Outbreak of Campylobacter infection among farm workers: an occupational hazard.
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We reviewed records of all outbreaks of food-borne illnesses due to schoollunch in Japan from 1987 through 1996 to determine the risk factors causing these outbreaks. Major hazards in 269 outbreaks were Salmonella spp., Campylobacter jejuni, Escherichia coli and Staphylococcus aureus. Foods including uncooked or partially cooked items, salad or egg products presented a high risk in 62 outbreaks with confirmed food sources. Contaminated food items were involved in 29 incidents (46.8%); storage of foods for an extended period before serving in 29 incidents (46.8%), inadequate cooking and cross contamination in 21 incidents (33.9%) each; infected employees in nine incidents (14.5%).
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In 2002, in The Netherlands a national study of gastroenteritis outbreaks was performed. Epidemiological information was collected by the Public Health Services (PHS) and the Food Inspection Services (FIS) using standardized questionnaires. Stool samples were collected for diagnostic testing. For foodborne outbreaks, food samples were taken. In total, 281 gastroenteritis outbreaks were included, mainly from nursing homes and homes for the elderly (57%), restaurants (11%), hospitals (9%) and day-care centres (7%). Direct person-to-person spread was the predominant transmission route in all settings (overall 78%), except for restaurant outbreaks where food was suspected in almost 90% (overall in 21% of outbreaks). The most common pathogen was norovirus (54%), followed by Salmonella spp. (4%), rotavirus group A (2%), Campylobacter spp. (1%) and only incidentally others. In conclusion, most outbreaks were reported from health and residential institutions, with norovirus as the dominant agent. Control should aim at reducing person-to-person spread. In foodborne outbreaks norovirus was common, due to contamination of food by food handlers. Salmonella , as the second foodborne pathogen, was mainly associated with raw shell eggs. These results stress the continuous need for food safety education, complementary to governmental regulation.
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In May/June 2005 an outbreak of diarrhoeal illness occurred among company employees in Copenhagen. Cases were reported from seven of eight companies that received food from the same catering kitchen. Stool specimens from three patients from two companies were positive for Campylobacter jejuni. We performed a retrospective cohort study among employees exposed to canteen food in the three largest companies to identify the source of the outbreak and to prevent further spread. Using self-administered questionnaires we collected information on disease, days of canteen food eaten and food items consumed. The catering kitchen was inspected and food samples were taken. Questionnaires were returned by 295/348 (85%) employees. Of 247 employees who ate canteen food, 79 were cases, and the attack rate (AR) was 32%. Consuming canteen food on 25 May was associated with illness (AR 75/204, RR=3.2, 95%CI 1.3-8.2). Consumption of chicken salad on this day, but not other types of food, was associated with illness (AR=43/97, RR=2.3, 95%CI 1.3-4.1). Interviews with kitchen staff indicated the likelihood of cross-contamination from raw chicken to the chicken salad during storage. This is the first recognised major Campylobacter outbreak associated with contaminated chicken documented in Denmark. It is plausible that food handling practices contributed to transmission, and awareness of safe food handling and storage has since been raised among kitchen staff. The low number of positive specimens accrued in this outbreak suggests a general underascertainment of adult cases in the laboratory reporting system by a factor of 20.
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Introduction: All workers, regardless of occupation are vulnerable to various hazards present at work. This study was carried out to determine the commonly encountered occupational hazard of laboratory animal workers in Singapore and the Philippines. Moreover, to determine the percentage of hazard exposure according to the workers’ personal profile, work profile, and frequency of exposure.
Methods: All members of the Association for Laboratory Animal Science of Singapore (n=150) and the Philippines (n=130) were invited in an online survey administered anonymously via email. Only those respondents who fulfilled the inclusion criteria (i.e. 18 years old and above and working in direct contact to animals and its environment) were included in the analysis.
Results: Laboratory animal workers experienced all hazards identified in the laboratory animal facilities. The three most common hazards encountered by workers based on the mean (M) and median (Mdn) number of exposures were animal-related injuries (M= 1.269, Mdn= 1), ergonomics (M= 1.067, Mdn= 0) and sharp-related injuries (M= 0.885, Mdn=1). There was no significant difference noted between these three hazards when compared to one another. These hazards were consistent regardless of age, gender, education, job, biosafety level of the facility, years of experience and type of animal exposures.
Conclusion: Laboratory animal workers in Singapore and the Philippines are exposed to various hazards in the workplace. Younger workers, and workers with higher day-to-day exposure to laboratory animals, should be prioritized for information dissemination, training, and supervision.
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Fresh produce is an important part of a healthy diet and is consumed in greater quantity in the United States than ever before. Consumption of cantaloupe has recently been associated with several large outbreaks of infections in North America, highlighting the need for a better understanding of practices and processes that may contribute to contamination. We reviewed all cantaloupe-associated outbreaks that were reported to the Centers for Disease Control and Prevention (CDC) and published in the literature. Twenty-three outbreaks occurred between 1984 and 2002; 1434 people became ill, 42 were hospitalized, and two died in these outbreaks. Aetiological agents in the outbreaks included five serotypes of Salmonella enterica , Campylobacter jejuni , Escherichia coli O157:H7, and norovirus. We reviewed processes contributing to cantaloupe contamination, conditions affecting survival and growth of bacterial pathogens on melons, and potential methods for sanitization. For maximum safety, industry, federal, and international partners must collaborate to ensure that appropriate interventions are in place to minimize the risk of contamination and prevent the growth of pathogens during cantaloupe production, processing, storage, and preparation.
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Abstract Food- or waterborne diseases in long-term care facilities (LTCF) can result in serious outcomes, including deaths, and they are potentially preventable. We analyzed data collected by OzFoodNet on food- and waterborne disease outbreaks occurring in LTCF in Australia from 2001 to 2008. We compared outbreaks by the number of persons affected, etiology, and implicated vehicle. During 8 years of surveillance, 5.9% (55/936) of all food- and waterborne outbreaks in Australia occurred in LTCF. These LTCF outbreaks affected a total of 909 people, with 66 hospitalized and 23 deaths. The annual incidence of food- or waterborne outbreaks was 1.9 (95% confidence intervals 1.0-3.7) per 1000 facilities. Salmonella caused 17 outbreaks, Clostridium perfringens 14 outbreaks, Campylobacter 8 outbreaks, and norovirus 1 outbreak. Residents were at higher risk of death during outbreaks of salmonellosis than for all other outbreaks combined (relative risk 7.8, 95% confidence intervals 1.8-33.8). Of 15 outbreaks of unknown etiology, 11 were suspected to be due to C. perfringens intoxication. Food vehicles were only identified in 27% (14/52) of outbreaks, with six outbreak investigations implicating pureed foods. Dishes containing raw eggs were implicated as the cause of four outbreaks. Three outbreaks of suspected waterborne disease were attributed to rainwater collected from facility roofs. To prevent disease outbreaks, facilities need to improve handling of pureed foods, avoid feeding residents raw or undercooked eggs, and ensure that rainwater tanks have a scheduled maintenance and disinfection program.
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A man who had recently started work as a packer in a chicken factory developed campylobacteriosis with severe complications. This prompted a qualitative assessment of the occupational infection risk. It is likely that his infection occurred by droplet transmission via the mouth. Serological studies have shown increased risk of infection to poultry workers, particularly in the first weeks of employment. Previous reports have identified the risks of airborne pathogen transmission, and these papers are reviewed here. Epidemiological evidence from the plant indicated that workers were three times more likely than the general population to suffer campylobacteriosis, and occupational health reporting confirms the risk to poultry workers. Employers should offer face masks to their workers for protection from airborne infection.
Campylobacteriosis
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Objective.
—To determine the incidence of recognized outbreaks ofCampylobacterenteritis associated with drinking raw milk during youth activities.Design.
—Retrospective survey of 51 state and territorial health departments.Setting.
—The 50 United States and the Territory of Puerto Rico.Populations.
—Persons in preschool through college.Measurement.
—Information was obtained for allCampylobacteroutbreaks associated with consumption of raw milk during youth activities from 1981 through 1990 that were investigated by state and territorial health departments. Results.—Twenty outbreaks were identified in 11 states. Four hundred fifty-eight outbreak-associated cases occurred among 1013 persons who drank raw milk, with an overall attack rate of 45%. At least one outbreak was reported for each year of the 10-year period. Fourteen outbreaks (70%) occurred among children in kindergarten through third grade, compared with one outbreak (5%) among fourth through sixth graders. The remaining five outbreaks (25%) occurred in mixed groups of children and teenagers. Only nine (60%) of 15 outbreaks identified from 1981 through 1988 were reported to theCampylobacternational surveillance system maintained by the Centers for Disease Control and Prevention.Conclusion.
—Drinking raw milk on school field trips or other youth activities continues despite the occurrence of multipleCampylobacteroutbreaks documented from this practice. Such illnesses can be prevented by educating dairy farmers and officials of schools and youth organizations about the hazards of drinking raw milk. Public health organizations need to develop and implement such educational programs. (JAMA. 1992;268:3228-3230)Cite
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Twelve cases of Campylobacter jejuni infection were identified on a university campus in the first 12 days of November 1997. Consumption of food from a single outlet, where poor food handling practices were identified, was statistically associated with infection. The epidemiological evidence suggested that what presented as a point source outbreak was a series of small cross contamination incidents associated with multiple strain types. The nature of this outbreak suggests that current surveillance systems are inadequate for the identification of campylobacter outbreaks. Enhanced surveillance should be introduced to identify case clusters of campylobacter infections and public health professionals should remember the risks of cross contamination associated with ubiquitously contaminated foodstuffs, especially raw meats and poultry. The role of strain typing in campylobacter epidemiology is as yet undefined.
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