A recent study by the Robert Koch Institute found that even small children in Germany eat raw meat more often than expected, so the Federal Institute for Risk Assessment (BfR) decided to remind Germans that raw meat for children is a bad idea.

"Raw animal foods are often contaminated with pathogens", explains Professor Dr. Dr. Andreas Hensel, president of BfR. "For this reason, especially vulnerable sections of the population, such as small children, pregnant women, the elderly and people with a weakened immune system, should as a rule not eat these foods raw."

Raw meat can transmit, among other things, salmonella, Campylo¬bacter, E. coli including EHEC, Yersinia, Listeria and also viruses and parasites.

A recent study by the Robert Koch Institute published in the Epidemiological Bulletin has shown that raw minced pork is the most important risk factor for contracting yersiniosis. Yesiniosis is a gastro-intestinal disease which is notably caused by the bacterium Yersinia enterocolitica. Yersinia are predominantly spread through food, especially raw pork. Pork, for example minced pork and seasoned minced meat, is often eaten raw in Germany. One of the surprising findings of the published study was the high number of children who had eaten raw minced pork. Even of children who were one-year-old or younger it was reported that almost 30% of those who had fallen ill (and 4 % of the control persons) had eaten raw minced pork.

In Germany and other European countries, Campylobacter is now the most prevalent bacterial pathogen for enteric infections in humans. In the year 2011, more than 70,000 human campylobacteriosis cases were reported.

Campylobacter bacteria are notably found in raw or insufficiently heated poultry meat, but also in raw meat of other animals as well as raw milk and hen’s eggs.
The number of reported salmonellosis cases in humans, especially from Salmonella Enteritidis, has fallen significantly in the last three years.

In contrast, human infections with Salmonella Typhimurium have decreased to a lesser extent. SalmonellaTyphimurium are especially common in turkey meat and pork. As part of zoonosis monitoring, salmonella, most frequently Salmonella Typhimurium, were detected in 5 % of minced meat samples in 2009. This finding confirms that raw minced meat can be a source of infection for humans.

To protect themselves against often severe cases of foodborne infections, especially vulnerable sections of the population such as children under five, pregnant women, elderly and persons with a weakened immune system should as a matter of principle refrain from eating raw foods. They should therefore avoid consuming raw mince or seasoned minced meat, raw sausage, raw milk and raw-milk cheese, raw fish (e.g. sushi) and certain fishery products (e.g. smoked and gravad salmon) as well as raw seafood (e.g. raw oysters).

All that and no mention of raw sprouts? In Germany? The risk assessors did say consumers can “protect themselves by cooking meat and poultry sufficiently and evenly” and that “such meat must be cooked until the juices run clear and the meat has a whitish (poultry), gray-pink (pork) or gray-brown (beef) color. The inside temperature of the meat should be at least 70 °C for two minutes. If in doubt, consumers can measure this temperature by means of a meat thermometer.”

Some risk assessors. Color is a lousy indicator and consumers should be using a tip-sensitive digital thermometer to erase doubt. And stop making little kids barf.

I sorta cringe, or maybe sigh, every time someone faithfully repeats the dogma that factory-farmed cattle are the source of E. coli O157:H7 and other shiga-toxin producing E. coli (STEC).

All ruminants carry STEC naturally, and there are well-documented and tragic outbreaks involving deer, goats, sheep, elk and others.

German researchers report on the occurrence of STEC in deer in Germany in the current issue of Epidemiology and Infection.

Deer poop has been directly or indirectly linked to several outbreaks:

• 1 dead and 14 sickened from E. coli O157:H7 from deer feces contaminating strawberries in Oregon in Aug. 2011;

• deer feces were a possible source of E. coli O157 in Oregon hazelnuts that sickened 8 in March 2011;

• 29 Minnesota high school students sickened with E. coli O103 and E. coli O145 after butchering and processing deer into venison in 2010;

• deer meat was involved in at least two recognized E. coli outbreaks; and,

• an E. coli O157:H7 outbreak in Oct. 1996 that killed a 16-month-old and sickened 76 others who drank juice which contained unpasteurized apple cider that was probably contaminated with deer feces.

In the current study, the Germans studied the virulence genes eae, e-hlyA and saa, thestx subtypes, pulsed-field gel electrophoresis (PFGE) patterns and serovars. In total, 120 samples of 60 animals were screened by real-time polymerase chain reaction (PCR). The PCR results showed a high detection rate of stx genes (83%). Mainly faecal samples, but also some lymphatic tissue samples, tested stx-positive. All isolates carried stx2, were eae-negative and carried e-hlyA in 38% and saa in 9% of samples. Serovars (O88:[H8], O174:[H8], O146:H28) associated with human diseases were also identified. In some animals, isolates from lymphatic tissue and faecal samples showed undistinguishable PFGE patterns. The examined deer were shown to be relevant reservoirs of STEC with subtype stx2b predominating.

The complete paper is available at http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8501556.

The translation is rough and details sketchy, but Focus is reporting a 6-year-old girl from Hamburg died over the weekend from the effects of EHEC, which probably means some strain of shiga-toxin producing E. coli.

A spokesman for the Health Authority of the City of confirming the news agency on Sunday evening, a case of illness with the pathogen.According to the newspaper "Die Welt" on Monday, the child died in the early hours of Sunday. The first grader had shown since the beginning of last week, symptoms of infection with the aggressive food germ, the head of a primary school in Hamburg-Blankenese said on Sunday. She was treated at a hospital. Apparently it was an isolated case

"This is an isolated incident," said the spokesman. "It is not at all comparable to the situation last year" (meaning sprouts and E. coli O104, in which 53 people died).

In a triumph of food porn over food safety, an investigation into an outbreak of salmonellosis in the summer of 2010 after a wedding party in Bavaria, Germany that sickened at least 52 people failed to pinpoint a specific food source but did uncover a number of disturbing food safety practices – such as adding rose petals to food and no temperature checks -- again linked to an unlicensed caterer.

German researchers report in Eurosurveillance this week that in the summer of 2010, a local health office in northern Bavaria, Germany, was informed that approximately half of the 110 guests of a wedding that had taken place the preceding weekend had contracted gastroenteritis. At the wedding party, soup and a late-lunch buffet (served from 3 p.m.) and a cold dinner buffet (served from 10 p.m.) had been provided by an out-of-town caterer. In addition, a wedding cake made by a local bakery and a number of cakes and desserts contributed by different wedding guests were served by the catering staff at 20.00. The food served at the wedding was suspected to be the source of the outbreak. Initial laboratory results of stool samples of some guests who became ill indicated Salmonella enterica subsp. enterica serovar Enteritidis (S. Enteritidis) as the causative pathogen.

According to the caterer, only the meat dishes were prepared at the caterer’s facilities in advance. All sauces, antipasti and salads were made from commercially produced ingredients and were prepared at the wedding party venue. Food items that required cooling were transported in cooling boxes and stored in cooling units at the venue. At the venue, the lunch buffet was set up for six hours, between 2 p.m. (the buffet was set up one hour before it was available to guests) and 8 p.m. No checks were carried out of holding temperatures of the warm or cold dishes. Salads and other cold dishes were not cooled during this period. Photographs of the buffet showed that a number of the cold dishes were decorated with non-edible flowers (such as roses), which were inserted into the food. The flowers had been purchased at a wholesale retailer. Cakes supplied by a number of wedding guests were stored without cooling until they were served at 20:00. The dishes of the dinner buffet were not cooled. They were first served at 10 p.m. It is unclear for how long the dishes of the dinner buffet were served; however, it is known that the catering personnel departed at 00.30.

Inspection of the catering facilities and interview of the catering staff revealed a number of shortcomings contravening European food hygiene regulations. The facilities used by the caterer were not registered with the local authorities. There were no records of the required staff training on food hygiene. No temperature controls of cooling devices or transport boxes were carried out, nor were temperatures monitored during preparation or serving of warm dishes. There were no records of HACCP concept planning or implementation. The company was banned from catering until proof of changes in their practices had been provided to the local authorities.

The cohort study showed that a variety of dishes were associated with a significantly increased risk of infection: in particular consumption of a group of lunch dishes containing mayonnaise was associated with a high relative risk. Despite the constraint of a two-week delay between the wedding party and the questionnaires being sent out, participants appeared to recollect well which dishes they had consumed.

The isolation of S. Enteritidis from two of the food samples at the wedding party was judged to show that the food served posed a health risk, as all the food items were ready for consumption without requiring further preparation or heating. The isolation of indistinguishable Salmonella strains from the food samples as well as from stool samples of respondents and catering personnel supported the hypothesis that the outbreak was foodborne.

There are several possibilities for the source of the Salmonella contamination in this outbreak. Mayonnaise is a well-recognized vehicle of contamination when raw egg is used as an ingredient. However, in this outbreak all cold dishes and salads were made from commercially prepared ingredients. As commercially produced mayonnaise and sauces are conventionally based on pasteurized ingredients, it is unlikely that they would be the primary source of contamination. Commercial mayonnaise by itself is also not suitable for Salmonella propagation, due to its low pH adjusted by acetic acid. However, addition of mayonnaise to other salad ingredients may alter the overall acetic acid concentration of the mixture, thus providing a suitable base for proliferation once the pathogen has been introduced by secondary contamination.

The environmental investigation revealed a number of infringements of food safety regulations, including a lack of staff training and the absence of records of a food safety concept according to the HACCP principles. Lack of temperature controls for food storage and transport as well as prolonged presentation of buffet dishes at room temperature provided ideal conditions for pathogen proliferation, regardless of the primary source of contamination.

While they do not replace official controls, the HACCP principles are central to the European concept of food safety by helping food business operators to attain a high standard of food safety. Successful implementation of procedures based on the HACCP principles requires the full cooperation and commitment of food business employees. Adequate training of personnel is central to achieving this goal.

The outbreak investigated in this study demonstrates the consequences of lack of staff training and the failure to identify hazards to food safety, as well as failure to implement control measures to mitigate such hazards. The use of flowers as food decoration demonstrated insufficient understanding of the potential for contamination through products that are not intended for food production and therefore not subject to food hygiene regulations.

Intelligently implemented food hygiene concepts not only benefit the consumer but are also very much in the interest of the food business operator, whose business can be threatened by food-borne outbreaks. Initial hygiene and food safety training for food business operators should therefore also explain microbiological principles underlying food safety practices in order to equip the businesses with the required background knowledge and motivation to design and implement an intelligent food safety/HACCP concept, including the consideration and identification of potential sources of contamination. Explicit mention of the dangers of the use of non-edible flowers for decoration should be considered in guides to good practice, which are a valuable instrument to aid food business operators with compliance with food hygiene rules and with the application of the HACCP principles.

The complete paper is available at http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20076.