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Canberra, Australia

Moffatt C.R.M.,OzFoodNet | Howard P.J.,Reference Pathology Laboratory | Burns T.,Environmental Health
Foodborne Pathogens and Disease

Introduction: Clostridium perfringens food poisoning is a commonly cited cause of gastroenteritis outbreaks among elderly long-term care facility (LTCF) residents, yet little is known about the natural history of disease in this vulnerable group. In July 2009, an investigation into diarrheal illness among LTCF residents was commenced. Methods: An environmental health investigation and retrospective cohort study were undertaken to confirm the outbreak, to identify a source and mode of transmission, and to implement public health measures to prevent further cases. Menu listings and food safety program details were obtained and food-handling practices were observed. Clinical notes of all residents were reviewed. A possible case was defined as any resident developing one or more acute loose stool episodes between the evenings of 23 July and 27 July. Results: Fifty-two residents (41%) had been ill with diarrhea, and eight residents had fecal samples positive for C. perfringens enterotoxin. LTCF staff failed to perform routine temperature checks on hot foods before the outbreak. A sweet-and-sour pork lunch served on 23 July was implicated in causing residents' illness, but no residual food remained for microbiological testing. Independent associations with illness were demonstrated among residents living in two wings of the facility that received a standard level of service, whereas an inverse association with illness was shown among residents living in an "extra service" wing. Male residents were also more likely to become ill. Illness was mild with case patients reporting a median of two loose stools (range 1-12). Conclusions: C. perfringens is an important cause of both foodborne and nonfoodborne gastroenteritis outbreaks in LTCF, but may be missed due to the often mild nature of illness. This investigation highlights the potential burden of C. perfringens disease among vulnerable LTCF populations. To prevent C. perfringens outbreaks, facilities must adhere to food safety plans and ensure high standards of infection control practice. © Copyright 2011, Mary Ann Liebert, Inc. Source

Kirk M.D.,Australian National University | Gregory J.,OzFoodNet | Brotohusodo N.,OzFoodNet
Australian Journal of Dairy Technology

In Australia, state and territory health departments conduct surveillance of foodborne diseases to identify outbreaks and monitor trends. in 2000, the Australian Government established OzFoodNet to enhance the surveillance of foodborne diseases at the national level. Each year in Australia, OzFoodNet records approximately 100 outbreaks of foodborne disease due to a variety of different foods. Since OzFoodNet began, few outbreaks have implicated dairy products, except for outbreaks where people have consumed unpasteurised milk while visiting dairy farms. Source

Ross I.L.,Institute of Medical and Veterinary Science | Davos D.E.,Institute of Medical and Veterinary Science | Mwanri L.,OzFoodNet | Raupach J.,Communicable Disease Control Branch | Heuzenroeder M.W.,Institute of Medical and Veterinary Science
Current Microbiology

In South Australia serotyping and phage typing are employed for routine Salmonella surveillance. Molecular techniques such as Multiple-locus variable number tandem repeat analysis (MLVA) are increasingly utilized to aid outbreak investigations. During 2007 three Salmonella enterica serovar Typhimurium outbreaks involving phage types DT9, DT29, and DT44 were investigated. Human, food and environmental isolates were also typed by MLVA. In the DT9 outbreak cluster MLVA demonstrated distinct groupings that corresponded to epidemiological differences in time, place, and descriptive information on potential transmission mechanisms. In contrast, the human and food isolates of both the DT29 and DT44 clusters had identical MLVA profiles for all but one case. These data correlated with the epidemiology suggesting that these isolates were closely related and probably a single agent. These findings illustrate that phage typing and MLVA can provide different but complementary information for epidemiological investigations of Salmonella outbreaks. © 2010 Springer Science+Business Media, LLC. Source

Kirk M.D.,Australian National University | Moffatt C.R.M.,OzFoodNet | Hall G.V.,Australian National University | Becker N.,Australian National University | And 9 more authors.
Infection Control and Hospital Epidemiology

We estimated the incidence of gastroenteritis in 16 Australian longterm care facilities. During 12 months' surveillance, 245 (96%) of 254 episodes of gastroenteritis among long-term care residents were associated with 17 outbreaks in 11 facilities. Incidence in long-term care residents was 0.64 episodes per 1,000 bed-days (95%confidence interval, 0.29-1.42). © 2010 by The Society for Healthcare Epidemiology of America. All rights reserved. Source

Moffatt C.,OzFoodNet | Appuhamy R.,Office of the Chief Health Officer | Andrew W.,Territory and Municipal Services Directorate | Wynn S.,Infection Control | And 2 more authors.
Western Pacific surveillance and response journal : WPSAR

INTRODUCTION: In April and June 2012, two outbreaks of Campylobacter gastroenteritis were investigated in an Australian aged-care facility (ACF); a Campylobacter-positive puppy was identified as a potential source of infection.METHODS: An expert panel was convened to assess transmission risk from the puppy to elderly residents and to guide further public health action. Criteria considered as part of the panel's assessment included the puppy's infectivity, the bacterium's transmissibility, puppy-resident contact, infection control and cleaning practices and animal management at the facility. A literature review was used to assist the panel, with a final risk being determined using a likelihood and consequence matrix.RESULTS: The panel determined that the setting and low infective dose made transmission likely despite varying degrees of contact between the puppy and cases. While infection control practices were generally appropriate, the facility's animal policy did not adequately address potential zoonotic risk.CONCLUSION: In summary, puppies should not be considered as companion animals in ACFs due to high rates of Campylobacter carriage and the underlying susceptibility of the elderly. Infection control and animal policies in ACFs should reflect an awareness of zoonotic disease potential. Source

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