An Outbreak of Cryptosporidium parvum across England &amp; Scotland Associated with Consumption of Fresh Pre-Cut Salad Leaves, May 2012

McKerr, Caoimhe; Adak, Goutam; Nichols, Gordon; Gorton, Russell; Chalmers, Rachel M.; Kafatos, George; Cosford, Paul; Charlett, André; Reacher, Mark; Pollock, Kevin; Alexander, Claire L.; Morton, Stephen

doi:10.1371/journal.pone.0125955

Cited by 71 publications

(39 citation statements)

References 20 publications

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“…This system for internal quality control should be encouraged in other countries and the storage period required should be extended to at least 4 weeks, since it typically takes more than 2 weeks from point of infection to confirmation (CDC, 2017). To further complicate source tracking, many LGV products implicated in outbreaks are mixes of varieties with different origins (MacDonald et al, 2011; McKerr et al, 2015). For example, in an outbreak of yersiniosis in Norway in 2011, the salad mix implicated contained four varieties of leafy vegetables originating from 12 suppliers in two countries, while the vegetables were mixed, washed, and packaged in Norway (MacDonald et al, 2011).…”

Section: Nature Of Recorded Disease Outbreaksmentioning

confidence: 99%

The Hurdle Approach–A Holistic Concept for Controlling Food Safety Risks Associated With Pathogenic Bacterial Contamination of Leafy Green Vegetables. A Review

et al. 2018

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Consumers appreciate leafy green vegetables such as baby leaves for their convenience and wholesomeness and for adding a variety of tastes and colors to their plate. In Western cuisine, leafy green vegetables are usually eaten fresh and raw, with no step in the long chain from seed to consumption where potentially harmful microorganisms could be completely eliminated, e.g., through heating. A concerning trend in recent years is disease outbreaks caused by various leafy vegetable crops and one of the most important foodborne pathogens in this context is Shiga toxin-producing Escherichia coli (STEC). Other pathogens such as Salmonella, Shigella, Yersinia enterocolitica and Listeria monocytogenes should also be considered in disease risk analysis, as they have been implicated in outbreaks associated with leafy greens. These pathogens may enter the horticultural value network during primary production in field or greenhouse via irrigation, at harvest, during processing and distribution or in the home kitchen/restaurant. The hurdle approach involves combining several mitigating approaches, each of which is insufficient on its own, to control or even eliminate pathogens in food products. Since the food chain system for leafy green vegetables contains no absolute kill step for pathogens, use of hurdles at critical points could enable control of pathogens that pose a human health risk. Hurdles should be combined so as to decrease the risk due to pathogenic microbes and also to improve microbial stability, shelf-life, nutritional properties and sensory quality of leafy vegetables. The hurdle toolbox includes different options, such as physical, physiochemical and microbial hurdles. The goal for leafy green vegetables is multi-target preservation through intelligently applied hurdles. This review describes hurdles that could be used for leafy green vegetables and their biological basis, and identifies prospective hurdles that need attention in future research.

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Section: Nature Of Recorded Disease Outbreaksmentioning

confidence: 99%

The Hurdle Approach–A Holistic Concept for Controlling Food Safety Risks Associated With Pathogenic Bacterial Contamination of Leafy Green Vegetables. A Review

et al. 2018

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“…Water is important in agriculture and food production, and irrigation may be conducted with water that is not of potable quality. Where this is done for salad items and soft fruit that are eaten without further treatment, then outbreaks can occur [73,74]. Contaminated water used for washing and food processing can also cause outbreaks.…”

Section: Settings Other Than Drinking Water and The Range Of Water-rmentioning

confidence: 99%

Climate Change and Water-Related Infectious Diseases

Nichols

Lake²,

Heaviside

2018

Atmosphere

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Background: Water-related, including waterborne, diseases remain important sources of morbidity and mortality worldwide, but particularly in developing countries. The potential for changes in disease associated with predicted anthropogenic climate changes make water-related diseases a target for prevention. Methods: We provide an overview of evidence on potential future changes in water-related disease associated with climate change. Results: A number of pathogens are likely to present risks to public health, including cholera, typhoid, dysentery, leptospirosis, diarrhoeal diseases and harmful algal blooms (HABS). The risks are greatest where the climate effects drive population movements, conflict and disruption, and where drinking water supply infrastructure is poor. The quality of evidence for water-related disease has been documented. Conclusions: We highlight the need to maintain and develop timely surveillance and rapid epidemiological responses to outbreaks and emergence of new waterborne pathogens in all countries. While the main burden of waterborne diseases is in developing countries, there needs to be both technical and financial mechanisms to ensure adequate quantities of good quality water, sewage disposal and hygiene for all. This will be essential in preventing excess morbidity and mortality in areas that will suffer from substantial changes in climate in the future.Atmosphere 2018, 9, 385 2 of 60 which do not suffer the consequences of extreme events to the same extent [4]. Due to the lifetime of greenhouse gases such as carbon dioxide in the atmosphere, and the timescales associated with ocean warming, even if global CO 2 emissions were curtailed immediately, the effects on the earth's climate, including increasing temperatures and sea level rise would continue for a number of decades before starting to plateau [2]. However, this should be seen as a general call to action to reduce emissions as soon as possible, given that the impacts are likely to extend beyond current conditions and there are indications that economic investment now will be likely to reduce costs later [5]. There is also a need to develop adaptations to cope with changes in climate. Recent research highlighting the health benefits of limiting future temperature rises to the more ambitious target of 1.5 • C rather than 2 • C, in line with the Paris agreement of 2016, further emphasises the need to limit emissions [6].Climate change affects health in a number of ways, and the impacts vary both geographically and between different populations. A growing and ageing population in much of the world means that the proportion of the population who are vulnerable to the effects of climate change will increase in the future [7]. The most direct impacts from climate change are from the effects of high temperatures, and from acute impacts relating to extreme events such as storms, floods and heatwaves. These physical or meteorological stressors can produce direct health effects, such as physical injury, illness, or mental health impacts du...

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“…Foodborne outbreaks of cryptosporidiosis have been linked to fresh vegetables [15,16], unpasteurized milk [17], and fresh-pressed apple cider [18]. Although foodborne outbreaks have been rare, global foodborne cryptosporidiosis could be underestimated [19].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Risk Factors of Cryptosporidium Infection in Children Hospitalized for Diarrhea in Guangzhou, China

Chen¹,

Atwill²,

Zhong³

et al. 2017

J Bacteriol Parasitol

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This study was conducted to determine the prevalence, species and risk factors of Cryptosporidium infection in children hospitalized for diarrhea in Guangzhou region of China. A cross-sectional study was conducted to assess the prevalence and risk factors of Cryptosporidium infection in children (2 weeks to 10 years old) who were hospitalized for diarrhea. Cryptosporidium oocysts were detected using direct immunfluorescent assay and species were determined by sequencing a fragment (~800 bp) of the 18S rRNA gene. A questionnaire contains host, sociodemographic, family, hygiene, diet, zoonotic, and environmental risk factors was administered to patients to identify key factors associated with infections. The observed Cryptosporidium prevalence was 6.9% and the true prevalence was estimated to be 9.0%. Cryptosporidium infection was similar between male (7.4%) and female (6.1%) children and negatively associated with age (i.e., infection was more likely in younger children). Infections in children were significantly associated with family members' diarrhea within past one month. Infection in children in suburban hospitals (7.8%) was significantly higher than that in urban hospitals (2.1%). The overall prevalence of Cryptosporidium in rainy season was significantly higher than that in non-rainy seasons. DNA sequences of the 18S rRNA gene from infected children were 99.12% to 100% identical to sequences in the GenBank of C. parvum isolates from humans and animals. Future works should determine the sources of zoonotic Cryptosporidium and routes of waterborne exposure in the rainy season in this region.

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An Outbreak of Cryptosporidium parvum across England & Scotland Associated with Consumption of Fresh Pre-Cut Salad Leaves, May 2012

Cited by 71 publications

References 20 publications

The Hurdle Approach–A Holistic Concept for Controlling Food Safety Risks Associated With Pathogenic Bacterial Contamination of Leafy Green Vegetables. A Review

The Hurdle Approach–A Holistic Concept for Controlling Food Safety Risks Associated With Pathogenic Bacterial Contamination of Leafy Green Vegetables. A Review

Climate Change and Water-Related Infectious Diseases

Prevalence and Risk Factors of Cryptosporidium Infection in Children Hospitalized for Diarrhea in Guangzhou, China

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