Welcome to the Microbiology Information

On the morning during August, several students from Northern Lehigh High School showed symptoms of staphylococcus infections or possibly respiratory “walking pneumonia.”

Later in the day, Principal Aileen Yadush wrote a letter to parents and had it posted on the school district’s Web site under a bold red link reading, “Alert!: Staphylococcus Infection Letter.”

The letter mentions the source of the infections was unclear but they narrowed it down to the school’s field house weight room.

The field house was closed and a professional cleaning crew was hired to scrub every surface and every piece of equipment.

The letter explained what type of bacteria it is - staphylococcus aureus, how to look for symptoms and what to do in case something unusual is found on students’ bodies.

The letter also assured parents and students “we will take every possible precaution in maintaining their safety and health.” which is a bold statement.

In a recent environmental survey conducted by University of Arizona researchers, surfaces in teachers’ classrooms came in as the Number 1 workplace for germs which is nearly 20 times higher than those found in lawyers’ offices, and seven times higher than doctors’ offices.

With over 2,000 parents questioned in the survey, 14 percent said they send their children to school despite running a fever higher than 100 degrees.

Educating children on proper hand washing and taking basic sanitation measures could hold down the germ level.

Bethlehem Health Bureau Director Judy Maloney says the bureau and local schools work clean-hand in clean-hand using a program called Germ City: Clean Hands, Healthy People.

The bureau also mailed a letter to principals at elementary and middle schools.

That letter urges schools to contact parents and let them know how important it is to keep sick children home.

Dr. Bonnie Coyle, director of St. Luke’s Hospital’s Community Health Department in Fountain Hill, says direct education programs are recommended by the Centers for Disease Control and Prevention to corral germs.

“If there is a child that has a disease that is a community health threat,” she says, “we get involved.”

In New Jersey, Mary Van Horn, supervisor of the Warren County Board of Health in Washington, says, “My department focuses on flu and pneumonia immunization, but good hand washing is so important.”

Coyle ventures one reason why.

“I think we’re seeing more emerging infectious disease threats,” Coyle says. “As the world becomes smaller through international travel, we’re seeing more drug-resistant tuberculosis. Then there are the things that have always been there (flu, staphylococcus, meningitis and other infectious diseases.)”

Coyle also says that since the 9/11 terrorism attacks, bioterrorism is becoming an issue.

“It’s certainly not a crisis,” she soothes, “but it’s something schools need to keep in mind.”

Source

While America’s food supply is the safest in the world, food poisoning is responsible for approximately 76 million illnesses in the United States each year. In fact, it is estimated that 60% or more of the raw poultry sold today probably has disease-causing bacteria. Anyone eating food contaminated by certain bacteria, parasites, or viruses can get food poisoning. Certain factors such as age and physical condition can make certain people more susceptible to food poisoning than others. Infants, pregnant women, the elderly and people with compromised immune systems are at greatest risk.

For most people in good condition, food poisoning is usually neither long lasting nor life-threatening. However, to less healthy individuals it can become a serious health threat, accounting for approximately 5,000 deaths each year.

The good news is that by taking simple precautionary steps while purchasing, handling, and preparing food you can prevent most cases of food poisoning in the home.

What causes food poisoning? Food poisoning is most commonly caused by bacteria, parasites, or viruses that may be present in the food that you have eaten. You may have heard the names of many of these organisms. They include Escherichia coli (E coli), Campylobacter jejuni, Clostridium botulinum, Shigella, Salmonella, Staphylococcus aureus, Trichinella, and Hepatitis A virus, just to name a few. They can be present in a wide range of food including red meat, poultry, milk and other dairy products, eggs, unpasteurized vegetable juices and ciders, spices, chocolate, seafood, and even water.

These organisms may be present on your food when it is bought or can get into the food, including cooked food, if the food comes into contact with raw meat juices on dirty utensils, cutting boards, or countertops used to prepare contaminated food. That’s why it is important not only to thoroughly cook your food, but to wash your hands, utensils, and countertops, before and after you handle raw foods.

What are the symptoms? Symptoms will vary depending on the type and amount of contaminants eaten. Some people may get ill after ingesting only a small amount of harmful bacteria, while others may remain free of symptoms after eating larger quantities. The most common symptoms of food poisoning include nausea, vomiting, diarrhea, stomach pain (cramps), fever, headache, and fatigue. Symptoms may develop as soon as 30 minutes after eating tainted food, but more commonly do not develop for several days or weeks. Symptoms of viral or parasitic food poisoning may not appear for several weeks, while some toxins in fish may take only a few minutes to cause symptoms.

If you have botulism, you probably will not have a fever and the symptoms may include blurred vision, fatigue, dry mouth and throat.

How food poisoning is diagnosed Food poisoning is often suspected when several people become ill after eating the same meal. To diagnose the cause of the illness, your doctor will need to know the symptoms and what was eaten right before the illness occurred. The doctor may need samples of the food, bowel movements, or vomit. These samples can be tested in a laboratory to determine if the food was contaminated and identify the organism causing the illness.

How is it treated? If the symptoms are severe, the victim should see a doctor or get emergency care. Treatment depends on the severity and cause of the food poisoning. Generally, for mild cases of food poisoning, the doctor will recommend for you to rest, drink fluids to prevent dehydration due to vomiting or diarrhea, and to follow a specific diet. It usually only takes about 1 to 5 days to recover from food poisoning.

If you have botulism, your doctor will prescribe an antitoxin. Other types of food poisoning have no antidote. Antibiotics are usually not helpful in treating food poisoning. Medicine to stop vomiting and stomach cramping may be given.

Prevention is the best approach to avoid food poisoning Most cases of food poisoning can be prevented. Below is a list of a few simple Do’s and Don’ts to help you avoid food-borne illness in the home.

● Do wash your hands, utensils, cutting boards, and countertops between different foods ● Do hrefrigerate or freeze perishables right away (Refrigerator temperature should be 41Ëš F and freezer 0ËšF) ● Do thoroughly cook foods. Cook beef, lamb, and pork to an internal temperature of 160ËšF; whole poultry and thighs to 180ËšF; poultry breasts to 170ËšF, ground chicken or turkey to 165ËšF ● Do hrefrigerate leftover foods as soon as possible; leftovers shouldn’t remain unrefrigerated longer than 2 hours. ● While food shopping, do select frozen foods and perishables such as meat, poultry, and fish last- before checking out ● Do use smooth cutting boards made of hard maple or plastic that are free of cracks and crevices ● Do store raw meats in leak-proof containers or on the bottom of the hrefrigerator to prevent juices from dripping on other foods ● Don’t allow uncooked meats, meat juices, or unwashed fruits and vegetables to come in contact with either cooked or washed foods ● Don’t buy frozen seafood if the packages are open, torn, or crushed on the edges ● Don’t buy food in cans that are bulging or dented, or in jars that are cracked ● Don’t ever buy outdated food. Check the “use by” or “sell by” dates ● Don’t buy unpasteurized milk or dairy products ● Do not buy hrefrigerated or frozen products that are not displayed at the proper temperature ● Do not let small children put foods away unsupervised

More information about this important health subject can be obtained from the following sources: Gateway to Government Food Safety Information www.foodsafety.gov U.S. Food and Drug Administration Center for Food Safety and Applied Nutrition http://vm.cfsan.fda.gov/~dms/wh-food.html Food Safety and Inspection Service United States Department of Agriculture www.fsis.usda.gov/OA/pubs/consumerpubs.htm

Supported as an educational service by Novartis Pharmaceuticals Corporation. This information is not intended for use as medical advice. You should discuss this information with your doctor.

Avaraham Henoch, MD 564 West 160th Street New York, NY 10032 Phone: (212) 740-6400

The Food and Drug Administration (FDA) has warned consumers about the risk of botulism food poisoning from Hot Dog Chilli Sauce Marketed under a Variety of Brand Names.

In particular are 10 ounce cans of Castleberry’s Hot Dog Chilli Sauce (UPC 3030000101), Austex Hot Dog Chilli Sauce (UPC 3030099533), and Kroger Hot Dog Chilli Sauce (UPC 1111083942) with “best by” dates from April 30, 2009 through May 22, 2009 due to possible contamination with clostridium botulinum.

Consumers who have any of these products or any foods made with these products should throw them away immediately. If the “best by” date is missing or unreadable consumers should throw the product out.

Two children in Texas and an Indiana couple who ate these products became seriously ill and have been hospitalized with the toxin.

Symptoms of botulism poisoning can begin from 6 hours to 2 weeks after eating food that contains the toxin. Symptoms may include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness that moves progressively down the body, affecting the shoulders first then descending to the upper arms, lower arms, thighs, calves, etc. Botulism poisoning can also cause paralysis of the breathing muscles which can result in death unless assistance with breathing (mechanical ventilation) is provided.

Individuals who show these symptoms and who may have recently eaten Castleberry’s Hot Dog Chilli Sauce, Austex Hot Dog Chilli Sauce, or Kroger Hot Dog Chilli Sauce should seek immediate medical attention.

All of the above products are manufactured by the Castleberry Food Company in Augusta, Georgia.

Castleberry has informed FDA that it is voluntarily recalling all of the potentially contaminated products and is cooperating with FDA, the Centres for Disease Control and Prevention (CDC), and the states’ active investigations into the cause of this contamination and scope of the products’ distribution.

Castleberry is also voluntarily recalling a number of products that are not under FDA’s regulatory authority.

For a list of these products, visit: www.castleberrys.com/news_productrecall.asp.

FDA will provide updates as more information becomes available. Consumers can call the FDA at 1-888-723-3366.

Castleberry recommends consumers with any questions or concerns about this recall should go to Castleberry’s website (www.castleberrys.com) or call Castleberry’s consumer hotline at 1-888-203-8446.

The list has also been expanding and can be found here

Although it is a rare occurrence, food poisoning due to Clostridium botulinum does occur. Such is the case with an Australian (Adelaide) company who manufactures pre-packed nachos product which was linked to a botulism infection in a 26 year old Melbourne man.

Clostridium botulinum is anaerobic, Gram-positive spore-forming rods, with heat resistant spore. They can be isolated from the soil and marine environment. Some strain (non-proteolytic) can grow slowly at temperatures down to 3.3°C. They usually will not produce toxins at pH lower than 4.6 and water activity (aw) values of less than 0.94. The toxin is one of the most potent toxins known and 10 - 6g is sufficient to kill an adult human. Unlike the staphylococcus aureus toxin which is heat stable, this toxin is easily destroyed by boiling for 10 minutes. Nitrate and nitrite are preservative which are effective in inhibiting the growth of Clostridium botulinum.

In March this year, the company, Mexican Express, previously recalled its 240g “Nachos to Go” products with a best before date of April 19. After further testing, it has decided to withdraw all remaining batches from sale and stop production until further notice. Interestingly, the product won the Vili’s Cakes Leadership Through Innovation in the Food Industry Award.

Consumers holding any of the items have been advised to throw them in the bin or return them.

Mexican Express managing director Ian Young said his first priority was the health and welfare of consumers. “We are putting the public first,” he said. “We are withdrawing Nachos to Go and have suspended production until the source of the botulism is found and we are satisfied about the product’s safety.”

The decision to stop production also followed intense discussions with health department officials in Adelaide and a review of the product formulation by the Dairy Authority of South Australia and Food Science Australia. I don’t think they had a choice.

Here’s what the company say about their hygiene,

“The company follows a strict step-by-step process to ensure it provides a safe, hygienic manufacturing environment for its products. Its QA operation has an SGS HACCP rating.” as for their HACCP plan, they must have forgotten one small Critical Control (CCP). So much for food companies using HACCP to ensure food safety and for SGS auditing their Quality systems.

For more information on the company profile click here.

Bacillus cereus is a gram positive rod that produces spores and has been recognized as an agent of food poisoning since 1955. There were 52 food poisoning outbreaks between 1972 and 1986 associated with Bacillus cereus were reported, however this is thought to only represent 2% of the total cases which have occurred during that time.

Bacillus cereus causes two types of food poisoning compared to bacterial infections. The first is characterized by nausea and vomiting and abdominal cramps and has an incubation period of 1 to 6 hours. This closely resembles Staphylococcus aureus enterotoxin food poisoning in its symptoms and incubation period and is called emetic toxin and or the “short-incubation”. This is caused by a preformed heat-stable enterotoxin of molecular weight less than 5,000 daltons. The mechanism and site of action of this toxin are unknown. The long-incubation form of illness is mediated by a heat-labile enterotoxin (molecular weight of approximately 50,000 daltons) which activates intestinal adenylate cyclase and causes intestinal fluid secretion.

The short-incubation form is most often associated with fried rice or starchy foods that has been cooked and then held at warm temperatures for several hours. The disease is often associated with Chinese restaurants. In one reported outbreak, macaroni and cheese made from powdered milk turned out to be the source of the bacterium.

The second type of food poisoning results primarily in abdominal cramps and diarrhea with an incubation period of 8 to 16 hours. Diarrhea may be a small volume or profuse and watery. This type is referred to as the “long-incubation” or diarrheal form of the disease, and it resembles more food poisoning caused by Clostridium perfringens. This type of food poisoning is frequently associated with meat or vegetable-containing foods after cooking. The bacterium has been isolated from 50% of dried beans and cereals and from 25% of dried foods such as spices, seasoning mixes and potatoes. One outbreak of the long-incubation form was traced to a “meals-on-wheels” program in which food was held above room temperature for a prolonged period.

The short-incubation or emetic form of the disease is diagnosed by the isolation of Bacillus cereus from the incriminated food. The long-incubation or diarrheal form is diagnosed by isolation of the organism from stool and food as well as the toxin using ELISA based kits such as TECRA.

Did you know that among the E. coli human pathogens, Verotoxin (Shiga-like toxin) forming strains (VTEC) have gained in importance in recent years. The group of enterohaemorrhagic E. coli (EHEC) with its highly pathogenic serovars 0157:H7, 026, 0103, 0111, 0145, and other strains are of particular concern.

Verotoxins can be classified into two main categories Verotoxin 1 (VT1, SLT1, Stx1) and Verotoxin 2 (VT2, SLT2, Stx2). EHEC strains may produce either VT1 or VT2 only or both VT1 and VT2 simultaneously. EHEC are capable of initiating life threatening illnesses, particularly in those with immune deficiency, young children and the elderly.

Detection of verotoxin is the easist way in which you can determine if the E.coli of interest is a pathogen of real concern.

E.coli is common everywhere with the main sources of infection being contaminated, raw or insufficiently heated foods of animal origin, e.g. meat and dairy products.

The reservoir for EHEC is the feces of cattle, sheep and goats. These microorganisms can enter food during the processing of meat and dairy products if hygienic conditions are inadequate. The drastic increase in the incidence of food infection caused by E. coli 0157 demands reliable and rapid methods of detection. In addition to traditional culture methods, immunological techniques are becoming more useful due to their improved specificity and sensitivity.

Duopath® Verotoxins is an immunological screening test based on the immune flow principle. The Duopath® Verotoxins GLISA test is an immunochromatographic rapid test intended to be used in food-analysing laboratories for the qualitative detection of Verotoxins (Shiga-like toxins) 1 and 2 from Verotoxinogenic E. coli (including E. coli O157:H7) isolated from food enrichments using FDA, USDA or other food enrichment methods.

This test has been validated and received AOAC approval for detection of Verotoxins 1 and 2 from isolated Verotoxin-producing E.coli (including E. coli O157:H7). Duopath® Verotoxin is also intended to be used in clinical laboratories for the qualitative identification of Verotoxins 1 and 2 (Shiga-like toxins 1 and 2) produced by E. coli isolated in cultures derived from clinical stool specimens. The identification aids in the diagnosis of diseases caused by enterohemorrhagic E. coli infections.

Contamination of ready-to-eat foods with coagulase-positive staphylococci is largely as a result of human contact.

Contamination should be minimised through good food handling practices and growth of the organism prevented through adequate temperature controls. Unsatisfactory levels of coagulase-positive staphylococci indicate that time/temperature abuse of a food is likely to have occurred following improper handling during food preparation.

A test for enterotoxin, SET, may be appropriate where levels of coagulase positive staphylococci exceed 1000 cfu per gram or where poor handling practices are suspected but it is likely that viable organisms may no longer be present in significant numbers.

Levels of ≥10000 cfu are considered as potentially hazardous as foods with this level of contamination may result in food borne illness if consumed.