Daily baked egg intake may accelerate the development of tolerance to raw egg in egg-allergic children.

Recent studies suggest that egg-allergic children who tolerate baked egg (BE) are more likely to outgrow egg allergy than children that do not tolerate it. The question to be answered is whether regular ingestion of BE accelerates tolerance to other forms of egg (cooked and raw). Our aim was to determine if daily ingestion of BE would accelerate tolerance to raw egg in BE-tolerant patients compared to patients who tolerate BE at diagnosis but eliminated it from their diet and to patients who didn't tolerate it. We performed a retrospective analysis of all children diagnosed of IgE-mediated egg allergy at the Pediatric Allergy Unit of the Complejo Hospitalario Universitario A Coruña, from 2008 to 2014. Seventy children were included. At diagnosis, 33 patients tolerated BE and kept its daily ingestion, 16 patients tolerated BE and were recommended to avoid it, and 21 patients didn't tolerate it. Patients tolerating BE who kept daily ingestion achieved tolerance to raw egg significantly earlier (p < 0.05) than the other two groups.Conclusion: Our data suggest that daily intake of BE in BE-tolerant children accelerates tolerance to raw egg.What is Known:• It has been suggested that egg-allergic children who consume baked egg (BE) products on a regular bases are more likely to outgrow egg allergy than children that do not tolerate themWhat is New:• Patients who tolerated BE on diagnosis and followed an exclusion diet show a similar evolution than patients who initially did not tolerate BE. Daily ingestion of BE seems to accelerates tolerance to raw egg.

Inactivation of salmonella strains in acidified broth and raw egg yolk as a function of pH and acid type.

Raw egg-based dishes present a safety risk when eggs of uncertain Salmonella status are used. Here, the inactivation of four Salmonella serovars at different combinations of acid, pH and temperature were investigated. Strains of egg or broiler-associated Salmonella serovars Enteritidis, Infantis, Typhimurium, and a heat resistant Senftenberg 775W were tested in broth and egg yolk. It was observed that although S. Senftenberg 775W survived better than its mutant lacking the loci of heat resistance, the wild type per se was not acid tolerant. For all strains, egg yolk acidification with vinegar to pH 3.9 and storage at 25 °C or 8 °C resulted in >4Log(cfu/mL) reductions within 2h or 24h, respectively. At pH 4.2, 2-3Log(cfu/mL) reductions were seen within 6h at 25 °C. In contrast, acidification with lemon juice to pH of 3.9 allowed for growth at 25 °C, while a pH of 2.9 ensured >4Log(cfu/mL) reductions within 24h. Egg yolk and acid form the basis for many recipes and with a ratio of 0.82 of vinegar (≥5% acetic acid) to egg yolk or 1.23 of lemon juice to yolk and storage at 25 °C for 2h or 24h, respectively, a high degree of safety can be obtained, if properly chilled raw eggs are used.

A Novel Double-Blind, Placebo-Controlled Food Challenge Matrix for Milk and Raw Egg.

BACKGROUND: The double-blind, placebo-controlled food challenge (DBPCFC) is still considered to be the gold standard in food allergy diagnosis. This test is however not common practice in routine due to several practical limitations, especially for non-IgE-mediated food allergy with its typical delayed food allergic reactions. OBJECTIVE: The aim of this study was to develop and evaluate DBPCFC matrices for the diagnosis of milk and egg allergies which can be applied at home for the diagnosis of delayed food allergic reactions. The main focus was the blinding of milk and raw egg and the development of matrices which can be prepared and consumed conveniently at home with a sufficiently long shelf life (+/- 6 months or longer). METHODS: A sensory test evaluated the blinding of the egg and milk in the matrices. The microbiological analysis confirmed the safety and stability of the developed matrices. To assess the applicability of the matrices, a pilot DBPCFC study for milk including 7 patients was conducted. RESULTS: Sensory tests confirmed that the masking of the allergenic ingredients was sufficient. Microbial safety and stability of the matrices were confirmed up to 6 months of storage at ambient temperatures in the dark. The DBPCFC for milk showed different outcomes and proved its applicability for use at home. CONCLUSION: A novel stable DBPCFC matrix for milk and raw egg has been developed that allows convenient use at the patients' home.

Preparation, characterization and physicochemical properties of novel low-phosphorus egg yolk protein.

BACKGROUND: In order to supply adequate dietary protein for chronic kidney disease (CKD) patients while simultaneously controlling phosphorus intake, a novel method was developed for the preparation of low-phosphorus egg yolk protein (LPYP) using alkaline protease auxiliary dephosphorization. In addition, the physicochemical properties of LPYP were studied. RESULTS: In comparison with raw egg yolk protein (RYP) and defatted egg yolk protein (DFYP), LPYP was found to exhibit differences in amino acid (AA) composition, protein secondary structure, surface hydrophobicity, solubility and emulsion stability. It was observed that dephosphorization improved the AA composition, soluble protein content and dissolution stability of egg yolk protein. In addition, phosphate groups were found to impose a critical influence on the emulsion stability and particle size distribution. The final phosphorus to protein mass ratio (P/Pro) of LPYP was 5.64, which met the requirements of a protein diet for CKD patients. The FAO/WHO mode closeness and stability coefficient were 0.958 and 98.62% respectively. CONCLUSION: LPYP can be effectively obtained by alkaline protease hydrolysis and subsequent alkali dephosphorization. The prepared LPYP can be considered to be a type of safe and suitable protein resource for CKD patients. © 2018 Society of Chemical Industry.

The Oral Provocation Test for Raw Egg in Patients with Hen Egg Allergy.

BACKGROUND: Many researchers have made efforts to develop diagnostic tools for predicting the outcome of oral food challenges (OFCs). The aim of this study was to assess the diagnostic value of the skin prick test (SPT) and blood-specific IgE concentrations based on the outcome of the OFCs for heated and raw hen egg. METHODS: This study included 103 children with suspected hen egg allergy (HEA; median age 23 months, range 10-155; 72 boys, 31 girls). Forty-three patients were diagnosed with HEA by OFC. Of 60 patients who tolerated heated egg white (HEW), 22 underwent the OFC for raw hen egg and 7 developed adverse reactions after ingesting raw egg. Their wheal diameters and specific IgE levels for egg white and ovomucoid were determined. RESULTS: Wheal diameters as well as blood-specific IgE levels for egg white and ovomucoid were significantly larger in children with positive OFC results for HEW than in those with negative results. However, there were no significant differences between the positive and negative test results for raw hen egg white (REW) in wheal diameter or blood-specific IgE levels. CONCLUSIONS: The SPT and blood-specific IgE can be used to diagnose HEA. However, the provocation test for REW in children without HEW allergy is important because the values of SPT and specific IgE were not significantly different between children with and without raw egg allergy.

Viable Campylobacter jejuni on Eggshells and Its Potential to Cross-contaminate Egg White and Yolk When Using a Manual Separation Technique, Determined by Culture and Propidium Monoazide (PMA) qPCR.

Manual separation of egg yolk from egg white using the eggshell is common practice in private households. For this, the egg is cracked and both components are separated by passing the egg yolk back and forth between the two halves of the eggshell, allowing the egg white to drip down while the egg yolk remains in the shell. During this process, the egg content naturally gets in contact with the outside of the eggshell, which might lead to a cross-contamination with its microorganisms, thus was correspondingly assessed in this study. Campylobacter jejuni is one of the most important zoonotic pathogens that can be found on eggshells. Therefore, this bacterium was used to artificially contaminate the eggshells (n = 22) with concentrations of 3.1 ± 0.6 log10 cfu/g. After separating the egg yolk from the egg white, cross-contamination was determined using culture and qPCR. Altogether, cross-contaminations with C. jejuni were found in 15 egg white (68%) and in three egg yolk (14%) samples. Afterward, 90 eggs from 30 egg packs from different producers in and around Munich (Germany) were obtained for field study purposes. To address the problem of culturing due to a possible viable but nonculturable (VBNC) status of C. jejuni, a method to differentiate viable and dead C. jejuni on eggshell using 10 µM propidium monoazide (PMA) and qPCR was developed. As a result, seven egg packs (23%) were positive for C. jejuni. Of these, only one (3%) was contaminated with viable cells, but still in a concentration of 3.3 log10 cells/g shell. According to these results and considering that eggshells might also be naturally contaminated with other pathogens, the authors recommend avoiding the manual separation technique of egg white and yolk by the eggshell. Especially if raw egg white or yolk is used for preparation of not sufficiently heated foods, where contaminating pathogens are not inactivated during processing, this technique might be a safety hazard for the consumer.

Acidification and extended storage at room temperature of mayonnaise reduce Salmonella Typhimurium virulence and viability.

Despite food safety recommendations, raw egg-based foods, such as mayonnaise, are frequently identified as the source of Salmonella during outbreaks. Acidification and storage temperature have been linked with reduced bacterial culturability. Raw egg-based sauces stored at 25 °C have historically been linked with faster decline of Salmonella culturability than preparations stored at 5 °C. This study aimed to determine whether reduced culturability in acidified mayonnaise correlated with reduced in vitro bacterial motility, invasiveness and viability as well as disease-causing capacity in BALB/c mice. Acidification of mayonnaise and incubation at 25 °C for 4 h significantly reduced culturability of Salmonella Typhimurium DT9 but was dependent on initial bacterial load. Bacteria recovered from acidified mayonnaise exhibited reduced invasiveness into polarized cultured intestinal epithelial cells and 12 h post inoculation were no longer invasive suggesting a reduced capacity to cause disease. To confirm this, BALB/c mice were inoculated with Salmonella Typhimurium contaminated mayonnaise stored at 5 °C or 25 °C for 12, 24, 48, 72, and 96 h. Mice inoculated with mayonnaise incubated at 5 °C for 12 and 24 h exhibited mild to moderate disease symptoms; all other mayonnaise treatment groups did not exhibit disease symptoms. In acidified mayonnaise, Salmonella Typhimurium DT9 exhibited a global downregulation of metabolism, stress response, and virulence genes upon addition to mayonnaise. After 4 h of incubation at both 5 °C and 25 °C, however, the vast majority of genes were upregulated which was maintained over the 96-hour experiment suggesting that bacteria were severely stressed. Salmonella Typhimurium DT9 cells were isolated from mayonnaise samples and ATP production was quantified. At both 5 °C and 25 °C, ATP production decreased in acidified mayonnaise preparations. At 25 °C, ATP production decreased more rapidly than at 5 °C. After 24 h, ATP production of bacteria in mayonnaise stored at 25 °C was not significantly different from the dead control group. Thus, the current recommendation of only serving freshly prepared raw egg-sauces or refrigerating immediately after preparation, could be placing consumers at higher risk for contracting salmonellosis.

A Review of Temperature, pH, and Other Factors that Influence the Survival of Salmonella in Mayonnaise and Other Raw Egg Products.

Salmonellosis is one of the main causes of foodborne illnesses worldwide, with outbreaks predominately linked to contamination of eggs and raw egg products, such as mayonnaise. This review explores previous studies that have investigated Salmonella control mechanisms utilized in the production of raw egg mayonnaise and other food products. Apart from the use of pasteurized eggs, the main control mechanism identified is the pH of the raw egg products, which plays an important role in the consistency and stability while affecting the survival of Salmonella spp. However, currently there is no consensus regarding the critical pH limit for the control of Salmonella. The effectiveness of pH as a control mechanism is influenced by the type of acid used, with the effectiveness of lemon juice compared with vinegar highly debated. Additionally, Salmonella susceptibility to pH stresses may also be influenced by storage temperature (in some studies refrigeration temperatures protected Salmonella spp. from acidulants) and is further complicated by the development of Salmonella cross-tolerance-induced responses, pH homeostasis achieved by the cellular antiport and symport systems, and acid tolerance response (ATR). These mechanisms all provide Salmonella with an added advantage to ensure survival under various pH conditions. Other confounding factors include the fat content, and the addition of NaCl, garlic and plant essential oils (PEOs) from mint, cinnamon, cardamom and clove.

A Salmonella Typhimurium outbreak linked to Vietnamese bread rolls in South Western Sydney, Australia, 2015

Introduction: In September 2015, the South Western Sydney (SWS) Public Health Unit was notified of a cluster of Salmonella Typhimurium (STm) cases with a common multiple-locus variable-number tandem repeats analysis (MLVA) pattern. An investigation was conducted to identify a source and contain the outbreak. Methods: The cluster was initially identified through routine geographic information system cluster scanning applied to the New South Wales Notifiable Conditions Management System. Additional cases were identified through a complaint to local council about a bakery. The bakery was inspected and 48 environmental and food swabs were collected for analysis. Results: A total of 26 suspected cases were identified, of which 14 were interviewed. STm MLVA type 3-16-9-11-523 was identified in 19 of 26 case stool specimens. Most cases (12/14) consumed bread rolls containing pork or chicken with chicken liver pâté and raw egg mayonnaise filling. Five cases identified a common bakery exposure. Environmental and food samples from the bakery isolated STm with an identical MLVA pattern. Discussion: An STm cluster in SWS was investigated and found to be linked to Vietnamese bread rolls containing pork or chicken with chicken liver pâté and raw egg mayonnaise filling. Confirmation of a distinct MLVA pattern among STm isolates from clinical, food and environmental samples provided evidence to establish an epidemiological link between the cases and the implicated premises and informed public health action to contain the outbreak.