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Furlong C.,Sydney South West Area Health Service Public Health Unit | Stephens N.,Sydney South West Area Health Service Public Health Unit | Shadbolt C.,NSW Food Authority | Maywood P.,Sydney South West Area Health Service Public Health Unit | And 2 more authors.
Epidemiology and Infection | Year: 2012

Twenty-two confirmed cases of Salmonella Infantis were identified in 70 residents of high-level care areas of a residential aged care facility in Sydney in April 2010 during an outbreak of gastroenteritis. A retrospective cohort study was conducted to identify a possible cause. Consuming a soft diet, pureed diet, or thickened fluid were each independently associated with illness. A logistic regression showed consumption of thickened fluid to be the only significant exposure associated with illness (adjusted odds ratio 118, 95% confidence interval 19-759). It was postulated that the thickened fluid had been contaminated by chicken mince, a sample of which also cultured S. Infantis. This finding reinforces the need to educate food-handlers on the risk of potential cross-contamination; it also highlights the need to consider all dietary components, such as thickened fluids, as potential vehicles for transmission in an outbreak. © Copyright Cambridge University Press 2012.


Farrell H.,University of Technology, Sydney | Farrell H.,Sydney Institute of Marine science | Seebacher F.,University of Sydney | O'Connor W.,Port Stephens Fisheries Institute | And 4 more authors.
Global Change Biology | Year: 2015

Species of Alexandrium produce potent neurotoxins termed paralytic shellfish toxins and are expanding their ranges worldwide, concurrent with increases in sea surface temperature. The metabolism of molluscs is temperature dependent, and increases in ocean temperature may influence both the abundance and distribution of Alexandrium and the dynamics of toxin uptake and depuration in shellfish. Here, we conducted a large-scale study of the effect of temperature on the uptake and depuration of paralytic shellfish toxins in three commercial oysters (Saccostrea glomerata and diploid and triploid Crassostrea gigas, n = 252 per species/ploidy level). Oysters were acclimated to two constant temperatures, reflecting current and predicted climate scenarios (22 and 27 °C), and fed a diet including the paralytic shellfish toxin-producing species Alexandrium minutum. While the oysters fed on A. minutum in similar quantities, concentrations of the toxin analogue GTX1,4 were significantly lower in warm-acclimated S. glomerata and diploid C. gigas after 12 days. Following exposure to A. minutum, toxicity of triploid C. gigas was not affected by temperature. Generally, detoxification rates were reduced in warm-acclimated oysters. The routine metabolism of the oysters was not affected by the toxins, but a significant effect was found at a cellular level in diploid C. gigas. The increasing incidences of Alexandrium blooms worldwide are a challenge for shellfish food safety regulation. Our findings indicate that rising ocean temperatures may reduce paralytic shellfish toxin accumulation in two of the three oyster types; however, they may persist for longer periods in oyster tissue. © 2015 John Wiley & Sons Ltd.


Najjar Z.,Sydney Local Health District Public Health Unit | Gupta L.,Sydney Local Health District Public Health Unit | Gupta L.,University of Sydney | Sintchenko V.,University of Sydney | And 3 more authors.
Medical Journal of Australia | Year: 2015

Three patients were diagnosed with listeriosis in different hospitals within a short period. Rapid molecular typing techniques and review of hospital menus using an electronic menu database allowed prompt identification of the source of infection and implementation of control measures that prevented further infections. © 2015, Australasian Medical Publishing Co. Ltd. All Rights Reserved.


PubMed | University of Sydney, University of Technology, Sydney, Port Stephens Fisheries Institute, Cawthron Institute and NSW Food Authority
Type: Journal Article | Journal: Global change biology | Year: 2015

Species of Alexandrium produce potent neurotoxins termed paralytic shellfish toxins and are expanding their ranges worldwide, concurrent with increases in sea surface temperature. The metabolism of molluscs is temperature dependent, and increases in ocean temperature may influence both the abundance and distribution of Alexandrium and the dynamics of toxin uptake and depuration in shellfish. Here, we conducted a large-scale study of the effect of temperature on the uptake and depuration of paralytic shellfish toxins in three commercial oysters (Saccostrea glomerata and diploid and triploid Crassostrea gigas, n=252 per species/ploidy level). Oysters were acclimated to two constant temperatures, reflecting current and predicted climate scenarios (22 and 27C), and fed a diet including the paralytic shellfish toxin-producing species Alexandrium minutum. While the oysters fed on A. minutum in similar quantities, concentrations of the toxin analogue GTX1,4 were significantly lower in warm-acclimated S. glomerata and diploid C. gigas after 12days. Following exposure to A. minutum, toxicity of triploid C. gigas was not affected by temperature. Generally, detoxification rates were reduced in warm-acclimated oysters. The routine metabolism of the oysters was not affected by the toxins, but a significant effect was found at a cellular level in diploid C. gigas. The increasing incidences of Alexandrium blooms worldwide are a challenge for shellfish food safety regulation. Our findings indicate that rising ocean temperatures may reduce paralytic shellfish toxin accumulation in two of the three oyster types; however, they may persist for longer periods in oyster tissue.


Yapa C.M.,NSW Health | Furlong C.,NSW Health | Rosewell A.,NSW Health | Ward K.A.,NSW Health | And 9 more authors.
The Medical journal of Australia | Year: 2016

OBJECTIVE: To determine the source and extent of a locally acquired hepatitis E virus (HEV) infection outbreak.DESIGN, SETTING AND PARTICIPANTS: A cluster of notified cases of HEV infection linked to a single restaurant (X) was identified in May 2014. People with laboratory-confirmed HEV infection in New South Wales between January 2013 and December 2014 were interviewed about potential risk factors for HEV infection. Co-diners at restaurant X and patients with suspected but unexplained viral hepatitis were retrospectively tested. Foods eaten by the infected persons were compared with those of seronegative co-diners. HEV RNA detected in sera from infected persons was sequenced and genotyped. Implicated foods were traced back to their sources.MAIN OUTCOME MEASURES: Potential sources of infection, including overseas travel and foods eaten, and origin of implicated food products.RESULTS: In 55 serologically confirmed cases of HEV infection, 24 people had not travelled overseas during their incubation periods. Of the 24, 17 reported having eaten at restaurant X, 15 of whom could be interviewed. All reported consuming pork liver pâté, compared with only four of seven uninfected co-diners (P < 0.05). The other seven people with locally acquired infections each reported consuming a pork product during their incubation periods. HEV RNA was detected in 16 of the 24 cases; all were of genotype 3. Sequencing indicated greater than 99% homology among restaurant X isolates. HEV RNA was isolated from pork sausages from a batch implicated in one of the locally acquired infections not linked with restaurant X. The pork livers used for pâté preparation by restaurant X were traced to a single Australian farm.CONCLUSIONS: This is the first reported HEV outbreak in Australia. HEV should be considered in patients presenting with a compatible illness, even without a history of overseas travel. Pork products should be thoroughly cooked before consumption.


Yapa C.M.,NSW Health | Yapa C.M.,Australian National University | Furlong C.,NSW Health | Rosewell A.,NSW Health | And 11 more authors.
Medical Journal of Australia | Year: 2016

Objective: To determine the source and extent of a locally acquired hepatitis E virus (HEV) infection outbreak. Design, setting and participants: A cluster of notified cases of HEV infection linked to a single restaurant (X) was identified in May 2014. People with laboratory-confirmed HEV infection in New South Wales between January 2013 and December 2014 were interviewed about potential risk factors for HEV infection. Co-diners at restaurant X and patients with suspected but unexplained viral hepatitis were retrospectively tested. Foods eaten by the infected persons were compared with those of seronegative co-diners. HEV RNA detected in sera from infected persons was sequenced and genotyped. Implicated foods were traced back to their sources. Main outcome measures: Potential sources of infection, including overseas travel and foods eaten, and origin of implicated food products. Results: In 55 serologically confirmed cases of HEV infection, 24 people had not travelled overseas during their incubation periods. Of the 24, 17 reported having eaten at restaurant X, 15 of whom could be interviewed. All reported consuming pork liver pâté, compared with only four of seven uninfected co-diners (P<0.05). The other seven people with locally acquired infections each reported consuming a pork product during their incubation periods. HEV RNA was detected in 16 of the 24 cases; all were of genotype 3. Sequencing indicated greater than 99% homology among restaurant X isolates. HEV RNA was isolated from pork sausages from a batch implicated in one of the locally acquired infections not linked with restaurant X. The pork livers used for pâté preparation by restaurant X were traced to a single Australian farm. Conclusions: This is the first reported HEV outbreak in Australia. HEV should be considered in patients presenting with a compatible illness, even without a history of overseas travel. Pork products should be thoroughly cooked before consumption. © 2016 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved.


Geary P.M.,University of Newcastle | Evans C.A.,University of Newcastle | Maswabi M.T.,University of Newcastle | Lee C.C.C.,The University of Newcastle | And 3 more authors.
Water Practice and Technology | Year: 2015

In managing water quality in catchments and estuaries, faecal contamination is typically assessed using microbial indicators, such as faecal coliform bacteria. Bacteriological indicators however cannot be used to distinguish whether the faecal contamination has been derived from human or animal sources. The ability to track contamination and distinguish between sources is particularly important where water is used for potable supply, recreational purposes and where commercial aquaculture for human consumption is undertaken. Various chemicals associated with human metabolism and activities which are present in faecal material (such as faecal sterol, pharmaceutical and fluorescent whitening compounds present in wastewaters) can be utilized to identify a human signal and therefore whether the faecal contamination in water is likely to have been derived from human sources. This paper demonstrates an approach and methodology for future work using a combination of these methods to distinguish human contaminant sources in stormwater runoff in an estuary where aquaculture is practised. © IWA Publishing 2015.


PubMed | Victorian Infectious Diseases Reference Laboratory, NSW Health, NSW Food Authority, Public Health Unit and Westmead Hospital
Type: Journal Article | Journal: The Medical journal of Australia | Year: 2016

To determine the source and extent of a locally acquired hepatitis E virus (HEV) infection outbreak.A cluster of notified cases of HEV infection linked to a single restaurant (X) was identified in May 2014. People with laboratory-confirmed HEV infection in New South Wales between January 2013 and December 2014 were interviewed about potential risk factors for HEV infection. Co-diners at restaurant X and patients with suspected but unexplained viral hepatitis were retrospectively tested. Foods eaten by the infected persons were compared with those of seronegative co-diners. HEV RNA detected in sera from infected persons was sequenced and genotyped. Implicated foods were traced back to their sources.Potential sources of infection, including overseas travel and foods eaten, and origin of implicated food products.In 55 serologically confirmed cases of HEV infection, 24 people had not travelled overseas during their incubation periods. Of the 24, 17 reported having eaten at restaurant X, 15 of whom could be interviewed. All reported consuming pork liver pt, compared with only four of seven uninfected co-diners (P <0.05). The other seven people with locally acquired infections each reported consuming a pork product during their incubation periods. HEV RNA was detected in 16 of the 24 cases; all were of genotype 3. Sequencing indicated greater than 99% homology among restaurant X isolates. HEV RNA was isolated from pork sausages from a batch implicated in one of the locally acquired infections not linked with restaurant X. The pork livers used for pt preparation by restaurant X were traced to a single Australian farm.This is the first reported HEV outbreak in Australia. HEV should be considered in patients presenting with a compatible illness, even without a history of overseas travel. Pork products should be thoroughly cooked before consumption.

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