Tag Archives: Listeria monocytogenes

Food Safety Lecture–It is Still A Jungle Out There

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Yesterday, I posted a blog that tried to summarize some of William Balistreri’s talk on Global Health.  He gave a 2nd Excellent Lecture on Food Safety at the Georgia AAP Nutrition Symposium.  One audience member suggested that this lecture was well-paired with the previous lecture as the awareness of food-borne illnesses might deter gluttony.

This lecture was packed with information regarding food safety; he highlighted the extensive and frequent food-borne illnesses.

Key points:

  • The problem of food-borne illness was put under a spotlight by Upton Sinclair in The Jungle (1906) which led to reforms in meat packing industry.  However, more work is needed
  • FSMA -Food Safety Modernization Act was signed into law in 2011; it’s aim is to create a proactive rather than reactive approach, Historic opportunity to increase food safety
  • Food-borne illnesses: 1 in 10 persons worldwide will be sick every year & leads to 1/2 million deaths worldwide each year.  125,000 deaths in children
  • Food-borne illnesses: 48 million cases in U.S. each year (CDC estimates) and 3000 deaths (MMWR 64:2, 2015)
  • Besides significant mortality rates for food-borne illnesses, they also contribute to post-infectious irritable bowel syndrome (~13% of all cases) and these illnesses can be indefinite
  • Social media, including “IwasPoisoned.com” and Yelp, will likely help identify outbreaks more quickly.  Newer molecular technologies during food processing has the potential to improve food safety.

Resources:

  • For those who want to keep up food-borne illnesses, Dr. Balistreri recommended food safety news, which provides daily emails. Link to subscribe: Food Safety News
  • Two books that were recommended: The Poison Squad by Deborah Blum and Outbreak by Timothy Lytton
  • The CDC has plenty of advice and a useful pamphlet regarding the key 4 steps with food preparation: Clean, Separate, Cook, Chill. https://www.cdc.gov/foodsafety/keep-food-safe.html
  • Another resource: FoodSafety.gov

Link to full talk slides PDF: FOOD SAFETY (10-10-19)  I have placed about 20 slides below which summarize much of the information that he conveyed.

 

 

Tracking down a serial killer

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Truth be told, I really do like the murder mystery genre.  In medicine, that particular type of drama is usually absent.  Nevertheless, it is fascinating when epidemiologists can track down an agent responsible for multiple deaths and widespread illness.  The latest example: Listeria monocytogenes (NEJM 2013; 369:  944-53).

This recent report isolated Listeria monocytogenes as the agent responsible for 147 outbreak-related cases in 28 states; there were 33 deaths.  The investigators used multistage epidemiological, trace-back, and environmental studies.  Molecular finger printing of the cases identified five distinct patterns which defined the outbreak cases. By comparing the outbreak cases to sporadic cases using the “Listeria initiative,” the authors were able to determine that uncut cantaloupe ingestion was much more common among the outbreak-related cases.  Subsequently, the source of the contaminated cantaloupe were traced back to a Colorado  farm that had switched to a different cleaning method in 2011.

Other data:

  • Only 7 cases (5%) were pregnancy-associated; 1 miscarriage occurred
  • The median age was 77 years in this cohort.
  • Most of the deaths were in the elderly, with only 2 deaths occurring in individuals less than 60
  • 143 patients required hospitalization

While this report discussed 147 outbreak-related cases, there were undoubtedly many more outbreak-related cases which were unidentified due to milder illness.

Bottomline: this report provides a framework for identifying outbreaks of contaminated produce.  It reinforces the need for good agricultural practices to minimize food borne-pathogen infections. It is a good read.

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