Researchers from the ZERO2FIVE Food Industry Centre at Cardiff Metropolitan University will be giving out thermometers during the Amgueddfa Cymru Food Festival in Cardiff on Sept. 9.

As part of the “Is your fridge cold enough?” project, 1,000 people will get a free thermometer to take home. They will be asked to upload information about the temperature of their fridge to an online portal. 

Data collection started at another event in August, where 500 thermometers were distributed. Work continues into October, after which data analysis will take place and findings will be prepared as an abstract for presentation at the International Association for Food Protection (IAFP) conference in 2024.

The citizen science project aims to obtain information about the operating temperatures of as many fridges as possible to determine if they are storing food safely. People who take part will be entered into a competition to win one prize of a £100 voucher ($125).

How to take part
Scientists will talk people through what they need to do and there will be a bilingual information sheet as part of the thermometer pack. Participants need to put the thermometer in the fridge door storage area and leave the door closed for at least 15 minutes. Past research has found the door of the refrigerator to be the warmest place in the fridge.

Then they should open the fridge and take a picture of the temperature on the thermometer.

Participants either scan the QR code or visit the web address on the information sheet to upload an image of the temperature displayed. On the portal there are questions regarding demographics, the temperature, and refrigeration practices. The portal to submit temperature information will remain open until October 9.

When a temperature above the recommended 5 degrees C (41 degrees F) is recorded, people are told that having a fridge operating at this level can encourage food poisoning organisms and spoilage bacteria to grow quicker. The portal also tells participants that they can reduce the risk of illness and help prevent food waste by gradually adjusting the dial, so temperature on the thermometer is 5 degrees C or less.

Benefit of citizen science projects
To take part in the project, visit ZERO2FIVE’s researchers in the Good Food Cardiff Zone area at the food festival in St Fagans National Museum of History.

Previous ZERO2FIVE research has found that people trust their fridges to ensure food is safe to eat, often without checking they are functioning at the correct temperature. Most households do not have refrigerator thermometers, meaning people may be storing food above the recommended 5 degrees C (41 degree F). This can lead to faster growth of spoilage and food poisoning bacteria.

Ellen Evans, who is leading the project, said: “This exciting citizen science project will give people a chance to take part in important research, but most importantly it will enable people to check whether their fridge is operating at a safe temperature and potentially reduce their risk of getting food poisoning. Fridge thermometers are an invaluable tool, and this is a great opportunity to get hold of one for free.” 

Meanwhile, the UK Association for Food Protection Conference has been scheduled at the All Nations Centre in Cardiff on Nov. 22, 2023. Speakers and the final program have yet to be confirmed.

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Officials now report that nine hospitalized children have been diagnosed with a complication that causes the kidneys to shut down.

Eleven daycare centers have been closed since Monday. Five of them may be allowed to reopen on Sept. 11 if no illnesses among attendees or staff have been confirmed. The five centers and six with known patients were closed as a cautionary move because they all use a central kitchen.

The Shiga toxin-producing E. Coli involved in the outbreak can also attack other organs and cause widespread organ failure. It is not unusual for children to appear to be recovering and then backslide into a much more severe infection.

Investigators have collected samples of leftovers and frozen food for testing, but those test results are not yet available.

About E. coli infections
Anyone who has developed symptoms of E. coli infection should seek medical attention and tell their doctor about their possible exposure to the bacteria. Specific tests are required to diagnose the infections, which can mimic other illnesses.

Alberta Health Services officials said the outbreak has peaked, though more patients could be identified. There is a chance of secondary infections where sick patients expose others in their families to the bacteria.

The symptoms of E. coli infections vary for each person but often include severe stomach cramps and diarrhea, which is often bloody. Some patients may also have a fever. Most patients recover within five to seven days. According to the Centers for Disease Control and Prevention (CDC), others can develop severe or life-threatening symptoms and complications.

Many people with HUS recover within a few weeks, but some suffer permanent injuries or death. This condition can occur among people of any age but is most common in children younger than five years old because of their immature immune systems, older adults because of deteriorating immune systems, and people with compromised immune systems such as cancer patients. 

About 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication known as a hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, tiredness, decreased frequency of urination, small unexplained bruises or bleeding, and pallor. 

People who experience HUS symptoms should immediately seek emergency medical care. People with HUS will likely be hospitalized because the condition can cause other serious and ongoing problems such as hypertension, chronic kidney disease, brain damage, and neurologic problems.

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The study was conducted by scientists at the University of Pretoria (UP) in 2019 and 2020 into the prevalence of Listeria monocytogenes in beef and beef products at abattoirs and retailers in the Gauteng, Mpumalanga and North West provinces.

It showed that 4.6 percent of chilled carcasses sampled at seven abattoirs in Gauteng were positive for Listeria. This means that contaminated items could enter the food chain as beef products sold at retail outlets in the province. 

The study, funded by Red Meat Research and Development South Africa, was prompted by the 2017-2018 outbreak of listeriosis with 1,065 confirmed cases and 218 deaths. It was traced to a ready-to-eat processed meat product called polony, made at a plant in Polokwane run by Enterprise Foods, which at that time was owned by Tiger Brands.

Ready-to-eat (RTE) food, including polony, were also positive for Listeria in the current study.

Supply chain assessment
“Processed foods become contaminated by contact with equipment, the handling of raw products, or from post-processing settings in which the pathogen can survive despite the routine use of disinfectants. Because of potential contamination during slaughter, carcasses can become contaminated, leading to contaminated meat and meat products,” said Dr Rebone Moerane, head of UP’s Department of Production Animal Studies, who was part of the research team.

Another study, published in the Journal of Food Safety, revealed that 8.3 percent, or 33 of 400, beef and beef products were contaminated with Listeria monocytogenes.

University of Pretoria researchers also looked at the prevalence and factors associated with Listeria in cattle, silage, feeds, and water on farms in the three provinces; in slaughtered cattle and carcasses at processing plants; and the contamination of beef products at retail. 

Samples were collected from cattle farms; carcass swabs were taken from abattoirs, and samples of raw beef and beef products, including ready-to-eat items, were collected from shops of all sizes. 

Researchers found the risk of exposure of cattle to listeriosis on farms is minimal. However, the detection of contaminated chilled carcasses sampled at Gauteng abattoirs is troubling, as are the findings at retail outlets, they said.

Get ahead of another outbreak
The prevalence of Listeria was 6 percent, 8.3 percent, and 9.3 percent in beef and beef products sampled in outlets in North West, Mpumalanga, and Gauteng respectively, and 4.3 percent, 11 percent and 9.3 percent for cold beef and beef products.

“Some of the contaminated products were RTE items – including polony, which is widely consumed, and biltong. This increases the risk of human exposure to the pathogen,” said Dr. Moerane. 

“It’s our hope that government and industry stakeholders will act on these findings and introduce strict control and monitoring measures at the appropriate stages in the beef production system. It’s vital that we use the outcomes of this study to get ahead of another potential outbreak of listeriosis.”

In most cases, Listeria monocytogenes isolates responded to penicillin, ampicillin and sulfamethoxazole-trimethoprim, which are important antimicrobials used to treat listeriosis.

Scientists recommended that government and industry implement stringent food safety measures at abattoirs and processing plants to reduce contamination and lower the possibility of another listeriosis outbreak. 

They also suggested follow-up studies of moist biltong, which is widely consumed in the country, to determine its ability to support the growth of Listeria and assess the risk posed to consumers. 

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The European Food Safety Authority (EFSA) and EU Commission’s Inter-European Union Reference Laboratories (EURL) Working Group on Next Genome Sequencing (NGS) organized the second Science Meets Policy conference this week. More than 100 people from 20 countries attended in-person while online viewers peaked at 257.

Stefano Morabito, from the Italian National Institute of Health (ISS); George Haringhuizen, at the Dutch National Institute for Public Health and the Environment (RIVM); João André Carriço, of bioMérieux; Katja Alt, from the German Federal Ministry of Food and Agriculture and Coen van der Weijden, from the Netherlands Food and Consumer Product Safety Authority (NVWA) were featured on a panel discussion.

Panelists highlighted the need for flexibility, especially as there are 27 countries in Europe at different stages in use of Whole Genome Sequencing and as outbreaks can involve nations outside the EU. They discussed the types of data needed, data quality and comparability, resource issues, how to build trust and the role of different parties including regulators and industry.

EFSA and ECDC’s One Health WGS system has been operating since July 2022 and while things are going well, not all member states are contributing equally.

Data sharing dilemmas

Bernhard Url, EFSA’s executive director, said genomic data sharing is now at a turning point.

“We believe that from a technological and methodological point of view we are ready to use WGS data more widely and with more impact. Many of the problems have been solved and the technical infrastructure has been built. There is no doubt, at least within the community, that data sharing adds value, because it leads to faster outbreak detection and better tracing. It increases the likelihood of connecting sporadic cases to clusters and to detect outbreaks and there is measurable economic impact,” he said.

However, despite the knowledge that sharing data helps, there are still some obstacles that prevent wider use, said Url.

“There are technological gaps as not all member states or organizations use WGS on a routine basis. There is also a worry that people and countries say we don’t have a robust legal basis to share data. There is a fear that people lose control of data, they produce the data, share it but don’t know what happens afterwards. There is a concern that if this technology would be used widely, many more clusters would be detected, which is good from a public health point of view, but it also would increase the workload of national authorities to follow-up and deal with these clusters.”

Url said it would be “unwise” to wait for legislators to define the rules of the game.

“The WGS community must do our part to create the conditions for success. We think there is a lot we can do to move data sharing forward in the current legislative framework. We still have to work on creating a mutual understanding about benefits and limitations of this technology. We have to agree on common guidelines, processes and procedures, otherwise we wouldn’t know how to compare different outcomes,” he said.  

“We want to act as openly as possible but as confidential as needed, there is a fine line that we have to find. EFSA has invested resources in creating a technological infrastructure for enabling WGS data sharing, mainly to tackle foodborne threats. We will continue to do our part to move genomic data sharing forward.”

United States perspective

Eric Stevens, from the U.S. Food and Drug Administration, said the GenomeTrakr network is the result of 12 years of work. At the end of 2021, there were 600,000 genomes in the public database, today it is more than 1,000,000 sequences.

“After more than a decade of experience, it is not the sequencing that is the challenge when transitioning to this data, it is how you are going to analyze it, train staff, gain the skills and enable the entire system to utilize it effectively,” he said.  

“Metadata helps to tell a complete picture, without it you have a DNA sequence, which can only tell you some stuff. Contextual data gives that data life, it tells you where those bacteria came from, how they were living and when we are starting to think about the interventions we can make, we need that information to understand the complete picture.

“For us, the best use is making it open data available to anyone because somebody maybe interested in Salmonella, somebody else in E. coli and sometimes they overlap with interventions you can make for preventive controls and reducing contamination.”

Stevens said once data is in the database, a variety of things can be looked at.

“When you start thinking of the global food chain you can think where do we need more data from and start doing some projects to tackle those problems to better understand how food becomes contaminated in the first place. You wouldn’t know any of this unless you had the data that can help point the way,” he said.

“GenomeTrakr is responsible for almost 100,000 food and environmental isolates to tell a more complete picture of linking clinical isolates back to their sources, so we can not only respond to foodborne outbreaks but then try to prevent them. When you start looking at where your sources of food and environmental isolates linked to human illnesses come from, you can start doing source attribution and more preventive targeting. If we can get to a point where we can upload data in real time we can start to make those connections as early as possible to get a contaminated product out of the market.”

It can also help in moving from responding to outbreaks to trying to prevent contamination occurring.

“In a facility for example, you are not going to do WGS to identify a pathogen, you can do a quick culture method to see presence or absence. But if you have a facility that is concerned about whether they have a resident pathogen you would 100 percent like this information from WGS. You could expand that further to farms and potential water sources,” said Stevens.  

“When you start doing projects in different parts of the world you start understanding that everybody has issues that maybe aren’t issues for you. We’ve done a lot of work in Latin America and the big problem in getting started in sequencing is availability of reagents. We hear it costs five to seven times more than what we pay. When we talk about this being utilized by the world we have to start focusing on those issues that are going to make the most impact.”

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The French Agency for Food, Environmental and Occupational Health and Safety (ANSES) said mushroom picking had started earlier than usual in 2023.

Rainy weather in several regions in August encouraged the growth of mushrooms. Growth varies yearly, depending on various things, including weather.

Since the start of August, intoxications reported to poison control centers (CAP) have increased. More than 250 cases have already been recorded, twice as many as in the same period in 2022.

There are several reasons for poisonings, including confusion of an edible species with a toxic variety or consumption of edible mushrooms in poor condition that were poorly preserved or insufficiently cooked.

It is not recommended to serve infants picked wild mushrooms but 74 young children were poisoned, including an 11-month-old child who required treatment in intensive care.

Not a new problem
Although ANSES issues recommendations yearly, cases are frequently reported to poison control centers.

Between July and December 2022, 1,923 poisonings were reported to CAPs. This was more than 1,269 cases in 2021. However, the number of serious cases was down slightly from 41 in 2021 to 37 in 2022. There were two deaths compared to four fatalities in 2021. The peak this past year was in October when more than 1,000 cases were recorded.

From all poisonings, 30 people had used recognition applications on smartphones. This is not advised due to the high risk of error.

Pick only specimens in good condition and take the entire mushroom to help with identification. Do not pick mushrooms near potentially polluted sites such as roadsides and landfills.

Store mushrooms in the fridge at a maximum of 4 degrees C (39.2 degrees F), avoid all contact with other foods, and consume within two days of picking. Ensure they are correctly cooked – 20 to 30 minutes in a pan or 15 minutes in boiling water – and don’t eat too many in one sitting.

ANSES recommends only collecting mushrooms they know, as some highly toxic ones are similar to edible species. Poisonous types can also grow where edible varieties had been picked in the past. If there is the slightest doubt, consult a specialist before consumption.

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Nineteen sick people are aged 63 to 93, including 13 men and six women. Patients have been reported from 10 different regions.

Six people with listeriosis have died. However, it is unclear what role the infection played in their death because most patients had other severe underlying diseases.

People have been sick with the same type of Listeria since autumn 2022, but 15 cases occurred from the end of May this year, said Folkhälsomyndigheten (the Public Health Agency of Sweden).

Of cases with available information, 14 reported eating vacuum-packed salmon from one of two brands before falling sick. Both these brands are produced by Leröy Seafood, and Listeria was detected in products and environmental samples in the firm’s facility.

In most cases, samples have only been analyzed qualitatively so it is unclear if Listeria was above the limit of 100 CFU/g, according to Livsmedelsverket (the Swedish Food Agency).

“For Leröy Smögen Seafood, safe and secure food is our priority, and we take this incident very seriously. We are doing everything we can to ensure this does not happen again. We have a good cooperation and dialogue with the Swedish Food Agency,” said a company statement.

Finding the source of infections
Further analysis of samples from food, the environment, and human cases found the same type of Listeria, which points to the salmon products being the likely source of infection. The company has increased sampling and is carrying out further clean-up measures at the facility.

In early August, the retailer Axfood recalled a batch of Falkenberg Seafood cold smoked salmon 200-grams after low levels of Listeria were found.

The product was available for sale in the majority of Axfood’s stores. Listeria was detected during the retailer’s internal checks.

“The production has not been stopped, but all batches are currently analyzed for the presence of Listeria before release on the market. The company must take action following its HACCP-based procedures. They must also investigate the cause of contaminated products with Listeria monocytogenes and take measures to prevent such contamination. This may involve changes to HACCP-based procedures or other measures,” said Mats Lindblad from Livsmedelsverket.

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Eleven daycare centers in Calgary, Alberta, Canada, have been closed because of the illnesses, which now number 96. During a press conference this afternoon, Dr. Francesco Rizzuti, medical officer of Alberta Health Services Calgary, said 22 patients had been hospitalized. 

Rizzuti said both adults and children have been confirmed sick as outbreak patients. The Alberta Health Services reported that all hospitalized patients are children. Rizzuti declined to say what specific complications the patients suffer, only that some symptoms are severe.

Patients started going to emergency rooms and being admitted to hospitals this past weekend, Rizzuti said. He made the decision Monday to close the 11 daycare centers because they share a common kitchen. On Tuesday morning investigators began collecting samples for testing. Among the samples collected were leftovers and frozen foods.

Parents have reported to Canadian media that they believe meatloaf served to children may be the source of the E. Coli, but Rizzuti would not confirm that.

More than 2,000 stool sample kits have been sent to the implicated daycare centers. Parents and staff can pick up the kits for free. Specific tests are required to diagnose E. Coli infection because it can mimic other illnesses.

Some media reports have said that the central kitchen used by the daycare centers had received non-compliance scores during recent inspections. However, Rizzuti said that is not the case and that the kitchen’s most recent inspections have shown compliance with food safety regulations.

Only some of the daycare centers that have been closed are associated with patients, said Rizzuti. But as a cautionary move he ordered all 11 using the central kitchen to be closed until the situation is resolved.

“We think there is a common source,” Rizzuti said during the press conference this afternoon, adding that it is not unusual for investigators to be unable to determine the source of outbreaks.

He said hospital care for those infected with E. coli can include treatment for dehydration, or, on a more severe scale, monitoring for hemolytic uremic syndrome, a type of kidney failure. Patients are also monitored for sepsis.

Investigators are calling each household with a confirmed illness in addition to collecting and testing samples. Rizzuti said it could take weeks or months to finish the investigation.

The following sites have been issued a closure order until issues are resolved:

• Fueling Brains Braeside
• Fueling Brains West 85th
• Fueling Brains New Brighton
• Fueling Brains Centennial
• Fueling Brains Bridgeland
• Fueling Brains McKnight
• Braineer Academy
• Kidz Space
• Little Oak Early Education (formerly Mangrove)
• Almond Branch School
• Vik Academy in Okotoks

Anyone who works at any of the daycare centers or has a child who attends them should be on the lookout for E. Coli symptoms.

About E. coli infections

Anyone who has developed symptoms of E. coli infection should seek medical attention and tell their doctor about their possible exposure to the bacteria. Specific tests are required to diagnose the infections, which can mimic other illnesses.

The symptoms of E. coli infections vary for each person but often include severe stomach cramps and diarrhea, which is often bloody. Some patients may also have a fever. Most patients recover within five to seven days. Others can develop severe or life-threatening symptoms and complications, according to the Centers for Disease Control and Prevention (CDC).

About 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication, known as a hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor. 

Many people with HUS recover within a few weeks, but some suffer permanent injuries or death. This condition can occur among people of any age but is most common in children younger than five years old because of their immature immune systems, older adults because of deteriorating immune systems, and people with compromised immune systems such as cancer patients. 

People who experience HUS symptoms should immediately seek emergency medical care. People with HUS will likely be hospitalized because the condition can cause other serious and ongoing problems such as hypertension, chronic kidney disease, brain damage, and neurologic problems.

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The Directorate-General of Health (DGS) said 209 cases were associated with the consumption of broa de milho (a type of cornbread) in some regions of the country since mid-July.

The clinical symptoms of cases directed a laboratory investigation that considered the short incubation period and duration, the literature, and had contributions from experts.

Patients presented similar symptoms, including a dry mouth, vision issues, dizziness, mental confusion, and decreased muscle strength. Symptoms were observed between 30 minutes to two hours after eating food. In most cases, they were classified as mild, but more than 40 people required hospital care.

Tropane alkaloid findings
In samples taken from flour, bread, and patients, the tropane alkaloids atropine and scopolamine were detected at very high levels.

An investigation found strong evidence of contamination with seeds from the Datura genus, a plant that may be present as weeds in cultivated fields. Such contamination can occur during harvesting.

This work involved regional departments of public health, the Economic and Food Safety Authority (ASAE) and the General Directorate of Food and Veterinary Affairs (DGAV).

Following the incident, DGAV is to release a guide for producers, to ensure better control of this plant in fields and after harvest.

In early August, officials warned people not to eat broa de milho in certain parts of the country but said the product “is, and should continue to be, an integral part of the Portuguese diet.”

Authorities restricted the use of raw materials in the manufacture of the implicated products.

The advice to avoid broa de milho in Leiria, Santarém, Coimbra, and Aveiro has now been lifted.

Authorities said this is due to the lack of new suspected cases and the absence of potentially contaminated products on the market. Businesses and consumers were thanked for following the earlier recommendations.

DGS added that a risk assessment does not justify maintaining the guidance to avoid broa de milho in the identified regions but if new cases arise the situation could change.

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The Joint FAO/WHO Expert Meeting on Microbiological Risk Assessment (JEMRA) event, at FAO headquarters in Rome on Sept. 18 to 22, will work on food attribution, analytical methods, and indicators of viruses in foods.

United States-based experts proposed for the meeting are Donald Schaffner, of Rutgers University; Xiang-Jin Meng, at Virginia Tech; Kali Kniel, from the University of Delaware; Lee-Ann Jaykus, at North Carolina State University; and Jacquelina Williams-Woods of the FDA.

In 2022, the Codex Committee on Food Hygiene (CCFH) asked JEMRA to provide scientific advice to inform a review of guidelines established in 2012. This was due to emerging issues associated with foodborne viruses and scientific developments.

Aims of first meeting
The main purpose of the past document was to give direction on how to prevent or minimize the presence of human enteric viruses in foods, especially Hepatitis A virus (HAV) and Norovirus.

It was applicable to all foods, with a focus on ready-to-eat food, from primary production through to consumption.

The guide also contains an annex on the control of Hepatitis A virus and Norovirus in bivalve mollusks and the same two agents in fresh produce.

JEMRA’s work will focus on reviews of the foodborne viruses and relevant food commodities of the highest public health concern; the analytical methods for relevant enteric viruses in foods and of scientific evidence on the potential of viral indicators or other indicators of contamination.

Experts will also look at the scientific evidence on prevention and intervention measures and the efficacy of interventions.

The provisional list of 23 scientists also includes Magnus Simonsson, director of the European Union Reference Laboratory (EURL) for foodborne viruses; Shannon Majowicz, from the University of Waterloo; and Joanne Hewitt, at Environmental Science and Research in New Zealand. 

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Recent modifications to FDA’s import alerts, as posted by the agency, are listed below. 

Click here to go to the FDA page with links to details on specific alerts.

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Alberta Health Services reports at least 50 children with symptoms of E. Coli infection have gone to hospitals. There are 17 lab-confirmed patients.

All 11 daycare centers share a common kitchen, according to the health services.

The following sites have been issued a closure order until issues are resolved:

• Fueling Brains Braeside
• Fueling Brains West 85th
• Fueling Brains New Brighton
• Fueling Brains Centennial
• Fueling Brains Bridgeland
• Fueling Brains McKnight
• Braineer Academy
• Kidz Space
• Little Oak Early Education (formerly Mangrove)
• Almond Branch School
• Vik Academy in Okotoks

Families with children attending any of the implicated locations are being sent letters advising of the outbreak and are being asked to monitor for symptoms and present to an emergency department if necessary.

About E. coli infections
Anyone with children at the implicated daycare centers who have developed symptoms of E. coli infection should seek medical attention and tell their doctor about their possible exposure to the bacteria. Specific tests are required to diagnose the infections, which can mimic other illnesses.

The symptoms of E. coli infections vary for each person but often include severe stomach cramps and diarrhea, which is often bloody. Some patients may also have a fever. Most patients recover within five to seven days. Others can develop severe or life-threatening symptoms and complications, according to the Centers for Disease Control and Prevention (CDC).

About 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication, known as a hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor. 

Many people with HUS recover within a few weeks, but some suffer permanent injuries or death. This condition can occur among people of any age but is most common in children younger than five years old because of their immature immune systems, older adults because of deteriorating immune systems, and people with compromised immune systems such as cancer patients. 

People who experience HUS symptoms should immediately seek emergency medical care. People with HUS will likely be hospitalized because the condition can cause other serious and ongoing problems such as hypertension, chronic kidney disease, brain damage, and neurologic problems.

(To sign up for a free subscription to Food Safety News,click here)

In late August, the National Health Surveillance System was notified of the cases following a meeting at a house in the district of Buenos Aires.

Three patients are adults and one is a child under 5 years old. All of them have been hospitalized and received treatment with antitoxin.

Investigations have revealed that all cases are related and shared, among other foods, some type of homemade preserve. Lab analysis identified botulinum toxin type A in one of the jars of this food.

Health officials said the early suspicion and notification of cases made it possible to quickly identify those affected, commence treatment and start the epidemiological investigation. This identified the homemade preserves as the source, which allowed potential further infections to be avoided.

Botulinum poisoning is a rare but life-threatening condition, caused by toxins produced by Clostridium botulinum bacteria. In foodborne botulism, symptoms generally begin 18 to 36 hours after eating contaminated food. However, they can occur as soon as six hours or up to 10 days later. Symptoms may include double or blurred vision, drooping eyelids, slurred speech, difficulty swallowing or breathing, paralysis, a thick-feeling tongue, dry mouth, and muscle weakness.

Trichinella situation

The Argentinian Ministry of Health has also shared updated data on Trichinella in the province of Buenos Aires.

So far in 2023, 160 suspected trichinosis (or trichinellosis) cases have been recorded, this includes 38 confirmed, 56 probable cases and another 65 still under investigation. Three outbreaks have been noted in Chivilcoy, Coronel Dorrego and one that affected several areas.

For the same period in 2022, 210 suspected cases were reported, of which 59 cases were confirmed and 141 were potential infections. Seven outbreaks were recorded.

Trichinellosis is transmitted by eating raw or undercooked pork contaminated with the parasite Trichinella.

Initial symptoms of infection are nausea, diarrhea, vomiting, fatigue, fever, and abdominal discomfort. Headaches, fevers, chills, cough, swelling of the face and eyes, aching joints and muscle pains, itchy skin, diarrhea or constipation may follow. Patients may have difficulty coordinating movements, and have heart and breathing problems.

Abdominal symptoms can occur one to two days after infection. Further symptoms usually start two to eight weeks after eating contaminated meat. Freezing, curing or salting, drying, smoking, or microwaving meat may not kill the organism. The best way to prevent trichinosis is to cook meat to a temperature of 71 degrees C (160 degrees F).

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Findings come from a report covering work of the UK’s national reference laboratory (NRL) for food microbiology between April 2022 and March 2023.

The UK Health Security Agency (UKHSA) provides the service for the Food Standards Agency (FSA) and Food Standards Scotland (FSS). It covers Listeria monocytogenes, coagulase-positive staphylococci, E. coli, Campylobacter, Salmonella, and antimicrobial resistance.

EU exit impact

The UK NRL had reduced opportunities with European Union Reference Laboratories (EURLs) due to EU exit, but participated in certain activities. It is no longer on the EURL Listeria challenge testing working groups and has been unable to attend all EURL annual workshops and training sessions. Certain presentations are on private webpages, which can no longer be accessed.

Despite some restrictions, the NRL attended the proficiency testing part of three of six EURL meetings remotely. The NRL gave advice to FSA, Official Laboratories (OLs) and other stakeholders and liaised with FSA on UK lab capabilities, including responding to queries.

Other work with the FSA included feedback on national monitoring plan sampling priorities and results of a Shiga toxin-producing E. coli (STEC) in flour study.

After the COVID-19 pandemic and leaving the EU, there has been a downward trend in EpiPulse and other alerts being sent to the UK NRL. In the latest reporting period, only one query was received from the Salmonella EURL regarding monophasic Salmonella Typhimurium and whether the strain had been seen in the UK in 2021-22, to which the NRL replied that it had not.

An audit report on Official Laboratories’ capabilities in England, Scotland, Wales and Northern Ireland is due to be published shortly. The NRL is also working on a review of AMR in Listeria monocytogenes and other Listeria in food.

Since exiting the EU, the UK has been developing a strategy for border controls on imported products from EU and non-EU countries, including animal and plant products and high risk food and feed of non-animal origin. The NRL met with the FSA to clarify sampling arrangements and expected sample numbers. However, delays in implementation of new sampling requirements for imported foods from the EU have meant that planning for additional testing within the OLs has also been delayed, according to the report.

Proposed activities for April 2023 to March 2024 include meetings with the Animal and Plant Health Agency (APHA) for AMR, Campylobacter and Salmonella, liaising with CEFAS on E. coli and Salmonella in shellfish and with Campden BRI to discuss challenge testing activities, and monitoring Official Laboratory performance.

Salmonella in UK eggs

In other news, the FSA has looked at Salmonella in UK-produced table eggs. The agency said the analysis does not indicate there is a need for another risk assessment. 

A risk assessment in 2016 found that due to a significant reduction in the risk from Salmonella in UK hen shell eggs produced under a recognized farm assurance scheme, such as the Lion Code or equivalent, the risk to consumers was very low. This led the FSA and FSS to update public advice on eating eggs in 2017, so that vulnerable groups could consume raw or runny eggs produced within an assurance scheme.

Eggs and egg products were the food type most commonly linked to Salmonella outbreaks in the UK between 2015 and 2020, said the review.

Between 2015 and 2019, 954 confirmed cases of salmonellosis were associated with consumption of eggs and/or egg products. This is a similar number of infections per year as reported in the 2016 assessment. Ten of 15 outbreaks had fewer than 45 cases. The largest incidents occurred in 2016 with 158 cases, in 2017 with 162 cases and in 2018 with 259 cases.

Two outbreaks of around 100 cases each were linked to Lion Code eggs. The 2016 risk assessment only found one small outbreak in 2009 traced to Lion code eggs. 

Prevalence of all Salmonella types in laying flocks in the UK in 2017 to 2021 was similar to 2009 to 2016 levels. However, the prevalence of regulated Salmonella serovars and Salmonella Enteritidis has roughly doubled in 2017 to 2021 but still remains within National Control Program (NCP) requirements.

Since the 2016 report, the implementation of whole genome sequencing for Salmonella surveillance by UK public health agencies has become routine. This has increased the sensitivity and specificity of case ascertainment in outbreak investigations, and confidence in source attribution, said FSA.

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The majority of topics highlighted at a recent World Trade Organization (WTO) meeting on food safety had already been discussed before.

At the WTO Committee on Sanitary and Phytosanitary (SPS) Measures meeting in July, members addressed specific trade concerns relating to food safety and animal and plant health.

The one new area was Canada’s restrictions on Brazilian pork from internationally recognized foot and mouth free zones without vaccination.

Ukraine shared information on the current functioning of its SPS infrastructure and other aspects of the food security situation. Russian officials said discussions about the war were outside the scope of the WTO.

U.S concern over Chinese rules

The United States repeated that it remains “deeply concerned” with China’s lack of explanation on how two decrees address food safety and public health. The United States said China has not provided the scientific basis or risk assessment that informed their development. 

The European Union gave information on proposals around plants obtained by certain new genomic techniques and their food and feed, which sets out rules for the use of such plants as part of EU sustainability initiatives. The EU also reported on recommendations to combat antimicrobial resistance as part of the One Health approach.

Australian officials said they had confidence in the process that led to the decision to release the treated water and the move was also supported by the United States and United Kingdom.

The next meeting of the SPS Committee is scheduled for mid-November 2023.

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A total of 33 confirmed and one probable case were linked to a pub in Wrexham.

Despite an investigation and testing, the precise source or route of transmission in the Salmonella Infantis outbreak was not identified.

In late July, an Outbreak Control Team (OCT) was established including Public Health Wales, Betsi Cadwaladr University Health Board and Wrexham County Borough Council’s environmental health team.

No details on the age range or gender of patients were released to protect their identity.

Source of outbreak unknown
Richard Firth, consultant in public health at Public Health Wales, and chair of the OCT, said several cases of Salmonella were identified in Wrexham at the end of July.

“We can confirm a total of 33 confirmed, genomically identical, cases of Salmonella infection and one probable case associated with The Nags Head public house on Mount Street, Wrexham, owned by Marston’s PLC,” he said.

“On July 31, control measures were put in place, which included a voluntary closure and deep clean of the premises, and testing of all staff. No further cases have been identified since the control measures were put in place.

“Whilst all the evidence indicates the exposure site for the infections being The Nags Head, extensive investigation and testing has not identified the precise source or route of transmission for the infections. Public Health Wales would like to extend our sympathies to those affected by this outbreak. We would also like to thank our multi-agency partners as well as the management and staff at both The Nags Head and Marston’s PLC for their proactive support throughout this investigation.”

About Salmonella
Food contaminated with Salmonella bacteria does not usually look, smell, or taste spoiled. Anyone can become sick with a Salmonella infection. Infants, children, seniors, and people with weakened immune systems are at higher risk of serious illness because their immune systems are fragile, according to the CDC.

Anyone who has developed symptoms of Salmonella food poisoning should seek medical attention. Sick people should tell their doctors about the possible exposure to Salmonella bacteria because special tests are necessary to diagnose salmonellosis. Salmonella infection symptoms can mimic other illnesses, frequently leading to misdiagnosis.

Symptoms of Salmonella infection can include diarrhea, abdominal cramps, and fever within 12 to 72 hours after eating contaminated food. Otherwise, healthy adults are usually sick for four to seven days. In some cases, however, diarrhea may be so severe that patients require hospitalization.

Older adults, children, pregnant women, and people with weakened immune systems, such as cancer patients, are more likely to develop a severe illness and serious, sometimes life-threatening conditions. Some people get infected without getting sick or showing any symptoms. However, they may still spread the infections to others.

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Earlier this week, the Centre for Health Protection (CHP) of the Department of Health revealed a suspected puffer fish poisoning case and reminded people not to consume puffer fish.

The patient is an 84-year-old man who developed dizziness, finger numbness and shortness of breath about one hour after eating cooked puffer fish, which was caught by himself on the same day in local waters. He was admitted to a hospital for treatment and is in stable condition.

Certain organs of puffer fish have high concentrations of tetrodotoxin, which is a potent neurotoxin that can affect the central nervous system. The toxin is not removed by cooking, boiling, drying or freezing. 

In another incident, suspected neurotoxic shellfish poisoning affected two people.

A 42-year-old female and a 45-year-old male presented with tingling of the tongue, vomiting and diarrhea a few minutes to three hours after consuming steamed snails at home. An initial investigation revealed the snails were bought from a seafood stall at Ap Lei Chau Market.

“Neurotoxic shellfish poisoning toxin is a natural toxin sometimes found in bivalve shellfish. It is heat-stable and cannot be destroyed through cooking,” said a CHP spokesman.

Advice from officials included sourcing shellfish from places where monitoring programs for toxins have been established and to only purchase such products from reliable sources.

Bacterial outbreaks
CHP also investigated two suspected food poisoning clusters affecting five people.

The first cluster had two females, aged 29 and 30, who developed abdominal pain, diarrhea, nausea, vomiting and fever about 15 hours after eating at a restaurant in Tsim Sha Tsui. The other cluster involved three females, aged 22 to 49, who had similar symptoms about 14 hours after having dinner at this restaurant on the same day. Two people were hospitalized.

Initial investigations pointed to pancakes made with eggs as the source of illness that might have been caused by Salmonella.

An imported case of Shiga toxin-producing E. coli (STEC) infection was recorded in mid-August.

A 2-year-old boy was suffering from vomiting in early August, and then had a fever, abdominal pain and diarrhea the next day. He was taken to hospital and admitted before being discharged the next day after his condition became stable. STEC was detected in a stool specimen.

The patient had been to Malaysia from July 29 to August 3. He had consumed yogurt and fresh fruit juice, and had contact with animals. He also swam at the beach and in a swimming pool. Two family members also recorded similar symptoms but had recovered.

The largest outbreak sickened at least 55 people. It involved 24 males and 31 females, aged 7 to 49, who came down with abdominal pain and diarrhea eight to 16 hours after having dinner at a canteen of a campsite in Tai Po.

Officials suspected penne carbonara contaminated with Clostridium perfringens as the source of illness. Initial investigations revealed a possible reason for the incident was improper food holding temperatures. 

Wild plants and bamboo shoot
In mid-August, a 69-year-old woman fell sick after accidentally consuming part of a dangerous plant. CHP reminded the public not to pick or consume wild plants, and to be aware of vegetables containing calcium oxalate raphide.

The patient reported oral numbness, a burning sensation of the mouth and shortness of breath shortly after consuming a wild taro that she was given as a gift from a friend in Tai Po. 

Taro is a popular ingredient used to prepare various dishes and desserts. However, some plants look like taro, such as giant alocasia, but contain toxins that can cause food poisoning.

CHP has also advised people not to consume raw bamboo shoot after a 67-year-old man and a 50-year-old woman fell ill.

The male patient bought fresh bamboo shoots from a shop in Mei Foo and the female patient pressed them into juice at home on the same day. The duo developed headache, dizziness, palpitation, nausea, limb numbness and shortness of breath 10 minutes after drinking the juice. 

“Raw bamboo shoot contain cyanogenic glycosides. Cyanogenic plant products such as bamboo shoot can cause poisoning when eaten raw and in sufficient amounts. Cyanogenic plants should be cut into smaller pieces, soaked in water and cooked thoroughly in boiling water before consumption,” said a CHP spokesman.

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The study evaluated remote assessments for Food Hygiene Rating Scheme (FHRS) re-rating inspections in England. The Food Standard Agency’s (FSA) COVID-19 recovery plan enabled local authorities to conduct an FHRS re-inspection under certain conditions remotely.

It found that remote assessment should be encouraged, provided the concept incorporates hybrid approaches, and the scope is extended to the entire FHRS rating process. Findings will also be considered part of FSA’s modernization of official food hygiene controls.

Low use of remote assessment
Twenty local authorities were interviewed, including 14 that had never used remote assessment for a hygiene re-rating, four that had previously used it, and two that were still using it at the time of the interview. Ten interviews with food businesses of varying sizes included eight with no experience of a remote assessment for a food hygiene re-rating and two that had received them.

A definition of remote assessment was not given, so local authorities were largely uncertain about the concept.

The report found two local authorities had used remote assessment for ratings, which was against FSA guidance. Several also incorrectly believed that any hygiene re-rating remote assessment still had to be followed by an in-person visit before a rating was issued.

Support for remote assessment was mixed. Local authorities that had not used it were not interested in doing so in the future, primarily because the low number of re-rating requests meant it was unlikely to impact their resourcing. Most respondents with experience of remote assessment would either be open to using it again or had continued to use it.

The use of remote assessment to carry out re-ratings entirely remotely was uncommon. This was mainly because local authorities received only a few eligible requests. FSA data shows 63 of 304 local authorities had used remote assessment for a FHRS re-inspection. Participants often used hybrid approaches such as digital tools to collect information and an in-person inspection.

Identified pros and cons
Such assessments were judged appropriate for highly compliant outlets with a history of good scores, lower-risk companies such as home bakers, and structural or document-related non-compliances.

Food firms were open to receiving a remote assessment, delivering it consistently across areas and to a sufficient standard with clear guidance.

Benefits included staff travel time savings and reduced costs. The drawbacks mentioned were that they sometimes took longer than in-person visits and perceived reduced validity due to a loss of sensory aspects and their scheduled nature, so the surprise element was lost.

External issues covered the types of firms requesting re-ratings being unsuitable for such an assessment, limitations in technological capacity, language and communication barriers, lack of familiarity with the remote assessment process, and privacy and data concerns.

Eight authorities noted that firms wanted value for money and would be unwilling to pay the same amount for a remote assessment as an in-person inspection.

Internal barriers to using technology included getting support from environmental health officers, insufficient guidance from the FSA, technological limitations, and knowing if and how much businesses should pay for remote ratings.

To support future use of remote assessment, respondents wanted to see clear messaging from FSA to local authorities and companies to illustrate support; and increased flexibility for councils to choose the scenarios in which they used remote or hybrid approaches.

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An analysis by the European Centre for Disease Prevention and Control (ECDC) focused on two sub-clusters of Salmonella Enteritidis sequence type (ST) 11 with 134 cases mostly reported between January and August 2023. This Salmonella Enteritidis sequence type is the most frequently detected in Europe.

In one cluster, 97 cases with recent or historical isolates, that were closely related genetically, were reported with 22 cases in Denmark, 19 in France and 12 each in Ireland and the Netherlands. Norway has nine patients, Austria and Belgium both have six, Finland has five, Slovenia has three, Sweden has two, and Germany has one.

Link to meat from Poland
In Denmark, the majority of 19 interviewed cases reported consumption of kebab or pizza that may have had chicken as an ingredient, before developing symptoms. In Austria, two of five interviewed patients reported eating chicken kebabs within seven days before the onset of symptoms and two sick people ate other dishes such as chicken burrito and chicken schnitzel.

Last week, the Danish Veterinary and Food Administration (Fødevarestyrelsen) found Salmonella in a batch of frozen chicken kebab meat from Poland, which was withdrawn from the market. The meat was intended to be further heat-treated before eating.

Further tests found it was the same type of Salmonella that sickened people in Denmark from May to August. Frozen chicken kebab products were mainly sold to restaurants. Salmonella cannot survive heat treatment above 75 degrees C (167 degrees F). Fødevarestyrelsen said it would intensify scrutiny on other batches of chicken products from Poland to ensure they are not contaminated with Salmonella.

In the other cluster, 37 cases were reported with 10 each from France and Germany. Austria has eight patients, Sweden has four, Norway has three, and Slovenia has two.

The majority of tested isolates have shown resistance to ciprofloxacin. When antibiotic treatment is required, ciprofloxacin is often used but other antibiotics are needed for these cases.  

More people sick
The two clusters represent only some Salmonella Enteritidis ST11 infections and these strains continue to pose a risk in Europe until sources in the food chain are properly investigated and controlled, said ECDC.

This is shown by information from Austrian authorities, who have recorded 27 sick people in all federal states except Tyrol. One cluster has 14 cases from February to May 2023. Patients are between the ages of 10 and 64.

Another cluster has seven patients aged between 5 and 63 and a 63-year-old man died. Austrian media reported the Klagenfurt public prosecutor’s office is investigating the death. The third cluster, with the latest illness in July, has six cases in Austria aged between 7 and 75.

There were also 65 infections associated with an English outbreak in 2023. For 43 cases linked to a restaurant, the mean age was 32 with a range of 6 to 61 and 17 were female. Epidemiological investigations suggested eggs or chicken as the likely cause.

Thorough cooking of meat and poultry and avoiding cross contamination from uncooked meat to ready-to-eat food are vital to prevent infection with Salmonella.

In 2021, ECDC and the European Food Safety Authority (EFSA) disclosed a multi-country outbreak of Salmonella Enteritidis ST11 linked to poultry products. In 2020 and 2022, two assessments were published on outbreaks of Salmonella Enteritidis ST11 linked to eggs and egg products, showing circulation of the bacteria responsible since 2013.

Meanwhile, a recent control campaign by the National Food Chain Safety Office (Nebih) in Hungary found numerous hygiene problems, Salmonella positive products and one site was temporarily suspended. The seasonal operation looked at outlets selling gyros – a type of sandwich with meat and salad – and other meats.

In late July, Nébih officials conducted inspections in seven gyros distribution units. Proceedings were opened against five sites due to hygiene and traceability deficiencies. The operation of one was suspended. It has since been re-inspected with defects corrected and the required cleaning carried out, allowing it to continue operating.

A total of 19 products were also sampled at eight producers. Tests confirmed Salmonella in seven batches of poultry, so proceedings were brought against the three producers involved. Another two findings of Salmonella in other checks resulted in action including a manufacturer being told to review slaughter hygiene.

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Reports in early August suggested post-Brexit border controls were to be pushed back for the fifth time.

Sanitary and phytosanitary controls were delayed for three months and will now be introduced beginning Jan. 31, 2024. This includes health certification on imports of medium risk animal products, plants, plant products and high risk food and feed of non-animal origin from the EU.

Documentary and risk-based physical inspections on medium risk animal products, plant products and high risk food and feed of non-animal origin from the EU will be implemented in late April 2024.

The Border Target Operating Model was developed with the help of the Scottish and Welsh Governments and following engagement with businesses in the UK.

Phytosanitary certificates will be digitized from 2023 with take-up depending on the readiness of trade partners.

Officials said risks from inadequate controls were significant. A recent UK-wide Salmonella outbreak caused by chicken products from Poland resulted in more than 1,000 confirmed illnesses, with potentially as many as 4,000 additional cases that were not reported, and cost an estimated £7.7 million ($9.7 million).

Recent inspections of shops by local authorities in the UK detected frozen, raw and uncooked meat products marked as suitable only for sale in the originating country. Further investigations found the items had been purchased by two importers, linked to more than 280 UK retail outlets. Products were exported commercially and pre-notified on the UK imports system. Although they didn’t test positive for African Swine Fever, the fact they reached the UK presents a serious threat to the pig industry.

Reaction to model and new timelines
Nigel Jenney, CEO of the Fresh Produce Consortium, said: “It’s clear, government has acted upon our concerns and will now implement a unique border approach for the benefit of consumers and industry. This focused risk-based approach will reinforce UK biosecurity and promote self-regulation to minimize supply chain disruption.”

The Chartered Institute of Environmental Health (CIEH) said there remains ambiguity about the future charging mechanism for checks. The group said fees and charges should be set at the local level to account for the unique requirements and resources of individual regions.

CIEH added there was a need for clarity in the risk categorization of goods. The distinction between high, medium, and low-risk is vital to ensure that controls maintain high standards without causing unnecessary delays.

“While the Border Target Operating Model promises an efficient and effective system, CIEH and our members have been consistent in demanding that it remains robust in safeguarding public health, food safety, and biosecurity. Furthermore, while we wholeheartedly support innovations that streamline trade and enhance security, it’s essential that such schemes are not introduced at the expense of rigorous safety and public health controls,” said Louise Hosking, executive director of environmental health.

Nichola Mallon, head of Trade and Devolved Policy at Logistics UK, said the group will study the model to see if it provides the detail needed by members and EU suppliers.

“Will three months be sufficient time for government to provide the necessary technical detail and guidance that businesses will need to change processes and adapt to the changes outlined by the new trading arrangements?,” she asked.

“After so much time, and so many delays, logistics businesses are losing confidence in the government’s ability to provide workable solutions to enable the new trading arrangements to be implemented.” 

The National Farmers Union (NFU) said the delay was “hugely frustrating”.

“For the past three years, our farmers have faced the full reach of EU controls on our exports while the EU has enjoyed continued easy access to the UK marketplace. It’s hugely frustrating for many producers that the government has yet again delayed the implementation of vital checks on goods entering from the EU,” said Minette Batters, NFU president.

The International Meat Trade Association (IMTA) raised concerns about the exact rates of physical checks, risk categories for rest of world products and the SPS charging regime.

“I think the delay will come as a relief to many of our members who have been concerned about the introduction of certification for imports from the EU and how that will impact on just in time supply chains. We hope that there will be a redoubling of efforts from government to engage with industry to ensure that when the, now delayed, changes are introduced sufficient consideration is given to just in time supply chains,” said Dan Soper, IMTA policy manager.

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The rank of countries regarding proper hand hygiene practices was: Denmark, Greece, Norway, Romania, Hungary, Germany, UK, Portugal, France, and Spain, according to a study published in the journal BMC Public Health.

Objectives were to evaluate which demographic groups are more likely to be exposed to foodborne pathogens and assess consumers’ self-reported hand hygiene practices.

Families with members aged over 65 were less likely to apply hand hygiene practices at key moments than those without elderly members. Families with children under 6 years old reported being up to twice as likely to wash their hands at critical times compared to those without kids.

“It is worrying that about half of the respondents seem to have insufficient handwashing routines to protect themselves and their family members from foodborne infection,” said researchers.

Not washing hands for long enough

Monitoring handwashing practices can be done by observation or video recording, by measuring soap consumption or in self-reported surveys. All these approaches have strengths and weaknesses, said scientists.

Questions used were part of a larger survey conducted between December 2018 and April 2019 in the European Safe Consume project.

Almost half of 7,866 respondents self-reported that they wash hands after touching raw chicken. Half of the participants washed hands with soap, however, only 15.1 percent respected the recommended duration of 20 seconds. It is advised people sing the Happy Birthday song twice to hit this time target.

High percentages of self-reported handwashing were noticed after going to the toilet and after touching something that may harbor pathogens. Only three quarters wash hands after touching raw meat or eggs.

More than half of 9,966 respondents self-reported washing hands with water and soap, as is recommended by official agencies.

Older respondents above 35 years of age were more likely to report proper hand hygiene practices than younger people. Those with a middle/high level of education were almost three times more inclined to report adequate hygiene practices at key moments, including during raw chicken preparation.

Handwashing and specific practices

The likelihood of washing hands after handling raw chicken was more than 60 percent for Danish respondents. Similar results were found for British, Greek, and Norwegian citizens.

After touching raw chicken, only 294 of 916 British respondents said they wash hands with regular soap. However, the highest frequency of washing hands for at least 20 seconds was for British respondents, while the lowest percentage was for Hungarians.

Percentages reporting handwashing after touching or feeding animals ranged from 51.3 in Denmark to 69.4 percent in Hungary.

Brits, Greeks, and Romanians were more likely to use antibacterial soap. Romanian and Greek respondents had the highest frequencies in terms of duration of handwashing.

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Scientists said findings can help guide and allocate public resources to prevent Bacillus cereus foodborne cases.

Data from 2010 to 2020 came from the National Foodborne Disease Outbreak Surveillance System.

A total of 419 Bacillus cereus outbreaks were reported, leading to 7,892 cases, 2,786 hospital admissions, and five fatalities. The bulk of outbreaks were recorded in summer, primarily between May and September, found the study published in China CDC Weekly.

Link to rice products and schools

The most recurrent food vehicle was connected with rice or flour-based products, notably those made with rice or fried rice and school canteens bore the brunt of outbreaks. This suggests contamination and improper storage during food preparation. So, it is essential to prioritize education for canteen staff on food safety and proper practices, said researchers.

“Given the difficulties students face in discerning food quality and the inherent nature of communal dining in schools, they are at a heightened risk for foodborne disease outbreaks. Therefore, to mitigate the frequency of such outbreaks, supervisory bodies should enhance their oversight and management of food safety in school canteens.”

Bacillus cereus produces toxins that can be classified into vomiting-type and diarrhea-type enterotoxins based on the symptoms they cause. Foodborne infections manifest with symptoms such as nausea, vomiting, and diarrhea.

The most outbreaks occurred in 2018 with 56 while 2012 had the most cases. The peak hospitalization rate was in 2011. One death occurred in 2014 and two each in 2015 and 2016.

Foods derived from rice or flour were identified as the primary cause of most outbreaks and associated cases. Bakery products were responsible for the highest hospitalization rate. Five deaths were traced to rice or flour-based products and complex foods. Rice and rice products accounted for more outbreaks than flour and flour products.

The primary source of these outbreaks, as well as related cases, was school cafeterias. However, the household setting had the highest hospitalization rate and mortality rate.

Factors behind outbreaks

Multifactor contamination was identified as the leading cause for outbreaks and associated cases. This was closely followed by improper storage, accounting for 111 outbreaks and 1,981 cases. The highest rate of hospitalization was attributed to food mishandling and ingestion errors.

In the multifactor classification, the occurrence of two factors was most prevalent. The most frequent combination was inadequate storage and inappropriate processing followed by ingredient contamination or spoilage with improper storage.

To mitigate the risk of Bacillus cereus outbreaks, it is essential to address a multitude of core control and management factors, said researchers.

“These include utilizing safe food ingredients, ensuring cleanliness and standardization throughout the food processing procedure, preventing cross-contamination, thoroughly cooking the food, among others. Implementing proper preservation to inhibit the growth of Bacillus cereus is of great significance.”

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Surrey Heath Borough Council prosecuted the former operator of Mogul Restaurant in Bagshot. The company was ordered to pay a fine of £25,000 ($31,400), a victim surcharge of £2,000 ($2,500) and the council’s costs of more than £14,000 ($17,600).  

The restaurant was also temporarily shut at the time of the outbreak under emergency prohibition provisions to protect the public whilst necessary improvements were made.  

In total, 18 confirmed cases were part of the Salmonella Java outbreak and four people were admitted to hospital. All of those affected ate at the restaurant between Oct. 22 and Nov. 1, 2022. 

Investigations into the specific food item responsible were inconclusive. However, Salmonella was detected in environmental samples from a fridge door handle and in chopped coriander. 

Shaun Macdonald, from Surrey Heath Borough Council, said the investigation and prosecution case was complex and thanked environmental health and legal teams for their work.

“I’d also like to take this opportunity to remind all food businesses in the borough of their food safety responsibilities. These are laid out in law and the council will not hesitate to take action against those who do not prepare food safely to the required standards. We want residents and other guests to really enjoy eating out and having special times with friends and family, without any concerns for their well-being, by ensuring the highest food hygiene standards are in place,” he said. 

Several seizures of smokies
Meanwhile, Milton Keynes City Council’s environmental health team has seized almost 270-kilograms (595 pounds) of smokies.

Smokies are made from the meat of sheep and goats with the skin still attached and cooked using a blowtorch or similar method, to minimize costs and maximize profits. Their production and sale is illegal in the UK.

The council found smokies at three premises in Milton Keynes after receiving a tip-off and confiscated the unfit meat. Condemnation orders were issued by Milton Keynes Magistrates Court.

“The illegal trade in smokies is a serious public health risk, as the meat can be infected with diseases and parasites that could be passed on to consumers. It is extremely important that meat sold to the public is fit for human consumption and we will consider prosecuting anyone found to be selling illegal meat,” said Paul Trendall, cabinet member with responsibility for environmental health.

In June, smokies were found at a shop in Gravesend after environmental health officers carried out an unannounced inspection at Moyibo Foods.

Staff initially denied having any smokies on site but a search identified some unlabeled smokie meat in a chest freezer along with prepacked and unlabeled meat, which was removed from the premises and destroyed.

Several breaches of food and health and safety legislation were identified, and the business was required to close for urgent work to be carried out. A follow-up visit the next day found the premises had been cleaned and re-organized with repairs to electrical sockets and reinstatement of the hot water system, so it was allowed to re-open.

In March, a shop in Katesgrove was fined after illegal food products were discovered by Reading Council’s environmental health team.

Officers went to Freddie’s Afro-Caribbean in Reading in February 2023 for a routine hygiene inspection. During the visit, a goat carcass and three part carcasses – known as smokies – were seized after being found wrapped in black bags on the floor of the chiller unit, for collection by a customer.

Carcasses were unskinned, spines had not been removed, and they did not have an approved health identification mark. Meat sold in the UK must carry this mark. The owner was unable to show the required paperwork when asked and there were no details about where the meat had been sourced.

At a hearing at Reading Magistrates Court, justices approved the condemnation and destruction of goods. Frederick Otoo, director of Freddie’s Afro-Caribbean, was ordered to pay £2,025 ($2,550) in costs to the council.

Karen Rowland, from the council, said a routine inspection was able to uncover something much more serious.

“The production and processing in this manner with this kind of meat has been deemed illegal in this country because we are unable to guarantee the correct steps have been taken to make the goods safe. We remain vigilant against potentially unsafe food finding its way to the UK unchecked or examined without accompanying documentation. All food businesses must be able to provide a clear audit trail of where produce has come from,” she said.

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Outlets are given a rating from 0 to 5, with 5 indicating “very good” food hygiene and 0 meaning “urgent improvement necessary.” In Wales and Northern Ireland, businesses are legally required to display their Food Hygiene Rating Scheme (FHRS) sticker. In England, they are only asked to do so.

Fieldwork in October and December 2022 included 1,525 covert audits of food businesses in England, Northern Ireland and Wales and 1,500 phone interviews of firms in these nations.

Around nine in 10 businesses in Northern Ireland and Wales said the legal requirement to display the rating was a good thing. In England, 82 percent reported they believed it would also be good, down slightly from 85 percent in 2021. The most common reason was that it is important to be transparent about food hygiene.

FSA decided in late 2022 that work toward a comment period and subsequent primary legislation for mandatory display in England should be temporarily paused but intends to raise the issue again with ministers in the future.

Display rates and scores
In England, 67 percent of businesses were displaying a food hygiene rating, either inside or in a location visible from outside. This is up slightly from 64 percent in 2021.

The figure was 87 percent in Northern Ireland and 91 percent in Wales. However, this means one in 10 sites do not display their score. In the survey, businesses commonly reported this was because there was nowhere suitable to show it outdoors. Self-reported rates of display were higher than those observed during audits.

In England and Northern Ireland, takeaways and sandwich shops were more likely than average to have a sticker on display, while pubs, bars, and nightclubs were less likely. In Wales, restaurants and catering sites were more likely to display their sticker, while retail businesses, such as supermarkets and food shops, were less likely.

In England, businesses with a rating of 5 were more likely than average to display a sticker, while those with a 4 or 3 were less likely. Only six out of 22 outlets with a rating of 2 or below had a sticker on show.

Most businesses had an online presence. However, relatively few with a website or Facebook Business page displayed their rating on these platforms. The majority felt that showing food hygiene ratings should become mandatory for at least some online platforms.

Auditors compared the ratings observed within businesses to those found on the FHRS database. In a few cases where the rating displayed did not match the database score, more sites had a higher rating than a lower one.

Business satisfaction

Most businesses reported being satisfied with their food hygiene rating. Those with a higher rating showed better satisfaction levels. Reasons for being dissatisfied included they were expecting a higher rating, a sense that the result was not fair, and the inspection was conducted at an inconvenient time.

Around one third of businesses considered a rating of 4 to be the minimum and very few would be satisfied with a 3 or less.

A few businesses reported they had requested a re-rating inspection or right to reply. Only around 1 in 20 in each country had applied for a re-rating and around 1 in 10 used their right to reply.

Businesses who were not satisfied with their rating but did not apply for a re-rating inspection said this was because fees were too high, they had not yet made all the changes suggested or due to a lack of time. In contrast to 2021, the COVID-19 pandemic was not mentioned as a barrier. Of outlets that did apply for a re-rating, more than half were awarded a higher grade. This is a significant increase from 28 percent in 2021.

The majority of businesses that received a food hygiene rating of 4 or less reported making changes to try to improve their score. In England, the most common action was undertaking repairs or improvements, closely followed by cleaning the workplace or premises. In Northern Ireland and Wales, the top action was improving documentation or record keeping. 

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In today’s society, concerns about food safety often revolve around allergens and pathogens. However, safe food goes beyond these considerations for a growing number of people in the United Kingdom.

Preventing foodborne illness and managing allergens remains vital but it is equally important to widen the definition of food safety to include the provision of essential nutritional information.

The availability of comprehensive nutritional data in all food outlets is crucial for individuals managing conditions such as diabetes. Diabetics rely on precise carbohydrate information to calculate their insulin dosage accurately.

Type 1 diabetes is a serious, autoimmune condition where the blood glucose (sugar) level is too high because your body can’t make a hormone called insulin. It has nothing to do with a poor diet or an unhealthy lifestyle, but these circumstances accelerate the chances of getting type 2.

Estimates from Diabetes UK show that 5 million people in the UK have diabetes, although not all of these are diagnosed, and it is type 1 for around 400,000 people. Nearly 1.9 million Americans have type 1 diabetes, according to the American Diabetes Association.

Living with diabetes is difficult, it is relentless, 24/7/365 and involves constant weighing of food and carbohydrate/insulin dosage calculations. Diabetes doesn’t just affect you physically, it can affect you emotionally too. There are many factors to consider, and it can be stressful knowing what’s best, but you shouldn’t need to put your life on hold. All kinds of food are fine for people with type 1 diabetes to eat.

A diabetic, or the parent of a diabetic child, inspects food labels for the nutritional content of that food (especially carbohydrates), if it is not there, we don’t buy because, without it, you cannot calculate the insulin dosage required to counteract those carbohydrates. This data is found on all packaged food products but not on any loose or pre-packed products, nor can you find it on most menus in restaurants, cafes, street vendors, or ice-cream vans.

Carb counting is really important to keep blood sugar levels steady and avoid spikes. This means matching insulin to the amount of carbs you eat and drink. It takes time and effort, but once you get the hang of it, carb counting can lead to better blood sugar control. It also gives you more choice over when – and how much – you eat. You can enjoy special occasions and treats by making changes to insulin doses.

Need for full nutritional data

When considering food safety, we must broaden our perspective to include the specific needs of individuals with various health conditions.

Food and hospitality venues should provide full nutritional data because for individuals with diabetes, knowing the carbohydrate content of foods is crucial. Access to accurate information enables them to make appropriate food choices and calculate insulin.

By providing detailed carbohydrate information, food outlets can assist diabetics in calculating insulin doses accurately, promoting better blood sugar control and reducing the risk of complications.

If comprehensive nutritional data is available, food establishments can attract health-conscious consumers, promote a positive brand reputation, and differentiate themselves in a competitive market. Additionally, accommodating specific dietary needs can increase customer satisfaction and loyalty.

Diabetes UK has published a guide with a list of outlets that have included the carbohydrate, sugar, fat and salt content in each serving on menus.

Mandating the provision of nutritional data in food venues is a critical step towards promoting transparency and accountability within the industry. It encourages manufacturers and food establishments to prioritize consumers’ health by formulating and offering healthier options.

Educational initiatives can raise awareness about the importance of issues beyond pathogens and allergens, emphasizing the significance of nutritional data. Collaboration among government agencies, food industry stakeholders, healthcare professionals, and consumer advocacy groups is also vital in developing comprehensive strategies to enhance food safety for vulnerable populations.

About the author: Ron Cook is a retired senior technical manager in the food industry who campaigns for easier access to nutritional data to help diabetics manage their condition. His efforts have been featured in The Sun and Public Sector Catering magazine. He has an 11-year-old daughter with type 1 diabetes.

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A study analyzed the association between socioeconomic deprivation and incidence of IID by certain gastrointestinal pathogens reported to the UK Health Security Agency (UKHSA).

Infectious intestinal disease (IID) is an infection of the gastrointestinal tract that causes gastroenteritis. While most cases are mild, some people have to miss work or school because of symptoms and for particular pathogens, public health measures require the exclusion of those in certain groups, such as food handlers, from work.

Data covers 2015 to 2018 for lab confirmed Salmonella, Campylobacter, Shigella, Giardia species, and norovirus infections. Findings were published in the journal of Epidemiology and Infection.

Pathogen variation
Campylobacter and Giardia decreased with increasing deprivation. However, the incidence of norovirus, non-typhoidal Salmonella, Salmonella typhi/paratyphi, and Shigella species increased with higher deprivation.

There were 314,381 patients reported during the 4-year study period, of which 167,299 were male and 59,827 were children.

Almost 250,000 cases lived in urban areas, and 4 percent reported travelling outside the UK within seven days of symptom onset.

About two-thirds of patients were infected with Campylobacter, 6 percent each with Giardia and Cryptosporidium, 8 percent each with norovirus and Salmonella, and 3 percent each with Salmonella typhi/paratyphi, and Shigella.

There was a clear trend of decreasing likelihood of a laboratory report with all IID pathogens with increasing deprivation, said researchers. They acknowledged that use of national surveillance data results in a dataset that over-represents pathogens such as Campylobacter and under-represents the true burden of norovirus infection in the community.

Results by mode of transmission
For pathogens most frequently associated with foodborne transmission, including Campylobacter and Salmonella, the incidence was lower in areas of higher deprivation.

“Our results could be influenced by the fact that individuals who consume fast foods, travelers to low- and middle-income countries, as well as those who live in rural areas and have regular contact with livestock have increased risk of Campylobacter infection,” said scientists. 

For waterborne pathogens, like Giardia, incidence was lower in regions of higher deprivation, even after accounting for rural and urban differences.

For pathogens transmitted by person-to-person contact, such as norovirus, Shigella species, and Salmonella typhi/paratyphi, incidence was higher in more deprived neighborhoods.

Infections most strongly associated with areas of increasing deprivation were those transmitted by person–person contact. This form of transmission can be contained by implementing policies targeting over-crowding and poor hygiene, said researchers. Those transmitted by zoonotic contamination of the environment were least likely to be associated with poorer areas.

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Canterbury Homekill Services Limited (CHK) and owners Noel Womersley and Halena Hitchcock were sentenced to multiple charges under the Animal Products Act in Christchurch District Court.

The company and its owners were fined NZ $84,500 (U.S. $49,900).

Ensuring safe meat
Vincent Arbuckle, New Zealand Food Safety deputy director-general, said the agency would take action when food businesses acted outside the rules.

“Consumers deserve and expect that the meat they buy has come from a legitimate supplier. This means any risks associated with the meat have been identified, managed, and checked to keep people safe,” he said.

New Zealand Food Safety led the prosecution because the meat had not been checked in the food safety system to ensure it was safe.

The company was allowed to process recreationally hunted animals for individuals but was not permitted to sell the meat.

Womersley had a chiller at CHK where he stored meat from hunting trips. Investigators found evidence of various other meat sales, including beef, pork, and goat, that CHK illegally supplied to customers after studying electronic records.

“The prosecution resulted from a careful investigation, begun in 2020, which found evidence the company was selling unregulated meat, including large quantities of venison, through their two retail butcher shops. A close analysis of invoice records revealed discrepancies between the venison sold and purchased, meaning unregulated meat was being sold,” said Arbuckle.

“Most food businesses invest significant effort to ensure they keep their customers safe. Health risks are associated with eating unsafe meat, particularly for vulnerable communities and those with weakened immune systems, so they must do the right thing.”

Fish poaching case
In a different case, a man who poached crayfish with a commercial value of nearly NZ $300,000 (U.S. $177,200) was jailed for more than two years.

John Nohotima was sentenced in Wairoa District Court on one charge following a prosecution by the Ministry for Primary Industries (MPI). Nohotima sold 4,664 recreationally-harvested crayfish to a group.

Other members of the poaching gang were sentenced in March to home detention and community work.

Nohotima’s sister, Anne Nohotima, was also given 100 hours of community work by Tauranga District Court for her role. She sold 210 crayfish that her brother poached.

Jodie Cole, Fisheries New Zealand regional fisheries compliance manager, said a large amount of the stolen crayfish was sold at a fraction of the legitimate market price.

“Nohotima used falsified customary permits to illegally harvest this crayfish with around 16 craypots, fishing from the waters near Mahia Peninsula. The crayfish was on-sold to the Kawerau-based ringleaders who distributed the crayfish throughout Auckland, Kawerau, Tauranga, Gisborne, Wairoa, Mahia, and Napier,” said Cole.

“If you’re offered seafood at a price that appears too good to be true – assume it was probably harvested illegally. We’d advise not to buy it, and to let us know who offered it to you.” 

Nohotima gained 72 permits between December and July 21, 2021, and sold the crayfish between September 2020 and August 2021. 

“Staff at the butcher shop in Rangiora noticed homekill meat was being brought into the shop from CHK because it was vacuum packed and unlabeled with supplier branding or packaging. They reported that offal from CHK came into the butcher shop in large tubs, still with grass, which was being cleaned and packaged for sale to the public. These meats were sold to the public through their retail butchery.” 

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Researchers analyzed the cause of household foodborne disease outbreaks from 2010 to 2020 using data from the National Foodborne Disease Surveillance System.

A total of 17,985 outbreaks, which resulted in 73,252 illnesses, 38,829 hospitalizations, and 1,269 deaths, were reported. Most episodes were from May to October, and the highest number occurred in July.

A similar study, published in China CDC Weekly, looked at outbreaks in catering facilities in the country using data from the same time period.

Wild mushroom problem
Fungi, mainly poisonous mushrooms, were the most implicated food category, with 8,873 household outbreaks. The second was toxic plants and their products, with 1,552. These include aconite, potherb, tung seed or oil, bitter bottle gourd, and Masang fruit. Fungi were the primary etiologic agent, with 31,125 illnesses and 736 deaths.

Household outbreaks rose from 118 in 2010 to 4,140 in 2020. Almost 700 outbreaks were from unknown food. Alcohol products caused the highest case fatality rate, found in the study published in the Foodborne Pathogens and Disease journal.

Salmonella was the top bacterial pathogen with 437 outbreaks, and the principal chemical agent was nitrite, causing 476 outbreaks. Pupal toxicants, tetrodotoxin (TTX), and saxitoxin were the leading poisonous animal toxins. Norovirus was the primary virus, with 13 outbreaks. The cause was unknown for more than 4,200 outbreaks with 75 deaths.

Plant saponin toxicants were mainly found in vegetables. Eggs and egg products were mostly contaminated by Salmonella, followed by meat and meat products with the same pathogen. Chemical pesticides were primarily found in vegetables.

Tackling the issues
Researchers said most poisonous mushroom outbreaks occurred in southwest China, including Yunnan, Hunan, and Guizhou provinces.

Outbreaks from vegetable products were mainly caused by improper processing. Inedibility and misuse, especially wrong identification, were the top contributing factors to illnesses related to poisonous mushrooms, mainly in southwest China. The leading cause of Salmonella contamination in meat and meat products was improper processing and poor storage.

“The reason is that wild poisonous mushrooms are similar in appearance to edible mushrooms, and it is difficult for ordinary people to distinguish edible mushrooms from poisonous mushrooms without proper equipment. This study showed that targeted interventions to reduce mushroom poisoning are critical in China,” said researchers.

“Severe and even fatal aconite root poisoning may occur after consuming herbal soups and foods prepared from aconite roots. If the raw preparations and large amounts of aconite root are used, even prolonged boiling may not have a protective effect.

“All regions should strengthen market surveillance and improve laboratory surveillance of pathogenic bacteria such as Salmonella in meat. Residents should raise their awareness of food safety and ensure meat safety by processing meat and raw foods separately and storing them safely.” 

Public health agencies should also boost the supervision of foodborne diseases to reduce the risks.

“Governments should strengthen supervision for provinces with a high incidence of foodborne diseases, especially during peak seasons. In addition, health education for household food handlers, such as proper food handling behavior and emphasis on kitchen hygiene, should be strengthened to improve residents’ awareness of food safety and effectively reduce the occurrence of foodborne diseases among families,” said researchers.

Scientists said it was necessary to change understanding around aconitum plants. Aconite roots are used to prepare herbal soups and meals for their beneficial health effects.

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South Dakota’s “lone voice” in Congress explained:

“Consumers don’t know where their beef comes from. It could be South Dakota, Brazil, or Canada,” said Johnson. “U.S. producers raise better beef, and they’re not getting the credit for it. My bill takes a step in the right direction to get accurate labels back on these products to increase consumer confidence in American-made and grown products.”

The Beef Origin Labeling Accountability Act:

• Directs the United States Trade Representative and Secretary of Agriculture to work together to determine a process of reinstating Mandatory Country of Origin Labeling (MCOOL) for beef compliant with World Trade Organization rules.
• Requires the two agencies to report to Congress on their progress in determining a trade-compliant means of MCOOL, including any recommendations for legislation that may be necessary and any engagement with international governments on the matter.
• Directs the USTR to consult with the Canadian and Mexican governments to resolve the outstanding MCOOL trade disputes the two countries have open against the U.S.

Johnson has been a leader on cattle policy during his time in the U.S. House. In 2023, Johnson’s Cattle Contract Library was implemented by the U.S. Department of Agriculture to increase transparency in the market. Additionally, in 2021, Johnson successfully secured a pilot program to supply grants to small cattle processors to expand competition in the packing industry.

Background on Mandatory Country of Origin Labeling:
In 2008, the Farm Bill implemented MCOOL and labeling for beef products from cattle born, raised and harvested in the United States. Canada and Mexico quickly filed a dispute with the World Trade Organization, claiming MCOOL violated WTO agreements. The U.S. lost multiple appeals to WTO rulings against MCOOL, and in December 2015, the WTO authorized more than $1 billion in tariffs against U.S. products from Canada and Mexico.

On December 18, 2015, Congress repealed MCOOL. The WTO cases remain active today, with Canada and Mexico keeping the cases open to put pressure on the U.S. to prevent any attempt at reinstating MCOOL. If the U.S. were to implement a new MCOOL program, Canada and Mexico could immediately retaliate. Johnson’s Beef Origin, Labeling Accountability Act seeks to close these open cases from Canada and Mexico to move forward on reinstating MCOOL. 

Entire bill text here.

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A DG Sante audit in Morocco, in March and April 2023, looked at microbiological contamination in food such as strawberries, leafy crops like lettuce, tomatoes, herbs and spices.

A 2015 audit found the safety of FNAO was mainly guaranteed by inspections and certifications of private standards. Also, the effectiveness of official controls was undermined by limited laboratory capacity for microbiological testing.

Moroccan situation
The latest audit also found microbiological food safety at primary production depends on good agricultural practices, inspections by buyers and private certification systems.

Officials could not provide data on the number of farms that are producing or supplying for export to the EU but did share post-farm gate information.

There are no official controls to verify measures taken on farm to prevent microbial contamination during growing and harvest but documentary checks take place afterwards. The absence of controls at these stages could present a problem in outbreak situations, said auditors.

Authorities have not considered the risk of environmental Listeria contamination at operators handling products intended to be eaten raw, as requested by EU legislation. Inspectors also demonstrated limited knowledge and expertise of how to verify food firms’ management of Listeria monocytogenes risk.

Moroccan officials said a new rule for ready-to-eat food businesses to take Listeria samples in processing areas and on equipment as part of their sampling plans should apply from the end of 2023.

The lab network is good but there is no official laboratory with accredited methods to detect Shiga toxin-producing E. coli (STEC) and foodborne viruses. A National Reference Laboratory for foodborne pathogens is planned for the future and accreditation should be achieved in 2024.

“The lack of accredited methods for these foodborne pathogens, in conjunction with the absence of national reference labs supporting the official laboratories, could have an impact on the reliable laboratory investigation of FNAO,” said auditors.

Portugal findings
A DG Sante audit in February and March 2023 in Portugal covered FNAO, including seeds intended for sprouting and sprouts.

There is a risk-based system for onsite controls but there are gaps in identifying high-risk growers and in the registration of processors. It is also not geared towards crops at primary production level which pose the greatest microbiological risks. This means products with potentially high food safety risks may not be subject to official controls, said auditors.

The audit team found training did not enable all inspectors to assess correctly some aspects of the operators’ own-check quality assurance systems regarding the time and place of Listeria monocytogenes sampling and HACCP.

During the second half of 2023, training will be reinforced on Listeria testing, cross-contamination, and critical control points. Several sessions on HACCP have already been carried out involving the General Directorate of Food and Veterinary Affairs (DGAV) and the Portuguese Meat Industry Association (APIC).

At the time of the visit, three sprout-producing operators were approved. However, one had ceased activities and another was suspended after detection of STEC in sprouts. A root cause investigation found problems with the water supply. A third was suspended after an inspection observed by the audit team. This was lifted after non-conformities were corrected.

At processing sites, auditors noticed produce dropped on the floor was put back on the transport belt, and workers did not change gloves after touching the floor. Condensation on ceilings over exposed produce was not always detected and dealt with efficiently.

Suitable lab capability is in place but authorities had yet to designate a National Reference Laboratory for foodborne viruses, which is against EU rules. This was addressed with INSA being named as the NRL in June 2023.

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There is a link between patients and different packaged brands of Spanish omelet (tortilla de patata), which is made with potatoes and eggs, purchased in various supermarkets in different regions.

The Norwegian cases stayed in Barcelona between July 10 and 23.

The first case, a 38-year-old man, was confirmed with onset of symptoms on July 23. He consumed the suspected product between July 17 and 23. The man required hospitalization on August 10, admission to the ICU on August 12, and treatment with botulinum antitoxin.

The second is a probable case; a 38-year-old woman, with onset of botulism symptoms on July 22. She reported eating the implicated product between July 14 and 20 but did not need hospitalization or specific treatment.

Eleven people sick

Five confirmed and four probable cases of botulism had previously been reported from June 21 to July 22. Sick people ranged from 23 to 63 years old with a median age of 49. Four confirmed patients required medical attention in intensive care units but no deaths have been reported.

Italy recorded two cases of botulism linked to omelets eaten in Spain. The patients are a 23-year-old woman and her 61-year-old father who returned home from Valladolid on July 1, having consumed the suspected item on June 30.

The other three confirmed patients live in Madrid, Galicia and Asturias and are aged 43, 49 and 50. Four probable patients are from Valencia, Andalusia and Madrid and are aged 49, 27, 63 and 48.

According to information from the Spanish Agency for Food Safety and Nutrition (AESAN), all brands of Spanish omelets consumed by the cases were made by a single company. Items were also distributed to Andorra, France, and Portugal.

All items with a batch number equal to or greater than 10001 and an expiration date later than September 2 are safe to eat. Spanish omelets with lot numbers between 5426 and 5563 should not be consumed.

Restart of operations

Earlier this month, the firm linked to the outbreak restarted production after being given the all-clear.

Grupo Empresarial Palacios Alimentación said the production line at the Mudrián factory had been reopened after approval from authorities. Production was stopped and products were removed from sale in July.

All official and internal analyses carried out on the products and manufacturing processes were negative for Clostridium botulinum and botulinum toxin, according to the company.

Palacios Alimentación said it was important to always follow the recommendations for use and conservation instructions on the labeling of such products, which should have been kept refrigerated.

Botulinum poisoning is a rare but life-threatening condition, caused by toxins produced by Clostridium botulinum bacteria. In foodborne botulism, symptoms generally begin 18 to 36 hours after eating contaminated food. However, they can occur as soon as six hours or up to 10 days later. Symptoms may include double or blurred vision, drooping eyelids, slurred speech, difficulty swallowing or breathing, paralysis, a thick-feeling tongue, dry mouth, and muscle weakness.

Anyone who has eaten suspect products and developed symptoms should immediately seek medical attention.

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