Overview of the impact of epidemic-assistance investigations of foodborne and other enteric disease outbreaks, 1946-2005

The significance of clean and dirty animals for bacterial dynamics along the beef chain

This study investigated the bacterial dynamics along the beef chain for clean and dirty cattle in the slaughter and processing lines, using classic quantitative methods and molecular analyses. In addition, the Norwegian national guidelines for Good Hygiene Practices in Norway were evaluated. In these guidelines, cattle presented for slaughter are categorised according to hide cleanliness, resulting in separate processing lines for meat from very dirty animals and reduced prices to farmers. The study was conducted in two commercial abattoirs in Norway. Two groups were compared; 40 visually clean cattle and 40 visually dirty cattle presented for slaughter, with 20 from each group at each abattoir. The same animals were sampled at five sampling sites: hides, carcass surfaces after dehiding, just before chilling, after chilling, and meat trimmings. Meat trimmings were sampled in only one abattoir. Three hundred and sixty samples were collected by swabbing 100 cm(2) of the brisket area at the first four sampling sites, and sampling 200 g of meat trimmings at the fifth site. The results showed that the hides of dirty cattle had more Enterobacteriaceae and higher Aerobic Plate Counts (APC) than visually clean cattle (P<0.05), however there was no significant difference for Escherichia coli. For the other sampling sites, there were no differences between the dirty and the clean group. An effect of chilling/drying of the carcass surfaces was demonstrated by the significant reduction in the number of carcasses on which E. coli and Enterobacteriaceae were detected; from 11% and 39% before chilling to 1% and 16% after chilling, respectively. Enterobacteriaceae and E. coli were detected in only three and one of the meat trimming samples, respectively. Amplification and sequencing of the 16S rRNA gene from 643 Enterobacteriaceae colonies derived from 107 samples demonstrated that Escherichia/Shigella were dominant within this family on the hides. However, after dehiding, after grading, and after chilling, the genera Citrobacter and Enterobacter dominated. The meat trimmings were dominated by the genera Kluyvera, Hafnia, and unclassified Enterobacteriaceae. The relative proportions of Escherichia/Shigella were higher for dirty animals than for clean animals, and were higher on hides than from sampling sites further down the chain (P<0.05). The minor differences in contamination on carcass surfaces and meat trimmings between clean and dirty cattle indicate that separate processing lines in Norwegian abattoirs seem to be unnecessary.

Detection of foodborne bacterial pathogens from individual filth flies

There is unanimous consensus that insects are important vectors of foodborne pathogens. However, linking insects as vectors of the pathogen causing a particular foodborne illness outbreak has been challenging. This is because insects are not being aseptically collected as part of an environmental sampling program during foodborne outbreak investigations and because there is not a standardized method to detect foodborne bacteria from individual insects. To take a step towards solving this problem, we adapted a protocol from a commercially available PCR-based system that detects foodborne pathogens from food and environmental samples, to detect foodborne pathogens from individual flies.Using this standardized protocol, we surveyed 100 wild-caught flies for the presence of Cronobacter spp., Salmonella enterica, and Listeria monocytogenes and demonstrated that it was possible to detect and further isolate these pathogens from the body surface and the alimentary canal of a single fly. Twenty-two percent of the alimentary canals and 8% of the body surfaces from collected wild flies were positive for at least one of the three foodborne pathogens. The prevalence of Cronobacter spp. on either body part of the flies was statistically higher (19%) than the prevalence of S. enterica (7%) and L.monocytogenes (4%). No false positives were observed when detecting S. enterica and L. monocytogenes using this PCR-based system because pure bacterial cultures were obtained from all PCR-positive results. However, pure Cronobacter colonies were not obtained from about 50% of PCR-positive samples, suggesting that the PCR-based detection system for this pathogen cross-reacts with other Enterobacteriaceae present among the highly complex microbiota carried by wild flies. The standardized protocol presented here will allow laboratories to detect bacterial foodborne pathogens from aseptically collected insects, thereby giving public health officials another line of evidence to find out how the food was contaminated when performing foodborne outbreak investigations.

Epidemic assistance from the Centers for Disease Control and Prevention involving American Indians and Alaska Natives, 1946-2005

The authors describe 169 Centers for Disease Control and Prevention epidemic-assistance investigations involving American Indians and Alaska Natives that occurred during 1946-2005. The unique relation between the US federal government and American Indian and Alaska Native tribes is described in the context of transfer in the 1950s of responsibility for Indian health to the US Public Health Service, which at the time included the Communicable Disease Center, the Centers for Disease Control and Prevention's precursor. The vast majority of epidemic-assistance investigations were for infectious disease outbreaks (86%), with a relatively limited number, since 1980 only, involving environmental exposures and chronic disease. Although outbreaks investigated were often widespread geographically, the majority were limited in scope, typically involving fewer than 100 patients. Epidemic-assistance investigations for hepatitis A, gastrointestinal and foodborne infectious diseases, vaccine-preventable diseases, zoonotic and vectorborne diseases, acute respiratory tract infections, environmental exposures, and chronic diseases are described chronologically in more detail.