Family health and nutrition:Norovirus

What is Norovirus? Have you had it?

By MARCIA WEBER

I had the opportunity to attend the Food Safety Summit which was held in Baltimore this month, and my first session featured norovirus -- you know, the virus we hear about associated with cruise ships.

I learned that it is the most common cause of gastroenteritis in the U.S. The Centers for Disease Control and Prevention estimates that each year more than 20 million cases of acute gastroenteritis are caused by noroviruses. That means about one in every 15 Americans will get norovirus illness each year.

The good news is that norovirus illness is usually not serious. Most people get better in 1 1/2 to 2 days. But norovirus illness can be serious in young children, the elderly and people with other health conditions; it can lead to severe dehydration, hospitalization and even death. It is estimated to cause more than 70,000 hospitalizations and 800 deaths each year in the United States.

Symptoms infection usually include diarrhea, throwing up, nausea and stomach cramping.

Anyone can be infected with noroviruses and get sick. You also can get the virus more than once during your life.

Illness often begins suddenly; you may feel very sick, with stomach cramping, throwing up, or diarrhea.

Other, less common symptoms may include low-grade fever, chills, headache, muscle aches and general sense of fatigue.

Norovirus is one of the leading causes of disease from contaminated foods in the United States. Food most commonly involved in foodborne norovirus outbreaks include leafy greens (such as lettuce), fresh fruit, and shellfish (such as oysters). However, any food item that is served raw or handled after being cooked can become contaminated.

Norovirus can spread quickly from person to person in crowded, closed places such as long-term care facilities, day care centers, schools and hotels, and it is often associated with cruise ships. It can also be a major cause of gastroenteritis in restaurants and catered-meal settings if contaminated food is served.

You can get sick by:

-- Eating food or drinking liquids that are contaminated with norovirus (someone gets stool or vomit on their hands, and then touches food or drink).

-- Touching surfaces or objects contaminated with norovirus, then putting your hand or fingers in your mouth.

-- Having direct contact with a person who is infected (caring for someone with the illness, sharing food or eating utensils with them).

Most people with norovirus illness are contagious from the moment they begin feeling sick until at least three days after they recover. But some people may be contagious for even longer.

There is no vaccine to prevent the infection, nor are there any drugs to treat people who get sick from the virus. Antibiotics will not help, because antibiotics fight against bacteria, not viruses. The best way to reduce your chance of getting norovirus is by following some simple tips.

-- Wash your hands carefully with soap and water, especially after using the toilet and changing diapers and always before eating or preparing food.

-- Carefully wash fruits and vegetables, and cook oysters and other shellfish thoroughly before eating them.

-- People with norovirus illness should not prepare food for others while they have symptoms and for three days after they recover.

-- If someone in your household is sick with norovirus, immediately clean and disinfect contaminated surfaces by using a bleach-based household cleaner as directed on the product label. If no such cleaning product is available, use a solution made with 5 tablespoons to 1 1/2 cups of household bleach for each gallon of water.

-- Immediately remove and wash clothing or linens that may be contaminated with vomit or stool. Handle soiled items carefully - without agitating them - to avoid spreading virus. If available, wear rubber or disposable gloves while handling soiled clothing or linens and wash your hands after handling. The items should be washed with detergent at the maximum available cycle length and then machine dried.

Let's keep Noroviurs away from our families and loved ones so we can enjoy the activities we have planned for the upcoming summer season!

Marcia Weber is York County's Penn State Cooperative Extension family and consumer sciences educator and certified food safety instructor.

Just how many Farm Rich E. coli victims are there?

We know that there are 24 infected people in 15 states, 7 who have been hospitalized, and 1 who developed hemolytic uremic syndrome (HUS).  But the reach of Farm Rich's E. coli tainted chicken quesadillas and possibly other products is certainly broader than that.

There is little doubt that the E. coli illnesses caused by Farm Rich's products have been underreported.  The concept of underreporting.;people sickened in an outbreak for whom, for any of a variety of reasons, microbiological data is not secured to confirm their relationship to the outbreak.;is common in E. coli and other outbreaks.  One commentator states, .;many cases of foodborne illness are not reported because the ill person does not seek medical care, the health-care provider does not obtain a specimen for diagnosis, the laboratory does not perform the necessary diagnostic test, or the illness or laboratory findings are not communicated to public health officials. Therefore, to calculate the total number of illnesses caused by each pathogen, it is necessary to account for underreporting, i.e., the difference between the number of reported cases and the number of cases that actually occur in the community. For Salmonella, a pathogen that typically causes nonbloody diarrhea, the degree of underreporting has been estimated at ~38 fold (Voetsch, manuscript in preparation). For E. coli O157:H7, a pathogen that typically causes bloody diarrhea, the degree of underreporting has been estimated at ~20 fold..;  See Paul Mead et al. http://www.cdc.gov/ncidod/EID/vol5no5/mead.htm.

In the Farm Rich E. coli outbreak, the CDC apparently agrees, and is concerned that we do not yet know, and may never know, the full scope of the outbreak.

The type of bacteria responsible for this outbreak is among those referred to as Shiga toxin-producing E. coli or STEC. Some types of STEC frequently cause severe disease, including bloody diarrhea and hemolytic uremic syndrome (HUS), which is a type of kidney failure. STEC bacteria are divided into serogroups (e.g., O157 or O121). E. coli O157 is the STEC serogroup found most commonly in U.S. patients. Other E. coli serogroups in the STEC group, including O121, are sometimes called .;non-O157 STECs..; Because clinical laboratories typically cannot directly identify non-O157 STEC serogroups, they must first test stool samples for the presence of Shiga toxins. Then, the positive samples must be sent to public health laboratories to look for non-O157 STEC. In recent years, the number of clinical laboratories that test for Shiga toxin has increased greatly, but some laboratories still do not perform these tests. Because of these complexities, many non-O157 STEC infections are probably not identified. The STEC O121 PFGE pattern in this outbreak is rare. In the past it has been seen less than 30 times in PulseNet.

If the information in the Meade article is any benchmark, there are a lot of sick people who have not been identified in the Farm Rich E. coli outbreak.  24 x 20 = 480.

White House Overruled FDA Attempt to Require Microbiological Testing at Food Facilities

A plan to require food facilities to conduct microbiological testing to ensure their products are safe to consume has been watered down by the White House Office of Management and Budget (OMB).

In response to the Food Safety Modernization Act, the Food and Drug Administration (FDA) drafted new food safety rules that mandated companies conduct product and environmental testing to prevent pathogens from getting into food supplies.

But when those rules were submitted to OMB for review, administration officials from OMB;s Office of Information and Regulatory Affairs stripped the provision requiring facilities to conduct microbiological testing. Such testing, according to food safety advocates, is necessary to confirm that a company's inspection program is working properly.

David Plunkett, a senior food safety attorney at the Center for Science in the Public Interest, criticized OMB for taking out the testing mandate. 

OMB once again protecting corporate bottom lines at the expense of protection for public health,; Plunkett told Food Safety News. .;Testing is critical to verification. I don't think a preventive food safety system can be effective without it. Unfortunately, OMB bean counting of the wrong costs results in a less effective prevention program and ultimately continuing food safety problems.

Restaurant strike 99% successful in Mumbai

Hotels and restaurants across India downed their shutters recently to protest against the ambiguous provisions of the Food Safety and Standards Act (FSSA), 2006, and the service tax levied by the Centre on air-conditioned eateries that serve alcohol. 
Shashikant Shetty, secretary, the Association of Hotels and Restaurants (AHAR), a Mumbai-based body, informed FnB News via telephone that although the eateries incurred losses worth approximately Rs 2,000 crore, there was an overwhelming response to it. 
In fact, he said the strike was 99 per cent successful in Mumbai. “The indifference by the multi-national quick service restaurant (QSR) chains was disappointing,” Shetty said. However, he added that it was deliberate on their part. 
“Jubilant Foodworks Ltd (the master franchisee for Domino's Pizza), McDonald's, Yum! Brands (which operates KFC and Pizza Hut) did not support us. The intention of the MNCs is mala fide. They want to wipe the smller Indian players out,” he said. 
“Even Faaso's, the Indian fast food chain offering wraps, did not join the protest,” he added. Others who stayed away included the fine dining restaurant The Great Kabab Factory and the upscale casual dining eatery Chili's. 
He added that AHAR will take a call on the next step only after they get in touch with other bodies, and hinted at another form of protest. “We are awaiting the next date for the hearing in the service tax case. It is slated to take place after the court resumes after the vacation,” he said. 
Nationwide scenario 
Over 20,000-22,000 eateries and sweet shops across the city remained shut. Maharashtra backed the day-long strike wholeheartedly, as did other western states like Goa and Gujarat, the central state of Chhattisgarh, and the Union Territory (UT) of Daman. 
In fact, three of the four southern states – Andhra Pradesh, Kerala and Tamil Nadu – also supported it. Shetty said Karnataka could not participate, because they are scheduled to go to the polls shortly.    
He added, “The only region from which we have not received any information about the strike yet is eastern India.” In addition to the service tax (which pushes up the total on the bill by almost five per cent), 12.5 per cent value-added tax (VAT) is also levied. 
“The most heartening fact is that restaurateurs in Meerut, Uttar Pradesh, are delighted, because they have got the state government's assurance on VAT and the Centre's assurance on service tax,” Shetty said. 
FSSA 
AHAR – which has over 6,000 members – had filed a petition before a division bench of the Bombay High Court, comprising chief justice Mohit Shah and justice M S Sanklecha, stating that certain rules of the Food Safety and Standards Act (FSSA), 2006, are not applicable to eateries. 
“We are not food manufacturing units, which come under the purview of the Act. Food is merely cooked in restaurants or hotels and served to the patrons. Cooking food is not manufacturing,” Shetty stated. 
“FSSA has framed ex-facie, ambiguous and unconstitutional rules and should be declared null and void. The association has sought a directive from the bench to the state government to create separate rules for food service providers,” he said. 
Adding that AHAR – which expects that the government declare that the Act is applicable to food manufacuring units – would meet the bench again, Shetty said, “Another cause for concern is the hygiene issues raised by food safety officers when they visit the kitchens in our establishments.” 
“At lunch hour, things are hectic in a kitchen. Scraps are bound to fall to the floor, and the sink is bound to have undone dishes. To focus on these, instead of the operational issues, is ridiculous,” Shetty added.

As Published in Word press

People’s campaign catches up as food hazards rise in Delhi

It was on a lazy Sunday that I noticed this van in our housing society crowded by the residents, mostly women with packets in hand. As curiosity got the better of me I too went into the lawns to find out which company wanted to hard sell its products to our colony this Sunday. Well, this time it was not the automobile company or the Insurance provider. It was a unique van equipped with lots of lab devices and smartly dressed technicians talking to the men and women. I learnt this was a mobile testing van which tells you how safe your food is. Residents were happily paying up to get their spices, groceries, snacks tested.

When it comes to eating, ignorance may not be bliss. In this age of heightened contamination, pesticides, germs and toxins of all kinds, it is best to know what you are eating. And food hazards are not limited to ‘eating out’ only. The vegetables, spices, food materials and ration you purchase from your grocer or retail outlet may often be as hazardous as the local dhaba. While we can avoid eating outside, there is little we can do about the risks involved with food items which we cook and consume at home. And do not feel reassured simply because your local grocer has known you for years and won’t let you down because the grocer himself may know little about the sophisticated methods in which toxins, chemicals, pesticides and other harmful items are blended into your food.

With awareness for food catching up among the urban and rural alike, the need to know exactly ‘what we are eating’ is rising every day. However, the risks involved in eating without being fully aware of the contents is one area where govt action alone is starkly insufficient. Random checks of the local Halwai shop, factories of food products and grocery shops cannot suffice in the matter. Besides, experts feel that the process of ‘Challaning’ violators only addresses the problem partly because these shopkeepers, dhabawallas must be made aware and counselled about the hazards and their remedies.

The mounting problem of consuming hazardous food is found at two distinct levels. One, most consumer do not know how dangerous are the toxic materials mixed in their food and what health hazards they pose. Two, there is a class of ‘aware’ citizens who do know the risks involved but there is precious little they can do about it. It is here that mobile food testing labs are coming in handy for the consumers. These labs, connected to a control room, visit places where food items can be instantly tested and results given out. The vans can visit a departmental store, a dhaba, a hotel\restaurant, a bazaar, a housing society…anywhere food needs to be tested.

Mukul Aggarwal, Director, TQS Global, which runs the mobile food testing vans’ campaign, ‘Earlier, we were quite alone but now this campaign is fast catching up.’

The modus operandi is simple. A mobile food testing van, reaches the destination where food is to be tested equipped with multi-point cameras. The technicians accept the sample to be tested, cooked, uncooked, raw etc. for a reasonable fees. The test is conducted in the van which is equipped with latest devices. At times, technicians may have to refuse a sample due to lack of necessary technical support in the van. In that case, the sample is sent to the lab. The results of tests are available online to the concerned parties with the help of an ID. The Global Food safety and surveillance broadcasting site tells you how far your sample adheres to food safety norms and what the hazards are. These mobile testing vans are equipped to accept at least five times the number of food samples as compared to the existing labs in national capital or various states.

Aggarwal agrees that the movement to create food safety awareness has been long with almost ten years gone by before people started volunteering to come and get their samples tested. But the campaign is catching up, more so when parents of little kids, mothers, shopkeepers and restaurants owners offer to pay for the tests to get the certificate of food safety.

‘However, our work doesn’t end with the tests. Once the results are out, we conduct counseling for the hotel \ dhaba \ restaurant \ owner, shopkeepers etc to explain to them how they can ensure that the food items they sell are safe and clean. Quite often, the shopkeepers themselves are unaware of the hazards involved for instance, toxins mixed in spices are impossible to detect without latest testing equipment, he added.

With government in Delhi contemplating to make registration and licensing must for roadside eateries restaurants, hotels and food processors this could be a good tool in the hands of the government to ensure that street food vendors observe better standards of hygiene and keep the food unadulterated.

  As Published in Frontier India

Ice-cream beats the heat, but FDA has a word of caution

20 samples of juices, ice candy, cold beverages draw officials' attention to 'substandard' quality.

With the sweltering heat bogging you down, you might just be tempted to lay your hands on an ice-cream or a glass of juice ready to be served to you by a roadside vendor or a food joint.

However, officials of the Food and Drug Administration (FDA) have a word of caution to share – watch out before you reach for these soothers. It could be infected with invisible germs that could make you sick to the gut.

Over the last ten days, FDA officials have spanned across the twin-township of Pimpri-Chinchwad and parts of Pune as part of a special drive to check food quality of cold beverages, iced gola’s and ice-creams which has maximum demand during the summer.

And the experienced eyes of the food safety inspectors have been drawing at least two samples on a daily basis which are suspected of being ‘sub-standard’ food item.

So far, 20 such samples of juices, ice candy, cold beverages, mango pulp, ice-creams etc have been drawn.

“However it takes at least 14 days for the food safety laboratory to send us the analysis report and hence we are yet to take any action,” said assistant commissioner (food), SS Desai.

When asked about the reason for drawing the samples out of hundreds of outlets, Desai said that it could be a variety of reasons from non-maintenance of hygiene, suspicion in raw material used to storage of food items that could lead to contamination.

“For example, if the juice is too sweet then it could also be an indication that saccharine is used and not sugar. If a vendor is serving kulfi, but the metal mold that it was prepared in has got rusted, it can lead to health problems. There are many such reasons which draw our attention,” said Shashikant Kekare, joint commissioner (food), FDA Pune.

He added that there have been cases where the pricing has been suspicious compared to the raw materials used. “We have drawn samples of 2-3 mango juices which were being sold at low prices which is not possible compared to the price of raw materials. Now we are awaiting the reports,” added Kekare.

While the drive in Pimpri-Chinchwad area is nearly over and parts of Fergusson College Road in Pune city checked, now the drive will fan out to other areas in the city, especially the ‘khau gallis’.

Meanwhile, FDA officials said that citizens must remain alert as recently two cases were detected by such tip-offs received from citizens.

“If one finds that the price of the product is less compared to the price of the raw materials, they can alert us. They can also alert us if they find a difference in taste, storage of raw materials is dirty or the area where the food is served is unhygienic. Hygiene levels of food handlers and servers should be checked,” said Kekare.

As Published in Wordpress

When it’s about your food, ignorance is not bliss - Mobile food testing labs ensure you get safe food wherever you go

It was on a lazy Sunday that I noticed this van in our housing society crowded by the residents, mostly women with packets in hand. As curiosity got the better of me, I, too, went into the lawns to find out which company wanted to hard sell its products to our colony this Sunday. Well, this time it was not the automobile company or the Insurance provider. It was a unique van equipped with lab devices and smartly dressed technicians talking to the men and women. I learnt this was a mobile testing van which tells you how safe your food is. Residents were happily paying up to get their spices, groceries, snacks tested.

When it comes to eating, ignorance may not be bliss. In this age of heightened contamination, pesticides, germs and toxins of all kinds, it is best to know what you are eating. And food hazards are not limited to ‘eating out’ only. The vegetables, spices, food materials and ration you purchase from your grocer or retail outlet may often be as hazardous as the food in a local dhaba. While we can avoid eating outside, there is little we can do about the risks involved with food items which we cook and consume at home. And do not feel reassured simply because your local grocer has known you for years and won’t let you down because the grocer himself may know little about the sophisticated methods in which toxins, chemicals, pesticides and other harmful items are blended into your food.

With awareness for food catching up among the urban and rural alike, the need to know exactly ‘what we are eating’ is rising every day. However, the risks involved in eating without being fully aware of the contents is one area where government action alone is starkly insufficient. Random checks of the local Halwai shop, factories of food products and grocery shops cannot suffice in the matter. Besides, experts feel that the process of 'Challaning' violators only addresses the problem partly because these shopkeepers, dhabawallas must be made aware and counselled about the hazards and their remedies.

The mounting problem of consuming hazardous food is found at two distinct levels. One, most consumer do not know how dangerous are the toxic materials mixed in their food and what health hazards they pose. Two, there is a class of ‘aware’ citizens who do know the risks involved but there is precious little they can do about it. It is here that mobile food testing labs are coming in handy for the consumers. These labs, connected to a control room, visit places where food items can be instantly tested and results given out. The vans can visit a departmental store, a dhaba, a hotel\restaurant, a bazaar, a housing society…anywhere food needs to be tested.

Mukul Aggarwal, director, TQS Global, which runs the mobile food testing vans’ campaign, says, “Earlier, we were quite alone but now this campaign is fast catching up.”

The modus operandi is simple. A mobile food testing van, reaches the destination where food is to be tested equipped with multi-point cameras. The technicians accept the sample to be tested, cooked, uncooked, raw etc. for a reasonable fees. The test is conducted in the van which is equipped with latest devices. At times, technicians may have to refuse a sample due to lack of necessary technical support in the van. In that case, the sample is sent to the lab. The results of tests are available online to the concerned parties with the help of an ID. The global food safety and surveillance broadcasting website tells you how far your sample adheres to food safety norms and what the hazards are. These mobile testing vans are equipped to accept at least five times the number of food samples as compared to the existing labs in national capital or various states.

Aggarwal agrees that the movement to create food safety awareness has been long with almost ten years gone by before people started volunteering to come and get their samples tested. But the campaign is catching up, more so when parents of little kids, mothers, shopkeepers and restaurants owners offer to pay for the tests to get the certificate of food safety.

“However, our work does not end with the tests. Once the results are out, we conduct counselling for the hotel\dhaba\restaurant\ owner, shopkeepers etc to explain to them how they can ensure that the food items they sell are safe and clean. Quite often, the shopkeepers themselves are unaware of the hazards involved for instance, toxins mixed in spices are impossible to detect without latest testing equipment, he added. 

With government in Delhi contemplating to make registration and licensing must for roadside eateries restaurants, hotels and food processors this could be a good tool in the hands of the government to ensure that street food vendors observe better standards of hygiene and keep the food unadulterated.



As published in    By Rahul Mahaajan (Senior Journalist)