Incidencia de las enfermedades transmitidas por alimentos en Ecuador / Incidence of foodborne diseases in Ecuador

RESUMEN Con el objetivo de describir las tasas de incidencia por cada 100 000 habitantes de los casos de enfermedades transmitidas por alimentos (ETA) durante el periodo 2015-2020 en Ecuador se realizó un análisis secundario de los registros de vigilancia epidemiológica y de las proyecciones poblacionales del Instituto Nacional de Estadística y Censos. Se reportaron 113 695 casos con una incidencia superior a los 100 casos por cada 100 000 habitantes (2015-2019). En el 2020 los registros son considerablemente inferiores a los reportes de años anteriores. La mayoría de los casos se reportaron como «otras intoxicaciones alimentarias¼. Las tasas de incidencia de ETA más altas se observaron en la región amazónica. En general existe una marcada variabilidad anual en la incidencia de las ETA según las regiones geográficas del Ecuador. En conclusión, las ETA representan un problema de salud pública en el Ecuador. Se deben diseñar estrategias preventivas integrales con especial énfasis en la región amazónica.

ABSTRACT In order to describe the incidence rates per 100 000 population of foodborne disease (FBD) cases during the period 2015-2020 in Ecuador, we carried out a secondary analysis of epidemiological surveillance records and population projections from the National Institute of Statistics and Census. A total of 113,695 cases were reported with an incidence of more than 100 cases per 100 000 population (2015-2019). In 2020, the records are considerably lower than those reported in previous years. Most cases were reported as "other food poisoning". The highest incidence rates of FBD were found in the Amazon region. In general, there is a marked annual variability in the incidence of FBD according to the geographic regions of Ecuador. In conclusion, FBD represent a public health problem in Ecuador. Comprehensive preventive strategies should be designed with special emphasis on the Amazon region.

Caracterización higiénico-sanitaria de la leche bovina del departamento de Nariño

RESUMEN Objetivo. Evaluar la calidad higiénico-sanitaria de la leche bovina de Nariño mediante los recuentos de mesófilos aerobios y de células somáticas y determinar presencia de microorganismos ambientales importantes en salud pública como Salmonella spp., Escherichia coli O157, Listeria monocytogenes, Staphylococcus aureus y Yersinia enterocolítica y evaluar las variaciones de los parámetros de calidad en dos periodos lluviosos diferentes. Materiales y métodos. Se tomaron muestras de leche en 180 predios de cuatro subregiones naturales, en épocas de diferente precipitación. A cada muestra se le realizó recuento de aerobios mesófilos, y el recuento de células somáticas por citometría de flujo, y el de Coliformes totales mediante lectura en placa. La detección de Salmonella spp., Escherichia coli O157:H7 y Listeria monocytogenes por el sistema de detección molecular MDS 3M, Staphylococcus aureus y Yersinia enterocolitica por microbiología convencional. Resultados. Los recuentos de células somáticas fueron superiores en la época de altas precipitaciones. La mediana de los recuentos de mesófilos y coliformes totales fue de 20.085 UFC/ml, 265 UFC/ml respectivamente sin diferencias significativas en los dos periodos. No se detectó Salmonella spp. ni E. coli O157/H7. No se observaron diferencias significativas en la frecuencia de presentación de Listeria sp., L. monocytogenes, Y. enterocolítica, Staphylococcus aureus y Staphylococcus coagulasa negativa entre los dos periodos de lluvia evaluados". Conclusiones. Se observó que el 80% de las muestras de leche analizadas en este estudio cumplen con los estándares de calidad higiénico-sanitaria y no se observó influencia de la época de muestreo sobre la calidad higiénica de la leche.

ABSTRACT Objective. The aim of this study is to evaluate the hygienic and sanitary quality of bovine milk from dairy farms of Nariño, Colombia by determining the presence of environmental microorganisms of public health importance such as Salmonella spp., Escherichia coli O157, Listeria monocytogenes, Staphylococcus aureus and Yersinia enterocolitica and to evaluate the impact that the rainy seasons have on milk quality Materials and methods. Milk samples were taken in 180 farms located in four natural subregions, both in the high rainfall season and in the low rainfall season. Mesophilic aerobic count, a somatic cell count by automated methods, and a total coliform count in 3M Petrifilm® plates were done to each milk sample. Detection of Salmonella spp., Escherichia coli O157:H7 and Listeria monocytogenes was done by the 3M MDS system, Staphylococcus aureus and Yersinia enterocolitica were isolated by conventional microbiology techniques. Results. The highest somatic cell counts were found during the high rain season. The median of the mesophilic, total coliform and somatic cell counts were 20,085 CFU/ml, 265 CFU/ml and 219,170 cells/ml, respectively, with no significant differences in the two rainy periods. Neither Salmonella spp. nor E. coli O157/H7 were detected. There was no significant difference among the presence of Listeria sp., L. monocytogenes, Y. enterocolitica, Staphylococcus aureus and coagulase negative Staphylococcus between the two rainy seasons. Conclusions. 80% of the milk samples met the hygienic and sanitary quality standards and no influence of the sampling period on the hygienic quality of the milk was observed.

Epidemiological and etiological characteristics of active surveillance of foodborne illness / 公共卫生与预防医学

Objective To realize the epidemiological and pathogenic characteristics of foodborne illness in Shiyan in 2019 and provide targeted measures for the prevention and control work of the foodborne illness． Methods The active surveillance data of foodborne illness in shiyan in 2019 were collected and analyzed. The Salmonella strains isolated from the patients with foodborne illness were tested with serotyping，PFGE molecular classification and drug sensitivity test respectively according to《National foodborne illness surveillance workbook 2019》. Result A total of 3 191 cases of foodborne illness were analyzed. The pre-school children were the highest-risk group of foodborne diseases. Grain and grain product was the main suspicious contaminated food．The main location of eating place was family. A total of 330 samples were tested. The positive detection rate of foodborne illness was 20.30%（73/330）.The main pathogen were Rotavirus and Salmonella,and the detection rates were 11.21%(37/330) and 4.85%(16/330) respectively. The pre-school children were the group with the highest detection rate, which was 57.27% (63/110). The dominant serotype of the 14 Salmonella strains isolated from patients were Salmonella typhimurium and Salmonella enteritis. 14 different genotypes were obtained through PFGE classification and clustering. 64.29% (9/14) of Salmonella strains were multidrug-resistant strains. The drug resistance rates of ampicillin and tetracycline were the highest, which were 71.43%（11/14）and 64.29%（10/14）respectively. Conclusions The publicity and education of food safety should be strengthened and the surveillance network system of food-borne disease should be further improved according to the epidemiological and pathogenic characteristics of foodborne illness in Shiyan in 2019, and the use of clinical antibiotics should be controlled reasonably as well.

Food Safety Knowledge, Beliefs and Behaviour among Health Sciences-related Field Undergraduate Students at a Local University (Pengetahuan, Kepercayaan dan Tingkah Laku Keselamatan Makanan dalam Kalangan Pelajar Bidang Berkaitan Sains Kesihatan di Sebuah Universiti Tempatan) / Jurnal Sains Kesihatan Malaysia

@#Foodborne disease is among the primary illness that causes morbidity and mortality in the world. Several studies show that most students do not have adequate food safety knowledge to protect themselves against foodborne diseases. This study aimed to determine the food safety knowledge, behaviour, and beliefs among undergraduate students at a local university in Malaysia. This cross-sectional study involves 121 respondents from three health science-related faculties at the studied institution. The questionnaire was distributed via an online platform. This study used multiple-choiceformat questions for Food Safety Knowledge and a Likert type scale for Food Safety Behaviour and Belief question statements. Most of the respondents were female (78%). About 16% of the respondents have experience working / volunteering in food services, and half of them are involved in food handling during their services. This study recorded a moderate score in all sections (knowledge, behaviour, beliefs) with a total percentage score of 60.3%, 60.3%, and 66.1%, respectively. A strong but not significant correlation between food safety knowledge and beliefs (r = 0.69 p > 0.05) and between food safety knowledge and behaviour (r = 0.83 p > 0.05) were observed. This study is useful as a basis to develop a targeted food safety education program among undergraduate students. Students with high knowledge of food safety will increase food safety beliefs and behaviour, thus preventing them from getting any foodborne illness.

Manejo higiénico de los alimentos y enfermedades de transmisión alimentaria / Hygienic handling of food and foodborne diseases

Las enfermedades transmitidas por alimentos (ETA) constituyen un importante problema de salud pública debido a su alta incidencia a nivel mundial, las directrices para la higiene de los alimentos deben ser aplicadas, no solo por la población en general, sino también por los servicios médicos y sistemas hospitalarios. Por tal razón, esta investigación tiene como objetivo conocer las condiciones de higiene de los alimentos y determinar enfermedades de transmisión alimentaria en una clínica de especialidades médicas en la ciudad de Ambato, Ecuador. La investigación fue observacional, descriptivo, de corte transversal, con una muestra de 117 personas de tres turnos de trabajo, a quienes se le aplicó un cuestionario de higiene alimentaria compuesto por 24 ítems distribuido en cinco (5) categorías, el análisis de los datos fue mediante la estadística descriptiva, aplicando el cálculo porcentual y análisis de distribución de frecuencias. Como resultado se evindeció mayor existencia de protocolo/norma para el lavado de manos (76,65%) y menor para la prohibición de uso de joyas y accesorios (29,91%), a pesar de esto, el cumplimiento de protocolo fue 100,00% en equipo de protección personal, prohibición de uso de joyas y accesorios, uso de uñas cortas, limpias y sin esmalte, accidentes cortopunzantes y manejo higiénico de personal con enfermedades dermatológicas, respiratorias y diarreicas. Por otra parte, se encontró un (1) caso de una intoxicación alimentaria causada por una cepa de la bacteria Scherichia coli enterotoxigénica (ETEC) sin identificación de nexo epidemiológico. Concluyendo, la higiene correcta de alimentos podría evitar la propagación de múltiplies enfermedades(AU)

Foodborne illnessare a major public health problem due to their high incidence worldwide, the guidelines for food hygiene must be applied, not only by the general population, but also by medical services and hospital systems. For this reason, this research aims to know the hygiene conditions of food and determine foodborne illness in a medical specialty clinic in the city of Ambato, Ecuador. The research was observational, descriptive, cross-sectional, with a sample of 117 people from three work shifts, to whom a food hygiene questionnaire composed of 24 items distributed in five (5) categories was applied, the data analysis was through descriptive statistics, applying the percentage calculation and frequency distribution analysis. As a result, there was a greater existence of protocol/norm for hand washing (76.65%) and less for the prohibition of the use of jewelry and accessories (29.91%), despite this, compliance with the protocol was 100.00% in personal protection equipment, prohibition of the use of jewelry and accessories, use of short, clean nails without polish, sharps accidents and hygienic handling of personal with dermatological, respiratory and diarrheal diseases. On the other hand, one (1) case of food poisoning caused by a strain of enterotoxigenic Scherichia coli (ETEC) bacteria without identification of an epidemiological link was found. In conclusion, correct food hygiene could prevent the spread of multiple diseases(AU)

Brote de Salmonella entérica subsp. entérica serovar Give asociado con enfermedad transmitida por alimentos en Vichada, Colombia, 2015 / An outbreak of Salmonella entérica subsp. entérica serovar Give associated with foodborne illness in the department of Vichada, Colombia, 2015

Resumen | Introducción. Salmonella entérica subsp. entérica serovar Give se encuentra en mamíferos rumiantes, cerdos, aves y ambientes acuáticos, pero rara vez en humanos. En Colombia este serotipo ocupó el decimoprimer lugar en frecuencia en la vigilancia por laboratorio de la enfermedad diarreica aguda entre el 2000 y el 2013. Objetivo. Caracterizar el fenotipo y el genotipo de S. Give en aislamientos relacionados con un brote de enfermedad transmitida por alimentos en el departamento de Vichada en la quinta semana epidemiológica del 2015. Materiales y métodos. Se buscó Salmonella spp. en 37 muestras de materia fecal con el método de estudio del Instituto Nacional de Salud. La muestra de sardinas enlatadas fue procesada según la norma ISO6579:2002 Cor.1:2004. Se determinó el serotipo en los aislamientos confirmados mediante serología o PCR en tiempo real, y se hicieron pruebas de sensibilidad a antimicrobianos y electroforesis en gel de campo pulsado con las enzimas Xbal y BlnI. Resultados. Todos los aislamientos de origen humano (11) y el aislamiento del alimento (1), se identificaron como S. Give y este último presentó resistencia a la tetraciclina. El análisis por PFGE-XbaI agrupó bajo el patrón COIN15JEXX01.0005 diez aislamientos de origen humano y a los restantes bajo el COIN15JEXX01.0006, con un 96,3 % de similitud. Los resultados de todos los aislamientos se confirmaron con la enzima BlnI; cuatro de ellos (tres humanos y el del alimento) se agruparon bajo el patrón COIN15JEXA26.002, con un porcentaje de similitud del 95,65 %. Conclusión. El estudio confirmó que las sardinas enlatadas se relacionaron con la transmisión de S. Give en el brote, que es el tercero ocasionado por este serotipo en Colombia.

Abstract | Introduction: Salmonella enterica subsp. enterica serovar Give is found in ruminants, pigs, poultry, and aquatic environments, but rarely in humans. In Colombia, this serotype was ranked 11th. in the laboratory surveillance of acute diarrheal disease between 2000 and 2013. Objective: To characterize phenotypic and genotypic isolates of Salmonella related to an outbreak of foodborne Illness in the department Vichada in the fifth epidemiological week of 2015. Materials and methods: Following the Instituto Nacional de Salud method, we tested 37 fecal samples for Salmonella spp. while the sample of canned sardines was processed according to the ISO 6579:2002 Cor.1:2004 standard. The isolates were confirmed by serology and/or real-time PCR, antimicrobial susceptibility tests, and pulsed-field gel electrophoresis with the XbaI and BlnI enzymes. Results: All human isolates (11) and that from food (1) were identified as S. Give. The food isolate exhibited tetracycline resistance. PFGE analysis with XbaI grouped ten isolates from samples of human origin in pattern COIN15JEXX01.0005 and the remaining isolates in COIN15JEXX01.0006 with 96.3% similarity. All isolates were confirmed with the BlnI enzyme, and four (three human isolates and the one from food) were matched to the pattern COIN15JEXA26.002 with 95.65% similarity. Conclusion: Our study confirmed that canned sardines were related to the transmission of S. Give in the outbreak, which is the third one caused by this serotype in Colombia.

Genotypical characterization of thermotolerant coliforms isolated from food produced by a Solidarity Economic Venture of Bahia (Brazil) / Caracterização genotípica de coliformes termotolerantes isolados de alimentos produzidos por um Empreendimento Econômico Solidário

Abstract Many Solidarity Economic Venture (SEV) are family farmers who seek to add value to production through artisanal processing, which can lead to food contamination. Thus, this study aimed to genotypically characterize thermotolerant coliforms (TtC) strains from food produced by local agribusinesses of SEV during January to April 2019. Samples from thirteen production units (PU) from the SEV were submitted to a microbiological analysis of thermotolerant coliforms (AFNOR 3M1/2 - 09/89), using a fast count method in Petrifilm™ dishes. The Polymerase Chain Reaction (PCR) technique was used to verify the following virulence genes (VGs) associated with Escherichia coli: stx, typical from enterohemorrhagic E. coli (EHEC); bfpA typical from entheropathogenic E. coli (EPEC) and elt and slt, typical from entherotoxigenic E. coli (ETEC). The results showed that two samples of queijadinha (typical Brazilian candy made with eggs and coconut) and one sample of cassava cake presented characteristic colonies TtC. This way, three strains were isolated in order to perform the PCR technique. However, the genes used in the reaction were not detected in the isolated strains. Therefore, it is suggested that the isolated strains are from E. coli pathotypes with different virulence genes than the ones analyzed belong other types of TtC, such as Enterobacter and Klebsiella. Although the virulence of genes has not been confirmed, the presence of TtC on food indicates hygiene flaws during production and, therefore, measurements to control and prevent contamination should be taken.

Resumo Muitos Empreendimentos Econômicos Solidários (EES) são formados por agricultores familiares que buscam agregar valor à produção por meio do beneficiamento artesanal, que pode ocasionar a contaminação dos alimentos. Desta forma, este estudo objetivou caracterizar genotipicamente coliformes termotolerantes (CT) isolados em alimentos produzidos por agroindústrias de um EES no período de janeiro a abril de 2019. Então, foi realizada análise microbiológica de coliformes termotolerantes (AFNOR 3M1/2 - 09/89), utilizando um método contagem de contagem rápida em placas Petrifilm™, em amostras de alimentos de treze Unidades de Produção (UP) do EES. Foram coletadas assepticamente cinco amostras de cada UP, totalizando 65 amostras. Utilizou-se a técnica de Reação em Cadeia de Polimerase (PCR) para verificação dos seguintes genes de virulência de Escherichia coli: stx, característico de E. coli enterohemorrágica (EHEC), bfpA, característico de E. coli enteropatogênica (EPEC) e elt e stI, característicos de E. coli enterotoxigênica (ETEC). Os resultados demonstraram que duas amostras de queijadinha e uma amostra do bolo de aipim apresentaram colônias características de coliformes termotolerantes. Desta forma, foram isoladas três cepas para a realização da PCR, no entanto os genes utilizados nas reações não foram identificados nas cepas isoladas. Portanto, sugere-se que as cepas isoladas sejam de patótipos de E. coli com genes de virulência diferentes dos analisados ou de outro membro dos CT, como Enterobacter e Klebsiella. Apesar de não serem confirmados os genes de virulência analisados, a detecção dos CT nos alimentos indica falhas na higiene durante a produção, portanto medidas para controlar e prevenir a contaminação dos produtos devem ser tomadas.

Contaminación bacteriana de esponja de lavado y bachas de cocina de Cantinas de Escuelas de Asunción y Gran Asunción

RESUMEN Introducción: Las esponjas y el fregadero constituyen un medio favorable para el crecimiento de microorganismos. Objetivo: Evaluar la presencia de microorganismos en esponjas de lavado y bachas de cocina de cantinas de escuelas y colegios de Asunción y gran Asunción. Materiales y Métodos: estudio fue observacional descriptivo de corte transversal. Se tomó muestras de esponjas de lavado e hisopado de bachas de cocina de 25 cantinas de escuelas y colegios públicos y privados de Asunción y gran Asunción. Se utilizo medios de cultivo para bacterias aerobias mesófilas y coliformes fecales, Staphylococcus aureus y Salmonella spp. Se considero contaminación la presencia de ≥100UFC para las bacterias aerobias mesófilas y cualquier crecimiento de bacterias patógenas. El análisis se realizó en Micorsoft Excell utilizando estadísticas descriptivas. Resultados: Fueron incluidas 11 instituciones privadas y 14 públicas. El 88% (22/25 de las esponjas presentaron alta contaminación con bacterias aerobias mesófilas; 20 (80%) con coliformes fecales y 1 (4%) estéril. Hisopados de bachas, 21 (84%) presentaron alta contaminación las mesófilas y 20 (80%) con coliformes fecales, 1 (4%). No se aisló Salmonella spp. ni Staphylococcus aureus. No hubo diferencias en la contaminación de bachas entre instituciones públicas o privadas, pero si en las esponjas 14/14 vs 6/11 en las públicas y privadas respectivamente p=0.008 (T Fisher). Conclusión: esponjas de cocina y las bachas de las escuelas de Asunción y gran Asunción estudiadas, presentaron alto porcentaje de contaminación bacteriana tanto con bacterias aerobias mesófilas como con coliformes fecales. No se aisló Staphylococcus aureus ni Salmonella spp.

ABSTRACT Introduction: Sponges and the sink are a favorable medium for microorganism growth. Objective: To evaluate the presence of microorganisms in washing sponges and kitchen sinks in school cafeterias in Asunción and Greater Asunción. Materials and Methods: This was a descriptive, observational and cross-sectional study. Samples were taken by swabbing from washing sponges and kitchen sinks from 25 public and private school cafeterias in Asunción and the Greater Asunción area. Culture media were used for aerobic mesophilic and fecal coliform bacteria, Staphylococcus aureus and Salmonella species. The presence of ≥100 CFU for mesophilic aerobic bacteria and any growth of pathogenic bacteria was considered contamination. The analysis was performed with Microsoft Excel using descriptive statistics. Results: 11 private and 14 public institutions were included. 88% (22/25 of the sponges presented high contamination with aerobic mesophilic bacteria; 20 (80%) with fecal coliforms and 1 (4%) was sterile. Sink swabs: 21 (84%) presented high contamination with mesophylls and 20 (80%) with fecal coliforms, 1 (4%) was sterile. No Salmonella species or Staphylococcus aureus was isolated. There were no differences in the contamination of sinks between public or private institutions, but in sponges, 14/14 (public) were contaminated vs 6/11 (private), p = 0.008 (T Fisher). Conclusions: kitchen sponges and sinks from the schools of Asuncion and Greater Asuncion area in this study presented a high percentage of bacterial contamination with both aerobic mesophilic bacteria and fecal coliforms. No Staphylococcus aureus or Salmonella species were isolated.

Genotypical characterization of thermotolerant coliforms isolated from food produced by a Solidarity Economic Venture of Bahia (Brazil)

Abstract Many Solidarity Economic Venture (SEV) are family farmers who seek to add value to production through artisanal processing, which can lead to food contamination. Thus, this study aimed to genotypically characterize thermotolerant coliforms (TtC) strains from food produced by local agribusinesses of SEV during January to April 2019. Samples from thirteen production units (PU) from the SEV were submitted to a microbiological analysis of thermotolerant coliforms (AFNOR 3M1/2 09/89), using a fast count method in Petrifilm dishes. The Polymerase Chain Reaction (PCR) technique was used to verify the following virulence genes (VGs) associated with Escherichia coli: stx, typical from enterohemorrhagic E. coli (EHEC); bfpA typical from entheropathogenic E. coli (EPEC) and elt and slt, typical from entherotoxigenic E. coli (ETEC). The results showed that two samples of queijadinha (typical Brazilian candy made with eggs and coconut) and one sample of cassava cake presented characteristic colonies TtC. This way, three strains were isolated in order to perform the PCR technique. However, the genes used in the reaction were not detected in the isolated strains. Therefore, it is suggested that the isolated strains are from E. coli pathotypes with different virulence genes than the ones analyzed belong other types of TtC, such as Enterobacter and Klebsiella. Although the virulence of genes has not been confirmed, the presence of TtC on food indicates hygiene flaws during production and, therefore, measurements to control and prevent contamination should be taken.

Resumo Muitos Empreendimentos Econômicos Solidários (EES) são formados por agricultores familiares que buscam agregar valor à produção por meio do beneficiamento artesanal, que pode ocasionar a contaminação dos alimentos. Desta forma, este estudo objetivou caracterizar genotipicamente coliformes termotolerantes (CT) isolados em alimentos produzidos por agroindústrias de um EES no período de janeiro a abril de 2019. Então, foi realizada análise microbiológica de coliformes termotolerantes (AFNOR 3M1/2 09/89), utilizando um método contagem de contagem rápida em placas Petrifilm, em amostras de alimentos de treze Unidades de Produção (UP) do EES. Foram coletadas assepticamente cinco amostras de cada UP, totalizando 65 amostras. Utilizou-se a técnica de Reação em Cadeia de Polimerase (PCR) para verificação dos seguintes genes de virulência de Escherichia coli: stx, característico de E. coli enterohemorrágica (EHEC), bfpA, característico de E. coli enteropatogênica (EPEC) e elt e stI, característicos de E. coli enterotoxigênica (ETEC). Os resultados demonstraram que duas amostras de queijadinha e uma amostra do bolo de aipim apresentaram colônias características de coliformes termotolerantes. Desta forma, foram isoladas três cepas para a realização da PCR, no entanto os genes utilizados nas reações não foram identificados nas cepas isoladas. Portanto, sugere-se que as cepas isoladas sejam de patótipos de E. coli com genes de virulência diferentes dos analisados ou de outro membro dos CT, como Enterobacter e Klebsiella. Apesar de não serem confirmados os genes de virulência analisados, a detecção dos CT nos alimentos indica falhas na higiene durante a produção, portanto medidas para controlar e prevenir a contaminação dos produtos devem ser tomadas.

Analysis of Food Safety Risk and Its Effect on Health / 沈阳医学院学报

According to the definition of WHO, food safety is a public health problem that affects the health of the human health. Food hygiene is to ensure food safety and harmless to human health, nutrition, health, and to make food be good for the body?s nor?mal needs of nutrition and health. Food hygiene can cause acute poisoning, chronic poisoning, and even carcinogenic, mutagenic effects. Therefore, we should strengthen and improve the legal system of food safety in our country to ensure food safety.

Surtos de salmonelose notificados no período de janeiro de 2009 a julho de 2014 no estado do Paraná, Brasil / Salmonellosis outbreaks reported from january 2009 to july 2014 in the state of Paraná, Brazil / Brotes de salmonelosis notificados en el periodo de enero de 2009 a julio de 2014 en el estado de Paraná, Brasil

A incidência de doenças relacionadas ao consumo de alimentos vem aumentando a cada dia, o que demonstra a importância de estudos que avaliem os agentes etiológicos envolvidos para que se possa traçar estratégias de controle do aparecimento de surtos. A salmonelose é uma enfermidade de grande importância para a saúde pública, sendo importante a sua investigação, visto que seu agente etiológico, a Salmonella spp. é um dos principais micro-organismos envolvidos em surtos de toxinfecções alimentares. Sendo assim, o objetivo do trabalho foi avaliar o número de surtos alimentares ocasionados por Salmonella spp., notificados no Estado do Paraná entre janeiro de 2009 a julho de 2014. Neste período foram notificados 105 surtos de toxinfecção alimentar e desses 19 casos (18,09%) foram confirmados em laboratório como sendo Salmonella spp. No entanto, dentre os surtos de Salmonella spp. ocorridos no período não houve nenhuma notificação de morte ocasionada por este agente. Os resultados demonstram a necessidade de realização de treinamento em Boas Práticas de Fabricação (BPF) para os manipuladores, além do planejamento de ações em educação sanitária para a população consumidora, e a necessidade de um maior controle dos surtos alimentares, para que se possa contribuir efetivamente no controle desse tipo de doença por meio da redução da população exposta ao risco.(AU)

The incidence of diseases related to food consumption is increasing, which shows the importance of studies assessing the etiologic agents involved so that strategies to control outbreaks can be developed. Salmonellosis is a disease of great importance to public health, and its investigation is important, since its etiological agent - Salmonella spp. - is one of the main microorganisms involved in food poisoning outbreaks. Thus, the objective of this study was to evaluate the number of food outbreaks caused by Salmonella spp., reported in the state of Paraná from January 2009 to July 2014. During this period, a total of 105 food poisoning outbreaks were reported, and from these, 19 cases (18.09%) were confirmed in laboratory as Salmonella spp. However, among the outbreaks of Salmonella spp. occurring during the period, there was no notification of death caused by this agent. The results demonstrate the need to have training in Good Manufacturing Practices (GMP) for handlers, in addition to planning activities in health education for the consuming population, as well as the need for greater control of food outbreaks, for effectively contributing to control this disease by reducing the population exposed to the risk.(AU)

La incidencia de enfermedades relacionadas con el consumo de alimentos está aumentando a cada día, lo que demuestra la importancia de estudios que evalúen los agentes etiológicos implicados, para que se pueda trazar estrategias de control del aparecimiento de brotes. La salmonelosis es una enfermedad de gran importancia para la salud pública, es importante su investigación, puesto que su agente etiológico, la Salmonella spp. es uno de los principales microorganismos implicados en brotes de intoxicaciones alimentares. Por lo tanto, el objetivo de este estudio ha sido evaluar el número de brotes por alimentos causados por Salmonella spp., reportados en el Estado de Paraná entre enero de 2009 a julio de 2014. Durante este período se reportaron 105 brotes de intoxicación alimentar, y de esos, 19 casos (18,09%) fueron confirmados en laboratorio como Salmonella spp. Sin embargo, entre los brotes de Salmonella spp. producidos durante el período no hubo ninguna notificación de muerte causada por este agente. Los resultados demuestran la necesidad de llevar a cabo la capacitación en Buenas Prácticas de Manufactura (BPF) para los manipuladores, además de planificaciones de acciones en educación sanitaria para la población consumidora, y la necesidad de un mayor control de los brotes alimentares, para que se pueda contribuir efectivamente en el control de ese tipo de enfermedad, por medio de la reducción de la población expuesta al riesgo.(AU)

Population-based Estimates of Acute Gastrointestinal and Foodborne Illness in Barbados: A Retrospective Cross-sectional Study.

The aim of this study was to determine the burden and impact of acute gastroenteritis (AGE) and foodborne diseases (FBDs) in Barbados through a retrospective, cross-sectional population survey and laboratory study in August 2010–August 2011. Face-to-face interviews were conducted with one person from each of 1,710 randomly-selected households. Of these, 1,433 (84%) interviews were completed. A total of 70 respondents reported having experienced AGE in the 28 days prior to the interview, representing a prevalence of 4.9% and an annual incidence rate of 0.652 episodes per person-year. Age (p=0.01132), season (p=0.00343), and income (p<0.005) were statistically associated with the occurrence of AGE in the population. Norovirus was the leading foodborne pathogen causing AGE-related illness. An estimated 44,270 cases of AGE were found to occur during the period of the study and, for every case of AGE detected by surveillance, an additional 204 cases occurred in the community. Economic costs of AGE ranged from BD$ 9.5 million to 16.5 million (US$ 4.25-8.25) annually. This study demonstrated that the public-health burden and impact of AGE and FBD in Barbados were high and provided the necessary baseline information to guide targeted interventions.

Magnitude, Distribution, and Estimated Level of Underreporting of Acute Gastroenteritis in Jamaica.

Jamaica is the third largest island in the Caribbean. The epidemiology of acute gastroenteritis (AGE) is important to Jamaica, particularly in the areas of health, tourism, and because of the potential impact on the local workforce and the economy. Data collected by the National Surveillance Unit on the prevalence of AGE transmitted by food are not accurate. To determine the true magnitude, risk factors, and the extent of underreporting of AGE in Jamaica, we conducted a cross-sectional, population-based retrospective survey during the periods of 21 February–7 March and 14-27 June 2009, corresponding to high- and low-AGE season respectively. Of the total 1,920 persons selected randomly by a multistage cluster-sampling process, 1,264 responded (response rate 65.8%). Trained interviewers administered a standardized, validated questionnaire during face-to-face interviews. The overall prevalence of self-reported AGE was 4.0% (95% CI 2.9-5.1) at a rate of 0.5 episodes/per person-year. The highest monthly prevalence of AGE (14.6%) was found among the 1-4 year(s) age-group and the lowest (2.1%) among the 25-44 years age-group. Of the 18 cases (36%) who sought medical care, 11% were hospitalized, 33% were treated with antibiotics, and 66.7% received oral rehydration fluids. Only 2 cases who sought medical care reportedly submitted stool specimens. The mean duration of diarrhoea was 3.1 days, which resulted in a mean loss of 4 productive days, with over half of the cases requiring someone to care for them. The burden of syndromic AGE for 2009 was extrapolated to be 122,711 cases, showing an underreporting factor of 58.9. For every laboratory-confirmed AGE case, it was estimated that 383 more cases were occurring in the population. This research confirms that the prevalence of AGE is underreported in Jamaica and not being adequately detected by the current surveillance system. The components of the integrated surveillance system for AGE in Jamaica, particularly the laboratory aspect, need to be strengthened.

Burden and Impact of Acute Gastroenteritis and Foodborne Pathogens in Trinidad and Tobago.

Objectives of this study were to determine the burden and impact of acute gastroenteritis (AGE) and foodborne pathogens in Trinidad and Tobago. A retrospective, cross-sectional population survey, based on selfreported cases of AGE, was conducted in November-December 2008 and May-June 2009 (high- and low- AGE season respectively) by face-to-face interviews. From 2,145 households selected to be interviewed, the response rate was 99.9%. Of those interviewed, 5.1% (n=110; 95% CI 4.3-6.2) reported having AGE (3 or more loose watery stools in 24 hours) in the 28 days prior to the interview (0.67 episodes/person-year). Monthly prevalence of AGE was the highest among children aged <5 years (1.3 episodes/year). Eighteen (16%) persons with AGE sought medical care (4 treated with oral rehydration salts and 6 with antibiotics), and 66% reported restricted activity [range 1-16 day(s)]. The mean duration of diarrhoea was 2.3 days (range 2-10 days). One case submitted a stool sample, and another was hospitalized. Overall, 56 (10%) AGE specimens tested positive for foodborne pathogens. It was estimated that 135,820 AGE cases occurred in 2009 (84% underreporting), and for every 1 AGE case reported, an additional 6.17 cases occurred in the community. The estimated economic cost of AGE ranged from US$ 27,331 to 19,736,344. Acute gastroenteritis, thus, poses a huge health and economic burden on Trinidad and Tobago.

Pesquisa de micro-organismos indicadores de condições higienicossanitárias, no processamento e comercialização de gelados comestíveis / Research on indicator microorganisms of hygienic-sanitary conditions in the processing and marketing of edible ice cream

Na cidade de Palmas -TO existe número considerável de pequenas indústrias de gelados comestíveis, porém não há dados que comprovem boas condições higienicossanitárias, que devem ser adotadas durante o processamento desses alimentos. Neste contexto, objetivou-se avaliar as condições higienicossanitárias do processamento de gelados comestíveis de uma indústria de pequeno porte. Foram realizadas análises para pesquisa de coliformes, contagem de Estafilococos coagulase-positiva e pesquisa de Salmonella sp. na água, mãos dos manipuladores, polpa de frutas, sorvete\picolé, equipamentos e carrinhos transportadores de sorvetes e picolés. A análise das mãos dos manipuladores não apresentou contaminação fecal e a pesquisa de Estafilococos coagulase-positiva indicou ausência de patógeno. Tanto para água quanto para polpa de frutas, sorvetes e picolés, as amostras estavam dentro do padrão federal. Na análise dos equipamentos houve maior contagem de coliformes totais para o equipamento cinco (pote de sorvete de 5L). A variação quanto à contaminação por coliformes em 4 das 17 amostras dos carrinhos de picolé e sorvete pode ser reflexo da má higienização feita pelos ambulantes. Em todas as análises realizadas houve, relativamente, baixa contagem de micro-organismos, devendo-se atentar à higiene das mãos dos manipuladores, bem como dos carrinhos transportadores de picolés e sorvetes.

In the city of Palmas - TO there is considerable number of small icedfood industries, but there is no data to show good hygienic-sanitary conditions that must be followed during the food processing. In this context, the objective was to evaluate the iced-food hygienic-sanitary processing conditions at a small industry. We performed tests for coliform count, coagulase-positive Staphylococci and Salmonella sp. in water, food handlers, fruit pulp, ice cream / popsicle, equipment and trolleys of ice cream and popsicles. The hands analysis of food handlers showed no fecal contamination and the research of coagulase-positive Staphylococci showed no pathogen. So much for water as for fruit pulp, ice cream and popsicles, the samples are within the federal pattern. In the analysis of the equipment there were higher counts of total coliforms for the equipment five (5L pot for packing ice cream). The variation in a coliform contamination in 4 out of 17 samples of ice cream and popsicle carts may be a reflection of miscarried hygiene made by street sellers. In all data analysis there were relatively low number of microorganisms, and attention to hand hygiene of food handlers, as well as trolleys popsicles and ice cream must be taken seriously.

Microbiological Assessment of Home-Delivered Meals for Children from Low-income Families during Production and Delivery

The purpose of this study was to assess the microbiological quality of home-delivered meals during production and delivery for children from low-income families. Production flows from a facility in Seoul that provides home-delivered meals were analyzed and the time-temperature of the food was measured. Microbiological assessment was performed for the production environment, personal hygiene, and food samples at each production and delivery step based on the process approach. It took 2 hours or longer from completion of production to meal delivery. An aerobic colony count (ACC) and coliform were not detected at knives, cutting boards, and dish towels. However, ACC (at pre-preparation, preparation, and packing areas) and coliform (at the preparation area) were detected on the hands and gloves of employees. Air-borne bacterial counts varied according to day and preparation area (ND~6 CFU/plate/15 min). Food temperatures, on the completion of production and meal delivery, fell into temperature danger zones. ACC and coliform counts of raw ingredients did not decrease after pre-preparation (washing and sanitizing) for menus involving food preparation with no cook step. ACC decreased after cooking step for menus of food preparation with cook step, but the ACC of the stir-fried and seasoned dried filefish fillet on the completion of cooking was too numerous to count due to improper heating. The ACC of seasoned young Chinese cabbages (a menu with complex food preparation) increased during delivery (from 2.5 log CFU/ml to 5.0 log CFU/ml). This qualitative assessment of foodborne pathogens revealed that B. cereus was detected in vegetable and meat product menus. These results suggest time-temperature control is necessary during production and delivery and management guidelines during production of home-delivered meals are provided for safe production.

Avaliação molecular de norovírus em pacientes com gastroenterite aguda / Molecular evaluation of norovírus in patients with acute gastroenteritis

INTRODUÇÃO: O norovírus foi recentemente identificado como o principal causador de surtos de gastroenterite aguda de origem não bacteriana em todo o mundo e está envolvido em episódios de origem alimentar. Neste estudo, foram avaliados pacientes com sintomas de gastroenterite aguda pelo período de um ano, a fim de se avaliar duas metodologias na identificação do NoV - a reação em cadeia por polimerase convencional e em tempo real -, incidência, sazonalidade e genótipo predominante. MÉTODOS: Após a extração do RNA, 50 amostras foram analisadas pela metodologia de PCR convencional e 365 amostras foram analisadas pela metodologia de PCR em tempo real. Todas as amostras que apresentaram resultado positivo pelas duas metodologias ou discordante foram sequenciadas, ao todo, 13 amostras foram sequenciadas. RESULTADOS: Das 50 amostras testadas pelas duas metodologias, 7 apresentaram resultado positivo pelo método convencional e 15 pelo método da PCR em tempo real. Do total de 365 amostras testadas pela metodologia de PCR, em tempo real, 48 foram positivas. Em relação às amostras sequenciadas, todas mostraram ser NoV do genogrupo II. Em relação à distribuição da incidência de amostras, positivas para NoV, ao longo do ano, pôde ser observada uma frequência de casos positivos maior na primavera, chegando a 29,7 por cento em novembro. CONCLUSÕES: Observamos que o PCR em tempo real é o método mais sensível para a identificação do Nov, que a incidência do NoV é de 13,2 por cento e o genogrupo II prevalece na população avaliada, sendo a primavera o período de maior taxa de infecção.

INTRODUCTION: Norovírus was recently identified as the main cause of outbreaks of acute gastroenteritis of non-bacterial origin worldwide and it is involved in episodes of foodborne origin. In this study, patients with symptoms of acute gastroenteritis were evaluated over a one-year period, in order to evaluate two methods for identifying norovírus (real-time and conventional polymerase chain reaction), along with its incidence, seasonality and predominant genotype. METHODS: After RNA extraction, 50 samples were analyzed using conventional PCR and 365 were analyzed using real-time PCR. All the samples that presented positive results using both methods or discordant results were sequenced. In all, 13 samples were sequenced. RESULTS: Out of the 50 samples tested using both methods, seven presented a positive result from the conventional method and 15 from real-time PCR. Out of the total of 365 samples tested using real-time PCR, 48 were positive. All of the sequenced samples were shown to present norovírus of genogroup II. Regarding the distribution of norovírus-positive sample incidence over the course of the year, higher frequency of positive cases was observed during the southern hemisphere spring, reaching 29.7 percent in November. CONCLUSIONS: We observed that real-time PCR was more sensitive for identifying norovírus. The incidence of norovírus was 13.2 percent and genogroup II predominated among the population evaluated, with the greatest infection rate in the southern hemisphere spring.

Un probiótico definido aumenta la exclusión de Salmonella enterica serovariedad Enteritidis durante la crianza de aves ligeras / Enhancement of competitive exclusion by a defined probiotic on Salmonella enterica serovar Enteritidis colonization during rearing of Leghorn chicks

Competitive exclusion degree from a defined (DP) and undefined probiotic (UDP) administered to one-day Leghorn chicks and challenged with 1 x 10(8) CFU of Salmonella enterica serovar Enteritidis fagotype 13A (SE) was evaluated. Birds with DP at 20 day old showed 21.7% of SE positive isolates in liver-spleen (LS), less than 51.7% recorded from birds without any probiotic. In a second study, birds that received DP living together with a group inoculated with SE at third day old, showed 7.5% infection in LS at 13 day of age and 12.5% at 15 day. Whereas, SE inoculated group had 75% and 57.5% of SE isolates, respectively. A third group, living with the last two, without DP or SE showed 27.5% of SE in LS at 13 day, and only 10% at 15 day of age. DP group at 13 day of age, showed a decrease of 75% of SE colonization at cecal tonsils (CT), instead, SE inoculated group was 100% colonized; at 15 day of age, DP decreased 51.4% of SE colonization in CT, while control group showed a decrease of 42.5%, and 68.6% of SE in CT at 13 and 15 days, respectively. In a third study, a DP booster group was dosed three times, at 14 days of age, it had only 4.5% of SE isolates from LS. Birds without DP showed 34.6% of SE isolates, and the group inoculated with only one dose had 17.2% of SE positive birds. DP booster group showed 22.7% of SE in CT, the group with one dose had 62% of SE isolates; birds without DP decreased only 3.9% of SE colonization. DP showed greater margin of protection, decreased horizontal transmission of SE PT13A in LS and CT, and it has good transmission potential. DP booster treatment was better than only one dose. DP is a good alternative for SE prevention and eradication in commercial poultry.

Se determinó el grado de exclusión de un probiótico definido (PECD) y otro no definido (PECND) administrados a aves de la raza Leghorn, de un día de edad, sobre el desafío con 1 x 10(8) UFC de Salmonella enterica serovariedad Enteritidis fagotipo 13A (SE). Las aves con PECD al día 20 mostraron 21.7% de aislamientos positivos de SE en hígado-bazo (HB), menor al 51.7% observado en las aves sin probiótico. En un segundo estudio, las aves que recibieron el PECD y convivieron en piso con un grupo inoculado con SE desde el día tres, mostraron una infección en HB de 7.5% al día 13 y 12.5% al día 15 de edad, el grupo inoculado mostró 75% y 57.5% de SE, respectivamente. Un tercer grupo que convivió con los dos anteriores y no recibió probiótico ni SE, mostró 27.5% de SE en HB al día 13 y sólo 10% al día 15. El grupo con el probiótico muestra una reducción de 75% de SE en tonsilas cecales (TC) al día 13, mientras que el inoculado fue 100% colonizado; al día 15, el probiótico redujo 51.4% la colonización, mientras que el testigo mostró una reducción de 42.5% al día 13 y de 68.6% al día 15. En un tercer estudio un grupo redosificado tres veces, al día 14 de edad disminuyó el porcentaje de aislamientos de SE en HB a tan sólo 4.5%. Las aves que no recibieron el probiótico mostraron 34.6% de SE y las aves que lo recibieron una sola vez mostraron 17.2%. El grupo con refuerzo mostró 22.7% de colonización en TC, el grupo con una dosis mostró 62% de aves positivas a SE, las aves sin probiótico redujeron sólo 3.9% esta colonización. El grupo con PECD muestra mayor margen de protección, reduce la transmisión horizontal de SE PT13A en HB y TC; exhibe además un buen potencial de transmisión. El refuerzo de dosificación del PECD fue mejor que una sola toma. El PECD constituye una buena alternativa en la prevención y erradicación de la SE en la avicultura comercial.

La radiación a la mesa / Radiation on the dining table

Zero tolerance to bacterial contamination means considering the acceptance of "radiation on the table". The process of food irradiation has been extensively studied, nevertheless its use remains a matter of some controversy. Despite unanimous agreement within the medical community of the safety of this procedure, occasional concerns arise from the consumers. Acommon consumer misconception is that irradiationmay turn the food "radioactive". A significant number of scientific studies on the topic were analyzed. We found no scientific study demonstrating that consumption of irradiated food might pose a risk to consumers. All studies conclude that food irradiation at the appropriate dose required to reduce contamination is safe and does not affect its nutritional valué. In order to emphasize the issue we discuss the potential benefit vs harm of irradiation of food contaminated with E. coli 0157: H7. The association of this bacteria with severe disease and death has been clearly established in contrast with the lack of a demonstrated risk due to meat irradiation. We conclude that the risks of food irradiation remains "unknown" simply because, after four decades of research, none has been identified. In contrast to the risks of acquiring a food transmitted bacterial disease, the risk of irradiation is negligible.

Tolerancia cero a la contaminación bacteriana implica considerar la inclusión de "la radiación a la mesa". La irradiación es uno de los métodos de procesado de alimentos que se han estudiado de forma más extensa y estricta; sin embargo, su aplicación sigue siendo materia de discusión. Incluso si la inocuidad está bien establecida (hay acuerdo unánime entre la comunidad científica), de vez en cuando surgen preguntas de los consumidores. Es importante destacar que no hay ningún estudio científico consistente y reproducible, que demuestre o sugiera que el consumo de un alimento irradiado podría suponer un riesgo para la salud de los consumidores. Creemos que esta revisión es un aporte importante al conocimiento. Es necesario desmentir los errores generalizados sobre la irradiación, especialmente la idea de que los alimentos se tornan radioactivos. Se analizó una cantidad considerable de investigaciones científicas difundidas en publicaciones especializadas. De ellas surge que los alimentos irradiados con la dosis necesaria para alcanzar el objetivo mi-crobiológico deseado, se consideran inocuos y saludables para el consumo y adecuados desde un punto de vista nutricional. Para ser más claros, nadie pondría en duda que Escherichia coli 0157: H7 puede causar la muerte, la carne irradiada no. En definitiva, los riesgos de la irradiación de los alimentos son desconocidos, simplemente porque después de cuatro décadas de investigaciones, no se ha encontrado ninguno. Este es un argumento de suficiente peso, contra los riesgos conocidos de contraer una enfermedad bacteriana transmitida por alimentos.

Brote de diarrea debida a intoxicación por alimentos en una empresa X: San José, Costa Rica, del 8 al 9 de julio 2003 / Outbreak of diarrhea due to food poisoning at a company for San José, Costa Rica, from 8 to 9 July 2003

El 9 de julio del 2003, se informó al Ministerio de Salud, la existencia de un brote de diarrea en una empresa X, en San José. Se investigó el brote, con el objetivo de verificar su mangnitud, determinar factores de riesgo y mecanismo de transmisión, también recomendar medidas de prevención y control, a las autoridades de salud. Se revisaron 40 expedientes clínicos de pacientes atendidos por diarrea, en el consultorio de la empresa. Se definió como caso a todo funcionario, que presentó más de 2 deposiciones semilíquidas, y que consumió alimentos del comedor de la empresa, el 8 julio del 2003. Se tomaron corpocultivos, muestras de alimentos consumidos, y se enviaron a un laboratorio privado para el análisis. Se realizó un estudio de cohorte retrospectivo, y se aplicó un cuestionario. Se calcularon los riesgos relativos, RR, con intervalos de confianza del 95 por ciento, las tasas de ataque y porcentajes para los alimentos servidos. El 100 por ciento de los casos presentaron diarrea, sin fiebre. A los coprocultivos y a las muestras de alimentos, no se les buscó Clostridium perfringens. Las muestras de agua no reportaron contaminación fecal. El alimento sospechoso: cerdo con piña, presentó un RR igual 1,94; IC: 95 por ciento, 1, 26-2,96. El período de incubación y la descripción de la enfermedad coincidieron con una intoxicación por Clostridium perfringens, por lo que, se asoció el brote al alimento sospechoso. Como en la empresa X se desconocían los procedimientos a seguir ante un brote de diarrea, causado por alimentos, se recomendó a los encargados de epidemiología del Área Rectora de Salud, capacitar en el abordaje de las intoxicaciones causadas por alimentos; a las empresas bajo su responsabilidad, que cuentan con establecimientos de alimentación.

On July the 9th., 2003, an outbreak in company X was notified to the Ministry of Public Health in San José. This outbreak was investigated with thepurposes of verifying its magnitude, determining risk factors, and mechanisms of transmission as well asrecommending prevention and control measures to the Local Health authorities. Forty clinical chartsbelonging to diarrhea patients seen at the company´s infirmary, were reviewed. The case definition was anyworker with more than 2 semi-liquid bowel movements and who ate in the worker´s dining room on the 8th.of July, 2003. Stool and food cultures were taken and sent for analysis to a private lab. A retrospective cohort study was carried out and a questionnaire wasadministered to the employees. Relative Risks (with 95% confidence intervals) as well as attack rates and percentages were calculated for the foodstuffs served. All cases showed diarrhea but without fever. Clostridium perfringens was not searched in either thestool or the food cultures. Water samples didn´t report fecal contamination. The likely source of contamination, namely pineapple pork, showed a relative risk of 1.94 with a confidence interval between 1.26 and 2.96. The incubation period as well as the clinical characteristics of the illness were consistent with an intoxication dueto Clostridium perfringens. Since the employees were unaware of the procedures to be followed duringa foodborne outbreak, training was offered to the Local Health Area which in turn, educated the companies under its supervision regarding protocols to be followed during any future similar problems.