A Campylobacter outbreak in a Barcelona school

Bacterial contamination and health risks of drinking water from the municipal non-government managed water treatment plants

Water quality and bacterial contamination from 18 drinking water municipal plants in three locations at Giza governorate were investigated. The average total count of bacteria detected after four stages of treatments in the investigated plants was 32 CFU/1 mL compared to 2330 cfu/mL for raw water, with a reduction percentage of 98.6. Although there is a relatively high removal percent of bacterial contamination from the water sources, however, several bacterial pathogens were identified in the produced water prepared for drinking including Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, and Shigella spp. After 3 days of water incubation at 30 °C, the amount of bacterial endotoxins ranged from 77 to 137 ng/mL in the water produced from the municipal plants compared to 621-1260 ng/mL for untreated water. The main diseases reported from patients attending different clinics and hospitals during summer 2014 at the surveyed locations and assuredly due to drinking water from these plants indicated that diarrheas and gastroenteritis due to E. coli and Campylobacter jejuni constituted 65.7% of the total patients followed by bacillary dysentery or shigellosis due to Shigella spp. (7.9%) and cholera due to Vibrio cholera (7.2%). There was an increase in serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) as well as urea and creatinine values of guinea pigs consuming water produced from the non-governmental plants for 6 months indicating remarkable liver and kidney damages. Histological sections of liver and kidney from the tested animal revealed liver having ballooning degeneration of hepatocytes and distortion and fragmentation of the nuclei, while the section of the kidney showed irregularly distributed wrinkled cells, degenerated Bowman's capsule, congested blood vessels, and inflammatory cells.

Campylobacter in the Food Chain

Currently Campylobacter is the most commonly reported zoonosis in developed and developing countries. In the European Union, the number of reported confirmed cases of human campylobacteriosis was 246,307 in 2016, which represents 66.3 cases per 100,000 population. The genus Campylobacter includes 31 species with 10 subspecies. Within the genus Campylobacter, C. jejuni subsp. jejuni and C. coli are most frequently associated with human illness. Mainly, the infection is sporadic and self-limiting, although some cases of outbreaks have been also reported and some complications such as Guillain-Barré syndrome might appear sporadically. Although campylobacters are fastidious microaerophilic, unable to multiply outside the host and generally very sensitive, they can adapt and survive in the environment, exhibiting aerotolerance and resistance to starvation. Many mechanisms are involved in this, including pathogenicity, biofilm formation, and antibiotic resistant pathways. This chapter reviews the sources, transmission routes, the mechanisms, and strategies used by Campylobacter to persist in the whole food chain, from farm to fork. Additionally, different strategies are recommended for application along the poultry food chain to avoid the public health risk associated with this pathogen.

Main Groups of Microorganisms of Relevance for Food Safety and Stability

Microbiology is important to food safety, production, processing, preservation, and storage. Microbes such as bacteria, molds, and yeasts are employed for the foods production and food ingredients such as production of wine, beer, bakery, and dairy products. On the other hand, the growth and contamination of spoilage and pathogenic microorganisms is considered as one of the main causes to loss of foodstuff nowadays. Although technology, hygienic strategies, and traceability are important factors to prevent and delay microbial growth and contamination, food remains susceptible to spoilage and activity of pathogen microorganisms. Food loss by either spoilage or contaminated food affects food industry and consumers leading to economic losses and increased hospitalization costs. This chapter focuses on general aspects, characteristics, and importance of main microorganisms (bacteria, yeasts, molds, virus, and parasites) involved in food spoilage or contamination: known and recently discovered species; defects and alterations in foodstuff; most common food associated with each foodborne disease; resistance to thermal processing; occurrence in different countries; outbreaks; and associated symptoms.

Are Campylobacter cases low risk for public health follow-up?

OBJECTIVES

Most Campylobacter cases are treated as low risk enterics (LRE) and receive a mailed letter from Toronto Public Health (TPH) with a questionnaire to gather basic risk information. This study sought to identify reasons why Campylobacter cases who were sent this questionnaire did not respond to the letter and to determine whether any of these cases were working in a high-risk occupation.

METHODS

Cases reported to TPH between June 11, 2012 and December 6, 2012 who had not returned the questionnaire within 30 days were telephoned. Participants were asked about awareness of the original letter, reasons for not responding, and whether they worked in a high-risk occupation.

RESULTS

Of the 226 cases identified as not responding to the letter, 172 (76.1%) were reached, and 162 (71.7%) answered the survey questions. The most frequent reason chosen for not responding to the original letter was "forgot" (54.4%). The most common suggestion chosen for ways to encourage response to the original letter was "more information on importance of returning questionnaire" (19.1%). Of the 119 cases with a known occupation, 3 (2.4%) were employed in a sensitive occupation - these include a family physician, a food server, and a line cook. None worked while ill. When prompted with a list of reasons for not returning the questionnaire, the majority of respondents indicated that they "forgot" (54.4%); the next most frequent response was "recovered by illness no longer considered it relevant" (21.5%).

CONCLUSION

To increase response rates in the future, a cover letter should more clearly explain why the response is being solicited by Public Health, even after recovery from the illness, and the form should be simplified for mail return. A very small number of clients originally not reached through the course of the routine LRE program were working in sensitive occupations. Since none reported working while ill, the likelihood of direct or indirect transmission of Campylobacter from these three individuals was low. Using a LRE system to monitor a widespread mostly low-morbidity gastroenteric illness can be an effective public health strategy.

Evaluation of the quality of foods for special diets produced in a school catering facility within a HACCP-based approach: a case study

A study was carried out to verify the appropriateness of the Hazard Analysis and Critical Control Point (HACCP) plan adopted in a school catering facility. To that end, the microbiological quality of foods, the correct implementation of special diets (lactose- and gluten-free) and the nutritional value of foods were assessed. Thirty-six samples of lactose-free and 87 samples of gluten-free special diet food preparations were subjected to microbiological, chemical, and nutritional analyses. The data collected demonstrate the effectiveness of the HACCP plan in reducing the occurrence of microbial and chemical (lactose and gluten) cross-contamination. The data obtained from the nutritional analyses showed that the dietary intake provided by the meals under study was satisfactory.