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PubMed1979

Enterotoxigenic enteric bacteria in foods and outbreaks of food-borne diseases in Sweden.

All of 86 food routinely examined for potentially pathogenic enteric bacteria were found to harbour one or more coliform species. None of the strains isolated produced heat-labile enterotoxin (LT) or showed invasive properties. The suckling mouse test indicated that one strain of Escherichia coli produced heat-stable enterotoxin (ST). Twelve incidents of suspected food poisoning were also investigated. In two of them the foods examined contained LT-producing strains of E. coli and in two there were LT-producing strains of Klebsiella pneumoniae. The counts of viable enterotoxigenic micro-organisms in these foods were 3000-30,000 E. coli/g and 50,000 to 1 million K. pneumoniae/g. The dominant symptom in all the incidents was watery diarrhoea. These seem to be the first reported cases of foodborne enterotoxigenic enteric bacteria in Europe. Though enterotoxigenic E. coli and related gram-negative enterotoxin-producing species are rare in correctly handled food in Sweden, these micro-organisms should be searched for when outbreaks of food poisoning are investigated.

Enterotoxins↗
PubMed2004

Antibacterial effect of crude water-soluble arrowroot (Puerariae radix) tea extracts on food-borne pathogens in liquid medium.

AIMS: To evaluate the effect of crude water-soluble arrowroot tea extracts on microbial growth of food-borne pathogens in liquid medium and to confirm the damage to bacterial cells using Transmission Electronic Microscopy (TEM). METHODS AND RESULTS: Inhibition of growth of Escherichia coli O157:H7, Salmonella enterica serovar Enteritidis, Listeria monocytogenes and Staphylococcus aureus was investigated using Brain Heart Infusion (BHI) broth containing 0 (control), 0.63, 1.25, 2.5 and 5.0% (w/v) arrowroot tea. Bacterial cell counts were performed on specific selective agar on days 0, 1, 3 and 5. BHI containing 5.0% arrowroot tea extract showed a 6-7 log suppression of growth for all test strains on days 3 and 5, compared with the control. Even 0.63% arrowroot tea effectively inhibited microbial growth of all test strains on day 5. TEM images of the samples treated with 5.0% arrowroot tea revealed the rupture of cell walls and nonhomogeneous disposition of cytoplasmic materials within treated bacteria. CONCLUSIONS: Crude water-soluble arrowroot tea extract strongly inhibited microbial growth of all test pathogens in liquid medium. SIGNIFICANCE AND IMPACT OF THE STUDY: Water-soluble arrowroot tea extract has the potential to be used directly on foods or as a spray on the surfaces of food handling and processing facilities in order to prevent microbial growth of both Gram-negative and Gram-positive bacteria.

Anti-Bacterial Agents↗
PubMed2006

Outbreak of acute gastroenteritis in an air force base in Western Greece.

BACKGROUND: On the 20th September 2005, soldiers and staff at the Air Force base in Western Greece experienced an outbreak of acute gastroenteritis. The purpose of this study was to identify the agent and the source of the outbreak in order to develop control measures and to avoid similar outbreaks in the future. METHODS: A case-control analytical approach was employed with 100 randomly selected cases and 66 controls. Patients completed standardized questionnaires, odds ratios were calculated and statistical significance was determined using chi2 test. In addition, to identify the source of the infection, we performed bacteriological examination of food samples (included raw beef, cooked minced meat, grated cheese and grated cheese in sealed package) collected from the cuisine of the military unit. RESULTS: More than 600 out of the 1,050 individuals who ate lunch that day, became ill. The overall attack rate, as the military doctor of the unit estimated it, was at least 60%. The overall odds ratio of gastroenteritis among those who had lunch was 370 (95% CI: 48-7700) as compared to those who didn't eat lunch. Among the symptoms the most prominent were watery diarrhoea (96%) and abdominal pain (73%). The mean incubation period was 9 h and the median duration of the symptoms was 21 h. In the bacteriological examination, Staphylococcus aureus was detected in a sample of raw beef (2,000 cfu per g) and in two samples of grated cheese; leftover cheese from lunch (7,800 cfu per g) and an unopened package purchased from the market (3,000 cfu per g). CONCLUSION: The findings of this study suggest that the aetiological agent of this outbreak was S. aureus. The food vehicle was the grated cheese, which was mixed with the beef and served for lunch in the military unit. This outbreak highlights the capacity of enterotoxin-producing bacteria to cause short term, moderately-severe illness in a young and healthy population. It underscores the need for proper food handling practices and reinforces the public health importance of timely notification of such outbreaks.

Acute Disease↗
PubMed2002

Position of the American Dietetic Association: nutrition and lifestyle for a healthy pregnancy outcome.

It is the position of the American Dietetic Association that women of childbearing potential should maintain good nutritional status through a lifestyle that optimizes maternal health and reduces the risk of birth defects, suboptimal fetal growth and development, and chronic health problems in their children. The key components of a health-promoting lifestyle during pregnancy include appropriate weight gain; consumption of a variety of foods in accordance with the Food Guide Pyramid; appropriate and timely vitamin and mineral supplementation; avoidance of alcohol, tobacco, and other harmful substances; and safe food-handling. Prenatal weight gain within the Institute of Medicine (IOM) recommended ranges is associated with better pregnancy outcomes. The total energy needs during pregnancy range between 2,500 to 2,700 kcal a day for most women, but prepregnancy body mass index, rate of weight gain, maternal age, and physiological appetite must be considered in tailoring this recommendation to the individual. The consumption of more food to meet energy needs and the increased absorption and efficiency of nutrient utilization that occurs in pregnancy are generally adequate to meet the needs for most nutrients. However, vitamin and mineral supplementation is appropriate for some nutrients and situations. This statement also includes recommendations pertaining to use of alcohol, tobacco, caffeine, street drugs, and other substances during pregnancy; food safety; and management of common complaints during pregnancy and specific health problems. In particular for medical nutrition therapy, pregnant women with inappropriate weight gain, hyperemesis, poor dietary patterns, phenylketonuria (PKU), certain chronic health problems, or a history of substance abuse should be referred to a qualified dietetics professional.

Adult↗
PubMed1997

Risk factors for diarrheal disease incidence in early childhood: a community cohort study from Guinea-Bissau.

To determine risk factors for diarrhea, the authors followed an open cohort of 1,314 children from Guinea-Bissau by weekly diarrhea recall interviews between April 1987 and March 1990. Data on feeding practices and measles infection were available for all children and, for 531 children, comprehensive data on explanatory variables were recorded. Of 57 variables, seven were independently associated with an increased incidence of diarrhea. These were a recent (in the past 14 days) diarrheal episode, male sex, being weaned from breast milk, not being looked after by the mother, head of the household being < 30 years old, eating cold leftovers, and drinking water from an unprotected public water supply. In breastfed children, only three variables were associated with diarrhea, including prior diarrhea, male sex, and not being looked after by the mother. Among weaned children, six variables delineated increased rates of diarrhea, including unprotected public water supply, eating of cold leftovers, and lack of maternal education. Major determinants of persistent diarrhea included weaning, lack of maternal education, and having pigs in the home. It is concluded that, in addition to the promotion of breastfeeding, important interventions against diarrhea include improvements in water supply, hygiene, and food handling. However, because of effect modification by breastfeeding, the largest effects of these interventions will probably be among weaned children.

Breast Feeding↗
PubMed2006

Ecology of antibiotic resistance genes: characterization of enterococci from houseflies collected in food settings.

In this project, enterococci from the digestive tracts of 260 houseflies (Musca domestica L.) collected from five restaurants were characterized. Houseflies frequently (97% of the flies were positive) carried enterococci (mean, 3.1 x 10(3) CFU/fly). Using multiplex PCR, 205 of 355 randomly selected enterococcal isolates were identified and characterized. The majority of these isolates were Enterococcus faecalis (88.2%); in addition, 6.8% were E. faecium, and 4.9% were E. casseliflavus. E. faecalis isolates were phenotypically resistant to tetracycline (66.3%), erythromycin (23.8%), streptomycin (11.6%), ciprofloxacin (9.9%), and kanamycin (8.3%). Tetracycline resistance in E. faecalis was encoded by tet(M) (65.8%), tet(O) (1.7%), and tet(W) (0.8%). The majority (78.3%) of the erythromycin-resistant E. faecalis isolates carried erm(B). The conjugative transposon Tn916 and members of the Tn916/Tn1545 family were detected in 30.2% and 34.6% of the identified isolates, respectively. E. faecalis carried virulence genes, including a gelatinase gene (gelE; 70.7%), an aggregation substance gene (asa1; 33.2%), an enterococcus surface protein gene (esp; 8.8%), and a cytolysin gene (cylA; 8.8%). Phenotypic assays showed that 91.4% of the isolates with the gelE gene were gelatinolytic and that 46.7% of the isolates with the asa1 gene aggregated. All isolates with the cylA gene were hemolytic on human blood. This study showed that houseflies in food-handling and -serving facilities carry antibiotic-resistant and potentially virulent enterococci that have the capacity for horizontal transfer of antibiotic resistance genes to other bacteria.

Animals↗
PubMed1996

Epidemic cholera in Guatemala, 1993: transmission of a newly introduced epidemic strain by street vendors.

Epidemic cholera reached Guatemala in July 1991. By mid-1993, Guatemala ranked third in the hemisphere in reported cases of cholera. We conducted a case-control study with two age-, sex-, and neighbourhood-matched controls per patient in periurban Guatemala City. Twenty-six patients hospitalized for cholera and 52 controls were enrolled. Seven (47%) of 15 stool cultures obtained after admission yielded toxigenic Vibrio cholerae O1. All seven were resistant to furazolidone, sulfisoxazole, and streptomycin, and differed substantially by pulsed-field gel electrophoresis from the Latin American epidemic strain dominant in the hemisphere since 1991. In univariate analysis, illness was associated with consumption of left-over rice (odds ratio [OR] = 7.0, 95% confidence interval [CI] = 1.4-36), flavored ices (-helados') (OR = 3.6, CI = 1.1 - 12), and street-vended non-carbonated beverages (OR = 3.8, CI = 1.2-12) and food items (OR = 11.0, CI = 2.3-54). Street-vended food items remained significantly associated with illness in multivariate analysis (OR = 6.5, CI = 1.4-31). Illness was not associated with drinking municipal tap water. Maintaining water safety is important, but slowing the epidemic in Guatemala City and elsewhere may also require improvement in street vendor food handling and hygiene.

Adolescent↗
PubMed1998

An outbreak of Salmonella hadar associated with food consumption at a building site canteen.

A biphasic outbreak of gastroenteritis caused by Salmonella hadar affected canteen employees and workers at a construction site in central Italy in September 1994. There were 448 symptomatic cases, from 61 of whom group C Salmonella was isolated. Six cases were canteen employees. Twenty-two other individuals were asymptomatic excreters. There were 10 secondary cases. Working as a food handler at the canteen constituted an increased risk of infection, independently of ingestion of the food (odds ratio: 62.1; 95% confidence interval (CI): 9.5-406.6). Having eaten at the canteen on the 19th and 20th September was identified as risk factor for subjects symptomatic within 72 hours (relative risk (RR): 17.0, 95% CI: 2.3-124.3), and cooled meat salad was identified as the vehicle of infection (RR: 36.6, 95% CI: 14.3-93.8). The use of portable toilets was another possible route of transmission of infection for all cases (RR: 1.3, 95% CI: 1.0-1.6). The index case was a cook who had symptoms five days before the peak of the outbreak. From 27 individuals both symptomatic and asymptomatic excreters group B, group D and not-typed Salmonellas were isolated. This study underlines the problem of improper food handling in salmonellosis outbreaks and emphasizes the role of several vehicles in the transmission of salmonellosis in a community.

Adult↗
PubMed1998

Molecular evidence for the gnathobasic derivation of arthropod mandibles and for the appendicular origin of the labrum and other structures.

Mandibles are feeding appendages functioning as "jaws" in the arthropod groups in which they occur. Which part of this appendage is involved in food manipulation (limb tip versus limb base), has been used to suggest phylogenetic relationships among some of the major taxa of arthropods (myriapods, crustaceans, and insects). As a way to independently verify the conclusions drawn from previous morphological analyses, we have studied the expression pattern of the gene Distal-less (Dll), which specifies the distal part of appendages. Our results show, in contrast to the traditional view, that both insect and crustacean adult mandibles are gnathobasic, handling food with the basal portion of the appendage. Furthermore, as is evident by the reduction in the number of Dll-expressing cells in the later developmental stages, adult diplopod jaws are also gnathobasic. Thus, jaws of all mandibulates (myriapods, crustaceans, and insects) seem to have a similar gnathobasic structure. We have also found that Dll is expressed in the labra of all arthropod taxa examined, suggesting that this structure is of appendicular derivation. Additionally, the spinnerets and book lungs of spiders, long considered on other grounds to be modified appendages, express Dll, confirming this interpretation. This study shows that, in addition to their use in phylogenetic and population genetic studies, molecular markers can be very useful for inferring the origins of a particular morphological feature.

Animals↗
PubMed2005

A large, multiple-restaurant outbreak of infection with Shigella flexneri serotype 2a traced to tomatoes.

BACKGROUND: Foodborne outbreaks of Shigella infection are uncommon and tomatoes are an unusual vehicle. We describe a large, multiple-restaurant outbreak of Shigella flexneri serotype 2a infection that was associated with tomatoes. METHODS: We conducted nationwide surveillance and a case-control study, collected fecal specimens for culture, and measured the survival of the outbreak strain of S. flexneri in tomatoes. RESULTS: We interviewed 306 of 886 ill restaurant patrons and 167 control subjects. Matched univariate analysis showed that several food items were associated with illness, but only tomatoes remained significant in multivariate models. Illness peaked at each restaurant within 24 h after the arrival of hand-sorted bruised and overripe tomatoes from a new distributor; all patient isolates that were tested were indistinguishable by PFGE. Sliced tomatoes from the distributor were inoculated with the outbreak strain, and viable S. flexneri were recovered for 72 h. CONCLUSION: To prevent such outbreaks, persons with shigellosis should be excluded from handling food at all points along the distribution chain.

Adult↗
PubMed1985

Two successive outbreaks of Clostridium perfringens at a state correctional institution.

An outbreak of acute gastrointestinal illness of short duration involving 100 inmates at a correctional institution followed a similar outbreak among the same population by eight days. Clostridium perfringens was the specific etiology in both outbreaks; the vehicle was roast beef in the first outbreak, ham in the second. Direct observation of food handling practices revealed that the meats were not cooled quickly enough following cooking; not reheated adequately prior to serving, and; held at improper temperatures prior to serving.

Animals↗
PubMed2002

Behavioral analysis of anorexia produced by hindbrain injections of AMPA receptor antagonist NBQX in rats.

The caudal brain stem integrates short-term feedback signals from the oral cavity and the food-handling abdominal viscera, as well as long-term homeostatic, cognitive, and emotional signals from the forebrain, to control ingestive behavior. Glutamate, acting on various receptor subtypes, plays a prominent role in this integrative process. Fourth ventricular injection of the alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA)/kainate receptor blocker 1,2,3,4-tetrahydro-6-nitro-2,3-dioxobenzo[f]quinoxaline-7-sulfonamide (NBQX, 0.5-5 nmol/3 microl) dose dependently suppressed intake of 15% sucrose in food-deprived and non-food-deprived rats compared with saline injection. Two consecutive paired NBQX injections (5 nmol) into the fourth ventricle did not produce conditioned taste aversion to saccharin, but LiCl did. Intraburst lick rate and lick efficiency were not affected, but burst size and number and initial lick rate were significantly decreased by NBQX. Local injection of NBQX (2 nmol) into and near the nucleus tractus solitarius also suppressed sucrose intake. These results suggest a general role for non-N-methyl-D-aspartate receptors in the transmission of positive (feedforward) signals, but do not identify the exact processing step involved, such as taste input, sensory-motor processing, or descending facilitation. More localized injections and response measures will be necessary.

Animals↗
PubMed1985

Foodborne outbreaks of campylobacteriosis: the United States experience, 1980-1982.

During 1980-1982, 23 foodborne outbreaks of diseases caused by Campylobacter were reported to the Centers for Diseases Control through the National Foodborne Surveillance Program, which collects reports from state and territorial epidemiologists throughout the United States. These outbreaks involved 748 ill persons, of whom 4% were hospitalized. For outbreaks with six or more ill persons, the median attack rate was 41%, the mean or median incubation periods ranged from 66 to 120 hours, and the mean duration of symptoms ranged from three to seven days. Raw milk was implicated or suspected in 14 outbreaks. In four of the other outbreaks, food handling errors were identified, and in five outbreaks, poultry, eggs, or beef were implicated or suspected. In three of four outbreaks in which Campylobacter was recovered from cows at the implicated dairies, some isolates from cows were serotypically identical to isolates from ill persons. In one egg-associated outbreak, one of the isolates of Campylobacter recovered from hens at the implicated egg farm was serotypically identical to an isolate recovered from an ill person. These findings underscore the hazard of eating undercooked or raw foods of animal origin such as raw milk. Raw milk contaminated by infected cows is a major cause of foodborne campylobacteriosis in the United States.

Animals↗
PubMed1989

[Case study: operation of a mother-child nutrition program in El Salvador].

One of the oldest international efforts in their combat of malnutrition have been the mother-child food programs (MCFP). The purpose of the study herein discussed was to detect the problems that affect the operation of the MCFP of the Ministry of Health of El Salvador, and to identify feasible measures to apply in a short term. This work analyzed the following: a) the operation of the program from the selection of the beneficiary to the delivery of the ration; b) the evolution of the beneficiaries, and c) the perception of the MCFP on mothers' part. The study covered 40 Health Services selected from all over the country; the revision of 556 children's files, and interviews to 136 mothers. It was found that the nurse is the person who plays the main role in the MCFP; that the most used criterion to enter or leave the program is the nutritional condition of the beneficiaries; that priority is given to children over pregnant women; that for most of the children there is a control kept on growth and vaccinations; and that what is mostly supervised is food handling and beneficiaries. Study of the children's files revealed that the average age of the children who enter the program is 18 months and at departure, 24 months, with a permanence of five months; and that the weight-for-age retardation when entering and leaving was similar for all the children studied, although it was different when the analysis was made by permanence and by age groups. Mothers' opinion on the MCFP permitted inference of what occurs at household levels with the donated foods; nevertheless, it is a subject that merits further study. Results of the study confirm some findings of others, although since they are specific for this Program, they allowed the appropriate decision-making for corrective measures of the MCPF.

Analysis of Variance↗
PubMed1992

AIDS: legal implications for managers.

As the incidence of acquired immunodeficiency syndrome (AIDS) escalates, its consequences increasingly will affect the workplace. Dietitians with management responsibilities will be called upon to make decisions concerning the rights of both employees and clients or patrons. They must be knowledgeable about AIDS-related legislation and its implementation in organizations and businesses. A major legal protection for workers with AIDS is the Vocational Rehabilitation Act, which prohibits discrimination against individuals on the basis of physical or mental disabilities. The Employee Retirement Income Security Act and the Comprehensive Omnibus Budget Reconciliation Act provide legal protections related to employee benefit programs. The National Labor Relations Act provides protection for all employees, including those infected with the AIDS virus. Current medical evidence indicates that AIDS is not transmitted through casual contact. Therefore, the presence of AIDS-infected individuals in the workplace does not violate the provisions of the Occupational Safety and Health Act. More recently, the Americans with Disabilities Act was amended to prohibit employers from removing workers from food-handling positions solely because of infection with AIDS. This review of legislation and litigation indicates that coworker and public fears, as well as management concerns about productivity and costs, are inadequate defenses against discrimination claims. Employees with AIDS are protected legally against adverse employment decisions motivated by their disease.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Reduction of rostral dorsal accessory olive responses during reaching.

1. Rostral dorsal accessory olive (rDAO) neurons are sensitive to light touch but have little or no discharge during active movement. We hypothesize that sensitivity of the rDAO is reduced during movement. To test this hypothesis, we evaluated sensitivity of rDAO neurons as cats reached out and retrieved a handle. On selected trials, mechanical or electrical perturbations to the forelimb were presented, and responses of rDAO neurons to the disturbances were recorded. 2. All rDAO units were highly sensitive to somatosensory stimuli during periods of stance. The cells responded to stimuli such as touch to hairs or light taps to the platform on which the cat was standing. 3. Discharges of rDAO neurons showed little or no synchronization to any aspect of the reaching task. rDAO neurons failed to fire to mechanical perturbations of the food handle during retrieval or hold phases of the task, even when their receptive fields included the surface of the paw in contact with the handle. 4. Electrical stimulation of the skin produced the greatest evoked response at all rDAO recording sites when the cats were at stance. Stimulation at any time during the reaching task, including periods of holding and licking, produced lower-amplitude evoked responses. The reduction in evoked response could be large and was restricted to the limb performing the task. 5. The data support the hypothesis that the cutaneous sensitivity of the rDAO is reduced during behavior. However, the inhibition does not appear to be tailored to specific times during the task or to neurons with specific receptive field locations on the actively moving limb. The reduction in sensitivity is as likely to be dependent on limb posture as on movement. We conclude that the rDAO discharge provides the cerebellum with information about vibration or contact during stance; it does not provide reliable information about undisturbed or disturbed movement. Climbing fiber input from rDAO might be useful in the preparation to make a movement, but it is probably not useful for correction of movement errors.

Animals↗
PubMed1992

Incidence and coincidence of Listeria spp., motile aeromonads and Yersinia enterocolitica on ready-to-eat fleshfoods.

A survey for the presence of Listeria spp., Yersinia enterocolitica and motile aeromonads in 203 samples of ready-to-eat fleshfoods purchased from retail outlets was conducted. Overall, 39.4%, 3.4% and 23.2% of samples were positive for the presence of Listeria spp., Y. enterocolitica and motile aeromonads respectively. Two factors have been identified as contributing to contamination of fleshfoods by these cold-tolerant bacteria. These are (i) the method of sale; delicatessen-bought foods were notably more contaminated than similar products bought pre-packaged, and (ii) the method of preservation. For motile aeromonads fermented foods were the least contaminated, whereas smoked and cooked products had similar incidence rates. For L. monocytogenes, significantly more (41.9%) smoked products were contaminated than fleshfoods preserved by other methods. For Y. enterocolitica, only cooked products were contaminated. In the case of cooked fleshfoods it must be assumed that most contamination occurs post-cooking and that contamination rates are increased by poor food handling procedures. Of the three possible pairwise combinations of these organisms, the coincidence of Y. enterocolitica and motile aeromonads was the only one that differed significantly from a random distribution (P less than 0.001), indicating that fleshfoods contaminated with Y. enterocolitica are probably also contaminated by motile aeromonads.

Aeromonas↗
PubMed1999

A case-control study of Yersinia enterocolitica infections in Auckland.

OBJECTIVE: To identify major risk factors for Yersinia enterocolitica (YE) and identify measures to reduce YE infections. METHODS: A prospective case control study, group age matched, using 186 cases of YE identified by community pathology laboratories and 379 randomly selected controls. Conducted between April 1995 and June 1996 in Auckland, New Zealand. Face-to-face interviews used a standardised questionnaire examining exposures to factors potentially associated with YE infections including untreated water, unreticulated sewerage, consumption of selected foods, selected food handling practices and socio-demographic factors. Multivariate logistic regression was used to calculate adjusted odds ratios for the potential risk factors. Population attributable risk (PAR) was calculated for significant exposures. RESULTS: Having more than two people living in the home was more common among cases than controls (OR = 2.2). Town supply water (OR = 0.2), reticulated sewerage (OR = 0.34) and looking after a young child (OR = 0.51) were significantly less common. Of the meats, only pork (OR = 1.34) had a higher consumption rate, while bacon (OR = 0.75) and smallgoods (OR = 0.73) were consumed less frequently by cases than controls. Eating food from a sandwich bar was more frequent among cases (OR = 1.18). Fruit and vegetable consumption was marginally less (OR = 0.98). The population attributable risk of these factors was 0.89, implying that 89% of YE would be eliminated if adverse exposures were removed. CONCLUSIONS: The risk of YE illness is increased by contact with untreated water, unreticulated sewerage and consumption of pork. Investigation of non-town water supply, informal sewerage systems and methods of preparation and consumption of pork are recommended to determine how YE enters the human food chain.

Adolescent↗