Food-related Illness Research Articles

Microbial Isolates a Potential Prophylactic for Preventing Foodborne Illness (LB356)

Bacteria of the genus Bacillus are a diverse group; several species within the genus are of interest due to their implications for public health and disease. For example, Bacillus anthracis is the causative agent of anthrax while Bacillus cereus, a close genetic relative, and Bacillus pumilus are both species that have been implicated in food poisoning. Phage therapy has shown promise in many areas of public health including prevention of diseases associated with food poisoning. Recently the use of phage to prevent Listeria monocytogenes infection has been approved for use on deli meats. Therefore, the aim of this study was to isolate bacteriophages capable of infecting B. pumilus and B. cereus in order to be used as potential prophylactics for preventing food‐related illness and or anthrax. A single phage capable of infecting B. pumilus was isolated from soil taken from the University of La Verne campus. Several more phage are currently being purified. Based on imaging and plaque morphology data the isolated phage is most likely a member of the Siphoviridae family and undergoes a lytic life cycle within B. pumilus. The host range for this particular virion appears small as tests on other members within the genus suggest it is only capable of infecting B. pumilus cells. Currently, phage for B. cereus are in the process of being purified.

Isolation of Bacteriophages against food borne pathogens Salmonella sp., and E.coli associated with meat products

Introduction Recent years have witnessed a large number of food borne outbreaks in many countries. It is estimated that there are between 81 million cases of food-borne illness each year, and approximately 50% of these cases are associated with meat and poultry. Microbial contamination of raw meat and meat products has been the predominant cause of food related illness. The major food borne pathogens such as Escherchia coli, Listeria monocyogenes and Salmonella associated with the meat products (Centers for Disease Control and Prevention, 2005). The ability of the pathogen to survive and/or grow under unfavorable conditions and the development of resistant strains with new virulent factors, represent a formidable challenge to food processing industries in marketing safe food products. There has also been an increase in consumer concern about the use of chemical additives to ensure product safety and to extend the shelf-life of foods.

To Bring Consumers to the Table, Simplify the Review

In the past decade, a significant push has been made for more transparencyinqualityreporting, includingmanynewtransparencyprovisionsinthePatientProtectionandAffordableCareAct, alsoknownas“Obamacare.” It ishardtoarguewiththeconcept. Transparencyworks in other fields. For example, after LosAngelesCountyrequiredrestaurants to publicly display a letter-grade card in their front windowswith anA,B,orC,correspondingtothe results of their latesthealth inspection, the countywitnesseda 20%dropinhospitalizations for food-related illnesses.1Thedramatic improvementwas attributed to a change in the behavior of restaurant owners andoperators, aswell as their customers. Public reporting provided a strong incentive for restaurant operators tomake actual improvements in hygiene—less than an Agradewasseenasadisasterforbusiness.Consumerswerelikely also votingwith their feet—decreasing their selectionof lowerrankingrestaurants.Changes inthequalityof thesupplyandthe quantity of the demand achieved a dramatic outcome. Does thisphenomenontranslate tohealthcare? It is easy to arguethatrestaurantsarenothospitals—thatsimplifyingthequalityofacomplexplacesuchasahospital,whichtreats thousands of patients for hundreds of different conditions, cannot bedistilled intoa single letter grade.But researchhas shownthat the samepublic reporting pressure that leads restaurant operators tocleangrillsandbetterregulatethetemperatureoffoodwillalso motivate hospital staff towashhands andprescribe timely antibiotics, tworelativelyeasy interventions thatcansignificantly dampenthespreadofdangerousinfections.2Whatwasmeasured wasindeedbeingmanaged.Similarpatternsareemergingamong physicians. A recent study by the Wisconsin Collaborative for HealthcareQuality,whichexaminedwhetherparticipatingphysician groups improved performance in the face of publicly reportedquality-of-caremeasures, is encouraging.3Most groups participatinginthecollaborativeeffortreportedinvestinginquality improvement projects in response to public reporting. So, it makes sense that the publicly reported comparisons of quality could help transform our health care system. Like the restaurant example, we can expect to see the same drivers of change, with both suppliers (providers of care) and customers (patients) influenced by the reports. Given reliable, easily obtained quality information, hypercompetitive providerswill improveperformance in thequest for anAgrade in their windows. And using the same information, consumers can vote with their feet, abandoning low-quality providers (and the equivalent of the C-graded diner). Theinterplayofthese2driversofchangeis important.Without the credible threat of consumerengagement, performance measurement is like the proverbial tree falling in an uninhabited forest. But theevidence that consumers actuallyusequality informationhas been thin.4Although someconsumers are willingtospendcountlesshoursresearchingprovidersandtreatments, they are a smallminority.Whenaskedwhy theydonot shop for care, oneof theprincipal reasons givenby consumers is that theavailable information isnot specific enough for their needs.5 Does itmatter how a hospital does on cardiac surgery when you are going in for hip replacement surgery? Apparently it does.Thearticle in this issuebyMcCrumand colleagues6examineswhetherperformanceonasmallsetofpublicly reportedmeasures ispredictiveofoverall hospital quality. Usinga largesampleofhospitals, theresearchers foundthathospitalsperforminginthetopquartileonthesetofpubliclyreported measureshad5 timesbetter oddsof alsobeing in the top set on more global measures of quality—specifically, overall risk-adjustedmortality.This isextremely important—wedonothaveto measureeveryaspectofquality toget a senseofoverall quality. The recent Institute ofMedicine consensus report,which oneofus (M.D.S.)washonored tochair,BestCareatLowerCost, included among its 10 recommendations the need for performance transparency.7 To be effective, such transparency requires the commitment of everyone who contributes to the health care transaction—health care delivery organizations, professional specialty societies, public andprivatepayers, and consumer and patient advocacy organizations. Knowing that we do not have to have an encyclopedic set of measures to achieve this goal brings us one step closer.

Photoinactivation of Bacteria Attached to Glass and Acrylic Surfaces by 405 nm Light: Potential Application for Biofilm Decontamination

Attachment of bacteria to surfaces and subsequent biofilm formation remains a major cause of cross-contamination capable of inducing both food-related illness and nosocomial infections. Resistance to many current disinfection technologies means facilitating their removal is often difficult. The aim of this study was to investigate the efficacy of 405 nm light for inactivation of bacterial attached as biofilms to glass and acrylic. Escherichia coli biofilms (10(3)-10(8) CFU mL(-1)) were generated on glass and acrylic surfaces and exposed for increasing times to 405 nm light (5-60 min) at ca 140 mW cm(-2). Successful inactivation of biofilms has been demonstrated, with results highlighting complete/near-complete inactivation (up to 5 log10 reduction on acrylic and 7 log10 on glass). Results also highlight that inactivation of bacterial biofilms could be achieved whether the biofilm was on the upper "directly exposed" surface or "indirectly exposed" underside surface. Statistically significant inactivation was also shown with a range of other microorganisms associated with biofilm formation (Staphylococcus aureus, Pseudomonas aeruginosa and Listeria monocytogenes). Results from this study have demonstrated significant inactivation of bacteria ranging from monolayers to densely populated biofilms using 405 nm light, highlighting that with further development this technology may have potential applications for biofilm decontamination in food and clinical settings.

The Physician's Role in Nutrition-Related Disorders: From Bystander to Leader

Doctors and hospitals must stop being bystanders to food-related illness and begin to become role models and educators in the transition to healthful eating habits, just as they did in tobacco cessation.

Distinct Renal Pathology and a Chemotactic Phenotype after Enterohemorrhagic Escherichia coli Shiga Toxins in Non-Human Primate Models of Hemolytic Uremic Syndrome

Enterohemorrhagic Escherichia coli cause approximately 1.5 million infections globally with 176,000 cases occurring in the United States annually from ingesting contaminated food, most frequently E. coli O157:H7 in ground beef or fresh produce. In severe cases, the painful prodromal hemorrhagic colitis is complicated by potentially lethal hemolytic uremic syndrome (HUS), particularly in children. Bacterial Shiga-like toxins (Stx1, Stx2) are primarily responsible for HUS and the kidney and neurologic damage that ensue. Small animal models are hampered by the inability to reproduce HUS with thrombotic microangiopathy, hemolytic anemia, and acute kidney injury. Earlier, we showed that nonhuman primates (Papio) recapitulated clinical HUS after Stx challenge and that novel therapeutic intervention rescued the animals. Here, we present detailed light and electron microscopic pathology examination of the kidneys from these Stx studies. Stx1 challenge resulted in more severe glomerular endothelial injury, whereas the glomerular injury after Stx2 also included prominent mesangiolysis and an eosinophilic inflammatory infiltration. Both toxins induced glomerular platelet-rich thrombi, interstitial hemorrhage, and tubular injury. Analysis of kidney and other organs for inflammation biomarkers showed a striking chemotactic profile, with extremely high mRNA levels for IL-8, monocyte chemoattractant protein 1, and macrophage inflammatory protein 1α and elevated urine chemokines at 48hours after challenge. These observations give unique insight into the pathologic consequences of each toxin in a near human setting and present potential pathways for therapeutic intervention.

Risky food safety behaviors are associated with higher BMI and lower healthy eating self-efficacy and intentions among African American churchgoers in Baltimore [corrected

BackgroundThere are an estimated 9.4 million cases of foodborne illness each year. Consumers have a key role in preventing foodborne illness, but differences in the practice of food safety behaviors exist, increasing risk for certain groups in the population. Identifying groups who are more likely to practice risky food safety behaviors can assist in development of interventions to reduce the disease burden of foodborne illnesses. The purpose of this investigation was to examine the relationships of health indicators and psychosocial factors with self-reported food safety behaviors.Methods and FindingsData were collected via questionnaire from 153 African Americans who attend churches in Baltimore City. Individuals reported high overall concern with food safety (mean score: 0.80±0.49 on a scale of −1 to +1) and practiced food safety behaviors with moderate overall frequency (mean score: 5.26±4.01 on a scale of −12 to +12), with considerable variation in reported frequencies depending on the food safety behavior. After adjusting for demographic variables, food safety behaviors were significantly associated with BMI and psychosocial variables. Riskier food safety behaviors were associated with higher body mass index (BMI) (β = −0.141 95%CI (−0.237, −0.044), p = 0.004). Self-efficacy for healthy eating (standard β [std. β] = 0.250, p = 0.005) and healthy eating intentions (std. β = 0.178, p = 0.041) were associated with better food safety behaviors scores.ConclusionsThese results show important relationships between weight-related health indicators, psychosocial factors and food safety behaviors that have not previously been studied. Interventions tailored to higher-risk populations have the potential to reduce the burden of food-related illnesses. Additional studies are needed to further investigate these relationships with larger and more diverse samples.

The public health impact of food-related illness

The purpose of this review is to provide an update on the public health impact of food-related illness in light of recent high-profile outbreaks and advances in the methodology to estimate illness burden. It includes mainly literature from high-income countries, as burden of illness estimations have been focussed in these countries. The public health burden of food-related illness is very high, no matter what method is used to measure it. Outbreaks provide only a partial insight because they represent a small proportion of all cases of food-related illness. Recent outbreaks have demonstrated a very wide variety of contaminated food vehicles and illustrated the challenges in investigations when the contaminated foodstuff is an ingredient of many other food items. Outbreaks will continue to challenge public health responses so that maintaining capacity to respond rapidly is crucial. Technological advances, such as whole genome sequencing, pave the way for identifying food-related illness much more rapidly than at present. There is a need to improve diagnostic yield in clinical laboratories and culturing organisms will remain important. Perhaps one of the greatest challenges, though, is to maintain the interest and support of the public when investigating food-related illness.

Health risk perceptions across time in the USA

Risk research has tended to focus on the elements of a risk that make it of more concern to the public or characteristics of the individual that change their risk perceptions. While these two lines of research have identified a number of important factors they have, for the most part, been isolated in time. This study begins to introduce time as a factor in risk perception research. Urban Americans were the focus of the study. The research was conducted over three years at six-month intervals. A mailed survey was sent to 250 individual household each survey period. Participants were asked about their perceptions of risk for Americans in general and for themselves and their families. They were asked to evaluate the overall risk environment compared to a year earlier and were asked to rank eight risk factors, again both for Americans in general and themselves and their families. Ordinal regression was the primary method of analysis. Participants perceived risk as increasing for each period of the study. The regression results for the general risk perceptions for Americans in general found attitudes to government, TV news viewership, and the January 2008 time period to be significant. For respondents and their families, income, children under 18, and attitude to government involvement were significant. For particular risk factors for Americans in general, the model provided the best fit for infectious diseases and the worst fit for accidents away from home. For respondents and their families, the model provided the best fit for natural disasters and the worst fit for food-related illnesses.

Development of a Paper-Based Analytical Device for Colorimetric Detection of Select Foodborne Pathogens

Foodborne pathogens are a major public health threat and financial burden for the food industry, individuals, and society, with an estimated 76 million cases of food-related illness occurring in the United States alone each year. Three of the most important causative bacterial agents of foodborne diseases are pathogenic strains of Escherichia coli , Salmonella spp., and Listeria monocytogenes , due to the severity and frequency of illness and disproportionally high number of fatalities. Their continued persistence in food has dictated the ongoing need for faster, simpler, and less expensive analytical systems capable of live pathogen detection in complex samples. Culture techniques for detection and identification of foodborne pathogens require 5-7 days to complete. Major improvements to molecular detection techniques have been introduced recently, including polymerase chain reaction (PCR). These methods can be tedious; require complex, expensive instrumentation; necessitate highly trained personnel; and are not easily amenable to routine screening. Here, a paper-based analytical device (μPAD) has been developed for the detection of E. coli O157:H7, Salmonella Typhimurium, and L. monocytogenes in food samples as a screening system. In this work, a paper-based microspot assay was created by use of wax printing on filter paper. Detection is achieved by measuring the color change when an enzyme associated with the pathogen of interest reacts with a chromogenic substrate. When combined with enrichment procedures, the method allows for an enrichment time of 12 h or less and is capable of detecting bacteria in concentrations in inoculated ready-to-eat (RTE) meat as low as 10(1) colony-forming units/cm(2).

USE OF ATTENUATED TOTAL REFLECTANCE INFRARED MICROSPECTROSCOPY TO DISCRIMINATE BACILLUS SPORES

In the present study, the potential of Fourier-transform infrared microspectroscopy to differentiate and discriminate Bacillus spp. spores that sporulated in two nonselective media were evaluated. Spore crops of Bacillus subtilis (ATCC 11779), Bacillus thuringiensis (ATCC 13368, ATCC 35866 and ATCC 55177), Bacillus amyloliquefacies (ATCC 496763) and Bacillus stearothermophilus (ATCC 7953) were obtained with Nutrient and Trypticase Soy Agar supplemented with 10 ppm of MnSO4.H2O. Spores were sonicated, washed with deionized water, and pellets (108 cfu/mL) were deposited onto the grids of hydrophobic membrane filters and dried to produce a uniform and thin film. Spectra were collected in the attenuated total reflectance mode in the mid-infrared region (4,000–700 cm−1). Our classification models, soft independent modeling of class analogy obtained from derivatized infrared spectra (1,800–900 cm−1), showed that the discrimination among spore crops was mainly attributed to infrared frequencies of spore coat proteins. PRACTICAL APPLICATIONS Despite regulatory efforts and emergence of new processing technologies, food-related illnesses remain a major concern for consumers and producers. Detection of bacterial spores using conventional methods is time consuming and challenging. Therefore, there is a need to develop rapid, simple and cost-effective methods to detect Bacillus spores. Fourier-transform infrared microspectroscopy is a viable technology to meet these demands.

Development of strategies for effective communication of food risks and benefits across Europe: Design and conceptual framework of the FoodRisC project

BackgroundEuropean consumers are faced with a myriad of food related risk and benefit information and it is regularly left up to the consumer to interpret these, often conflicting, pieces of information as a coherent message. This conflict is especially apparent in times of food crises and can have major public health implications. Scientific results and risk assessments cannot always be easily communicated into simple guidelines and advice that non-scientists like the public or the media can easily understand especially when there is conflicting, uncertain or complex information about a particular food or aspects thereof. The need for improved strategies and tools for communication about food risks and benefits is therefore paramount. The FoodRisC project ("Food Risk Communication - Perceptions and communication of food risks/benefits across Europe: development of effective communication strategies") aims to address this issue. The FoodRisC project will examine consumer perceptions and investigate how people acquire and use information in food domains in order to develop targeted strategies for food communication across Europe.Methods/DesignThis project consists of 6 research work packages which, using qualitative and quantitative methodologies, are focused on development of a framework for investigating food risk/benefit issues across Europe, exploration of the role of new and traditional media in food communication and testing of the framework in order to develop evidence based communication strategies and tools. The main outcome of the FoodRisC project will be a toolkit to enable coherent communication of food risk/benefit messages in Europe. The toolkit will integrate theoretical models and new measurement paradigms as well as building on social marketing approaches around consumer segmentation. Use of the toolkit and guides will assist policy makers, food authorities and other end users in developing common approaches to communicating coherent messages to consumers in Europe.DiscussionThe FoodRisC project offers a unique approach to the investigation of food risk/benefit communication. The effective spread of food risk/benefit information will assist initiatives aimed at reducing the burden of food-related illness and disease, reducing the economic impact of food crises and ensuring that confidence in safe and nutritious food is fostered and maintained in Europe.

Foodborne, food related illness and role of the healthcare professionals.

Foodborne infection is a major health issue and its impact on global social and economic development remains unknown (1). A paper published in the journal Nature estimates 30% of all infections over the last 60 years were Foodborne (2). The Centre for Disease Control in the United States estimates that 76 million people per year are affected by Foodborne illness, with 300,000 requiring hospital treatment and 5000 fatalities (3). Specific foods are associated with specific Foodborne infections and food poisoning (3). Examples include unpasteurised milk (Campylobacter); shellfish (noroviruses); unpasteurized apple cider (Escherichia coli O157:H7), raw and undercooked eggs (Salmonella); fish (ciguatera poisoning); raspberries (Cyclospora); strawberries (hepatitis A virus); and ready-to-eat meats (Listeria). In clinical practice, healthcare professionals, including physicians, have to interpret clinical symptoms; enabling correct diagnosis and the differentiation of Foodborne illness from food allergy and intolerance, celiac disease, the irritable bowel syndrome, inflammatory bowel disease, viral infection and malignancy (4). An up to date understanding of diagnostic testing is fundamental to the identification of a food related illnesses. Obasanjo published a review in Medscape (5) that summarises the key aspects of the primer published in 2001 by the Foodborne Illness Primer Work Group (FIPWG) and its subsequent updates published in Morbidity and Mortality Weekly Reports (MMWR) (6). The article highlights that in routine clinical practice it is important to maintain good communication between physicians, local testing laboratories and public health authorities. The review reports that most laboratories limit stool culture to screening for species such as Salmonella, Shigella, Campylobacter jejuni or E. coli. Laboratories require advanced notification if Yersinia, Vibrio, E Coli 0157:H7 or other Campylobacter species are suspected, because additional media and incubation conditions are required. Special laboratory procedures are also required to identify infection due to parasites such as Cryptosporidium and Cyclospora cayetanensis. In practice, this means physicians need to communicate with their local laboratories to ensure that arrangements for specialist testing are in place prior to the sending of samples. Furthermore public health authorities need a close relationship with local laboratories to provide advice regarding local antibiotic sensitivities and to initiate community investigation of outbreak sources. Electronic request, information technology, eLearning, etc., have become synonyms or replacements for new and different types of communication. Although new models of communication have added a litany of words to our vocabulary and created novel ways to highlight tasks and develop plans, the way we communicate has become more complicated and potentially more confusing. Maintaining good communication is a necessity within each clinical setting and across clinical speciliaties. The paper by Obasanjo serves as a reminder that knowledge about rarer conditions can aid differential diagnosis. Specific considerations are required when investigating Foodborne infections in severely ill patients, immunocompromised patients, those with a significant travel history or in those who fail to respond to empiricial treatment. Identifying the underlying Foodborne infection may necessitate repeating stool cultures, reviewing histology results and serology. Obasanjo reminds us that physicians need be aware of unusual symptoms and signs such as rashes, myalgia, arthralgia and focal neurological weakness (5). Neurological signs such as meningism or orofacial weakness may indicate life-threatening diagnoses such as Botulism, seafood contamination, mushroom poisoning or chemical poisoning (e.g. organophosphates). The review also highlights that treatment of Foodborne microbial infections with antibiotics needs to be considered carefully and should be based upon evidence of appropriateness of treatment, antimicrobial susceptibility tests as well as interpretation of signs, symptoms and results of stool microscopy/culture. Antibiotics have no effect upon viral infections such as the common head cold and only about 5-10% of bronchitis cases are caused by a bacterial infection. Misuse and overuse of antibiotics has serious effects on public health. Antibiotic resistant bacteria are a growing threat and becoming increasingly common. Unfortunately, the low threshold of using antibiotics, in certain countries in the Middle East, might create multi-antibiotic resistant life threatening infections or "super bugs" (7). Antibiotic abuse also places the patient at unnecessary risk of adverse effects of antibiotics. Judicial use of antibiotics is therefore recommended. In conclusion, healthcare professionals play a key role in the identification and treatment of Foodborne illness. Awareness of algorithms for the correct diagnosis of food related enteropathies, good communication with testing laboratories and prompt case reporting to public health authorities are essential. Awareness on the limited benefits of antibiotics therapy should also be a priority to prevent the development of antibiotic resistant “superbugs.”

Scombroid Fish Poisoning After Eating Seared Tuna

Food safety is an increasing concern to Americans. Recent recalls of peanuts and pistachios, and Food and Drug Administration (FDA) warnings to pregnant women to avoid eating fish have increased government oversight of food processing and handling. Consumers can play an important role in alerting their healthcare providers to food-related illness. Vigilant healthcare providers can notify public health officials to investigate a suspected foodborne illness. The authors present a case of a healthy postdoctoral fellow who developed symptoms of scombroid fish poisoning immediately after consuming a salad containing seared tuna. The successful diagnosis of this case occurred because the patient, physician, city health department and FDA lab collaborated in a coordinated fashion.

Persistence of Escherichia coli on injured iceberg lettuce in the field, overhead irrigated with contaminated water.

Fresh produce is increasingly implicated in food-related illnesses. Escherichia coli can survive in soil and water and can be transferred onto plant surfaces through farm management practices such as irrigation. A trial was conducted to evaluate the impact of field conditions on E. coli persistence on iceberg lettuce irrigated with contaminated water, and the impact of plant injury on the persistence of E. coli. Lettuce heads were injured at 14, 7, 3, 2, 1, and 0 days before inoculation, with uninjured heads used as a control. All lettuce heads (including controls) were overhead irrigated with a mixture of nonpathogenic E. coli strains (10(7) CFU/ml). E. coli counts were measured on the day of inoculation and 5 days after, and E. coli was detected on all lettuce head samples. Injury immediately prior to inoculation and harvest significantly (P = 0.00067) increased persistence of E. coli on lettuce plants. Harsh environmental conditions (warm temperatures, limited rainfall) over 5 days resulted in a 2.2-log reduction in E. coli counts on uninjured lettuce plants, and lettuce plants injured more than 2 days prior to inoculation had similar results. Plants with more recent injuries (up to 2 days prior to inoculation) had significantly (P = 7.6 x 10(-6)) greater E. coli persistence. Therefore, growers should postpone contaminated water irrigation of lettuce crops with suspected injuries for a minimum of 2 days, or if unavoidable, use the highest microbiological quality of water available, to minimize food safety risks.

Improved Inactivation of Nonenveloped Enteric Viruses and Their Surrogates by a Novel Alcohol-Based Hand Sanitizer

Norovirus is the leading cause of food-related illness in the United States, and contamination of ready-to-eat items by food handlers poses a high risk for disease. This study reports the in vitro (suspension test) and in vivo (fingerpad protocol) assessments of a new ethanol-based hand sanitizer containing a synergistic blend of polyquaternium polymer and organic acid, which is active against viruses of public health importance, including norovirus. When tested in suspension, the test product reduced the infectivity of the nonenveloped viruses human rotavirus (HRV), poliovirus type 1 (PV-1), and the human norovirus (HNV) surrogates feline calicivirus (FCV) F-9 and murine norovirus type 1 (MNV-1) by greater than 3 log(10) after a 30-s exposure. In contrast, a benchmark alcohol-based hand sanitizer reduced only HRV by greater than 3 log(10) and none of the additional viruses by greater than 1.2 log(10) after the same exposure. In fingerpad experiments, the test product produced a 2.48 log(10) reduction of MNV-1 after a 30-s exposure, whereas a 75% ethanol control produced a 0.91 log(10) reduction. Additionally, the test product reduced the infectivity titers of adenovirus type 5 (ADV-5) and HRV by > or =3.16 log(10) and > or =4.32 log(10), respectively, by the fingerpad assay within 15 s; and PV-1 was reduced by 2.98 log(10) in 30 s by the same method. Based on these results, we conclude that this new ethanol-based hand sanitizer is a promising option for reducing the transmission of enteric viruses, including norovirus, by food handlers and care providers.

Insecticide contamination as a cause of food related illness

To the Editor:We describe nine organophosphate (OP) poisoning incidents after eating bread rolls made at the same bakery from wheat flour contaminated with chlorpyrifos.All patients presented to th...

Foodborne Pathogens: Microbiology and Molecular Biology

Foodborne pathogens can create a considerable amount of work at state and local health departments. Between foodborne outbreaks, restaurant inspections, environmental testing, botulism reports, customer complaints, and confirmation of isolates referred for testing, many health department resources are directed toward these pathogens and preventing illness from them. Moreover, the mass media are increasingly interested in food safety, particularly after large, multistate outbreaks caused by Escherichia coli O157:H7 and Salmonella, among other pathogens, and increasing public interest in raw and unpasteurized foods that are perceived as more natural or healthy. The audience for Foodborne Pathogens: Microbiology and Molecular Biology appears to be public health practitioners working on epidemiologic, environmental, and laboratory aspects of foodborne illness. One of the book's strengths is that it attempts to include reference material on epidemiology and on the molecular and microbiologic aspects of the various pathogens. However, as the title suggests, the emphasis is on molecular and microbiologic aspects, and much of the information is extremely technical and primarily for the laboratory scientist. The book includes a range of food pathogens, from bacteria and viruses to mycotoxins. The primary omission is bovine spongiform encephalopathy. Chronic wasting disease is included briefly in a chapter on potential food pathogens, which makes the omission of bovine spongiform encephalopathy all the more striking. In addition to separate chapters on individual pathogens or groups of pathogens, the book covers laboratory issues, including animal and cell culture models, molecular approaches for detection, and stress responses of foodborne pathogens. Other chapters are based on more sensational topics, such as bioterrorism and food, although this chapter discusses the subject in general terms. In a chapter on biosensor-based detection of foodborne pathogens, the authors conclude, not convincingly, that biosensors will soon be as widespread as glucose kits and home pregnancy tests. Overall, the book is a good reference for health departments, especially the chapters on individual pathogens. However, the book could have used stronger editorial oversight. Books like this one, in which experts in highly specialized fields are each invited to write a chapter, will by their very nature lack an overriding point-of-view, but at the very least, the book should have had a strong introduction to put the content in context. A large number of pathogens have emerged or been identified in the past 30 years, and a great deal of media attention is given to food-related illness. This book appears to be aimed at industrialized countries, despite the perception that the food supply in these countries is safe. Because much food is imported and exported throughout the world, including to and from industrialized nations, some basic discussion of the extent of foodborne illness in different parts of the world, and the resulting risk to the overall food supply, would have helped to frame the need for the book and the resources many health departments are putting toward foodborne illness.

Importância do Staphylococcus aureus nas mastites subclínicas: pesquisa de enterotoxinas e toxina do choque tóxico, e a relação com a contagem de células somáticas

Staphylococcus aureus is one of the major agents of contagious mastitis and has high incidence worldwide in most of dairy herds. Besides the economic impact, the public health aspects of the enterotoxins and the toxic shock syndrome toxin are very important. The enterotoxin A is frequently correlated with food related illness in man and can be associated with raw, pasteurized and other milk products. The toxic shock syndrome is caused most frequently by toxic shock syndrome toxin, but enterotoxins B and C also can be implicated. The aim of this study was to verify the occurrence of Staphylococcus aureus enterotoxins and toxic shock syndrome toxin producers. Milk samples from cows with clinical and subclinical mastitis were collected. The results of toxins research by celofane over agar to TNAase and by commercial kit to enterotoxins were associated with the electronic somatic cell count. Total of 209 milk samples from cows with clinical and subclinical mastitis caused by S.aureus were verified. A total of 209 (98.86%) were TNAase producers, nine samples (4.39%) were enterotoxin producers, and one of them (0.49%) was EED producer, three (1.46%) EEC producers and three (1.46%) EEB producers. The toxic shock syndrome toxin was not identified in any of the samples assayed on this study. There was no statistical correlation between the somatic cell count results and the samples with toxin production.

A review of the needs and current applications of hazard analysis and critical control point (HACCP) system in foodservice areas

The reported food related illness per year was 76 millions cases in the US [Food Control 13(6–7) (2002) 363] and 9.4 millions in the UK [Food Control 14 (2003) 169], and this data indicated that there are still needs for improvement in the food production chain. The food service area is one of the last hurdles for food items in the food chain and, millions of people eat out or utilize catering services each year which stresses the need for an improved system of food safety in food service. Also, in the food service area, especially in small or medium size food business there visually appears to be a tremendous need for a better system than is currently in place. Research [Food Control 14 (2003) 169; Food Control 11 (2000) 447] showed that education with knowledge of food safety and proper food handling are needed and will help the food service personnel (workers and managers) with a better understanding in food service and better hygiene practices which resulted in safer foods. Besides, risk assessment, HACCP has been applied in most of the food production areas. For most of the food chain, HACCP is mandatory by law and government's regulations. There appears to be needs for applying Pre-requisite Programs (PRP) [Food Control 14 (2003) 169; Irish J. Agric. Food Res. 39 (2000) 221] and later HACCP in food service areas to ensure the safety of food consumption in the total food chain [Food Control 12(3) (2001) 165] since a chain is no stronger than its weakest link. This paper will discuss the needs, current applications and the prospects of HACCP in food service areas.