Two Listeria monocytogenes outbreaks in a cancer centre: onsite food premises and their potential health risk to patients.

BACKGROUND: This report describes two L. monocytogenes outbreak investigations that occurred in March and September of 2018 and that linked illness to a food premises located in an Ontario cancer centre. The cancer centre serves patients from across the province. METHODS: In Ontario, local public health agencies follow up with all reported laboratory-confirmed cases of listeriosis to identify possible sources of disease acquisition and to carry out investigations, including at suspected food premises. The Canadian Food Inspection Agency (CFIA) is notified of any Listeria-positive food product collected in relation to a case. The CFIA traces Listeria-positive product through the food distribution system to identify the contamination source and ensure the implicated manufacturing facility implements corrective measures. RESULTS: Outbreaks one and two each involved three outbreak-confirmed listeriosis cases. All six cases were considered genetically related by whole genome sequencing (WGS). In both outbreaks, outbreak-confirmed cases reported consuming meals at a food premises located in a cancer centre (food premises A) before illness onset. Various open deli meat samples and, in outbreak two, environmental swabs (primarily from the meat slicer) collected from food premises A were genetically related to the outbreak-confirmed cases. Food premises A closed as a result of the investigations. CONCLUSIONS: When procuring on-site food premises, healthcare facilities and institutions serving individuals with immuno-compromising conditions should consider the potential health risk of foods available to their patient population.

BALANCE (Bioengineering Approaches for Lifestyle Activity and Nutrition Continuous Engagement): developing new technology for monitoring energy balance in real time.

Methods that measure energy balance accurately in real time represent promising avenues to address the obesity epidemic. We developed an electronic food diary on a mobile phone that includes an energy balance visualization and computes and displays the difference between energy intake from food entries and energy expenditure from a multiple-sensor device that provides objective estimates of energy expenditure in real time. A geographic information system dataset containing locations associated with activity and eating episodes is integrated with an ArcPad mapping application on the phone to provide users with a visual display of food sources and locations associated with physical activity within their proximal environment. This innovative tool captures peoples' movement through space and time under free-living conditions and could potentially have many health-related applications in the future.

BALANCE: Towards a Usable Pervasive Wellness Application with Accurate Activity Inference.

Technology offers the potential to objectively monitor people's eating and activity behaviors and encourage healthier lifestyles. BALANCE is a mobile phone-based system for long term wellness management. The BALANCE system automatically detects the user's caloric expenditure via sensor data from a Mobile Sensing Platform unit worn on the hip. Users manually enter information on foods eaten via an interface on an N95 mobile phone. Initial validation experiments measuring oxygen consumption during treadmill walking and jogging show that the system's estimate of caloric output is within 87% of the actual value. Future work will refine and continue to evaluate the system's efficacy and develop more robust data input and activity inference methods.