[Monitoring of lettuce crops of Ribeirão Preto, SP, Brazil]

Systematic Review: Nontyphoidal Salmonella in Food from Latin America

In Latin America, nontyphoidal Salmonella (NTS) is one of the most important etiological agents of foodborne infections; it can survive in soil, water, and food even after processing. Here, we aimed to perform a systematic review by collecting data on the prevalence, serotypes, and antimicrobial resistance (AMR) of NTS isolated from different food products in Latin America, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Out of 1766 studies screened, 244 reports from 13 Latin American countries were eligible. Among these, 182 reported NTS prevalence, 87 reported NTS serotypes, and 83 reported serotypes with AMR patterns. The NTS prevalence ranged from 0.005% to 93.3%, regardless of country and food. Meat showed the highest NTS prevalence. Enteritidis, Typhimurium, and Derby were the most frequently observed serotypes in different food products. The serotypes Enteritidis, Typhimurium, and Infantis, isolated from animal products, showed the highest AMR rate. The presence of NTS in fruits and vegetables, which are generally consumed raw or as ready-to-eat food, indicates a high risk of salmonellosis from consuming these foods. Thus, the reduction of this pathogen in the food chain requires a One Health approach, involving good agricultural and manufacturing practices, low antimicrobial use, and proper waste management.

Prevalence of enteroparasites in vegetables marketed in the municipality of Conceição da Barra, Espírito Santo, Brazil

OBJECTIVE

To monitor the frequency of enteroparasites in lettuce (Lactuca sativa) and parsley (Petrosolium sativum) samples, marketed in commercial buildings in the municipality of Conceição da Barra, Espírito Santo, Brazil.

MATERIALS AND METHODS

Between August 2015 and July 2016, four different popular commercial buildings (fairs, markets and supermarkets) were selected as the largest vegetable suppliers in the municipality of Conceição da Barra, Espírito Santo. A total of 40 samples were analyzed using the modified spontaneous sedimentation method at the Laboratory of Parasitology and Hematology of Centro Universitário Norte do Espirito Santo, Universidade Federal do Espírito Santo.

RESULTS

The most frequent organism in the study population were the commensal Entamoeba coli and the parasites E. histolytica/E.dispar, hookworm, Balantidium coli, Ascaris sp., Toxocara sp., Taenia sp. and Dipylidium sp.

CONCLUSIONS

The results indicate a high degree of contamination of the vegetables, probably related to the precariousness of production, transportation and handling, making it necessary to adopt measures that guarantee the best quality of food and, consequently, better population health.

Prevalence of enteroparasites in vegetables marketed in the city of Jaguaré, Espírito Santo, Brazil

OBJECTIVE

To monitor the frequency of enteroparasites in lettuce (Lactuca sativa) and parsley (Petrosolium sativum) samples, marketed in commercial buildings in the municipality of Jaguaré, Espírito Santo, Brazil.

MATERIALS AND METHODS

Between August 2016 and July 2017, five different popular commercial buildings (markets, supermarkets and fairs) in the municipality of Jaguaré, considered the main local vegetable suppliers were selected. Throughout the research, 30 vegetable samples were randomly selected for parasitological analysis in 3 replicates for each commercial building under study. The obtained samples were analyzed by the modified spontaneous sedimentation method at the Laboratory of Parasitology and Hematology of Universidade Federal do Espírito Santo.

RESULTS

Of the 30 samples analyzed, 83.3% were positive for parasitic contamination and the most common parasites were Hookworm, Balantidium coli, Isospora belli, Ascaris sp. and Entamoeba sp.

CONCLUSIONS

The results indicate a high degree of contamination of the vegetables, probably related to the precariousness of production, transportation and handling, making it necessary to adopt measures that ensure the best quality of food and, consequently, better population health.

Giardia: an under-reported foodborne parasite

Foodborne zoonotic pathogens are a serious public health issue and result in significant global economic losses. Despite their importance to public health, epidemiological data on foodborne diseases including giardiasis caused by the enteric parasite, Giardia duodenalis, are lacking. This parasite is estimated to cause ∼28.2 million cases of diarrhoea each year due to contamination of food, but very few foodborne outbreaks have been documented due to the limitations of current detection as well as surveillance methods. The current method for the recovery of Giardia cysts from food matrices using immunomagnetic separation requires further standardisation and cost reduction before it can be widely used. It also should incorporate downstream molecular procedures for genotyping, and traceback and viability analyses. Foodborne giardiasis can be potentially controlled through improvements in national disease surveillance systems and the establishment of Hazard Analysis and Critical Control Point interventions across the food chain. Studies are needed to assess the true prevalence and public health impact of foodborne giardiasis.

A perspective on Cryptosporidium and Giardia, with an emphasis on bovines and recent epidemiological findings

Cryptosporidium and Giardia are two common aetiological agents of infectious enteritis in humans and animals worldwide. These parasitic protists are usually transmitted by the faecal-oral route, following the ingestion of infective stages (oocysts or cysts). An essential component of the control of these parasitic infections, from a public health perspective, is an understanding of the sources and routes of transmission in different geographical regions. Bovines are considered potential sources of infection for humans, because species and genotypes of Cryptosporidium and Giardia infecting humans have also been isolated from cattle in molecular parasitological studies. However, species and genotypes of Cryptosporidium and Giardia of bovids, and the extent of zoonotic transmission in different geographical regions in the world, are still relatively poorly understood. The purpose of this article is to (1) provide a brief background on Cryptosporidium and Giardia, (2) review some key aspects of the molecular epidemiology of cryptosporidiosis and giardiasis in animals, with an emphasis on bovines, (3) summarize research of Cryptosporidium and Giardia from cattle and water buffaloes in parts of Australasia and Sri Lanka, considering public health aspects and (4) provide a perspective on future avenues of study. Recent studies reinforce that bovines harbour Cryptosporidium and Giardia that likely pose a human health risk and highlight the need for future investigations of the biology, population genetics and transmission dynamics of Cryptosporidium and Giardia in cattle, water buffaloes and other ruminants in different geographical regions, the fate and transport of infective stages following their release into the environment, as well as for improved strategies for the control and prevention of cryptosporidiosis and giardiasis, guided by molecular epidemiological studies.

Neurocysticercosis

Cysticercosis is one of the most common parasitic diseases of the nervous system in humans, and constitutes a major public health problem for most of the developing world. The clinical manifestations of neurocysticercosis (NCC) largely depend on the the host immune response against the parasite. NCC diagnosis is based upon neuroimaging studies (computerized tomography, magnetic resonance imaging) and antibody/antigen detection in the serum and the cerebrospinal fluid. Anticysticercal therapy has been marked by an intense controversy. Randomized controlled trials evaluating the clinical benefit of treatment have yield conflicting data with some studies indicating a benefit and others failing to show a difference. Prevention strategies must rely on multiple approaches, tailoring each to the special features of the particular endemic area.

Risk factors for Giardia infection among hospitalized children in Cuba

The risk factors associated with Giardia infection, in children hospitalized in Havana, Cuba, were recently explored. Children aged ≥5 years were more likely to be positive for Giardia infection than the younger children, with an odds ratio (OR) of 3·41 [95% confidence interval (CI) = 1·36-9·69]. The risk factors found to be associated with Giardia infection in univariate analyses were rural residence (OR = 3·01; CI = 1·23-7·35), belonging to a household that did not receive water from an aqueduct (OR = 3·27; CI = 1·21-8·91), drinking unboiled water (OR = 3·64; CI = 2·14-6·26), nail biting (OR = 3·47; CI = 1·97-6·08), eating unwashed vegetables raw (OR = 4·84; CI = 2·33-10·14), and a personal (OR = 3·23; CI = 1·58-6·59) or family history (OR = 3·96; CI = 1·53-10·47) of previous parasitic infection. In multivariate analyses, however, only two (modifiable) risk factors were found to be independently and significantly associated with Giardia infection: nail biting and eating unwashed vegetables raw. It therefore seems that, at least at the individual level, giardiasis-prevention activities in Havana should be focussed on health education to improve personal hygiene and food-related practices. If appropriately managed, the surveillance of drinking water and foodstuffs, for Giardia and other parasites, might also help to reduce the hospitalization of Cuban children.

[Evaluation of the contamination of lettuce crops after the establishment of the monitoring system in Ribeirão Preto, SP]

This study evaluated the microbiological and parasitological contamination of 88 market gardens producing green vegetables, of which 47 had been investigated previously. The contamination rate was 38.3% in the market gardens previously evaluated and 43.9% in the new market gardens. Food safety requires a continuous and efficient sanitary surveillance system for market gardens.

Análise da cadeia de produção de verduras em Ribeirão Preto, SP

Com o objetivo de avaliar o risco cumulativo de contaminação de hortaliças, investigou-se 45 cadeias produtoras. Foi detectada a presença de coliformes a 45ºC, Salmonella e/ou parasitas em 69% delas, em todas as etapas de produção. Ressalta-se a necessidade de se intensificar o controle de qualidade ao longo da cadeia produtiva.

Ocorrência de Cryptosporidium spp. e outros parasitas em hortaliças consumidas in natura, no Recife

O objetivo deste estudo foi verificar a ocorrência de enteroparasitas em hortaliças comercializadas e consumidas em Pernambuco. Foram utilizadas 100 amostras de hortaliças: 40 amostras de alface lisa (Lactuca sativa), 40 de agrião (Nasturtium officinale) e 20 de acelga (Beta vulgaris), provenientes de feiras livres e supermercados. A detecção de Cryptosporidium spp. foi realizada conforme Monge e Arias sendo utilizado dois métodos de coloração, Koster modificado e Ziehl-Nielsen. Foi usada a técnica de sedimentação espontânea de Gelli et al. para a análise parasitológica. As análises de coliformes totais e Escherichia coli foram realizadas de acordo com Andrews. Os resultados obtidos mostraram um percentual de contaminação parasitária em 60% de alface, 30% de agrião e 20% de acelga, destacando-se o Ascaris lumbricoides, Strongyloides stercoralis e Ancylostoma duodenale dentre os helmintos, e o Cryptosporidium spp., Entamoeba coli e o complexo Entamoeba histolytica/Entamoeba díspar, dentre os protozoários com maior freqüência. As hortaliças mais contaminadas por coliformes totais e Escherichia coli foram alface nas amostras de supermercado e agrião em feira livre. Esses dados sugerem a necessidade da adoção de medidas educativas aos produtores, e do monitoramento das águas destinadas à irrigação das hortas.

Irrigation water as source of foodborne pathogens on fruit and vegetables

Awareness is growing that fresh or minimally processed fruit and vegetables can be sources of disease-causing bacteria, viruses, protozoa, and helminths. Irrigation with poor-quality water is one way that fruit and vegetables can become contaminated with foodborne pathogens. Groundwater, surface water, and human wastewater are commonly used for irrigation. The risk of disease transmission from pathogenic microorganisms present in irrigation water is influenced by the level of contamination; the persistence of pathogens in water, in soil, and on crops; and the route of exposure. Groundwater is generally of good microbial quality, unless it is contaminated with surface runoff; human wastewater is usually of very poor microbial quality and requires extensive treatment before it can be used safely to irrigate crops; surface water is of variable microbial quality. Bacteria and protozoa tend to show the poorest survival outside a human host, whereas viruses and helminths can remain infective for months to years. Guidelines governing irrigation water quality and strategies to reduce the risk of disease transmission by foodborne pathogens in irrigation are discussed.

[Microbiological and parasitological contamination of lettuce (Lactuca sativa) from self service restaurants of Niterói city, RJ]

Thirty samples of lettuces from self service restaurants of Niterói were analyzed to detect bacteriological and parasitological contamination. Sixteen samples presented fecal coliform, 16 mesophilic aerobic microorganisms greater than 10(7) UFC/g and 3 cysts of Entamoeba coli. These data suggest the need of better orientation for food handlers regarding the hygiene of processed vegetables.

Risk factors for sporadic giardiasis: a case-control study in southwestern England

To investigate risk factors for sporadic infection with Giardia lamblia acquired in the United Kingdom, we conducted a matched case-control study in southwest England in 1998 and 1999. Response rates to a postal questionnaire were 84% (232/276) for cases and 69% (574/828) for controls. In multivariable analysis, swallowing water while swimming (p<0.0001, odds ratio [OR] 6.2, 95% confidence intervals [CI] 2.3 to 16.6), recreational fresh water contact (p=0.001, OR 5.5, 95% CI 1.9 to 15.9), drinking treated tap water (p<0.0001, OR 1.3, 95% CI 1.1 to 1.5 for each additional glass per day), and eating lettuce (pç=0.01, OR 2.2, 95% CI 1.2 to 4.3) had positive and independent associations with infection. Although case-control studies are prone to bias and the risk of Giardia infection is minimized by water treatment processes, the possibility that treated tap water is a source of sporadic giardiasis warrants further investigation.

Occurrence of parasites on fruits and vegetables in Norway

Between August 1999 and January 2001, samples of various fruits and vegetables obtained within Norway were analyzed by published methods for parasite contamination. Neither Cyclospora oocysts nor Ascaris (or other helminth) eggs were detected on any of the samples examined for these parasites. However, of the 475 samples examined for Cryptosporidium oocysts and Giardia cysts, 29 (6%) were found to be positive. No samples were positive for both parasites. Of the 19 Cryptosporidium-positive samples. 5 (26%) were in lettuce, and 14 (74%) in mung bean sprouts. Of the 10 Giardia-positive samples, 2 (20%) were in dill, 2 (20%) in lettuce, 3 (30%) in mung bean sprouts, 1 (10%) in radish sprouts, and 2 (20%) in strawberries. Mung bean sprouts were significantly more likely to be contaminated with Cryptosporidium oocysts or Giardia cysts than the other fruits and vegetables. Concentrations of Cryptosporidium and Giardia detected were generally low (mean of approximately 3 [oo]cysts per 100 g produce). Although some of the contaminated produce was imported (the majority, if sprouted seeds are excluded), there was no association between imported produce and detection of parasites. Crvptosporidium oocysts and Giardia cysts were also detected in water samples concerned with field irrigation and production of bean sprouts within Norway. This is the first time that parasites have been detected on vegetables and fruit obtained in a highly developed. wealthy country, without there being an outbreak situation. These findings may have important implications for global food safety.

[Monitoring of vegetables sold in Ribeirão Preto, SP, Brazil]

The ingestion of raw vegetables represents an important means of transmission of several infectious diseases. The objective of the present study was to perform a microbiological and parasitological evaluation of the vegetables commercially sold in the municipality of Ribeirão Preto, SP, Brazil. Of a total of 172 commercial concerns analyzed, 115 (67%) presented irregularities in the vegetables they sold, such as elevated concentration of fecal coliforms in 63%, presence of Salmonella in 9%, and presence of enteroparasites in 33%. The commercial concerns with the highest frequencies of vegetables showing inadequate results were: grocery stores (92%), CEAGESP (75%), fruit and vegetables stores (71%), traveling vendors (71%), fairs (69%), supermarkets (52%), and vegetable gardens (18%). The type of contamination was uniformly distributed among these commercial concerns. Most of the contaminated vegetables (61%) were from gardens located in the municipality of Ribeirão Preto. Considering the high frequency of fecal contamination and the potential risk of disease transmitted by vegetables, we suggest greater enforcement in the sanitary surveillance of the food offered to the population.