Outbreaks and Alerts: January 3, 2011

A daily digest of international outbreaks, alerts and food safety news

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United States

• Multistate Outbreak. December 28th: Alfalfa sprouts from Tiny Green Organic Farm (Urbana, IL) have been blamed for an outbreak of Salmonella Typhimurium (Salmonella I 4,[5],12:i:-), which has sickened at least 94 people in 16 states and the District of Columbia.
• West Virginia. December 30th: Food Safety News reports that the Cabell-Huntington County Health Department has vaccinated 236 people after 11 individuals were infected with hepatitis A in the Milton, WV area. The source of the hepatitis outbreak has not been identified.
• New York, NY. January 3rd: The Queen Mary 2, en route to New York from Southampton, was boarded in St. Kitts by an inspector from the CDC Vessel Sanitation Program after the cruise ship reporting that 185 passengers (out of a total of 2,483) and 29 crew members were suffering from diarrhea and vomiting.

Canada

• Laval, QC. December 29th: The Cité-de-la-Santé Hospital in Laval has closed its doors to visitors in an attempt to control an outbreak of gastroenteritis that has affected both patients and staff at the hospital. Ambulances have been instructed to avoid the hospital until further notice.
• Hamilton, ON. January 2nd: Clostridium difficile contributed to the death of a 91-year old woman at St. Joseph's Hospital in Hamilton, bringing the total number of C. difficile related deaths at the facility to eleven since October 2010.

Europe

• Swansea, Wales, UK. January 3rd: Managers at Morriston Hospital have closed seven wards and asked the public to avoid visiting the hospital as part of a program to contain an outbreak of norovirus gastroenteritis.
• Bonn/Koblenz, Germany, January 3rd: A passenger who was infected with norovirus before boarding the Prinses Juliana has been identified as the source of an outbreak of gastroenteritis among passengers of the Rhine cruise ship. The ship was quarantined for one day after 50 of the ship's 150 passengers developed diarrhea and vomiting.
• Kalmykia, Russia. January 3rd: An emergency has been declared after veterinarians detected anthrax in meat from a slaughtered cow. Eight cases of human anthrax also are suspected, but have not yet been confirmed.

Asia, Africa and the Pacific Islands

• Hong Kong. December 30th: The Centre for Food Safety reports that fresh pig liver may be one of the sources of food-borne hepatitis E virus infections in Hong Kong, after determining that 16 out of 51 liver samples from roaster pigs were positive for the virus.
• Beijing, China. December 31st: A random inspection of 35 rice noodle factories in Dongguan in early December revealed that only 5 of the 35 factories were manufacturing rice noodles that met government standards. Among the problems found during the inspections were noodles made with rotten grain and potentially carcinogenic additives.
• Cebu, Philippines. January 1st: Twelve cases of diarrhea have been reported in Catmon (Cebu province). One person has died.
• Harare, Zimbabwe. January 3rd: Cholera has been reported in at least 20 households in the Mbare suburb of Majubheki. According to news reports, the sewage system in Mbare has broken down, resulting in the contamination of drinking water with raw sewage.
• Jakarta, Indonesia. January 3rd: Six members of one Central Java family died from apparent food poisoning after eating tiwul, a traditional dish made from dried cassava powder.
• Papua New Guinea. January 3rd: PNG's cholera outbreak has spread to another district in East Sepik, with at least 10 confirmed deaths. In a separate incident, a nurse at Port Moresy General Hospital became infected with cholera after coming into contact with a patient's feces and vomit.

Latin America and the Caribbean

• Jamaica. December 23rd: The Ministry of Health is investigating a possible case of food poisoning after eleven persons who shared a meal were taken to St. Ann's Bay hospital. One of the eleven victims was dead on arrival, and the others received treatment. Samples of the meal were taken for testing, but no results have been released as of January 3rd.
• Dominican Republic. December 30th: Vibrio cholerae, has been found in the drinking water of two villages adjacent to the border with Haiti. At least 20 people in the area are suffering from cholera-like symptoms; 139 cholera cases have been confirmed nationwide.
• Tambor, Costa Rica. December 31st: Salmonella was found in a sample of chicken served at the Hotel Barceló Playa Tambor after 80 hotel guests complained of gastrointestinal symptoms. Nevertheless, none of the ill guests were found to be infected with Salmonella; instead, they were determined to be suffering from norovirus infections. The hotel was closed on December 26th as a result of the outbreak, and remained closed through the New Year's weekend.
• Bolivar, Colombia. December 31st: A possible cholera outbreak in temporary shelters in three municipalities has health authorities on the alert. The shelters were opened to house people who were forced to flee areas affected by flooding.
• Haiti. December 31st: The death toll from Haiti's cholera epidemic has reached 3,333; more than 150,000 infections have been reported.

Outbreaks and Alerts: June 27, 2010

A daily digest of international outbreaks, alerts and food safety news

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United States

• Atlanta, GA. June 25: CDC reports that 37 people in 18 states are confirmed to have been infected with Salmonella Chester. At least seven people were treated in hospital. The outbreak strain was recovered from an intact package of Marie Callender's Cheesy Chicken and Rice single-serve frozen dinner found in the home of one of the Minnesota outbreak victims.
• Little Rock, AR. June 25: Three cases of severe diarrheal illness have occurred in Saline County this month and have been linked to swimming in the Saline River near the Highway Five Bridge. The Arkansas Department of Health (ADH) has tested water from the area and found it to be unsafe for swimming.
• Lincoln, NE. June 25: Nebraska has issued a health alert for toxic blue-green algae at Swan Creek 5A Lake near Tobias in Saline County.
• Juneau, AK. June 25: A middle-aged man from Haines is in hospital in Juneau. The man developed symptoms consistent with Paralytic Shellfish Poisoning after eating Dungeness crab in Haines on Friday.
• Cary, NC. June 26: Forty members of a Cary Baptist church – including members of the pastor's family – developed Norovirus gastroenteritis after 140 members of the congregation shared a potluck lunch last Sunday.
• Glencoe, IL. June 26: Seven cases of Salmonella gastroenteritis have been linked to the Skokie Country Club in Glencoe since June 10. The club voluntarily closed its kitchen on Thursday (June 24). According Amy Poore, spokesperson for the Cook County Department of Health, the seven cases are completely unrelated to the Salmonella Hvittingfoss outbreak that is still under investigation in the state.

Europe

• Harwich, UK. June 25: Eight-six passengers on the Jewel of the Seas (Royal Caribbean) cruise ship were reported to be suffering from Norovirus gastroenteritis when the shipped docked in Harwich on Thursday – the second outbreak reported on the Jewel of the Seas this month. The ship will be thoroughly disinfected before the next group of passengers is allowed to board, according to a Royal Caribbean spokesperson.

Asia, Africa and the Pacific Islands

• Mumbai, India. June 25: Twenty-four children, including a nine-month-old baby, from the Asha Sadan Rescue Home at Umerkhadi were admitted to JJ Hospital, Byculla, on June 24th, following complaints of vomiting and upset stomachs. The children, who were treated at the hospital and released, became ill a couple of hours after eating a dinner that consisted of dal, rice and dudhi halwa.
• Cameroun. June 25: The Ministry of Public Health reports that 23 people have died of cholera and 140 have been confirmed infected with Vibrio cholerae within the last several weeks. The outbreak is centered in seven health districts in the far north of the country.

Outbreaks and Alerts: June 8, 2010

A daily digest of international outbreaks, alerts and food safety news

If you would like to receive automatic email alerts for all new articles posted on eFoodAlert, please click here or submit your request using the sidebar link. Please include "subscribe eFoodAlert" in the subject line.

United States

• Anchorage, AK. June 7: Sapphire Princess completes Alaska cruise after 96 passengers come down with Norovirus gastroenteritis. Some of the infected passengers were "asked" to remain in their rooms for the duration of the voyage to limit the spread of the highly contagious virus. The ship was "super-sanitized" in Seattle before the next load of passengers was permitted to embark.
• Silver Spring, MD. June 7: Lifesoy Inc., a San Diego-based manufacturer of ready-to-eat soy products that was cited by FDA for preparing, packing, and holding articles of food under insanitary conditions, has entered into a consent decree of permanent injunction in the U.S. District Court for the Southern District of California. The consent decree requires Lifesoy to stop manufacturing and distributing food products until the company registers with the FDA and complies with federal laws regarding sanitary practices.
• Springfield, IL. June 7: 48 cases of Salmonella Hvittingfoss have now been associated with the ongoing investigation of illnesses among customers who ate at certain Subway restaurants in 18 Illinois counties. All patients, of which 17 had been hospitalized, are recovering. Health investigators still have not traced the illnesses to a specific food source.
• San Bernardino, CA. June 7: Two persons were issued citation for hawking (illegal selling) infractions, 16 persons received citations for misdemeanor food violations, and one person received a citation for felony violation of dairy products during an "Illegal Vendor Compliance Operation" conducted by the Rural Crime Task Force and the West Foothill Sheriff's Station. Three of the violators later returned to the area and were arrested and booked into the West Valley Detention Center for a Health and Safety Code. The action was taken following complaints from the public about an increase in the number of illegal roadside food vendors in the area.
• Saratoga Springs, UT. June 8: The Utah County Department of Health thinks that the Campylobacter outbreak in Saratoga Springs may be waning. As of the last published update (May 20th), there have been 17 confirmed and 333 probable cases of Campylobacter gastroenteritis. The outbreak has been blamed on contaminated drinking water.

Canada

• Ottawa, ON. June 7: The Ontario Ministry of Children and Youth Services has shut down the Little Angels Academy daycare facility on Cedarview Road in the Barrhaven area, citing health reasons.

Europe

• Aberdeen, Scotland. June 7: MV Hjaltland, which is currently docked at Aberdeen harbour, has been taken out of service for 48 hours for extensive cleaning after a bus party from Hereford became ill within an hour of boarding the vessel on Friday in Lerwick.
• France. June 8: The number of confirmed cases of salmonellosis in the outbreak that has been linked to contaminated dried sausage from Salaisons du Lignon has risen to 90 people. The manufacturer has expanded an earlier product recall to encompass all Lou Montagnard brand "Saucisse sèche droite nature La Pause Auvergnate" with expiration dates up to and including 24/08/10.
• Sweden. June 8: The National Food Administration has received complaints of a metallic taste in some pine nuts. After extensive lab testing, NFA toxicologists have been unable to detect any hazardous chemical or toxin in the pine nuts.
• Vladivostok, Russia. June 8: Food safety specialists are warning consumers that 3.5 million eggs that were past their expiration dates were sold in the Vladivostok area. These eggs may present a health risk if consumed.

Asia, Africa and the Pacific Islands

• Ho Chi Minh City, Vietnam. June 7: Food poisoning has caused 10 deaths and 704 illnesses in Vietnam during the past month. Of the 704 illness victims, 517 sought hospital treatment.
• Ado-Ekiti, Nigeria. June 4: Three people have died of apparent food poisoning in a local farming community. Leftover food and soup that the victims shared has been sent for analysis to determine the cause of the deaths.

Australia and New Zealand

• Wellington, NZ. June 8: Medsafe has placed sales restrictions on some cough and cold medicines for children. Cough and cold medicines for children under 12 years old will now be sold only in pharmacies except for those containing ingredients such as honey, lemon and other natural substances.
• Sydney, Australia. June 8: Suchen Trading Pty Ltd, the previous owner of Tum Tum’s Thai restaurant in Sydney’s Darlinghurst was charged with 24 offences under the Food Act, including poor food handling, pest infestation, poor hygiene, unclean premises and lack of maintenance of the premises during inspections conducted in January 2008. Suchen was ordered by the Industrial Magistrate's Court to pay $35,200 in fines and costs.

Norovirus Notebook: May 12, 2009

Norovirus – also known to its victims as the Winter Vomiting Bug, the Nursing Home Bug, and the Cruise Ship Bug (and somewhat more formally as the Norwalk-like virus) – can be counted upon to make its appearance on a regular basis any time of year.

We'll be tracking the travels of this highly infectious and very rugged virus on a weekly basis.

 

Australia, New Zealand and Pacific Islands

• Australia, April 22 – Ballarat Health Service's Hailey House, an assisted living residence, was hit with a Norovirus outbreak that sickened 25 residents and 14 staff members of the facility. The facility, which houses 60 residents, implemented restrictions on visitors until the outbreak had run its course.
  
• New Zealand, April 24 – Wanganui and Hawke's Bay regional Hospitals reported outbreaks of gastroenteritis. Visitors were asked to stay away from both facilities until the outbreaks, which were suspected to have been caused by Norovirus, were brought under control.
  

Europe, Including Russia

• UK, April 22 – Two wards were closed, and visiting restrictions placed on a third at Taunton’s Musgrove Park Hospital after three patients at the hospital were diagnosed with Norovirus. Visitors were asked to stay away until the outbreak was over.
  
• UK, April 23 – Warwick Hospital also was hit with an outbreak of Norovirus gastroenteritis, resulting in the closure of three wards and limits on visitors elsewhere in the hospital. 
  
• UK, May 7 – Countess of Chester Hospital in Cheshire is experiencing an outbreak of Norovirus that has prompted hospital officials to ban visitors. Hospital management has not indicated how many patients have been infected, or whether staff members also have been stricken. A hospital spokesperson assured the public that the ban on visitors was in no way related to the current outbreak of Influenza A(H1N1).
  

Western Hemisphere

• Canada, April 23 – Macaulay Lodge, a 44-bed nursing home in Whitehorse, was quarantined by Yukon health officials after reporting an outbreak of Norovirus infections. Residents were restricted to their rooms, group activities scaled back and the public discouraged from visiting after 19 residents and 12 staff members complained of gastroenteritis. 
  
• Canada, April 25 – North Bay's North East Mental Health Centre closed its doors after a week-long struggle to contain an outbreak of Norovirus that sickened at least 22 patients and staff. The facility was expected to remain closed for several days to avoid spreading the outbreak to the community.
  
• Canada, April 28 – Ecole St. Pierre, a Sudbury (Ontario) school, was scrubbed down and disinfected after Norovirus infected 66 students and staff at the 220-student school. Students were required to remain at home for 48 hours after their symptoms disappeared before being permitted to return to school.
  
• USA (New York), April 18 – 160 students and staff at a Westchester County high school experienced a wave of gastrointestinal illnesses that left school administrators scrambling to respond. The school will be providing its students with a refresher course on appropriate personal hygiene and hand-washing techniques.
  
• USA (Nebraska), April 22 – State health officials suspect that Norovirus was the cause of an outbreak of gastroenteritis that affected dozens of patrons of the Marina Inn, a South Sioux City restaurant. The restaurant closed for disinfection at the urging of heath authorities.
  
• Panama Canal Cruise, April 23 – The Island Princess has reported an outbreak of gastroenteritis on board that has affected at least 100 passengers and five crew members. The ship, which is part of the Princess Cruise Line, sailed from Ft. Lauderdale for a 15-day cruise through the Caribbean and the Panama Canal, up the Pacific coast of Central America and Mexico, and ending in Los Angeles. The CDC has not yet confirmed a diagnosis, but the reported symptoms are consistent with Norovirus. This is the ninth cruise ship outbreak of gastroenteritis reported to CDC so far this year, and the second that involves Princess Cruises.
  

Please join us again next week for another edition of Norovirus Notebook.

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Norovirus Notes

While public health attention has been focused on Salmonella Saintpaul in tomatoes and E. coli O157:H7 in ground beef, the ever-present norovirus has quietly been striking down restaurant patrons and cruise line passengers.

Last week, approximately 60 restaurant patrons and 40 employees of an Illinois golf club complained of nausea and other "flu-like symptoms" after eating, visiting or working in the dining area of the Arrowhead Golf Club. Specimens obtained from ill employees were found to contain norovirus. The dining area was closed for thorough cleaning and disinfection. It is expected to reopen this evening.

This past week, between 80 and 90 people attending a bible camp near Oakhurst, California were stricken with diarrhea and vomiting. No lab results are available, but local health officials are attributing the outbreak to norovirus.

Norovirus is well known for the outbreaks of gastroenteritis it has caused in the past on cruise ships. And 2008 has been no exception. Norovirus has been responsible for seven out of eight cruise ship outbreaks of gastroenteritis so far. A ninth outbreak is still under investigation.

One cruise line in particular – Holland America Line – seems to be particularly susceptible to norovirus outbreaks this year. Four of the norovirus outbreaks have involved Holland America ships: the Volendam, the Noordam, the Ryndam, and the Zaandam. A fifth Holland America ship, the Veendam, is the setting for the outbreak that is still under investigation.

Norovirus is a highly contagious pathogen, and can survive on surfaces such as hand rails and door knobs for days. Staying healthy in the midst of a shipboard outbreak is difficult, but possible. To avoid illness, it is essential to be scrupulous about frequent and careful hand-washing, especially before eating, drinking, brushing teeth or any other activities that might bring the hands in contact with the face.

Food Poisoning Around The World - The Tour Continues

I was out of town for a few days, and I decided to catch up on news by scanning one of my favorite sites for outbreak information - FoodHACCP.com. As a result, I have extended our food poisoning world tour by adding several stops.

Vietnam
Visitors to northern parts of Vietnam should be aware that the country's outbreak of acute diarrhea has spread to two more provinces, and has afflicted more than 500 people so far. The Xinhua News Agency reports that more than 100 of the diarrhea victims have been confirmed to be suffering from cholera.

According to health officials, the cholera is being transmitted by contaminated high-risk foods such as blood pudding, raw vegetables and raw shrimp paste. In addition, the Vietnamese health authorities claim that poor personal hygiene is a factor in the spread of the disease, as only 12% of Vietnamese wash their hands with soap.

Adelaide, Australia
The outbreak of Shigella that I reported on last week appears to be winding down. Only one additional case has been confirmed.

Hong Kong
Four male passengers of a cruise ship that visited Hong Kong have come down with Hepatitis E infections. The round-the-world cruise began on January 7th and ended March 28th. The ship, which has a capacity of 1,800 passengers, stopped in Hong Kong on February 26th and 27th.

Hepatitis E is endemic to Central and Southeast Asia, North and West Africa, and Mexico. It is spread through contaminated food or water, and its symptoms and incubation period are similar to hepatitis A.

Belfast, Northern Ireland
Three family members are suffering from an E. coli O157:H7 infection. One of the victims, a child less than 4 years old, attends a nursery school. The other two victims are adults. Children attending the same nursery school will be screened for E. coli O157:H7 as a precaution. This outbreak comes just a few weeks after an apparently-unrelated outbreak of E. coli O157:H7 that struck six other children attending various nursery schools in and around Belfast.

New Zealand
The number of people infected by the Salmonella Mbandaka on New Zealand's South Island has increased to 23 since my last posting. Most recently, one more illness has been reported in Marlborough, and one each in Canterbury and Invercargill. The source of the outbreak is still unknown. This outbreak has claimed one victim so far – a 74 year-old woman from Nelson.


Washington State, USA
More than 65 out of 350 people were stricken with norovirus while attending a medical conference at the Gaylord National Resort and Convention Center. Several of the victims required hospital treatment for dehydration before flying home.

Stay tuned for further updates to our world tour itinerary. This trip won't end until there are no more food poisoning outbreaks to report.

Norovirus: A Special Kind Of Seasickness

According to an article in San-Diego's Union Tribune, the Holland American ship Ryndam left San Diego for a 10-day Mexican cruise on February 15th, with 1,226 apparently-healthy passengers and 556 crew members on board. By the time the ship returned to port yesterday, 104 of the passengers and 6 crew members had fallen ill with what is suspected to be Norovirus. One of the stricken passengers, an 81 year-old woman, was taken away by ambulance upon disembarking.

Norovirus is a highly infectious – though short-lived – disease, which is easily spread by hand-to-mouth contact. Victims usually suffer from nausea, vomiting and diarrhea. Symptoms, which can begin abruptly and with very little warning, typically last for 24-48 hours. The virus may continue to be shed by victims in their stools for as long as two weeks after they have apparently recovered.

According to the CDC, the Ryndam is the sixth ship to be hit with an outbreak of gastroenteritis so far this year. Norovirus has already been confirmed as the cause of four of the six oubreaks. In 2007, there were 23 gastroenteritis outbreaks on board ships calling at US ports. Sixteen were caused by Norovirus, including outbreaks during three consecutive sailings of the Ryndam last winter.

Cruise ships that call at U.S. ports are subject to inspection under the CDC Vessel Sanitation Program. The inspection scores and detailed reports are all available on the CDC web site, and it's wise to check this site when contemplating a cruise. The Ryndam was last inspected on December 13, 2007 and received a grade of 97 out of 100 (86 or higher is considered a "pass"). But a successful inspection cannot shield a ship from an embarking passenger who is carrying the virus.

Norovirus particles can survive on dry surfaces, such as deck rails, bathroom counter tops and eating utensils for days and – as I mentioned in my recent post about institutional Norovirus outbreaks – are resistant to many common disinfectants. Moist heat and chlorine bleach are the two most effective ways to kill the virus.

Cruise ship passengers are a captive audience – perfect targets for a virus such as Norovirus. The only protection against becoming infected with this virus during an outbreak at sea is to practice scrupulous personal hygiene. Frequent and thorough hand-washing is a must – before every meal, and after touching door handles, rails, elevator buttons, and other surfaces that might have been contaminated by an infected passenger.

For more information on cruising with Norovirus, check out the CDC's Norovirus web page.

'Tis The Season For Norovirus - Always

Norovirus keeps cropping up. The New York Post reported yesterday that emergency rooms in that city are seeing 500 cases of norovirus a day. The Centers for Disease Control reports that there have been at least 14 confirmed outbreaks of the virus on cruise ships calling at US ports this year. And now, Hong Kong's Centre for Health Protection has advised that there have been 93 norovirus outbreaks in childcare centers, schools and other institutions in the former Crown Colony in 2007, affecting 921 people.

Victims of norovirus infection suffer from vomiting, nausea and copious, watery diarrhea. The virus is very hardy, and survives for days on dry surfaces. It is usually spread through direct or indirect contact with contaminated vomit or feces.

To protect yourself from contracting a norovirus infection, pay special attention to personal hygiene. If you are spending time in public areas - hotels, restaurants, department stores, nursing homes, childcare centers, cruise ships or movie theaters - be careful to avoid touching your hands to your face at any time. Wash your hands frequently and thoroughly, using plenty of soap and hot running water.

The Cruise Bug Bites!

There was trouble in paradise last week - a Norovirus outbreak during a seven day cruise around the Hawaiian Islands on the Pride of Hawaii. The virus hit at least 225 of the roughly 2500 passengers on the ship.

Norovirus (formerly known as Norwalk-like virus) has developed over the last several years into a major headache for cruise lines, hotels, nursing homes and any other places where large numbers of people congregate. It is spread by direct or indirect contact from an infected individual, and can survive for a long time on surfaces such as handrails and doorknobs. Victims of Norovirus usually suffer from vomiting, diarrhea and/or cramps.

While the only cure for a Norovirus infection is to survive it, there are things you can do to minimize the risk of becoming a victim of this virus if you are spending time in a public place such as a hotel or a cruise ship.

1. Wash your hands carefully and frequently with soap and hot water, especially after touching a surface that might have been touched by other people (such as a doorknob, elevator button or handrail) and before eating or touching your face.
2. If you are planning a cruise, check out the sanitation inspection history of the cruise line and the specific ship, if you can. Ships that call at U.S. ports are inspected twice yearly by the CDC under their Vessel Sanitation Program. The detailed results of these inspections are available on the CDC web site.
3. If you are on a cruise and you are told that a Norovirus outbreak is in progress, follow all of the instructions you are given. The staff will be trying to contain the outbreak, and your cooperation might make the difference between getting sick and enjoying the balance of your cruise.