Nursing home cases were key in Minnesota Salmonella probe

first_imgJan 23, 2009 (CIDRAP News) – A physician’s report of diarrhea cases in a nursing home, followed by the discovery of cases in several other institutions, provided the key that enabled Minnesota disease detectives to figure out before anyone else that peanut butter was the culprit in the current nationwide Salmonella outbreak.When epidemiologists compared food product invoices from institutions that had cases, they found that the one thing the places had in common was King Nut peanut butter, Minnesota officials said. That led to testing of the peanut butter and the discovery of the outbreak strain of Salmonella in it.”If we didn’t have those institutional cases, we still might not know it’s peanut butter causing this outbreak,” said Kirk Smith, DVM, PhD, director of the foodborne disease unit at the Minnesota Department of Health (MDH) in St. Paul.The outbreak began back in September but did not become public until early this month. So far there have been 491 cases in 43 states and one more in Canada, the Centers for Disease Control and Prevention (CDC) reported in a teleconference with clinicians today. In addition, there have been seven deaths possibly related to the illnesses.The outbreak has been traced to a Peanut Corp. of America (PCA) facility in Blakely, Ga., which makes peanut butter distributed by King Nut Cos. and others to institutions and food services. PCA also sells peanut butter and peanut paste from the plant to a number of food companies, which process them into cracker snacks, cookies, ice cream, candy, and other products. The outbreak has triggered a long list of product recalls.Probe began in NovemberMinnesota cases in the outbreak began showing up in November, according to Carlota Medus, PhD, MPH, a foodborne disease epidemiologist at the MDH. By late in the month the department had found a couple of cases that featured the outbreak strain, Salmonella enterica serotype Typhimurium, she reported.Minnesota began interviewing case-patients about what they had eaten, using a hypothesis-generating questionnaire developed by the CDC for this outbreak, said Smith. Besides Smith and Medus, investigators included another MDH foodborne disease epidemiologist, Stephanie Meyer, and Team Diarrhea, a group of seven graduate students in public health.”After we had our first four cases, there was a lead from another state that the cause might be chicken,” he said. “So we followed up on the chicken sources on our cases and the [Minnesota] Department of Agriculture [MDA] traced it back to the plant level, and it just wasn’t very compelling.”Meanwhile, the early interviews led to some suspicion that peanut butter could be involved. “We had several cases interviewed, and I think most if not all of them had eaten peanut butter, but we were having trouble with brand names, and certain aspects of it were not clear,” said Medus.Big break in the caseBy Dec 22 Minnesota had nine cases, but no good evidence as to the cause. But then came the big break in the hunt.”On Dec 22 we received a call from a clinician who reported an outbreak of Salmonella in a nursing home and that the lab that did the testing had noticed additional cases in the community,” said Medus. “At that point we didn’t know if these were part of the national outbreak. By the next day the first Salmonella isolates had arrived at our lab, and we were able to confirm that at least one of them was part of the national outbreak.” The nursing home was in Brainerd in north-central Minnesota.Clinical labs routinely send Salmonella isolates to the MDH for typing, but it usually takes several days before they arrive. In this case the samples were sent immediately. “Because of that report, we didn’t have to wait for the Salmonella isolates to come in, which would’ve been a few days down the road,” Smith explained.The physician who reported the nursing home cases didn’t know there was a widespread Salmonella outbreak going on, but reported them because they were in a nursing home, according to Medus.Homing in on peanut butterThe discovery of outbreak cases at one nursing home was significant but not sufficient to implicate peanut butter, said Medus. Shortly afterward, however, cases started showing up at other institutions, including nursing homes, colleges, and an elementary school, according to Smith.She said that development prompted the next investigative step: collecting menus from the various institutions and, with the help of the MDA, gathering invoices for the food products used. “We went to the invoices and started comparing them, and the one thing they had in common was the King Nut [peanut butter],” she said. In checking the documents, the investigators looked at all foods, not just peanut butter, she noted.Smith said the regional pattern of the institutional cases offered another important clue: “All the institutions served King Nut peanut butter, and what was interesting was that the institutions were all in northern and northwestern Minnesota. And we found that the King Nut peanut butter they were getting was from a distributor out of Fargo,  Sysco.”What was intriguing to us was that there is a  Sysco distributor in the Twin Cities, and they did not distribute King Nut peanut butter, and we were not seeing [institutional] cases in the catchment area for that distribution. So it was all kind of coming together.”With the peanut butter as a suspected source, MDA and MDH labs began testing peanut butter collected from the institutions. Eventually an opened 5-pound tub of peanut butter from the Brainerd nursing home yielded the outbreak strain—or, more precisely, two strains.Smith explained that the outbreak involves two very closely related Salmonella strains as identified by pulsed-field gel electrophoresis. “We found both strains in the open jar of peanut butter,” he said.Going public with findingsThe Minnesota agencies announced the discovery of Salmonella in the peanut butter on Jan 9, and, after further testing, reported on Jan 12 that it matched the outbreak strain. King Nut issued a recall on Jan 10.The US Food and Drug Administration (FDA), however, did not publicly tie PCA-made products to the outbreak immediately. Because the Salmonella-tainted container had been opened, there was a possibility it had been contaminated at the nursing home, rather than at the plant where it was made. It was not until Jan 19, when Connecticut officials reported finding the outbreak pathogen in an unopened container of King Nut peanut butter, that the FDA publicly linked the outbreak to the PCA facility.With an opened container, “there’s always the concern that somebody could’ve gotten sick from some other source and then contaminated that tub,” said Smith. However, he said that looked unlikely in this case, because Salmonella was found in samples taken from a number of locations within the tub. Moreover, both outbreak strains were found, whereas if the product had been contaminated by an infected person at the nursing home, probably only one strain would have been present.Also, Smith said that as Minnesota officials were investigating the institutional cases, they were hearing from other states that they also had cases at institutions that had received King Nut peanut butter. “It wasn’t just the isolate, it was all the institutions receiving this one brand,” he said.Other products involvedBut it also became clear during the investigation that not all cases were related to King Nut peanut butter. Smith said that no institutional cases were found in the Twin Cities area, but there were other cases that couldn’t be explained by the peanut butter. “Then other health departments around the country said their cases had been eating peanut butter crackers,” he added. That led to a CDC case-control study that tied some cases to peanut butter–containing products such as crackers.Minnesota investigators have been able to connect almost all the state’s cases to particular food products, said Medus. “We have fewer than 5 cases that we can’t explain yet, out of 36 cases,” she said. And, said Smith, more than half of those have been linked to products other than King Nut peanut butter.Untraditional epidemiologySmith and Medus agree that the institutional cases were critical in finding the food culprit.”If we didn’t have the institutional cases, it would’ve been a lot harder to implicate a product. The noninstitutional cases ate a lot of different products,” said Medus. With tens of different products and hundreds of cases, “You won’t have a single product common to all, which makes it extremely difficult to figure out a product [source],” she said.Smith commented, “This was a little untraditional in that it wasn’t cracked by looking at the interview data but by noticing the institutional link and getting the menus and getting our Department of Ag to compare and contrast.”See also: CDC outbreak update outbreak update read more

PREMIUMIndonesia should focus on renewable energy, not nuclear, activists say

first_imgNuclear energy renewable-energy renewable-energy-bill Activists are warning the government to steer clear of building nuclear power plants, citing safety concerns and urging Indonesia to focus on renewable energy instead.A Greenpeace Indonesia official, Satrio Swandiko, said Indonesia should heed the lessons of the Fukushima Daiichi nuclear power plant disaster in Japan, which was caused by an earthquake and tsunami in March 2011.Greenpeace’s Japan chapter surveyed Fukushima city, as well as the nearby towns of Naraha and Okuma in Fukushima prefecture in October and November 2019. In Fukushima’s city center, Greenpeace found at least 45 radioactive hot spots — 11 of which had radiation levels equal to and even above the Japanese government’s decontamination target of 0.23 microSieverts per hour. It showed that the impact of the nuclear meltdown continued years after the incident.“Indonesia has a high risk of… Log in with your social account Linkedin Google LOG INDon’t have an account? Register here Topics : Forgot Password ? Facebooklast_img read more

South Korea church hit by COVID-19 says members to give plasma for research

first_imgAround 4,000 recovered COVID-19 patients from a religious group at the center of South Korea’s largest outbreak will donate plasma for research, an official said on Tuesday, a day after local officials filed a lawsuit against the church.In February and March, a massive outbreak among members of the Shincheonji Church of Jesus made South Korea the scene of the first large outbreak outside of China.At least 5,213 of the country’s total 12,484 cases have been linked to the church outbreak, according to the Korea Centers for Disease Control and Prevention (KCDC). Shincheonji says it fully complied with government efforts.The National Institute of Health said 185 people have so far come forward to donate plasma as of Monday and said they were in talks with Shincheonji for donations.South Korea health officials have said that in the absence of other treatments or vaccines, plasma therapy may be a way to lower the death rate, especially in critical patients.At least 17 South Koreans have received the experimental therapy, which involves using plasma from recovered patients with antibodies to the virus, enabling the body to defend against the disease.South Korea has reported 281 deaths from COVID-19.Health authorities said they were testing 176 people who came into contact with crew members on a Russian fishing vessel docked at Busan after 16 aboard the vessel were tested positive.  Church founder Lee Man-hee had internally advised recovered members to donate their plasma, which is badly needed for coronavirus research, Shincheonji media coordinator Kim Young-eun told Reuters on Tuesday.Many of recovered church members wanted to donate to express thanks to the government and medical staff, she said.The city of Daegu – where most of the church infections were centered – filed a civil lawsuit against the church on Monday, seeking 100 billion won ($82.75 million) in damages.Daegu authorities had previously filed a complaint against the church accusing it of not submitting a full list of members and facilities, and not cooperating with city health efforts.center_img Topics :last_img read more

First-half contraction in palm oil output, exports due to ‘domino effect’: GAPKI

first_img“The main [cause of] the decline in production isn’t really COVID-19, but rather the domino effect of the palm oil price crash, which pushed down palm oil cultivation and fertilizer sales,” he said.Along with the decline in palm oil production the first half of 2020, exports fell 11.4 percent yoy to 15.5 million tons from 17.5 million tons, according to GAPKI data.“Global demand for palm oil products has declined significantly, which has affected our export performance. [This is] because countries are in lockdown, and we don’t know how long [the situation] will last,” Joko said.According to Statistics Indonesia (BPS), half-year palm oil exports fell 5.49 percent yoy to US$76.41 billion. The World Trade Organization (WTO) has forecast that global trade in 2020 will contract by 13 percent at best and 32 percent at worst amid the worldwide disruption caused by the pandemic.According to GAPKI data, palm oil exports to all major destinations had declined except for exports to India, the United States and Pakistan, which grew  23 percent, 7 percent and 1 percent, respectively.Meanwhile, domestic consumption of the commodity in the first half of 2020 posted a slight yoy increase of 2.8 percent to 8.6 million tons, mainly due to increased production of oleochemicals during the pandemic.Oleochemicals are chemicals derived from oils and fats of both vegetable and animal origins, and are processed into soaps, shampoos and detergents, as well as other consumer and industrial products, including sanitation and pharmaceutical products.Joko added that the market share of domestic consumption grew 37 percent compared to exports, due to high domestic demand“In June, the domestic market share for palm oil products reached an unseen level of 37 percent, as last year’s figure was around 30 percent. Hopefully, we can maintain our strong domestic market and attain equilibrium,” he said.Chairman Togar Sitanggang of the Indonesian Oleochemical Manufacturers Association (Apolin) said that oleochemical exports had spiked 24 percent yoy in the first half to reach 1.8 million tons for a total value of $1.3 billion.As demand for oleochemicals continued to rise, Apolin projected that full-year exports could reach 3.7 million tons with an estimated value of $2.6 billion, higher than last year’s figure of 3.2 million tons valued at around $2 billion.“Everyone has a sanitation product in their pocket [now], which has increased demand for oleochemical products and overall production. We also haven’t experienced any disruption thanks to the government, and no overseas orders have been cancelled,” Togar said.Topics : Indonesia, the biggest palm oil producer in the world, saw production and exports of the commodity contract in the first half of the year due to economic impacts of the pandemic as well as rolling impacts of drought and a price crash in previous years, the industry association has stated.The Indonesian Oil Palm Association (GAPKI) reported that half-year production of crude palm oil (CPO) and palm kernel oil (PKO) had declined 9.2 percent year-on-year (yoy) to 23.5 million tons.While the COVID-19 health crisis played a role in the decline in palm oil production, said GAPKI chairman Joko Supriyono, the palm oil price crash in 2018 and last year’s prolonged drought due to El Niño had a major effect on overall output.last_img read more

VIDEO: Creating New Land in Nigeria

first_img<span data-mce-type=”bookmark” style=”display: inline-block; width: 0px; overflow: hidden; line-height: 0;” class=”mce_SELRES_start”></span>Jan De Nul Group today released this video about the company’s major land reclamation project in Nigeria.In 2015, JDN started this land reclamation project for the Dangote Group. The African company wanted to build its own oil refinery and fertilizer plant in Lekki, 60 kilometers east of Lagos.For the project, JDN brought in two of its largest, world leading hopper dredgers. Working continuously from November 2015 to January 2017, JDN reclaimed around 2,400 hectares of new land.Just off the coast, at a depth of twenty to fifty meters, JDN dredged 55 million cubic meters of sand for this reclamation project.last_img read more

Battered Italy sees rays of hope in grim death data

first_imgBut Angelo Borrelli also noted that thereal number of infections was probably 10 times higher than the official count. The number of new officially registered infections fell from 6,557 on Saturday to 4,789 on Monday. AFP ROME – Italy’s top coronavirus responseofficial Tuesday attributed two successive declines in the daily death rate toa painful national lockdown that appeared to be finally bearing fruit.center_img The civil protection chief also said thenation of 60 million was on course to overtake China’s total number ofconfirmed COVID-19 cases in a week./PNlast_img read more

Cardinals Get Wins Over Trojans

first_imgThe St Louis Cardinals 7th Grade Boys Basketball team defeated by Sunman Dearborn by a score of 43-21 tonight.The win improves the Cardinals record to 4-2. Scoring for the Cardinals were Charlie Schebler, Alec Bunselmeier, Noah Tuveson, Benjamin Harmeyer and Peyton Ditmer.The Cardinals will be in action at home next Monday night against the Benjamin Rush Cubs.Courtesy of Cardinals Coach Ryan Schebler.The St Louis Cardinals 8th Grade Boys Basketball team improved their record to 3-3 on the season with a home win against Sunman Dearborn Thursday Night by a final score of 25 to 17.Cayden Pohlman and Abe Streator knocked down 2 free throws each in the 4th quarter to secure the win.The Cardinals will return to action on Monday against Benjamin Rush.Courtesy of Cardinals Coach Mike Burkhart.last_img read more

Ivy Tech plans riverfront Shakespeare production-Rescheduled to September 6

first_imgLawrenceburg, In. — Ivy Tech Community College will host a free production of a Shakespeare play next week at its Lawrenceburg Riverfront location.The Cincinnati Shakespeare Company’s summer production of “A Midsummer Night’s Dream” will be at 6:30 p.m. September 6 at the College’s plaza atop the parking garage at the Riverfront Campus, 50 Walnut St.The renowned company, one of only a handful nationwide to have performed Shakespeare’s entire canon of plays, will perform for free as part of the College’s growing liberal arts and community outreach programs. Everyone is invited to bring lawn chairs and blankets and enjoy an evening of free Shakespeare on the river.The play is one of Shakespeare’s silliest comedies and involves a pair of “star-crossed” lovers who run away to find happiness but first find mischief and madness in a nearby forest that is populated with fairies, magic, and fun. Originally written in 1595 for a wedding reception which was attended by Queen Elizabeth I of England, this play is sure to make you laugh and put you in a romantic mood.last_img read more

Green takes I-37 Modified checkers

first_imgGreen had jumped out to an early lead from the eighth starting spot and put some distance on Jeremy Davenport, Cody Tidwell, Jake Rollins and Greg Dinsmore.Dinsmore advanced to second but was half a straightaway back until caution flew on lap 13. The restart saw Dinsmore and Tidwell on Green’s bumper, but as the two fought for second Green inched ahead.Dinsmore’s run to the front ended with brake problems, leaving Tidwell to take up the charge on a re­start. Green got a couple car lengths on Tidwell and Carroll with Flanagan and Cody Leonard side-by-side for fourth. Rick Green was challenged but never caught Before taking Saturday’s IMCA Modified checkers at I-37 Speedway.By J.M. HallasPLEASANTON, Texas (July 28) – Rick Green took home the top money in Saturday’s IMCA Modi­fied feature at I-37 Speedway, but it wasn’t easy after midway. Tidwell gave Green a look on the final lap, but Green held him off for his first I-37 victory in sev­eral years.last_img read more

Assam Premier Club Championship League Match Abandoned Due to Heavy Rain

first_imgOur Sports ReporterGUWAHATI: The match between Sakti Sangha and NSSA, Karimganj in Assam Premier Club Championship League abandoned today because of heavy rain. Chasing 216 runs to win NSSA were 36-0 in 4 overs when rain interrupted the match and later umpires abandoned the tie. Earlier elected to bat Mangaldoi outfit Sakti Sangha scored 215-9 in their 50 overs. Priyankar Chakraborty (63, 103 balls, 4X7) scored half century. Brief scores: Sakti Sangha 215-9 (50 overs), Priyankar Chakraborty 62, Joydip Singh 35, Imtiyazur Rahman 34, Abdus Salam 3-40, NSSA 36-0 (4 overs), Dipankar Adityan (27no). Tomorrow’s match: Gauhati Town Club vs Bongaigaon Cricket Coaching Centre.Also read: Local Sportslast_img read more