Paralytic Shellfish Poison (PSP) has been detected at unsafe levels in shellfish on Vashon Island at Point Vashon and Tramp Harbor. As a result, the Washington State Department of Health (DOH) has closed Vashon Island (except Quartermaster Harbor) beaches to recreational shellfish harvest.

The closure includes all species of shellfish including clams, geoduck, scallops, mussels, oysters, snails and other invertebrates; the closure does not include crab or shrimp. Crabmeat is not known to contain the PSP toxin, but the guts can contain unsafe levels. To be safe, clean crab thoroughly and discard the guts (“butter”). Working with partners, Public Health – Seattle & King County is posting advisory signs at beaches warning people to not collect shellfish.

Commercial beaches are sampled separately and commercial products should be safe to eat.

Anyone who eats PSP contaminated shellfish is at risk for illness. PSP poisoning can be life-threatening and is caused by eating shellfish containing this potent neurotoxin. A naturally occurring marine organism produces the toxin. The toxin is not destroyed by cooking or freezing.

A person cannot determine if PSP toxin is present by visual inspection of the water or shellfish. For this reason, the term “red tide” is misleading and inaccurate. PSP can only be detected by laboratory testing.

Symptoms of PSP usually begin 30-60 minutes after eating the contaminated shellfish, but may take several hours. Symptoms are generally mild, and begin with numbness or tingling of the face, arms, and legs. This is followed by headache, dizziness, nausea, and loss of muscle coordination. Sometimes a floating sensation occurs. In cases of severe poisoning, muscle paralysis and respiratory failure occur, and in these cases death may occur in 2 to 25 hours.

Since Friday, August 18, the Arkansas Department of Health has received and is investigating approximately 30 reports of people ill with what is likely a foodborne illness. To date, we have four confirmed cases of Salmonella. At this point, epidemiological information suggests that the Chuck Wagon Restaurant in Stuttgart, Arkansas is the likely site of the outbreak.

Arkansas Department of Health is taking steps to address this outbreak. We are collecting biological specimens from patients that are ill. In addition, we are collecting information about where they have eaten and any other common exposures they might have had. This may include animal or worksite exposure. ADH has inspected the site that has been identified as a common food source for these individuals and identified risks were removed. We have received cooperation from the site and have provided additional food safety training to all employees. Arkansas Department of Health will be conducting a follow-up inspection.

People who ate at the restaurant on or around Aug. 14-16, and are experiencing symptoms should contact their healthcare provider first, and then the Arkansas Department of Health either at 501-537-8969 or by email at adh.foodsafe@arkansas.gov.

The week before I arrived in Oahu for work on the ongoing Scallops Hepatitis A Outbreak, the Hawaii State Department of Health confirmed one new case of rat lungworm disease in an Oahu resident.  The adult case was currently hospitalized and the department confirmed their illness late on Tuesday afternoon last week. The last reported case of rat lungworm disease on Oahu was in 2010.

The Oahu resident began experiencing symptoms consistent with rat lungworm disease in July. DOH staff from the Vector Control Program and Disease Investigation Branch started conducting onsite property assessments this morning in East Oahu. Vector Control staff surveyed for slug, snail and rat activity. Current findings do not show evidence of slugs or semi-slugs nearby.

This is the first case of rat lungworm disease contracted on Oahu in 2017, bringing the statewide total of confirmed cases to 16 for this year.

“This is a serious disease that can be acquired on any of our islands because slugs and snails throughout the state carry the parasite responsible for the illness,” said Keith Kawaoka, deputy director of Environmental Health. “This is a grim reminder that we all need to take precautions when working in our gardens and on farms, and eliminate slugs, snails and rats from our communities to reduce the risks posed by this parasitic disease.”

Angiostrongyliasis, also known as rat lungworm, is a disease that affects the brain and spinal cord. It is caused by a parasitic nematode (roundworm parasite) called Angiostrongylus cantonensis. The adult form of A. cantonensis is only found in rodents. However, infected rodents can pass larvae of the worm in their feces. Snails, slugs, and certain other animals (including freshwater shrimp, land crabs, and frogs) can become infected by ingesting this larvae; these are considered intermediate hosts. Humans can become infected with A. cantonensis if they eat (intentionally or otherwise) a raw or undercooked infected intermediate host, thereby ingesting the parasite.

This infection can cause a rare type of meningitis (eosinophilic meningitis). Some infected people don’t have any symptoms or only have mild symptoms; in some other infected people the symptoms can be much more severe. When symptoms are present, they can include severe headache and stiffness of the neck, tingling or painful feelings in the skin or extremities, low-grade fever, nausea, and vomiting. Sometimes, a temporary paralysis of the face may also be present, as well as light sensitivity. The symptoms usually start 1 to 3 weeks after exposure to the parasite, but have been known to range anywhere from 1 day to as long as 6 weeks after exposure. Although it varies from case to case, the symptoms usually last between 2–8 weeks; symptoms have been reported to last for longer periods of time.

You can get angiostrongyliasis by eating food contaminated by the larval stage of A.cantonensis worms. In Hawaii, these larval worms can be found in raw or undercooked snails or slugs. Sometimes people can become infected by eating raw produce that contains a small infected snail or slug, or part of one. It is not known for certain whether the slime left by infected snails and slugs are able to cause infection. Angiostrongyliasis is not spread person-to-person.

Diagnosing angiostrongyliasis can be difficult, as there are no readily available blood tests. In Hawaii, cases can be diagnosed with a polymerase chain reaction (PCR) test, performed by the State Laboratories Division, that detects A. cantonensisDNA in patients’ cerebrospinal fluid (CSF) or other tissue. However, more frequently diagnosis is based on a patient’s exposure history (such as if they have history of travel to areas where the parasite is known to be found or history of ingestion of raw or undercooked snails, slugs, or other animals known to carry the parasite) and their clinical signs and symptoms consistent with angiostrongyliasis as well as laboratory finding of eosinophils (a special type of white blood cell) in their CSF.

There is no specific treatment for the disease. The parasites cannot mature or reproduce in humans and will die eventually. Supportive treatment and pain medications can be given to relieve the symptoms, and some patients are treated with steroids. No anti-parasitic drugs have been shown to be effective in treating angiostrongyliasis, and there is concern that they could actually make the symptoms worse because of the body’s response to potentially more rapidly dying worms. Persons with symptoms should consult their health care provider for more information.

To prevent angiostrongyliasis, don’t eat raw or undercooked snails or slugs, and if you handle snails or slugs, be sure to wear gloves and wash your hands. Eating raw or undercooked freshwater shrimp, land crabs and frogs may also result in infection, although, there has not been any documented cases in Hawaii. You should also thoroughly inspect and wash fresh produce and vegetables, especially if eaten raw. Eliminating snails, slugs, and rats founds near houses and gardens might also help reduce risk exposure to A. cantonensis.

When preparing food for cooking, any suspect food products should be boiled for at least 3 to 5 minutes, or frozen at 5°F (15°C) for at least 24 hours; this will kill the larval stage of the worm.

According to a Public Health England report, thousands of people in the UK may have been put at risk of contracting Hepatitis E from pork products sold at a leading supermarket which it would not name.

The virus could have infected up to 200,000 people in the UK each year from 2014 to 2014.

By tracing the habits of those infected, the study concluded that only “Supermarket X” was significantly associated with Hepatitis E, in particular own brand sausages. Only pork products from Europe, mainly Holland and Germany, and not the UK carry the strain.

However, sources told the Sunday Times that the supermarket involved was Tesco.

According to the CDC, Hepatitis E is a liver infection caused by the Hepatitis E virus.  Hepatitis E is a self-limited disease that does not result in chronic infection. While rare in the United States, Hepatitis E is common in many parts of the world. It is transmitted from ingestion of fecal matter, even in microscopic amounts, and is usually associated with contaminated water supply in countries with poor sanitation. There is currently no FDA-approved vaccine for Hepatitis E.

Hepatitis E is most common in developing countries with inadequate water supply and environmental sanitation. Large hepatitis E epidemics have been reported in Asia, the Middle East, Africa, and Central America.

Most people with Hepatitis E recover completely. During Hepatitis E outbreaks, the overall case-fatality rate is about 1%. However, for pregnant women, Hepatitis E can be a serious illness with mortality reaching 10%–30% in their third trimester of pregnancy. Hepatitis E could also be serious among persons with preexisting chronic liver disease resulting in decompensated liver disease and death.

The CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Salmonella infections. This outbreak includes four different types of Salmonella: Kiambu, Thompson, Agona, and Gaminara. The same strain of these types of Salmonella were found in samples collected from papayas and from ill people.

A total of 173 people infected with the outbreak strains of Salmonella Kiambu (51), Salmonella Thompson (111), Salmonella Agona (7), or Salmonella Gaminara (4) have been reported from 21 states.  Connecticut 6, Delaware 4, Iowa 2, Illinois 3, Kentucky 4, Louisiana 1, Maryland 8, Massachusetts 8, Michigan 1, Minnesota 4, Missouri 1, North Carolina 5, New Jersey 36, New York 50, Ohio 1, Oklahoma 4, Pennsylvania 8, Tennessee 1, Texas 9, Virginia 16, Wisconsin 1.  Fifty-eight ill people have been hospitalized. One death was reported from New York City.

Epidemiologic and laboratory evidence indicates that Maradol papayas from the Carica de Campeche farm in Mexico are the likely source of this multistate outbreak. Three brands of Maradol papayas have been recalled: Caribeña brand, distributed by Grande Produce; certain Cavi brand papayas distributed by Agroson’s; and Valery brand papayas, distributed by Freshtex Produce, LLC. If anyone has these papayas in their home, they should dispose of them immediately. The FDA has also added the Carica de Campeche farm to Import Alert (IA) 99-35, after testing found multiple strains of Salmonella present in the fruit. Thus far, Salmonella strains matching the outbreak patterns by PFGE were only isolated from papayas from the Carica de Campeche farm.

As of today, there are eighteen cases linked to the recent E. coli O157:H7 outbreak. Of the eighteen cases, twelve are children and six are adults. All reported illnesses are associated with playing in the water at Commodore Beach in Lake Wildwood or taking care of someone who is infected. The best method of prevention when caring for an ill person is frequent washing and drying of your hands.

There have been a total of ten hospitalizations and of those, nine have been discharged home. To date, of those with laboratory-confirmed E. coli O157:H7, the onset of symptoms has ranged from July 20-29, 2017. The Public Health Department will continue to follow up on reports of illness received from health care providers.

The five public beaches at Lake Wildwood remain closed, and the no swimming advisory remains in effect for the lake. The Environmental Health Department continues to take samples from around the lake for testing; however, the cause of the outbreak remains under investigation.

The Toledo-Lucas County Health Department released a set of statistics showing how wide the food-borne Norovirus linked to Mama C’s spread.

According to the health department, there were a total of 378 primary cases and an additional 40 secondary cases.

In all, there were people affected in 12 Ohio counties. There were also people in four additional states affected by the outbreak.

The shop reopened Monday, following a deep cleaning supervised by the health department.

The health department ruled the virus was food-borne rather than environmental.

Norovirus is the leading cause of gastroenteritis, or what we commonly think of as stomach flu symptoms. It causes 23 million cases of gastroenteritis per year, or over half of all gastroenteritis cases in the U.S., and is the second most common virus after the common cold.

Norovirus is usually transmitted from the feces to the mouth, either by drinking contaminated food or water or by passing from person to person. Because noroviruses are easily transmitted, are resistant to common disinfectants, and are hard to contain using normal sanitary measures, they can cause extended outbreaks.

The Columbian reports that Spanish Sonrise Dairy is recalling whole raw milk because it may be contaminated with E. coli.

The Yacolt dairy announced the recall on Tuesday, after routine sampling by the state Department of Agriculture found E. coli in the raw cream processed from whole raw milk, according to a news release issued by Spanish Sonrise Dairy.

The recall affects raw milk with a “best by” date of Aug. 23. The milk, which was bottled in half-gallon glass containers, was sold directly to private customers and at one retail store, Camas Produce.

E. coli infections may cause severe diarrhea, stomach cramps and bloody stool. Symptoms generally appear three to four days after exposure but can take as long as nine days to appear, according to the news release.

This isn’t the first recall for the Yacolt dairy. Spanish Sonrise issued a recall of raw milk and cream products in April 2015 after routine testing revealed listeria monocytogenes contamination. At the time of the first recall, the owners said they planned to close the dairy.

The Packer reports today that the Wisconsin Department of Health Services has linked 11 cases of salmonellosis to the consumption of fresh shelled peas from farmers markets.

A news release Aug. 11 tied seven illnesses to the peas, and another four cases have been confirmed since then.

The seven people initially reported as cases were all infected with the same strain of salmonella, and all of them had eaten fresh shelled peas that were purchased July 22 from farmers markets in Green Bay, Madison and Fond du Lac, according to the release.

Health officials are still working to determine the source of the outbreak.

The Wisconsin Department of Health Services has recommended that people throw away shelled peas purchased July 19-Aug. 5 at the Dane County Farmers Market in Madison, the Downtown Green Bay Farmers Market, or the Fond du Lac Farmers Market.

Not included in that notice are peas that were sold in their pod or shell or peas purchased at other farmers markets.

As of August 9, 2017, 141 people infected with the outbreak strains of Salmonella Kiambu (51) or Salmonella Thompson (90) have been reported from 19 states. Connecticut 5, Delaware 4, Iowa 2, Illinois 2, Kentucky 3, Louisiana 2, Maryland 8, Massachusetts 6, Michigan 1, Minnesota 4, North Carolina 3, New Jersey 27, New York 39, Ohio 1, Oklahoma 4, Pennsylvania 8, Texas 7, Virginia 14, Wisconsin 1, Total 141
Illnesses started on dates ranging from May 17, 2017 to July 27, 2017. Ill people range in age from less than 1 year to 95, with a median age of 39. Among 136 ill people with available information, 83 (61%) are female. Among 98 people with available information, 66 (67%) are of Hispanic ethnicity. Among 103 people with available information, 45 (44%) have been hospitalized. One death was reported from New York City.

Illnesses that occurred after July 14, 2017, might not be reported yet due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 4 weeks.

Based on information collected to date, CDC is now recommending that consumers not eat Maradol papayas from the Carica de Campeche farm in Mexico. If consumers aren’t sure if their Maradol papaya came from the Carica de Campeche farm, they should ask the place of purchase. When in doubt, don’t eat it; just throw it out. Restaurants and retailers should not serve or sell Maradol papayas from the Carica de Campeche farm.

As was reported in the last update on August 4, FDA tested other papayas imported from Mexico and isolated several types of Salmonella bacteria, including Salmonella Agona, Salmonella Kiambu, Salmonella Gaminara, Salmonella Thompson, and Salmonella Senftenberg. CDC is working to determine if there are any illnesses with these other types of Salmonella linked to this outbreak.

The FDA is advising consumers not to eat Maradol papayas from the Carica de Campeche farm in Mexico because they are linked to an outbreak of salmonellosis.

Three brands of Maradol papayas have been recalled: Caribeña brand, distributed by Grande Produce; certain Cavi brand papayas distributed by Agroson’s; and Valery brand papayas, distributed by Freshtex Produce, LLC. If anyone has these papayas in their home, they should dispose of them immediately.

Recent Op-ed in the Hill on Import Risks:

http://thehill.com/blogs/pundits-blog/energy-environment/343444-why-the-us-imports-tainted-food-that-can-kill-you