Dr. Dr. Chuck Dodd (DVM, PhD), program manager for veterinary services in the U.S. Army Public Health Command Region – Europe, shared his experiences from the midst of the E. coli O104 outbreak associated with raw sprouts centered in Germany earlier this year.

The video of Dr. Dr. Dodd, looking sharp in his military fatigues and fresh from another of his 100-mile ultra-marathons, is available at http://bites.ksu.edu/dodd-lecture as are the PowerPoint slides.

Late last night, Canadian health types issued a media release saying there were people sick from E. coli O157:H7 in several provinces linked to walnuts.

I noted that was really crappy risk communication – not being clear about what was known in terms of sick people and what was not known -- which is expected of government agencies like Health Canada, especially when they proclaimed a couple of days ago they were a founding member of some international Center of Excellence in Food Risk Communication (it’s a website and sucks).

About an hour ago (2:16 p.m. Eastern, April 4, 2011) the Public Health Agency of Canada (PHAC) announced there have been 13 cases of E. coli O157:H7 in Quebec, Ontario and New Brunswick (those are provinces in Canada). Nine individuals have been hospitalized and two cases developed hemolytic uremic syndrome (HUS).

The strivers for excellence in food risk communication note:

“You can help reduce your risk of becoming ill by following safe food handling precautions:
◦ Clean counters and cutting boards and wash your hands regularly.
◦ Read labels and follow cooking and storage instructions for all foods.
◦ Make sure to check the "best before" date on all foods.
◦ Use warm soapy water to clean knives, cutting boards, utensils, your hands and any surfaces that have come in contact with food, especially meat and fish.
◦ Refrigerate or freeze perishable food within two hours of cooking.
◦ Freeze or consume leftovers within four days of cooking.
◦ Always reheat leftovers until steaming hot before eating.
◦ Keep refrigerators clean and at a temperature below 4° C, or 40° F. Install a thermometer in your refrigerator to be sure.”

I have no idea how this applies to raw walnuts, like the ones I had on my salad for lunch (those yummy walnuts were from California, not Egypt, Lebanon, Syria, Turkey, Saudi Arabia or Iran, the places from where the fingered distributor, Amira Enterprises Inc. of St. Laurent, QC, imports things like walnuts.

And rather than toss out the suspect walnuts, Canadian health types recommend “consumers who have raw shelled walnuts in their home can reduce the risk of E. coli infection by roasting the walnuts prior to eating them. Consumers should place the nuts on a cooking sheet and bake at 350°F for 10 minutes, turning the nuts over once after five minutes.”

This does not account for the risk of cross-contamination with a virulent pathogen. My microbiology friends look forward to testing out this advice. I wonder what it was based on?
 

Graphic messages and reminders that use a shock-and-shame approach may get more people to wash their hands, according to a Kansas State University professor and his colleagues.

"Those 'Employees Must Wash Hands' signs in bathrooms may not be the most effective reminder," said Doug Powell, professor of food safety at K-State. "We wanted a comprehensive review of what others had done, and combined this with our own work on food safety messages that lead to behavior change. We weren't interested in self-reported surveys where everyone says they always wash their hands, but studies based on observed increases in handwashing compliance."

Powell worked with Casey Jacob, a former K-State research assistant in the department of diagnostic medicine and pathobiology, and Sarah Wilson, formerly of the University of Guelph. Their review of techniques to improve handwashing behavior was just published in the journal Critical Public Health.

The review was conducted as background for several ongoing experiments involving Powell and colleagues to increase handwashing rates in cafeterias, restaurants, hospitals, veterinary clinics and petting zoos. The team has previously designed handwashing campaigns at K-State involving both shock and shame.

"Social pressure, or shame, has been successfully used, especially within an entire organization," Powell said. "If you were in the bathroom at a restaurant and saw an employee not washing his or her hands, would you say, 'Dude, wash your hands?' The shock approach is designed to get people to 'be the bug' -- just for a moment -- and think about where their hands have been and where they are going to be, especially when around hospitals, food service or animals. Dangerous microorganisms move around a lot."

Behavior-change interventions to improve hand-hygiene practice: A review of alternatives to education
03.mar.11
Critical Public Health
Sarah Wilson; Casey J. Jacob; Douglas Powell
http://www.informaworld.com/smpp/content~content=a934338802~db=all~jumptype=rss
Despite the role of hand hygiene in preventing infectious disease, compliance remains low. Education and training are often cited as essential to developing and maintaining hand-hygiene compliance, but generally have not produced sustained improvements. Consequently, this literature review was conducted to identify alternative interventions for compelling change in hand-hygiene behavior. Of those, interventions employing social pressures have demonstrated varying influence on an individual’s behavior, while interventions that focus on organizational culture have demonstrated positive results. However, recent research indicates that handwashing is a ritualized behavior mainly performed for self-protection. Therefore, interventions that provoke emotive sensations (e.g., discomfort, disgust) or use social marketing may be the most effective.

Some 1,200 people have, according to legal-types in the U.K., been sickened after staying at the First Choice-owned Holiday Village Turkey resort since 2005.

Although First Choice has paid out over £100,000 to 34 claimants who stayed at the hotel in 2005 and 2007, solicitors say it has "refused to accept responsibility" over more recent cases.

First Choice said they were in negotiations with the law firm to resolve the issue amicably and couldn't comment further, but they did manage to keep talking and do further damage:

"First Choice would like to take this opportunity to assure all its customers that we closely audit all the resorts to which we operate, including the Holiday Village Turkey, to ensure that health, hygiene and comfort levels are maintained.

"Reports of sickness in 2010 were minimal; in particular, out of the 46,000 customers who have stayed there this year, only 0.42 per cent have reported minor ailments such as a mild stomach upset.

"This figure is extremely low, and has been substantiated by the Health Protection Agency, who have confirmed that they have received no reports of infection at the property this year.”

Telling 193 paying customers that their barfing was a statistical anomaly isn’t going to win future customers. And won’t help in court.