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FoodHACCP Newsletter
01/12 2015 ISSUE:634

Health Dept Needs More Teeth to Ensure Food Safety
Source : http://www.newindianexpress.com/cities/kochi/Health-Dept-Needs-More-Teeth-to-Ensure-Food-Safety/2015/01/12/article2615566.ece
By Shalet Jimmy  (Jan 12, 2015)
Even after the full-fledged Food Safety and Standards Act-2006 came into existence, there is no clarity as to which agency should conduct the inspection of the food sold in the State - the Food Safety Department or the Health Department.
Reply to an RTI query submitted on October 16, 2014, shows that the authority to conduct food inspection is vested with the Food Safety Department, not the Health Department.“The lack of clarity in the matter is the primary reason why the Food Safety and Standards Act could not be implemented successfully in Kerala,” says sources in the Health Department.“Call it a paradox. The Health Department, which has around 5,000 staff, carries out all the activities pertaining to food safety, but without any legal backing. Meanwhile, the Food Safety Department, which is legally responsible for such activities, is facing severe staff shortage. The issue could have been easily sorted out if the Health Department officials were given the power to conduct food safety inspections,” they pointed out.
The RTI report says that as per a  government circular (66562/RC(3)/2012 LSGD), the role of a Health Inspector is restricted to field inspection. The local bodies issues licence based on the inspection conducted by a Health Inspector.  “But, that is a circular, not a law,”  said the sources.The RTI report further points out that according to the Food Safety and Standards Act, a medical certificate from a registered medical practitioner is mandatory, not the health card issued by the Health Department.
“So, where is the legal backing for the inspections being carried out by the Health Department? Effective checking would be possible only if both the departments go hand-in-hand. In every gramapanchayat, there is one health inspector, and two or more junior health inspectors. Sadly, the government has not been able to utilise their services, and has restricted them to the areas of immunisation, family planning and prevention of non-communicable disease, which do not require strict monitoring,” said the sources.The Health Department has a tendency to follow the Madras Public Health Act-1939 and the Travancore Cochin Public Health Act-1955 quite often. However, reply to another RTI query moved in the Health Department on November 22, 2014, states that Chapter-XII (from Section-114 to 121) that deals with food control, and sections of Madras Public Health Act that gives the Health Department power to tackle food safety issues, had been annulled with the implementation of the Food Safety and Standards Act.
Directorate of Health Services Director Dr P K Jameela said that the Health Department had the power to intervene everything that has something to do with the well-being of the people. “Both the departments have to go hand-in-hand to make the process successful. Besides, a Unified Public Health Act can settle this issue to a great extent,” she added.

7 Deaths, 1 Fetal Loss Tied to Bidart Apples Listeria Outbreak
Source : http://www.foodpoisonjournal.com/foodborne-illness-outbreaks/7-deaths-1-fetal-loss-tied-to-bidart-apples-listeria-outbreak/#.VLMmb9hxns1
By Bruce Clark (January 11, 2015)
As of January 10, 2015, the CDC reports a total of 32 people infected with the outbreak strains of Listeria monocytogenes had been reported from 11 states:  Arizona (4), California (2), Minnesota (4), Missouri (5), Nevada (1), New Mexico (6), North Carolina (1), Texas (4), Utah (1), Washington (1), and Wisconsin (3).
•Thirty-one ill people have been hospitalized, and seven deaths have been reported. Listeriosis contributed to at least three of these deaths.
•Ten illnesses were pregnancy-related (occurred in a pregnant woman or her newborn infant), with one illness resulting in a fetal loss.
•Three invasive illnesses (meningitis) were among otherwise healthy children aged 5–15 years.
•To date, 25 (89%) of the 28 ill people interviewed reported eating commercially produced, prepackaged caramel apples before becoming ill.
The Public Health Agency of Canada (PHAC) has identified 2 cases of listeriosis in Canada with the same PFGE patterns as seen in the U.S. outbreak.
On January 9, 2015, according to Bidart Bros., the United States Food and Drug Administration (FDA) announced the results of findings from additional tests performed on samples collected from Bidart Bros. apple processing plant near Bakersfield, California. Test results confirm two strains of Listeria monocytogenes were found at the apple processing facility and are believed to be the same strains associated with the outbreak. Those same strains were also found in Bidart Bros. apples collected from a retailer by the FDA.
The CDC recommends that consumers not eat any of the recalled Granny Smith and Gala apples produced by Bidart Bros. and that retailers not sell or serve them.

Apple Listeria Outbreak Timeline – From Production to Illness
Source : http://www.marlerblog.com/legal-cases/apple-listeria-outbreak-timeline-from-production-to-illness/#.VLMmr9hxns1
By Bill Marler (Jan 10, 2015)
The Outbreak:  On December 18, 2014, the Minnesota Department of Health reported four Listeria monocytogenes illnesses.  The Minnesota cases purchased caramel apples from Cub Foods, Kwik Trip, and Mike’s Discount Foods, which carried Carnival brand and Kitchen Cravings brand caramel apples. These apples were produced by H. Brooks and supplied indirectly by Bidart Brothers.

On January 10, 2015, the CDC reports, a total of 32 people infected with the outbreak strains of Listeria monocytogenes had been reported from 11 states: Arizona (4), California (2), Minnesota (4), Missouri (5), Nevada (1), New Mexico (6), North Carolina (1), Texas (4), Utah (1), Washington (1), and Wisconsin (3).  The Public Health Agency of Canada (PHAC) has identified 2 cases of listeriosis in Canada with the same pulsed-field gel electrophoresis (PFGE) patterns as seen in the U.S. outbreak.
•Thirty-one ill people have been hospitalized, and seven deaths have been reported. Listeriosis contributed to at least three of these deaths.
•Ten illnesses were pregnancy-related (occurred in a pregnant woman or her newborn infant), with one illness resulting in a fetal loss.
•Three invasive illnesses (meningitis) were among otherwise healthy children aged 5–15 years.
The Lawsuit:  On December 22, 2014, we filed a wrongful death lawsuit against Safeway Inc, in the Superior Court of Santa Cruz on behalf of James Raymond Frey, 87, and the estate of his deceased wife, Shirlee Jean Frey, 81, who died tragically on December 2, 2014 after consuming a Listeria-tainted caramel apple purchased at the Safeway in Felton, California. The case number is CISCV180721.   The complaint was amended on December 29, 2014 to add in two additional parties – Happy Apple and Bidart Brothers.
The Recalls:  On December 24, 2014, Happy Apple Company of Washington, Missouri, voluntarily recalled Happy Apples brand caramel apples with a best use by date between August 25 and November 23, 2014. On December 31, 2014, Happy Apple Company expanded the recall to include Kroger brand caramel apples produced by Happy Apple Company with a best use by date between September 15 and November 18, 2014.
On December 27, 2014, California Snack Foods voluntarily recalled Karm’l Dapple brand caramel apples with a best use by date between August 15 and November 28, 2014.
On December 29, 2014, Merb’s Candies of St. Louis, Missouri issued a voluntary recall of Merb’s Candies Bionic Apples and Double Dipped Apples that would have been available from September 8 through November 25, 2014.
On January 6, 2015, Bidart Bros. of Bakersfield, California voluntarily recalled Granny Smith and Gala apples because environmental testing revealed contamination with Listeria monocytogenes at the firm’s apple-packing facility. The recall includes all Granny Smith and Gala apples shipped from its Shafter, California packing facility in 2014. CDC recommends that consumers not eat any of the recalled Granny Smith and Gala apples produced by Bidart Bros. and that retailers not sell or serve them.
The Genetic Connection:  On January 9, 2015, according to Bidart Bros., the United States Food and Drug Administration (FDA) announced the results of findings from additional tests performed on samples collected from Bidart Bros. apple processing plant near Bakersfield, California. Test results confirm two strains of Listeria monocytogenes were found at the apple processing facility and are believed to be the same strains associated with the outbreak. Those same strains were also found in Bidart Bros. apples collected from a retailer by the FDA.
The Bug:  Listeria monocytogenes is an organism that can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women. Approximately 2,500 cases of listeriosis are estimated to occur in the U.S. each year. About 200 in every 1,000 cases result in death.

 

 





 

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Thirty Sickened After Eating Rosca de Reyes Bread
Source : http://foodpoisoningbulletin.com/2015/thirty-sickened-after-eating-rosca-de-reyes-bread/
By Linda Larsen (Jan 10, 2015)
The California Health Care Agency says that more than 30 people from “multiple unrelated groups” have been sickened after eating Rosca de Reyes Bread distributed by Cholula’s Bakery in Santa Ana. Symptoms include dizziness, palpitations, stomach aches, and numbness. Several people went to the hospital. Since symptoms happened within 20 minutes of eating the bread, it’s probably not an infectious agent that is causing the illnesses.
Rosca de Reyes Bread RecallThe bread was distributed on January 5 and 6, 2015 to retail outlets in Orange County and Long Beach. It was sold at Cholula’s Bakery in Santa Ana, El Nopal Mercado in San Juan Capistrano, La Bodega Ranch in Orange, La Bodega Ranch in Fullerton, Santa Ana Marquet in Santa Ana, and Tony’s Liquor in San Juan Capistrano. It was also sold at Gonzalez Marquet in Placentia, Taqueria Mocorito Restaurant in Anaheim, Taco Boy in Anaheim, Brianna’s Ice Cream in Anaheim, and La Bodega Ranch Market in Long Beach. You can see addresses of the retail outlets at the CHCA web site.
The bakery was investigated and closed after officials discovered a cockroach infestation, according to ABC7. Officials aren’t sure if that is the problem with the bread. The product is usually eaten on Three Kings Day, also called Epiphany Day.
On edit: Initial testing has found the presence of a synthetic drug in the bread. The bakery is going to stay closed until all opened food is thrown out, all ingredients used to make the bread is discarded, and food safety training has been implemented for all staff.
If you purchased any Rosca de Reyes bread from Cholula’s Bakery, do not eat it. Throw it out or return to the place of purchase for a refund. If you did eat this bread, contact the Santa Ana Police Department at 714-245-8390.

Portions of Pet Food Safety Study are the ‘Epitome of Junk Science’
Source : http://www.foodsafetynews.com/2015/01/shocked-and-saddened/#.VLMe99hxns1
By Phyllis Entis (Jan 9, 2015)
Opinion
On March 31, 2013, I announced that I was “moving on,” and I ended my daily posts on eFoodAlert. Since then, I have been concentrating on my creative writing projects. Nevertheless, I’ve continued to monitor food safety stories, muttering under my breath from time to time about the quality of some of the coverage. But I have not been motivated to comment publicly on any of these stories until today’s release of a pet food safety study carried out under the auspices of the Association for Truth in Pet Food (ATPF). I decided that I could not let this report stand unchallenged and unanswered.
The Association for Truth in Pet Food, headed by Susan Thixton, has just released a report that details the results of mycotoxin, nutrient and bacteria tests carried out on a number of brands of canned and dry cat foods and dog foods. According to James Andrews, writing for Food Safety News, the testing program was sponsored by consumers through crowdfunding and coordinated by ATPF.
Susan Thixton, writing in her TruthAboutPetFood.com blog, describes the results of the study as “shocking and sad.” In my opinion, her adjectives are correct but misapplied. What I find “shocking and sad” is the waste of consumers’ money in a wild goose chase after low-level pathogens of minimal risk to either humans or their pets.
Consider the “qualifying pathogens” reported in the detailed study:
•Acinetobacter. This is a low-grade pathogen that is mainly associated with hospital-acquired infections (especially in intensive care units), or with community-spread outbreaks in war zones and natural disaster areas.
•Pseudomonas. These bacteria are present in the environment, in our water, and in food. It is a cause of “swimmer’s ear.” Otherwise, Pseudomonas is an opportunistic pathogen, typically either hospital-acquired or affecting individuals with compromised immune systems or respiratory systems, such as cystic fibrosis patients.
•Streptococcus. While some species of Streptococcus are pathogenic (e.g., Streptococcus pyogenes), others are benign. Some species of Streptococcus are used in the production of fermented dairy products and are considered to be probiotic.
•Staphylococcus. While Staphylococcus aureus is associated with food poisoning (via its production of enterotoxins) and with infections, other species of Staphylococcus are either benign or are low-grade pathogens associated with hospital-acquired infections. Staphylococcus epidermidis is a common inhabitant of the skin of humans and animals. Even Staphylococcus aureus is carried on the skin and in the nasal passages of many individuals.
•Bacillus. Most species of Bacillus are benign and are widely dispersed in the environment. Bacillus is a spore-former and very heat-resistant. It can be found with great frequency in dried foods, including spices, flour, and powdered dairy products. Bacillus cereus is a source of foodborne illness, but it must attain high concentrations before it can cause illness.
In addition to these “qualifying pathogens,” the study organizers decided to troll through the foods for a long list of other irrelevant microbes, including Anaerococcus, Comamonadaceae, Corynebacteriaceae, Halomonas (another low-risk pathogen associated with contamination of intravenous lines), Cloacibacterium, Bifidobacterium (a probiotic), Pantoea, Gemella, Peptoniphilus, Actinomyces, Sphingobium, Bradyrhizobium, Tumebacillus, Paracoccus, Paenibacillus, Lactococcus, Acetobacter, Chloroplast and Lactobacillus (a probiotic).
The author of the study provided absolutely no rationale for this selection. Nor was any explanation offered for excluding known human and animal pathogens, such as Salmonella and Campylobacter, from the list. Where was the logic in this? What was the point in throwing money at a laundry list of irrelevant microbes? The funding did not allow species-level identification of any of the bacteria, according to the study report. Yet, without species-level identification, the results of the bacterial testing of the pet foods are worthless.
I also take issue with the presentation of the mycotoxin test results. The results are reported at levels of parts per billion (PPB), whereas these results are usually reported as parts per million (ppm). By changing the manner of reporting the results, the study makes the data appear more shocking. For example, FDA recommends a limit of 10 ppm for fumonisins in grain destined for pet food. This is the same as saying 10,000 parts per billion. Even the worst-performing pet food sample was well within this guidance level. Furthermore, the comparison table presents an arbitrary set of risk values generated using a proprietary formula developed by Alltech, an animal nutrition company. There is no way to substantiate the validity or the significance of these so-called risk levels.
I have refrained from commenting on the portion of the report dealing with nutritional analysis, as this is outside of my expertise. I sincerely hope that someone else will put this portion of the report under a microscope.
I acknowledge the good intentions of Susan Thixton and the Association for Truth in Pet Food, but I am appalled at the way in which this study was designed and carried out. The portions of the study relating to bacterial analysis and presentation of the mycotoxin results are the epitome of junk science. The pet-loving consumers who funded this study — and their dogs and cats — deserved far better.

Early Food Safety Workers Tested Poisons by Eating Them
Source : http://www.smithsonianmag.com/smart-news/early-food-safety-workers-us-tested-poisons-eating-them-180953864/?no-ist
By  Marissa Fessenden (Jan 09, 2015)
They were hailed as heroes and even had a song
In the late 1800s, food in the U.S. was full of imitations (corn syrup masquerading as maple syrup, for instance) and questionable preservatives such as borax—now commonly used as a detergent but certainly not advisable to consume. The time was ripe for some food safety reform, but when Harvey W. Wiley, a chemist at the Department of Agriculture, introduced bill after bill, all were killed, according to the U.S. Food and Drug Administration’s website. He needed something drastic to capture the nation’s attention, so he assembled a Poison Squad.
The Poison Squad was assembled of the best and brightest. For Esquire, Bruce Watson writes:
The human lab rats were “twelve young clerks, vigorous and voracious.” All were graduates of the civil service exam, all were screened for “high moral character,” and all had reputations for “sobriety and reliability.” One was a former Yale sprinter, another a captain in the local high school’s cadet regiment, and a third a scientist in his own right. All twelve took oaths, pledging one year of service, promising to only eat food that was prepared in the Poison Squad’s kitchen, and waiving their right to sue the government for damages -- including death -- that might result from their participation in the program.
When his 12 young men were given borax-laced meals, reports Phil Edwards for Vox, they did indeed get sick. Five years of tests covered salicylic acid, sulfuric acid, sodium benzoate and formaldehyde. And the symptoms that cropped up—nausea, stomachaches and vomiting in the most extreme instances—inspired people around the country to write in and demand regulation.
The Pure Food and Drug Act of 1906 can be attributed to the heroic suffering Squad and its zealous leader, Wiley. They were hailed as heroes and even had a song, Vox reports:
On Prussic acid we break our fast;
we lunch on a morphine stew;
We dine with a matchhead consomme,
drink carbolic acid brew;
-The Song Of The Poison Squad by S.W. Gillilan
In 1912, when Wiley retired, the FDA reports that a headline of the day read: "WOMEN WEEP AS WATCHDOG OF THE KITCHEN QUITS AFTER 29 YEARS."
If the state of food safety then seems bad, consider that deaths and illness from food poisoning still hits millions each year in the U.S. Now, many of the problems are microbe-based, rather than from poisons deliberately added to preserve. The Food Safety Modernization Act is intended to address our problems, although it has its critics. While reinstating the Poison Squad would be extreme, there’s still a case to be made for more dedicated efforts to make what we eat safe.

New Year’s resolutions related to food safety
Source : http://msue.anr.msu.edu/news/new_years_resolutions_related_to_food_safety
By Lisa Treiber Michigan State University Extension(Jan 9, 2015)
Still pondering on a resolution? Consider making changes on how you handle food and your habits in the kitchen to prevent foodborne illness.
Many of us make New Year’s resolutions at the end of an old year or the beginning of a new year; usually they are for self-improvement, healthier lifestyle or something along those lines. Have you ever considered making resolutions to improve handling food or preventing foodborne illness? Think about some of these easy changes you could make to prevent foodborne illness in 2015, a few small changes or a purchase of a small tool could make all the difference in the world.
1. Utilize a food thermometer when cooking. A food thermometer is one of best tools you can have in your kitchen, it isn’t just for the grill area it should be used in the kitchen too. Do not rely on the “color” of a product to determine if it is done. Studies have shown that this is not a safe indicator. Cooking ground meat to 165 degrees Fahrenheit can prevent potentially harmful bacteria from making one sick. The thermometer is also useful when reheating foods to determine if they have been heated to a safe temperature.
2.Wash hands. Handwashing should always be done prior to prepping food. Did you know as you work on different steps in your recipe you may need to stop and wash your hands again? If you handle raw meat, crack eggs open or are interrupted and leave the work area, it is very important to take a minute and wash hands with warm, soapy water before returning to your task. Once the recipe is completed it is good to once again wash hands as you complete clean up. This may seem excessive, but you are preventing potential cross-contamination problems by taking these steps. Germs are everywhere – some of the highest concentration spots in our homes are cupboard knobs and drawer pulls, cell phones, iPads and other devices we may be using for our recipes.
3.Don’t cook when you are sick. In the business world, people who are sick are not allowed to prepare food. This rule should apply in your home as well. It is very easy to transmit an illness to food and to other people, especially if the food prep person has a fever, diarrhea or something more serious. Sometimes we think we have picked up a “bug” of one kind or another and in actuality it is a foodborne illness.
4.Think about how you use your kitchen towels. Kitchen towels can harbor a lot of bacteria. If you decide to use them they should be washed daily. Studies have shown very large quantities of bacteria can reside on these towels, helping you re-introduce bacteria onto your hands, dishes and countertops. It is recommended when you hand wash dishes that you let them air dry. Also be conscious of what you are using the towel for, is it just for food prep or are you finding yourself carrying it on your shoulder, dusting, wiping spills etc. Be aware of how germy towels can become and remember, you cannot see germs.
5.Using paper towels? Paper towels are a wonderful aid in the kitchen, as long as they are used as a single-use tool. Researchers have observed people working in kitchens, wiping something down or drying hands and then re-using the paper towel over and over again, promoting cross-contamination. Paper towels are designed for single-use.
6.Wash your produce prior to eating. Prior to consuming fresh produce should be washed (pdf). If you have purchased “pre-washed” lettuce or other produce, follow the manufacture directions.
7.Purchase refrigerator and freezer thermometers. A thermometer in your refrigerator or freezer provides assurance your food is being held at the proper temperature. In the event of a power outage, these tools are very valuable in helping you determine if the appliance has maintained a proper cold temperature to keep your food safe.
8.Handle your food like a business. To ensure safe and high-quality food, proper storage (pdf) extends the shelf life of food. Remember to date food as you put it away, rotate food, putting the newest food in the back and oldest in the front, and toss food that is no longer safe to consume.
9.Cool foods safely. Refrigerate foods quickly because cold temps slow the growth of harmful bacteria. With large quantities of soups, sauces or stew, divide into smaller, shallow containers, never place a large cooking vessel in the fridge to cool.
10.Stop washing meat or poultry. Washing raw meat or poultry can spread bacteria to your sink, countertops and other surfaces in your kitchen. If this is a practice you have done – stop!
Making a resolution and sticking to it can be tricky. Michigan State University Extension suggests you practice these ideas. Preventing foodborne illness is one resolution we can all get behind to have a healthy and happy New Year!
This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://bit.ly/MSUENews. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).

CDC: Listeria Cases Linked to Caramel Apples Hold Steady at 32 in US and 2 in Canada
Source : http://www.foodpoisonjournal.com/foodborne-illness-outbreaks/cdc-listeria-cases-linked-to-caramel-apples-hold-steady-at-32-in-us-and-2-in-canada/#.VLMnINhxns1
By Denis Stearns (Jan 8, 2015)
As of January 8, 2015 the CDC reports, a total of 32 people infected with the outbreak strains of Listeria monocytogenes had been reported from 11 states: Arizona (4), California (2), Minnesota (4), Missouri (5), Nevada (1), New Mexico (6), North Carolina (1), Texas (4), Utah (1), Washington (1), and Wisconsin (3).
•Thirty-one ill people have been hospitalized, and six deaths have been reported. Listeriosis contributed to at least three of these deaths.
•Ten illnesses were pregnancy-related (occurred in a pregnant woman or her newborn infant), with one illness resulting in a fetal loss.
•Three invasive illnesses (meningitis) were among otherwise healthy children aged 5–15 years.
•To date, 23 (88%) of the 26 ill people interviewed reported eating commercially produced, prepackaged caramel apples before becoming ill.
•The Public Health Agency of Canada (PHAC) has identified 2 cases of listeriosis in Canada with the same pulsed-field gel electrophoresis (PFGE) patterns as seen in the U.S. outbreak.
On January 6, 2015, Bidart Bros. of Bakersfield, California voluntarily recalled Granny Smith and Gala apples because environmental testing revealed contamination with Listeria monocytogenes at the firm’s apple-packing facility. The recall includes all Granny Smith and Gala apples shipped from its Shafter, California packing facility in 2014. CDC recommends that consumers not eat any of the recalled Granny Smith and Gala apples produced by Bidart Bros. and that retailers not sell or serve them.
To date, three firms that produce caramel apples have issued voluntary recalls after receiving notice from Bidart Bros. that there may be a connection between Bidart Bros. apples and this listeriosis outbreak. On December 24, 2014, Happy Apple Company of Washington, Missouri, voluntarily recalled Happy Apples brand caramel apples with a best use by date between August 25 and November 23, 2014. On December 31, 2014, Happy Apple Company expanded the recall to include Kroger brand caramel apples produced by Happy Apple Company with a best use by date between September 15 and November 18, 2014. On December 27, 2014, California Snack Foods voluntarily recalled Karm’l Dapple brand caramel apples with a best use by date between August 15 and November 28, 2014. On December 29, 2014, Merb’s Candies of St. Louis, Missouri issued a voluntary recall of Merb’s Candies Bionic Apples and Double Dipped Apples that would have been available from September 8 through November 25, 2014.
CDC’s Advice to Consumers continues to recommend that U.S. consumers not eat any commercially produced, prepackaged caramel apples, including plain caramel apples as well as those containing nuts, sprinkles, chocolate, or other toppings, until more specific guidance can be provided.

Norovirus at Chuck E Cheese in Woodbury
Source : http://foodpoisoningbulletin.com/2015/norovirus-at-chuck-e-cheese-in-woodbury/
By Carla Gillespie (Jan 08, 2015)
A norovirus outbreak has sickened at least 30 people who visited a Chuck E. Cheese  in Woodbury, MN last week. The restaurant closed for a cleaning in Tuesday evening and reopened Wednesday afternoon.
Symptoms of a norovirus infection are vomiting and diarrhea.  No hospitalizations have been reported. It is not clear how many of those sickened were children.
Highly contagious, norovirus, the leading cause of food posioning outbreaks in the U.S., sickens about 20 million Americans each year. Most, about 65 percent, happen at restaurants and originate from an infected food worker.
People with norovirus shed billions of viral particles in their stool and vomit. The virus is transmitted when a food handler who has been sick has microscopic amounts of vomit or stool on his or her hands and touches food that is eaten by someone else.

The virus is easily transmitted in shared spaces that are not carefully and thoroughly cleaned. The amount of norovirus that fits on the head of a pin is enough to make 1,000 people sick.
A person with norovirus is most contagious while they are experiencing symptoms but may also infect others before symptoms start and after they resolve which is why public health workers urge sick restaurant employees to stay home if they are sick.
Norovirus is hard to kill and can remain on foods even at temperatures below freezing and above 140°F. It can survive of on countertops or utensils for up to two weeks. It can also resist many common disinfectants and hand sanitizers.

Minnesota Chuck E. Cheese Link in Norovirus Outbreak
Source : http://www.marlerblog.com/case-news/minnesota-chuck-e-cheese-link-in-norovirus-outbreak/#.VLMnmthxns1
By Bill Marler (Jan 08, 2015)
With a mouse as a mascot, does a viral outbreak seem that odd?
MPR and AP report that Minnesota health officials are trying to track down people who may have been exposed to norovirus at a Chuck E. Cheese restaurant in Woodbury last weekend.
“As of (Wednesday), we know there had been 60 calls made and about 50 percent of those were reporting symptoms,” said Jean Streetar, Washington County’s public health program manager.
Those symptoms include vomiting and diarrhea.
Health officials are urging people to take extra measures to wash their hands and isolate people who may be ill. The virus is considered very contagious, although no hospitalizations have been reported so far.
As many as 1,000 people a day may go through the restaurant.
Noroviruses are common causes of food poisoning and spread through contaminated surfaces, food and beverages. Besides vomiting and diarrhea, the illness can cause abdominal pain, headaches, body aches.
The Minnesota Department of Health has reported 43 outbreaks of norovirus since the beginning of November.

CA Bakery Closed After Holiday Bread Reportedly Sickens At Least 30 People
Source : http://www.foodsafetynews.com/2015/01/ca-bakery-closed-after-at-least-30-people-reportedly-sickened/#.VLMn1thxns1
By News Desk (Jan 08, 2015)
At least 30 people in Southern California were reportedly sickened after eating a special holiday bread known as Rosca de Reyes. The sweet bread contains candied fruit and a little baby Jesus figurine inside and is traditionally eaten on Jan. 6 to celebrate the Latin American holiday of Three Kings Day (or Epiphany Day).
Local health officials said several people complained of various symptoms, including dizziness, blurred vision, anxiety, palpitations and numbness, after eating the bread from Cholula’s Bakery in Santa Ana, CA.
About a dozen of the sickened individuals went to three different local hospitals, according to news reports, prompting hospital officials to contact the Santa Ana police department.

“Some people had symptoms as soon as 20 minutes after eating the bread. We don’t think it’s like a infectious agent so we’re looking at other agents,” said Helene Calvet of the Orange County Health Agency.
The bakery was closed and its permit suspended after health officials reportedly found traces of a cockroach infestation.
In addition to the Cholula’s outlet in Santa Ana, the bakery distributed the holiday bread to a number of different retail locations in Orange County, officials said. They are: El Nopal Mercado in San Juan Capistrano, El Bodega Ranch in Orange and Fullerton, Santa Ana Marquet in Santa Ana, Tony’s Liquor in San Juan Capistrano, Gonzalez Marquet in Placentia, Taqueria Mocorito Restaurant in Anaheim, Taco Boy in Anaheim and Brianna’s Ice Cream in Anaheim, along with La Bodega Ranch Market in Long Beach.
Health officials said Thursday they were continuing to investigate the situation and advised the public not to eat any Rosca de Reyes from Cholula’s Bakery.

China regulator to strengthen 'grim' food, drug safety control
Source : http://www.reuters.com/article/2015/01/07/us-china-foodsafety-idUSKBN0KG0DB20150107
By SHANGHAI, Reuters (Jan 07, 2015)
 Food and drug safety in China is "grim" and will get stronger oversight, the food and drug regulator said on Wednesday, after a series of scares last year hit the reputations of global firms such as McDonald's Corp and Wal-Mart Stores Inc.
The China Food and Drug Administration has struggled to control a string of high-profile scandals over the years, from donkey meat products tainted with fox, heavy metals in baby food and allegations of expired meat sold to fast-food chains.
"We must soberly recognize the current foundations of China's food and drug safety are still weak, with new and old risks together creating a grim situation," the regulator said in a statement on its website after a meeting in Beijing this week.
Safety scares have affected the reputations and China sales of global companies from U.S. fast-food chains McDonald's and Yum Brands Inc to retailers such as Wal-Mart and France's Carrefour SA.
China will increase "active" regulation to prevent food and drug safety scares, with more on-site inspections, random tests and unannounced visits, the regulator said. The quality of personnel, legal structures, management methods and technological aspects were all currently insufficient, it said.
Regulators overseeing the country's food industry are thinly stretched, company executives told Reuters, and inspectors often struggle to deal with China's fragmented food supply chains.
The regulator said China would look to attract more personnel, standardize training methods and promote greater cooperation between regions.
The government has struggled to restore confidence in its $1 trillion food processing industry since six infants died in 2008 after drinking adulterated milk, creating a space for imported goods which are often seen as safer and of higher quality.
Food safety laws are incomplete and responsibility to enforce them is unclear, making it difficult for regulators to do their jobs, Gao Guan, deputy secretary-general of the China Meat Association, told Reuters last year.
($1 = 6.2085 Chinese yuan renminbi)

Food poisoning can change your life
Source : http://msue.anr.msu.edu/news/food_poisoning_can_change_your_life
By Karen Fifield Michigan State University Extension (Jan 05, 2015)
Long term effects of foodborne illness.
Most of the time we think of food poisoning as stomach cramps, maybe vomiting and diarrhea. Rarely do we hear or see the long term effects it can have on a body. There are some serious complications that can become a part of your life. Foodborne illness can be as small as feeling like the flu, or it can be deadly.
Different types of foodborne illness affect each body in various ways. If you have a compromised immune system, are very young or are older, chances of contracting a foodborne illness is greater. Also depending on what virus, bacteria or toxin is contracted your symptoms and severity can be different.
Kidney failure is a serious complication that can occur with hemolytic-uremic syndrome (HUS). This is a possibility after contracting E. coli bacteria. The bacteria can cause an infection that can produce a toxin substance that may cause injury to the kidney.
Chronic arthritis can be brought on with an infection of Shigella or Salmonella. It starts with eye irritation and painful urination. If this is not taken care of it can lead to chronic arthritis. This leads to a life time of inflammation and joint pain. Another foodborne illness that can contribute to chronic arthritis is Campylobacter.
With different types of bacteria, viruses and toxins that can occur from foodborne illness there are still several other long term affects that can take place. There can be brain and nerve damage or even death that can change the life of individuals with low or compromised immune systems, infants or the very young and older adults. We all can contract foodborne illness but the chances are increased for these individuals. Listeria can cause mental retardation, seizures, paralysis, blindness and deafness in newborn infants.
Michigan State University Extension recommends taking simple precautions by washing your hands often and for at least 20 seconds under warm, running water. Keep hot foods hot, 135 degrees Fahrenheit or above. Keep cold foods cold, 40 degrees Fahrenheit or lower and when in doubt, through it out. Do your part in keeping your food safe and free from foodborne pathogens.
This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://bit.ly/MSUENews. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).

Food safety top concern for American businesspeople in Taiwan: poll
Source : http://focustaiwan.tw/news/asoc/201501080026.aspx
By Jeffrey Wu (Jan. 08, 2015)
Food safety is the biggest anxiety for U.S. businesspeople living in Taiwan, according to an annual survey released Thursday by the American Chamber of Commerce (AmCham) in Taipei.
Among the least favorite aspects of living in Taiwan, the poll listed food safety as the major concern, followed by lack of an English-friendly environment.
The category of food safety was included in the annual Business Climate Survey this year for the first time and it immediately replaced the lack of an English-friendly environment, which had been the chief concern among American businesspeople in Taiwan for the past three years..
Issues with banking and other financial services were listed third, while low-quality drinking water and inadequate library services were fourth and fifth, respectively.
On the benefits of living in Taiwan, the poll showed that the amicability of the Taiwanese people was at the top of the list, followed by family safety, both for the fourth consecutive year.
Ease of living, quality of health services, and transportation options were in third, fourth and fifth place, respectively.
AmCham Chairman Thomas Fann noted that despite the food safety concerns, the business leaders at AmCham companies praised the high quality of life in Taiwan, describing Taiwan as "a safe and friendly environment in which to live and work."
The survey, conducted for the fifth year, received valid responses from 245 AmCham member executives.
Founded in 1951, AmCham Taipei has more than 1,000 members representing about 500 companies and 27 committees advocating for various industry interests in Taiwan.

Caramel Apple Outbreak Warning: Listeria Can Grow in Freezer
Source : http://foodpoisoningbulletin.com/2015/caramel-apple-outbreak-warning-listeria-can-grow-in-freezer/
By Linda Larsen (Jan 07, 2015)
The ongoing Listeria monocytogenes outbreak linked to commercially produced, prepackaged caramel apples has brought this bacteria into the spotlight. At least 32 people are sickened; 31 have been hospitalized, six people have died, and three children have Listeria meningitis. There are many things we don’t know about this pathogen, but we do know it’s a tricky little bug.
Caramel Apple Lawsuit for ListeriaListeria is present in the environment and can live in the intestines of animals, birds, and people without causing illness. It can also have a long incubation period, up to 70 days, from the time of exposure to when symptoms first appear.
But the trickiest thing about Listeria monocytogenes is that it can grow at refrigerator and freezer temperatures which are the traditional preservation methods used for preventing bacterial growth in food. Listeria bacteria can double their population within 1 day at 41°F.
If your freezer temperature is at 0°F or above, you could have a problem. And since refrigerators are set between 32°F and 40°F and are usually higher, the bacteria can have a field day in that appliance. That’s why the FDA has set a zero tolerance for Listeria monocytogenes bacteria in food sold in the U.S. Attorney Fred Pritzker, who represents clients sickened by this bacterium, said, “Because Listeria is so dangerous, every food processor should be aware of it and specifically implement policies and procedures to prevent contamination.”
Listeria is one of the few bacteria that doesn’t need a lot of water to grow, which makes it problematic for low water foods. It’s also salt-tolerant, unlike most bacteria.
Now that you know this, what can you do about this outbreak? First of all, throw away any commercially prepared, caramel apples you may have purchased this fall, even if they are stored in the freezer. Four brands (Happy Apple, Kroger, Karm’l Dapple, and Merb’s Candies) have been recalled, and two others (Carnival and Kitchen Cravings in Minnesota) are associated with the outbreak.
Then wash your hands with soap and warm water and clean the storage area, whether cupboard, pantry, refrigerator, or freezer, with a mild bleach solution to kill any bacteria. The recommended concentration for the cleaning solution is 1 tablespoon bleach for every gallon of hot water.
If you ate a commercially prepared prepackaged caramel apple in the last 70 days, monitor yourself for the symptoms of the illness. The long incubation time is one of the most problematic issues with this bacterial infection.
But now that you are informed, you can protect yourself. The symptoms of a Listeria infection can be gastrointestinal, with abdominal cramps, diarrhea, and nausea. They can also be flu-like, including headache, stiffness, fever, and confusion. Pregnant women are usually only mildly ill, but listeriosis can be devastating, causing miscarriage, stillbirth, and infection in the newborn baby. If you do get sick, see your doctor because treatment is available.

Missouri Caramel Apple Listeria Probe Intensifies
Source : http://foodpoisoningbulletin.com/2015/missouri-caramel-apple-listeria-probe-intensifies/
By Carla Gillespie (Jan 7, 2015)
In Missouri, where Listeria in caramel apples has sickened five people, an investigation into the source of the outbreak has intensified. State health officials are working with the U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) to discover the source of the problem and the scope of distribution of the caramel apples.
Caramel Apple Lawsuit for ListeriaSo far, the list of stores in Missouri that sold prepackaged, commercially prepared caramel apples that may have been contaminated with Listeria includes Walmart, Sam’s Club, Kroger, and Merb’s Candies. None of these stores is still selling the recalled caramel apples, but symptoms of a Listeria infection, which include fever, stiff neck, muscle aches and gastrointestinal issues, can take as long as 70 days to develop.
All of the case patients in Missouri are in the eastern or northeastern part of the state. The last case was reported in mid-November, according Ryan Hobart, a spokesman for the Missouri Department of Health and Senior Services.
Caramel-Listeria-LawsuitThree of the case patients, who range in age from 25 to 92, are male and two are female, Hobart told Food Poisoning Bulletin. One of them has died, but the cause of death was not listed as Listeria.
Listeria illnesses linked to caramel apples have been reported  in 10 others state. So far, the total number of people sick is 32. Six people have died. The case count by state is as follows: Arizona (4), California (2), Minnesota (4), Missouri (5), Nevada (1), New Mexico (6), North Carolina (1), Texas (4), Utah (1), Washington (1), and Wisconsin (3).
Half of all the case patients are over the age of 66. Ten of the illnesses are associated with a pregnancy including at least three babies who were born prematurely with Listeria infections and one fetal loss. Three children under the age of 15 have been diagnosed with Listeria meningitis.

Food Safety Not a Likely Hot Topic for 2015 Legislatures
Source : http://www.foodsafetynews.com/2015/01/food-safety-not-a-likely-hot-topic-for-2015-state-legislatures/#.VLMiINhxns1
By Dan Flynn (Jan 6, 2015)
Is it possible that enough cottage food bills got passed to carry the economy through to recovery, that most folks are happy with their raw-milk laws, and that the once-heralded “food freedom” movement never got out of a few towns in Maine (whose names no one can remember now)?
State legislatures in California, Montana, Wisconsin, Ohio and Maine have already gaveled their 2015 sessions to order, according to the Denver-based National Conference of State Legislatures (NCSL). Legislatures in 42 states, five territories and the District of Columbia kick off their 2015 sessions sometime this month.
But food-safety topics often targeted by state lawmakers since 2010 may not be getting as much attention in 2015 as they did previously. Food safety did not make the 2015 list of “hot issues” prepared by NCSL analysts.
“As lawmakers roll up their sleeves to begin work on many important issues, state fiscal conditions, at least, are stronger than they have been for several years. With only a few exceptions, state finances continue to improve slowly but steadily from the depths of the Great Recession,” writes NCSL’s Julie Lays.
“NCSL’s most recent fiscal survey of the states found most spending in line with appropriated levels for FY 2015. In fact, as the New Year approached, only Medicaid and corrections in a couple of states were running over-budget,” she notes.
Financially stronger states should be good news for state and local health departments, which, since 2008, saw personnel cuts reducing everything from restaurant and grocery store inspections to their capacities for investigating illnesses spread by food and water sources.
This past November, Republicans took control of both chambers in 30 states, the most since 1920. The GOP took over 11 formerly Democratic chambers and gained roughly 290 new House and Senate seats, for control of about 4,100 of the nation’s total 7,383 legislative seats. And Republicans ended up controlling 33 governor’s offices after ousting Democrats in the mostly “blue states” of Arkansas, Illinois, Maryland and Massachusetts.
After that first GOP surge taking over state legislative seats in 2010, about two dozen states adopted so-called cottage food laws, which made it legal to use home kitchens to make certain low-risk foods.
Home kitchens were usually exempted from licensing and inspections, and such bills often passed over the objection of state and local food-safety officials. Cottage food laws were also sold as an economic development strategy in hard-pressed states.
States have also looked at a lot of raw-milk bills since 2010, but those battles have not really produced much change in policy, and it’s possible lawmakers will take a break from raw milk in 2015.
At present, 12 states ban retail sales of raw milk for human consumption, 10 allow raw milk sales at the retail level, and 28 allow raw milk to be sold only on the farm or through herd-share agreements. The U.S. Food and Drug Administration bans the interstate sale and/or transportation of raw milk.
Introduction of raw-milk bills appears to have slowed significantly from previous years, but it’s still early. If raw milk does fall off the legislative table, an indication may come in Wisconsin, where the 2015 session got underway on Monday.
The Wisconsin Legislature did lift its raw-milk ban in 2010, but the bill was vetoed by former Democratic Gov. Jim Doyle. In the five years since, attempts to lift the ban haven’t come close.
In Montana, where the biennial legislative session also got underway on Monday, no food-safety bills have been introduced or even drafted. However, according to a draft bill, Big Sky Country lawmakers may call for a top-to-bottom review of the Montana Department of Public Health and Human Services.
Nor does it appear that the Ohio Legislature, which also went into session on Monday, has anything on its food-safety agenda.
Maybe an early bill filing in Florida reveals what might pass for “food safety” legislation this year. Florida and Utah are the only two states that do not allow consumers to take beer home from craft breweries in so-called “growlers.”
That’s what craft brewers call half-gallon refillable jugs. A pair of Florida lawmakers is out to get their state off that list by making growlers as legal as 32-ounce and 128-ounce jugs are today.
Why aren’t growlers legal in the secular state of Florida? It seems that big brewers such as Budweiser have held the issue hostage until they get what they want, such as on-site tasting rooms. But they may be coming around to also supporting a “clean bill” for growlers.
Craft brewing is booming in Florida, with $432 million in sales in 2013 and 4,080 related jobs. Florida Gov. Rick Scott says he’ll sign the growler bill.
Craft brewing just might be on a roll. The waste product from the brewing process (known as “spent grain”), which is often fed to animals, was exempted from the Food Safety Modernization Act in 2014.

Norovirus – The Leading Foodborne Bug in the USA
Source : http://www.foodpoisonjournal.com/food-poisoning-information/norovirus-leading-foodborne-bug-in-the-usa/#.VLMiYthxns1
By Bill Marler (Jan 05, 2015)
An Introduction to Norovirus
The Centers for Disease Control and Prevention (CDC) estimates that noroviruses cause nearly 21 million cases of acute gastroenteritis annually, making noroviruses the leading cause of gastroenteritis in adults in the United States. [1] According to a relatively recent article in the New England Journal of Medicine:
The Norwalk agent was the first virus that was identified as causing gastroenteritis in humans, but recognition of its importance as a pathogen has been limited because of the lack of available, sensitive, and routine diagnostic methods. Recent advances in understanding the molecular biology of the noroviruses, coupled with applications of novel diagnostic techniques, have radically altered our appreciation of their impact. Noroviruses are now recognized as being the leading cause of epidemics of gastroenteritis and an important cause of sporadic gastroenteritis in both children and adults.
Of the viruses, only the common cold is reported more often than a norovirus infection—also referred to as viral gastroenteritis. [2]
Nature has created an ingenious bug in norovirus. [3] The round blue ball structure of norovirus is actually a protein surrounding the virus’s genetic material. [4]  The virus attaches to the outside of cells lining the intestine, and then transfers its genetic material into those cells.  Once the genetic material has been transferred, norovirus reproduces, finally killing the human cells and releasing new copies of itself that attach to more cells of the intestine’s lining. [5]
Norovirus (previously called “Norwalk-like virus” or NLV) is a member of the family Caliciviridae. The name derives from the Latin for chalice—calyx—meaning cup-like, and refers to the indentations of the virus surface. [6] The family of Caliciviridae consists of several distinct groups of viruses that were first named after the places where outbreaks occurred.  The first of these outbreaks occurred in 1968 among schoolchildren in Norwalk, Ohio.  The prototype strain was identified four years later, in 1972, and was the first virus identified that specifically caused gastroenteritis in humans.  Other discoveries followed, with each strain name based on the location of its discovery—e.g., Montgomery County, Snow Mountain, Mexico, Hawaii, Parmatta, Taunton, and Toronto viruses.  A study published in 1977 found that the Toronto virus was the second most common cause of gastroenteritis in children.  Eventually this confusing nomenclature was resolved, first in favor of calling each of the strains a Norwalk-like virus, and then simply, a norovirus – the term used today.
Humans are the only host of norovirus, and norovirus has several mechanisms that allow it to spread quickly and easily.  Norovirus infects humans in a pathway similar to the influenza virus’ mode of infection. In addition to their similar infective pathways, norovirus and influenza also evolve to avoid the immune system in a similar way.  Both viruses are driven by heavy immune selection pressure and antigenic drift, allowing evasion of the immune system, which results in outbreaks.  Norovirus is able to survive a wide range of temperatures and in many different environments.  Moreover, the viruses can spread quickly, especially in places where people are in close proximity, such as cruise ships and airline flights, even those of short duration. [7] As noted by the CDC in its Final Trip Report:
noroviruses can cause extended outbreaks because of their high infectivity, persistence in the environment, resistance to common disinfectants, and difficulty in controlling their transmission through routine sanitary measures.
Norovirus outbreaks can result from the evolution of one strain due to the pressure of population immunity. [8] Typically, norovirus outbreaks are dominated by one strain, but can also involve more than one strain. [9] For example, some outbreaks associated with shellfish have been found to contain up to seven different norovirus strains. [10] Swedish outbreak studies also reveal a high degree of genetic variability, indicating a need for wide detection methods when studying these outbreaks. [11]
By way of further example, in 2006, there was a large increase in the number of norovirus cases on cruise ships. Norovirus cases were increasing throughout Europe and the Pacific at the same time. [12] One issue with cruise ships is the close contact between people as living quarters are so close, and despite education efforts, there still seems to be a lack of public understanding regarding how the illness is spread. [13] On the other hand, reporting occurs much more quickly in these situations because of the close proximity and concentration of illness, allowing for the quicker detection of outbreaks. [14] Cruise ship outbreaks often occur when new strains of norovirus are appearing, providing a good indicator system for new norovirus strains.   In this case, two new variants appeared within the global epidemic genotype, suggesting a strong pressure for evolution against the human immune system. [15] This points to the need for an international system of guidelines in tracing norovirus outbreaks.
Most norovirus outbreaks from contaminated food occur in food service settings, according to a Vital Signs report by the Centers for Disease Control and Prevention. Infected food workers are frequently the source of these outbreaks, often by touching ready-to-eat foods served in restaurants with their bare hands. The food service industry can help prevent norovirus outbreaks by enforcing food safety practices, such as making sure workers always practice good hand hygiene on the job and stay home when they are sick.
Norovirus often gets a lot of attention for outbreaks on cruise ships, but those account for only about 1 percent of all reported norovirus outbreaks. Norovirus is highly contagious and can spread anywhere people gather or food is served, making people sick with vomiting and diarrhea. [16]“Norovirus outbreaks from contaminated food in restaurants are far too common.” said CDC Director Tom Frieden, M.D., M.P.H. “All who prepare food, especially the food service industry, can do more to create a work environment that promotes food safety and ensures that workers adhere to food safety laws and regulations that are already in place.” [17]
How is Norovirus Transmitted?
Norovirus causes nearly 60% of all foodborne illness outbreaks.  Norovirus is transmitted primarily through the fecal-oral route, with fewer than 100 norovirus particles needed to cause infection. [18] Transmission occurs either person-to-person or through contamination of food or water.[19]  CDC statistics show that food is the most common vehicle of transmission for noroviruses; of 232 outbreaks of norovirus between July 1997 and June 2000, 57% were foodborne, 16% were spread from person-to-person, and 3% were waterborne. [20] When food is the vehicle of transmission, contamination occurs most often through a food handler improperly handling a food directly before it is eaten. [21]
Infected individuals shed the virus in large numbers in their vomit and stool, shedding the highest amount of viral particles while they are ill.   Aerosolized vomit has also been implicated as a mode of norovirus transmission. [22] Previously, it was thought that viral shedding ceased approximately 100 hours after infection; however, some individuals continue to shed norovirus long after they have recovered from it, in some cases up to 28 days after experiencing symptoms. [23] Viral shedding can also precede symptoms, which occurs in approximately 30% of cases.  Often, an infected food handler may not even show symptoms.  In these cases, people can carry the same viral load as those who do experience symptoms. [24]
A Japanese study examined the ability of asymptomatic food handlers to transfer norovirus. Approximately 12% of asymptomatic food handlers were carriers for one of the norovirus genotypes.  This was the first report of norovirus molecular epidemiology relating asymptomatic individuals to outbreaks, suggesting that asymptomatic individuals are an important link in the infectivity pathway.  Asymptomatic infection may occur because some people may have acquired immunity, which explains why some show symptoms upon infection and some do not.  Such immunity does not last long, though.  These discoveries reveal just how complicated the pathway of norovirus infection is, as well as how difficult it is to define the true period of infectivity.  Furthermore, it remains unclear why some people do not become sick with norovirus even when they are exposed.  Very little is known about the differences in hygiene practices, behaviors, and personal susceptibility between those who become infected and those who do not, which brings up the potential for more research. [25] Discrepancies exist in the published research about infective doses for norovirus, with earlier studies having used a much higher dose to trigger immune responses.
Symptoms and Risks of Norovirus Infection
Norovirus illness usually develops 24 to 48 hours after ingestion of contaminated food or water. Symptoms typically last a relatively short amount of time, approximately 24 to 48 hours. [26] These symptoms include nausea, vomiting, diarrhea, and abdominal pain.  Headache and low-grade fever may also accompany this illness.   People infected with norovirus usually recover in two to three days without serious or long-term health effects.
Although symptoms usually only last one to two days in healthy individuals, norovirus infection can become quite serious in children, the elderly, and immune-compromised individuals. [27] In some cases, severe dehydration, malnutrition, and even death can result from norovirus infection, especially among children and among older and immune-compromised adults in hospitals and nursing homes. [28] In England and Wales, 20% of those over the age of 65 die due to infectious intestinal illness other than Clostridium difficile.  Recently, there have been reports of some long-term effects associated with norovirus, including necrotizing entercolitis, chronic diarrhea, and post-infectious irritable bowel syndrome, but more data is needed to support these claims. [29]
Diagnosing a Norovirus Infection
Diagnosis of norovirus illness is based on the combination of symptoms, particularly the prominence of vomiting, little fever, and the short duration of illness. [30] If a known norovirus outbreak is in progress, public health officials may obtain specimens from ill individuals for testing in a lab.  These lab tests consist of identifying norovirus under an electron microscope. A reverse transcriptase polymerase chain reaction test (RT-PCR assay) also can detect norovirus in food, water, stool samples, and on surfaces. These tests isolate and replicate the suspected virus’ genetic material for analysis. [31] An ELISA can also be performed, which detects antigens. They are easier to perform than RT-PCR, but less sensitive and can also result in many false negatives. [32]
Treating a Norovirus Infection
There is no specific treatment available for norovirus.  In most healthy people, the illness is self-limiting and resolves in a few days; however, outbreaks among infants, children, elderly, and immune-compromised populations may result in severe complications among those affected.  [33] Death may result without prompt measures.  The replacement of fluids and minerals such as sodium, potassium and calcium – otherwise known as electrolytes – lost due to persistent diarrhea is vital. This can be done either by drinking large amounts of liquids, or intravenously.
Recent research has looked into the potential for developing a norovirus vaccine. Researchers indicate that coming up with a norovirus vaccine would be similar to vaccinating for influenza, by using screening in order to select for the most prevalent strains. This is a quite challenging process.  Other challenges include the fact that cell culture and small-animal models are limited, host pre-exposure histories are complicated, and there is always the potential for the evolution of novel immune escape variants, rendering the vaccine useless. [34] Furthermore, scientists would likely face a lack of funding to develop a vaccine because vaccine development is expensive. [35]
Preventing Norovirus Infection
Common settings for norovirus outbreaks include restaurants and events with catered meals (36%), nursing homes (23%), schools (13%), and vacation settings or cruise ships (10%).  Proper hand washing is the best way to prevent the spread of norovirus.
The good news about norovirus is that it does not multiply in foods as many bacteria do. [36] In addition, thorough cooking destroys this virus.   To avoid norovirus, make sure the food you eat is cooked completely.  While traveling in in areas that have polluted water sources, raw vegetables should be washed thoroughly before being served, and travelers should drink only boiled drinks or carbonated bottled beverages without ice.
Shellfish (oysters, clams, mussels) pose the greatest risk and any particular serving may be contaminated with norovirus; there is no way to detect a contaminated oyster, clam, or mussel from a safe one.  Shellfish become contaminated when their waters become contaminated—e.g., when raw sewage is dumped overboard by recreational or commercial boaters).   Shellfish are filter feeders and will concentrate virus particles present in their environment. With shellfish, only complete cooking offers reliable protection; steaming does not kill the virus or prevent its transmission. [37] Some researchers suggest that norovirus monitoring in shellfish areas could be a good preventive strategy as well.  Waterborne norovirus outbreaks are ubiquitous, but difficult to recognize. Improved analysis of environmental samples would have the potential to significantly improve the detection for norovirus in shellfish waters. [38]
Finally, and as briefly mentioned earlier, outbreaks of norovirus infections have become synonymous with cruise ships. [39] Healthcare facilities also experience a high incidence of norovirus outbreaks.  [40] The CDC has published information regarding the prevention of norovirus outbreaks on cruise ships and in healthcare facilities on its website.  Once a case has occurred, even more stringent hygienic measures than normal are required in order to prevent an outbreak, particularly on an enclosed space such as a cruise ship.
1.  CDC, Norovirus:  Technical Fact Sheet, from Centers for Disease Control and Prevention Web site, http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus-factsheet.htm(last modified on August 24, 2011) (last checked on Jan. 3, 2012).
2.  Siebenga, JJ, et al., “Norovirus Illness Is a Global Problem: Emergence and Spread of Norovirus GII.4 Variants, 2001–2007,” JOURNAL OF INFECTIOUS DISEASES, Vol. 200, No. 5, pp. 802-812 (2009). Full text available online at http://jid.oxfordjournals.org/content/200/5/802.long
3.  CDC, “Updated Norovirus Outbreak Management and Disease Prevention Guidelines,” MORBIDITY AND MORTALITY WEEKLY REPORT, Vol. 60, Recommendations and Reports No. 3, pp. 1-15 (March 4, 2011). Full text available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6003a1.htm
4.  Westrell T, et al., “Norovirus outbreaks linked to oyster consumption in the United Kingdom, Norway, France, Sweden and Denmark,”  EURO-SURVEILLANCE (European Communicable Disease Bulletin), Vol. 15, No. 12 (Mar. 25 2010). Full text available online at http://www.eurosurveillance.org/images/dynamic/EE/V15N12/art19524.pdf
5.  Lysen, M, et al., “Genetic Diversity among Food-Borne and Waterborne Norovirus Strains Causing Outbreaks in Sweden,” JOURNAL OF CLINICAL MICROBIOLOGY, Vol. 47, No. 8, pp. 2411-2418 (2009). Full text available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2725682/?tool=pubm
6.  Verhoef, L, et al., “Emergence of New Norovirus Variants on Spring Cruise Ships and Prediction of Winter Epidemics,” EMERGING INFECTIOUS DISEASES, Vol. 14, No. 2, pp. 238-243 (Feb. 2008). Full text available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600213/pdf/06-1567_finalR.pdf
7.  CDC, Facts about Norovirus on Cruise Ships, last updated July 20, 2009, available through the Centers for Disease Control and Prevention website, at http://www.cdc.gov/nceh/vsp/pub/Norovirus/Norovirus.htm (last checked on January 4, 2012).
8.  CDC, “Outbreaks of Gastroenteritis Associated with Noroviruses on Cruise Ships – United States, 2002,” MORBIDITY AND MORTALITY WEEKLY REPORT, Vol. 51, No. 49, pp. 1112-15 (Dec. 13, 2002). Full text available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5149a2.htm
9.  Donaldson, E., et al., “Viral shape-shifting: norovirus evasion of the human immune system,” NATURE REVIEWS, MICROBIOLOGY, Vol. 8, No. 3, pp. 231-239 (March 2010). Abstract available online at http://www.ncbi.nlm.nih.gov/pubmed/20125087
10.  Antonio, J, et al., “Passenger Behaviors During Norovirus Outbreaks on Cruise Ships,” INTERNATIONAL SOCIETY OF TRAVEL MAGAZINE, Vol. 15, No. 3, pp. 172-176 (May-June 2008). Abstract available online at http://www.ncbi.nlm.nih.gov/pubmed/18494694
11.  Norovirus is the leading cause of disease outbreaks from contaminated food in the U.S.  http://www.cdc.gov/media/releases/2014/p0603-norovirus.htm
12.  CDC, “Norwalk-like viruses’—Public health consequences and outbreak management,” MORBIDITY AND MORTALITY WEEKLY REPORT, Vol. 50, Recommendations and Reports No. 9, pp. 1-18 (June 1, 2001). Full text available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5009a1.htm
13.  American Public Health Association (APHA), Heymann, David L., editor, “Norovirus Infection,” in CONTROL OF COMMUNICABLE DISEASES MANUAL, pp. 227-29, (18th Ed. 2008).
14.  CDC, Norovirus in Healthcare Facilities Fact Sheet, released December 21, 2006, available through Centers for Disease Control and Prevention website, at http://www.cdc.gov/ncidod/dvrd/revb/gastro/downloads/noro-hc-facilities-fs-508.pdf (last checked on January 4, 2012).
15.  Cáceres, VM, et al., “A viral gastroenteritis outbreak associated with person-to-person spread among hospital staff,” INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, Vol. 19, No. 3, pp. 162-7 (March 1998). Abstract available online at http://www.ncbi.nlm.nih.gov/pubmed/9552183
16.  Marks, PJ, et al., “Evidence of airborne transmission of Norwalk-like virus (NLV) in a hotel restaurant,” EPIDEMIOLOGY AND INFECTION, Vol. 124, No. 3, pp. 481-87 (June 2000). Full text available online at http://www.cdc.gov/nceh/ehs/Docs/Evidence_for_Airborne_Transmission_of_Norwalk-like_Virus.pdf
17.  Patterson, T, Hutchin, P, and Palmer S, “Outbreak of SRSV gastroenteritis at an international conference traced to food handled by a post symptomatic caterer,” EPIDEMIOLOGY AND INFECTION,  Vol. 111, No. 1, pp. 157-162 (Aug. 1993). Available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2271183/?tool=pubmed
18.  Treanor, John J. and Dolin, Raphael, “Norwalk Virus and Other Calciviruses,” in Mandell, Douglas, and Bennett’s PRINCIPLES AND PRACTICE OF INFECTIOUS DISEASES, Fifth Edition, Chap. 163, pp. 1949-56 (2000, Mandell, Bennett, and Dolan, Editors).
19.  Janneke, C, et al., “Enhanced Hygiene Measures and Norovirus Transmission during an Outbreak,” EMERGING INFECTIOUS DISEASES, Vol. 15, No., pp. 24-30 (Jan. 2009). Full text available online at http://wwwnc.cdc.gov/eid/article/15/1/08-0299_article.htm
20.  Mayo Clinic, “Norovirus Infection,” Mayo Clinic Web site, information last updated April 15, 2011 (as of last checking on Jan. 3, 2012), available online at http://www.mayoclinic.com/health/norovirus/DS00942/DSECTION=1.
21.  Harris, JP, et al., “Deaths from Norovirus among the Elderly, England and Wales,” EMERGING INFECTIOUS DISEASES, Vol. 14, No. 10, pp. 1548-1552 (Oct. 2008). Full text available online at http://wwwnc.cdc.gov/eid/article/14/10/08-0188_article.htm
22.  Said, Maria, Perl, Trish, and Sears Cynthia, “Gastrointestinal Flu: Norovirus in Health Care and Long-Term Care Facilities,” HEALTHCARE EPIDEMIOLOGY, vol. 47, pp. 1202-1208 (Nov. 1, 2008). Full text available online at http://cid.oxfordjournals.org/content/47/9/1202.full.pdf+htm
23.  Vinje, J, “A Norovirus Vaccine on the Horizon?” EMERGING INFECTIOUS DISEASES, Vol. 202, No. 11, pp. 1623-1625 (2010). Full text available online at http://jid.oxfordjournals.org/content/202/11/1623.ful
24.  Tu E.T., et al., “Norovirus excretion in an age-care setting,” JOURNAL OF CLINICAL MICROBIOLOGY, Vol. 46, pp. 2119-21 (June 2008). Full text available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446857/pdf/2198-07.pd
25.  Mead, Paul M, et al., “Food-related Illness and Death in the United States,” EMERGING INFECTIOUS DISEASES, Vol. 5, No. 5, pp. 607-25 (September-October 1999). Full text available online at  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2627714/pdf/10511517.pdf
26.  Duizer, E, et al., “Probabilities in norovirus outbreak diagnosis,” JOURNAL OF CLINICAL VIROLOGY, Vol. 40, No. 1, pp. 38-42 (Sept. 2007). Abstract available online at http://www.ncbi.nlm.nih.gov/pubmed/17631044
27. Middleton, PJ, Szmanski, MT, and Petric M, “Viruses associated with acute gastroenteritis in young children,” AMERICAN JOURNAL OF DISEASES OF CHILDREN, Vol. 131, No. 7, pp. 733-37 (July 1977). Abstract available online at http://www.ncbi.nlm.nih.gov/pubmed/195461
28.  Fankhauser, RL, et al., “Epidemiologic and molecular trends of ‘Norwalk-like viruses’ associated with outbreaks of gastroenteritis in the United States,” JOURNAL OF INFECTIOUS DISEASES, Vol.186, No. 1, pp. 1-7 (July 1, 2002). Full text of article available online at http://jid.oxfordjournals.org/content/186/1/1.long
29.  Lowther, J, Henshilwood, K, and Lees DN, “Determination of Norovirus Contamination in Oysters from Two Commercial Harvesting Areas over an Extended Period, Using Semiquantitative Real-Time Reverse Transcription PCR,” JOURNAL OF FOOD PROTECTION, Vol. 71, No. 7, pp. 1427-1433 (2008). Abstract available online at http://www.ncbi.nlm.nih.gov/pubmed/18680943
30.  Scallan, E., et al., “Foodborne Illness Acquired in the United States—Major Pathogens,” EMERGING INFECTIOUS DISEASES, Vol. 17, No. 1, pp. 7-15 (2011). Full text available online at http://wwwnc.cdc.gov/eid/article/17/1/p1-1101_article.htm
31.  Kirkland, KB, et al., “Steaming oysters does not prevent Norwalk-like gastroenteritis,” PUBLIC HEALTH REPORTS, Vol. 111, pp. 527-30 (1996). Full text available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1381901/pdf/pubhealthrep00045-0057.pdf
32. Maunula, L, Miettinen, IT, and Bonsdorff, CH, “Norovirus Outbreaks from Drinking Water,” EMERGING INFECTIOUS DISEASES, Vol. 11, No. 11, pp. 1716-1721 (2005).  Full text available online at http://wwwnc.cdc.gov/eid/content/11/11/pdfs/v11-n11.pd
33.  CDC, “Outbreaks of Gastroenteritis Associated with Noroviruses on Cruise Ships – United States, 2002,” MORBIDITY AND MORTALITY WEEKLY REPORT, Vol. 51, No. 49, pp. 1112-15 (Dec. 13, 2002). Full text available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5149a2.htmOzawa, K, et al., “Norovirus Infections in Symptomatic and Asymptomatic Food Handlers in Japan,” JOURNAL OF CLINICAL MICROBIOLOGY, Vol. 45, No. 12, pp. 3996-4005 (Oct. 2007). Abstract available online at http://jcm.asm.org/content/45/12/3996.abstract
34.  Fankhauser, RL, et al., “Epidemiologic and molecular trends of ‘Norwalk-like viruses’ associated with outbreaks of gastroenteritis in the United States,” JOURNAL OF INFECTIOUS DISEASES, Vol.186, No. 1, pp. 1-7 (July 1, 2002). Full text of article available online at http://jid.oxfordjournals.org/content/186/1/1.long
35.  Lowther, J, Henshilwood, K, and Lees DN, “Determination of Norovirus Contamination in Oysters from Two Commercial Harvesting Areas over an Extended Period, Using Semiquantitative Real-Time Reverse Transcription PCR,” JOURNAL OF FOOD PROTECTION, Vol. 71, No. 7, pp. 1427-1433 (2008). Abstract available online at http://www.ncbi.nlm.nih.gov/pubmed/18680943
36.  Scallan, E., et al., “Foodborne Illness Acquired in the United States—Major Pathogens,” EMERGING INFECTIOUS DISEASES, Vol. 17, No. 1, pp. 7-15 (2011). Full text available online at http://wwwnc.cdc.gov/eid/article/17/1/p1-1101_article.htm
37.  Kirkland, KB, et al., “Steaming oysters does not prevent Norwalk-like gastroenteritis,” PUBLIC HEALTH REPORTS, Vol. 111, pp. 527-30 (1996). Full text available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1381901/pdf/pubhealthrep00045-0057.pdf
38.  Maunula, L, Miettinen, IT, and Bonsdorff, CH, “Norovirus Outbreaks from Drinking Water,” EMERGING INFECTIOUS DISEASES, Vol. 11, No. 11, pp. 1716-1721 (2005).  Full text available online at http://wwwnc.cdc.gov/eid/content/11/11/pdfs/v11-n11.pdf
39.  CDC, “Outbreaks of Gastroenteritis Associated with Noroviruses on Cruise Ships – United States, 2002,” MORBIDITY AND MORTALITY WEEKLY REPORT, Vol. 51, No. 49, pp. 1112-15 (Dec. 13, 2002). Full text available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5149a2.htm
40.  Ozawa, K, et al., “Norovirus Infections in Symptomatic and Asymptomatic Food Handlers in Japan,” JOURNAL OF CLINICAL MICROBIOLOGY, Vol. 45, No. 12, pp. 3996-4005 (Oct. 2007). Abstract available online at http://jcm.asm.org/content/45/12/3996.abstract

Failure to Finalize Rules Delays Labels on Mechanically Tenderized Beef
Source : http://www.foodsafetynews.com/2015/01/failure-to-finalize-rules-means-no-labels-on-mechanically-tenderized-beef-in-2016/#.VLMi79hxns1
By James Andrews (Jan 5, 2015)
For at least another three years, consumers shopping for steak and other whole cuts of beef will continue to be left in the dark about beef treated with mechanical tenderization, a processing technique that softens up meat but can drive potentially harmful pathogens below the surface.
The U.S. Department of Agriculture (USDA) has been working on new mandatory labels for mechanically tenderized beef, but in order to get those labels implemented by 2016, they needed to be finalized by USDA and White House Office of Management and Budget (OMB) before the end of 2014.
The agencies didn’t meet that deadline, and now the earliest consumers will see labels on mechanically tenderized beef in grocery stores will be 2018. That’s due to the fact that new labeling laws are implemented in two-year increments to make things easier on manufacturers.
Consumer groups and members of Congress had been urging the agencies to finalize the rules before the end of 2014, noting that failing to do so would put consumers at unnecessary risk for at least another two years.
“It’s extremely disappointing because consumers are going to be at risk from this product for much longer than they need to be,” said Christopher Waldrop, director of the Food Policy Institute at the Consumer Federation of America. “The delay was totally unnecessary.”
Waldrop told Food Safety News that he placed most of the blame for the delay on USDA. After the agency’s Food Safety and Inspection Service drafted the proposed labeling rules, USDA held up the process for too long at the department level before finally sending it to OMB for approval in late November.
“OMB really could have turned it around quickly, but the USDA didn’t really give them enough time to finish the process by the end of the year,” Waldrop said.
USDA officials did not have a comment on the situation and directed inquiries on the status of the rules to OMB.
On Dec. 31, Congresswoman Rosa DeLauro (D-CT) urged the Obama administration to put out a rule on mechanically tenderized beef labeling before the clock struck midnight.
“These products are not currently adequately labeled so consumers do not know that they are different, present different risks, and require different preparation than whole cuts of beef,” she said in a written statement. “This is not a small problem: a 2008 USDA study indicated that about 50 million pounds of mechanically tenderized beef products are sold every month.”
Mechanical tenderization of beef poses health risks because it can transfer potential pathogens from the surface of the meat down into the center. If the cuts are cooked rare or not thoroughly enough, the pathogens in the center may go on to sicken the consumer.
A number of foodborne illness outbreaks in recent years have been connected to mechanically tenderized beef, including the 2012 outbreak of E. coli O157:H7 in Canada from XL Foods, which resulted in the largest beef recall in Canadian history. According to USA Today, at least five outbreaks in the U.S. have recently been attributed to mechanically tenderized beef, resulting in 174 confirmed illnesses and four deaths.
In a bit of positive news, the federal government did pass labeling rules on meats with added salt solutions just ahead of the year-end deadline.
Waldrop said that his organization and other consumer-advocacy groups planned to push the Obama administration to find some way to still implement mechanical tenderization labeling for 2016. Since some companies will have to change their labels for both added solutions and mechanical tenderization, doing so at the same time would make sense and save money.
Still, he expressed skepticism over the viability of pushing through the rules for 2016 now that the 2014 deadline was missed.
“There was no reason for this not to happen,” he said. “USDA delayed the thing.”

Dairy Food Safety Victoria to regulate new raw milk rules
Soruce : http://www.abc.net.au/news/2015-01-05/dairy-food-safety-victoria-to-regulate-new-raw-milk-rules/6000730
By Nikolai Beilharz (Jan 05, 2015)
Dairy Food Safety Victoria has been tasked with regulating the changes to how raw milk is sold in the state.
Last week the Victorian Government announced that any raw, cosmetic milk sold in Victoria has to have a bittering agent added to it to make it unpalatable.
The new laws come into effect after a child died and others were hospitalised from drinking raw milk.
Jennifer McDonald, the chief executive officer of Dairy Food Safety Victoria, said her group is sending out information to all licensed dairy farmers.
Ms McDonald said the focus of the group's work will be to differentiate milk not for human consumption, from milk that is pastuerised and safe for human use.
"People who are producing dairy products not intended for human consumption, will clearly identify those products and make them so they are not able to be consumed, in the same way that other consmetics are treated," she said.
"There are a number of different ways that they can deter consumption, and a bittering agent is one of those ways."
Ms McDonald says she is only aware of four of the group's licencees who are producing and selling bath milk.
"That's the product that is most likely to be mistaken or taken to be food."
Ms McDonald has acknowledged that getting information about the change has been complicated by the quick introduction of the laws, but she said her organisation was in touch with the four known raw milk suppliers to offer advice about the new license conditions for the sale of their product.
"They've all had a conversation with me that indicates that they're willing to participate in the system, and we're talking with them about the different way in which they might decide to go," she said.
"Some may decide to get out of the market completely, but others will ensure that they comply with the new licence conditions."

Salmonella: What, Why and Who?
Source : http://www.foodpoisonjournal.com/food-poisoning-information/salmonella-what-why-and-who/#.VLMjiNhxns1
By Andy Weisbecker (Jan 05, 2015)
WHAT IS SALMONELLA?
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 one in charge, Dr. Salmon got all the credit.  In any case, today the number of known strains of the bacteria totals over two thousand.  In recent years, concerns have been raised, as particular strains of the bacteria have become resistant to traditional antibiotics, in both animals and humans.
The term Salmonella refers to a group or family of bacteria that variously cause illness in humans.  The taxonomy and nomenclature of Salmonella have changed over the years and are still evolving.  Currently the Centers for Disease Control and Prevention (CDC) recognizes two species which are divided into seven subspecies.  These subspecies are divided into over 50 serogroups based on somatic (O) antigens present.  The most common Salmonella serogroups are A, B, C, D, E, F, and G.  Serogroups are further divided into over 2,500 serotypes.  Salmonella serotypes are typically identified through a series of tests of antigenic formulas listed in a document called the Kauffmann-White Scheme published by the World Health Organization Collaborating Centre for Reference and Research on Salmonella.[1]
Three serotypes–Enteriditis, Typhimurium, and Newport–have persisted as the serotypes most often isolated in patients and reported to the CDC over the last decade.  In 2009 these three serotypes accounted for 42% of all reported cases of Salmonella.[2]  Other serotypes are less common.  For example, that same year Salmonella serotype Braenderup ranked 11th out of reported Salmonella serotypes, accounting for only 720 cases of the 40,828 reported Salmonella cases that year.[3]
A.             Where Does Salmonella Come From?
Salmonella is an enteric bacterium, which means that it lives in the intestinal tracts of humans and other animals, including birds.  Salmonella bacteria are usually transmitted to humans by eating foods contaminated with animal feces or foods that have been handled by infected food service workers who have practiced poor personal hygiene.  Contaminated foods usually look and smell normal.  Contaminated foods are often of animal origin, such as beef, poultry, milk, or eggs, but all foods, including vegetables, may become contaminated. Many raw foods of animal origin are frequently contaminated, but thorough cooking kills Salmonella.  The food handler who neglects to thoroughly wash his or her hands with soap and warm water after using the bathroom may contaminate foods that have otherwise been properly prepared.
B.             What are the Symptoms of Salmonellosis?
Once in the lumen of the small intestine, the bacteria penetrate the epithelium, multiply, and enter the blood within 24 to 72 hours.  Variables such as the health and age of the host and virulence differences among the serotypes affect the nature of the diagnosis.  Infants, the elderly, individuals hospitalized, and the immune-suppressed are the populations that are the most susceptible to disease and suffer the most severe symptoms.
“The majority of persons infected with Salmonella have diarrhea, fever, and abdominal cramps 12-72 hours after exposure.  The illness usually lasts 4-7 days, and the majority of persons recover without treatment.” MMWR Weekly, supra at 684. However, much longer incubation periods of 120 hours to 31 days have been documented in previous Salmonella outbreaks.[4]
The acute symptoms of Salmonella gastroenteritis include the sudden onset of nausea, abdominal cramping, and bloody diarrhea with mucous. As already noted, there is no real cure for a Salmonella infection; treatment, therefore, tends to be palliative – although prescription of antibiotics is common, even if usually contraindicated.
Medical treatment is acutely important if the patient becomes severely dehydrated or if the infection spreads from the intestines. Persons with severe diarrhea often require re-hydration, usually with intravenous fluids.  Antibiotics are not necessary or indicated unless the infection spreads from the intestines, and then it can be treated with ampicillin, gentamicin, trimethoprim/sulfamethoxazole, or ciprofloxacin. Unfortunately, some Salmonella bacteria have become resistant to antibiotics, largely as a result of the use of antibiotics to promote the growth of feed animals.
MEDICAL COMPLICATIONS
A.        Reactive Arthritis
The term reactive arthritis refers to an inflammation of one or more joints, following an infection localized at another site distant from the affected joints.  The predominant site of the infection is the gastrointestinal tract.  Several bacteria, including Salmonella, induce septic arthritis.[5] The resulting joint pain and inflammation can resolve completely over time or permanent joint damage can occur.[6]
The reactive arthritis associated with Reiter’s may develop after a person eats food that has been tainted with bacteria. In a small number of persons, the joint inflammation is accompanied by conjunctivitis (inflammation of the eyes), and uveitis (painful urination). Id.  This triad of symptoms is called Reiter’s Syndrome.[7] Reiter’s syndrome, a form of reactive arthritis, is an uncommon but debilitating syndrome caused by gastrointestinal or genitourinary infections. The most common gastrointestinal bacteria involved are Salmonella, Campylobacter, Yersinia, and Shigella. Reiter’s syndrome is characterized by a triad of arthritis, conjunctivitis, and urethritis, although not all three symptoms occur in all affected individuals.[8]
Although the initial infection may not be recognized, reactive arthritis can still occur. Reactive arthritis typically involves inflammation of one joint (monoarthritis) or four or fewer joints (oligoarthritis), preferentially affecting those of the lower extremities; the pattern of joint involvement is usually asymmetric. Inflammation is common at enthuses—i.e., the places where ligaments and tendons attach to bone, especially the knee and the ankle.
Salmonella has been the most frequently studied bacteria associated with reactive arthritis. Overall, studies have found rates of Salmonella-associated reactive arthritis to vary between 6 and 30%.[9]  The frequency of post-infectious Reiter’s syndrome, however, has not been well described.  In a Washington State study, while 29% developed arthritis, only 3% developed the triad of symptoms associated with Reiter’s syndrome.[10]  In addition, individuals of Caucasian descent may be more likely those of Asian descent to develop reactive arthritis,[11] and children may be less susceptible than adults to reactive arthritis following infection with Salmonella.[12]
A clear association has been made between reactive arthritis and a genetic factor called the human leukocyte antigen (HLA) B27 genotype. HLA is the major histocompatibility complex in humans; these are proteins present on the surface of all body cells that contain a nucleus, and are in especially high concentrations in white blood cells (leukocytes). It is thought that HLA-B27 may affect the elimination of the infecting bacteria or an individual’s immune response.[13] HLA-B27 has been shown to be a predisposing factor in one-half to over two-thirds of individuals with reactive arthritis.[14]  While HLA-B27 does not appear to predispose to the initial infection itself, it increases the risk of developing arthritis that is more likely to be severe and prolonged. This risk may be slightly greater for Salmonella and Yersinia-associated arthritis than with Campylobacter, but more research is required to clarify this.[15]
B.        Irritable Bowel Syndrome
A recently-published study surveyed the extant scientific literature and noted that post-infectious irritable bowel syndrome (PI-IBS) is a common clinical phenomenon first-described over five decades ago.[16]  The Walkerton Health Study (WHS) further notes that:
Between 5% and 30% of patients who suffer an acute episode of infectious gastroenteritis develop chronic gastrointestinal symptoms despite clearance of the inciting pathogens.[17]
In terms of its own data, the “study confirm[ed] a strong and significant relationship between acute enteric infection and subsequent IBS symptoms.”[18]  The WHS also identified risk-factors for subsequent IBS, including:  younger age; female sex; and four features of the acute enteric illness—diarrhea for > 7days, presence of blood in stools, abdominal cramps, and weight loss of at least ten pounds.[19]
Irritable bowel syndrome (IBS) is a chronic disorder characterized by alternating bouts of constipation and diarrhea, both of which are generally accompanied by abdominal cramping and pain.[20]  In one recent study, over one-third of IBS sufferers had had IBS for more than ten years, with their symptoms remaining fairly constant over time.[21]  IBS sufferers typically experienced symptoms for an average of 8.1 days per month.[22]
As would be expected from a chronic disorder with symptoms of such persistence, IBS sufferers required more time off work, spent more days in bed, and more often cut down on usual activities, when compared with non-IBS sufferers.[23]  And even when able to work, a significant majority (67%), felt less productive at work because of their symptoms.[24]  IBS symptoms also have a significantly deleterious impact on social well-being and daily social activities, such as undertaking a long drive, going to a restaurant, or taking a vacation.[25]  Finally, although a patient’s psychological state may influence the way in which he or she copes with illness and responds to treatment, there is no evidence that supports the theory that psychological disturbances in fact cause IBS or its symptoms.[26]
AGING
Morbidity and mortality in the elderly from infectious disease, generally, is far greater than in other populations.  For instance, death rates for infectious diarrheal disease alone are five (5) times higher in people over 74 years of age than in the next highest group, children under four (4) years of age, and fifteen times higher than the rates seen in younger adults.  Published studies attribute the elderly’s heightened risks, both of infection and mortality due to enteric infectious disease, to several factors:  (1) the aging of the gastrointestinal tract (reduced gastric acidity/reduced gastric motility); (2) a higher prevalence of underlying medical disorders (co-morbidity factors); and (3) malnutrition and a decline in the immune response that leaves the host less able to defend itself against infectious agents.
A.        Aging of the Gastrointestinal Tract—An Invitation to Infection
Inflammation and shrinkage of the gastric mucosa increase with age.  These changes lead to low gastric acidity.  In patients with gastric ulcer disease, the drugs used to treat the condition further block gastric acid production.  Because stomach acids play an important role in limiting the number of bacteria that enter the small intestine, low gastric acidity increases the likelihood of infection if a pathogen is ingested with food or water.
Gastrointestinal motility (peristalsis) decreases with age.  Peristalsis, which is the mechanism that propels the stomach contents through the intestinal tract, is also the mechanical means for removing ingested, life-threatening pathogens.  The risk of infection by potentially invasive pathogens corresponds with the duration of contact between the pathogen and the intestinal mucosa.  Thus, a decrease in peristalsis delays the clearance of the pathogen from the intestinal tract and contributes substantially to the increased prevalence and severity of infection in the elderly.
B.        A Higher Prevalence of Underlying Medical Conditions—Co-Morbidity Factors
Underlying medical conditions or disease (co-morbid factors) also contribute to the morbidity and mortality of infection in the elderly.  Among hospitalized patients, those older than 65 develop pneumonia twice as often as younger patients due to poor nutrition, neuromuscular disease (poor cough reflex and aspiration), pharyngeal colonization, depressed level of alertness, endotracheal intubation, intensive care unit admission, nasogastric tube use, and antacid use.  Pneumonia is the leading infectious cause of death in the elderly.
Atherosclerosis, another common co-morbid disease, compromises circulation and blood flow to the peripheral tissues and the skin, particularly in elderly individuals who are hospitalized and bedridden with an infectious illness.  Unfortunately, it is the skin and the previously discussed mucous membranes that serve as the body’s first line of defense against invasion by infectious microorganisms.  Loss of the integrity of the skin may result in the development of pressure ulcers, which are warm, moist mediums for infectious microorganisms to rapidly multiply and are associated with a number of infectious complications.
When an infectious microorganism, regardless of source, gains access to the bloodstream, the patient may develop systemic sepsis, also known as bacteremia.  Bacteremia is most common in people who are already affected by, or are being treated for, some other medical problem (co-morbid disease); conversely, people in good health with strong immune systems rarely develop bacteremia.  The main sources of bacteremia in elderly patients are the urinary tract, gastrointestinal tract, respiratory tract, and the skin.  Other potential sources include surgical wounds, invasive tubes and catheters, intravenous lines—virtually any site where an invasive medical procedure has occurred.  Bacterial organisms most likely to cause bacteremia include members of the Staphylococcus, Streptococcus, and Escherichia coli genera.  Because bacteremia is far more prevalent in those with co-morbid conditions, which group is substantially populated by the elderly, the presence of co-morbid conditions is clearly a determinant of the mortality associated with infectious disease.
C.        A Weakened Immune System—the Inability to Fight off Infection
With advancing age come progressive weakness, decline, and dysfunction of the immune system.  Many of the body’s natural physiologic responses to infection are therefore blunted in the elderly; and the intensity of many clinical signs and symptoms in an elderly patient with an infectious process are heightened when compared to those in a younger person.  This age-related decline contributes significantly to the increased risk of severe illness and mortality in elderly persons with infectious disease.
The effect of a weakened immune response on the health of an elderly person often manifests most apparently during periods of intense stress (e.g., surgery, sepsis, multiple organ failure, malnutrition, dehydration).
[1]           Grimont, PAD, Weill, F. Antigenic formulae of the Salmonella serovars, 2007, 9th Edition. WHO Collaborating Centre for Reference and Research on Salmonella. Paris: Pasteur Institute. http://www.pasteur.fr/ip/portal/action/WebdriveActionEvent/oid/01S-000036-089.
[2]           http://www.cdc.gov/ncezid/dfwed/PDFs/SalmonellaAnnualSummaryTables2009.pdf, Table 1.
[3]           Id.
[4]           O’ Mahony, et al., An outbreak of Salmonella Heidelberg infection associated with a long incubation period, J. Public Health (1990) 12 (1): 19-21;  Abe, et al., Prolonged Incubation Period of Salmonellosis Associated with Low Bacterial Doses, J. Food Protection (2004) Vol. 67, No. 12; 2735-2740.
[5]           See J. Lindsey, “Chronic Sequellae of Foodborne Disease,” Emerging Infectious Diseases, Vol. 3, No. 4, Oct-Dec, 1997.
[6]           Id.
[7]           Id. See also, Dworkin, et al., “Reactive Arthritis and Reiter’s Syndrome following an outbreak of gastroenteritis caused by Salmonella enteritidis,” Clin. Infect. Dis., 2001 Oct. 1;33(7): 1010-4; Barth, W. and Segal, K., “Reactive Arthritis (Reiter’s Syndrome),” American Family Physician, Aug. 1999, online at www.aafp.org/afp/990800ap/499.html.
[8]           Hill Gaston JS, Lillicrap MS.  (2003).  Arthritis associated with enteric infection. Best Practices & Research Clinical Rheumatology.  17(2):219-239.
[9]           Id.
[10]          Dworkin MS, Shoemaker PC, Goldoft MJ, Kobayashi JM.  “Reactive arthritis and Reiter’s syndrome following an outbreak of gastroenteritis caused by Salmonella enteritidis.  Clin. Infect. Dis. 33(7):1010-1014.
[11]          McColl GJ, Diviney MB, Holdsworth RF, McNair PD, Carnie J, Hart W, McCluskey J, “HLA-B27 expression and reactive arthritis susceptibility in two patient cohorts infected with Salmonella Typhimurium,”  Australian and New Zealand Journal of Medicine 30(1):28-32 (2001).
[12]          Rudwaleit M, Richter S, Braun J, Sieper J, “Low incidence of reactive arthritis in children following a Salmonella outbreak,” Annals of the Rheumatic Diseases. 60(11):1055-1057 (2001).
[13]          Hill Gaston and Lillicrap, supra Note 7.
[14]          Id.; Barth WF, Segal K., “Reactive arthritis (Reiter’s syndrome).” American Family Physician.  60(2):499-503, 507 (1999).
[15]          Hill Gaston and Lillicrap, supra Note 7.
[16]          J. Marshall, et al., Incidence and Epidemiology of Irritable Bowel Syndrome After a Large Waterborne Outbreak of Bacterial Dysentery, Gastro., 2006; 131;445-50 (hereinafter “Walkerton Health Study” or “WHS”). The WHS followed one of the largest E. coli O157:H7 outbreaks in the history of North America. Contaminated drinking water caused over 2,300 people to be infected with E. coli O157:H7, resulting in 27 recognized cases of HUS, and 7 deaths. Id. at 445.  The WHS followed 2,069 eligible study participants. Id.  For Salmonella specific references, see Smith, J.L., Bayles, D.O., Post-Infectious Irritable Bowel Syndrome: A Long Term Consequence of Bacterial Gastroenteritis, Journal of Food Protection. 2007:70(7);1762-1769.
[17]          Id. at 445 (citing multiple sources).
[18]          WHS, supra note 34, at 449.
[19]          Id. at 447.
[20]          A.P.S. Hungin, et al., Irritable Bowel Syndrome in the United States: Prevalence, Symptom Patterns and Impact, Aliment Pharmacol. Ther. 2005:21 (11); 1365-75.
[21]          Id. at 1367.
[22]          Id.
[23]          Id. at 1368.
[24]          Id.
[25]          Id.
[26]          Amy Foxx-Orenstein, DO, FACG, FACP, IBS—Review and What’s New, General Medicine 2006:8(3) (Medscape 2006) (collecting and citing studies).  Indeed, PI-IBS has been found to be characterized by more diarrhea but less psychiatric illness with regard to its pathogenesis. See Nicholas J. Talley, MD, PhD, Irritable Bowel Syndrome: From Epidemiology to Treatment, from American College of Gastroenterology 68th Annual Scientific Meeting and Postgraduate Course (Medscape 2003).
Salmonella:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Salmonella outbreaks. The Salmonella lawyers of Marler Clark have represented thousands of victims of Salmonella and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Salmonella lawyers have litigated Salmonella cases stemming from outbreaks traced to a variety of foods, such as cantaloupe, tomatoes, ground turkey, salami, sprouts, cereal, peanut butter, and food served in restaurants.  The law firm has brought Salmonella lawsuits against such companies as Cargill, ConAgra, Peanut Corporation of America, Sheetz, Taco Bell, Subway and Wal-Mart.
If you or a family member became ill with a Salmonella infection, including Reactive Arthritis or Irritable bowel syndrome (IBS), after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Salmonella attorneys for a free case evaluation.

 

 

 

 

Internet Journal of Food Safety (Operated by FoodHACCP)
[2014] Current Issues

Vol 16.59-67
Antimicrobial action of essential oils against food borne pathogens isolated from street vended fruit juices from Baripada Town, India
Chandi C. Rath and P. Bera

Vol 16.53-58
Conventional Microbiology, Salmosyst Method and Polymerase Chain Reaction
: A Comparison in the Detection of Salmonella spp. in Raw Hamburgers
Jorge Luiz Fortuna, Virginia Léo de Almeida Pereira, Elmiro Rosendo do Nascimento andRobson Maia Franco


Vol 16.45-52
Impact of Traditional Process on Hygienic Quality of Soumbala a Fermented Cooked Condiment in Burkina Faso.
Marius Kounbesioune Somda, Aly Savadogo, Francois Tapsoba, Cheikna Zongo,
Nicolas Ouedraogo, Alfred Sabadenedyo Traore

Vol 16.36-44
Prevailing Food Safety Practices and Barriers to the Adoption of the WHO 5-Keys
to Safer Food Messages in Rural Cocoa-Producing Communities in Ghana
Rose Omari, Egbert Kojo Quorantsen, Paul Omari, Dorothy Oppey, Mawuli Asigbee

Vol 16.29-35
Microbiological Quality of Meat at the Abattoir and Butchery Levels in Kampala City, Uganda
Paul Bogere and Sylvia Angubua Baluka
Vol 16.26-28
Microbial Contamination of Raw Fruits and Vegetables
Ankita Mathur , Akshay Joshi* , Dharmesh Harwani


Vol 16.17-25
Consumer Food Safety Awareness and Knowledge in Nigeria
Olasunmbo Abolanle Ajayi and Taiwo Salaudeen
Vol 16.12-16
Microbiological Quality of Selected Meat Products from the Canterbury Region of New Zealand
Rui Huan, Christopher O. Dawson, Malik Altaf Hussain


Vol 16.9-11
NUTRITIVE COMPOSITION OF CHANNA STRIATUS FISHES AFTER 2,4-D PESTICIDE TREATMENT
Anusuya, S.Hemalatha


Vol 16.6-8
Effect of 2,4-D Pesticide on Fish Physiology and its Antioxidant Stress
Anushiya, Hemalatha

Vol 16.1-5
Edible Coatings of Carnauba Wax ??A Novel Method For Preservation and Extending Longevity of Fruits and Vegetables- A Review.
Puttalingamma .V

 


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