Detection of Toxoplasma gondii and Sarcocystis sp. in the meat of common minke whale (Balaenoptera acutorostrata): A case of suspected food poisoning in Japan

A case of suspected food poisoning related to the consumption of raw meat from a common minke whale (Balaenoptera acutorostrata) was reported in Tokyo, Japan, in June 2020. Microscopic analysis revealed tissue cysts of Toxoplasma gondii and sarcocysts of Sarcocystis sp. in whale meat. The SAG2 and ITS1 region sequences of T. gondii were detected in the DNA extracted from the meat. Genotyping of the multilocus nested PCR-RFLP using the genetic markers SAG1, SAG2 (5'- SAG2, 3'-SAG2, and alt. SAG2), SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and Apico revealed that the genotype of T. gondii was type II, with a type I pattern for the L358 locus. In the phylogenetic analyses of the six loci (GRA6, GRA7, SAG1, HP2, UPRT1, and UPRT7), these sequences clustered into haplogroup 2. Moreover, the sequences of the virulence-related genes ROP5 and ROP18 of T. gondii isolated from whale meat were similar to those of the type II ME49 reference strain. Sequence analyses of the mtDNA cox1 gene, 18S rRNA gene, and ITS1 region indicated the highest similarity of sarcocyst isolated from whale meat to Sarcocystis species that infect birds or carnivores as intermediate hosts; however, the species could not be identified. To our knowledge, this is the first report of T. gondii and Sarcocystis spp. being detected in same whale meat ingested by patients involved in a suspected food poisoning case in Japan.

Identification of toxic Gelsemium elegans in processed food and honey based on real-time PCR analysis

Gelsemium elegans (GE) is a widely distributed hypertoxic plant that has caused many food poisoning incidents. Its pollen can also be collected by bees to produce toxic honey, posing a great threat to the health and safety of consumers. However, for the complex matrices such as cooked food and honey, it is challenging to perform composition analysis. It is necessary to establish more effective strategies for investigating GE contamination. In this study, the real-time PCR (qPCR) analysis combined with DNA barcode matK was proposed for the identification and detection of GE. Fifteen honey samples along with twenty-eight individuals of GE and the common confusable objects Lonicera japonica, Ficus hirta, Stellera chamaejasme and Chelidonium majus were gathered. Additionally, the food mixtures treated with 20-min boiling and 30-min digestion were prepared. Specific primers were designed, and the detection capability and sensitivity of qPCR in honey and boiled and digested food matrices were tested. The results demonstrated that the matK sequence with sufficient mutation sites was an effective molecular marker for species differentiation. GE and the confusable species could be clearly classified by the fluorescence signal of qPCR assay with a high sensitivity of 0.001 ng/μl. In addition, this method was successfully employed for the detection of deeply processed food materials and honey containing GE plants which even accounted for only 0.1 %. The sequencing-free qPCR approach undoubtedly can serve as a robust support for the quality supervision of honey industry and the prevention and diagnosis of food poisoning.

Molecular characterization and toxigenic profiles of Bacillus cereus isolates from foodstuff and food poisoning outbreaks in Brazil

Bacillus cereus sensu stricto (s.s.) is a well-known foodborne pathogen that produces a range of enterotoxins and is able to cause two different types of foodborne illnesses-the emetic and the diarrheal syndromes. In this study, 54 B. cereus s.s. strains isolated from foodstuff and foods involved in food poisoning outbreaks were characterized according to the presence of toxin-encoding genes, virulence-encoding genes, and panC typing. Most isolates were assigned to panC groups IV (61.1%) and III (25.9%), but members of groups II and V could also be found. Investigation of specific alleles revealed high numbers of isolates carrying toxin and other virulence genes including nheA (100%), nheB (100%), hblA (79.6%), hblC (79.6%), hblD (74.1%), cytK-2 (61.1%), clo (100%), pc-plc (75.9%), sph (68.5%), pi-plc (66.6%), hlyIII (62.9%), and hlyII (24.1%). All isolates were negative for ces and cytK-1. In summary, we detected various enterotoxin and other virulence factor genes associated with diarrheal syndrome in strains analyzed, implicated or not with food poisoning. Furthermore, the most isolates analyzed belong to high-risk phylogenetic groups' panC types III and IV. Our study provides a convenient molecular scheme for characterization of B. cereus s.s. strains responsible for food poisoning outbreaks in order to improve the monitoring and investigation and assess emerging clusters and diversity of strains.

Characterization and multilocus sequence typing of Clostridium perfringens isolated from patients with diarrhoea and food poisoning in Tai'an region, China

OBJECTIVES

Clostridium perfringens (C. perfringens) is a significant opportunistic pathogen. This study aims to examine the occurrence of C. perfringens in patients with diarrhoea and food poisoning and compare the genetic similarities with strains found in poultry retail markets and poultry farms in the same city (Tai'an, China).

METHODS

Clostridium perfringens was isolated from 30 human faecal samples and genotyped using multiplex PCR. The antimicrobial susceptibility test was conducted using the Kirby-Bauer disk diffusion method. Genetic relationships were analysed through Multi-locus sequence typing (MLST) and Phylogenetic analysis.

RESULTS

The positive rate of C. perfringens was found to be 96.67%. Among the positive samples, 91.67% of the faecal samples from patients with food poisoning contained type F strains of C. perfringens, while only 16.67% of the samples from diarrhoea cases contained type F. The drug susceptibility test revealed that the majority of isolates displayed broad-spectrum antimicrobial resistance. Out of the 57 isolates tested for drug susceptibility, 89.47% demonstrated resistance to at least three antibiotics. The MLST results indicated that strains originating from the same host and environment tended to be more closely related. However, certain strains associated with food poisoning and diarrhoea in patients shared the same ST and CC as some strains found in the retail market. These strains were also found to be phylogenetically similar to some retail market strains, suggesting potential risks to human health.

CONCLUSIONS

Therefore, it is crucial to enhance the management of poultry retail markets in order to mitigate these associated risks.

Lysozyme Peptides as a Novel Nutra-Preservative to Control Some Food Poisoning and Food Spoilage Microorganisms

Foodborne illnesses and microbial food contamination are crucial concerns and still issues of great worldwide concern. Additionally, the serious health hazards associated with the use of chemical preservatives in food technology. Lysozyme (Lz) is an active protein against Gram-positive bacterial cell wall through its muramidase lytic activity; however, several authors could identify some antimicrobial peptides derived from Lz that have an exaggerated and broad-spectrum antibacterial activity. Therefore, a lysozyme peptides preparation (LzP) is developed to broaden the Lz spectrum. In this work, we investigated the potential efficacy of LzP as a novel Nutra-preservative (food origin) agent against some pathogenic and spoilage bacteria. Our results showed that LzP demonstrated only 11% of the lysozyme lytic activity. However, LzP exhibited strong antibacterial activity against Escherichia coli, Salmonella enteritidis, and Pseudomonas species, while Salmonella typhi and Aeromonas hydrophila exhibited slight resistance. Despite the lowest LzP concentration (0.1%) employed, it performs stronger antibacterial activity than weak organic acids (0.3%). Interestingly, the synergistic multi-component formulation (LzP, glycine, and citric acid) could inhibit 6 log10 cfu/ml of E. coli survival growth. The effect of heat treatment on LzP showed a decrease in its antibacterial activity at 5 and 67% by boiling at 100 °C/30 min, and autoclaving at 121 °C/15 min; respectively. On the other hand, LzP acquired stable antibacterial activity at different pH values (4-7). In conclusion, LzP would be an innovative, natural, and food origin preservative to control the growth of food poisoning and spoilage bacteria in food instead chemical one.

Prevalence of Anisakis larvae in cultured mackerel Scomber japonicas in Japan and the relationship between the intensity of Anisakis infection in cultured mackerel and fish fatness

Incidences of food poisoning caused by Anisakis have increased in Japan, and a significant number of anisakiasis cases in Tokyo attributed to the consumption of mackerel (Scomber japonicus) have been reported. There are two types of cultured mackerel in Japan: those cultured fully from controlled parent fish eggs and those cultured from wild juveniles collected from the sea. In this study, we aimed to investigate the prevalence of Anisakis larvae in cultured mackerel (184 fish) in 15 products and identified the species using molecular analysis to evaluate the risk of food poisoning. In total, 1567 Anisakis larvae were detected in 70 of 130 mackerel in 10 products; however, Anisakis larvae were not detected in 54 mackerel using artificially reared juveniles in 5 products. Moreover, 277 larvae were detected in fish muscle, and 98.6 % (273/277 larvae) were molecularly identified as Anisakis simplex sensu stricto (A. simplex). Conversely, 1043 Anisakis pegreffii larvae were identified genetically and/or morphologically but only 2 larvae were identified in the muscle. There was no significant relationship between the host coefficient of fatness and the infection intensity of Anisakis larvae in individual fish (Spearman's rank correlation coefficient test, P > 0.05). Based on the results of the analysis of the cytochrome c oxidase subunit2 (cox2) gene of A. simplex and A. pegreffii detected in this study, we attempted to estimate the catch area of the juveniles (Pacific stock and Tsushima Warm Current stock). The clusters on the phylogenetic tree of the cox2 gene of A. pegreffii from the mackerel presumed to be the two above mentioned geographic distributions were not separated and these geographic origins could not be estimated. This study revealed that mackerel cultured using wild juveniles are likely to be contaminated with Anisakis larvae, which can be detected not only in the visceral organs, but also in the muscle. Anisakis infection in cultured mackerel did not influence fish growth and evaluating the intensity of Anisakis based on the fatness level of the mackerel was complicated. To prevent anisakiasis caused by the consumption of mackerel cultured using wild juveniles, it is important to steadily control Anisakis through heating and freezing.

Molecular characterization of enterotoxin genes in methicillin-resistant S. aureus isolated from food poisoning outbreaks in Egypt

BACKGROUND

Staphylococcus aureus (S. aureus), especially methicillin-resistant S. aureus (MRSA), is a known disease-causing bacteria with many associated health hazards. Staphylococcal food poisoning can result from staphylococcal enterotoxins (SEs).

METHODS

In this study, 50 S. aureus isolates were isolated from the gastrointestinal tract (GIT) clinical samples of patients with food poisoning in clinical laboratories at Mansoura University Hospital, Egypt. For determination their antibiogram, these isolates were tested for antimicrobial sensitivity against 12 antimicrobial agents using the agar disk diffusion test. After DNA extraction from the isolates, conventional polymerase chain reaction (PCR) was used to detect mecA and SEs genes.

RESULTS

As a result, all isolates were ampicillin and cefoxitin-resistant, while 86% (43 of 50) of the tested isolates exhibited multidrug resistance (MDR). In contrast, the highest sensitivity was confirmed against vancomycin, linezolid and quinolones, namely ciprofloxacin and norfloxacin. Although 100% of the isolates were mecA positive, staphylococcal enterotoxin genes set-A, set-B, set-C, set-G, set-M, and set-O genes were detected in 56%, 20%, 8%, 32%, 16%, and 24%, of the tested isolates, respectively. Finally, isolates encompassing SEs genes were used to validate a microarray chip, indicating its potential for a better methodological approach for detecting and identifying SEs in human samples.

CONCLUSION

The genotypic findings of this study may help explain the enterotoxigenic patterns in S. aureus among Egyptian patients with food poisoning.

Genomic analysis and biological characterization of a novel Schitoviridae phage infecting Vibrio alginolyticus

Vibrio alginolyticus is a Gram-negative bacterium commonly associated with mackerel poisoning. A bacteriophage that specifically targets and lyses this bacterium could be employed as a biocontrol agent for treating the bacterial infection or improving the shelf-life of mackerel products. However, only a few well-characterized V. alginolyticus phages have been reported in the literature. In this study, a novel lytic phage, named ΦImVa-1, specifically infecting V. alginolyticus strain ATCC 17749, was isolated from Indian mackerel. The phage has a short latent period of 15 min and a burst size of approximately 66 particles per infected bacterium. ΦImVa-1 remained stable for 2 h at a wide temperature (27-75 °C) and within a pH range of 5 to 10. Transmission electron microscopy revealed that ΦImVa-1 has an icosahedral head of approximately 60 nm in diameter with a short tail, resembling those in the Schitoviridae family. High throughput sequencing and bioinformatics analysis elucidated that ΦImVa-1 has a linear dsDNA genome of 77,479 base pairs (bp), with a G + C content of ~ 38.72% and 110 predicted gene coding regions (106 open reading frames and four tRNAs). The genome contains an extremely large virion-associated RNA polymerase gene and two smaller non-virion-associated RNA polymerase genes, which are hallmarks of schitoviruses. No antibiotic genes were found in the ΦImVa-1 genome. This is the first paper describing the biological properties, morphology, and the complete genome of a V. alginolyticus-infecting schitovirus. When raw mackerel fish flesh slices were treated with ΦImVa-1, the pathogen loads reduced significantly, demonstrating the potential of the phage as a biocontrol agent for V. alginolyticus strain ATCC 17749 in the food. KEY POINTS: • A novel schitovirus infecting Vibrio alginolyticus ATCC 17749 was isolated from Indian mackerel. • The complete genome of the phage was determined, analyzed, and compared with other phages. • The phage is heat stable making it a potential biocontrol agent in extreme environments.

Identification and poisoning diagnosis of Aconitum materials using a genus-specific nucleotide signature

Aconitum genus generally contains hypertoxic alkaloids. Poisoning incidents due to the improper ingestion of Aconitum materials frequently occur around the world. DNA barcoding is considered as a powerful tool for species identification, but complete sequences of conventional DNA barcodes are sometimes unattainable from food and highly processed products due to severe DNA degradation. Therefore, a shorter molecular marker will be more profitable for the authentication and poisoning diagnosis of Aconitum materials. In this study, 1246 psbA-trnH sequences and chloroplast genomes representing 183 taxa of Aconitum were collected, and a 23-bp nucleotide signature unique to Aconitum genus (5'-TATATGAGTCATTGAAGTTGCAG-3') was developed. The nucleotide signature was conserved and universal within Aconitum while divergent among other genera. The specific molecular signature was then successfully applied to the detection of processed Aconitum ingredients. To further evaluate the application potential of nucleotide signature in completely unknown mixture samples, boiled food mixtures, containing different ratios of Aconitum materials, were sequenced by high-throughput sequencing technology. The results showed that the nucleotide signature sequence could be directly extracted from raw sequencing data, even at a low DNA concentration of 0.2 ng/µl. Consequently, the 23-bp genus-specific nucleotide signature represents a significant step forward in the use of DNA barcoding to identify processed samples and food mixtures with degraded DNA. This study undoubtedly provides a new perspective and strong support for the identification and detection of Aconitum-containing products, which can be further introduced to the diagnosis of food poisoning.

Large outbreak of Jimsonweed (Datura stramonium) poisoning due to consumption of contaminated humanitarian relief food: Uganda, March-April 2019

Background

Jimsonweed (Datura stramonium) contains toxic alkaloids that cause gastrointestinal and central nervous system symptoms when ingested. This can be lethal at high doses. The plant may grow together with leguminous crops, mixing with them during harvesting. On 13 March 2019, more than 200 case-patients were admitted to multiple health centres for acute gastrointestinal and neurologic symptoms. We investigated to determine the cause and magnitude of the outbreak and recommended evidence-based control and prevention measures.

Methods

We defined a suspected case as sudden onset of confusion, dizziness, convulsions, hallucinations, diarrhoea, or vomiting with no other medically plausible explanations in a resident of Napak or Amudat District from 1 March—30 April 2019. We reviewed medical records and canvassed all villages of the eight affected subcounties to identify cases. In a retrospective cohort study conducted in 17 villages that reported the earliest cases, we interviewed 211 residents about dietary history during 11–15 March. We used modified Poisson regression to assess suspected food exposures. Food samples underwent chemical (heavy metals, chemical contaminants, and toxins), proteomic, DNA, and microbiological testing in one national and three international laboratories.

Results

We identified 293 suspected cases; five (1.7%) died. Symptoms included confusion (62%), dizziness (38%), diarrhoea (22%), nausea/vomiting (18%), convulsions (12%), and hallucinations (8%). The outbreak started on 12 March, 2–12 h after Batch X of fortified corn-soy blend (CSB +) was distributed. In the retrospective cohort study, 66% of 134 persons who ate CSB + , compared with 2.2% of 75 who did not developed illness (RR_adj = 22, 95% CI = 6.0–81). Samples of Batch X distributed 11–15 March contained 14 tropane alkaloids, including atropine (25-50 ppm) and scopolamine (1-10 ppm). Proteins of Solanaceae seeds and Jimsonweed DNA were identified. No other significant laboratory findings were observed.

Conclusion

This was the largest documented outbreak caused by food contamination with tropane alkaloids. Implicated food was immediately withdrawn. Routine food safety and quality checks could prevent future outbreaks.

New analytical methods using carbon-based nanomaterials for detection of Salmonella species as a major food poisoning organism in water and soil resources

Salmonella is one of the most prevalent causing agents of food- and water-borne illnesses, posing an ongoing public health threat. These food-poisoning bacteria contaminate the resources at different stages such as production, aggregation, processing, distribution, as well as marketing. According to the high incidence of salmonellosis, effective strategies for early-stage detection are required at the highest priority. Since traditional culture-dependent methods and polymerase chain reaction are labor-intensive and time-taking, identification of early and accurate detection of Salmonella in food and water samples can prevent significant health economic burden and lessen the costs. The immense potentiality of biosensors in diagnosis, such as simplicity in operation, the ability of multiplex analysis, high sensitivity, and specificity, have driven research in the evolution of nanotechnology, innovating newer biosensors. Carbon nanomaterials enhance the detection sensitivity of biosensors while obtaining low levels of detection limits due to their possibility to immobilize huge amounts of bioreceptor units at insignificant volume. Moreover, conjugation and functionalization of carbon nanomaterials with metallic nanoparticles or organic molecules enables surface functional groups. According to these remarkable properties, carbon nanomaterials are widely exploited in the development of novel biosensors. To be specific, carbon nanomaterials such as carbon nanotubes, graphene and fullerenes function as transducers in the analyte recognition process or surface immobilizers for biomolecules. Herein the potential application of carbon nanomaterials in the development of novel Salmonella biosensors platforms is reviewed comprehensively. In addition, the current problems and critical analyses of the future perspectives of Salmonella biosensors are discussed.

Ex Vivo and In Vitro Methods for Detection of Bioactive Staphylococcal Enterotoxins

Staphylococcus aureus is a major bacterial cause of clinical infections and foodborne illnesses.Through the synthesis of a group of Staphylococcal enterotoxins (SEs), gastroenteritis occurs and the SEs function as superantigens to massively activate T cells. The ability to rapidly detect and quantify SEs is imperative in order to learn the causes of staphylococcal outbreaks and to stop similar outbreaks in the future. Also, the ability to discern active toxin is essential for development of food treatment and processing methods. Here, we discuss the various methodologies for detection and analysis of SEs.

A systematic review on mobile health applications for foodborne disease outbreak management

Background

Foodborne disease outbreaks are common and notifiable in South Africa; however, they are rarely reported and poorly investigated. Surveillance data from the notification system is suboptimal and limited, and does not provide adequate information to guide public health action and inform policy. We performed a systematic review of published literature to identify mobile application-based outbreak response systems for managing foodborne disease outbreaks and to determine the elements that the system requires to generate foodborne disease data needed for public action.

Methods

Studies were identified through literature searches using online databases on PubMed/Medline, CINAHL, Academic Search Complete, Greenfile, Library, Information Science & Technology. Search was limited to studies published in English during the period January 1990 to November 2020. Search strategy included various terms in varying combinations with Boolean phrases “OR” and “AND”. Data were collected following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. A standardised data collection tool was used to extract and summarise information from identified studies. We assessed qualities of mobile applications by looking at the operating system, system type, basic features and functionalities they offer for foodborne disease outbreak management.

Results

Five hundred and twenty-eight (528) publications were identified, of which 48 were duplicates. Of the remaining 480 studies, 2.9% (14/480) were assessed for eligibility. Only one of the 14 studies met the inclusion criteria and reported on one mobile health application named MyMAFI (My Mobile Apps for Field Investigation). There was lack of detailed information on the application characteristics. However, based on minimal information available, MyMAFI demonstrated the ability to generate line lists, reports and offered functionalities for outbreak verification and epidemiological investigation. Availability of other key components such as environmental and laboratory investigations were unknown.

Conclusions

There is limited use of mobile applications on management of foodborne disease outbreaks. Efforts should be made to set up systems and develop applications that can improve data collection and quality of foodborne disease outbreak investigations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12283-6.

Determinants of Healthcare Utilisation for Foodborne Illness Among Students in Saudi Arabia: A Cross-Sectional Study

BACKGROUND

Understanding of healthcare utilisation during foodborne illness is vital for public health practice, and healthcare planning. Present study aims to identify patterns and determinants of healthcare-seeking behaviour in response to foodborne illness among students of Saudi Arabia.

METHODS

A cross-sectional survey was conducted among 252 students of Saudi Electronic University located in four major cities (Riyadh, Abha, Dammam and Jeddah) of Saudi Arabia. Study participants were students who reported a foodborne illness within 1 month prior to the survey. A multivariate logistic regression models were used to analyse association of healthcare-seeking behaviour with knowledge and attitude about food poisoning of participants.

RESULTS

Of the 252 participants who experienced foodborne illness symptoms, 69.8% visited doctor for seeking care, while 7.5% visited pharmacy, 9.1% got treated by the family and peers and 13.4% did not do anything. Healthcare-seeking behaviour of participant showed association with knowledge of the cause of food poisoning (AOR: 1.98; 95% CI 1.04-3.78, P = .036); and attitude of participant that food poisoning illnesses is a serious health problem and may lead to death (AOR: 2.15; 95% CI 1.33-2.71, P = .014).

CONCLUSIONS

In this study, majority of the participants used healthcare for treatment during the food poisoning episode, and healthcare-seeking behaviour depended on perceived severity of the disease consequences. Knowledge on food poisoning was found to be an important determinant in utilisation of healthcare services. Health promotion and educational programmes are recommended to further increase the healthcare utilisation for foodborne illness.

Designing a highly immunogenic multi epitope based subunit vaccine against Bacillus cereus

Objective

Serious non-gastrointestinal-tract infections and food poisoning are caused by Bacillus cereus. Vaccination against B. cereus is very important. The aim of this study was to identify and analyze B and T cell epitopes for chromate transporter protein of the bacteria.

Methods

Multiple sequence alignment with the Clustal Omega method was used to identify conserved regions and Geneious Prime was used to produce a consensus sequence. T and B cell epitopes were predicted by various computational tools from the NetCTL and Immune Epitope Database (IEDB), respectively.

Results

Altogether, 6 HTL cells and 11 CTL epitopes were predicted. This vaccine's molecular docking is done with Patch Dock and LigPlot to verify interactions. The immune server (C-IMMSIM) was used to develop In silico immune response in order to assess the multi-epitope vaccine's immunogenic profile.

Conclusion

We designed universal vaccine against B. cereus responsible for food poisoning. The disease may be avoided with the aid of the proposed epitope-based vaccine.

The diarrhetic shellfish-poisoning toxin, okadaic acid, provokes gastropathy, dysbiosis and susceptibility to bacterial infection in a non-rodent bioassay, Galleria mellonella

Diarrhetic shellfish-poisoning (DSP) toxins such as okadaic acid and dinophysistoxins harm the human gastrointestinal tract, and therefore, their levels are regulated to an upper limit of 160 μg per kg tissue to protect consumers. Rodents are used routinely for risk assessment and studies concerning mechanisms of toxicity, but there is a general move toward reducing and replacing vertebrates for these bioassays. We have adopted insect larvae of the wax moth Galleria mellonella as a surrogate toxicology model. We treated larvae with environmentally relevant doses of okadaic acid (80–400 μg/kg) via intrahaemocoelic injection or gavage to determine marine toxin-related health decline: (1) whether pre-exposure to a sub-lethal dose of toxin (80 μg/kg) enhances susceptibility to bacterial infection, or (2) alters tissue pathology and bacterial community (microbiome) composition of the midgut. A sub-lethal dose of okadaic acid (80 μg/kg) followed 24 h later by bacterial inoculation (2 × 10⁵Escherichia coli) reduced larval survival levels to 47%, when compared to toxin (90%) or microbial challenge (73%) alone. Histological analysis of the midgut depicted varying levels of tissue disruption, including nuclear aberrations associated with cell death (karyorrhexis, pyknosis), loss of organ architecture, and gross epithelial displacement into the lumen. Moreover, okadaic acid presence in the midgut coincided with a shift in the resident bacterial population over time in that substantial reductions in diversity (Shannon) and richness (Chao-1) indices were observed at 240 μg toxin per kg. Okadaic acid-induced deterioration of the insect alimentary canal resembles those changes reported for rodent bioassays.

The effect of sodium chloride and temperature on the levels of transcriptional expression of staphylococcal enterotoxin genes in Staphylococcus aureus isolates from broiler carcasses

Staphylococcus aureus is one of the most common pathogens associated with food poisoning, which is caused by the ingestion of food contaminated with staphylococcal enterotoxins (SE). Our study aims at evaluating the occurrence and expression of five SE genes (sea, seb, sec, sed, and see) in S. aureus previously isolated from broiler carcasses. Besides that, it also presents an in vitro analysis of the effects of sodium chloride and temperature on the levels of transcriptional expression. A total of 30 S. aureus isolates were investigated for the presence of SEs by PCR assay. The expression level and the effects of sodium chloride (2.5% NaCl), as well as temperature (8 ºC and 12 ºC), on the transcriptional expression, were evaluated by a quantitative reverse transcription PCR (RT-qPCR). Twelve isolates carried at least one of the SE genes. Among them, five representative isolates presented transcriptional expression for at least one gene. Both sodium chloride and low temperatures interfered with the expression of the SE genes, decreasing their values. However, one isolate displayed relative expression 2.25 times higher for sed gene than S. aureus FRI 361 in optimal conditions (p < 0.05), demonstrating their toxigenic potential even under salt stress. There was no evidence of enterotoxin gene expression at 8 ºC.

Acute gastroenteritis outbreak in a school associated with religious ceremony in Mirzapur District, Uttar Pradesh, India

Background

A suspected food-poisoning outbreak occurred in a residential school in Mirzapur, India, in February, 2017.

Objective

We investigated the outbreak to find out the epidemiology and to identify the risk factors.

Methods

A descriptive study followed by retrospective-cohort study was done to investigate the outbreak. Cases (defined as ≥3 or more loose stools in 24 h, abdominal pain, or vomiting with onset between February 1 and 4, 2017) were searched by reviewing sick/patient registers from school and nearby health facilities. Cases were also searched through active surveillance by visiting school hostels. Stool samples were sent for microbiological testing. Food sources and food handlers were also assessed.

Results

Among 468 students, 204 cases were identified (44% attack rate) without any mortality. The median age was found to be 14 years (range: 10-18 years) and 59% were male. Relative risk with consumption of curd, apple, and panjiri (sweetened wheat flour) was found to be 15.4, 2.5, and 3.7, respectively. All these three food items were served as prasad, a religious offering. Only consumption of sweetened curd (adjusted odds ratio = 36.1, 95% confidence interval = 12.1-107.8) was significantly associated with gastroenteritis. No microorganism was isolated from two tested stool samples. Curd from the vendor was prepared from nonpasteurized milk. There were no illnesses among food-handlers.

Conclusions

This outbreak of acute gastroenteritis in a residential school was associated with consumption of curd, likely contaminated with preformed toxins. We recommend implementation of the food safety and standards authority of India regulations.

The genomic characterisation and comparison of Bacillus cereus strains isolated from indoor air

Background

Bacillus cereus is ubiquitous in nature, found in environments such as soil, plants, air, and part of the insect and human gut microbiome. The ability to produce endospores and biofilms contribute to their pathogenicity, classified in two types of food poisoning: diarrheal and emetic syndromes. Here we report gap-free, whole-genome sequences of two B. cereus strains isolated from air samples and analyse their emetic and diarrheal potential.

Results

Genome assemblies of the B. cereus strains consist of one chromosome and seven plasmids each. The genome size of strain SGAir0260 is 6.30-Mb with 6590 predicted coding sequences (CDS) and strain SGAir0263 is 6.47-Mb with 6811 predicted CDS. Macrosynteny analysis showed 99% collinearity between the strains isolated from air and 90.2% with the reference genome. Comparative genomics with 57 complete B. cereus genomes suggests these strains from air are closely associated with strains isolated from foodborne illnesses outbreaks. Due to virulence potential of B. cereus and its reported involvement in nosocomial infections, antibiotic resistance analyses were performed and confirmed resistance to ampicillin and fosfomycin, with susceptibility to ciprofloxacin, tetracycline and vancomycin in both strains.

Conclusion

Phylogenetic analysis combined with detection of haemolytic (hblA, hblC, and hblD) and non-haemolytic (nheA, nheB, and nheC) enterotoxin genes in both air-isolated strains point to the diarrheic potential of the air isolates, though not emetic. Characterization of these airborne strains and investigation of their potential disease-causing genes could facilitate identification of environmental sources of contamination leading to foodborne illnesses and nosocomial infections transported by air.

Probable association between Anisakis infection in the muscle of skipjack tuna (Katsuwonus pelamis) and human anisakiasis in Tokyo, Japan

Anisakiasis is a gastrointestinal disease caused by parasitic anisakid nematodes, mainly Anisakis simplex sensu stricto (A. simplex). Anisakiasis is prevalent in Japan and approximately 40% of anisakiasis cases in Tokyo occur through the consumption of raw or marinated mackerel. However, in 2018, there was a sudden increase in the number of the food poisoning cases in Tokyo caused by consumption of skipjack tuna (Katsuwonus pelamis). Therefore, we investigated anisakiasis cases resulting from ingestion of skipjack tuna in Tokyo, and surveyed the presence of Anisakis larvae in skipjack tuna in 2018 and 2019. Nineteen samples from 15 patients (13 in 2018 and 2 in 2019) with anisakiasis surely caused by ingestion of skipjack tuna were all identified as A. simplex. The higher mean abundance of Anisakis simplex larvae in skipjack tuna muscle in May 2018 (1.30; 13 larvae/10 fishes) compared to that in the other periods was regarded as a contributing factor in the increase in anisakiasis cases by ingesting skipjack tuna in 2018. To verify whether Anisakis larvae migrate from the visceral organs to the muscle during the period from fishing on the boat until processing for sale, the number of Anisakis larvae in skipjack tuna caught from August to November 2018 was investigated by removing the visceral organs at three different timings, i.e., immediately after catching, after landing, and after transport to the laboratory. Anisakis larvae were detected in the muscle irrespective of the timings at which visceral organs were removed. All larvae from the muscle were detected only from the ventral part and were identified as A. simplex. We thus consider that avoiding raw consumption of the ventral muscle should be an effective measure to prevent anisakiasis.

A novel staphylococcal enterotoxin SE02 involved in a staphylococcal food poisoning outbreak that occurred in Tokyo in 2004

Staphylococcal enterotoxins (SEs) are extracellular proteins, produced mainly by Staphylococcus aureus, which cause staphylococcal food poisoning (SFP) when ingested. Here, a novel SE was identified from two strains, which were identified as the causative microbes of the SFP outbreak that occurred in Tokyo in 2004. Both strains harbored the SEA gene, but its production was lower than that of other SEA-producing SFP isolates. Whole-genome sequencing analysis demonstrated that both strains harbored a SE-like gene besides sea. Phylogenetic analysis revealed that the amino acid sequence deduced from the SE-like gene belonged to the SEB group. Therefore, this gene was presumed to be a novel SE gene and termed "SE02." The stability of SE02 against heating and proteolytic digestions was a little different from that of SEA. SE02 has both superantigenic and emetic bioactivities. Namely, SE02 activated mouse splenocytes and exhibited emetic activity in the common marmoset. SE02 mRNA was highly expressed in both isolates during the exponential phase of cultivation. In addition, SE02 protein was produced at 20 °C and 25 °C, which reflects the actual situation of SFP. SE02 appears to be a novel emetic toxin that was likely the causative toxin in combination with SEA in the SFP outbreak.

The occurrence of Staphylococcus aureus, enterotoxigenic and methicillin-resistant strains in Iranian food resources: a systematic review and meta-analysis

INTRODUCTION

Staphylococcus aureus, in particular its enterotoxigenic strains, is a well-known pathogen in food microbiology as one of the most common causes of food poisoning. This study aimed to investigate the prevalence of S. aureus enterotoxigenic strains in Iranian food resources by using a systematic review and meta-analysis.

METHODS

A systematic search was performed using electronic databases from papers that were published by Iranian authors to the end of July 2017. Then, 34 publications which met our inclusion criteria were selected for data extraction and analysis.

RESULTS

The average pooled prevalence of S. aureus in food resources was 15.5% (95% CI: 12.7%-18.9%) ranging from 1.1% to 52%. According to the examined publications the estimated average prevalence of enterotoxigenic strains was estimated at 53.7% (95% CI: 41.4%-65.6%) ranging from 13% to 83.3%. The average prevalence of methicillin-resistant S. aureus in contaminated resources was estimated at 15.5% (95% CI: 11.1%-21.4%) ranging from 0% to 32%. The results showed that SEA and SEG were the most prevalent classic and new staphylococcal enterotoxins' (SEs) types. The results of antibiotic resistance pattern showed the highest resistance rates to β-lactams, tetracycline and erythromycin.

CONCLUSIONS

The present analysis showed a significant presence of enterotoxigenic strains of S. aureus and a high rate of staphylococcal enterotoxins among food resources in Iran. However, also the prevalence of MRSA strains is remarkable and requires an improvement of the hygienic conditions to reduce the risk of MRSA dissemination in community and hospitals. Furthermore, the rational use of antibiotics in the environments related to food resources is recommended.

Histamine Fish Poisoning and Histamine Production by Raoultella ornithinolytica in Milkfish Surimi

ABSTRACT

In April 2017, an outbreak of histamine fish poisoning causing illness in nine victims associated with consumption of milkfish surimi products (fish ball) occurred in Kaohsiung City, southern Taiwan. Of the two suspected frozen milkfish surimi samples, one sample contained 91.06 mg/100 g of histamine, levels that are greater than the potential hazard action level (50 mg/100 g) in most illness cases. Moreover, 28 frozen milkfish surimi samples from retail stores were collected and tested to determine the occurrence of histamine. One (3.6%) of 28 commercial surimi samples had histamine levels greater than the U.S. Food and Drug Administration (FDA) guideline for decomposition of 5 mg/100 g for scombroid fish and/or products. Thirteen histamine-producing bacterial strains isolated from suspected and commercial surimi samples were identified as prolific histamine formers, able to produce 98.4 to 121.8 mg/100 mL of histamine in Trypticase soy broth supplemented with 1.0% l-histidine. In addition, milkfish surimi was inoculated with Raoultella ornithinolytica at 5.0 log CFU/g and stored at 4, 15, 25, and 37°C to investigate bacterial growth and formation of histamine. The histamine contents quickly increased to more than 50 mg/100 g in samples stored at 37 and 25°C within 12 and 24 h, respectively, as well those stored at 15°C within 96 h. To our knowledge, this is the first report in Taiwan to demonstrate that milkfish surimi products could cause histamine intoxication.

HIGHLIGHTS

Readiness of school teachers to accept notifications about causes and preventive measures on food poisoning

INTRODUCTION

In this era of globalization, urbanization, and rapidly expanding unhygienic food corners across the globe, the incidence of food poisoning is very common nowadays.

AIM

The aim of our study was to investigate the perceptions and readiness of schoolteachers to accept notifications on food poisoning as a part of education to the students.

METHODOLOGY

A descriptive cross-sectional study was carried out with the help of a validated questionnaire for data collection. Our research involved schoolteachers from both primary and secondary schools in Muar. The questionnaire was pretested among the eligible trainee teachers and yielded an internal consistency reliability coefficient (c = Cronbach's alpha) of 0.082. This study was conducted from October 29, 2017, to December 14, 2018, in Muar. Our sample size was 259. Ethical consent was obtained from the Institution Ethical Committee.

RESULTS

A total of 259 schoolteachers from both primary and secondary schools in Muar were included in this study. In our study, 81.1% of the teachers responded that they can easily educate their students about food poisoning. Most of them (93.1%) were ready to receive notifications on food poisoning in any mode, and about 72% of the teachers preferred WhatsApp as their mode of receiving notification. The least (1.2%) preferred mode of notification was LINE (a social app). Teachers' willingness to disseminate the information regarding food poisoning was also higher (98.5%).

CONCLUSIONS

We concluded that majority of the schoolteachers had a good perception and were ready to receive the notifications on food poisoning through WhatsApp as a part of education to the students.

Factors associated with safe food handling practices in the food service sector

PURPOSE

This review assessed the methodological quality of relevant food safety studies, investigated the available evidences for factors associated with safe food handling practices (SFHPs) and suggested required improvements.

METHODS

A systematic literature search was carried out in five databases. A pre-designed criteria was used for data extraction and quality assessment. Evidence synthesis was performed, based on specified criteria.

RESULTS

Out of a total of 1768 published research articles, 28 met the inclusion criteria. Strong evidence suggests that food handlers' knowledge and attitudes on food safety contribute to SFHPs. Moderate evidence exists about the association between a food handler's food safety training and SFHPs. Limited evidence is available about the influence of the educational level and work experience of a food handler, to SFHPs. Insufficient evidence exists about the association between socio-demographic characteristics and SFHPs. A conceptual framework is presented to illustrate the associations.

CONCLUSIONS

Available evidence supports that in order to promote SFHPs, responsible authorities should focus on improving on the food safety knowledge and attitudes of food handlers. Future food safety studies may richly benefit from overcoming the methodological shortcomings presented in this review.

Risk presented to minimally processed chilled foods by psychrotrophic Bacillus cereus

BACKGROUND

Spores of psychrotrophic Bacillus cereus may survive the mild heat treatments given to minimally processed chilled foods. Subsequent germination and cell multiplication during refrigerated storage may lead to bacterial concentrations that are hazardous to health.

SCOPE AND APPROACH

This review is concerned with the characterisation of factors that prevent psychrotrophic B. cereus reaching hazardous concentrations in minimally processed chilled foods and associated foodborne illness. A risk assessment framework is used to quantify the risk associated with B. cereus and minimally processed chilled foods.

KEY FINDINGS AND CONCLUSIONS

Bacillus cereus is responsible for two types of food poisoning, diarrhoeal (an infection) and emetic (an intoxication); however, no reported outbreaks of food poisoning have been associated with B. cereus and correctly stored commercially-produced minimally processed chilled foods. In the UK alone, more than 1010 packs of these foods have been sold in recent years without reported illness, thus the risk presented is very low. Further quantification of the risk is merited, and this requires additional data. The lack of association between diarrhoeal food poisoning and correctly stored commercially-produced minimally processed chilled foods indicates that an infectious dose has not been reached. This may reflect low pathogenicity of psychrotrophic strains. The lack of reported association of psychrotrophic B. cereus with emetic illness and correctly stored commercially-produced minimally processed chilled foods indicates that a toxic dose of the emetic toxin has not been formed. Laboratory studies show that strains form very small quantities of emetic toxin at chilled temperatures.

Syndromic surveillance using ambulance transfer data in Tokyo, Japan

Bioterrorism attacks become more probable when important high-profile international or political events are held, such as G7 summit meetings or mass gathering events including Olympic and Paralympic games and FIFA World Cup tournaments. Outbreaks of infectious disease and widespread incidents of food poisoning are also public health concerns at such times. In Japan, the Tokyo Metropolitan Government operates Ambulance Transfer Syndromic Surveillance (ATSS), which can help monitor such incidents. The present study presents and assesses the ATSS framework. During the study period of October 2017 through November 2018, we monitored 33 areas for symptoms of 9 categories: vomiting/nausea, dizziness, palpitation, unconsciousness, breathing disorder, fever, spasm/paralysis, collapse/weakness, and bloody emesis/nasal hemorrhage. Among all symptoms, we found 9929 low-level aberrations, 2537 medium-level aberrations, and 577 high-level aberrations, with respective frequencies of 9.2%, 2.3%, and 0.5%. Of those, Tokyo Metropolitan Institute of Public Health reported the information to Tokyo Metropolitan Government 28 times during the period. Of the 28 identified clusters, Tokyo Metropolitan Government judged the necessity for investigating 7. All of those were investigated at hospitals by the jurisdictional public health center. Because ATSS covers almost the entire Tokyo metropolitan area, with about 13.8 million residents, it is definitely the largest syndromic surveillance in the world.

Lettuce-derived secretory IgA specifically neutralizes the Shiga toxin 1 activity

MAIN CONCLUSION

An edible plant was tested as a host for the production of secretory monoclonal IgA against Shiga toxin 1 (Stx1). The lettuce-derived IgA completely protected Vero cells from Stx1. Secretory immunoglobulin A (SIgA) is thought to control mucosal infections and thus it may be applicable to oral passive immunotherapy. Edible plants are candidate hosts for producing oral formulations with SIgA against pathogenic agents. We previously established a recombinant IgA specific for the B subunit of Shiga toxin 1 (Stx1B) consisting of the Fab fragment of Stx1B-specific monoclonal IgG and the Fc region of IgA (hyIgA). Here, we developed transgenic lettuce (Lactuca sativa) that produces hyIgA in a secretory form (S-hyIgA). An Arabidopsis-derived light-harvesting complex II (LHCB) promoter was used for the expression of all four transgenes (hyIgA heavy, light and j chains, and secretory component). Agrobacterium-mediated transformation was carried out to introduce genes into lettuce leaf discs by means of a single vector harboring all four transgenes. Consistent with the tissue specificity of the LHCB promoter, the expression of hyIgA transgenes was observed in leaf and stem tissues, which contain chloroplasts, at the mRNA and protein levels. The leaves produced hyIgA in a more than tenfold higher yield as compared with stems. The lettuce-derived S-hyIgA was found to bind to Stx1B in a dose-dependent manner by means of ELISA. A leaf extract of the transgenic lettuce completely neutralized the cytotoxicity of Stx1 against Vero cells, which are highly susceptible to Stx1. In conclusion, we established a transgenic lettuce producing a secretory form of hyIgA that can bind bacterial toxin. The results indicate that edible practical plants containing S-hyIgA will provide a possible means for immunotherapy for food poisoning.

Determination of Histamine in Japanese Spanish Mackerel (Scomberomorus niphonius) Meat Implicated in a Foodborne Poisoning

An incident of foodborne poisoning causing illness in seven victims due to ingestion of fried Japanese Spanish mackerel (JS mackerel; Scomberomorus niphonius) meat occurred in September 2014 in Hualien County, eastern Taiwan. Of the two suspected fish meats, one raw sample contained 3,318 ppm of histamine and one fried sample contained 1,906 ppm of histamine, levels which are greater than the potential hazard action level (500 ppm) in most illness cases. Given the allergy-like symptoms of the victims and the high histamine content in the suspected fish samples, this foodborne poisoning was strongly suspected to be caused by histamine intoxication. In addition, five histamine-producing bacterial strains isolated from suspected raw fish samples, capable of producing 152 to 1,020 ppm of histamine in Trypticase soy broth supplemented with 1.0% l-histidine, were identified as Hafnia alvei (one strain), Enterobacter aerogenes (two strains), Raoultella ornithinolytica (one strain), and Morganella morganii (one strain) by 16S rDNA sequencing with PCR amplification. Moreover, 12 raw fish samples and 39 fried fish samples from retail stores were collected and tested to determine the occurrence of histamine. Two of 12 commercial raw fish samples (16.7%) had histamine levels greater than the U.S. Food and Drug Administration guideline for decomposition of 50 ppm for scombroid fish or product or a combination of both. To our knowledge, this is the first report in Taiwan to demonstrate that the JS mackerel meat products could cause histamine intoxication.

Dangers of Clostridium perfringens food poisoning in psychiatric patients

Clostridium perfringens food poisoning can be fatal in patients with chronic constipation. We report the investigation and management of a probable outbreak of C. perfringens food poisoning among psychiatric patients in Cape Town, South Africa, in 2013.

YouTube™ as a source of information on food poisoning

BACKGROUND

YouTube™ ( http://www.youtube.com ), as a very popular video site around the world, is increasingly being used for health information. The objectives of this review were to assess the overall usefulness of information on food poisoning presented on YouTube™ for patients.

METHODS

The YouTube™ website was systematically searched using the key words "food poisoning", "foodborne diseases" and "foodborne illness". One hundred and sixty videos meet the inclusion criteria. Two independent reviewers scored the videos utilizing a customized usefulness scoring scheme separately and assessed the video duration, views, days since upload, likes, and dislikes. The videos were categorized as education, entertainment, News & Politics and People & Blogs. A usefulness score was devised to assess video quality and to categorize the videos into "slightly useful", "useful", and "very useful".

RESULTS

Most videos were educational 66 (41.3%). Educational videos had significantly higher scores, but had no significant differences in likes, views or views/day. Over half of the videos (97/160) were categorized as "useful". The mean posted days (885.2 ± 756.1 vs 1338.0 ± 887.0, P = 0.043) and the mean duration of video (12.8 ± 13.9 vs 3.5 ± 3.4, P < 0.001) were both significantly different in the very useful group compared with the slightly useful group. There was no correlation between usefulness and the number of likes, the number of dislikes, the number of views, or views/day.

CONCLUSION

YouTube™ is a promising source of information regarding food poisoning. Educational videos are of highest usefulness. Considering that there is a lot of low-credibility information, consumers need to be guided to reliable videos in the field of healthcare information.

Fluorometric determination of okadaic acid using a truncated aptamer

Okadaic acid (OKA), a marine toxin produced by dinoflagellates, is responsible for most human diarrhetic shellfish poisoning-associated health disorders. A competitive displacement assay for OKA is described here. An OKA-binding aptamer was truncated with two sequences, one labeled with 6-carboxyfluorescein (FAM), and one with a quencher. On addition of OKA, it will bind to the aptamer and green fluorescence pops up because label and quencher become spatially separated. One of the truncated aptamers exhibis an excellent binding capability (Kd 2.77 nM) for OKA compared to its full-length aptamer (526 nM). The selectivity of the assay was proven by the successful fluorometric determination of OKA in the presence of common diarrhoetic toxins and in shellfish extracts. The detection limit is as low as 39 pg·mL^-1. Graphical abstract Schematic representation of the competitive displacement assay for okadaic acid (OKA). The OKA-binding aptamer is truncated with two parts, one labeled with 6-carboxyfluorescein (FAM), and one with a quencher. On addition of OKA, green fluorescence pops up because label and quencher become spatially separated.

Knowledge, attitude and practices among parents regarding food poisoning: a cross-sectional study from Palestine

BACKGROUND

Food serves as a vehicle for many pathogenic and toxigenic agents that cause food-borne diseases. Knowledge, attitude, and practices are key factors in reducing the incidence of food-borne diseases in food service areas. The main objective of this study was to evaluate knowledge, attitude, and practices related to food poisoning among parents of children in Nablus, Palestine.

METHODS

A cross-sectional study was conducted in primary healthcare centers in Nablus district from May to July 2015. Data were collected using structured questionnaire interviews with parents to collect information on food safety knowledge, attitudes, and practices, alongside sociodemographic characteristics.

RESULTS

Four-hundred and twelve parents were interviewed, 92.7% were mothers. The median knowledge score was 12.0 with an interquartile range (IQR) of 11.0-14.0. The median attitude score was 11.0 with IQR of 10.0-13.0, while the median practice score was 18.0 with IQR of 16.0-19.0. Significant modest positive correlations were found between respondents' knowledge and attitude scores regarding food poisoning (r = 0.24, p < 0.001), knowledge and practice scores regarding food poisoning (r = 0.23, p < 0.001), and attitude and practice scores regarding food poisoning (r = 0.30, p < 0.001). Respondents with a higher education level and who live in a city were the only factors significantly associated with higher knowledge scores (p < 0.05). Attitude improved as educational level increased (p < 0.05) and income level increased (p < 0.05). Those of female gender and employed were statistically significantly associated with higher satisfactory hygienic practices in relation to the prevention of food poisoning (p < 0.05).

CONCLUSIONS

Knowledge, attitude, and practices regarding food poisoning prevention are associated with each other and are affected by a complex interplay between socio-economic variables. The study highlights the need for health education programmes and general awareness campaigns that intend not only to enhance knowledge but also promote parents to practice food safety measures strictly and further strengthen their awareness level.

Food poisoning outbreak in a religious mass gathering

Background

Food poisoning outbreaks are commonly seen in mass social events where food is prepared under temporary arrangements. This study reports a food poisoning outbreak in a city of western Maharashtra, India, where around 4000 people had consumed food during a religious community lunch and reported sick to the nearby hospital with complaints of diarrhea, abdominal cramps, fever with chills, and vomiting.

Methods

This was a retrospective-prospective study. Investigation of the food poisoning outbreak was conducted to identify the causes and recommend preventive measures. Interview method was used to elicit food history from the affected and non-affected persons. Inspection of the cooking area was conducted to find the likely source of contamination.

Results

A total of 291 patients reported sick after consumption of meal at a religious mass gathering. The range of incubation period was from 10 hours to 40 hours. Predominant features were diarrhea (100%), abdominal cramps (89%), fever with chills (81%), and vomiting (28.5%). Maximum relative risk of 14.89 was seen for green gram (moong dal) with 95% confidence interval of 2.16-102.6. Keeping the incubation period and clinical profile in view, the likely organisms are enteropathogenic Escherichia coli or Salmonella spp.

Conclusion

Maintaining food safety during mass gatherings is a major challenge for public health authorities. The Food Safety and Standards Act (2006) in India brings the food consumed during religious gatherings such as 'prasad' and 'langar' under its purview and comprehensively addresses this issue.

Foodborne botulism in Turkey, 1983 to 2017

OBJECTIVE

The aim of this study is to assess the epidemiology of foodborne botulism cases which were seen and published in Turkey.

MATERIAL AND METHODS

This study covers the cases and outbreaks of botulism that have been identified and published in any region of Turkey, between 1983 and 2017. This systematic review was performed in accordance with the guidelines for performing and reporting systematic reviews and meta-analyses. The search was done on PubMed and Google in English and Turkish languages. Demographic features of the cases, nutritional sources, the development process of the disease, clinical symptoms and signs, the duration of hospitalization, treatment and mortality rates were analyzed.

RESULTS

Totally 95 patients (57 female and 38 male) were assessed from the published. The food which caused the majority of intoxication cases was canned green beans, and all the foods were home-canned goods. There cords showed that botulism antitoxin was given to 56 patients. The time from exposure to illness onset was 26.9 h. While 18 patients died at the end of follow-up and treatment (mortality 19%), 77 patients were discharged with full recovery.

CONCLUSION

Among 95 botulism cases, spread in Turkey over the last 35 years, the predominant source of toxin was home-canned food and green beans, in particular. Since community and emergency room physicians may be the first to treat patients with any type of botulinum intoxication, they must know how to diagnose and treat this rare but potentially lethal disease.

Characterization of A Staphylococcal Food Poisoning Outbreak in A Workplace Canteen during the Post-Earthquake Reconstruction of Central Italy

In summer 2017, a foodborne outbreak occurred in Central Italy, involving 26 workers employed in the post-earthquake reconstruction. After eating a meal provided by a catering service, they manifested gastrointestinal symptoms; 23 of them were hospitalized. The retrospective cohort study indicated the pasta salad as the most likely vehicle of poisoning. Foods, environmental samples, and food handlers' nasal swabs were collected. Bacillus cereus (Bc) and coagulase-positive staphylococci (CPS) including S. aureus, together with their toxins, were the targets of the analysis. CPS, detected in all the leftovers, exceeded 10⁵ CFU/g in the pasta salad, in which we found Staphylococcal Enterotoxins (SEs) (0.033 ng SEA/g; 0.052 ng SED/g). None of the environmental and human swabs showed contamination. We characterized 23 S. aureus from foods. They all belonged to the human biotype, showed the same toxigenic profile (sea, sed, sej, and ser genes), and had the same Pulsed Field Gel Electrophoresis (PFGE) pattern; none of them harbored mecA or mupA genes. We also detected Bc contamination in the pasta salad but none of the isolates harbored the ces gene for the emetic toxin cereulide. The EU Reference Laboratory for CPS confirmed the case as a strong-evidence outbreak caused by the ingestion of SEs produced by a single strain of S. aureus carried by the same human source. This outbreak was successfully investigated despite the emergency situation in which it occurred.

A fluorometric assay for staphylococcal enterotoxin B by making use of platinum coated gold nanorods and of upconversion nanoparticles

An aptamer based fluorometric assay is presented for fast and accurate detection of staphylococcal enterotoxin B (SEB). It is making use of platinum-coated gold nanorods (AuNR@Pt) and upconversion nanoparticles (UCNPs). The aptamer against SEB is immobilized on AuNR@Pt while the complementary DNA fragment of SEB aptamer is immobilized on UCNPs. As the concentration of SEB increases, the fluorescence of the satellite assembly (AuNR@Pt-UCNPs) is gradually restored. Under the optimized conditions, fluorescence (best measured at excitation/emission wavelengths of 980/543 nm) linearly increases in the 2.0-400 pg·mL^-1 SEB concentration range. The limit of detection is as low as 0.9 pg·mL^-1 (at an S/N of 3), significantly lower than existing methods. The method was applied to the determination of SEB in spiked milk samples. The average recoveries ranged from 91.2% to 104.6%, confirming the practicality of this method. Graphical abstract Schematic illustration of a fluorometric assay based on inner filter effect (IFE) between platinum coated gold nanorods (AuNR@Pt) and upconversion nanoparticles (UCNPs) for the determination of staphylococcal enterotoxin B (SEB).

Food poisoning caused by scombroids: A case-control study

The aim of this study is to report the epidemiological characteristics of a food poisoning outbreak due to scombroid fish in a hospital. A case-control study (1:4) was conducted. Patients either symptomatic of food poisoning (cases) or asymptomatic (controls) eating at the hospital cafeteria were included. To identify the source of the outbreak, sanitary control factors were assessed. Microbiological studies and the mast cell tryptase test were performed. All cases and controls received a questionnaire enquiring about symptoms and foods consumed. The odds ratios (OR) for all risk factors and their 95% confidence intervals (CI) were assessed. In total, 20 individuals (90% female) were included in the study: four cases and 16 controls. The overall mean age was 43 years (SD: 10.2). The most frequent symptom observed was facial and neck erythaema (100%). Microbiological cultures were negative, the mast cell tryptase test was normal and breakdown of the cold chain did not occur. The most likely source of the outbreak was fried anchovies (OR: 34.7; 95% CI: 1.50-809.6; p=0.02). Methods suitable to the rapid assessment of the outbreak allowed us to establish prompt preventive measures and identify the likely aetiology.

Metahemoglobinemia in infants over one year

BACKGROUND AND OBJECTIVES

Methaemoglobinaemia is a typical acute intoxication disorder in children under one year old. It is produced by excess nitrates which induce the haemoglobin's iron oxidation, preventing its adequate binding to oxygen. It is more frequent in infants due to its lower enzymatic activity.

PATIENTS

Two cases of 15-month-old infants with methaemoglobinaemia after the intake of vegetables, atypical by the age of the patients and the initial severity in the first case that simulated a septic syndrome. Both cases evolved well with adequate oxygen therapy.

CONCLUSIONS

Although the most frequent clinical manifestation is cyanosis associated with respiratory distress, methaemoglobinaemia can present with more severe and confusing symptoms. The main treatment is oxygen therapy at high concentrations and methylene blue as an intravenous antidote only in selected cases. The intake of vegetables is the main cause of this in infants, so it is important to give adequate information to parents about the consumption and preservation of these foods during the first year of life.

New product, old problem(s): multistate outbreak of Salmonella Paratyphi B variant L(+) tartrate(+) infections linked to raw sprouted nut butters, October 2015

A cluster of Salmonella Paratyphi B variant L(+) tartrate(+) infections with indistinguishable pulsed-field gel electrophoresis patterns was detected in October 2015. Interviews initially identified nut butters, kale, kombucha, chia seeds and nutrition bars as common exposures. Epidemiologic, environmental and traceback investigations were conducted. Thirteen ill people infected with the outbreak strain were identified in 10 states with illness onset during 18 July-22 November 2015. Eight of 10 (80%) ill people reported eating Brand A raw sprouted nut butters. Brand A conducted a voluntary recall. Raw sprouted nut butters are a novel outbreak vehicle, though contaminated raw nuts, nut butters and sprouted seeds have all caused outbreaks previously. Firms producing raw sprouted products, including nut butters, should consider a kill step to reduce the risk of contamination. People at greater risk for foodborne illness may wish to consider avoiding raw products containing raw sprouted ingredients.

Epidemiological studies on Clostridium perfringens food poisoning in retail foods

Clostridium perfringens is an important anaerobic pathogen causing food-borne gastrointestinal (GI) diseases in humans and animals. Meat and meat products are the most common vehicles of C. perfringens type A food poisoning. Contamination of meat by the intestinal contents of slaughtered animals may serve as an important source of this pathogen to the food supply. One hundred and fifty-five non-outbreak food samples were obtained from meat and retail food and examined for the presence of C. perfringens. Multiplex polymerase chain reaction assay to determine the toxin genotype of C. perfringens isolates, and extraction and purification of C. perfringens enterotoxin from enterotoxin gene (cpe)-positive isolates were carried out. The homogeneity of the purified enterotoxin was demonstrated by polyacrylamide gel electrophoresis. In addition, stool samples were collected from 150 persons who had been in contact with animals, and enzyme-linked immunosorbent assays were carried out for the qualitative determination of C. perfringens enterotoxin in the stool samples. The results demonstrated that approximately 2.6% of the tested meat and retail meat samples were contaminated with cpe-positive C. perfringens. The recommended laboratory criteria used to implicate C. perfringens in food-borne disease should involve the detection of C. perfringens enterotoxin production or the presence of the cpe gene in foods or faeces, or in the suspected C. perfringens isolates. In the present study some isolates such as tuna contained the enterotoxin gene although they had a low count of C. perfringens.

Data on volatile compounds produced by serotype D Clostridium botulinum

We analyzed the volatile compounds produced by serotype D Clostridium botulinum (D-CB16) in trypticase peptone/yeast extract/glucose (TYG) medium using gas chromatography/mass spectrometry (GC/MS). The volatile compounds were captured by solid-phase microextraction and applied to GC/MS for separation and identification of the compounds in TYG medium with or without the cultivation of C. botulinum D-CB16. Thirty-five and 34 volatile compounds were identified in media without and with D-CB16 cultivation, respectively. Of the compounds identified in the medium with the strain, twenty-one were not detected in the original medium, indicating that these were produced by C. botulinum D-CB16.

In silico identification of molecular mimics involved in the pathogenesis of Clostridium botulinum ATCC 3502 strain

Bacterial pathogens invade and disrupt the host defense system by means of protein sequences structurally similar at global and local level both. The sharing of homologous sequences between the host and the pathogenic bacteria mediates the infection and defines the concept of molecular mimicry. In this study, various computational approaches were employed to elucidate the pathogenicity of Clostridium botulinum ATCC 3502 at genome-wide level. Genome-wide study revealed that the pathogen mimics the host (Homo sapiens) and unraveled the complex pathogenic pathway of causing infection. The comparative 'omics' approaches helped in selective screening of 'molecular mimicry' candidates followed by the qualitative assessment of the virulence potential and functional enrichment. Overall, this study provides a deep insight into the emergence and surveillance of multidrug resistant C. botulinum ATCC 3502 caused infections. This is the very first report identifying C. botulinum ATCC 3502 proteome enriched similarities to the human host proteins and resulted in the identification of 20 potential mimicry candidates, which were further characterized qualitatively by sub-cellular organization prediction and functional annotation. This study will provide a variety of avenues for future studies related to infectious agents, host-pathogen interactions and the evolution of pathogenesis process.

Cooking methods employing natural anti-oxidant food additives effectively reduced concentration of nephrotoxic and carcinogenic aristolochic acids in contaminated food grains

Emerging evidence suggests that aristolochic acids (AA) produced naturally by a common weed Aristolochia clematitis in the cultivation fields is contaminating the food products in Balkan Peninsula and acting as the etiological agent in the development of Balkan endemic nephropathy. In this study, we investigated the combined use of natural anti-oxidative "food additives" and different cooking methods to find a solution for the widespread contamination of AA in food products. The results indicated that the addition of healthy dietary supplements (such as cysteine, glutathione, ascorbic acid, citric acid and magnesium) during cooking, is a highly efficient method in lowering the concentration of AA in the final food products. Because previous observation indicated one of the toxicological mechanisms by which AA exert its toxicity is to induce oxidative stress in internal organs, it is anticipated that these added anti-oxidants will also help to attenuate the nephrotoxicity of AA.

Evaluating Food Safety Knowledge and Practices of Food Processors and Sellers Working in Food Facilities in Hanoi, Vietnam

Consumption of fast food and street food is increasingly common among Vietnamese, particularly in large cities. The high daily demand for these convenient food services, together with a poor management system, has raised concerns about food hygiene and safety (FHS). This study aimed to examine the FHS knowledge and practices of food processors and sellers in food facilities in Hanoi, Vietnam, and to identify their associated factors. A cross-sectional study was conducted with 1,760 food processors and sellers in restaurants, fast food stores, food stalls, and street vendors in Hanoi in 2015. We assessed each participant's FHS knowledge using a self-report questionnaire and their FHS practices using a checklist. Tobit regression was used to determine potential factors associated with FHS knowledge and practices, including demographics, training experience, and frequency of health examination. Overall, we observed a lack of FHS knowledge among respondents across three domains, including standard requirements for food facilities (18%), food processing procedures (29%), and food poisoning prevention (11%). Only 25.9 and 38.1% of participants used caps and masks, respectively, and 12.8% of food processors reported direct hand contact with food. After adjusting for socioeconomic characteristics, these factors significantly predicted increased FHS knowledge and practice scores: (i) working at restaurants and food stalls, (ii) having FHS training, (iii) having had a physical examination, and (iv) having taken a stool test within the last year. These findings highlight the need of continuous training to improve FHS knowledge and practices among food processors and food sellers. Moreover, regular monitoring of food facilities, combined with medical examination of their staff, should be performed to ensure food safety.

Food poisoning associated with ingestion of wild wasp broods in the upstream region of the Lancang river valley, Yunnan province, China

INTRODUCTION

Food poisoning due to wild wasp broods ingestion has long been noted in the upstream region of the Lancang river valley, Yunnan province, China. This study describes the epidemiological and clinical features of the poisoning and possible causes.

METHODS

Surveillance data collected between 2008 and 2016 were analyzed to produce demographic data on patients, information on clinical presentations, wasp species identification, and estimations of possible risk factors for symptomatic cases.

RESULTS

Eleven poisoning events were associated with the ingestion of wild wasp broods, including 46 exposed persons with 31 symptomatic living cases and 8 deceased cases that were reported in the Yunnan province between 2008 and 2016. Poisoning cases were only detected in the upstream region of the Lancang river valley in the autumn. The severity of the symptoms was correlated with an evident dose-effect relationship regarding the quantity ingested. The mean latent period from wild wasp broods ingestion to the onset of the symptoms was 10 h for symptomatic living cases and 7 h for deceased cases, respectively. Both gastrointestinal and neurological symptoms were commonly observed in the poisoning cases.

CONCLUSION

The toxin source may be indirectly caused by the wasp broods due to the prevalence of local poisonous plants, such as Tripterygium wilfordii Hook F, Tripterygium hypoglaucum Hutch and Vaccinium bracteatum Thunb. Educational programs at the start of wasp harvest season in September in the high-risk area should be carried out to reduce the incidence of poisonings.

[Field epidemiological investigation on a foodborne outbreak caused by Staphylococcus aureus enterotoxin, in Hangzhou, 2014]

Objective: To identify the cause on a foodborne breakout in a university of Hangzhou in 2014. Methods: Data on cases were gathered from the out-patient logs of the university affiliated or neighboring hospitals to describe the disease distribution and epidemiological curves. Case-control and field studies on hazard factors were conducted simultaneously. Results: The incubation period was 1.5-5.0 hours, of which the median was 3 during the outbreak. All the cases consumed food from a restaurant called Chen's Snacks nearby their university and suffered from the Staphylococcus aureus enterotoxin. Results from the Staphylococcus enterotoxin testing were positive in 3 stool and 6 food samples, out of the total 18 samples. Conclusion: This foodborne outbreak was caused through food poisoning by vermicelli which was contaminated with Staphylococcus aureus.

Staphylococcal food poisoning caused by Staphylococcus argenteus harboring staphylococcal enterotoxin genes

Staphylococcal food poisoning (SFP) is caused by staphylococcal enterotoxins (SEs) preformed in food materials. SE genes are encoded on mobile genetic elements and are widely found across Staphylococcus species including S. argenteus, although most SFP cases are caused by S. aureus. S. argenteus, recently discriminated from S. aureus as a novel species, are non-pigmented staphylococci phenotypically related to S. aureus. In 2014 and 2015, two independent food poisoning cases occurred in Osaka, Japan, in which non-pigmented staphylococci were predominantly isolated. Several enterotoxin genes (seb, seg, sei, sem, sen, seo, and selu2) were found in their genome and the production of SEB was confirmed by reverse passive agglutination tests. The non-pigmented isolates from patients, food handlers, food, and cooking utensils all produced the same pulsed-field gel electrophoresis pattern. These non-pigmented isolates were coagulase-positive and biochemically identical to S. aureus. We performed further genetic analysis using nucA sequencing and multi-locus sequence typing, and identified these isolates as S. argenteus. We also found that seb was encoded on the Staphylococcus aureus pathogenicity island, while seg, sei, sem, sen, seo, and selu2 were encoded on the enterotoxin gene cluster. From these results, we concluded that the two food poisoning outbreaks were SFP cases caused by S. argenteus harboring SE genes.

[Three cases of scombroid poisoning]

INTRODUCTION

Scombroid poisoning is a poorly known type of food poisoning due to the presence of histamine in spoiled fish of the Scombridae family. We report 3 cases of scombroid poisoning seen at the Fréjus-Saint-Raphaël hospital in the Var region.

OBSERVATIONS

Within around thirty minutes of eating a meal containing tuna, three patients presented varied symptoms: malaise, itchy rash, headache, and for two of them, nausea. The diagnosis of scombroid poisoning was based on the circumstances in which the clinical signs appeared and on the signs themselves. The patients were given antihistamines and one injection of intravenous corticosteroids, and symptoms regressed rapidly within a few hours.

DISCUSSION

The symptoms of scombroid poisoning appear within a few minutes after eating fish of the Scombridae family and related species. The first symptoms are cutaneous, with flush, pruritus, and erythema of the face and trunk having an urticarial appearance, together with faintness. Gastrointestinal symptoms include nausea, vomiting, abdominal cramps and occasionally diarrhea. Symptoms subside within a few hours. Histamine is present in the flesh of these fish due to decarboxylation of histidine through the action of Gram-negative bacteria whose development is enhanced by heat and sun. Scombroid poisoning is one of the most common types of poisoning caused by eating fish but it is underdiagnosed by dermatologists. The diagnosis is made by measuring histamine levels in the incriminated fish or in the patient's plasma.

[Screening on key techniques used for surveillance and disposal of public health emergencies]

Objective: To explore the key techniques used for surveillance and disposal of infectious diseases, food poisoning and hospital infection to improve the ability of surveillance and disposal on public health emergency. Methods: Framework on surveillance and disposal of infectious diseases, food poisoning and hospital infection was set up, based on literature review and expert group discussion. Delphi method and technique for order preference by similarity to ideal solution comprehensive evaluation method were used for ordering preference by similarity, to screen key techniques set for surveillance and disposal of the above said events. Results: Framework to be used for selecting key techniques was designed, based on the classification of emergency events, processing cycle of emergency events and level of techniques. Twenty six public health experts were selected for a 2-round consultation, with their authority as 0.796. Ten key techniques with important significance for surveillance and disposal of infectious diseases, food poisoning and hospital infection were selected from each event. Among these key techniques, the early-warning system was recognized as the key technique, important for the surveillance and disposal of all three emergency events. Items as technology used for unknown pathogenic microorganism detection, personal protection, gene sequencing and tracing technology, microorganism molecular typing technology, nucleic acid detection technology etc. were the key techniques and need to develop for the surveillance and disposal of infectious diseases and iatrogenic infection. Data regarding key technologies on security and privacy, early warning and forecasting, field rapid detection were sorted out that all in need to improve the surveillance programs on disposal of infectious diseases and food poisoning. Data exchange appeared another key technique on infectious diseases, with toxin detection and other 5 techniques the key techniques for food poisoning. Data collection, standardization and other 3 techniques appeared as the key techniques on iatrogenic infection. Conclusions: Key techniques were selected in this study to meet the requirements of surveillance, disposal of infectious disease, food poisoning and iatrogenic infection. Authority of the experts got improved in the two-round consultation, ensuring the reliability of the results of screening and providing a scientific basis for the further research and priority development of the key techniques.