Salmonella contamination in non-UK produced shell eggs on retail sale in some regions of England.
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Animals↗
Biomedical subjects
C L Little
Publications and source records attributed to C L Little.
Food-borne botulism in the United Kingdom.
Food-borne botulism is a rare but serious disease caused by ingestions of neurotoxin [botulinum neurotoxins (BoNTs)] produced as a result of the growth of the bacterium Clostridium botulinum in foods before consumption. The disease is rare in the United Kingdom, and only 62 cases have been recognized between 1922 and 2005. This report provides a brief review of C. botulinum and food-borne botulism as well as descriptions of the six episodes (33 cases with three deaths) of this disease that occurred in the United Kingdom between 1989 and 2005. The six incidents illustrate the importance of the risk factors of poor processing or storage of commercially prepared foods, improper home preservation of foods and travel to countries where botulism is much more common than in the United Kingdom. Even small outbreaks of food-borne botulism can precipitate a national emergency and inundate public health and acute care provision. This report provides a reminder to public health professions of the occurrence, diagnosis, treatment and control of this rare but serious food-borne disease.
Acute Disease↗
Prevalence of Listeria monocytogenes and other Listeria species in butter from United Kingdom production, retail, and catering premises.
Two recent listeriosis outbreaks involving butter prompted this first cross-sectional study on the prevalence, levels, and types of Listeria species in 3229 samples of butter from production, retail, and catering premises in the United Kingdom during May and June 2004. When the criteria of the Microbiological Guidelines were used, 99.4% of samples were found to be of satisfactory microbiological quality, 0.5% were of acceptable quality, and 0.1% were of unsatisfactory quality as a result of high levels (>100 CFU/g) of Listeria spp. The butter samples with Listeria spp. present at more than 100 CFU/g were negative for L. monocytogenes. L. monocytogenes was detected in 0.4% (n=13) of samples, all at levels of less than 10 CFU/g, and were therefore of acceptable quality. Butter was contaminated more frequently with Listeria spp., including L. monocytogenes, when packed in plastic tubs, when in pack sizes of 500 g or less, when stored or displayed above 8 degrees C, when a hazard analysis system was not in place, and when the manager had received no food hygiene training. This study demonstrates that although butter is regarded as a low-risk product, it may provide an environment for the persistence and growth of Listeria spp., including L. monocytogenes. The control of L. monocytogenes in food processing and supply systems is critical in order to minimize the potential for this bacterium to be present in foods at the point of consumption at levels hazardous to health.
Butter↗
Sesame seed products contaminated with Salmonella: three outbreaks associated with tahini.
In November 2002, the first of three outbreaks of Salmonella Montevideo infection in Australia and New Zealand was identified in New South Wales, Australia. Affected persons were interviewed, and epidemiologically linked retail outlets inspected. Imported tahini was rapidly identified as the source of infection. The contaminated tahini was recalled and international alerts posted. A second outbreak was identified in Australia in June-July 2003 and another in New Zealand in August 2003. In a total of 68 S. Montevideo infections, 66 cases were contacted. Fifty-four (82%) reported consumption of sesame seed-based foods. Laboratory analyses demonstrated closely related PFGE patterns in the S. Montevideo isolates from human cases and sesame-based foods imported from two countries. On the basis of our investigations sesame-based products were sampled in other jurisdictions and three products in Canada and one in the United Kingdom were positive for Salmonella spp., demonstrating the value of international alerts when food products have a wide distribution and a long shelf life. A review of the controls for Salmonella spp. during the production of sesame-based products is recommended.
Australia↗
Salmonella and raw shell eggs: results of a cross-sectional study of contamination rates and egg safety practices in the United Kingdom catering sector in 2003.
This study was prompted by epidemiological investigations of the unusual number of Salmonella Enteritidis outbreaks associated with the use of eggs in catering premises in England and Wales during 2002. The aims of the study, performed between April and May 2003, were to establish the rate of Salmonella contamination in raw shell eggs from catering premises, investigate any correlation between the origin and type of eggs and the presence of particular serotypes or phage types (PTs) of Salmonella, and examine the use of raw shell eggs in catering premises in the United Kingdom. A total of 34,116 eggs (5,686 pooled samples of six eggs) were collected from 2,104 catering premises, most of which were eggs produced in the United Kingdom (88%). Salmonella was isolated from 17 pools (0.3%) of eggs. Of these, 15 were Salmonella Enteritidis, which were further characterized to PTs as follows: PT6 (0.1%), PT4 (0.07%), PT12 (0.04%), PT1 (0.04%), and PT14b (0.02%). Salmonella Livingstone and Salmonella Typhimurium definitive type 7 resistant to ampicillin, streptomycin, sulfonamides, and tetracycline were also isolated. The Salmonella contamination rate of eggs produced in the United Kingdom appears to have decreased significantly since 1995 and 1996. This trend is reflected in the decrease of Salmonella Enteritidis and, in particular, Salmonella Enteritidis PT4. The impact of the United Kingdom Food Standards Agency's advice on the use of eggs, issued in January 2003, is discussed.
Animals↗
Prevalence of Campylobacter, Salmonella, and Escherichia coli on the external packaging of raw meat.
During September and October 2002, 3,662 prepackaged raw meat samples were collected to evaluate the extent and nature of microbiological contamination on external surfaces of the packaging, which could potentially cross-contaminate ready-to-eat foods during and after purchase. Salmonella was detected on two (<1%) samples of external packaging (both from raw chicken), and Campylobacter was detected on 41 (1.1%) samples of external packaging. The external packaging of game fowl exhibited the highest Campylobacter contamination (3.6%), followed by raw chicken (3.0%), lamb (1.6%), turkey (0.8%), pork (0.2%), and beef (0.1%); Campylobacter jejuni and Campylobacter coli accounted for 59% (24 of 41) and 24% (10 of 41) of the contaminating Campylobacter species, respectively. C. coli isolates from the external packaging were more multiresistant to antimicrobial drugs, including quinolones such as ciprofloxacin, than was C. jejuni. Escherichia coli (an indicator of fecal contamination) was isolated from the external packaging on 4% of the raw meat samples at levels of 40 to 10(5) CFU per swab. The external packaging of raw meats is a vehicle for potential cross-contamination by Campylobacter, Salmonella, and E. coli in retail premises and consumers' homes. The external surface of heat-sealed packaging was less frequently contaminated with Campylobacter and E. coli compared with other types of packaging (e.g., overwrapping, bag, and tie tape) (P < 0.0001 to 0.01). In addition, external packaging of raw meats was contaminated less frequently with Campylobacter and E. coli when packaging was intact, packaging and display areas were visually clean, display temperatures were below 8 degrees C, and hazard analysis systems were in place.
Animals↗
The effect of information and behavioural training on endoscopy patients' clinical outcomes.
This study was designed to examine the effects of preparatory information and behavioural training on patients about to undergo an endoscopy procedure. Forty-five first-time endoscopy patients (aged 20-70 years), were randomly assigned to one of three groups (cognitive, cognitive/behavioural and control group). The cognitive group received a 12 min preparation with sensory and procedural information relating to the sensations and sequence of events associated with the endoscopy procedure. The cognitive/behavioural group received, in addition, instruction in deep breathing exercises, tongue depressor task and swallowing technique. Results indicated that patients in the two experimental conditions experienced significantly fewer signs of behavioural distress during endoscopy. The cognitive group required a significantly shorter time to induce the scope. There were no statistical differences between the groups however, for mood, physiological and anxiety measures, although a positive trend was evident for the two intervention groups.
Adult↗
An outbreak due to peanuts in their shell caused by Salmonella enterica serotypes Stanley and Newport--sharing molecular information to solve international outbreaks.
Salmonellosis is a global problem caused by the international movement of foods and high incidence in exporting countries. In September 2001, in an outbreak investigation Australia isolated Salmonella Stanley from imported peanuts, which resulted in a wider investigation in Canada, England & Wales and Scotland. Patients infected with Salmonella serotypes known to be isolated from peanuts and reported to surveillance systems were interviewed to determine exposure histories. Tagged image file format (TIFF) images of pulsed-field gel electrophoresis (PFGE) patterns of Salmonella isolates were shared electronically amongst laboratories. Laboratories tested packets of 'Brand X' peanuts from various lots and product lines. In total, 97 cases of S. Stanley and 12 cases of S. Newport infection were found. Seventy-three per cent (71/97) of S. Stanley cases were in persons of Asian ethnicity. Twenty-eight per cent of cases recalled eating Brand X peanuts and a further 13% had peanuts in their house in the previous month or had eaten Asian-style peanuts. Laboratories isolated S. Stanley, S. Newport, S. Kottbus, S. Lexington and S. Unnamed from Brand X peanuts. Isolates of S. Stanley from peanuts and human patients were indistinguishable by PFGE. This international outbreak resulted from a product originating from one country affecting several others. Rapid sharing of electronic DNA images was a crucial factor in delineating the outbreak; multinational investigations would benefit from a harmonized approach.
Adolescent↗
Microbiological examination of ready-to-eat cold sliced meats and pâté from catering and retail premises in the UK.
AIMS: To establish the microbiological quality of cold ready-to-eat sliced meats and pâté from catering and retail premises, and investigate links hypothesized between foodborne Campylobacter infection and the consumption of cold sliced meats. METHODS AND RESULTS: A total of 4078 cold meat and pâté samples were collected and examined according to a standardized protocol. Comparison with published microbiological guidelines revealed that most ready-to-eat meat and pâté samples (75%) were of satisfactory/acceptable microbiological quality and 25% were of unsatisfactory/unacceptable quality. Two cold meat samples (<1%) were of unacceptable microbiological quality because of the presence of Campylobacter jejuni in 25 g and Listeria monocytogenes at 3.4 x 104 CFU g-1. CONCLUSIONS: Acceptable microbiological quality was associated with premises where the management was trained in food hygiene and those that had hazard analysis in place. Poor microbiological quality was associated with storage above 8 degrees C, presliced meats, infrequent cleaning of slicing equipment and poor control of practices that may lead to cross contamination. SIGNIFICANCE AND IMPACT OF THE STUDY: This study provides important information about the microbiological quality of cold ready-to-eat meats and pâté. It also assists caterers, retailers, enforcement officers and policy makers to understand how different food safety practices affect microbiological quality.
Campylobacter jejuni↗
Microbiological quality of pre-cut fruit, sprouted seeds, and unpasteurised fruit and vegetable juices from retail and production premises in the UK, and the application of HAACP.
A study of ready-to-eat pre-cut fruit, sprouted seeds, and unpasteurised fruit and vegetable juices from retail and production premises was undertaken in the UK to determine the microbiological quality of these products, and to verify the application of hazard analysis and critical control points (HACCP) procedures by food operators. Almost all (99%; 2,075/2,096) samples were of satisfactory/acceptable microbiological quality. Two (0.1%) samples (melon, beansprouts) were of unacceptable quality due to the presence of Listeria monocytogenes at 102 cfu/g or more while a further 19 (0.9%) were unsatisfactory due to Escherichia coli levels in the range of 102 to 106 cfu/g. Neither Salmonella spp. nor E. coli O157 were detected in samples examined. A hazard analysis system was in place in most (85%) premises visited, and in 80% it was documented. Most managers (83%) had received some form of food hygiene training. Minimally processed produce is exposed to a range of conditions during production and distribution, and this may increase the potential for microbial contamination, highlighting the need of applying good hygiene practices from farm to fork to prevent contamination and/or bacterial growth. Such products should be stored and displayed at or below 8 degrees C.
Escherichia coli↗
The microbiological quality of ready-to-eat foods with added spices.
A microbiological study of ready-to-eat foods with added spices or spice ingredients was undertaken to identify any risk factors in the production, storage and display of this product and to establish their effect on microbiological quality. Examination of 1946 ready-to-eat foods from sandwich bars, cafés, public houses, restaurants, specialist sandwich producers, bakers, delicatessens, market stalls and mobile vendors found that 1291 (66%) were of satisfactory/acceptable microbiological quality, 609 (32%) were of unsatisfactory quality, and 46 (2%) were of unacceptable quality. Unacceptable results were due to high levels of B. cereus and/or other Bacillus spp. (>/=10(5) cfu g(-1)). Unsatisfactory results were mostly due to high Aerobic Colony Counts (up to >/=10(7) cfu g(-1)), Enterobacteriaceae (>/=10(4) cfu g(-1)), Escherichia coli (>/=10(2) cfu g(-1)), and Bacillus spp (>/=10(4) cfu g(-1)). Examination of 750 spices and spice ingredients revealed that B. cereus were present in 142 (19%) samples, other Bacillus spp. in 399 (53%) samples, and Salmonella spp. (S. enteritidis PT 11) in one (<1%) sample. Approximately a third (222) of spice and spice ingredients examined contained high counts (>/=10(4) cfu g(-1)) of B. cereus and/or other Bacillus spp., and appeared to be associated with the corresponding ready-to-eat foods containing similar high counts of these organisms (P<0.0001). Acceptable microbiological quality of ready-to-eat foods to which spices or spice ingredients have been added was associated with premises that had management food hygiene training and hazard analysis in place. Poor microbiological quality was associated with preparation on the premises, premises type, little or no confidence in the food business management of food hygiene, and small premises as indicated by local authority inspectors' confidence in management and consumer at risk scores.
Bacillus cereus↗
Microbiological study of ready-to-eat salad vegetables from retail establishments uncovers a national outbreak of salmonellosis.
The increasing availability of bagged prepared salad vegetables reflects consumer demand for fresh, healthy, convenient, and additive-free foods that are safe and nutritious. During May and June 2001 a study of retail bagged prepared ready-to-eat salad vegetables was undertaken to determine the microbiological quality of these vegetables. Examination of the salad vegetables revealed that the vast majority (3,826 of 3,852 samples; 99.3%) were of satisfactory or acceptable microbiological quality according to Public Health Laboratory Service microbiological guidelines, while 20 (0.5%) samples were of unsatisfactory microbiological quality. Unsatisfactory quality was due to Escherichia coli and Listeria spp. (not Listeria monocytogenes) levels in excess of 10(2) CFU/g. However, six (0.2%) samples were of unacceptable microbiological quality because of the presence of Salmonella (Salmonella Newport PT33 [one sample], Salmonella Umbilo [three samples], and Salmonella Durban [one sample]) or because of a L. monocytogenes level of 660 CFU/g, which indicates a health risk. In each case, the retailer involved and the UK Food Standards Agency were immediately informed, and full investigations were undertaken. Nineteen cases of Salmonella Newport PT33 infection were subsequently identified throughout England and Wales. The outbreak strain of Salmonella Newport PT33 isolated from the salad and from humans had a unique plasmid profile. Campylobacter spp. and E. coli O157 were not detected in any of the samples examined. The presence of Salmonella, as well as high levels of L. monocytogenes, is unacceptable. However, minimally processed cut and packaged salad is exposed to a range of conditions during growth, harvest, preparation, and distribution, and it is possible that these conditions may increase the potential for microbial contamination, highlighting the necessity for the implementation of good hygiene practices from farm to fork to prevent contamination and/or bacterial growth in these salad products.
Colony Count, Microbial↗
Microbiological quality of open ready-to-eat salad vegetables: effectiveness of food hygiene training of management.
During September and October 2001, a microbiological study of open, ready-to-eat, prepared salad vegetables from catering or retail premises was undertaken to determine their microbiological quality. The study focused on those salad vegetables that were unwrapped and handled either by staff or customers in the premises where the sample was taken. Examination of salad vegetables from food service areas and customer self-service bars revealed that most (97%; 2,862 of 2,950) were of satisfactory or acceptable microbiological quality, 3% (87) were of unsatisfactory microbiological quality because of Escherichia coli levels in the range of 10(2) to 10(5) colony-forming units per gram. One (<1%) sample was of unacceptable microbiological quality because of the presence of Listeria monocytogenes at 840 colony-forming units per gram. The pathogens E. coli O157, Campylobacter spp., and salmonellas were not detected in any of the samples examined. The display area for most food service and preparation areas (95%) and self-service salad bars (98%) that were visited was judged to be visibly clean by the sampling officer. Most self-service bars (87%) were regularly supervised or inspected by staff during opening hours, and designated serving utensils were used in most salad bars (92%) but in only a minority of food service areas (35%). A hazard analysis system was in place in most (80%) premises, and in 61%, it was documented. Most (90%) managers had received food hygiene training. A direct relationship was shown between increased confidence in the food business management and the presence of food safety procedures and the training of management in food hygiene.
Colony Count, Microbial↗
Study of cleaning standards and practices in food premises in the United Kingdom.
A study was undertaken to determine the microbiological status of surfaces used in the preparation of ready-to-eat foods, and to assess cleaning standards and practices in food premises in the UK. A total of 6,533 environmental samples were examined from 1,502 catering (such as restaurants, cafés, and sandwich bars) or retail premises (such as butchers, delicatessens, and bakers): 2,033 samples from chopping/cutting boards, 2,009 from worktop surfaces, 1,359 from food containers, and 1,132 from cleaning cloths. Cleaning cloths were more heavily contaminated with bacteria (Aerobic Colony Count (ACC), Enterobacteriaceae, E. coli, and Staph. aureus) compared to surfaces sampled. Campylobacter spp. were detected in two (0.2%) and Salmonella spp. from one (0.1%) of the cleaning cloths. Surfaces that were visually dirty, wet, last cleaned over 24 hours ago, and boards that were scored or damaged were found to have higher levels of bacteria. A hazard analysis system was in place in most (70%) food premises visited, and in 52% it was documented. Most managers (89%) had received some form of food hygiene training. Documented cleaning schedules and cleaning records were only present in approximately half (55% and 44%, respectively) of the premises. Most did not have separate implements for cleaning raw and ready-to-eat food areas (67%), or stored cleaning equipment for high risk (ready-to-eat food) areas away from those used in low risk (raw, non ready-to-eat food) areas (70%). Deficiencies in the correct use of cleaning products, such as the minimum contact time for disinfectants, were identified. Surface samples (chopping/cutting boards, worktops, and food containers) and cleaning cloths with ACC levels in excess of 10(3) cfu/cm2, swab or ml were associated with premises that did not have management food hygiene training, hazard analysis, cleaning schedules or cleaning records in place, and with little or no confidence in the food business management of food hygiene as indicated by Local Authority Inspectors' Confidence in Management scores.
Bacteria↗
Microbiological quality of food in relation to hazard analysis systems and food hygiene training in UK catering and retail premises.
A meta-analysis of eight UK food studies was carried out to determine the microbiological quality of food and its relationship with the presence in food businesses of hazard analysis systems and food hygiene training. Of the 19,022 premises visited to collect food samples in these studies between 1997 and 2002, two thirds (66%) were catering premises and one third (34%) were retail premises. Comparison with PHLS Microbiological Guidelines revealed that significantly more ready-to-eat food samples from catering premises (20%; 2,511/12,703) were of unsatisfactory or unacceptable microbiological quality compared to samples from retail premises (12%; 1,039/8,462) (p < 0.00001). Three quarters (76%) of retail premises had hazard analysis systems in place compared with 59% of catering premises (p < 0.00001). In 87% of retail premises the manager had received some form of food hygiene training compared with 80% of catering premises (p < 0.00001). From premises where the manager had received no food hygiene training a greater proportion of samples were of unsatisfactory and unacceptable microbiological quality (20% retail, 27% catering) compared with premises where the manager had received food hygiene training (11% retail, 19% catering) (p < 0.00001). Where the manager of the premises had received food hygiene training, documented hazard analysis systems were more likely to be in place (p < 0.00001). Higher proportions of samples of unsatisfactory and unacceptable microbiological quality (17% retail, 22% catering) were from premises where there was no hazard analysis system in place compared to premises that had a documented hazard analysis system in place (10% retail, 18% catering) (p < 0.00001). Our meta-analysis suggests that the lower microbiological quality of ready-to-eat foods from catering premises compared with those collected from retail premises may reflect differences in management food hygiene training and the presence of a hazard analysis system. The importance of adequate training for food handlers and their managers as a pre-requisite for effective hazard analysis and critical control point (HACCP) based controls is therefore emphasised.
Allied Health Personnel↗
Microbiological quality of take-away cooked rice and chicken sandwiches: effectiveness of food hygiene training of the management.
During August 2001 a microbiological study of ready-to-eat cooked rice from take-aways and of chicken sandwiches made on the premises from sandwich bars was undertaken. The intention was to identify risk factors in the production, storage and handling of cooked rice and sandwiches, and to establish their effect on microbiological quality. Examination of cooked rice revealed that the majority of samples (87%; 442 of 508) were of satisfactory/acceptable microbiological quality; 50 (10%) were unsatisfactory, and 16 (3%) were of unacceptable quality due to Bacillus cereus and/or other Bacillus spp in excess of 10(5) cfu/g. The microbiological quality of cooked rice was associated with cuisine type (p < 0.00001), rice type (p < 0.01), cooking (p < 0.01), serving methods (p < 0.00001), and management food hygiene training (p < 0.01). Examination of chicken sandwiches found that most (75%; 335 of 449) were of satisfactory/acceptable microbiological quality and 114 (25%) were unsatisfactory. Acceptable microbiological quality of sandwiches was associated with sandwich bars that had hazard analysis in place (p < 0.05). Smaller businesses, as indicated by Local Authority Inspectors' Consumer at Risk scores, were more likely to have samples classified as unsatisfactory or unacceptable compared to larger businesses (p < 0.001). The majority (90%) of premises had hand-washing facilities accessible and available for use, although only over half (55%) were correctly used as judged by the sampling officer. Where the manager of the premises had received some form of food hygiene training, food safety procedures such as the hazard analysis system were more likely to be in place (p < 0.0001).
Animals↗
Collaborative investigation of an outbreak of Salmonella enterica serotype Newport in England and Wales in 2001 associated with ready-to-eat salad vegetables.
In June 2001, as part of a microbiological study of bagged, ready-to-eat salad products, Salmonella enterica serotype Newport was isolated from a sample of pre-packed green salad distributed by a major supermarket retailer. The strain was characterised by phage typing, plasmid profile typing and pulsed-field gel electrophoresis. Other isolates of S. Newport from cases of human infection in England and Wales in the first six months of 2001 were similarly characterised. Of 60 strains from cases of human infection, 19 were found to be indistinguishable from that isolated from the salad product. This study highlights the benefits of an integrated approach to outbreak investigations, involving the various elements of the PHLS and the Food Standards Agency, and acknowledges the full co-operation of the retailer in ensuring the rapid withdrawal of the contaminated product.
Disease Outbreaks↗