Wednesday, March 29, 2017
I received sad news this morning. An elderly friend of mine had died. She became ill while on a cruise. The official cause will probably be listed as “congestive heart failure” or something similar. But although that explanation will be much more acceptable to the cruise line, it is not the whole story.
First, a bit of background. My friend is (I typed “is” as I am still having trouble using the past tense..)..was in her 80’s. Like many people of that age, she had a few chronic conditions, one being arthritis, and another, a “weak” heart. But she had never had a heart attack and her doctor in the UK considered her well enough to go on the cruise with her caregiver.
I was told that she really enjoyed the trip up until day 22 of this 44 day cruise. At that point there was an outbreak of food poisoning on the ship. She became very ill, dehydrated, and had to be sent to a hospital in Jamaica, which was the closest port. Several of the passengers ended up there, especially those who were over 60. At least one died soon after she was hospitalized in Jamaica.
Along with a few of the others, my friend was confined to the intensive care unit. After a few days she seemed to be better, but because she was still weak and considered at risk, she was sent to a hospital in Florida, and then to one in England, where she now lived. She died there.
If you have been following this blog, you will know that food poisoning outbreaks on cruise ships are common, with the majority of them caused by norovirus – a highly contagious group of viruses which often infects both passengers and crew. Usually an outbreak starts through contaminated food (perhaps contaminated by a crew member), but you can also catch it directly from someone who is ill (by taking care of them, using the same eating utensils or even from sprayed vomit), and, from surfaces.
Most people recover after 1-3 thoroughly miserable days. However, passengers who are older frequently develop severe dehydration which can aggravate or lead to other serious conditions as seemed to have occurred in my friend’s case. It is not unusual for relapses to happen a couple of weeks or so after the food poisoning incident itself, even after the patient seems to have recovered and has been released from hospital.
The Safe Food Handbook (available on Amazon) discusses how you can protect yourself, as do other posts on this blog. Be careful if you are going on a cruise!
Friday, March 24, 2017
I want to say right at the outset, that I believe in the value of school lunch. When I was a poor malnourished refugee child, I really appreciated that food. It is very hard to pay attention in class if you are hungry. But food poisoning outbreaks at schools are not unusual, simply because institutional food, prepared and served in bulk, is always more risky. And of course, such outbreaks get a lot of media coverage.
Recently there was a very large outbreak in Egypt caused by a school lunch (see earlier post), in which some 3,300 children had to be sent to hospital. In all, it is estimated that there have been 4,650 school lunch associated food poisoning cases nationwide in Egypt just this month (March, 2017). But Egypt is not the only country where such outbreaks occur. I have read case studies of school food poisoning outbreaks in India, Canada, UK, Japan and elsewhere. How the school lunch is organized and how sanitary the conditions are, varies in these and other countries.
In the United States, the National School Lunch Program is carefully supervised, but even then, food poisoning outbreaks occur. It is estimated that between 1991 and 2000 (I don’t have later statistics) there were 300 outbreaks of food poisoning in American schools, which made at least 16,000 students ill. The largest during that decade affected school children in seven states in 1997-1998. It was unusual in that it was caused by a toxic mold in frozen burritos.
But there have been many different types of causes over the years. Bacteria such as Salmonella, E.coli and Staphylococcus strains have been found to cause food poisoning in school lunches. Even agricultural chemicals have been involved, though less than they are in Third World countries. Several incidents have of course been caused by the common norovirus. That was the cause of the recent outbreak of food poisoning at the St. Charles East High School in Illinois, USA, in which some 800 students became ill.
As of this past Wednesday, the Ministry of Education in Egypt suspended school lunches, which feed some 9 million students a day. It plans to set up a committee (the usual bureaucratic solution) and conduct an investigation of why school lunches are so unsafe. I can hazard a few guesses.
Sunday, March 19, 2017
So far the causal agent or specific lunch item has not been identified. I would lay my money on norovirus. One reason I suspect norovirus is because the symptoms are typical. Another is that norovirus was also suspected in one of the food poisoning outbreaks at Al-Arbak University in Cairo in 2013 and is quite common in such mass meal programs all over the world (see next post).
In all, Egypt’s food has had a bad run of luck over the last few years and it is commonly known that national hygiene in food processing, packaging, preparation and food service is poor. The world is beginning to wonder whether it is safe to eat at all, particularly since it has caused havoc overseas as well as domestically.
The worst case of such exported food was that large outbreak of E. coli 0104 food poisoning which originated in Northern Germany in 2011. It made some 4,100 people ill, mainly in Europe, and killed at least 50. After many false turns by investigators, it was finally traced to fenugreek seeds imported from Egypt that had been sprouted in Germany (see the several posts on this blog).
You may also recall the Salmonella-contaminated organic celery seed that originated in Egypt. I had to pat myself on the back for predicting correctly on this blog that these seeds had been imported from Egypt.
Then over the last few months there has been that Hepatitis A problem with frozen strawberries imported from Egypt, which were used to make not-so-healthy smoothies in the U.S. They have given 143 unsuspecting people in 9 states a dangerous liver disease.
Of course, this isn't the end of the list.
Tuesday, March 14, 2017
I was dining with friends at a highly recommended local restaurant a few years ago, when I bit into a nail in my dessert. Of course, I sent it back. A pity. The dessert tasted delicious. That is, until I crunched into that nail. I was lucky I did not break a tooth. Although they brought me a replacement dessert - the least they could do - it just didn't taste the same afterwards.
Metal in food is not that unusual, although it is usually small pieces of metal shavings – not the size of the nail that I almost ate. For instance, a few days ago there was a recall in the United States for some nine meatballs and chicken fried steak products that were produced by King’s Command Foods, LLC., of Kent, Washington.
And it doesn’t just happen in the U.S. I did a quick search to see what I could find out about similar incidents in other countries. In the UK for instance, there was a recall last month of “meat free mince” and of “crunchy biscuit spread” because of pieces of metal, both sold by that large UK supermarket Tesco as well as by other supermarkets. And last year there was a recall of biscuits in Germany by the Verden biscuit and wafer factory Hans Freitag. The company in the German case noted that its metal detectors had unfortunately not picked up the “metal hair” (metal detectors used on biscuits? That's something I didn’t know!)
Now if the restaurant I ate at had used a metal detector on my dessert, that nail would certainly have been picked up before the dessert landed on my table. I was thinking of going by and suggesting it to them. But I noticed that the restaurant has closed. No wonder, if that's the kind of food they served!
Saturday, March 11, 2017
I have posted 32 posts on this blog relating to this incident, starting shortly after the disaster, and correctly predicting the food contamination that occurred. I have to admit that I was surprised to find that the most popular of the posts dealt with contamination of seaweed, with almost 10,000 views.
Looking once again at the sad photos from this incident in today's New York Times, my heart went out to the victims of this tragic incident.
Wednesday, March 8, 2017
Why these places? True the virus is highly contagious. But there is another reason - these are all places where food is prepared by food service workers. Low income food service workers, with no health insurance, often turn up for work when they are ill so that they don't lose the wages they need to live on. In fact, if they have been ill with this virus, they should actually stay home for at least two days after they feel fine, because they could still be contagious. But of course, they don't. Can you blame them?
It estimated that at least 21 million people in the U.S. get sick from Norovirus every year, and some 70,000 or so are sick enough to end up in hospital. Those who die are often already ill or are older people who become very badly dehydrated. That is why I have often warned seniors not to eat at salad bars, which are a common place for the virus to hide out.
Sunday, March 5, 2017
So here’s some bad news and good news about this virus.
The bad news about Norovirus is that it is a very contagious virus which you can catch not just from food (especially salad bars) but also all kinds of surfaces such as hand rails, countertops and even plastic bags. Don’t suck your thumb or bite your fingernails and wash your hands thoroughly before eating (Is my son reading this?). What is more, you can feel truly awful if you have it. Also bad news is the fact that it is often caught in places where you go to have fun – not get sick – such as cruises, restaurants, weddings, parties and celebrations of all kinds (I won’t put schools and nursing homes on that “fun” list). Another piece of bad news is that you can catch it more than once. Having been ill with Norovirus once will not protect you from getting it. As in the case of the flu, there are many types of noroviruses.
The good news is that while you may feel absolutely awful for what seems like a million years, you’re likely to get better quickly – usually between one to three days. Another piece of good news is that if you are fairly healthy to start off with and keep yourself well hydrated while vomiting all over the place, you will be OK once it’s over. This could be another plus - you may find that you have just undergone a crash weight loss program. And the final good news is that if you work outside your home, or are in charge of cooking for your household, you will have a couple of days of rest afterwards, as no one will want you anywhere near them or preparing any food while you could still be contagious.