[One Case for Two]. / Ein Fall für zwei.

One Case for Two Abstract. We report on a 59-year-old patient with a rash, hypotension and chest pain after eating tuna fish. A diagnosis of scombroid fish poisoning was made. It is a syndrome resembling an allergic reaction that occurs after eating fish of the Scombridae family contaminated with high levels of histamine. The authorities responsible for food safety should be immediately informed in order to investigate the event from their perspective, i.e. inspect selling premises, sample and test implicated food, as well as to take appropriate measures. Anaphylaxis rarely manifests as a vasospastic acute coronary syndrome, called Kounis syndrome.

Detection of Hepatitis E Virus RNA in Raw Cured Sausages and Raw Cured Sausages Containing Pig Liver at Retail Stores in Switzerland.

Hepatitis E virus (HEV) is the causative agent of an acute and self-limiting hepatitis and is increasingly detected in food products containing pork. In this study, 102 raw sausages containing pig liver (mortadella di fegato) and 18 raw pork sausages (salami type sausage) collected at retail level in a region of southern Switzerland were screened for the presence of HEV by quantitative real-time reverse transcription PCR. HEV was detected in 12 (11.8%) of 102 mortadella di fegato products but not in any of the salami sausages. Viral loads in the mortadella di fegato sausages ranged from log HEV 2.3 to 5.7 genome copies per gram of food product. This study identifies mortadella di fegato type sausages made with raw pig liver as a potential source of HEV infection in humans.

Complete Genome Sequences of Two Swiss Hepatitis E Virus Isolates from Human Stool and Raw Pork Sausage.

We present here the full-length genome sequences of two hepatitis E virus genotype 3 (HEV-3) isolates from a human stool sample from a patient with acute hepatitis and a raw sausage containing pig liver. Sequence analysis implies that Swiss HEV isolates may form a novel subgroup of HEV-3 viruses.

Full-Genome Sequence of Listeria monocytogenes Strain H34, Isolated from a Newborn with Sepsis in Uruguay.

The foodborne pathogen Listeria monocytogenes causes severe disease mainly in the vulnerable populations of the young, old, pregnant, and immunocompromised. Here, we present the genome sequence of L. monocytogenes H34, a serotype 1/2b, lineage I, sequence type 489 (ST489) strain, isolated from a neonatal sepsis case in Uruguay.

Local Outbreak of Listeria monocytogenes Serotype 4b Sequence Type 6 Due to Contaminated Meat Pâté.

In January and February 2016, five cases of confirmed and two cases of probable infection due to Listeria monocytogenes serotype 4b, sequence type (ST) 6 belonging to a single pulsed-field gel electrophoresis pulsotype pattern were registered in a region of southern Switzerland. L. monocytogenes was detected in blood samples (four cases) and pleural fluid (one case). Furthermore, L. monocytogenes 4b ST6 was detected in a stool sample of an asymptomatic person exposed to a common food. Forthwith, the food safety authority and a local gourmet meat producer reported L. monocytogenes contamination of meat pâté. Analysis of further food and environmental samples from the premises of the producer yielded isolates matching the clinical strains and confirmed the presence of L. monocytogenes 4b ST6 in the mincing machine as the cause of the food contamination.

Further evidence for staphylococcal food poisoning outbreaks caused by egc-encoded enterotoxins.

Staphylococcal food poisoning represents the most prevalent foodborne intoxication worldwide. It is caused by oral intake of enterotoxins preformed by Staphylococcus aureus in food. The relevance of newly described enterotoxins in outbreaks of staphylococcal food poisoning is controversially discussed. Although the staphylococcal enterotoxins SEG, SEI, SEM, SEN, and SEO elicit emesis in a monkey feeding assay, there has been no conclusive proof of their emetic activity in humans. In this study, we provide further evidence suggesting that one of these enterotoxins or a combination of SEG, SEI, SEM, SEN, and SEO cause staphylococcal food poisoning. We investigated two outbreaks registered with the Swiss Federal Office of Public Health, in which only Staphylococcus aureus strains harboring the egc cluster, including seg, sei, sem, sen, and seo linked to typical signs of staphylococcal food poisoning were isolated. The outbreaks were caused by consumption of raw goat cheese and semi-hard goat cheese, and were linked to strains assigned to CC45 (agr type I) and CC9 (agr type II), respectively. These outbreaks provide further evidence that newly-described staphylococcal enterotoxins are likely to cause staphylococcal food poisoning in humans.

Питание и здоровье в Европе: новая основа для действий

В данной публикации, предназначенной для работников здравоохранения, всесторонне рассматриваются различные аспекты политики в области пищевых продуктов и питания и приводятся соответствующие фактические данные. В ней затрагиваются вопросы ухудшения состояния здоровья, вызванного пищевыми продуктами и питанием, и связанных с этим затрат, обосновывается необходимость принятия мер и предлагаются конкретные действия, которые могут предприниматься лицами, определяющими политику. Особое внимание в публикации уделяется насущной необходимости выработки комплексной политики в области пищевых продуктов и питания с участием различных секторов в целях стабильного и непрерывного производства продуктов питания, их безопасности и обеспечения всех людей пищевыми продуктами высокого качества и питательной ценности. Краткое содержание данной публикации для лиц, разрабатывающих и определяющих политику, опубликовано в 2002 г. на англ. яз. и рус. яз. Плохое питание, болезни, передаваемые через пищевые продукты, и отсутствие безопасного доступа к доброкачественным пищевым продуктам являются весьма важной составляющей бремени болезней и смертности в Европейском регионе ВОЗ. Улучшение рациона и режима питания, безопасность пищевых продуктов и обеспеченность продуктами питания не только уменьшат или предотвратят страдания отдельных людей и населения в целом, но и помогут сократить расходы и издержки систем здравоохранения и обеспечить социально-экономические выгоды и преимущества для стран.

Food and health in Europe: a new basis for action.

Poor nutrition, foodborne disease and lack of secure access to good food make an important contribution to the burden of disease and death in the WHO European Region. Better diets, food safety and food security will not only reduce or prevent suffering to individuals and societies but also help cut costs to health care systems and bring social and economic benefits to countries. People's chances for a healthy diet depend less on individual choices than on what food is available and whether it is affordable. Policies to benefit health through good food and nutrition must extend beyond the health sector to include sectors ranging from agriculture and food processing, manufacturing and trade to transport, retailing, catering and advertising. Food and nutrition policies should be coordinated so that public health is given due priority in the making of food policies by non-health sectors. This publication discusses in depth the components of food and nutrition policies and the evidence supporting them. It describes food- and nutrition-related ill health and its costs, shows the need for action and describes the steps for decision-makers to take. This book highlights the urgent need for integrated, multisectoral food and nutrition policies to encourage the sustainable production of food, its safety and the provision of food of high nutritional quality for all.

Food and health in Europe: a new basis for action

Aimed at health professionals, this publication discusses in depth the components of food and nutrition policies and the evidence supporting them. It describes food- and nutrition-related ill health and its costs, shows the need for action and describes the steps for decision-makers to take. This book highlights the urgent need for integrated, multisectoral food and nutrition policies to encourage the sustainable production of food, its safety and the provision of food of high nutritional quality for all. A summary of the book’s content, aimed at policy-makers, was published in English and Russian in 2002. Poor nutrition, foodborne disease and lack of secure access to good food make an important contribution to the burden of disease and mortality in the WHO European Region. Better diets, food safety and food security will not only reduce or prevent suffering to individuals and societies but also help cut costs to health care systems and bring social and economic benefits to countries.

Assessment of dietary exposure to some persistent organic pollutants in the Republic of Karakalpakstan of Uzbekistan.

A 1999 study heightened long-standing concerns over persistent organic pollutant contamination in the Aral Sea area, detecting elevated levels in breast milk and cord blood of women in Karakalpakstan (western Uzbekistan). These findings prompted a collaborative research study aimed at linking such human findings with evidence of food chain contamination in the area. An international team carried out analyses of organochlorine and organophosphate pesticides, polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs), and polychlorinated dibenzofurans (PCDFs) on samples of 12 foods commonly produced and consumed in Karakalpakstan. Analysis consistently detected long-lasting organochlorine pesticides and their metabolites in all foods of animal origin and in some vegetables such as onions and carrots--two low-cost components of many traditional dishes. Levels of PCBs were relatively low in all samples except fish. Analyses revealed high levels of PCDDs and PCDFs (together often termed "dioxins") in sheep fat, dairy cream, eggs, and edible cottonseed oil, among other foodstuffs. These findings indicate that food traditionally grown, sold, and consumed in Karakalpakstan is a major route of human exposure to several persistent toxic contaminants, including the most toxic of dioxins, 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD). Intake estimations demonstrate that consumption of even small amounts of locally grown food may expose consumers to dioxin levels that considerably exceed the monthly tolerable dioxin intake levels set by the World Health Organization. Data presented in this study allow a first assessment of the risk associated with the consumption of certain food products in Karakalpakstan and highlight a critical public health situation.

Hazards and Critical Control Points of Food Vending Operations in a City in Zambia.

Hazard analyses were conducted at several cooked food vending operations in a large city in Zambia, near a downtown bus park and at a large market. Samples of raw, processed, and cooked foods sold on streets or by small food shops were collected and tested for common foodborne pathogens and indicator organisms. Results showed that some raw foods (ground meat, chicken, chicken intestine) or processed foods (dried minnows; kapenta) were contaminated by salmonellae or contained high populations of Staphylococcus aureus (pasteurized milk) or Bacillus cereus (caterpillars). Cooking usually gave time-temperature exposures that would have been lethal for vegetative forms of foodborne pathogens. Holding of foods other than nshima often provided time-temperature exposures conducive to microbial growth, particularly in foods held overnight. Large populations of aerobic mesophilic organisms, thermotolerant coliform bacteria, and sometimes Escherichia coli were recovered from these foods. Ten million Clostridium peifringens per gram were isolated from a sample of leftover beef stew. Large populations (> 105) of S. aureus were recovered from a sample of leftover chicken, and large populations of B. cereus (> 107) were isolated from leftover rice. Time-temperature exposures during reheating had variable effects in terms of killing the microorganisms that germinated from surviving spores or that reached the foods after cooking, but heat-stable toxins would not have been inactivated.

Hazards and Critical Control Points of Food Preparation in Homes in Which Persons Had Diarrhea in Zambia.

Following identification of some cases of diarrhea from persons who either sought treatment at a health clinic that served two townships near a large city in Zambia or got water from a deep protected well in one of the townships, hazard analyses were done of food preparation and storage practices at 17 homes. Samples of foods at various stages of preparation, foods held overnight, and drinking water were collected from the homes of the ill persons and were tested for common foodborne pathogens and indicator organisms. Salmonella was isolated from a sample of leftover kapenta (cooked dried minnows). Thermotolerant coliforms and Escherichia coli were isolated from water from shallow wells and a treated community supply. Although thermtolerant coliforms were not recovered from the protected well site, they were isolated from a sample of water collected in a home that used this supply. Several leftover foods, however, contained much larger populations of thermotolerant coliforms and larger populations of aerobic mesophilic organisms than the water. Furthermore, leftover nshima (boiled and whipped corn meal) and porridge contained large populations (>105) of Bacillus cereus per gram. Foods during cooking attained temperatures that would have been lethal to vegetative cells of foodborne pathogens. After cooking, they were subjected to time-temperature abuse during holding until eaten or while held overnight.

Hazards Associated with Holding and Reheating Foods at Vending Sites in a Small Town in Zambia.

Hazard analyses were done at 11 cooked-food-vending sites and related food-vending operations in a small-town market along a highway in Zambia. The analyses consisted of observations and time-temperature measurements at the vending sites and interpretations of results of laboratory tests of samples of foods (including leftovers) collected after holding and reheating. Salmonellae were isolated from dried ants, a cooked meatball on display, and pumped river water used by the vendors. Ants for sale at the market contained 107 Bacillus cereus cells per g. Nshima (boiled maize meal) was held at high temperatures in pans over glowing charcoal in which steam was generated throughout the entire holding period during the day, preventing bacterial growth. Large populations of B. cereus , however, were isolated from a sample left overnight at ambient room temperature. Cooked foods other than nshima were held at room or outdoor ambient temperatures throughout the day and overnight. High aerobic mesophilic colony, thermotolerant coliform and, in a few foods, Escherichia coli counts were found in foods after several hours of holding during the day of preparation and of foods held overnight. Temperatures attained during reheating were variable and sometimes would have resulted in survival of foodborne pathogens that multiplied during holding.

Detection, Isolation and Identification of Osmotolerant Yeasts from High-Sugar Products.

A simple presence-absence test for detection of small numbers of osmotolerant yeasts in foods was developed. Yeast extract glucose 50 broth [consisting of 0.5% (w/w) yeast extract and 50% (w/w) glucose] was used as enrichment medium and was incubated with agitation at 30°C. The detection was done by (a) microscope and (b) streaking 0.03 ml of enrichment culture on selective yeast extract glucose 50 agar and incubation at 30°C for 5-7 d. If no yeast cells were observed under the microscope within 10 d of incubation, the product sample was judged as "free from osmotolerant yeasts." In accordance with this method 28 strains of osmotolerant yeasts were isolated from 27 spoiled high-sugar products. Twenty-four strains were identified as Zygosaccharomyces rouxii , 2 Zygosaccharomyces bailii and 1 each as Torulaspora delbrueckii and Debaryomyces hansenii .

Influence of Prolonged Culture Storage on the Osmotolerance of Zygosaccharomyces Yeasts.

To record the effects of prolonged culture storage on the sugar tolerance of Zygosaccharomyces rouxii and Z. bailii , the fermentation behavior of three freshly isolated strains in four different glucose broths (aw values; 0.963, 0.936, 0.909 and 0.858, respectively) was compared with that of the same strains after 2 years of storage (a) on high-sugar agar slants with repeated subculturing and (b) in Biomalt (liquid malt extract) without subculturing. The trials with stock strains resulted in large reductions of both ethanol yield and production rate. Cells stored in liquid malt extract showed a slightly faster and stronger fermentation than cells maintained on agar slants. Therefore, for storage of osmotolerant culture collections use of natural liquid products such as Biomalt, without subculturing, is suggested.

Cardinal Temperatures for Growth of Osmotolerant Yeasts in Broths at Different Water Activity Values.

All three cardinal temperatures (Tmin, Topt and Tmax) for growth of 6 strains as well as Tmin and Tmax for growth of an additional 23 strains were determined in solutions of 10, 30, 50 and 60% (w/w) glucose at aw (20°C) of 0.990, 0.970, 0.922 and 0.868, respectively. The Topt for growth of Zygosaccharomyces rouxii and Z. bisporus were 24-28.5°C at aw >0.990 and 31-33°C at aw in the range of 0.922-0.868. Z. bailii showed Topt for growth of 29-31°C and 33-35°C at aw >0.990 and aw <0.922, respectively. The Topt for growth of Torulaspora delbrueckii was 27-28.5°C at aw <0.990 and 31-33.5 at aw in the range of 0.922-0.868. Debaryomyces hansenii showed a Topt of 24°C and 27-29.5°C at aw >0.990 and aw <0.922, respectively. The Tmin and Tmax for growth were also shifted toward higher values as the aw decreased; at aw<0.922 none of the tested strains grew at 4°C within 30 d. Several strains could grow at 42°C only in the presence of high sugar concentrations.

Influence of Frozen Storage and Thaw-Freeze Stresses on the Viability of Osmotolerant Yeasts.

The influence of frozen storage at -25°C as well as repeated thaw-freeze stresses on the viability of osmotolerant yeast was investigated using cell suspensions in 20% (v/v) glycerol. Osmotolerant yeasts were particularly sensitive to both frozen storage and thaw-freeze stresses.

Heat Resistance of Vegetative Cells and Asci of Two Zygosaccharomyces Yeasts in Broths at Different Water Activity Values.

The heat resistance of vegetative cells and asci of two osmotolerant yeasts ( Zygosaccharomyces rouxii and Z. bailii ) was investigated in two different broths of aw 0.963 and 0.858, respectively. The highest heat resistance was observed with asci of Z. bailii LMZ 108, showing a decimal reduction time (D-value) at 60°C and aw 0.858 of 14.9 min. Asci of Z. rouxii LMZ 100 were less heat resistant (D60°C-value at aw 0.858 = 3.5 min). The heat resistance (D-values) of asci at aw 0.963 proved to be 20- to 50-fold and 5- to 8-fold higher than the D-valucs of the corresponding vegetative cells of Z. rouxii and Z. bailii , respectively. However, the lower the aw of the heating broth, the smaller the differences between heat resistance of asci and that of vegetative cells. Morever, different preparations of the same cell material were found to lead to different heat resistances.

Activity of Na-Benzoate and Ethyl-Paraben Against Osmotolerant Yeasts at Different Water Activity Values.

To preserve high sugar products, the effectiveness of sodium benzoate and ethyl-paraben (para-hydroxybenzoic acid ethylester) against 18 osmotolerant yeast strains was investigated at different water activity values (aw). The influence of pH, acidulant, humectant as well as inoculum level on the tolerance limits for growth of selected strains has also been determined. The tolerance limits for growth of all 18 tested strains were only slightly affected by the aw of the substrate, provided that the preservative concentration reflects only the amount of water and not the whole volume of the substrate. At aw < 0.900 and pH<4.0 1500 ppm Na-benzoate was necessary to inhibit growth of all 18 tested osmotolerant yeast strains for 30 d, while in a similar medium but at higher pH-values Na-benzoate was less effective. Similarly, at aw <0.900 and pH 3.0 a 30-day-free shelf life was guaranteed by addition of 400 ppm ethyl-paraben, while a higher concentration of ethyl-paraben (900 ppm) was necessary if the medium was acidulated to pH 4.8 only. The activity of Na-benzoate or ethyl-paraben against osmotolerant yeasts was usually poor if the initial count of contaminants was high. Zygosaccharomyces bailii was the most preservative-resistant osmotolerant yeast among the tested genera and species.