 September 2012, a total of 28 (eight confirmed, six probable, and 14 suspected) cases including 14 deaths had been reported from Haut-Uélé district in Province Orientale. The reported cases and deaths have occurred in two health zones – 18 cases, including 11 deaths in Isiro and 10 cases, including three deaths in Viadana. The fatal cases in Isiro include three health-care workers.
All alerts have been investigated and so far Ebola has not been reported from outside Isiro and Viadana health zones. Initial samples were tested by Uganda Virus Research Institute (UVRI) in Entebbe, Uganda, and were confirmed for Ebola virus (Ebola subtype Bundibugyo). Subsequent samples have been confirmed by the field laboratory in Isiro that has been established by the US Centers for Disease Control and Prevention (CDC). A National Task Force convened by the Congolese Ministry of Health is working with several partners including WHO, Médecins Sans Frontières (MSF), International Federation of Red Cross and Red Crescent Societies (IFRC) and CDC to control the outbreak.
WHO has deployed epidemiologists and logisticians from the Regional Office for Africa (including the Inter-country Support Team) and WHO headquarters to support the MoH and is working closely with partners in the areas of coordination, surveillance, epidemiology, logistics for outbreak response, public information and social mobilization. Support from the Global Outbreak Alert and Response Network (GOARN), includes deployment of an anthropologist to assist with a clearer understanding of the social and anthropological issues among the affected population that could impact the on-going response efforts.
Control activities that are being carried out include active case finding and contact tracing, enhanced surveillance, case management, public information and social mobilization and reinforcing infection control practices.
With respect to this event, WHO does not recommend that any travel or trade restrictions be applied to Democratic Republic of Congo.
There is currently no indication that this Ebola outbreak is related to the recent Ebola outbreak in Kibaale district of Uganda.
General information on Ebola subtypes
There are five identified subtypes of Ebola virus. The subtypes have been named after the location they have been first detected in Ebola outbreaks. Three subtypes of the five have been associated with large Ebola haemorrhagic fever (EHF) outbreaks in Africa. Ebola-Zaire, Ebola-Sudan and Ebola-Bundibugyo. EHF is a febrile haemorrhagic illness which causes death in 25-90% of all cases. The Ebola Reston species, found in the Philippines, can infect humans, but no illness or death in humans has been reported to date.