Monday, November 28, 2011

Health Canada issues reminder to the public about the risks of raw shellfish

Health Canada issued a Information Update last Thursday concerning the risks of eating raw or undercooked shellfish and steps you can take to avoid foodborne illness from shellfish.

It is well done and very informative and I‘d like to share this info here.

OTTAWA- Health Canada would like to remind Canadians that raw shellfish - such as oysters, clams, scallops, mussels and cockles - can carry bacteria, viruses and toxins that can cause foodborne illness if they are not harvested, stored, handled or prepared appropriately.

Shellfish is a nutritious food choice. As with all foods, it is important to store, handle and prepare shellfish appropriately to help prevent illness. In particular, children, pregnant women, seniors and people with weakened immune systems are more susceptible to foodborne illness and should avoid eating raw or undercooked shellfish.

Here are some steps you can take to prevent foodborne illness from shellfish:
  • Buy shellfish from reputable sources, and keep them cold (below 4°C). A retailer selling raw shellfish should be able to show you a shellfish shipper's tag.
  • Refrigerate immediately after purchase. Do not put live shellfish in a closed container or into fresh water. Cover the shells with a damp cloth and place on the lowest shelf of the refrigerator. Store shucked (opened) shellfish in a closed container. Raw shellfish can be kept refrigerated for a few days, depending on their freshness and quality, and can be stored in the freezer for 2-4 months. Shucked oysters should be frozen if you do not eat them within two days.
  • Check the packaging on frozen shellfish. Make sure that the packaging is not torn or open and that there is minimal frost or ice crystal formation on the packaging. Too much frost could mean that the shellfish has been frozen for a long time or has been thawed and refrozen. Place the frozen shellfish in the freezer immediately after purchase until you are ready to use it. You should never defrost shellfish at room temperature. Thaw food in the refrigerator, in cold water, or in the microwave if you will be cooking it immediately. If thawing in cold water, replace water every 30 minutes.
  • Keep raw shellfish separate from cooked foods and follow good hygiene practices: wash hands before preparing foods, wash hands after handling raw shellfish, and wash counters and utensils with soap and warm water after preparation.
  • Make sure your shellfish is fresh. Fresh oysters, clams, scallops, mussels and cockles should have tightly closed shells or they should close their shells when you tap them.
  • Shucked oysters (usually sold in tubs) are not meant for raw consumption.
  • It is best to cook oysters, clams, scallops, mussels and cockles to minimize the chances of foodborne illness. Guidelines for cooking shellfish are:
    • Boil oysters, clams, scallops, mussels and cockles until the shells open, and then boil for an additional 3-5 minutes. You should also boil or simmer shucked shellfish for at least 3 minutes or until the edges curl.
    • Steam for 4-9 minutes and throw out those that did not open.
    • Fry for at least 3 minutes at 190°C (375°F).
    • Bake for at least 10 minutes at 230°C (450°F).
If you wish to harvest shellfish yourself, make sure you do so in areas that are open for harvesting. Chemical contaminants or natural toxins from marine algae could be present in shellfish any time of the year, and cooking will NOT destroy these toxins. Contact your nearest Department of Fisheries and Oceans office listed in the blue pages of your local telephone directory for information on areas currently open for shellfish harvesting. You may also want to check with your local or provincial government about harvesting restrictions or consumption advice for shellfish not purchased from commercial establishments.

Saturday, November 26, 2011

India: cases of meningococcal meningitis fatalities fall for the third straight year

Health Minister Ghulam Nabi Azad said at least 245 people have died in 2011 from the bacterial infection, meningococcal meningitis. The vast majority of cases (179) were seen in West Bengal.

Though the number seems high, Azad rightly points out that deaths due to meningitis were showing a declining trend in the past three years.

In 2010, 341 people died due to the disease, down from 467 in 2009 and 542 in 2008.

Meningococcal meningitis is caused by the bacterium, Neisseria meningitidis, which causes the most severe form of bacterial meningitis. Meningitis is an infection of the membranes covering the brain and spinal cord. It can also be found in the bloodstream. This particular type of meningitis is very severe and can result in death if not treated promptly. Even in cases where treatment has been given, the fatality rate is around 15%.

The symptoms of bacterial meningitis are sudden, with fever, stiff neck, body aches and headaches. As the disease progresses other symptoms may include nausea, vomiting, photophobia and seizures. A petechial rash seen on the trunk and lower extremities, bleeding complications, multi-organ failures and shock are usually final signs. This disease has the ability to kill within hours of getting it.

Up to 10-20% of older children and young adults carry this organism in the mouth and nose, though the carriage rate will vary with age and closeness of population. The majority of people that carry this bacterium have no clinical disease. The organism is spread person to person through respiratory secretions from the nose and mouth (coughing, sneezing and kissing). 

Experts are unsure why some people advance to meningitis disease while many do not.

Crowded living conditions facilitate the spread of the organisms and places like military barracks and college dormitories are well documented areas of concern with this disease.
If you have close contact with someone with meningococcal meningitis, see your doctor for prophylactic antibiotics.

Meningococcal meningitis is a devastating disease with epidemic potential. This disease is considered a medical emergency and if you have the classic symptoms see your health care professional. It can be treated with antibiotics, but without delay

Sri Lanka primary school closed over mumps outbreak

Sri Lankan health officials ordered the principal of a primary school to close grade 1-5 classes Friday in an effort to prevent further spread of an outbreak of mumps in the student population.

Ministry of Health official, Dr. Prasad Liyanage had the principal of Ratmale Junior School in the Matugama Education Zone close classes after 67 students reportedly contracted the viral disease, mumps.

There is no indication how the outbreak originated and how long the school will remain closed.

Mumps is an acute viral disease that is characterized by fever and swelling and tenderness in one or more of the salivary glands. Maximum infectiousness occurs between two days prior to onset of illness to four days afterwards.

Complications to mumps may include orchitis (which has been reported to be a risk factor for testicular cancer), encephalitis and spontaneous abortion. Sterility in males is a rare possible outcome.

Mumps outbreaks occur in settings, where prolonged, close contacts facilitate transmission, like colleges and schools. Mumps is spread by droplets of saliva or mucus from the mouth, nose, or throat of an infected person, usually when the person coughs, sneezes, or talks. Items used by an infected person, such as cups or soft drink cans, can also be contaminated with the virus, which may spread to others if those items are shared.

Friday, November 25, 2011

Woman dies from paralytic shellfish poisoning in Bataan, Philippines

An elderly woman died and four others were hospitalized due to paralytic shellfish poisoning after eating "sulib" or sunset shell.

The illnesses prompted the Bureau of Fisheries and Aquatic Resources (BFAR) to issue a ban Monday on the eating, gathering or harvesting, transporting and marketing of shellfish from seven towns and one city along the coastal waters of Bataan due to red tide.

The BFAR advisory goes on to say, “Based on the results of red tide monitoring activities of BFAR and the red tide monitoring center in Bataan, shellfishes collected from Bataan coastal waters in Balanga City and the towns of Mariveles, Limay, Orion, Pilar, Abucay, Samal and Orani are now positive for the red tide toxin.

According to a Philippine News Agency report:
Melinda Lucio, 71, from the fishing village of Tabing-Ilog in this town died last Friday while her husband Raymundo Lucio, 71 and grandson Bryan Lucio, 12 were hospitalized after eating "adobong sulib" that the old man caught and cooked.
Bryan upon arrival from school also ate his lunch with the "adobong sulib."
Raymundo said his grandson was forced to vomit and brought to the hospital with them. The old woman died at the hospital from alleged shellfish poison.
The old man said he has been gathering "sulib" for more than 50 years and this was the first time that he learned that someone died from it.
Two others from the village, Remedios dela Cruz and Dexter Esconde, complained of vomiting, stomach ache and numbness of lips after likewise eating "sulib", a report from Tabing-Ilog barangay chairman Glenn Velasco showed.
“It was so alarming and saddening that one died but we learned of the presence of red tide earlier or many would have died or hospitalized,” Mayor dela Fuente said.

The Washington Department of Health, Office of Shellfish and Water Protection describe Paralytic shellfish poison (PSP):

PSP is naturally occurring toxin, called a "biotoxin", that is produced by some species of microscopic algae.  PSP can concentrate in shellfish and, when eaten, can cause illness in humans.  This biotoxin affects the nervous system and paralyzes muscles, thus the term "paralytic" shellfish poison.  High levels of PSP can cause severe illness and death.

All molluscan shellfish (those having a hinged shell) including clams, mussels, oysters, geoduck, and scallops are capable of accumulating PSP.  So can moon snails and other gastropods. 

It's normal for biotoxin-producing algae to be present in marine water. They are usually at very low concentrations and pose no problems.  However, when the algae "blooms" the concentration increases dramatically.  The increased algae simply becomes a greater food source for shellfish.  The more algae the shellfish eat, the more biotoxin they accumulate.  Biotoxins don't harm shellfish, so the level in their tissue continues to climb until the bloom subsides.  When the number of toxin-producing algal cells returns to normal low levels, the shellfish eventually flush the toxin from their systems.  It can be several days to several months or longer before they're safe to eat again.

Shellfish containing toxic levels of PSP don't look or taste any different from shellfish that are safe to eat. In addition, PSP is not destroyed by cooking or freezing. 

Thursday, November 24, 2011

Auckland measles outbreak continues with 77 new cases in November

The measles outbreak in Auckland that began in May continued into November as health officials report 77 new confirmed or probable cases so far this month.

Since the end of May, 353 measles cases have been reported. Of that, greater than sixty cases required hospitalization.

Auckland health authorities, in an effort to slow down the spread, launched a new immunization campaign where infants get two doses of the MMR vaccine by 13 months old, rather than by four years.

In addition, health officials are also encouraging those aged between 15 and 41 to check their own immunization status if they're unsure.

Friday, November 18, 2011

Alaska reverses trend in gonorrhea cases

Alaska has held the dubious distinction of being the state on top, or near the top, with the highest number of cases of chlamydia and gonorrhea for several years now.

However, according to an Alaska Department of Health and Social Services news release Thursday, it appears that one of these trends is starting to change.

Data released by the State of Alaska Section of Epidemiology, there has been a 23 percent decrease in the number of gonorrhea infections reported during the first three quarters of 2011 compared to the first three quarters of 2010.

There were 770 laboratory confirmed cases of gonorrhea in the first three quarters of 2011, compared to 1,005 in 2010.

The report, published in the Epidemiology Bulletin, give credit to these decreases to a couple of factors ; more awareness of sexually transmitted infections among health care providers and the public in general and through increased emphasis on notifying sexual partners — including the use of expedited partner therapy, where sexual partners can receive treatment without going to a provider.

Although the news is encouraging to state health officials, they acknowledge that this is just the beginning. Susan Jones, the HIV/ STD Program Manager says “I’m pleased to see this decline, but we’re not out of the woods yet.”

Alaskans offered free in-home STD test kits

Monday, November 14, 2011

Columbia eliminates river blindness

The major announcement was made Friday at the Inter-American Conference on Onchocerciasis in Bogota, Colombia according to a Merck press release.

The major milestone of Columbia eliminating river blindness from within its borders represents the first country suffering from river blindness in the Americas to reach this goal. 

Officials attribute the successes in Latin America to a sustained public-private partnership led by The Carter Center that offers health education and drug treatment donated by Merck.

At the conference, sponsored by The Carter Center, the Pan American Health Organization, the Lions Clubs International Foundation, and the Bill & Melinda Gates Foundation, also announced were the successes of Guatemala and Mexico.

Both countries have broken the transmission cycle of river blindness and will halt their Mectizan® drug treatment programs for the disease in 2012, beginning the three-year post treatment monitoring process. 

According to the Carter Center, Guatemala and Mexico represented 70 percent of the region’s disease burden, making their success even more noteworthy.

The Carter Center blog explains the process:
After Mectizan® treatments are stopped; a three-year post treatment monitoring (surveillance) period is required to ensure that the infection does not return.  Colombia is the first country to complete this three year process; Mexico and Guatemala now join Ecuador, which is already in the post treatment monitoring phase.
The two remaining affected countries in Latin America – Brazil and Venezuela – continue to battle river blindness by providing mass treatment with Mectizan® tablets in hopes of interrupting transmission next year.
Former U.S. President and Carter Center founder Jimmy Carter said of the announcements, “River blindness is a devastating disease that multiplies the challenges and burdens already faced by poverty stricken populations. Thanks to thousands of dedicated health workers and volunteers in the Americas and the generosity of Merck and the Mectizan Donation Program, this public health threat will soon be eliminated from the Western Hemisphere.”

Onchocerciasis is an infection caused by the parasite Onchocerca volvulus (worm), spread by the bite of an infected blackfly.

It is also called River Blindness because the transmission is most intense in remote African rural agricultural villages, located near rapidly flowing streams.

Persons with heavy infections will usually have one or more of the three conditions: dermatitis, eye lesions, and/or subcutaneous nodules. Superficial skin biopsies will identify the parasite microscopically.

According to the Global Network of Neglected Tropical Diseases, 37 million people are infected with onchocerciasis or river blindness worldwide, the vast majority of people infected living in Africa. 110 million people in 35 countries are at risk of infection. Half a million people are severely visually impaired from this disease, with 270,000 blind.

Tuesday, November 1, 2011

WHO and CDC send teams to Marshall Islands to assist in dengue outbreak

In the wake of a declared state of emergency by the government in the Marshall Islands, an international team of infectious disease control experts arrived in Majuro Monday to assist in controlling a rapidly growing dengue fever outbreak.
The dengue fever outbreak, which has grown to 74 confirmed cases and 45 probable cases, has been attributed to increased rainfall in the area.
According to a Radio New Zealand report, Secretary of Health, Justina Langidrik, says an entomology team from the World Health Organization and group from the Centers for Disease Control and Prevention in Atlanta will be assisting health officials.
“They will be working with the Ministry to look at the breeding sites. And we’ve already had some plans for a major clean-up on the island. And we’ve already distributed all these educational material and travel advisory on the radio and all these things.”