Category Archives: foodbourne outbreak

Research – Collective food poisoning (TIAC) ​​with E. coli O157 producing Shiga toxins, associated with the consumption of raw cucumbers

Sante Publique

On September 9, 2021, the Regional Health Agency (ARS) of Hauts-de-France was informed of a suspicion of collective food poisoning (TIAC) ​​affecting half-board students, educated in several schools in a municipality. of the Lille metropolis. On September 13, 2021, two cases of hemolytic and uremic syndrome (HUS) were diagnosed in two hospitalized children attending school in this town. Public Health France Hauts-de-France was asked by the Hauts-de-France ARS to provide support for the investigations and management of this TIAC. A total of 35 cases of gastroenteritis, with bloody diarrhea and fever (>38°C) in half of the cases, were identified. Ten cases were hospitalized and two children developed HUS. The cases identified were half-board students in four school groups (29 cases), a parent of a student and elderly people benefiting from the municipality’s home meal delivery service (5 cases). The case canteens were all supplied by the central municipal kitchen. The shape of the epidemic curve was in favor of a common and point source of contamination during meals on September 2 or 3, 2021. The case-control survey, carried out in schools, concluded that only the consumption of cucumbers in salad, served with the meal on September 2, was statistically and significantly associated with the occurrence of the disease. A strain of E. highly pathogenic Shiga toxin-producing (STEC) O157 coli was isolated from the stool cultures of eight cases, including the two children who developed HUS and in the offending cucumber salad. Genomic analysis of the strains confirmed the genetic clustering of clinical and food strains that belonged to the same genomic cluster. The veterinary investigation revealed that a failure in the decontamination process, associated with incomplete peeling of the contaminated cucumbers, contributed to the occurrence of this TIAC. The cucumbers in question came from Belgium and the Belgian health authorities were informed via the dedicated European alert circuits. No other episodes of clusters of STEC infection related to this TIAC have been reported to the ARS over the period while cucumbers from the same batch had been widely distributed in communities and commercial catering services in the Hauts-de-France region. The food vehicle, incriminated in this TIAC, is part of the plants at risk because of its raw mode of consumption. It is important to remind vulnerable populations and collective catering services that preventing the risk of STEC infection, linked to the consumption of raw vegetables, requires washing, disinfection and peeling.

Research – Spread of Hepatitis A virus strains of genotype IB in several EU countries and the United Kingdom – including foodborne spread

ECDC

As of 29 September 2022, 303 cases with identical or closely related HAV strains have been identified in Austria (7), Germany (8), Hungary (161), the Netherlands (8), Slovenia (35), Sweden (8), and the UK (76). Currently available epidemiological and microbiological data suggest that human-to-human transmission has occurred, and possibly also transmission through contaminated food.

On 15 February 2022, Hungary reported an outbreak of HAV genotype IB with the disease onset of the first case in early December 2021. To date, 161 cases (139 males, 22 females) have been confirmed with this strain in the National Hepatitis Reference Laboratory in Hungary. The weekly number of reported hepatitis A cases have been declining since June 2022. Several infected people identified themselves as men who have sex with men (MSM), suggesting possible transmission among sexual contacts. Several patients have been hospitalised.

In July 2022, a foodborne outbreak was suspected with a link to a restaurant in Hungary, where 16 people fell ill with HAV IB infection. Some of the patients reported consuming cold soup made with frozen berries. In the UK, no clear source of infection has been identified, but epidemiological investigations so far indicate possible foodborne infections in addition to person-to-person transmission. Germany, the Netherlands, and Sweden have reported a total of nine cases infected with strains matching the sequences of the UK strain. Investigations of these cases didn’t find any clear risk factors for infection such as a travel history or consumption of berries. Further investigations are ongoing.

HAV is highly transmissible through contaminated water, food, and via the faecal–oral route among close contacts (e.g. household contacts, sexual contacts, and contacts in day-care centres or schools), with an average incubation period of four weeks, ranging from two to six weeks. The virus is highly resistant to environmental conditions as well as to several preservation methods like acidification or freezing. Therefore, possible food-borne transmission should be investigated when several cases are reported within a short period.

Practising good hand hygiene – including thoroughly washing hands with soap after using the bathroom, changing nappies, and before preparing or eating food – plays an important role in preventing the spread of hepatitis A. Scaling up surveillance to detect and investigate sporadic and clusters of cases possibly associated with foodborne transmission in collaboration with food safety authorities is essential.

MSM are at risk of HAV infection when engaging in sexual practices that facilitate faecal-oral transmission of the virus. Hepatitis A vaccination, which is safe and highly effective, is the main option for response in the context of the current circulation of HAV genotype IB among MSM. The World Health Organisation and most EU/EEA countries recommend hepatitis A vaccination for MSM.

Besides vaccination, other options can contribute to the prevention of transmission among MSM: the use of condoms for anal sex, which have the additional benefit of offering protection against other sexually transmitted infections and good personal hygiene (e.g. washing hands and genital areas before and after sex). For the provision of primary prevention advice, authorities should consider engaging with civil society, social media, media outlets and dating apps to raise awareness among MSM about the risk of contracting HAV and the importance of vaccination. MSM who have already contracted the infection should be referred to sexual health services for further testing.

Research – Increase in food outbreaks by Escherichia coli. How to prevent them

ACSA

In recent months, outbreaks caused by Escherichia coli have increased (Ireland, Scotland, etc.). Recently, in France, pizzas contaminated by this bacterium affected 56 people─ including 55 small children─ and caused two deaths.

This bacterium is naturally present in our digestive microflora. Although most strains of E. coli  are harmless to humans, others can cause infections or carry antibiotic resistance genes. Among the pathogenic strains, shigatoxigenic E. coli is responsible for serious infections in children and the elderly.

Ruminants, especially cattle, are healthy carriers of these bacteria. Therefore, the bacteria present in their excrement can contaminate animal products (meat and dairy) and the environment (soil and water). Contamination occurs, for example, in the meat slaughterhouse (through the remains or after the evisceration of the animals) or at the time of milking the milk of cattle, sheep or goats.

With regard to plants, this contamination can occur during the spreading of manure or livestock effluents on farmland, or during the use of contaminated irrigation water.

The main foods implicated in outbreaks of shigatoxigenic E. coli infections are undercooked minced beef, non-pasteurized dairy products (raw milk and raw milk cheeses), raw vegetables (salad, young shoots, sprouts), unpasteurized fruits or vegetables and contaminated drinking water .

Throughout the food chain, the management of this risk is based on the application of effective self-controls and the verification of the effectiveness of the measures implemented.

With regard to the consumer, the prevention of infections through food is based on the application of the following measures:

  • Wash hands with soap and water when leaving the toilet, before preparing and eating food, and after handling raw or non-raw food.
  • Wash and peel the vegetables, if possible; and also fruits and aromatic herbs, especially those that are eaten raw.
  • For sensitive populations (young children and the elderly), thoroughly cook ground meat and ground meat products (70°C), avoid consumption of raw milk and raw milk products (except for cooked pressed cheeses), and of raw or undercooked flour.

Research-Sources and trends of human Salmonellosis in Europe, 2015-2019: an analysis of outbreak data

asca

Study published in the International Journal of Food Microbiology. The aim of this study was to determine the main food sources and recent trends of  Salmonella outbreaks in Europe. Data from outbreaks in 34 European countries during the 2015-2019 period are taken into account. 

In general, the most important food source of the salmonellosis outbreaks were eggs, pork series and meat products in general. While eggs were the most important source of infection in all regions, pork was the second most common source in Northern and Western Europe, and meat products (in general) in Eastern and Southern Europe. 

There were 939 outbreaks caused by Salmonella enteritidis , 130 by Salmonella typhimurium and its monophasic variant, 107 by other known serotypes, and 332 by other unknown types.

Complex food categories such as baked goods, buffet meals, mixed foods, sweets and chocolate, canned food products, and beverages were grouped as unknown sources in the analysis because it was not possible to identify the exact components responsible for the infection.

In total, 1,508 salmonella outbreaks were included in the analysis. Of these, 1,040 were caused by simple foods and 468 by unknown food sources. Most of the outbreaks were reported in Eastern Europe, followed by Southern, Western and Northern Europe.

Outbreaks caused by S. enteritidis (SE) and other known serotypes (other than SE and S. typhimurium and its monophasic variant [STM]) were attributed primarily to eggs, whereas outbreaks caused by STM were primarily attributed to the Pork Meat. In general, there was a significant increase in the number of reported outbreaks between 2015 and 2019, mainly due to the increase in outbreaks in Eastern Europe while, in Northern and Southern Europe, outbreaks caused by SE decreased significantly between the years 2015 and 2019. Outbreaks related to the consumption of cheese and fish are steadily declining.

Research – Summary of FDA’s Strategy to Help Prevent Salmonellosis Outbreaks Associated with Bulb Onions

FDA

Background

Onions are one of the most commonly consumed vegetables in the United States. Grown in more than 170 countries, they are also one of the most important horticultural crops worldwide. Bulb onions are characterized by having hollow, tubular, blue-green leaves and can be purchased fresh or frozen to use in cooked dishes or consumed raw as an ingredient or garnish. Bulb onions are typically dried or cured to reduce decay and increase shelf life.

In 2020 and 2021Salmonella outbreaks associated with the consumption of bulb onions produced in the U.S. and Mexico caused more than 2,100 confirmed cases of foodborne illness in the United States. The 2020 outbreak in the U.S. cost an estimated $203 million in consumer health-related losses. The 2021 outbreak in the U.S. cost an estimated $188 million in consumer health-related losses. [1]

Overview of Salmonellosis Outbreaks Associated with Bulb Onions

In 2020, the FDA’s Coordinated Outbreak Response & Evaluation (CORE) Network, in collaboration with the Centers for Disease Control and Prevention (CDC) and state and local partners, investigated a multistate outbreak of Salmonella Newport infections linked to the consumption of domestically grown red bulb onions. While no conclusive root cause could be identified, the agency’s investigation report identified several plausible opportunities for contamination including irrigation water, sheep grazing on adjacent land, and signs of animal intrusion, such as scat and large flocks of birds that may spread contamination.

In 2021, the FDA led investigations of a multistate outbreak of Salmonella Oranienberg infections linked to the consumption of red, white, and yellow bulb onions imported from the State of Chihuahua, Mexico. The FDA worked closely with Mexican competent authorities through the established Food Safety Partnership to investigate potential source(s) of contamination within the implicated region.  However, the agency was unable to conduct an on-farm investigation at the time, and no conclusive root-cause was determined.

Summary of FDA’s Strategy to Help Prevent Future Outbreaks of Salmonellosis linked to Bulb Onions[2]

Food safety is a shared responsibility. The bulb onion industry is responsible for meeting applicable food safety requirements. In addition, the FDA believes it is imperative that we share data, knowledge, and information and work collaboratively with industry and state regulators to enhance food safety and advance the goals and objectives of FDA’s Strategy for the Safety of Imported Food. Based on review of the outbreak investigational findings, historical data, and engagements with industry and other stakeholders, the agency has identified several measures that can be taken to reduce future incidences of foodborne illness related to bulb onions, including:

  • Engaging domestic and foreign industry and government partners to promote a broad understanding of the outbreak investigation findings, applicable Produce Safety Rule requirements, and the importance of root cause analysis after outbreaks.
  • Prioritizing inspections of bulb onion farms in the United States and Mexico that are covered by the FDA’s Produce Safety Rule.
  • Identifying and assessing practices and conditions associated with onion curing.
  • Supporting research efforts to better understand bulb onion production practices, including the impact of different soil conditions and curing practices on the safety of bulb onions.
  • Supporting industry-led efforts to develop and implement best practices for bulb onion production.

The agency has also identified the following additional actions specific to imported bulb onions:

  • Prioritizing Foreign Supplier Verification Program inspections of bulb onion importers to ensure that onion importers are verifying that foreign suppliers follow processes and procedures that provide the same level of public health protection as U.S. food safety requirements.
  • Increasing strategic and targeted sample collection and testing of imported bulb onions from the State of Chihuahua, Mexico.
  • Continuing to collaborate with Mexican competent authorities through the established Food Safety Partnership to help ensure the safe production of bulb onions in the State of Chihuahua, Mexico.

By implementing these activities, the FDA seeks to:

  • Encourage high rates of compliance with the applicable FDA food safety requirements across the bulb onion supply chain through education, outreach, and technical assistance to the growers, distributers, and importers of bulb onions.
  • Verify and measure the rate of industry compliance through inspections and sampling.
  • Broaden scientific knowledge about production methods that can reduce future incidences of foodborne illness related to bulb onions.

USA – Could the Wendy’s E. coli Outbreak have sickened over 2,600?

Food Poison Journal

According to the CDC, as of September 1, 2022, a total of 97 people infected with the outbreak strain of E. coli O157:H7 have been reported from six states – Indiana 11, Kentucky 1, Michigan 58, New York 1, Ohio 24, and Pennsylvania 2.  It is expected, according to the NCBI database, that the actual numbers of ill will be 115 or more shortly.  Interestingly, according to the CDC, for E. coli O157:H7, there is an underreporting rate of 26.1 – meaning for everyone 1 person counted by the CDC another 26.1 were actually sickened.

USA – FDA Core Outbreak Investigation Table

FDA

What’s New

  • For the Cyclospora outbreak in a not yet identified food (reference #1080), sample collection and analysis has been initiated and an on-site inspection has been initiated.
  • For the Salmonella Mississippi outbreak in a not identified food (reference #1097), the investigation is closed, and the outbreak has ended.
  • A new outbreak has been added to the table: Salmonella Litchfield (reference #1105) in a not yet identified food. Traceback has been initiated.
  • For the Salmonella Typhimurium outbreak in a not yet identified food (reference #1095), the case count has increased from 84 cases to 86 cases.

USA – 60 Potential Illnesses Linked to a Salmonella Outbreak in Spring Branch County – Possibly from an Event at Lost Mission?

Food Poisoning News

According to one victim in what is alleged to be an outbreak of 60+ patrons, a food poisoning outbreak (she contracted salmonella) is currently being investigated by the Bexar/Comal County Health Departments in Texas. According to one source, multiple food items were served, including Whataburger and cake, among other things.   The victim who has come forward, Sarah Castillo, however, ate chicken piccata, a Caesar salad, angel hair pasta, and green beans. According to Ms. Castillo, she began experiencing symptoms of salmonella shortly after attending a wedding at a local, and very popular, venue called Lost Mission.  Lost Mission is located in Spring Branch Texas.

The beautiful wedding, unfortunately, turned into a dismal affair for Ms. Castillo after she became ill with the symptoms and side-effects of salmonellosis. She was compelled to seek medical treatment from the Texas MedClinic Urgent Care, and then when her condition deteriorated, University Hospital in San Antonio.

Research -Austrian officials find Listeria at company linked to outbreak

Food Safety News

Officials investigating a deadly outbreak in Austria have found Listeria at the company thought to be responsible.

Listeria isolates with the same genetic fingerprint as the outbreak strain were detected in three environmental samples from the firm in Lower Austria.

Käserei Gloggnitz previously recalled all kajmak, drinking yogurt and cream cheese products because of potential Listeria monocytogenes contamination. Kajmak is a type of cheese.

The Listeria strain behind the incident does not match any of those in the AGES Listeria database, which contains more than 15,000 sequences of human, food and environmental isolates.

Cluster analyzes by the Austrian Agency for Health and Food Safety (AGES) found eight infections occurred since 2020 because of an identical Listeria strain. Three people died between 2020 and 2022.

Illnesses occurred in Vienna. The patients are five women and three men aged between 29 and 82 years old.

The outbreak strain has also been detected in a food product from the suspected company. This food was served in a restaurant mentioned when the sick people were interviewed.

The Ministry of Social Affairs, Health, Care and Consumer Protection (BMSGPK) had asked AGES to investigate the outbreak.

USA – D.C. Cobb’s linked to illness outbreak

Food Poison Journal

The McHenry County Department of Health has closed its illness outbreak survey linked to D.C. Cobb’s, 1204 N. Green Street in McHenry, and is continuing its gastrointestinal illness outbreak investigation.

After sharing the illness outbreak investigation survey on Tuesday, MCDH received 508 completed survey responses. MCDH would like to thank everyone who completed the survey for their assistance in the investigation.

The data collected from the survey and individual interviews is being analyzed to determine the scope and cause of the outbreak including whether any food items are the likely source of the illness and to identify other risk factors that contributed to the spread. Stool specimens are being collected from ill individuals to be tested to identify the type of pathogen that led to the illness.

MCDH staff is conducting a food analysis using the data collected from the survey. The food analysis involves looking at the foods that ill and well individuals ate to determine the likelihood that someone became ill after eating a particular food item. It is not always possible to determine a single food item during an outbreak investigation. This can happen if multiple food items led to the spread of illness or if there is not enough information to determine the cause of illness.