Microbiological quality of vegan alternatives to dairy and meat products in England during 2022-3.

AIMS: Plant-based alternatives to meat and dairy products have become increasingly popular in the UK. Despite a public perception that they have a relatively low microbiological risk, outbreaks of illness have been linked with these foods. This study aimed to assess the microbiological safety and quality of vegan alternatives to dairy and meat products available in England. METHODS AND RESULTS: Samples were collected between September 2022 and March 2023 from retail, production, and catering premises, and tested for a range of bacterial pathogens and hygiene indicators using standard procedures. A total of 937 samples were tested, of which 92% were of a satisfactory microbiological quality, 3% were borderline, and 5% were unsatisfactory. Those interpreted as unsatisfactory were due to elevated counts of Enterobacteriaceae and Escherichia coli (indicators of poor hygiene) rather than pathogenic microorganisms. Listeria monocytogenes was present in five samples of tofu, all from the same producer (all at counts of <100 CFU g-1), while other Listeria species were detected at counts of <20 CFU g-1 in two burgers and two 'vegan chicken' products. The majority of samples did not have pH and water activity values that would significantly contribute to preventing microbial growth: 62.4% had pH > 5.0 and 82.4% had Aw > 0.94. CONCLUSIONS: The majority of vegan products examined were of a satisfactory quality, but results demonstrate that microbiological control must be maintained using appropriate processing and storage temperatures, and application of a safe length of shelf life.

The microbiological quality of flour products in the UK with respect to Salmonella and Shiga-toxin-producing Escherichia coli.

AIM: To investigate the possible contamination of raw flour and raw flour-based products, such as pancake/batter mixes, with Salmonella, generic Escherichia coli, and Shiga-toxin-producing E. coli (STEC). Samples included flours available for sale in the UK over a period of four months (January to April 2020). The Bread and Flour regulations, 1998 state the permitted ingredients in flour and bread but it does not specify the regular monitoring of the microbiological quality of flour and flour-based products. METHODS AND RESULTS: Samples of raw flour were collected by local authority sampling officers in accordance with current guidance on microbiological food sampling then transported to the laboratory for examination. Microbiological testing was performed to detect Salmonella spp., generic E. coli, and STEC characterized for the presence of STEC virulence genes: stx1, stx2, and subtypes, eae, ipah, aggR, lt, sth, and stp, using molecular methods Polymerase Chain Reaction (PCR). Of the 882 flours sampled, the incidence of Salmonella was 0.1% (a single positive sample that contained multiple ingredients such as flour, dried egg, and dried milk, milled in the UK), and 68 samples (7.7%) contained generic E. coli at a level of >20 CFU/g. Molecular characterization of flour samples revealed the presence of the Shiga-toxin (stx) gene in 10 samples (5 imported and 5 from the UK) (1.1%), from which STEC was isolated from 7 samples (0.8%). Salmonella and STEC isolates were sequenced to provide further characterization of genotypes and to compare to sequences of human clinical isolates held in the UKHSA archive. Using our interpretive criteria based on genetic similarity, none of the STEC flour isolates correlated with previously observed human cases, while the singular Salmonella serotype Newport isolate from the mixed ingredient product was similar to a human case in 2019, from the UK, of S. Newport. Although there have been no reported human cases of STEC matching the isolates from these flour samples, some of the same serotypes and stx subtypes detected are known to have caused illness in other contexts. CONCLUSION: Results indicate that while the incidence was low, there is a potential for the presence of Salmonella and STEC in flour, and a genetic link was demonstrated between a Salmonella isolate from a flour-based product and a human case of salmonellosis.

A survey of Salmonella, Escherichia coli, and antimicrobial resistance in frozen, part-cooked, breaded, or battered chicken products on retail sale in the UK.

AIM: Frozen, breaded chicken products have been implicated in Salmonella outbreaks, and may be incorrectly perceived as ready-to-eat, leading to mishandling or undercooking by consumers. This study aimed to assess the prevalence of Salmonella and antimicrobial resistant (AMR) Escherichia coli in these products. METHODS AND RESULTS: Samples of frozen, raw, or partly cooked, coated chicken products were collected between April and July 2021 from retailers in the UK and tested for Salmonella spp., generic E. coli, extended spectrum beta-lactamase-producing, colistin-resistant, and carbapenem-resistant E. coli. One isolate of each bacterial type from each sample was selected for minimum inhibitory concentration determination for a range of antimicrobials. Salmonella was detected in 5 of 310 (1.6%) samples, identified as Salmonella Infantis in three samples and Salm. Java in two. One Salm. Infantis isolate was multidrug resistant, while the other Salmonella isolates were each resistant to at least one class of antimicrobials. Generic E. coli were detected in 113 samples (36.4%), with multidrug resistance being demonstrated in 20.0% of these. Escherichia coli with the ESBL phenotype were detected in 15 (4.8%) of samples and the AmpC phenotype in 2 (0.6%). A colistin-resistant E. coli was isolated from one sample; this possessed the mcr-1 gene. No carbapenem-resistant E. coli were detected. The five Salmonella-positive samples from this study, together with 20 Salmonella-positive products from an earlier study in 2020/2021, were cooked according to the manufacturers' instructions. Following cooking, Salmonella was not detected in any samples. CONCLUSIONS: This survey demonstrates continued contamination of frozen, coated chicken products with Salmonella, and provides data on the prevalence of AMR in these products.

Whole genome sequencing reveals antimicrobial resistance determinants (AMR genes) of Salmonella enterica recovered from raw chicken and ready-to-eat leaves imported into England between 2014 and 2019.

AIMS: To compare the antimicrobial resistance (AMR) genes in a genetically diverse group of Salmonella enterica recovered from foods imported into England between 2014 and 2018. METHODS AND RESULTS: Whole genome sequence was used to detect AMR genes or chromosomal mutations associated with AMR in Salmonella recovered from edible leaves imported from Asia (n = 115) as compared to Salmonella (n = 231) isolated from raw chicken, 74% originated from South America. Among isolates from edible leaves, three (3%) showed resistance to at least one antimicrobial agent, two (2%) of which were multidrug resistant (MDR, resistance to three or more antimicrobial classes). Resistance to at least one antimicrobial agent was detected in 214 (93%) in the chicken isolates, with 164 (71%) showing MDR. Genetic diversity and AMR profiles were highly heterogeneous across the different serovars. CONCLUSIONS: Resistance was rare among the Salmonella isolates from edible leaves but common (including MDR) among those from raw chicken. SIGNIFICANCE AND IMPACT OF THE STUDY: Surveillance of AMR in imported foods is essential for monitoring the risk of transmission of resistance from the food chain to humans and provides added public health value to pre-existing controls of the food chain.

National outbreak of Shiga toxin-producing Escherichia coli O157:H7 linked to mixed salad leaves, United Kingdom, 2016.

We investigated a large outbreak of Escherichia coli O157 in the United Kingdom (UK) with 165 cases between 31 May and 29 July 2016. No linked cases were reported in other countries. Cases were predominately female (n = 128) and adult (n = 150), 66 attended hospital and nine had features of haemorrhagic uraemic syndrome. A series of epidemiological studies (case-control, case-case, ingredients-based and venue-based studies) and supply chain investigations implicated mixed salad leaves from Supplier A as the likely outbreak vehicle. Whole genome sequencing (WGS) indicated a link with strains from the Mediterranean and informed the outbreak control team to request that Supplier A cease distributing salad leaves imported from Italy. Microbiological tests of samples of salad leaves from Supplier A were negative. We were unable to confirm the source of contamination or the contaminated constituent leaf although our evidence pointed to red batavia received from Italy as the most likely vehicle. Variations in Shiga toxin-producing E.coli surveillance and diagnosis may have prevented detection of cases outside the UK and highlights a need for greater standardisation. WGS was useful in targeting investigations, but greater coverage across Europe is needed to maximise its potential.

Recurrent seasonal outbreak of an emerging serotype of Shiga toxin-producing Escherichia coli (STEC O55:H7 Stx2a) in the south west of England, July 2014 to September 2015.

The first documented British outbreak of Shiga toxin-producing Escherichia coli (STEC) O55:H7 began in the county of Dorset, England, in July 2014. Since then, there have been a total of 31 cases of which 13 presented with haemolytic uraemic syndrome (HUS). The outbreak strain had Shiga toxin (Stx) subtype 2a associated with an elevated risk of HUS. This strain had not previously been isolated from humans or animals in England. The only epidemiological link was living in or having close links to two areas in Dorset. Extensive investigations included testing of animals and household pets. Control measures included extended screening, iterative interviewing and exclusion of cases and high risk contacts. Whole genome sequencing (WGS) confirmed that all the cases were infected with similar strains. A specific source could not be identified. The combination of epidemiological investigation and WGS indicated, however, that this outbreak was possibly caused by recurrent introductions from a local endemic zoonotic source, that a highly similar endemic reservoir appears to exist in the Republic of Ireland but has not been identified elsewhere, and that a subset of cases was associated with human-to-human transmission in a nursery.

Partial Failure of Milk Pasteurization as a Risk for the Transmission of Campylobacter From Cattle to Humans.

BACKGROUND: Cattle are the second most common source of human campylobacteriosis. However, routes to account for this scale of transmission have not been identified. In contrast to chicken, red meat is not heavily contaminated at point of sale. Although effective pasteurization prevents milk-borne infection, apparently sporadic infections may include undetected outbreaks from raw or perhaps incompletely pasteurized milk. METHODS: A rise in Campylobacter gastroenteritis in an isolated population was investigated using whole-genome sequencing (WGS), an epidemiological study, and environmental investigations. RESULTS: A single strain was identified in 20 cases, clearly distinguishable from other local strains and a reference population by WGS. A case-case analysis showed association of infection with the outbreak strain and milk from a single dairy (odds ratio, 8; Fisher exact test P value = .023). Despite temperature records indicating effective pasteurization, mechanical faults likely to lead to incomplete pasteurization of part of the milk were identified by further testing and examination of internal components of dairy equipment. CONCLUSIONS: Here, milk distribution concentrated on a small area, including school-aged children with low background incidence of campylobacteriosis, facilitated outbreak identification. Low-level contamination of widely distributed milk would not produce as detectable an outbreak signal. Such hidden outbreaks may contribute to the substantial burden of apparently sporadic Campylobacter from cattle where transmission routes are not certain. The effective discrimination of outbreak isolates from a reference population using WGS shows that integrating these data and approaches into surveillance could support the detection as well as investigation of such outbreaks.

Public Health Investigation of Two Outbreaks of Shiga Toxin-Producing Escherichia coli O157 Associated with Consumption of Watercress.

An increase in the number of cases of Shiga toxin-producing Escherichia coli (STEC) O157 phage type 2 (PT2) in England in September 2013 was epidemiologically linked to watercress consumption. Whole-genome sequencing (WGS) identified a phylogenetically related cluster of 22 cases (outbreak 1). The isolates comprising this cluster were not closely related to any other United Kingdom strain in the Public Health England WGS database, suggesting a possible imported source. A second outbreak of STEC O157 PT2 (outbreak 2) was identified epidemiologically following the detection of outbreak 1. Isolates associated with outbreak 2 were phylogenetically distinct from those in outbreak 1. Epidemiologically unrelated isolates on the same branch as the outbreak 2 cluster included those from human cases in England with domestically acquired infection and United Kingdom domestic cattle. Environmental sampling using PCR resulted in the isolation of STEC O157 PT2 from irrigation water at one implicated watercress farm, and WGS showed this isolate belonged to the same phylogenetic cluster as outbreak 2 isolates. Cattle were in close proximity to the watercress bed and were potentially the source of the second outbreak. Transfer of STEC from the field to the watercress bed may have occurred through wildlife entering the watercress farm or via runoff water. During this complex outbreak investigation, epidemiological studies, comprehensive testing of environmental samples, and the use of novel molecular methods proved invaluable in demonstrating that two simultaneous outbreaks of STEC O157 PT2 were both linked to the consumption of watercress but were associated with different sources of contamination.

Foodborne Outbreak of Extended Spectrum Beta-lactamase Producing Shigella sonnei Associated with Contaminated Spring Onions in the United Kingdom.

Globalization of the food supply chain has created conditions favorable for emergence and spread of multidrug-resistant (MDR) foodborne pathogens. In November 2021, the UK Health Security Agency detected an outbreak of 17 cases infected with the same strain of MDR extended spectrum beta-lactamase (ESBL)-producing Shigella sonnei. Phylogenetic analysis of whole-genome sequencing data revealed the outbreak was closely related to strains of S. sonnei isolated from travelers returning to the UK from Egypt. None of the outbreak cases reported travel and all 17 cases reported eating food from a restaurant/food outlet in the week prior to symptom onset, of which 11/17 (64.7%) ate at branches of the same national restaurant franchise. All 17 cases were adults and 14/17 (82.4%) were female. Ingredient-level analyses of the meals consumed by the cases identified spring onions as the common ingredient. Food chain investigations revealed that the spring onions served at the implicated restaurants could be traced back to a single Egyptian producer. The foodborne transmission of ESBL-producing bacteria is an emerging global health concern, and concerted action from all stakeholders is required to ensure an effective response to mitigate the risks to public health.

Levels and genotypes of Salmonella and levels of Escherichia coli in frozen ready-to-cook chicken and turkey products in England tested in 2020 in relation to an outbreak of S. Enteritidis.

Frozen reformulated (FR) breaded chicken products have previously been implicated in causing human salmonellosis. A multi-country Salmonella enterica serovar Enteritidis outbreak involving several strains with >400 reported human cases in the UK occurred in 2020. Initially S. Infantis was detected in one sample from a case home but S. Enteritidis was then also isolated using a S. Enteritidis specific PCR in combination with isolation via a Craigie-tube. This prompted a survey to examine the presence and levels of Salmonella and E. coli in ready-to-cook FR poultry products in England in 2020. From a total of 483 samples, including two from cases' homes, Salmonella was detected in 42 chicken samples, these originated from six out of 53 production plants recorded. Salmonella detection was associated with elevated levels of generic E. coli (OR = 6.63). S. Enteritidis was detected in 17 samples, S. Infantis in 25, S. Newport in four and S. Java, S. Livingstone and S. Senftenberg in one each. The highest levels of Salmonella were 54 MPN/g for S. Infantis and 28 MPN/g for S. Enteritidis; 60% of the Salmonella-positive samples had <1.0 MPN/g. S. Enteritidis was detected together with S. Infantis in five samples and with S. Livingstone in one. Where S. Enteritidis was detected with other Salmonella, the former was present at between 2 and 100-fold lower concentrations. The Salmonella contamination was homogeneously distributed amongst chicken pieces from a single pack and present in both the outer coating and inner content. The S. Enteritidis were all outbreak strains and detected in six products that were linked to four production plants which implicated a Polish origin of contamination. Despite S. Infantis being most prevalent in these products, S. Infantis from only two contemporaneous human cases in the UK fell into the same cluster as isolates detected in one product. Except for one human case falling into the same cluster as one of the S. Newport strains from the chicken, no further isolates from human cases fell into clusters with any of the other serovars detected in the chicken samples. This study found that higher E. coli levels indicated a higher probability of Salmonella contamination in FR chicken products. The results also highlight the importance of recognising co-contamination of foods with multiple Salmonella types and has provided essential information for detecting and understanding outbreaks where multiple strains are involved.

The use of alkaline phosphatase and possible alternative testing to verify pasteurisation of raw milk, colostrum, dairy and colostrum-based products.

Pasteurisation of raw milk, colostrum, dairy or colostrum-based products must be achieved using at least 72°C for 15 s, at least 63°C for 30 min or any equivalent combination, such that the alkaline phosphatase (ALP) test immediately after such treatment gives a negative result. For cows' milk, a negative result is when the measured activity is ≤ 350 milliunits of enzyme activity per litre (mU/L) using the ISO standard 11816-1. The use and limitations of an ALP test and possible alternative methods for verifying pasteurisation of those products from other animal species (in particular sheep and goats) were evaluated. The current limitations of ALP testing of bovine products also apply. ALP activity in raw ovine milk appears to be about three times higher and in caprine milk about five times lower than in bovine milk and is highly variable between breeds. It is influenced by season, lactation stage and fat content. Assuming a similar pathogen inactivation rate to cows' milk and based on the available data, there is 95-99% probability (extremely likely) that pasteurised goat milk and pasteurised sheep milk would have an ALP activity below a limit of 300 and 500 mU/L, respectively. The main alternative methods currently used are temperature monitoring using data loggers (which cannot detect other process failures such as cracked or leaking plates) and the enumeration of Enterobacteriaceae (which is not suitable for pasteurisation verification but is relevant for hygiene monitoring). The inactivation of certain enzymes other than ALP may be more suitable for the verification of pasteurisation but requires further study. Secondary products of heat treatment are not suitable as pasteurisation markers due to the high temperatures needed for their production. More research is needed to facilitate a definitive conclusion on the applicability of changes in native whey proteins as pasteurisation markers.

An outbreak of human listeriosis associated with frozen sweet corn consumption: Investigations in the UK.

The use of Whole genome sequencing (WGS) identified a multi-country outbreak of human listeriosis associated with consumption of frozen sweet corn produced in Hungary. The purpose of this report was to summarise information on the cases occurring in the UK which were part of this outbreak and outline investigations on the presence of Listeria monocytogenes in the affected food chain. Prior to the international recall of this product in 2018, 12 UK cases of listeriosis were identified as infected by the outbreak strain between 2015 and 18. Epidemiological and microbiological investigations confirmed these cases as belonging to the outbreak. A further case occurred in 2019 and a contaminated frozen pack from one of the implicated batches of sweet corn was recovered from the patient's domestic freezer. The outbreak strain was also detected in products from a sandwich manufacturer in 2018 which added frozen sweet corn directly to sandwich fillings. The sandwich manufacturer's sweet corn was supplied by a distributor in England which obtained frozen products from the Hungarian manufacturer implicated in the outbreak. Within the distributor's premises, 208 food and environmental samples were taken: L. monocytogenes was detected in 44% of 70 samples of frozen sweet corn and 5% of 79 other foods. The outbreak strain was detected in the frozen sweet corn, in one other frozen food (mixed vegetables) and in the factory environment. The outbreak strain was also recovered from frozen beans on retail sale in the first four months of 2019. Five other L. monocytogenes strains together with two other Listeria species were detected in samples from the importer's premises. One of the L. monocytogenes strains in the importer's factory, which was distinct from the outbreak strain, was also recovered from sweet corn collected from the sandwich manufacturer, sweet corn tested in England in 2013 and 2016 and the blood of two cases of human listeriosis which occurred in England in 2014. This report shows how analysis by WGS provides evidence to understand complex food chains. This report also highlights risks for transmission of human listeriosis from frozen sweet corn and the potential for misuse of this food as a ready-to-eat product.

Microbiological Quality of Cooked Chicken: Results of Monitoring in England (2013-17).

Results from monitoring of the microbiological quality of 2,721 samples of ready-to-eat cooked chicken collected between 2013 to 2017 in England were reviewed: 70% of samples were from retail, catering or manufacture and 30% were imported and collected at English ports. Samples were tested for a range of bacterial pathogens and indicator organisms. Six samples (<1%) had unsatisfactory levels of pathogens which were potentially injurious to health. Neither Salmonella nor Campylobacter were recovered from any sample. Two samples from catering settings contained either an unsatisfactory level of Bacillus cereus (5 x 10 6 CFU/g) or an unsatisfactory level of coagulase positive staphylococci (1.6 x 10 4 CFU/g). Listeria monocytogenes was recovered from 36 samples (one at manufacture, 26 at catering and nine at retail) and in four instances, unsatisfactory levels (≥10 2 CFU/g) were detected (three samples collected at catering and one at retail). For L. monocytogenes there were no significant differences between the rates of contamination with between the samples collected from ports, manufacture, retail supermarkets and other retailers (p = 0.288). There were no differences between the rates of contamination for other potential pathogens detected between samples from different settings. The prevalence of hygiene indicators ( Escherichia coli , Enterobacteriaceae and Aerobic Colony Counts) at import was significantly lower than in samples collected from manufacturers, retail or catering (p < 0.01). Samples collected from catering gave poorer results than all other settings. Regardless of the stage in the food chain, samples from Thailand and from other non-EU countries were of significantly better microbiological quality with respect to indicator organisms than those from the UK or from other EU countries (p = <0.001).

Occurrence of Listeria and Escherichia coli in frozen fruit and vegetables collected from retail and catering premises in England 2018-2019.

Frozen vegetables have previously been associated with outbreaks of listeriosis in both the USA and Europe. An outbreak of Listeria monocytogenes serogroup 4 caused 53 cases in five European countries between 2015 and 2018. Whole genome sequencing (WGS) indicated that frozen sweet corn from a producer in Hungary was the source of illness. However, limited data is available on the prevalence of Listeria in frozen produce. A study of frozen fruit and vegetables from catering and retail premises in England was therefore carried out to assess their microbiological quality with respect to Listeria and Escherichia coli. Between December 2018 and April 2019, 1050 frozen fruit and vegetable samples were collected. Of these, 99% were of a satisfactory or borderline microbiological quality. Eleven samples (1%) contained ≥100 cfu/g of Escherichia coli (considered unsatisfactory in products labelled as ready-to-eat). Listeria monocytogenes or other Listeria species were detected in six samples (2%) of fruit compared to 167 samples (24%) of vegetables and six samples (26%) of fruit and vegetable mixes, but none at a level of ≥100 cfu/g. Characterisation by WGS of 74 L. monocytogenes isolates identified ten genetic clusters indicating a common source. For 8 of the 10 clusters, the isolates came from homogenous food types: four were sweet corn, and there was one cluster each for beans, peas, peppers and broccoli. There were five genetic associations between isolates from frozen vegetables and from clinical cases of listeriosis, including two cultures from frozen beans that were indistinguishable from the 2015-2018 sweet corn outbreak strain. This study indicates that L. monocytogenes was present in 10% of frozen vegetables and even though products are generally not ready-to-eat and are intended to be cooked prior to consumption, these have the potential to cause illness. Clear cooking and handling instructions are therefore required on these products to ensure that the health of consumers is not put at risk, and appropriate Good Manufacturing Practice measures should be followed by all fruit and vegetable freezing plants in order to reduce contamination with Listeria during processing.

Assessment of the microbiological safety of edible dried seeds from retail premises in the United Kingdom with a focus on Salmonella spp.

Sesame seed products have recently been associated with a number of Salmonella outbreaks in the UK and elsewhere. Aside from sesame seeds, there is little published information on the prevalence of Salmonella spp. in edible seeds. A study of 3735 samples of retail edible dried seeds in the UK was therefore carried out between October 2007 and March 2008 to assess their microbiological safety in relation to Salmonella contamination and levels of Escherichia coli, an indicator of faecal contamination. Overall, Salmonella was detected in 23 samples (0.6%), of which over half (57%) were sesame seeds. Other seeds contaminated with Salmonella were linseed (1 sample), sunflower (1 sample), alfalfa (1 sample), melon (4 samples) and mixed seeds (3 samples). E. coli was detected in 9% of samples, with 1.5% containing unsatisfactory levels (> or = 10(2)/g). These included melon, pumpkin, sesame, hemp, poppy, linseed, sunflower and mixed seeds. The UK retailers affected by the detection of Salmonella in their products recalled the contaminated batches, and Food Standards Agency food alerts were issued to advise against the consumption of affected seed products. This study highlights the importance of good hygiene practices and effective decontamination procedures during the production of these products.

Assessment of the Microbiological Safety of Precut Fruit from Retail and Catering Premises in the United Kingdom.

Fresh fruit has been associated with a number of foodborne outbreaks in recent years. In particular, a large outbreak of listeriosis in the United States in 2011 was associated with consumption of cantaloupe melon, and an outbreak of Salmonella Newport in the United Kingdom and Europe (also in 2011) was linked to watermelon consumption. A study of precut fruit products from catering and retail premises in the United Kingdom was, therefore, carried out to assess their microbiological safety. Between January and March 2012, samples (1,188) of ready-to-eat precut fruit were collected from retail and catering premises in the United Kingdom, and 99% were of satisfactory microbiological quality. However, four samples (0.3%) were of an unsatisfactory quality (one with 800 CFU/g Listeria monocytogenes and three with >100 CFU/g Escherichia coli), and five samples (0.4%) were of a borderline quality owing to the presence of E. coli (two samples with a level of 20 CFU/g), Staphylococcus aureus (two samples with levels of >50 CFU/g), or L. monocytogenes (one sample with a level of 80 CFU/g). L. monocytogenes or other Listeria species were detected in a further 54 samples (4.5%) at levels below the threshold considered to be borderline or unsatisfactory. A significantly larger proportion of samples from one national supermarket chain was contaminated with L. monocytogenes than other supermarkets, and two types were, in this study, unique to this supermarket. This study shows that overall, the microbiological quality of ready-to-eat precut fruit was good. However, the presence of Listeria species in 5% of samples highlights the need for good hygiene during preparation and satisfactory temperature and time control during storage of these food products.

Assessment of the Microbiological Quality of Meat Pies from Retail Sale in England 2013.

Outbreaks of foodborne illness caused by Bacillus cereus and Listeria monocytogenes in England associated with meat pie consumption were detected in 2012. To obtain baseline data for pies unrelated to outbreaks, 862 samples of ready-to-eat meat pies were collected at retail or from catering facilities in England in 2013 and examined to enumerate food-poisoning bacteria and indicator organisms using Organization for Standardization (ISO) methods for Listeria spp. including L. monocytogenes (ISO 11290), Clostridium perfringens (ISO 21528), coagulase-positive staphylococci including Staphylococcus aureus (ISO 6888), Bacillus spp. including B. cereus (ISO 1737), Escherichia coli (ISO 16649), Enterobacteriaceae (ISO 21528), and aerobic colony counts (ACCs; ISO 4833). Microbiological quality was satisfactory in 94% of samples, borderline in 5%, and unsatisfactory in 1%. The proportion of pies from markets that were borderline or unsatisfactory significantly increased, and the proportion of borderline or unsatisfactory pies from supermarkets significantly decreased. Among the refrigerated (0 to 15°C) pies, microbiological quality significantly decreased in pies stored at >8°C and further significantly decreased at in pies stored at ambient temperature (>15 to 25°C). Samples collected at 25 to 40°C had the highest proportion of borderline or unsatisfactory results, but results improved in pies stored at >40°C. The most common cause for borderline or unsatisfactory results was elevated ACCs (5% of all samples). Within the individual microbiological parameters, borderline or unsatisfactory results resulted from elevated Enterobacteriaceae or Bacillus levels (10 samples for each), C. perfringens levels (2 samples), and S. aureus or E. coli levels (1 sample each). L. monocytogenes was recovered from one pie at <10 CFU/g. A literature review revealed a range of microbiological hazards responsible for food poisoning and meat pie consumption, and surveillance data from 1992 to 2012 from England indicated that C. perfringens was the most commonly reported cause of outbreaks of foodborne illness.

Epidemiological and Microbiological Investigation of an Outbreak of Severe Disease from Shiga Toxin-Producing Escherichia coli O157 Infection Associated with Consumption of a Slaw Garnish.

Investigating outbreaks of Shiga toxin-producing Escherichia coli (STEC) in England is a priority due to the potential severity of disease. However, there are often challenges in investigating outbreaks due to the small numbers of cases, poor patient recall, and low levels of bacteria that are challenging to detect in food samples using traditional laboratory culture techniques, and frequently a source is not identified. In September 2014, we investigated an STEC O157 outbreak associated with consuming a slaw garnish, and we report our findings here. Twenty confirmed cases were identified. Outbreak cases were interviewed, and menus reviewed to identify dishes consumed outside the home. Cases shared a history of eating meals at different chain restaurants. Analysis of menu items indicated shared consumption of slaw garnishes by 85.6% cases, although just 35.7% reported consuming them during interviews. Whole-genome sequencing linked cases where interpretation of the multilocus variable number tandem repeat analysis profile was obscured and indicated that the strain originated from a domestic (i.e., United Kingdom) source. Traceback identified that carrots and cabbages grown in the United Kingdom were the likely source of infection. Samples of products were examined, but STEC was not recovered. Epidemiological investigations linked the outbreak to consumption of a slaw garnish, which was poorly recalled by cases, and likely comprised of domestically produced raw vegetables. The causative organism was not isolated from food samples, and we conclude that future investigations should include sampling of animals and wildlife in the vicinity of farms where implicated produce is grown.

Wessex shopping basket survey - a structured approach to local food sampling.

The shopping basket approach to food sampling, in which ready-to-eat food items from a shopping list were sampled at premises chosen at random, was adopted by 15 Environmental Health Departments in the Wessex region. A total of 2037 samples were analysed over a 30-month period. The microbiological quality varied considerably between food categories, with gravy and stock samples giving the highest proportion of satisfactory results. Sliced meats, cooked rice and sandwiches gave the poorest overall results. Whilst the majority of unsatisfactory results were due to elevated levels of indicator organisms (Aerobic Colony Count, Enterobacteriaceae and Escherichia coli), unsatisfactory or potentially hazardous levels of pathogens (Staphylococcus aureus, Bacillus cereus, Clostridium perfringens or Listeria monocytogenes) were detected in 1% of samples. Salmonella was not detected in any sample. The shopping basket survey was considered to be a useful way of structuring local sampling, and the random selection of premises was found to be a considerable advantage over previous sampling plans. In addition, the survey drew attention to a number of microbiological problems with specific food types, leading to more detailed investigations.