Bacterial diversity in six species of fresh edible seaweeds submitted to high pressure processing and long-term refrigerated storage.

Seaweeds are highly perishable foods due to their richness in nutrients. High pressure processing (HPP) has been applied for extending the shelf life of fresh seaweeds but there is no information on the effect of HPP on the bacterial diversity of seaweeds. The culturable bacteria of six species of fresh edible seaweeds (green seaweeds Codium fragile and Ulva lactuca, brown seaweeds Himanthalia elongata, Laminaria ochroleuca and Undaria pinnatifida, and red seaweed Chondrus crispus) were investigated and compared to those of HPP-treated (400 and 600 MPa for 5 min) seaweeds, at the start and end of their refrigerated storage period. A total of 523 and 506 bacterial isolates were respectively retrieved from untreated and HPP-treated seaweeds. Isolates from untreated seaweeds belonged to 18 orders, 35 families, 71 genera and 135 species whereas isolates from HPP-treated seaweeds belonged to 13 orders, 23 families, 43 genera and 103 species. HPP treatment significantly reduced the number of isolates belonging to 6 families and greatly increased the number of Bacillaceae isolates. At the end of storage, decreases in bacterial diversity at the genus and species level were observed for untreated as well as for HPP-treated seaweeds.

Epidemiological Characterization of Listeria monocytogenes Infections in Pavia Province in 2017 Reveals the Presence of Multiple Concurrently Circulating Strains.

Consumption of raw food, especially smoked fish, meat, soft cheeses, and vegetables, contaminated with Listeria monocytogenes can cause listeriosis, which can be invasive in pregnant women, elderly, and immunocompromised and diabetic patients. Through June to November of 2017, 11 patients developed invasive listeriosis in a small area of northern Italy. In the same period, 15 food samples (ready-to-eat seafood, raw vegetables, cheese samples, and salami) collected during the routine screening programs in the same area were found to be contaminated with L. monocytogenes. We characterized the isolates to determine the relatedness of L. monocytogenes strains isolated from patients and isolates from food samples and food-processing plants. Whole genome sequencing analysis showed that multiple L. monocytogenes strains were circulating in the area and no association was found between clinical and food isolates.

Factors associated with food safety knowledge and practices among meat handlers in Bangladesh: a cross-sectional study.

BACKGROUND: Food handlers can play a vital role into reducing foodborne diseases by adopting appropriate food handling and sanitation practices in working plants. This study aimed to assess the factors associated with food safety knowledge and practices among meat handlers who work at butcher shops in Bangladesh. METHODS: A cross-sectional study was conducted among 300 meat handlers from January to March, 2021. Data were collected through in-person interviews using a structured questionnaire. The questionnaire consisted of three parts; socio-demographic characteristics, assessments of food safety knowledge, and food safety practices. A multiple logistic regression model was used to identify the factors associated with food safety knowledge and practices. RESULTS: Only 20% [95% confidence interval, (CI) 15.7-24.7] and 16.3% (95% CI 12.3-20.7) of the respondents demonstrated good levels of food safety knowledge and practices, respectively. The factors associated with good levels of food safety knowledge were: having a higher secondary education [adjusted odds ratio (AOR) = 4.57, 95% CI 1.11-18.76], income above 25,000 BDT/month (AOR = 10.52, 95% CI 3.43-32.26), work experience of > 10 years (AOR = 9.31, 95% CI 1.92-45.09), ≥ 8 h per day of work (AOR = 6.14, 95% CI 2.69-13.10), employed on a daily basis (AOR = 4.05, 95% CI 1.16-14.14), and having food safety training (AOR = 8.98 95% CI 2.16-37.32). Good food safety knowledge (AOR = 5.68, 95% CI 2.33-13.87) and working ≥ 8 h per day (AOR = 8.44, 95% CI 3.11-22.91) were significantly associated with a good level of food safety practice. CONCLUSIONS: Poor knowledge and practices regarding food safety were found among Bangladeshi meat handlers. Findings may help public health professionals and practitioners develop targeted strategies to improve food safety knowledge and practices among this population. Such strategies may include education and sensitization on good food safety practices.

Prevalence and factors associated with intestinal parasitic infections among food handlers working at higher public University student's cafeterias and public food establishments in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Intestinal infection is still an important public health problem in low-income countries. Food handlers may be infected by a wide range of enteropathogens and have been implicated in the transmission of many infections to the public. Therefore, the aim of this review was to produce the pooled prevalence and factors associated with intestinal parasitic infections among food handlers working at higher public University student's cafeterias and public food establishments in Ethiopia. METHODS: Articles published in PubMed/Medline, Hinari, Web of Science, Science Direct, and Google Scholar were used using a search strategy. Observational studies (cross-sectional) revealing the prevalence and factors associated with intestinal parasitic infections at higher public University student's cafeterias and public food establishments were incorporated. Meta-analysis was computed using STATA version 14 statistical software. Heterogeneity of the study was assessed using Cochrane Q test statistics and I2 test. The pooled prevalence of the intestinal parasitic infection and associated factors among food handlers was calculated by the random-effect model. RESULTS: Out of 138 reviewed studies, 18 studies were included to estimate the pooled prevalence of intestinal parasitic infections among food handlers in Ethiopia. All the eighteen articles were included in the analysis. This study revealed that the pooled prevalence of intestinal parasitic infections was 28.5% (95% CI: 27.4, 29.7). E. hystolitica /E. dispar complex 6.38 (95% Cl: 5.73, 7.04), A.lumbricodes 4.12 (95% Cl: 3.56, 4.67), and G. lamblia 3.12(95% Cl: 2.65, 3.60) were the most common intestinal parasitic infections in this study. Untrimmed fingernail 3.04 (95% CI: 2.19, 4.22), do not washing hands after defecation 2.71 (95% CI: 1.93, 3.82), do not washing hands after touching any body parts 2.41 (95% CI: 1.64, 3.56), do not made medical checkup 2.26 (95% CI: 1.57, 3.25), and do not receive food safety training 1.79 (95% CI: 1.30, 2.45) were factors significantly and positively associated with intestinal parasitic infections. CONCLUSION: Parasitic infections among food handlers were significantly high. Untrimmed fingernail, do not washing hands after defecation, do not washing hands after touching any body parts, do not made regular medical checkup and do not receive food safety training were factors that increase the prevalence of intestinal parasitic infections.

Intestinal parasites among food handlers of food service establishments in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Intestinal parasites remain considerable public health problems in low-income countries where poor food hygiene practice is common. Food handlers, people involved in preparing and serving food, working with poor personal hygiene could pose a potential threat of spreading intestinal parasites to the public in a community. The aim of this systematic review and meta-analysis was, therefore, to synthesize the pooled prevalence estimate of intestinal parasites and associated pooled odds ratio of hygienic predictors among food handlers of food service establishments in Ethiopia that could aid to further bringing down the burden of intestinal parasites and it can also be used as a springboard for future studies. METHODS: We searched exhaustively for studies Published before 20 April 2019 using eight Databases; PubMed, Science Direct, Web of Science, Scopus, Embase, Google Scholar, ProQuest, and Ovid MEDLINE® complemented by the gray literature search. In the final synthesis, we included twenty study reports. We used the Cochrane Q test and I2 test to assess heterogeneity of studies, while we employed a funnel plot followed by Egger's regression asymmetry test and Begg rank correlation methods to evaluate publication bias. We also performed a point estimates and 95% confidence interval for each study using STATA version 14 statistical software. RESULTS: The overall pooled prevalence estimate of intestinal parasites among food handlers of food service establishments in Ethiopia was 33.6% (95%CI: 27.6-39.6%). Among ten intestinal parasites identified from food handlers, Entamoeba histolytica/ dispar (11, 95%CI: 7.9-14.1%) and Ascaris lumbricoides (8.8, 95%CI: 6.4-11.2%) were the most predominant intestinal parasites. Food handlers who washed hands after toilet use had 54% (OR, 0.46, 95% CI: 0.23-0.94) protection from intestinal parasites compared to those who did not. CONCLUSIONS: This study revealed that intestinal parasitic infections are notable among food handlers of food service establishments in Ethiopia, which may be a risk for transmitting intestinal parasites to food and drinks consumers through the food chain. Thus, periodic stool checkup, training on intestinal parasitic infections and personal hygiene should be applied to reduce public health and socio-economic impacts of parasitic infections.

Microbiological quality of kitchens sponges used in university student dormitories.

BACKGROUND: Kitchen sponges are a major source of cross-contamination as they can transfer foodborne pathogens, infectious agents and spoilage causing microorganisms to food contact surfaces. Several studies have revealed that university students adopt poor practices regarding food safety, hygiene, and the handling of kitchen cleaning equipment. METHODS: A total of fifty kitchen sponges were collected along with a questionnaire addressing social demographics and kitchen sponge usage by students living at the University of Sharjah dormitories. The effect of storage (3 and 10 days) on the microbial population of kitchen sponges at room temperature (21 °C) was assessed. Enterobacteriaceae isolated from sponges were identified and their antibiotic resistance determined. RESULTS: Student responses revealed that kitchen sponges used to clean food contact surfaces were also used to clean the oven (32%), sink (26%), refrigerator (10%), and to clean spills on the floor (4%). Kitchen sponges contained high counts of mesophilic aerobic bacteria (7.9 log10/cm3), coliform (7.2 log10/cm3), Enterobacteriaceae (7.3 log10/cm3) and yeasts and molds (7.0 log10/cm3). After storage of the sponges at room temperature (21 °C) for 3 and 10 days, the number of mesophilic aerobic bacteria, coliform, Enterobacteriaceae and yeasts and molds decreased by 0.4 and 1.3 log10/cm3, 0.7 and 1.4 log10/cm3, 0.4 and 1.1 log10/cm3, and 0.6 and 1.3 log10/cm3, respectively. The most frequently isolated Enterobacteriaceae were Enterobacter cloacae (56%) and Klebsiella oxytoca (16%). All E. cloacae isolates were resistant to amoxicillin, cefalotin, cefoxitin and cefuroxime axetil. CONCLUSIONS: This study showed that students living in dormitories lacked good hygienic practices and were at increased risk of food poisoning. Kitchen sponges were highly contaminated with potentially pathogenic bacteria which could be transferred from the general kitchen environment to food contact surfaces and consequently lead to food contamination.

Prevalence of Listeria species and L. monocytogenes in ready-to-eat foods in the West Pomeranian region of Poland: Correlations between the contamination level, serogroups, ingredients, and producers.

Poland is one of the largest food producers in Europe, and the West Pomeranian region of Poland is a large producer of RTE food. Thus, the objective of this study was to determine the prevalence of Listeria sp. and L. monocytogenes (LM) in RTE foods manufactured by 13 selected Polish food producers whose processing plants are located in this region. In total, 650 samples of RTE foods, and 263 ingredients of salads and desserts were analyzed. Almost 18% of the RTE foods failed to meet the zero tolerance limit for Listeria, which means they should not be allowed for retail. LM was isolated from 13.5% of the samples, with counts of 10-100 CFU/g noted in half of them. Products with meat and dairy ingredients, and fish products, sandwiches, sprouts and sushi, were at the highest statistically significant risk of LM contamination. Four serogroups were identified among the LM isolated from RTE foods, of which the 4b-4d-4e serogroup was predominating. The samples most heavily contaminated with LM contained even 2 serogroups. Results were subjected to the cluster analysis and principal component analysis to determine correlations between food groups, food ingredients, producers, contamination level, and serogroups of LM.

[Integrated management method in the prevention department of a COVID-19 epidemic outbreak in a large meat processing plant in Bari province]. / Modalità di gestione integrata nel dipartimento di prevenzione di un focolaio epidemico di COVID-19 in un grande stabilimento di lavorazione di carni della provincia di Bari.

Aim of this paper is to describe the management of an outbreak of COVID-19 in a slaughtering and meat processing plant in Bari Province (Southern Italy). At the end of the outbreak investigation, 18.4% of the employees were positive to the molecular test for SARS-CoV-2. Higher prevalence has been reported in the bovine slaughtering house and swine meat processing plant.In addition to lack of physical distancing and correct use of personal protective equipment, the spread of the virus has been eased by low level of literacy, indoor microclimate, intensive working time, and aerosol-generating procedures in specific areas of the processing plant where more positive cases have been detected. The analysis of this cluster may suggest specific actions to prevent similar outbreaks in the future.

Molecular characterization of Listeria monocytogenes isolates from a small-scale meat processor in Montenegro, 2011-2014.

The presence of Listeria monocytogenes was evaluated in a small-scale meat processing facility in Montenegro during 2011-2014. L. monocytogenes isolates from traditional meat products and environmental swabs were subjected to a) molecular characterization b) serotyping by both multiplex PCR and next generation sequencing (NGS) c) potential antimicrobial resistance (AMR) was assessed by extraction of specific genes from NGS data and d) screening for the presence of some disinfectant resistance markers. Overall, traditional meat products were contaminated, most likely from incoming raw materials, with 4 major specific STs of L. monocytogenes (ST515, ST8, ST21, ST121) representing 4 clonal complexes (CC1, CC8, CC21, CC121) identified during the four-year period. These strains belonged to serogroup IIa which predominated, followed by IVb (ST515, CC1). The strains from environmental swabs belonged, exclusively, to ST21 and were isolated from cutting board and floor swabs in 2011. Furthermore, we found Tn6188, a novel transposon conferring tolerance to BC, to be specific to sequence type ST121. In addition, antimicrobial resistance genes mprF and fosX were present in clonal complexes CC21 and CC121, while complexes CC8 and CC1 exclusively harbored the mprF antimicrobial resistance gene.

Potential reservoirs and routes of Cronobacter transmission during cereal growing, processing and consumption.

Cronobacter are opportunistic bacterial pathogens of both infants and adults. We investigated the incidence and distribution of Cronobacter in 1245 samples of cereal and related environments. 39.1% (101/258) rice-related and 46.9% (98/209) wheat-related samples tested positive for Cronobacter, and the positive rate differed notably according to processing method. Cronobacter was found in rice and wheat plants at the tillering, filling and mature stages. Soil, water and swab samples from nearby milling plants were assayed, and results revealed that 6.3% (7/122) of water from paddy fields, 49.1% (28/57) and 62.1% (41/67) of swab samples from rice and wheat flour milling plants were Cronobacter positive. Pulsed-field gel electrophoresis (PFGE) subtyping indicated that some strains had a common profile, which suggested their persistence in the environment, potential transmission routes and cross-contamination in processing. Finally, we surveyed 18 families to evaluate potential risks. None of the families who primarily ate rice cooked with water tested positive for Cronobacter, though of 66.7% families (6/9) whose food staples were produced from wheat flour tested positive. Taken together, our results are important for understanding Cronobacter transmission and will aid in the development of additional control measures to reduce the risk of infection by these opportunistic pathogenic bacteria.

Psychosocial and organizational determinants of safe food handling at retail and food service establishments: a systematic review and meta-analysis.

Various psychosocial and organizational factors have been investigated as determinants of food handlers' food safety behaviours. A systematic review and meta-analysis of studies in this area was conducted to identify and synthesize the key behavioural determinants. Standard systematic review steps were followed: comprehensive search strategy; relevance screening; article characterization; risk of bias assessment; data extraction; and random-effects meta-analysis. Sixty-two relevant studies were identified, and knowledge was the most commonly investigated behavioural determinant (n = 51). Increased knowledge was consistently associated with safe food handing behaviours across both correlation (r = 0.30; 95% confidence interval [CI]: 0.12, 0.46; n = 24 studies; I2 = 98%) and odds ratio (OR) measures (adjusted OR = 1.85; 95% CI: 1.27, 2.70; n = 3; I2 = 0%). Seven other behavioural determinant categories were also consistently associated with various food safety behaviour outcomes. In contrast, no association was found between food handler experience and behaviour. The findings can inform the development of targeted training initiatives for food handlers.

Video observation of hand-hygiene compliance in a manufacturer of ready-to-eat pie and pastry products.

Food-handler hand-hygiene can be a contributory factor for food-borne illness. Cognitive data (knowledge/attitudes/self-reported practices), while informative, are not indicative of behaviour, and are subject to biases. Consequently, observation of behaviour is superior to survey data. However, researcher presence in direct observation increases reactivity, whereas video observation gives comprehensive analysis over a longer period, furthermore, familiarity reduces reactivity. Although video observation has been used to assess food safety at retail/foodservice, this valuable method is under-utilized in food-manufacturing environments. For the study, footage (24 h) was reviewed to assess compliance in a food-manufacturing site with company protocol. Video observation of food-handlers entering production (n = 674) was assessed; upon 70 occasions no attempt to implement hand-hygiene was observed. Of attempted hand-hygiene practices (n = 604), only 2% implemented compliant practices. Although 78% of attempts utilized soap, only 42% included sanitizer. Duration ranged from 1 to 69 s (Median 17 s). The study provides hand-hygiene data in an area that observational data is seldom captured.

Antibiotic resistance pattern and spa types of Staphylococcus aureus strains isolated from food business and hospital kitchen employees in Çanakkale, Turkey

Background/aim: The aim of this study was to determine antibiotic resistance profiles and spa types of Staphylococcus aureus strains isolated from food business employees in Çanakkale, Turkey. Materials and methods: S.aureus isolates were collected from hand and nasal swabs of 300 individuals working in 17 food businesses and 9 hospital kitchens. All S. aureus isolates obtained from each carrier were typed by staphylococcal protein A (spa) typing method.Staphylococcal cassette chromosome mec (SCCmec) and multilocus sequence typing (MLST) of MRSA were performed by sequencing method. Results: Of the 300 individuals, 125 (41.6%) were found to be carriers of S. aureus, 215 isolates of which were obtained in total. Three (1.4%) of 215 isolates were identified as MRSA. Sixty spa types were identified among the 121 MSSA isolates, the most common being t084 (9%). A novel spa type was discerned and added to the Ridom SpaServer database as t14963. The MLST type of the MRSA strains identified as spa type t786 was ST88 and as spa type t223 was ST22. All MRSA were determined to be SCCmec type IVa. Conclusion: spa typing can be performed to screen for transmission of S. aureus. t786, ST88, and SCCmec IVa MRSA strains were identified for the first time in Turkey.

Seroprevalence and distribution of leptospirosis serovars among wet market workers in northeastern, Malaysia: a cross sectional study.

BACKGROUND: Leptospirosis is a zoonotic disease associated with occupations which exposed workers to environments contaminated with urine of infected animals. The objective of this study was to determine the seroprevalence of leptospirosis among wet market workers in Kelantan. METHODS: A cross sectional study was conducted in two main wet markets in Kelantan and 232 wet market workers were randomly selected. Blood samples were analysed for microscopic agglutination test (MAT) against 20 live leptospirosis reference serovars. MAT titres of 1:100 or more were considered as seropositive. RESULTS: It was found that the overall seroprevalence for leptospirosis among the respondents was 33.6% (95% CI = 27.5, 39.7). The samples were tested positive against serovars Melaka (IMR LEP 1), Terengganu (IMR LEP 115), Sarawak (IMR LEP 175), Copenhageni (IMR LEP 803/11), Hardjobovis (IMR LEP 27), Australis, Autumnalis, Bataviae, Canicola, Grippotyphosa, Hardjoprajitno, Icterohaemorrhagiae, Javanica, Pyrogenes, Terrasovi, Djasiman, Patoc and Pomona. The predominant serovars was Autumnalis (18.2%). CONCLUSION: Wet markets workers were at risk for leptospirosis infection evidenced by high seroprevalence of leptospirosis in this study. Further research need to be conducted to determine factors that favours infection in this groups.

Possible effect of maternal safe food preparation behavior on child malnutrition in Benin, Africa.

BACKGROUND: In many developing countries, faulty complementary feeding practises and frequently contaminated foods are contributing factors to child malnutrition. The aims of this study were to evaluate the nutrition status of, and clarify the maternal safe food preparation behaviors associated with malnutrition in, children aged <5 years in Cotonou, Benin. METHODS: This study targeted 300 mother-child pairs visiting the University Hospital of Mother and Child Cotonou Lagoon. Mothers were interviewed using a structured questionnaire. Child height/length and weight measurements were determined and Z-scores were calculated using the 2006 World Health Organization Child Growth Standards. Children with Z-score < -2 were considered to have stunting or be underweight. On logistic regression analysis, significant variables on bivariate analysis, the associations of which were clarified in previous studies, were established as independent variables. Approximately 80% of the children who participated in this study were aged < 1 year. Being underweight was analyzed as a dependent variable. RESULTS: Regarding nutrition status, 11.0% of the children had stunting and 14.7% were underweight. On logistic regression analysis, underweight was correlated significantly with birthweight. As a remarkable point, food refrigeration was statistically significant. Food refrigeration can possibly be regarded as a maternal safe food preparation behavior. CONCLUSIONS: Maternal safe food preparation behaviors can prevent child malnutrition, even after considering biological and socioeconomic factors.

Intestinal helminth co-infection and associated factors among tuberculosis patients in Arba Minch, Ethiopia.

BACKGROUND: Helminths affect the outcome of tuberculosis by shifting cell mediated immune response to humoral and by total suppression of the host immune system. On the reverse, Mycobacterium infection favors immune escape of helminths. Therefore assessing helminth co-infection rate and predisposing factors in tuberculosis patients is mandatory to set strategies for better case management. METHODS: Facility based cross-sectional study was conducted in Arba Minch to assess the prevalence and associated factors of intestinal helminths among pulmonary tuberculosis patients from January to August, 2016. A structured questionnaire was used to capture data about socio-demographic characteristics, clinical history and possible risk factors for intestinal helminth infections. Height and weight were measured to calculate body-mass index. Appropriate amount of stool was collected and processed by direct saline and formol-ether concentration techniques following standard protocols. All the data were analyzed using SPSS version 20.0. RESULTS: A total of 213 (57.3% male and 42.7% female) pulmonary tuberculosis patients were participated in the study. The overall co-infection rate of intestinal parasites was 26.3%. The infection rate of intestinal helminths account 24.4% and that of intestinal protozoa was 6.1%. Ascaris lumbricoides accounted the highest frequency of 11.3%. Living in rural residence (AOR = 3.175, 95% CI: 1.102-9.153, p = 0.032), Eating vegetables/ fruits without washing or peeling off (AOR = 2.208, 95% CI: 1.030-4.733, p = 0.042) and having body-mass index <18.5 (AOR = 3.511, 95% CI: 1.646-7.489, p = 0.001) were associated with intestinal helminth infection. CONCLUSION: The infection rate by intestinal helminths was 24.4%. Ascaris lumbricoides was the most prevalent helminth. Residence, habit of washing vegetables/fruits before use and body-mass index were associated factors with intestinal helminthiasis. Therefore health care providers should screen and treat TB patients for intestinal helminthiasis in order to ensure good prognosis.

What is a nutritious snack? Level of processing and macronutrient content influences young adults' perceptions.

Snacking has become more prevalent in developed countries. While poor food choices pose health risks, nutritious choices contribute important nutrients to overall dietary intakes. Young adults consumer snacks frequently and nutritious choices should be promoted among this group. However, how young adults define the term 'nutritious' currently and how they evaluate the nutritiousness of various snack foods required further investigation. The current study used a mixed methods design with 115 young adults invited to sort 32 commonly available snack foods into a line ranging from 'not nutritious' to 'very nutritious'. The sorting data was analysed by hierarchical cluster analysis and multi-dimensional scaling (MDS) analysis. Participants were also asked to define the word 'nutritious', with definitions then categorized and number of counts per category analysed. Predictors of perceived snack nutritiousness were sugar (ß = -0.45, P < 0.005), fat (ß = -0.43, P < 0.05), nut (ß = 0.45, P < 0.05) and fruit/vegetable (ß = 0.33, P < 0.05) content. Level of food processing was significantly related to perceived nutritiousness (ß = 0.79, P=<0.05). The terms given within the definitions most frequently were: 'vitamins' (40%), 'good for body/body needs' (40%), 'minerals' (39%), 'low in sugars' (36%), 'protein' (32%), 'healthy' (28%) and 'long lasting source of energy' (27%). Results of the current study provide first insight into how young adults interpret the term 'nutritious'. This could help in the design of more effective nutrition education materials and food product labels to guide healthy choices in this age group.

Protocol for a cluster-randomised trial to determine the effects of advocacy actions on the salt content of processed foods.

BACKGROUND: Corporate decisions affecting the composition of processed foods are a potent factor shaping the nutritional quality of the food supply. The addition of large quantities of salt to foods is incompatible with Australian Dietary Guidelines and the reformulation of processed foods to have less salt is a focus of non-governmental organisations (NGOs). There is evidence that advocacy can influence corporate behaviour but there are few data to define the effects of NGOs working in the food space. The aim of this study is to quantify the effects of advocacy delivered by a local NGO on the salt content of food products produced or marketed by companies in Australia. METHODS/DESIGN: This is a cluster-randomised controlled trial that will be done in Australia from 2013 to 2015 which includes 45 food companies. The 23 companies in the control group will receive no specific intervention whilst the 22 companies in the intervention group will receive an advocacy program based upon an established theory of change model. The primary outcome will be the mean change in sodium content (mg/100 g) of processed foods produced or marketed by intervention compared to control companies assessed at 24 months. Interim outcomes (statements of support, published nutrition policies, level of engagement, knowledge and use of technology to reduce salt, salt reduction plans, and support for national initiatives) will also be assessed and a qualitative evaluation will provide more detailed insight. DISCUSSION: This novel study will provide robust randomised evidence about the effects of advocacy on food company behaviour and the quality of the processed food supply. A finding of improved food company behaviour will highlight the potential for greater investment in advocacy whilst the opposite result will reinforce the importance of government-led initiatives for the improvement of the food supply. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02373423. 26/02/2015.

Sources of Calicivirus contamination in foodborne outbreaks in Denmark, 2005-2011--the role of the asymptomatic food handler.

BACKGROUND: Norovirus (NoV) is the predominant cause of foodborne disease outbreaks. Virus contamination may occur during all steps of food processing, from production to preparation and serving. The relative importance of these different routes of contamination is unknown. METHODS: The purpose of this study was to estimate the proportions of outbreaks caused by asymptomatic and symptomatic food handlers (FHs). Reports of foodborne NoV and sapovirus outbreaks (n=191) that occurred over a 7-year period were extracted, reviewed, and categorized according to the available evidence for source of contamination. RESULTS: In 64 (34%) of the outbreaks, contamination from FHs took place during preparation or serving of food. In the majority of these outbreaks (n=41; 64%), the FHs were asymptomatic during food handling. Some had been in contact with ill household members before handling the food and remained asymptomatic; others developed symptoms shortly after or were post-symptomatic. In 51 (27%) of the outbreaks, contamination occurred during production of the food, and in 55 (29%) of the outbreaks, contamination had supposedly occurred after serving a guest at a self-serve buffet. CONCLUSIONS: Guidelines regarding exclusion of FHs where household members suffer from gastroenteritis could limit the number of outbreaks.

Food safety knowledge and practices of young adults.

The objective of the study described in this article was to ascertain the food safety knowledge and practices of undergraduate students attending a major American university. The study participants were undergraduate college students (mean age 18.9 +/- 1.14 SD) enrolled in a required health course. The students were invited to take a validated food safety knowledge questionnaire as part of a health risk behavior online survey. The 786 respondents indicated their food is most often prepared at on-campus dining facilities and the majority of the students (72%) felt they were "unlikely or "very unlikely" at risk of foodborne disease. The mean food safety knowledge score of the participants was 10.23 (43%) +/- 4.13 SD (25%-60%), indicating the study population overall has poor knowledge of safe food practices. As a result, food safety educational initiatives and awareness campaigns should be developed to better inform young adults about safe food handling practices and habits.