Category Archives: Food-borne illness

A Pig from Jersey

The last Saturday of June, 1957, having finished my internship, I left Lansing, MI, about midnight in my little VW with orders to report to CDC in Atlanta at 8:00 AM Monday to begin my two years of service in the US Public Health Service. I was to audit the course for the Epidemic Intelligence Service before reporting to the Technical Development Laboratory in Savannah, GA. The EIS course was founded and taught by Alexander Langmuir. Langmuir was a bigger than life, charismatic story teller who quickly made me feel that epidemiology was the most fascinating subject available to mere humans. There were maybe 40 or 50 of us taking the course and in front of our assigned seats there was a stack of reading material that looked generally pretty serious. But on the top of the stack there was a small paperback book with the title “Eleven Blue Men” by Berton Roueche. It looked strangely out of place and unserious and I put it aside for later.

I don’t remember when “later” arrived, but when it did, I was treated to a series of fascinating articles of which the Jersey pig was the first. It concerned a schlachtfest being held at the New York Labor Temple, a German-American meeting-and-banquet hall. A schlachtfest, for those of you uninitiated, is a pork feast. The pig in question was purchased by a butcher in Staten Island and the carcass was taken to the Labor Temple in Manhattan where it was converted into sausage among other things. One of the men involved in this escapade had eaten some of the raw sausage to check on the seasoning, and the rest is history. The man became very ill with fever (he later died) and the physician, a Dr Levy, came to the diagnosis when he discovered an elevated eosinophil count in his blood smear. It was then confirmed by a muscle biopsy which showed numerous Trichinella spiralis parasites.

Trichinosis is one of the many parasites one studies about in Microbiology, but I had never seen a case until some years ago when I was assisting in an outpatient laboratory here in Salt Lake City. I didn’t see the patient myself but I heard her story second-hand. This young lady had been on vacation in Hawaii and had been invited to a luau. The luau was the genuine thing apparently with a whole roast pig on a rotisserie above a fire. Everybody enjoyed the fresh roast pork. Except that the young lady in question arrived somewhat late to the proceedings and her portion of pork was from a more interior portion of the carcass that had not been adequately heated to kill the larvae.

Here the details are sketchy but she apparently had the usual GI symptoms followed by severe muscle pain. By this time she was back home in Salt Lake City and her doctor ordered the usual lab tests including a CBC. Thus the blood smear that showed more eosinophils than I had ever seen before. This was some time in the 1970s and I don’t remember the percentage of eosinophils
but I think it may have been around 30%, about 10 times normal. The smear was lit up with red lights like a Christmas tree. That number of eosinophils doesn’t define trichinosis but it certainly is highly suggestive.

Today trichinosis is very rare, but it is just the rare diseases we don’t think of that can rear their ugly heads and bite us in the rear. Tricky trichinosis. Maybe the ancient Hebrews knew something important. Whatever. May Trichinella spiralis rest in peace and bother us no more.

Gordon Short, MD
Brevis Corporation


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September is Food Safety Month

September is National Food Safety Month and because everybody eats, everybody should be reminded about the importance of safe food handling. Safe food handling is critical of course for those who prepare your food, but the food-consumer should be careful not to introduce microbial pests while eating. Proper hand-washing is the common denominator of effective infection prevention. To help you with your mission of promoting food-safety and infection prevention Brevis is holding a September Special.

Sick Facts

  • Foodborne illnesses cost the U.S. about $78 billion per year.
  • Each year, approximately 1 in 6 Americans gets foodborne illness.
  • Foodborne illnesses result in over 3,000 deaths each year.
  • 68% of outbreaks occur at restaurants.
    Sourced from CDC.gov

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Clean hands, safe food, healthy people.

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Food Safety (CDC.gov)

Prevention always starts with good hand hygiene

Searching for the cause of an E Coli outbreak can send investigators in many different directions. This is a reminder that good hand hygiene practices and proper food preparation are of utmost importance. E Coli can be found in contaminated soil or water but it can also be spread through infected people. Germs that make us sick are everywhere and while we cannot always control where or how our food is grown we can control how we prepare it and make sure our hands are clean when doing so. Check out these links to the latest news on the Romain lettuce E Coli outbreak and the CDC which both reference person-to-person contact and the importance of hand washing.

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4 Tips for a Safe Summer Picnic

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With summer in full swing you’ve probably attended a picnic or two. Don’t let the great outdoors leave you vulnerable to germs and infection. Here are 4 tips to have a healthy summer picnic:

 

Keep cold food cold. Use gel packs or ice in your cooler to keep cold food at or below 40 ℉ and prevent the growth of bacteria.

 

Keep hot food hot. When grilling, cook your food thoroughly and keep it hot until serving. You may want to bring your food thermometer: the safe temperature for ground beef is 160 ℉, and for chicken it’s 165 ℉.

 

Make sure all food prep and eating surfaces are clean. Use disinfecting wipes to clean tables and chairs. Keep plates and utensils clean, and avoid cross-contamination while preparing food.

 

Have everyone wash their hands! Before preparing and eating food (and after touching most anything outdoors) simple soap and clean water from a jug will do for an outdoor handwashing. Moist towelettes are also a good option.

 

Hand-washing remains the most effective prevention against the spread of germs in home and community settings. For extra confidence in your family’s hand-washing abilities, use GlitterBug Gel or Potion, and help everyone enjoy the rest of a safe, healthy summer.

 

Source: http://www.fda.gov/Food/ResourcesForYou/Consumers/ucm109899.htm

Antibiotics in the foods we eat: Why the drugs are losing their power

The Centers for Disease Control (CDC) and the World Health Organization (WHO) have called for an end to the nontherapeutic use of drugs in animals that are used to treat human disease. Why? The short answer is giving healthy livestock these drugs breeds superbugs that can infect people.

Here’s a great explanation from the Union of Concerned Scientists: “Bacteria become resistant to antibiotics through overexposure to them. Hardy strains of the bacteria survive the exposure and pass on that resistance trait to successive generations. And they also pass the trait across to other bacteria that are unrelated, including some that cause human disease. Eventually the antibiotic wipes out all the vulnerable bacteria, and only resistant bacteria remain. Then the drug is no longer effective.”

The U.S. Food and Drug Administration (FDA) started testing retail meat and poultry for antibiotic-resistant bacteria in 1996. It was not until 2008, however, that Congress required companies to report the quantity of antibiotics they sold for use in agriculture to the FDA. Why is that so important? According to a report from the New York Times, “In 2011, drugmakers sold nearly 30 million pounds of antibiotics for livestock — the largest amount yet recorded and about 80 percent of all reported antibiotic sales that year. The rest was for human health care.”

That’s right, 80 percent of antibiotics are being used for livestock! That means the meat and poultry we humans eat give resistant bacteria a direct route to us — right through the grocery store and into our kitchens. But combating resistance requires monitoring both the prevalence of antibiotic-resistant bacteria in our food, as well as the use of antibiotics on livestock.

In March of this year, McDonald’s announced a plan to require chicken suppliers to stop using antibiotics important to human medicine within two years. Chicken supplier Tyson Inc. reported they’ll also stop giving chickens the same antibiotics used by humans; Tyson noted it has reduced the use of antibiotics effective in humans by more than 84 percent since 2011. The National Chicken Council also released a statement that says chicken producers have been working to phase out the use of antibiotics important in human medicine to promote growth in animals.

Restaurant chains Chipotle and Panera already say they serve chicken raised without antibiotics, but the announcement by McDonald’s is notable because of its size. McDonald’s has more than than 35,000 locations on Earth, and the U.S. has the highest concentration of them — about one for every 20,000 residents according to The Guardian’s Datablog. Compare that to Chipotle’s nearly 1,800 U.S. locations and Panera’s almost 1,900 U.S. locations.

There is more than enough scientific evidence to justify curbing the rampant use of antibiotics for livestock, yet the food and drug industries are fighting proposed legislation to reduce these practices. What do you think about antibiotic use in agriculture and livestock? Should they all move to using drugs that are not considered medically important for humans? Share your insights now in the comments section.

 

The filthy dirty truth about handwashing and hygiene in public restrooms

hygiene habits in public restrooms

We’ve all been there: You have to “go” and you’re nowhere near home so you have a choice: shame yourself or (gasp!) use a public restroom. So you consult a phone app to find the closest clean restroom (yes, there are several apps) and enroute to your designated clean loo you strategize how to get your business done and come out unscathed. How do you get IN or OUT of the restroom without touching the door handle, for instance? Do you use your elbow? Do you grab a tissue or moist wipe from the pack you always keep handy? Same goes for the stall door. And what if the seat is in the wrong position? You can always employ the squat-and-hover method and flush the toilet with your foot.

Discussing the variations is like watching a skit on Saturday Night Live. Let’s say you flushed the toilet with your foot. Well, that means the next person might use their hands and whatever was on your shoe is now on their hands. And vice versa. You used a paper towel to open the door, but there’s no garbage to dispose of the now dirty towel…so where do you put it? And let’s say you placed your handbag or backpack on the hook on the stall door, but what was on the hook before you got there? Because you may be taking it with you. It’s a vicious cycle. Is there a solution?

After one of the largest handwashing surveys in the UK revealed some “deplorable habits” recently, a company there launched a product to promote hand hygiene and shame bad hygiene by displaying rates on screens in bathrooms. The product was piloted across different types of businesses such as education, office and retail facilities as well as other sectors where good hand hygiene is essential—and the company claims the “informal nudge” and increased peer pressure helped drive good behavior rates up dramatically. “Hand washing rates rose to 90 per cent within two days of the data being displayed, before stabilising between 80 per cent and 85 per cent.”

Of course, we never tire of handwashing discussions around here. Now, another new survey from restroom fixture manufacturer Bradley Corporation has gone and given us more fodder by covering the actions many of us take to avoid touching anything in a restroom. Sounds oddly familiar and we’re not alone: 57% of people using public restrooms operate the flusher with their foot; 55% use paper towels with the door handle; 45% open and close the door with behind (we assume that’s a hip or bum); and 69% of people use their elbows to avoid all contact in a public restroom.

We look forward to a world where 100% of respondents are washing their hands, but in the meantime we’ll take an increase in people using paper towels, elbows, feet and bums, too.  Of course, there’s always room for improvement when it comes to the state of public restrooms. In fact, an unpleasant restroom experience can create a damaging and lasting impression for a business—and that’s bad for business. According to the Bradley survey, the majority of consumers believe an unclean restroom indicates poor management (69%), lowers their opinion of the company (67% ) and signifies that the business doesn’t care about customers (63%).

Which brings us to another improvement we’re thrilled to see in the business of taking care of our business: clean public restroom apps. There are several out there and we’re not making a recommendation, but it can’t be worse than going to a public restroom without some kind of head’s up.

  • Sit or Squat is brought to you by none other than Charmin, the makers of toilet paper and it has one purpose: to identify bathrooms around you and let you know if they’re nice and clean . . . or not so nice. This app is crowd-sourced, but it receives mixed feedback from users.
  • Toilet Finder uses the slogan “May the flush be with you” and claims its database to includes more than 70,000 public-accessible restrooms.
  • Whizzer claims to be the ultimate bathroom locator and lets you search by current location to find clean restrooms, those that are open late at night, and those with showers. You can also search to include baby changing stations, feminine hygiene products, and can even specify just how clean you want the restroom to be. You can even follow them on Twitter!
  • Diaroogle.com calls themselves “the premier toilet search engine” and when the time comes for us to go, we really hope they’re right.
  • Bathroom Scout offers turn-by-turn navigation can lead you directly to blessed relief. If imagery is available on street view, “Bathroom Scout” can also show you the location around the bathroom, providing added peace of mind.
  • Where to Wee is an app that helps you find and rate restrooms worldwide. “Whether it’s a road-trip that never seems to end, or an endless line in front of the women’s restroom: when you gotta go, you gotta know.

Guess who’s coming to dinner? Salmonella and other food-borne illnesses if Senator Tillis has anything to say about it.

Handwashing is required by restaurant workers

Is requiring food workers to wash their hands after using the bathroom an onerous government intrusion? Senator Thom Tillis of North Carollina thinks so.

During a recent appearance at the Bipartisan Policy Center, Senator Tillis stated that businesses are bogged down by government regulations, so he thinks restaurants should be able to opt-out of the requirement that employees wash their hands after using the restroom—as long as they let customers know.

Tillis told the story of a time a woman asked him if hand washing wasn’t the sort of regulation that needed to be on the books. With his right hand raised for emphasis, Tillis concluded that in his example most businesses who posted signs telling customers their food workers didn’t have to wash their hands would likely go out of business. Tillis’s example takes pressure off businesses to provide safe food, and forces consumers to judge every meal’s likelihood of making them violently ill. Ah, the free market!

In case you didn’t know, the FDA requires handwashing and here’s why: “Proper handwashing reduces the spread of fecal-oral pathogens from the hands of a food employee to foods.” Gross! Recently, a restaurant in Mercer County, New Jersey was cited for handwashing violations—just a month before a worker tested positive for hepatitis A. The Centers for Disease Control and Prevention says hepatitis A is spread when an infected person doesn’t wash his or her hands after going to the bathroom and touches other objects or food.

In 2013, an All American Grill in Tillis’s home state gave a hundred people salmonella. The health department identified several health violations that could have contributed to food cross-contamination, including the fact that the hand washing sink was out of paper towels and soap, and didn’t have sufficiently hot water, all factors that “could serve as a deterrent to hand washing or render it ineffective,” according to the department. In that situation that market didn’t take care of the safety risks—100 ill guests and employees did.

Tillis was the butt of a lot of jokes after his comments went public. Jon Stewart even did this segment “Mr. Unclean,” on The Daily Show. Says Stewart, “You do realize that that’s a regulation too, right? … That’s not getting rid of a regulation, that just makes you an inconsistent ideologue with a light fecal dusting in your latte.”

Telling people to wash their hands never gets old around here. If workers are serving food and not washing their hands, they’re also serving up germs and sickness. So if free-market ideology means we can’t go out to eat without worrying about getting sick we’ll just stay home for dinner.

What’s for dinner? You’re twice as likely to get sick eating at a restaurant.

Food-borne illness in restaurants

Cook at home or go out for dinner? Hungry Americans contemplate their options millions of times a day and going out for dinner wins out frequently. If you’re eating at restaurants, though, you’re twice as likely to get a food-borne illness. In fact, sit at a table with five friends or family members and you can expect that one of you will get sick.

It seems almost nonsensical (not to mention gross) that delicious, healthy foods—especially “real” foods, with all its life-sustaining and delicious qualities—can be tainted with deadly bacteria. Yet there are a whopping 250 different microbes or toxins that can cause foodborne illness (although 90 percent of the known outbreaks are caused by just seven microbes, including Salmonella and E. coli.) This year in the U.S. alone, 48 million people will get sick from contaminated food and roughly 3,000 Americans will die because of a pathogen in something they ate.

If you’re thinking about jumping into some cooking courses and staying “in” to eat for the rest of your mortal life, though, that’s not the solution. Although the issues restaurants face during food preparation are vastly different from a home cook’s, eating at home is a danger, too. A recent survey from the Center for Science in the Public Interest (CSPI) that says you’re chances of getting sick are doubled at restaurants probably doesn’t have all of the data (we’re pretty sure most people don’t report their mother or grandmother for giving them home-cooked illnesses), so don’t panic. Just keep a few key things in mind.

The National Restaurant Association depends on safe ingredients and the industry has trained more than 5.6 million food service workers in the safe handling and serving of food. That’s very. Very good. A few specific food items bear a large burden for food-borne illnesses, too, so be wary. Raw milk, for instance was linked to 104 outbreaks last year. And while your mouth is watering over the menu at your favorite diner, consider these tips (as strange as they may seem):

1. Stick to ordering the “popular” dishes on the menu. The turnover of these menu items is higher, so it’s far less likely that the food has been lying around in a fridge for a while.

2. If the Monday special is the catch of the day, don’t order it! In fact, NEVER order fish on a Monday. Chances are the chef bought it for their busy Saurday ight, but didn’t sell it, so it’s on been sitting in the fridge since then.

3. Ask to see the kitchen. If you think that’s overstepping your bounds, you’re dead wrong. Do you buy shoes without trying them on? The kitchen where your food is prepared is no different. It’s all part of the package you’re paying for and you don’t want to pay by getting sick!

4. Beware of menu specials. Ideally, they’re created with amazing produce or some farm-raised beef the chef has had his eye on. Unfortunately, specials also often the way restaurants move old stock. They dress it up, give it a new name, and voila—potential food-borne bacteria.

5. Put your nose down into that plate of food and really breathe in. Does it smell aromatic? Then dig in. If it doesn’t smell the way food should, send it back!

When you eat at home, make certain the food you’re buying, preparing, and cooking is safe, too. How? The nonprofit food safety watchgroup (the “food police”) has also published the definitive consumer’s guide to avoiding foodborne illness. Written by Sarah Klein, the senior food safety attorney for CSPI, From Supermarket to Leftovers: A Consumer’s Guide to Buying, Preparing, Cooking and Storing Food Safely offers tips for avoiding disease-causing microbes that can make you acutely ill.

Beware the Daily Catch