In July of 2014, a California packing house recalled stone fruit due to Listeria that was discovered through testing. There were no illnesses reported at the time.
CDC took the PFGE patterns from the Listeria isolated at the peach facility and matched against human cases of Listeria infection across the country. Two cases, one in Minnesota and one in Massachusetts had matching patters and had eaten fruit that may have come from the company.
If the connection is truly there, this would be the first cases of listeriosis from stone fruit.
But what about the scenario here? Basically FDA (or USDA) isolates Listeria from a product followed by the CDC running the isolate's DNA patter through their database to match that bacteria’s DNA pattern with any cases of illness that have occurred across the country . Then in those cases where there is a DNA match, they happen to find that person ate (or may have ate) that product at some point, then that food would be implicated. But was it really the food that resulted in the illness? Or is it circumstantial evidence? Could that person have eaten another item that contained that specific strain of Listeria?
CDC MMWR
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6410a6.htm?s_cid=mm6410a6_e
Notes from the Field: Listeriosis Associated with Stone Fruit — United States, 2014
Weekly
March 20, 2015 / 64(10);282-283
Brendan R. Jackson, MD1, Monique Salter, MPH2, Cheryl Tarr, PhD1, Amanda Conrad, MPH1,3, Emily Harvey4, Lisa Steinbock5, Amy Saupe, MPH6, Alida Sorenson, MPH7, Lee Katz, PhD1, Steven Stroika1, Kelly A. Jackson, MPH1, Heather Carleton, PhD1, Zuzana Kucerova, MD, PhD1, David Melka2, Errol Strain, PhD2, Mickey Parish, PhD2, Rajal K. Mody, MD1 (Author affiliations at end of text)
On July 19, 2014, a packing company in California (company A) voluntarily recalled certain lots of stone fruits, including whole peaches, nectarines, plums, and pluots, because of concern about contamination with Listeria monocytogenes based on internal company testing (1). On July 31, the recall was expanded to cover all fruit packed at their facility during June 1–July 17 (2). After the initial recall, clinicians, state and local health departments, CDC, and the Food and Drug Administration (FDA) received many inquiries about listeriosis from concerned consumers, many of whom had received automated telephone calls informing them that they had purchased recalled fruit. During July 19–31, the CDC Listeria website received >500,000 page views, more than seven times the views received during the previous 52 weeks. However, no molecular information from L. monocytogenes isolates was available to assess whether human illnesses might be linked to these products.
Friday, March 20, 2015
Thursday, March 19, 2015
Trader Joe's Recalls Walnut Pieces Due To Salmonella
Trader Joe's is recalling walnut pieces due to the potential to be contaminated by Salmonella. The contamination was found through routine testing by a laboratory contracted by FDA. To date, no illnesses have been reported.
FDA Recall Notice
http://www.fda.gov/Safety/Recalls/ucm438472.htm
Trader Joe’s Recalls Raw Walnuts Because of Possible Health Risk
Contact: Consumer: (626) 599-3817
Media: (626) 599-2843
FOR IMMEDIATE RELEASE — March 17, 2015 — Monrovia, CA — Trader Joe’s Company is recalling Raw Walnuts because these products have the potential to be contaminated with Salmonella, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.
The recalled Trader Joe’s Raw Walnuts were distributed to Trader Joe’s stores nationwide.
FDA Recall Notice
http://www.fda.gov/Safety/Recalls/ucm438472.htm
Trader Joe’s Recalls Raw Walnuts Because of Possible Health Risk
Contact: Consumer: (626) 599-3817
Media: (626) 599-2843
FOR IMMEDIATE RELEASE — March 17, 2015 — Monrovia, CA — Trader Joe’s Company is recalling Raw Walnuts because these products have the potential to be contaminated with Salmonella, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.
The recalled Trader Joe’s Raw Walnuts were distributed to Trader Joe’s stores nationwide.
Kraft Recalls Mac&Cheese Due to Complaints about Metal Pieces
Kraft Foods is recalling Mac and Cheese product after receiving 8 complaints about metal. Approximately 242,000 cases (approx. 6.5 million boxes) are being recalled.
From the report, the product was produced on one manufacturing line over the period of approximately one month. One would expect that the company would have a metal detector in place at the end of the line / after filling and sealing of the box.
It is good that the consumer complaint system was able to identify this, but the bad thing is that it was not caught through the preventive maintenance or quality program.
The News Gazette
http://www.news-gazette.com/news/local/2015-03-18/updated-recalled-mac-cheese-was-made-champaign-plant.html
Updated: Recalled mac & cheese was made at Champaign plant
Wed, 03/18/2015 - 5:05pm | Don Dodson
CHAMPAIGN — Kraft Foods is trying to determine how small pieces of metal got into some boxes of original-flavor Kraft Macaroni & Cheese at the Champaign plant where it's made.
"We believe a piece of stainless steel got wedged in a metal piece of equipment, which may have generated friction that resulted in small pieces of metal potentially falling into the product," Kraft spokeswoman Joyce Hodel said.
On Tuesday, Kraft voluntarily recalled about 6.5 million boxes of the product after receiving eight reports of consumers finding metal in the boxes. No injuries were reported.
From the report, the product was produced on one manufacturing line over the period of approximately one month. One would expect that the company would have a metal detector in place at the end of the line / after filling and sealing of the box.
It is good that the consumer complaint system was able to identify this, but the bad thing is that it was not caught through the preventive maintenance or quality program.
The News Gazette
http://www.news-gazette.com/news/local/2015-03-18/updated-recalled-mac-cheese-was-made-champaign-plant.html
Updated: Recalled mac & cheese was made at Champaign plant
Wed, 03/18/2015 - 5:05pm | Don Dodson
CHAMPAIGN — Kraft Foods is trying to determine how small pieces of metal got into some boxes of original-flavor Kraft Macaroni & Cheese at the Champaign plant where it's made.
"We believe a piece of stainless steel got wedged in a metal piece of equipment, which may have generated friction that resulted in small pieces of metal potentially falling into the product," Kraft spokeswoman Joyce Hodel said.
On Tuesday, Kraft voluntarily recalled about 6.5 million boxes of the product after receiving eight reports of consumers finding metal in the boxes. No injuries were reported.
A Kansas Meals-on-Wheels Operation Involved in Norovirus Outbreak.
A report concluded that a Meals-on-Wheels operation in Kansas was responsible for at least 61 illnesses, although the exact source was not identified.
So someone working for the operation, whether a food preparation person or a delivery person, or even an upstream provider, had to have the illness or had been exposed to someone with the virus.
The clientele served by Meals-on-Wheels would be classified as high risk, so procedures must be in place to prevent employees or volunteers from working when sick, or have exposed to someone who is sick.
Chanute.com
http://www.chanute.com/news/article_86b43810-cdc3-11e4-a460-7f7fd0d80954.html?mode=jqm
Investigative report released in January norovirus outbreakPosted 14 hours ago
JOSHUA VAIL
Tribune reporter
The Kansas Department of Health and Environment Division of Public Health has released its investigative report on the January norovirus outbreak associated with Meals on Wheels.
The investigation concluded that the most likely source of the infection was the Meals on Wheels kitchen in Chanute, but enough data to pinpoint a more specific source could not be obtained.
So someone working for the operation, whether a food preparation person or a delivery person, or even an upstream provider, had to have the illness or had been exposed to someone with the virus.
The clientele served by Meals-on-Wheels would be classified as high risk, so procedures must be in place to prevent employees or volunteers from working when sick, or have exposed to someone who is sick.
Chanute.com
http://www.chanute.com/news/article_86b43810-cdc3-11e4-a460-7f7fd0d80954.html?mode=jqm
Investigative report released in January norovirus outbreakPosted 14 hours ago
JOSHUA VAIL
Tribune reporter
The Kansas Department of Health and Environment Division of Public Health has released its investigative report on the January norovirus outbreak associated with Meals on Wheels.
The investigation concluded that the most likely source of the infection was the Meals on Wheels kitchen in Chanute, but enough data to pinpoint a more specific source could not be obtained.
Saturday, March 14, 2015
Blue Bell Ice Cream Linked to 3 Deaths of Hospitalized Patients
Blue Bell ice cream is being linked to 3 deaths and 2 other illnesses that occurred in one Kansas hospital and over the course of one year. The patients were not hopitalized for Listeria but came into contact it while there at the hospital. All were older patients. While the patients were infected with one of four strains, 3 of the strains have been found in product samples by South Carolina Dept of Health during routine testing. After investigating the facility, Texas Department of Health collected samples from the manufacturing facility and found the organisms in the same products.
A later news report stated that officials said that Listeria may be a factor and that four of the five ate milkshakes made with the ice cream. Interesting.
So a few things to note.
1) To date, this is the only setting that had an outbreak. Why one hospital?
2) Was product handled by the hospital? It would appear so that milkshakes were made from the ice cream.
So while it is yet to be determined, if you had to guess, could it be that indeed the Listeria was present in the ice cream, but the fact that milkshakes were served, could indicate that though handling and preparation, the organism was able to grow to a higher level within the milkshake during preparation and handling. Could it be that the patients left the milkshake warm up before eating, or ate it over the period of a day. So this served as amplification step? Perhaps this is why we didn't see any cases associated with frozen treats? You are not going to eat them after they melted. Of course this is all hard to tell based upon the limited information provided in the news reports.
A later news report stated that officials said that Listeria may be a factor and that four of the five ate milkshakes made with the ice cream. Interesting.
So a few things to note.
1) To date, this is the only setting that had an outbreak. Why one hospital?
2) Was product handled by the hospital? It would appear so that milkshakes were made from the ice cream.
So while it is yet to be determined, if you had to guess, could it be that indeed the Listeria was present in the ice cream, but the fact that milkshakes were served, could indicate that though handling and preparation, the organism was able to grow to a higher level within the milkshake during preparation and handling. Could it be that the patients left the milkshake warm up before eating, or ate it over the period of a day. So this served as amplification step? Perhaps this is why we didn't see any cases associated with frozen treats? You are not going to eat them after they melted. Of course this is all hard to tell based upon the limited information provided in the news reports.
Thursday, March 12, 2015
Reusable Plastic Containers - Best Practices Guide
The Reusable Packaging Association (RPA) released a best practices guide for safe use of reusable plastic containers (RPCs). Reusable containers have become a integral part of the food supply chain, and like other tools/equipment used in the food chain, they can impact food safety. It is silly to argue this even if there haven't been any outbreaks of illness that have pinpointed the returnable containers as responsible. Studies have shown that contamination can be carried by the containers, and thus, it can serve as a source of contamination.
So expanding a little on a few keys from this guideline:
Reusable Packaging Association
http://reusables.org/4613/general/rpa-guidelines-and-best-practices-for-the-safe-use-of-returnable-containers-in-food-supply-chains
RPA Guidelines and Best Practices for the Safe Use of Returnable Containers in Food Supply Chains
The RPA Guidelines and Best Practices for the Safe Use of Returnable Containers in Food Supply Chains was created by the Reusable Packaging Association (RPA) to collectively insure a safe and wholesome food supply chain by users and suppliers of reusable containers. To learn more read RPA Best Practices Guide_FINAL and RPA Guidelines_ FAQs_FINAL
So expanding a little on a few keys from this guideline:
- Risk analysis - as part of a HACCP or HARPC analysis, what impact would contamination on the containers have. Is the food carried in the containers destined for the processing line or is it RTE. But even if the item is to be processed, contamination by spoilage organisms also needs to be considered.
- Clean - With food items where there is higher risk, whether that be pathogens or spoilage organisms, cleaning is probably necessary. And this is where there may be an issue....cleaning is not easy. Equipment that automatically cleans may be expensive, and doing it manually can be a challenge. But the basics of cleaning for food contact surfaces still apply - remove the solids, clean with an appropriate cleaner, rinse, sanitize, air dry.
- Cover - Once cleaned, that surface can be contaminated if not protected, during both storage and shipping. Storing in a covered storage area or shipping in a closed trailer to prevent those aerial poop bombers (birds) may be necessary. Wrapping in plastic may also be necessary.
- Verify - Is cleaning and protective measures for shipping and storage adequate. Visual observation is important, but microbiological testing can tell if the sanitation process really works. Swab testing for APCs may be enough, but sponge sampling for pathogens may also be needed.
- Usage - traceability is important, so follow the accepted practice for labeling the RPCs.
Reusable Packaging Association
http://reusables.org/4613/general/rpa-guidelines-and-best-practices-for-the-safe-use-of-returnable-containers-in-food-supply-chains
RPA Guidelines and Best Practices for the Safe Use of Returnable Containers in Food Supply Chains
The RPA Guidelines and Best Practices for the Safe Use of Returnable Containers in Food Supply Chains was created by the Reusable Packaging Association (RPA) to collectively insure a safe and wholesome food supply chain by users and suppliers of reusable containers. To learn more read RPA Best Practices Guide_FINAL and RPA Guidelines_ FAQs_FINAL
Food Waste and Sustainability - Reducing Waste with Food Safety in Mind
A UK group called WRAP ( Waste & Resources Action Programme ) issued a report on food waste and the impact on the economy as well as on the environment. According to the report, the cost of wasted food in the US is about $162 billion. This waste is generated throughout the food chain, from the field to the kitchen table, and in a time when many go hungry, there is a need to put waste reduction controls in place.
The NY Times published a series of articles on waste reduction controls for the consumers and restaurants. One is providing tips for utilizing food that would otherwise be wasted and another on being more efficient in the kitchen (articles below).
For food processors and retailers, there is the Food Waste Reduction Alliance. A nice publication on their website is a Best Practices Guide. This includes information on food donations.
There will be an increasing emphasis on reducing food waste, especially as there are many people who do not get enough food
Regardless of where those controls are instituted, one important factor that must be part of any food reduction control activity is food safety. As we try to store food longer, or utilize foods or parts of food previously thought of as unusable, food safety can be an issue.
One concern is collecting raw food / kitchen waste for composting. Often times, raw foods will have pathogens like Salmonella and Campylobacter associated with them, chicken skin for example. Cooked foods can also be a concern. Cooks foods, with no or very little bacterial flora, can serve as a growth media for spore-forming pathogens that survived the cooking (such as Clostridium perfringens or Clostridium botulinum) or for environmental pathogens such as Listeria or Staphylococcus. There are however, spoilage bacteria that may work to prevent this. A study of kitchen waste has shown that common spoilage bacteria, primarily lactic acid bacteria, are often in our collection points and prohibit or eliminate any food safety issues. This is not to say that kitchen waste shouldn't be handled and stored properly.
A more important control though is proper composting. Proper composting will eliminate pathogens, so it is important to do this prior to using compost in a garden.
Molds are one hazard to consider when utilizing food or food waste. As food is handled and/or store for a long time, or when it is handled and restored, mold can be introduced, and then grow during storage. A number of mold species can produce mycotoxins and these mycotoxins are dangerous in that they can cause a wide broad range of health issues including being carcinogenic, mutagenic, and having harmful to organs such as the liver. It is also important to note that mycotoxins are heat resistant, and will not be eliminated by cooking.
People will often try to salvage food with mold on it. In general, once a food becomes moldy, it should be discarded. This includes fruits and vegetables. If within a lot of fruits of vegetables, items are showing mold, the effected product should be sorted out immediately. It is also important to note that mold spores may have deposited on the good product from the mold growing nearby, and that good food may show signs of mold spoilage in a matter of days. Therefore, you want to use that salvaged product sooner rather than later.
An issue with long term storage of refrigerated foods is Listeria. Unlike many of the other bacterial pathogens, Listeria can grow at refrigeration temperatures. This is a especially a concern for soft chesses and deli meats. These are two items that should not be used once the product has reached the end of its stated shelf-life. It is also important to keep you refrigerator clean.
Manufacturer-established shelf-life dates have come under fire as a big cause for much of the food waste that is seen. True, many of these dates are based upon quality, or best quality, and have little or no relation to safety, with the exception of deli meats or dairy products such as soft cheeses. My input to this is that rather to argue about whether product should be thrown out by the end of that date, is to put the emphasis on using the product before it gets to that point. Perhaps it would be better to focus on the consumer better utilizing food. Better utilization would entail better determining the amount of food that can be used within a given amount of time, such as a week or the time between shopping trips. This way, perishables will be used before they go bad. Better utilization also includes rotating food on the shelf, so that we don't end up finding that expired product in the back of the shelf. Face it, who hasn't had to throw out a box of Fruit Loops that got pushed behind everything else on that shelf. Being more deliberate in your choices at the store. If like me, you buy 5 cans of a new product only to find out as you eat the first can.....it's not very good. Then the rest sit...forever. Or there is a sale on Sriracha flavored beans - buy five get two free, and of course you get 7 cans only to tire on them after the first three. Lastly, preparing too much. Who finishes that 2lb can of pork'n beans?
NY Times
http://www.nytimes.com/2015/02/26/us/food-waste-is-becoming-serious-economic-and-environmental-issue-report-says.html?_r=0
Food Waste Is Becoming Serious Economic and Environmental Issue, Report Says
By RON NIXONFEB. 25, 2015
WASHINGTON — With millions of households across the country struggling to have enough to eat, and millions of tons of food being tossed in the garbage, food waste is increasingly being seen as a serious environmental and economic issue.
A report released Wednesday shows that about 60 million metric tons of food is wasted a year in the United States, with an estimated value of $162 billion. About 32 million metric tons of it end up in municipal landfills, at a cost of about $1.5 billion a year to local governments.
The problem is not limited to the United States.
The report estimates that a third of all the food produced in the world is never consumed, and the total cost of that food waste could be as high as $400 billion a year. Reducing food waste from 20 to 50 percent globally could save $120 billion to $300 billion a year by 2030, the report found.
The NY Times published a series of articles on waste reduction controls for the consumers and restaurants. One is providing tips for utilizing food that would otherwise be wasted and another on being more efficient in the kitchen (articles below).
For food processors and retailers, there is the Food Waste Reduction Alliance. A nice publication on their website is a Best Practices Guide. This includes information on food donations.
There will be an increasing emphasis on reducing food waste, especially as there are many people who do not get enough food
Regardless of where those controls are instituted, one important factor that must be part of any food reduction control activity is food safety. As we try to store food longer, or utilize foods or parts of food previously thought of as unusable, food safety can be an issue.
One concern is collecting raw food / kitchen waste for composting. Often times, raw foods will have pathogens like Salmonella and Campylobacter associated with them, chicken skin for example. Cooked foods can also be a concern. Cooks foods, with no or very little bacterial flora, can serve as a growth media for spore-forming pathogens that survived the cooking (such as Clostridium perfringens or Clostridium botulinum) or for environmental pathogens such as Listeria or Staphylococcus. There are however, spoilage bacteria that may work to prevent this. A study of kitchen waste has shown that common spoilage bacteria, primarily lactic acid bacteria, are often in our collection points and prohibit or eliminate any food safety issues. This is not to say that kitchen waste shouldn't be handled and stored properly.
A more important control though is proper composting. Proper composting will eliminate pathogens, so it is important to do this prior to using compost in a garden.
Molds are one hazard to consider when utilizing food or food waste. As food is handled and/or store for a long time, or when it is handled and restored, mold can be introduced, and then grow during storage. A number of mold species can produce mycotoxins and these mycotoxins are dangerous in that they can cause a wide broad range of health issues including being carcinogenic, mutagenic, and having harmful to organs such as the liver. It is also important to note that mycotoxins are heat resistant, and will not be eliminated by cooking.
People will often try to salvage food with mold on it. In general, once a food becomes moldy, it should be discarded. This includes fruits and vegetables. If within a lot of fruits of vegetables, items are showing mold, the effected product should be sorted out immediately. It is also important to note that mold spores may have deposited on the good product from the mold growing nearby, and that good food may show signs of mold spoilage in a matter of days. Therefore, you want to use that salvaged product sooner rather than later.
An issue with long term storage of refrigerated foods is Listeria. Unlike many of the other bacterial pathogens, Listeria can grow at refrigeration temperatures. This is a especially a concern for soft chesses and deli meats. These are two items that should not be used once the product has reached the end of its stated shelf-life. It is also important to keep you refrigerator clean.
Manufacturer-established shelf-life dates have come under fire as a big cause for much of the food waste that is seen. True, many of these dates are based upon quality, or best quality, and have little or no relation to safety, with the exception of deli meats or dairy products such as soft cheeses. My input to this is that rather to argue about whether product should be thrown out by the end of that date, is to put the emphasis on using the product before it gets to that point. Perhaps it would be better to focus on the consumer better utilizing food. Better utilization would entail better determining the amount of food that can be used within a given amount of time, such as a week or the time between shopping trips. This way, perishables will be used before they go bad. Better utilization also includes rotating food on the shelf, so that we don't end up finding that expired product in the back of the shelf. Face it, who hasn't had to throw out a box of Fruit Loops that got pushed behind everything else on that shelf. Being more deliberate in your choices at the store. If like me, you buy 5 cans of a new product only to find out as you eat the first can.....it's not very good. Then the rest sit...forever. Or there is a sale on Sriracha flavored beans - buy five get two free, and of course you get 7 cans only to tire on them after the first three. Lastly, preparing too much. Who finishes that 2lb can of pork'n beans?
NY Times
http://www.nytimes.com/2015/02/26/us/food-waste-is-becoming-serious-economic-and-environmental-issue-report-says.html?_r=0
Food Waste Is Becoming Serious Economic and Environmental Issue, Report Says
By RON NIXONFEB. 25, 2015
WASHINGTON — With millions of households across the country struggling to have enough to eat, and millions of tons of food being tossed in the garbage, food waste is increasingly being seen as a serious environmental and economic issue.
A report released Wednesday shows that about 60 million metric tons of food is wasted a year in the United States, with an estimated value of $162 billion. About 32 million metric tons of it end up in municipal landfills, at a cost of about $1.5 billion a year to local governments.
The problem is not limited to the United States.
The report estimates that a third of all the food produced in the world is never consumed, and the total cost of that food waste could be as high as $400 billion a year. Reducing food waste from 20 to 50 percent globally could save $120 billion to $300 billion a year by 2030, the report found.
Impact of Rapid Clinical Testing of Foodborne Pathogens on Outbreak Investigations
It is easy to make the assumption that rapid diagnostics, CIDT or Culture Independent Diagnostic Tests, would help in determining the cause of an outbreak, but this may not be the case. While rapid testing may help with the treatment of a patient by determining the type of organism that caused the illness, without isolating the organism through good old fashion culture methods, the investigation essentially stops there. To go beyond diagnosis of the illness to a point where the exact strain of the organism can be determined for matching purposes, isolation and cultural confirmation is needed.
An increasing number of tests completed by clinical laboratories are using CIDTs. In some cases where a positive is found, no further isolation was attempted, and in other cases, the lab was not able to isolate the organism. In the past, the isolated organisms would then be forwarded to the public health laboratories for further identification and characterization, including if an organism was antibiotic resistant. The organism could be subtyped and this information is used in determining if this illness/organism is part of a wider outbreak.
The inability to culture a CIDT positive sample may also indicate a false positive, especially where the type of CIDT used was an antigen based technology.
CDC MMWR
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6409a4.htm?s_cid=mm6409a4_e
Bacterial Enteric Infections Detected by Culture-Independent Diagnostic Tests — FoodNet, United States, 2012–2014
Weekly
March 13, 2015 / 64(09);252-257
Martha Iwamoto, MD1, Jennifer Y. Huang, MPH1, Alicia B. Cronquist, MPH2, Carlota Medus, PhD3, Sharon Hurd, MPH4, Shelley Zansky, PhD5, John Dunn, DVM6, Amy M. Woron, PhD6, Nadine Oosmanally, MSPH7, Patricia M. Griffin, MD1, John Besser, PhD1, Olga L. Henao, PhD1 (Author affiliations at end of text)
The increased availability and rapid adoption of culture-independent diagnostic tests (CIDTs) is moving clinical detection of bacterial enteric infections away from culture-based methods. These new tests do not yield isolates that are currently needed for further tests to distinguish among strains or subtypes of Salmonella, Campylobacter, Shiga toxin–producing Escherichia coli, and other organisms. Public health surveillance relies on this detailed characterization of isolates to monitor trends and rapidly detect outbreaks; consequently, the increased use of CIDTs makes prevention and control of these infections more difficult (1–3). During 2012–2013, the Foodborne Diseases Active Surveillance Network (FoodNet*) identified a total of 38,666 culture-confirmed cases and positive CIDT reports of Campylobacter, Salmonella, Shigella, Shiga toxin–producing E. coli, Vibrio, and Yersinia. Among the 5,614 positive CIDT reports, 2,595 (46%) were not confirmed by culture. In addition, a 2014 survey of clinical laboratories serving the FoodNet surveillance area indicated that use of CIDTs by the laboratories varied by pathogen; only CIDT methods were used most often for detection of Campylobacter (10%) and STEC (19%). Maintaining surveillance of bacterial enteric infections in this period of transition will require enhanced surveillance methods and strategies for obtaining bacterial isolates.
An increasing number of tests completed by clinical laboratories are using CIDTs. In some cases where a positive is found, no further isolation was attempted, and in other cases, the lab was not able to isolate the organism. In the past, the isolated organisms would then be forwarded to the public health laboratories for further identification and characterization, including if an organism was antibiotic resistant. The organism could be subtyped and this information is used in determining if this illness/organism is part of a wider outbreak.
The inability to culture a CIDT positive sample may also indicate a false positive, especially where the type of CIDT used was an antigen based technology.
CDC MMWR
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6409a4.htm?s_cid=mm6409a4_e
Bacterial Enteric Infections Detected by Culture-Independent Diagnostic Tests — FoodNet, United States, 2012–2014
Weekly
March 13, 2015 / 64(09);252-257
Martha Iwamoto, MD1, Jennifer Y. Huang, MPH1, Alicia B. Cronquist, MPH2, Carlota Medus, PhD3, Sharon Hurd, MPH4, Shelley Zansky, PhD5, John Dunn, DVM6, Amy M. Woron, PhD6, Nadine Oosmanally, MSPH7, Patricia M. Griffin, MD1, John Besser, PhD1, Olga L. Henao, PhD1 (Author affiliations at end of text)
The increased availability and rapid adoption of culture-independent diagnostic tests (CIDTs) is moving clinical detection of bacterial enteric infections away from culture-based methods. These new tests do not yield isolates that are currently needed for further tests to distinguish among strains or subtypes of Salmonella, Campylobacter, Shiga toxin–producing Escherichia coli, and other organisms. Public health surveillance relies on this detailed characterization of isolates to monitor trends and rapidly detect outbreaks; consequently, the increased use of CIDTs makes prevention and control of these infections more difficult (1–3). During 2012–2013, the Foodborne Diseases Active Surveillance Network (FoodNet*) identified a total of 38,666 culture-confirmed cases and positive CIDT reports of Campylobacter, Salmonella, Shigella, Shiga toxin–producing E. coli, Vibrio, and Yersinia. Among the 5,614 positive CIDT reports, 2,595 (46%) were not confirmed by culture. In addition, a 2014 survey of clinical laboratories serving the FoodNet surveillance area indicated that use of CIDTs by the laboratories varied by pathogen; only CIDT methods were used most often for detection of Campylobacter (10%) and STEC (19%). Maintaining surveillance of bacterial enteric infections in this period of transition will require enhanced surveillance methods and strategies for obtaining bacterial isolates.
Friday, March 6, 2015
Knowing Your Water Source - Ground Water Awareness Week
This coming week is Ground Water Awareness Week, and this is good time to understand where your water comes from, even if it is through a municipality, and what impact there would be for your product/process if there would be a water contamination event, such as brown water coming out of the spigots, bad test results, or an announcement of a boil advisory by the municipal provider.
There have been a number of outbreaks associated with drinking water, but the risk of contamination to a food establishment is dependent upon the types of processes run. So it is important to conduct a risk analysis, considering you water source, the types of contaminates that can be present, and the impact of your processes on those contaminates.
The types of contaminates in water can be found on the EPA website (US Environmental Protection Agency. Drinking water contaminants. http://www.epa.gov/safewater/contaminants/index.html).
General information on well water can be found on the CDC Websites:
There have been a number of outbreaks associated with drinking water, but the risk of contamination to a food establishment is dependent upon the types of processes run. So it is important to conduct a risk analysis, considering you water source, the types of contaminates that can be present, and the impact of your processes on those contaminates.
The types of contaminates in water can be found on the EPA website (US Environmental Protection Agency. Drinking water contaminants. http://www.epa.gov/safewater/contaminants/index.html).
General information on well water can be found on the CDC Websites:
- http://www.cdc.gov/healthywater/drinking/private/wells/index.html
- http://www.cdc.gov/healthywater/drinking/training-education.html#webtraining.
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