Investigation of an outbreak of Salmonella oranienburg infections in Norway, caused by contaminated black pepper

Simultaneous vacuum ultra violet-amalgam lamp radiation and near-infrared radiation heating for a synergistic bactericidal effect against Escherichia coli O157:H7 and Salmonella enterica serovar Typhimurium in black peppercorn

This study evaluated the effect of simultaneous irradiation with vacuum ultraviolet (VUV)-amalgam lamp and near-infrared radiation (NIR) to inactivate foodborne pathogens in black peppercorn (Piper nigrum) while monitoring its piperine content and color. NIR treatment for 20 min caused an increase in black peppercorn temperature to 70 °C, and its bactericidal effect showed only 3.14 and 1.88 log reductions of Escherichia coli O157:H7 and Salmonella Typhimurium respectively. Single treatment with a VUV-amalgam lamp for 20 min achieved 2.26 and 1.55 log reductions of E. coli O157:H7 and S. Typhimurium, respectively. However, simultaneous treatment for 15 min produces a greater than 5-log reduction of both foodborne pathogens without changes of black peppercorn quality. The underlying bactericidal mechanism of the VUV-amalgam lamp is 254 nm irradiation with ozone generated by 185 nm irradiation. The ozone concentration was maintained with VUV-amalgam lamp single treatment but decreased during simultaneous treatment. In contrast, due to the drying effect of NIR irradiation, water vapor reacts with 185 nm irradiation or ozone to produce a variety of reactive oxygen species (ROS) such as hydrogen peroxide and hydroxyl radical during simultaneous treatment. The hydrogen peroxide concentration measured by Gastec increased during simultaneous treatment. We also investigated various generated types of ROS that can contribute to a synergistic bactericidal effect. We compared the bactericidal effect of sequential and simultaneous treatments with NIR and VUV-amalgam lamps to black peppercorn. Although sequential treatment showed additional inactivation efficacy, reductions of pathogens were significantly lower than with simultaneous treatment. These findings suggest that simultaneous VUV-amalgam lamp and NIR irradiation treatment via generation of ROS can increase bacterial inactivation efficacy of foodborne pathogens in black peppercorns without quality changes.

A Salmonella enterica Serovar Oranienburg Clone Caused a Cluster of Bacteremia Cases in Persons With No Recognizable Underlying Diseases in Japan

Background

Salmonella enterica subspecies enterica serovar Oranienburg (SO) is a foodborne pathogen but rarely causes systemic infections such as bacteremia. Between July and September 2018, bacteremia cases caused by SO were identified in 12 persons without any underlying medical conditions in the southern Kyushu area of Japan.

Methods

Randomly amplified polymorphic DNA (RAPD) analysis was performed to investigate the genetic similarity of the 12 bacteremia-related strains and other Japanese isolates. Furthermore, a series of whole-genome sequence (WGS)-based phylogenetic analyses was performed with a global SO strain set (n = 1648).

Results

The resolution power of RAPD was insufficient to investigate the genetic similarity between the bacteremia-related strains and other strains. WGS-based phylogenetic analyses revealed that the bacteremia-related strains formed a tight cluster along with 2 strains isolated from asymptomatic carriers in 2018 in the same area, with a maximum within-cluster single-nucleotide polymorphism (SNP) distance of 11. While several strains isolated in the United States and the United Kingdom were found to be closely related to the bacteremia-related strains, 2 strains isolated in 2016 in the southern Kyushu area were most closely related, with SNP distances of 4-11 and 5-10, and had the same plasmids as the bacteremia-related strains.

Conclusions

The 12 bacteremia cases identified were caused by a single SO clone. As none of the bacteremia patients had any underlying diseases, this clone may be prone to cause bacteremia. Although further analyses are required to understand its virulence, particular attention should be given to this clone and its close relatives in the surveillance of nontyphoidal salmonellae.

Pulsed-Light Treatment of Dried Parsley: Reduction of Artificially Inoculated Salmonella and Impact in Given Quality Parameters

ABSTRACT

Dried parsley is regularly contaminated with foodborne pathogens, especially Salmonella. Application of contaminated ingredients in ready-to-eat dishes without further thermal treatment represents a considerable health risk. This study examined the suitability of pulsed light as a novel decontamination method of Salmonella in dried parsley, along with the impact on selected quality parameters (chlorophyll content, phenolic compounds, color, and odor) and product characters (temperature and water activity value). Samples were inoculated with one of three Salmonella isolates (Salmonella Cerro or one of two isolates of Salmonella Agona) at two contamination levels of 103 or 107 CFU/g and treated under various experimental factors, including distance to the light source and exposure time, resulting in fluences in the range of 1.8 to 19.9 J/cm2. At selected parameter settings (9.8 and 13.3 J/cm2), the effect of prolonged storage time (48 h) of inoculated samples before treatment on the reduction of Salmonella Cerro was examined. Samples treated at the same fluences were also stored for 35 days at 22 to 25°C. The three Salmonella isolates were significantly reduced by pulsed light (P < 0.05). Reduction factors ranged between 0.3 and 5.2 log CFU with varying sensitivities of the isolates. In general, increasing fluences (depending on exposure time and distance to the light source) resulted in increasing reductions of Salmonella. However, on closer examination, exposure time and distance to the light source had a varying influence on the reduction of the different Salmonella isolates. Decreasing reduction factors were observed by increasing the contamination level and prolonging the storage time of inoculated samples before treatment. No undesirable changes in quality parameters and sensory analysis were detectable at fluences of 9.8 and 13.3 J/cm2, indicating that pulsed light may be a suitable alternative for the decontamination of dried parsley.

HIGHLIGHTS

Microbial Contamination of Fresh Produce: What, Where, and How?

Promotion of healthier lifestyles has led to an increase in consumption of fresh produce. Such foodstuffs may expose consumers to increased risk of foodborne disease, as often they are not subjected to processing steps to ensure effective removal or inactivation of pathogenic microorganisms before consumption. Consequently, reports of ready-to-eat fruit and vegetable related disease outbreak occurrences have increased substantially in recent years, and information regarding these events is often not readily available. Identifying the nature and source of microbial contamination of these foodstuffs is critical for developing appropriate mitigation measures to be implemented by food producers. This review aimed to identify the foodstuffs most susceptible to microbial contamination and the microorganisms responsible for disease outbreaks from information available in peer-reviewed scientific publications. A total of 571 outbreaks were identified from 1980 to 2016, accounting for 72,855 infections and 173 deaths. Contaminated leafy green vegetables were responsible for 51.7% of reported outbreaks. Contaminated soft fruits caused 27.8% of infections. Pathogenic strains of Escherichia coli and Salmonella, norovirus, and hepatitis A accounted for the majority of cases. Large outbreaks resulted in particular biases such as the observation that contaminated sprouted plants caused 31.8% of deaths. Where known, contamination mainly occurred via contaminated seeds, water, and contaminated food handlers. There is a critical need for standardized datasets regarding all aspects of disease outbreaks, including how foodstuffs are contaminated with pathogenic microorganisms. Providing food business operators with this knowledge will allow them to implement better strategies to improve safety and quality of fresh produce.

Dehydrated foods: Are they microbiologically safe?

Dried foods are low water activity foods with water activity ranging from 0.03 to 0.7. They are commonly misconstrued to be inherently safe from food borne pathogenic bacteria. However, there are many reported cases where many food borne illnesses were caused by the consumption of dried foods contaminated with Salmonella spp., Cronobacter spp., Staphylococcus spp. and E. coli. In this work, we have systematically reviewed the literature dealing with the effect of drying/dehydration on the survival of pathogenic microorganisms with special focus on Salmonella spp. We have also reviewed and synthesized the literature dealing with the effect of drying process on microorganisms in dried vegetables, meat, fish, spices, mushroom and powdered foods. This review concludes that dried foods are not inherently safe microbiologically and required other hurdles to achieve microbial safety.

The response of foodborne pathogens to osmotic and desiccation stresses in the food chain

In combination with other strategies, hyperosmolarity and desiccation are frequently used by the food processing industry as a means to prevent bacterial proliferation, and particularly that of foodborne pathogens, in food products. However, it is increasingly observed that bacteria, including human pathogens, encode mechanisms to survive and withstand these stresses. This review provides an overview of the mechanisms employed by Salmonella spp., Shiga toxin producing E. coli, Cronobacter spp., Listeria monocytogenes and Campylobacter spp. to tolerate osmotic and desiccation stresses and identifies gaps in knowledge which need to be addressed to ensure the safety of low water activity and desiccated food products.

Survival of Salmonella on chamomile, peppermint, and green tea during storage and subsequent survival or growth following tea brewing

The survival of Salmonella on dried chamomile flowers, peppermint leaves, and green tea leaves stored under different conditions was examined. Survival and growth of Salmonella was also assessed after subsequent brewing using dried inoculated teas. A Salmonella enterica serovar cocktail was inoculated onto different dried tea leaves or flowers to give starting populations of approximately 10 log CFU/g. The inoculum was allowed to dry (at ambient temperature for 24 h) onto the dried leaves or flowers prior to storage under 25 and 35 °C at low (<30% relative humidity [RH]) and high (>90% RH) humidity levels. Under the four storage conditions tested, survival followed the order 25 °C with low RH > 35 °C with low RH > 25 °C with high RH > 35 °C with high RH. Salmonella losses at 25 °C with low RH occurred primarily during drying, after which populations showed little decline over 6 months. In contrast, Salmonella decreased below detection after 45 days at 35 °C and high RH in all teas tested. The thermal resistance of Salmonella was assessed at 55 °C immediately after inoculation of tea leaves or flowers, after drying (24 h) onto tea leaves or flowers, and after 28 days of storage at 25 °C with low RH. All conditions resulted in similar D-values (2.78 ± 0.12, 3.04 ± 0.07, and 2.78 ± 0.56, at 0 h, 24 h, and 28 days, respectively), indicating thermal resistance of Salmonella in brewed tea did not change after desiccation and 28 days of storage. In addition, all brewed teas tested supported the growth of Salmonella. If Salmonella survives after storage, it may also survive and grow after a home brewing process.

Low-water activity foods: increased concern as vehicles of foodborne pathogens

Foods and food ingredients with low water activity (a(w)) have been implicated with increased frequency in recent years as vehicles for pathogens that have caused outbreaks of illnesses. Some of these foodborne pathogens can survive for several months, even years, in low-a(w) foods and in dry food processing and preparation environments. Foodborne pathogens in low-a(w) foods often exhibit an increased tolerance to heat and other treatments that are lethal to cells in high-a(w) environments. It is virtually impossible to eliminate these pathogens in many dry foods or dry food ingredients without impairing organoleptic quality. Control measures should therefore focus on preventing contamination, which is often a much greater challenge than designing efficient control measures for high-a(w) foods. The most efficient approaches to prevent contamination are based on hygienic design, zoning, and implementation of efficient cleaning and sanitation procedures in the food processing environment. Methodologies to improve the sensitivity and speed of assays to resuscitate desiccated cells of foodborne pathogens and to detect them when present in dry foods in very low numbers should be developed. The goal should be to advance our knowledge of the behavior of foodborne pathogens in low-a(w) foods and food ingredients, with the ultimate aim of developing and implementing interventions that will reduce foodborne illness associated with this food category. Presented here are some observations on survival and persistence of foodborne pathogens in low-a(w) foods, selected outbreaks of illnesses associated with consumption of these foods, and approaches to minimize safety risks.

Extended-spectrum β-lactamase-producing Salmonella enterica serovar Oranienburg (CTX-M-2 group) in a pediatric hospital in Tucumán, Argentina

INTRODUCTION: Salmonella sp infections have been reported over recent years in hospitals in Argentina and other countries due to multiresistant strains. The aim of this study was to characterize the extended-spectrum β-lactamases in third-generation cephalosporin-resistant strains of Salmonella enterica serovar Oranienburg. METHODS: We studied 60 strains isolated from children with gastroenteritis and/or extraintestinal complications. The antibiotic susceptibility patterns of the isolates were analyzed and the β-lactamases were characterized using phenotyping and genotyping methods. RESULTS: All the strains were resistant to ampicillin, cefotaxime, cefepime and aztreonam and partially susceptible to ceftazidime, thus corresponding well with the resistance phenotype conferred by CTX-M-type β-lactamases. An isoelectric point enzyme (pI = 7.9) was detected in all of the strains, and this was confirmed by PCR as a member of the CTX-M-2 group. CONCLUSIONS: This is the first report of Salmonella enterica serovar Oranienburg producing β-lactamases of the CTX-M-2 group in a pediatric hospital in Tucumán, Argentina.

Pathogen survival in chorizos: ecological factors

This study addressed health risks from ethnic sausages produced on a small scale, without inspection, in California and elsewhere. Mexican-style chorizo, a raw pork sausage that is not cured, fermented, or smoked, was contaminated experimentally in the batter with Escherichia coli O157:H7, Listeria monocytogenes, or Salmonella serotypes and stuffed into natural casings. Formulations were based on a market survey in California. Physical parameters that were controlled were pH, water activity (a(w)), and storage temperature. The pH was adjusted with vinegar, stabilizing at 5.0 within 24 h. Initial a(w) levels adjusted with salt were 0.97, 0.95, 0.93, 0.90, and 0.85; levels declined with time because of evaporation. Pathogen numbers declined with storage up to 7 days, with few brief exceptions. Main effects and interactions of constant temperature and pH with declining a(w) on survival of the pathogens were determined. Maximum death rates occurred at higher a(w) for E. coli O157:H7 and Salmonella than for L. monocytogenes. Salt used to adjust a(w) affected palatability. Spices (black pepper, chili pepper, chili powder, cumin, garlic, guajillo pepper, oregano, and paprika) comprised another, potentially significant aspect of the sausage formulation. Some (notably black pepper and cumin) carried an indigenous microflora that contributed significantly to the microbial load of the sausage batter. Only undiluted fresh and powdered garlic exhibited a significant antimicrobial effect on the pathogens. Although each of the tested formulations caused death of the inoculated pathogens, none of the death rates was sufficiently rapid to ensure safety within the probable shelf life of the product.

International outbreak of Salmonella Oranienburg due to German chocolate

BACKGROUND

This report describes a large international chocolate-associated Salmonella outbreak originating from Germany.

METHODS

We conducted epidemiologic investigations including a case-control study, and food safety investigations. Salmonella (S.) Oranienburg isolates were subtyped by the use of pulsed-field gel electrophoresis (PFGE).

RESULTS

From 1 October 2001 through 24 March 2002, an estimated excess of 439 S. Oranienburg notifications was registered in Germany. Simultaneously, an increase in S. Oranienburg infections was noted in other European countries in the Enter-net surveillance network. In a multistate matched case-control study in Germany, daily consumption of chocolate (matched odds ratio [MOR]: 4.8; 95% confidence interval [CI]: 1.3-26.5), having shopped at a large chain of discount grocery stores (MOR: 4.2; CI: 1.2-23.0), and consumption of chocolate purchased there (MOR: 5.0; CI: 1.1-47.0) were associated with illness. Subsequently, two brands from the same company, one exclusively produced for that chain, tested positive for S. Oranienburg. In two other European countries and in Canada chocolate from company A was ascertained that also contained S. Oranienburg. Isolates from humans and from chocolates had indistinguishable PFGE profiles. No source or point of contamination was identified. Epidemiological identification of chocolate as a vehicle of infections required two months, and was facilitated by proxy measures.

CONCLUSIONS

Despite the use of improved production technologies, the chocolate industry continues to carry a small risk of manufacturing Salmonella-containing products. Particularly in diffuse outbreak-settings, clear associations with surrogates of exposure should suffice to trigger public health action. Networks such as Enter-net have become invaluable for facilitating rapid and appropriate management of international outbreaks.

Molecular subtyping methods for detection of Salmonella enterica serovar Oranienburg outbreaks

This study involved 82 Salmonella enterica serovar Oranienburg isolates from patients with gastroenteritis and/or focal infections, healthy carriers, and cuttlefish chips which were epidemiologically linked to a major outbreak that had affected 1,505 people in Japan between 1998 and 1999. We concurrently investigated four different molecular subtyping methods using human salmonellosis-associated Salmonella serovars and their applicability in detection of serovar Oranienburg in an outbreak. Pulsed-field gel electrophoresis (PFGE), enterobacterial repetitive intergenic sequence PCR (ERIC2-PCR), or 16S/23S rRNA ribotyping provided a high degree of interserovar discrimination for most of the serovars, with PFGE being the most discriminatory. For intraserovar typing of serovar Oranienburg, ERIC2-PCR was found to be the most sensitive. Native plasmid profiling, however, revealed nine different subgroups among epidemiologically and genetically related outbreak strains. Using these methods, a link was confirmed between food (cuttlefish chips) and patients in the serovar Oranienburg outbreak. This study underscores the limitations of chromosome-based and plasmid-based typing methods.

An evaluation of the Norwegian Salmonella surveillance and control program in live pig and pork

Population data and apparent prevalence data from the Salmonella surveillance and control program in pigs (NSSCP) from 1998 and 1999 were used in a simulation model to evaluate the efficacy of the program. The model consists of three parts: modelling of individual prevalence at the abattoir (abattoir part), modelling of the number of sampled herds of different sizes when carcasses are randomly sampled at the abattoir (sampling strategy part) and finally, modelling of the within herd prevalence (within herd part). A total of 136,550 sows and 2,866,550 finishing pigs slaughtered, 4446 herds and 11 herds positive for Salmonella in 1994/1995-2000 were included in the abattoir part, sampling strategy part and the within herd part of the model, respectively. The abattoir part showed an average estimated prevalence of Salmonella in sows and finishing pigs of (median) 0.4% (5-95 percentiles = 0.03-2%) and 0.1% (0.04-0.2%) respectively. The estimated number of infected sow carcasses that entered the market was 502 (37-2157) while the estimated number of finishing pig carcasses was 2919 (1218-5771). The probability of being sampled for the 10% smallest herds was (mean) 1.9% (1.6-2.2), to 25% (24.7-26.5%) for the 10% largest herds. The within herd prevalence was estimated to be from 1% to 4% for Norwegian pig herds. The conclusions drawn from this evaluation are that the NSSCP does not have any significant consumer protection effect, and that the documentation could be done more effectively using the herd rather than the individual animal as the unit of sampling. Sampling should focus on the larger herds supplying most of the meat on the market and on herds that produce breeding sows and piglets and thus can contribute to the spread of Salmonella among herds.

A fatal case of pepper poisoning

An 8 month old infant died as the result of administration of a traditional remedy, given orally as an infusion of a red powder. The symptoms on admission were coughing with diarrhoea and vomiting. Analysis of the powder using high-performance liquid chromatography (HPLC) confirmed the suspicion of capsaicin. Pepper preparations, which are used as traditional medicines, are highly toxic and their use on infants should be discouraged.

Identification, assessment and management of food-related microbiological hazards: historical, fundamental and psycho-social essentials

Microbiological risk assessment aimed at devising measures of hazard management, should take into account all perceived hazards, including those not empirically identified. It should also recognise that safety cannot be "inspected into" a food. Rather hazard management should be the product of intervention strategies in accordance with the approach made mandatory in the EU Directive 93/43 and the USDA FSIS Pathogen Reduction HACCP system; Final Rule. It is essential too that the inherent variability of the biological attributes affecting food safety is recognised in any risk assessment. The above strategic principles may be conceptualised as a four-step sequence, involving (i) identification and quantification of hazards; (ii) design and codification of longitudinally integrated ("holistic") technological processes and procedures to eliminate, or control growth and metabolism of, pathogenic and toxinogenic organisms; (iii) elaboration of microbiological analytical standard operating procedures, permitting validation of "due diligence" or responsible care, i.e. adherence to adopted intervention strategies. This should be supported by empirically assessed reference ranges, particularly for marker organisms, while the term "zero tolerance" is refined throughout to tolerable safety limit; (iv) when called for, the need to address concerns arising from lay perceptions of risk which may lack scientific foundation. In relation to infectious and toxic hazards in the practical context the following general models for quantitative holistic risk assessment are presented: (i) the first order, basic lethality model; (ii) a second approximation taking into account the amount of food ingested in a given period of time; (iii) a further adjustment accounting for changes in colonization levels during storage and distribution of food commodities and the effects of these on proliferation of pathogens and toxin production by bacteria and moulds. Guidelines are provided to address: (i) unsubstantiated consumer concern over the wholesomeness of foods processed by an innovative procedure; and (ii) reluctance of small food businesses to adopt novel strategies in food safety. Progress here calls for close cooperation with behavioural scientists to ensure that investment in developing measures to contain risk deliver real benefit.

Salmonella and the international food trade

Non-typhoid Salmonella spp. continue to figure prominently in many national epidemiological registries as the leading cause of bacterial foodborne disease. Although Salmonella enterocolitis is generally a self-limiting illness that may require fluid and electrolyte replacement, the disease can spread systemically and degenerate into a chronic condition such as reactive arthritis, osteomyelitis, cardiac inflammation or neural disorders. Ampicillin, chloramphenicol and trimethoprim-sulfamethoxazole have provided the mainstay of therapy for the clinical management of bacteremic salmonellosis. However, the increasing occurrence of strains that are resistant to one or more of these traditional antibacterial drugs has resulted in the wider use of quinolones for the treatment of Salmonella septicaemia. Successful clinical results with these newer drugs are already being overshadowed by the emergence of salmonellae that are resistant to these therapeutic agents. A rapidly growing international trade in agricultural, aquacultural and manufactured food products has greatly facilitated the introduction of new Salmonella serovars within the geographical boundaries of importing countries. This paper reviews the prevalence of Salmonella in selected food types that are subject to the import-export market and attendant epidemiological overtones. More specifically, the importance of fresh fruits and vegetables, spices, cheese, and aquacultural products as vehicles of human infection will be underlined. The potential impact of the widespread use of antibiotics of importance in human medicine in the aquaculture industry will also be discussed. The ubiquitous distribution of Salmonella in the natural environment and its prevalence in the global food chain, the physiological adaptability and virulence of this important human bacterial pathogen, and its potentially serious economic impact on the food industry predicate the need for continued vigilance and stringent controls at all levels of food production.

Comparison of epidemiological markers of Salmonella strains isolated from different sources in Spain

A comparative study of the phage types, antimicrobial susceptibility patterns, and plasmid profiles of 171 strains of Salmonella isolated from food, epidemic outbreaks, and water-contaminated environments as well as sporadic human isolates was carried out to determine the most adequate marker in epidemiological investigations. Typing based on the plasmid profiles appears to be the most effective method for grouping strains with the same serotype obtained from a single outbreak and from environmental sources. However, none of the three markers tested allow us total discrimination and identification of related strains from a common source for epidemiological tracing. Therefore, the combined use of the three methods is necessary for determining whether common source isolates are related.

Outbreak of Salmonella typhimurium infection traced to contaminated chocolate and caused by a strain lacking the 60-megadalton virulence plasmid

We describe an outbreak of Salmonella typhimurium infection, caused by contaminated chocolate produced by one Norwegian company, which occurred in Norway and Finland in 1987. A total of 349 bacteriologically verified cases were recorded in Norway, and 12 cases were recorded in Finland. There was a predominance of young children among the patients (median age, 6 years), many of whom developed acute hemorrhagic diarrhea. The outbreak strain exhibited a rare phage lysis pattern and a characteristic plasmid profile lacking the 60-MDa virulence-associated plasmid. DNA hybridization failed to demonstrate any DNA sequence homology between the outbreak strain and the virulence plasmid. The outbreak strain was nonlethal for orally infected mice. The finding of only less than or equal to 10 S. typhimurium cells per 100 g of chocolate in about 90% of the positive samples obtained from retail outlets suggested that an inoculum of fewer than 10 organisms may have been sufficient to cause symptomatic disease.

Plasmid characterization of Salmonella typhimurium transmitted from animals to humans

The transmission of pathogenic bacteria from animals to humans is widely studied because of its public health importance. In this study, we show the transmission of Salmonella typhimurium from cattle which had received no growth-promoting antibiotics to humans who had direct contact with the ill animals. On one cattle farm, the veterinarian attending the sick animals became ill, and two other individuals living on the farm later developed salmonellosis. The strains isolated from both humans and animals at one farm were identical as to antibiotic susceptibility and phage type, and they were specifically traced by the presence of a common 24-megadalton plasmid. Restriction enzyme digests of this plasmid from both human and animal strains were identical. At another farm, tetracycline-resistant S. typhimurium strains possessing a different profile (eight plasmids) were isolated from both animals and humans. The tetracycline-resistant clone was also isolated from animals at a third farm, but with animals and humans having no known contact with those of the other two farms.