Outbreak Of Illness Research Articles

Comparison between levels of Homocysteine, Interleukin-6 and Interleukin-10 in severe cases of Egyptian COVID-19 patients

Coronavirus disease 2019 (COVID-19) is the reason of an outbreak of respiratory illnesses ranging from typical cold to severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome. We intended to compare levels of IL-6, IL-10, and homocysteine in the sera of severe COVID-19 Egyptian patients and connect them with the extent of the illness. This cross-sectional study included 90 COVID-19 Egyptian patients. They included 45 non severe cases (group 1) and 45 severe cases (group 2). There was statistically significantly increase in IL-6 in group 2 (median = 7.05, IQR = 6.2 – 7.9; p<0.001) in comparison to group 1 (median = 4.96, IQR = 4.5 – 5.8) and statistically significantly increase in IL-10 in group 2 (154.1 ± 73.3) in comparison to group 1 (47.04 ± 23.8; p<0.001). There were no variations in the examined groups’ homocysteine levels (p= 0.318). Furthermore, there was statistically substantial positive connection (r=0.30) between IL-6 and AST (p=0.046) and between IL-10 and HCT (r = 0.37, p=0.012). In addition, data of other studied parameters are presented. In conclusion, IL-6 and IL-10 could be proposed for follow up of COVID-19 patients and to detect cases before progressing to a severe disease stage.

The Experiences of Expectant and New Mothers in Accessing Maternal Healthcare Services during the COVID-19 Pandemic in Mmabatho, North-West, South Africa

Access to maternal healthcare has been a challenge for women of African descent. Similarly, to previous illness outbreaks such as the Ebola and Zika outbreaks, the Coronavirus pandemic effects vary from one demographic group to another. Women, compared to men, are left in a more vulnerable position due to long-existing social inequalities and disparities. Differentiated effects include, amongst others, access to health and healthcare, risk of infection and coping strategies. This study examined the experiences of expectant and new mothers in accessing maternal healthcare services during the COVID-19 pandemic. In-depth interviews were used, and participants were selected from Mmabatho, North-West Province in South Africa. The findings show that women accessing maternal healthcare services have had diverse experiences. Some expectant and new mothers experienced fear, anxiety, and frustration, while some had more positive experiences. The positive experiences included spending more time with their families and newborn babies. Some of the participants were worried because of the fear of being infected with the coronavirus. Furthermore, the unavailability and inadequacy of, as well as limited access to, maternal healthcare services during the COVID-19 pandemic negatively affected some of the women in the study. This study recommends that public and private sectors responsible for providing maternal healthcare should have emergency preparedness measures in place to ensure the continuous provision of maternal healthcare and cushion women in future disease pandemics.

Institutional outbreaks of influenza-like illnesses in the state of São Paulo: an analysis of the epidemiological profile during the COVID-19 pandemic

ObjectivesThis study aimed to spatiotemporally analyze the profile of influenza-like illness (ILI) outbreaks in the state of São Paulo, Brazil, between 2020 and 2022. Study designThis was a cross-sectional retrospective study. MethodsOutbreaks of ILI with final diagnoses of COVID-19, influenza, or other respiratory viruses (ORVs) recorded between January 2020 and November 2022, obtained from the Notifiable Diseases Information System (SINAN NET) Outbreak module, were analyzed. Kernel density estimates and Getis-Ord Gi∗ statistics were performed to identify spatial clusters. ResultsA total of 13,314 ILI outbreaks were identified, involving 130,568 cases and 2649 deaths. Of these, 104,399 (80%) were confirmed as COVID-19, 15,861 (12%) were confirmed as ORV, and 10,308 (8%) were confirmed as influenza. The year 2021 had the highest number of outbreaks and cases. Schools recorded the most outbreaks and cases, followed by long-term care facilities for older adults (LTCs). The highest average number of cases per outbreak and the highest attack rates occurred at social gatherings and prisons. Prisoners were three times more likely to contract COVID-19 during outbreaks than people in other institutions. The highest hospitalization and mortality rates for all virus types occurred in the LTC group. The occurrence and intensity of outbreaks were highly heterogeneous among the different institutions after the introduction of new SARS-CoV-2 variants in the state. ConclusionsILI outbreaks were not randomly distributed; they clustered in specific areas. Transmissibility varied among different institutions with different responses to the COVID-19 pandemic. These results can be used as a basis for prioritizing actions and allocating resources during future pandemics.

Molecular Detection of Cyclospora cayetanensis in Two Main Types of Farm Soil Using Real-Time PCR Assays and Method Modification for Commercial Potting Mix.

Cyclospora cayetanensis is a foodborne protozoan parasite that causes outbreaks of diarrheal illness (cyclosporiasis) with clear seasonality worldwide. In the environment, C. cayetanensis oocysts are very robust, and contact with contaminated soil may serve as an important vehicle in the transmission of this organism, and it is considered a risk factor for this infection. The present study evaluated a flotation concentration method, previously shown to provide the best detection results when compared with DNA isolation directly from soil samples, in two main types of farm soil, silt loam soil and sandy clay loam, as well as in commercial potting mix samples inoculated with different numbers of C. cayetanensis oocysts. The flotation method was able to detect as few as 10 oocysts in 10 g of either type of farm soil without modifications, but needed an extra wash and samples of reduced size for the processing of the commercial potting mix to be able to detect 20 oocysts/5 g. A recently modified real-time PCR method for the detection of C. cayetanensis based on a mitochondrial gene target was also evaluated using selected samples of each type of soil. This comparative study confirmed that the concentration of oocysts in soil samples by flotation in high-density sucrose solutions is a sensitive method that can detect low numbers of oocysts in different types of soil.

Foodborne Illness Outbreaks at Retail Food Establishments - National Environmental Assessment Reporting System, 25 State and Local Health Departments, 2017-2019.

Each year, state and local public health departments report hundreds of foodborne illness outbreaks associated with retail food establishments (e.g., restaurants or caterers) to CDC. Typically, investigations involve epidemiology, laboratory, and environmental health components. Health departments voluntarily report epidemiologic and laboratory data from their foodborne illness outbreak investigations to CDC through the National Outbreak Reporting System (NORS); however, minimal environmental health data from outbreak investigations are reported to NORS. This report summarizes environmental health data collected during outbreak investigations and reported to the National Environmental Assessment Reporting System (NEARS). 2017-2019. In 2014, CDC launched NEARS to complement NORS surveillance and to use these data to enhance prevention efforts. State and local health departments voluntarily enter data from their foodborne illness outbreak investigations of retail food establishments into NEARS. These data include characteristics of foodborne illness outbreaks (e.g., etiologic agent and factors contributing to the outbreak), characteristics of establishments with outbreaks (e.g., number of meals served daily), and food safety policies in these establishments (e.g., ill worker policy requirements). NEARS is the only available data source that collects environmental characteristics of retail establishments with foodborne illness outbreaks. During 2017-2019, a total of 800 foodborne illness outbreaks associated with 875 retail food establishments were reported to NEARS by 25 state and local health departments. Among outbreaks with a confirmed or suspected agent (555 of 800 [69.4%]), the most common pathogens were norovirus and Salmonella, accounting for 47.0% and 18.6% of outbreaks, respectively. Contributing factors were identified in 62.5% of outbreaks. Approximately 40% of outbreaks with identified contributing factors had at least one reported factor associated with food contamination by an ill or infectious food worker. Investigators conducted an interview with an establishment manager in 679 (84.9%) outbreaks. Of the 725 managers interviewed, most (91.7%) said their establishment had a policy requiring food workers to notify their manager when they were ill, and 66.0% also said these policies were written. Only 23.0% said their policy listed all five illness symptoms workers needed to notify managers about (i.e., vomiting, diarrhea, jaundice, sore throat with fever, and lesion with pus). Most (85.5%) said that their establishment had a policy restricting or excluding ill workers from working, and 62.4% said these policies were written. Only 17.8% said their policy listed all five illness symptoms that would require restriction or exclusion from work. Only 16.1% of establishments with outbreaks had policies addressing all four components relating to ill or infectious workers (i.e., policy requires workers to notify a manager when they are ill, policy specifies all five illness symptoms workers need to notify managers about, policy restricts or excludes ill workers from working, and policy specifies all five illness symptoms requiring restriction or exclusion from work). Norovirus was the most commonly identified cause of outbreaks reported to NEARS, and contamination of food by ill or infectious food workers contributed to approximately 40% of outbreaks with identified contributing factors. These findings are consistent with findings from other national outbreak data sets and highlight the role of ill workers in foodborne illness outbreaks. Although a majority of managers reported their establishment had an ill worker policy, often these policies were missing components intended to reduce foodborne illness risk. Contamination of food by ill or infectious food workers is an important cause of outbreaks; therefore, the content and enforcement of existing policies might need to be re-examined and refined. Retail food establishments can reduce viral foodborne illness outbreaks by protecting food from contamination through proper hand hygiene and excluding ill or infectious workers from working. Development and implementation of policies that prevent contamination of food by workers are important to foodborne outbreak reduction. NEARS data can help identify gaps in food safety policies and practices, particularly those concerning ill workers. Future analyses of stratified data linking specific outbreak agents and foods with outbreak contributing factors can help guide the development of effective prevention approaches by describing how establishments' characteristics and food safety policies and practices relate to foodborne illness outbreaks.

A worldwide review of illness outbreaks involving mixed salads/dressings and factors influencing product safety and shelf life.

The trends toward healthy living, vegetarianism, and busy schedules have increased salad popularity. Salads are usually consumed raw without any thermal treatment, and therefore, without proper care they can become major vehicles for foodborne illness outbreaks. This review examines the microbial quality of 'dressed' salads which contain two or more vegetables/fruits and salad dressings. The possible sources of ingredient contamination, recorded illnesses/outbreaks, and overall microbial quality observed worldwide, besides the antimicrobial treatments available are discussed in detail. Noroviruses were most frequently implicated in outbreaks. Salad dressings usually play a positive role in influencing microbial quality. However, this depends on several factors like the type of contaminating microorganism, storage temperature, dressing pH and ingredients, plus the type of salad vegetable. Very limited literature exists on antimicrobial treatments that can be used successfully with salad dressings and 'dressed' salads. The challenge with antimicrobial treatments is to find ones sufficiently broad in spectrum, compatible with produce flavour which can be applied at competitive cost. It is evident that renewed emphasis on prevention of produce contamination at the producer, processor, wholesale and retail levels plus enhanced hygiene vigilance at foodservice will have a major impact on reducing the risk of foodborne illnesses from salads.

Restaurant-associated foodborne illness outbreaks in the United States: an epidemiological assessment comparing outbreak occurrence and density before [2000–2019] and during [2020] the COVID-19 pandemic

Restaurant-associated foodborne illness outbreaks in the United States: an epidemiological assessment comparing outbreak occurrence and density before [2000–2019] and during [2020] the COVID-19 pandemic

Recent Clinical Isolates of Enterovirus D68 Have Increased Replication and Induce Enhanced Epithelial Immune Response Compared to the Prototype Fermon Strain.

In 2014, enterovirus D68 (EV-D68), previously associated primarily with mild respiratory illness, caused a large outbreak of severe respiratory illness and, in rare instances, paralysis. We compared the viral binding and replication of eight recent EV-D68 clinical isolates collected both before and during the 2014 outbreak and the prototype Fermon strain from 1962 in cultured HeLa cells and differentiated human primary bronchial epithelial cells (BEC) to understand the possible reasons for the change in virus pathogenicity. We selected pairs of closely related isolates from the same phylogenetic clade that were associated with severe vs. asymptomatic infections. We found no significant differences in binding or replication in HeLa cell cultures between the recent clinical isolates. However, in HeLa cells, Fermon had significantly greater binding (2-3 logs) and virus progeny yields (2-4 logs) but a similar level of replication (1.5-2 log increase in viral RNA from 2 h to 24 h post infection) compared to recent isolates. In differentiated BECs, Fermon and the recent EV-D68 isolates had similar levels of binding; however, the recent isolates produced 1.5-2-log higher virus progeny yields than Fermon due to increased replication. Interestingly, no significant differences in replication were identified between the pairs of genetically close recent EV-D68 clinical isolates despite the observed differences in associated disease severity. We then utilized RNA-seq to define the transcriptional responses in BECs infected with four recent EV-D68 isolates, representing major phylogenetic clades, and the Fermon strain. All the tested clinical isolates induced similar responses in BECs; however, numerous upregulated genes in antiviral and pro-inflammatory response pathways were identified when comparing the response to clinical isolates versus Fermon. These results indicate that the recent emergence in severe EV-D68 cases could be explained by an increased replication efficiency and enhanced inflammatory response induced by newly emerged clinical isolates; however, host factors are likely the main determinants of illness severity.

Levels and Distribution of Salmonella in Naturally Contaminated Cashews

Raw materials associated with foodborne illness outbreaks are rarely available for evaluation. The levels and distribution of Salmonella were determined in naturally contaminated raw cashews linked to a salmonellosis outbreak associated with a fermented cashew cheese analog. Two unopened 22.7-kg boxes from a single lot of cashew kernel pieces were each divided into seven approximately equal units, 14 in total. Three 10-g subsamples per unit (n = 21) were evaluated for aerobic plate count (APC), coliform counts, and Escherichia coli counts, and 10 50-g subsamples per unit (n = 70) were enriched for the presence of Salmonella. Presumptive Salmonella-positive colonies were confirmed using CHROMagar Salmonella and real-time PCR (invA) and then serotyped using antigenic methods and genome sequencing prediction tools. APC and coliform counts ranged from 1.81 to 5.47 (mean 2.44 ± 0.63) log CFU/g and 0.60 to 5.20 (mean 1.74 ± 0.80) log CFU/g, respectively. Salmonella was recovered from four units in Box 1 and all seven units in Box 2. One of the 10 subsamples was positive in all but four of the positive units; one (Box 1) and three (Box 2) units had two positive subsamples. The level of Salmonella in the two boxes combined was 0.0023 most probable number/g (95% confidence interval [0.0014, 0.0038]). Salmonella Urbana was isolated from three of five positive subsamples in Box 1 and eight of 10 positive subsamples in Box 2. Salmonella Fresno and Vinohrady were unique to single subsamples from Box 1, and Salmonella Nima was isolated from two subsamples from Box 2. Of the four serovars recovered, Salmonella Urbana and Salmonella Vinohrady were in common with outbreak-associated clinical or product isolates. Understanding the distribution and concentration of Salmonella in naturally contaminated cashews provides important information for hazard analysis and risk assessments for soaked and fermented cashew products.

Genomic Characterization of Mosquito Isolates of Chikungunya Virus (Outbreak Strains 2022) Using Next-Generation Sequencing.

Background: A massive outbreak of dengue-like illness was reported from Pune district of Maharashtra, India during May-June 2022. Isolation and characterization of the etiological agent at genomic level for possible mutations that led to higher transmissibility is the topic of the study. Methods: Entomological investigations were carried out by ICMR-National Institute of Virology (Pune, India); Aedes aegypti mosquitoes were collected and processed for virus detection by molecular techniques. Positive mosquito pools were processed for virus isolation in cell culture. Sanger sequencing and whole-genome sequencing (WGS) using Oxford Nanopore Technology platform were used for genomic characterization. Results: Reverse transcriptase RT-PCR and qRT-PCR analysis detected chikungunya virus (CHIKV) in mosquito samples. Six CHIKV isolates were obtained. WGS revealed four nonsynonymous mutations in the structural polyprotein region, and five in the nonstructural polyprotein encoding region when compared with Yawat-2000 and Shivane-2016 strains. Sixty-four nucleotide changes in the nonstructural polyprotein region and 35 in the structural polyprotein region were detected. One isolate had an exclusive amino acid change, T1123I, in the nsP2 (protease) region. Conclusion: Abundant Ae. aegypti breeding and detection of CHIKV RNA in mosquitoes confirmed it as a chikungunya outbreak. Novel mutations detected in the epidemic strain warrants investigations to address their role in disease severity, transmission, and fitness.

Multinational Outbreak of Listeria monocytogenes Infections Linked to Enoki Mushrooms Imported from the Republic of Korea 2016–2020

Keeping the global food supply safe necessitates international collaborations between countries. Health and regulatory agencies routinely communicate during foodborne illness outbreaks, allowing partners to share investigational evidence. A 2016–2020 outbreak of Listeria monocytogenes infections linked to imported enoki mushrooms required a multinational collaborative investigation among the United States, Canada, Australia, and France. Ultimately, this outbreak included 48 ill people, 36 in the United States and 12 in Canada, and was linked to enoki mushrooms sourced from one manufacturer located in the Republic of Korea. Epidemiologic, laboratory, and traceback evidence led to multiple regulatory actions, including extensive voluntary recalls by three firms in the United States and one firm in Canada. In the United States and Canada, the Korean manufacturer was placed on import alert while other international partners provided information about their respective investigations and advised the public not to eat the recalled enoki mushrooms. The breadth of the geographic distribution of this outbreak emphasizes the global reach of the food industry. This investigation provides a powerful example of the impact of national and international coordination of efforts to respond to foodborne illness outbreaks and protect consumers. It also demonstrates the importance of fast international data sharing and collaboration in identifying and stopping foodborne outbreaks in the global community. Additionally, it is a meaningful example of the importance of food sampling, testing, and integration of sequencing results into surveillance databases.

Predicting Food Safety Violations via Social Media to Improve Public Health Surveillance

Foodborne illness outbreaks originating in food service establishments (FSEs) are a serious public health concern. There are multiple ways that FSEs can contribute to the propagation of foodborne illnesses. However, not all these risks can be detected by health authorities during official inspections for two reasons. First, health authorities have limited resources, meaning not every FSE can be inspected as often and expediently as necessary. Second, because the food safety and hygiene standards of FSEs are dynamic, the inspection results might represent a snapshot that fails to resemble the current FSE situation. Consequently, it would be helpful to have an early warning system that can allow health authorities to predict the risk levels of FSEs and proactively intervene by demanding that high-risk FSEs take appropriate countermeasures. Considering that customers who feel sick after visiting an FSE may not report their experience to health authorities but instead disclose this information by posting online reviews on social media platforms, this study leverages social media data to predict food safety violations by FSEs. The empirical data for this study derive from two sources: the FSE inspection results from the Department of Health and Mental Hygiene in New York City, which labeled each FSE according to whether it violated food safety regulations, and textual reviews posted by FSE customers on Yelp. Machine learning algorithms were employed to extract textual features from the reviews and construct predictive models. Our results demonstrate that customer reviews posted on social media platforms are valuable for predicting FSE food safety violations. Health authorities can leverage social media data to construct predictive models and deploy them to optimize resource allocation and prioritize interventions to prevent foodborne illness outbreaks originating in FSEs, improving public health. FSE managers can also deploy the models to improve their hygiene standards in response to alerts raised. By taking appropriate countermeasures earlier, they can reduce their risk of financial loss due to negative inspection results.

Food Safety Culture from The Perspective of The School Food Service in Malaysia

Foodborne illness outbreaks associated with food produce suggest a focus on food safety culture within food safety management systems throughout food supply chains would benefit the school food service industry. The recent presence of food safety culture in food hygiene standards will drive the need for better understanding, integration into business activities, and monitoring, to help ease foodborne incidents in school food service industry. The purpose of this review was to identify definitions of food safety culture and methods of measuring its performance in the context of the Malaysia school food service industry. Investigation of how to better apply and integrate a positive food safety culture into existing food safety management systems was conducted. A roadmap for food safety culture improvement in Malaysia school food service is presented, highlighting the challenges and opportunities. Food safety culture can be developed by using feedback from regular culture assessments that identify weaknesses and opportunities for improvement, leading to increased knowledge, alignment of attitudes, and better food safety and hygiene behavior. Overall, the development of measurement tools specific to school food service operations would be beneficial. Despite unpredicted challenges like the COVID-19 pandemic, the Malaysia school food service industry continues to investigate the effectiveness of its food safety management.

Abstract #1408228: Potential Association Among Enteroviruses, Acute Flaccid Myelitis and Type 1 Diabetes

Non-polio enteroviruses, like EV-D68, caused a nationwide outbreak of respiratory illness in the US in the fall of 2021. It has been shown that EV-D68 plays a role in causing acute flaccid myelitis (AFM). In addition, the association between enterovirus infections and type 1 diabetes (T1DM) has been widely studied and established. We report a case in which a 19-year-old male consulted for progressively ascending bilateral weakness in the lower extremities. Four weeks prior, he was diagnosed with T1DM and diabetic ketoacidosis (DKA). On exam, he had decreased sensation to light touch, vibration, and temperature below the knees, decreased motor strength 2/5 in bilateral lower extremities, and absence of patellar and Achille reflexes. Thyroid tests, Creatinine Kinase, Aldolase, and vitamin B12 were all normal. Spine MRI showed an enhancement along the L5 and sacral roots. CSF studies were significant for the positive oligoclonal band, the elevated protein level (87gm/dL), and no white blood cell count. CSF gram stain was negative for any organisms. EBV, HSV, and HIV testing were negative. A nonspecific respiratory panel only performed at the time of diagnosis with AFM was negative. The electromyogram did not show any type of acute inflammatory demyelinating polyneuropathy or evidence of myopathy. CT abdomen/pelvis demonstrated mild splenomegaly with small swollen lymph nodes of the periaortic and mesenteric area, which are commonly seen in viral infections. A Digital Subtraction Angiography study did not show any abnormality in spinal vessels. The patient received immunoglobulin and steroid, which was stopped early due to bradycardia and hyperglycemia. Neurology diagnosed the patient with AFM secondary to viral infection, in which the patient may have been infected prior to his diagnosis of DKA. The patient’s weakness resolved, and he was discharged with basal-bolus insulin and is to follow up with neurology and endocrinology outpatient. Enterovirus infection has been associated with T1DM and AFM. While the Respiratory PCR Panel was negative, it was only obtained several weeks after the onset of symptoms. Pathogenesis of extra-respiratory complications of enteroviruses may associate with viremia and systemic dissemination of the virus, which may not be detected by a respiratory PCR panel. Infection by an enterovirus remains the most likely etiology for both immune-mediated disorders, especially during a nationwide outbreak. We recommend providers consider enterovirus infection as a potential cause of AFM, and autoimmune diabetes in order to perform a throughout workup. In a patient with hyperglycemia and flaccid paralysis, T1DM should be suspected.

Rising trends of foodborne illnesses in the U.S.: short communication.

Foodborne illness is caused by the intake of food and water contaminated by different bacteria, viruses, and parasites, as well as poisons or toxins. Approximately 31 different pathogens are documented as causative organisms for causing foodborne illness outbreaks. Climatic changes and varying agricultural practices contribute significantly to the increased incidence of foodborne illness. Foodborne illness can also occur due to the utilization of improperly cooked food. The symptoms of food poisoning may appear sooner or later after contaminated food intake. Symptoms may vary among individuals depending on the disease severity. Despite continuous preventive measures, foodborne illness is still a significant public health threat in the United States. Frequent dining at fast-food restaurants and the use of processed foods present an immense risk of foodborne illness. The food supply in the United States is among the safest in the world, yet we see a surge in foodborne illnesses. People should be encouraged to wash their hands before cooking, and the utensils in which food is being prepared should be kept clean and washed properly before using them. Physicians and other healthcare professionals are facing a host of new challenges in responding to foodborne illnesses. Patients should seek a doctor immediately when they experience symptoms like blood in the stool, hematemesis, prolonged diarrhea for 3 or more days, severe abdominal cramping, and high fever.

MRNA Vaccine for Infectious Disease Prevention and Cancer Immunotherapy

The recent rapid advance in biotechnology has enabled the therapeutic use of messenger RNA (mRNA) to fight against a wide range of viral diseases and cancers. The development of mRNA vaccine and mRNA therapeutic agent showed extraordinary potential in safety, effica-cy, and industrial production. One of the most effective preventive measures against unex-pected, widespread outbreaks of infectious illnesses, like the pandemic coronavirus sickness that is presently raging, is the use of mRNA vaccines (COVID-19). It took decades for scien-tists to make the mRNA vaccine an applicable approach for medical use due to the stability and delivery of mRNA. Although the previous challenges were overcome, scientists still in-tended to further improve the stability, immunogenicity, delivery systems, and translation ef-ficiency of mRNA into the body to make mRNA technology even more powerful in both pre-ventative and therapeutic use. Encouraging results showed that the mRNA vaccine is a tre-mendous platform against infectious diseases and cancers, which is a new era in vaccinology and oncology. This study concentrated on a thorough overview of mRNA vaccine develop-ment, including a basic explanation of the mechanism of action of mRNA vaccines, various delivery techniques, present obstacles, and future prospects of mRNA vaccines for both pre-ventive and therapeutic purposes.

Use of Online Consumer Complaint Forms to Enhance Complaint-Based Surveillance for Foodborne Illness Outbreaks in Minnesota

Foodborne illness complaint systems that collect consumer reports of illness following exposure at a food establishment or event are a primary tool for detecting outbreaks of foodborne illness. Approximately, 75% of outbreaks reported to the national Foodborne Disease Outbreak Surveillance System are detected through foodborne illness complaints. The Minnesota Department of Health added an online complaint form to their existing statewide foodborne illness complaint system in 2017. During 2018–2021, online complainants tended to be younger than those who used traditional telephone hotlines (mean age 39 vs 46 years; p value < 0.0001), reported illnesses sooner following onset of symptoms (mean interval 2.9 vs 4.2 days; p value = 0.003), and were more likely to still be ill at the time of the complaint (69% vs 44%; p value < 0.0001). However, online complainants were less likely to have called the suspected establishment to report their illness than those who used traditional telephone hotlines (18% vs 48%; p value < 0.0001).Of the 99 outbreaks identified by the complaint system, 67 (68%) were identified through telephone complaints alone, 20 (20%) through online complaints alone, 11 (11%) using a combination of both, and 1 (1%) through email alone. Norovirus was the most common outbreak etiology identified by both complaint system methods, accounting for 66% of outbreaks identified only via telephone complaints and 80% of outbreaks identified only via online complaints. Due to the COVID-19 pandemic in 2020, there was a 59% reduction in telephone complaint volume compared to 2019. In contrast, online complaints experienced a 25% reduction in volume. In 2021, the online method became the most popular complaint method. Although most outbreaks detected by complaints were reported by telephone complaints alone, adding an online form for complaint reporting increased the number of outbreaks detected.

Vector competence of Anopheles stephensi for O’nyong-nyong virus: a risk for global virus spread

BackgroundO’nyong-nyong virus (ONNV) is a mosquito-borne alphavirus causing sporadic outbreaks of febrile illness with rash and polyarthralgia. Up to now, ONNV has been restricted to Africa and only two competent vectors have been found, Anopheles gambiae and An. funestus, which are also known malaria vectors. With globalization and invasive mosquito species migrating to ONNV endemic areas, there is a possible risk of introduction of the virus to other countries and continents. Anophelesstephensi, is closely related to An. gambiae and one of the invasive mosquito species of Asian origin that is now present in the Horn of Africa and spreading further east. We hypothesize that An. stephensi, a known primary urban malaria vector, may also serve as a new possible vector for ONNV.MethodsOne-week-old female adult An.stephensi were exposed to ONNV-infected blood, and the vector competence for ONNV, i.e. infection rates (IRs), dissemination rates (DRs), transmission rates (TRs), dissemination efficiency (DEs) and transmission efficiency (TEs), were evaluated. Infection (IRs), dissemination efficiency (DEs) and transmission efficiency (TEs) were determined. Detection of ONNV RNA was analysed by RT-qPCR in the thorax and abdomen, head, wings, legs and saliva of the infected mosquitoes at four different time points, day 7, 14, 21 and 28 after blood meal. Infectious virus in saliva was assessed by infection of Vero B4 cells.ResultsThe mean mortality across all sampling times was 27.3% (95 confidence interval [CI] 14.7–44.2%). The mean rate of infection across all sampling periods was 89.5% (95% CI 70.6–95.9). The mean dissemination rate across sampling intervals was 43.4% (95% CI 24.3–64.2%). The mean TR and TE across all mosquito sampling time intervals were 65.3 (95% CI 28.6–93.5) and 74.6 (95% CI 52.1–89.4). The IR was 100%, 79.3%, 78.6% and 100% respectively at 7, 14, 21 and 28 dpi. The DR was the highest at 7 dpi with 76.0%, followed by 28 dpi at 57.1%, 21 dpi at 27.3% and 14 dpi at the lowest DR of 13.04%. DE was 76%, 13.8%, 25%, 57.1% and TR was 79%, 50%, 57.1% and 75% at 7, 14, 21 and 28 dpi respectively. The TE was the highest at 28 dpi, with a proportion of 85.7%. For 7, 14 and 21 dpi the transmission efficiency was 72.0%, 65.5% and 75.0% respectively.ConclusionAnopheles stephensi is a competent vector for ONNV and being an invasive species spreading to different parts of the world will likely spread the virus to other regions.Graphical

Antimicrobial properties of poly (vinyl alcohol) films with zeolitic imidazolate framework (ZIF-8) nanoparticles for food packaging.

Antimicrobial packaging films are of interest to the fresh produce industry due to the high number of foodborne illness outbreaks associated with these products. This study evaluated the antimicrobial effectiveness of poly (vinyl alcohol) (PVA) films with embedded zeolitic imidazolate framework (ZIF-8) nanoparticles carrying trans-cinnamaldehyde (TC) against Escherichia coli MG1655 in spinach leaves. PVA films were synthesized using distilled water and mixed at 90°C for 1h. The synthesized nanoparticles were introduced at various mass ratio concentrations (0%-5% weight of ZIF-8@TC nanoparticles to PVA), namely PVA-Z8-0 (control) through PVA-Z8-5. The PVA and ZIF-8@TC solution was mixed for 24h until it seemed homogenous, cast, and dried in a ventilated oven at 35°C for 24h. The release rate of TC from the PVA/ZIF-8@TC into both ethanol and methanol was characterized using HPLC methods. Disk diffusion and growth studies were performed to quantify the films antimicrobial effectiveness. Disk diffusion test showed that antimicrobial activity against E. coli MG1655 increased (p <0.05) with increased nanoparticles concentration. Growth characteristics were described by the Baranyi model with some variations. About 0.26, 0.73, and 1.65 log reductions were achieved with the PVA-Z8-1 to PVA-Z8-3 films, respectively, while total inactivation was achieved with both the PVA-Z8-4 and PVA-Z8-5 films (p <0.05). Similarly, the Baranyi model described the inhibitory profiles of the different films. This study contributes to the overall food safety body of knowledge regarding fresh produce and other packaged foods through the development of biopolymeric films with embedded nanoparticles to entrap natural antimicrobials. PRACTICAL APPLICATION: This study paves the way for further research on the development of active polymeric films for food packaging applications.

An Overview of Foodborne Sample-Initiated Retrospective Outbreak Investigations and Interagency Collaboration in the United States

Foodborne outbreak investigations have traditionally included the detection of a cluster of illnesses first, followed by an epidemiologic investigation to identify a food of interest. The increasing use of whole genome sequencing (WGS) subtyping technology for clinical, environmental, and food isolates of foodborne pathogens, and the ability to share and compare the data on public platforms, present new opportunities to identify earlier links between illnesses and their potential sources. We describe a process called sample-initiated retrospective outbreak investigations (SIROIs) used by federal public health and regulatory partners in the United States. SIROIs begin with an evaluation of the genomic similarity between bacterial isolates recovered from food or environmental samples and clusters of clinical isolates while subsequent and parallel epidemiologic and traceback investigations are initiated to corroborate their connection. SIROIs allow for earlier hypothesis generation, followed by targeted collection of information about food exposures and the foods and manufacturer of interest, to confirm a link between the illnesses and their source. This often leads to earlier action that could reduce the breadth and burden of foodborne illness outbreaks. We describe two case studies of recent SIROIs and present the benefits and challenges. Benefits include insight into foodborne illness attribution, international collaboration, and opportunities for enhanced food safety efforts in the food industry. Challenges include resource intensiveness, variability of epidemiologic and traceback data, and an increasingly complex food supply chain. SIROIs are valuable in identifying connections among small numbers of illnesses that may span significant time periods; detecting early signals for larger outbreaks or food safety issues associated with manufacturers; improving our understanding of the scope of contamination of foods; and identifying novel pathogen/commodity pairs.