Acute Liver Failure after Ingestion of Fried Rice Balls: A Case Series of Bacillus cereus Food Poisonings

Bacillus cereus foodborne intoxications and toxicoinfections are on a rise. Usually, symptoms are self-limiting but occasionally hospitalization is necessary. Severe intoxications with the emetic Bacillus cereus toxin cereulide, which is notably resistant heat and acid during cooking, can cause acute liver failure and encephalopathy. We here present a case series of food poisonings in five immunocompetent adults after ingestion of fried rice balls, which were massively contaminated with Bacillus cereus. The patients developed a broad clinical spectrum, ranging from emesis and diarrhoea to life-threatening acute liver failure and acute tubular necrosis of the kidney in the index patient. In the left-over rice ball, we detected 8 × 106Bacillus cereus colony-forming units/g foodstuff, and cereulide in a concentration of 37 μg/g foodstuff, which is one of the highest cereulide toxin contaminations reported so far from foodborne outbreaks. This report emphasizes the potential biological hazard of contaminated rice meals that are not freshly prepared. It exemplifies the necessity of a multidisciplinary approach in cases of Bacillus cereus associated food poisonings to rapidly establish the diagnosis, to closely monitor critically ill patients, and to provide supportive measures for acute liver failure and—whenever necessary—urgent liver transplantation.

Natural Disasters—Origins, Impacts, Management

Natural hazards are processes that serve as triggers for natural disasters. Natural hazards can be classified into six categories. Geophysical or geological hazards relate to movement in solid earth. Their examples include earthquakes and volcanic activity. Hydrological hazards relate to the movement of water and include floods, landslides, and wave action. Meteorological hazards are storms, extreme temperatures, and fog. Climatological hazards are increasingly related to climate change and include droughts and wildfires. Biological hazards are caused by exposure to living organisms and/or their toxic substances. The COVID-19 virus is an example of a biological hazard. Extraterrestrial hazards are caused by asteroids, meteoroids, and comets as they pass near earth or strike earth. In addition to local damage, they can change earth inter planetary conditions that can affect the Earth’s magnetosphere, ionosphere, and thermosphere. This entry presents an overview of origins, impacts, and management of natural disasters. It describes processes that have potential to cause natural disasters. It outlines a brief history of impacts of natural hazards on the human built environment and the common techniques adopted for natural disaster preparedness. It also lays out challenges in dealing with disasters caused by natural hazards and points to new directions in warding off the adverse impact of such disasters.

Understanding uptake of prevention and mitigation of COVID-19 at work actions in Iran

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has required organizations to make changes to ways of working to prevent and mitigate COVID-19 in employees. OBJECTIVE: To assess the workplace response to COVID-19 in Iran. METHODS: 255 organizations completed a two-part survey. Part 1 collected data describing the business; Part 2 comprised the International Labor Organization (ILO) 30-item Prevention and Mitigation of COVID-19 at Work Actions Checklist. A four-point Likert scale was used to score each item according to whether preventative measures had been actioned. RESULTS: We found a dichotomy of commitment to managing COVID-19 at work. 42.5%of organizations had fully implemented the ILO recommended preventative actions, and 45.6%workplaces had not implemented any. Large organizations had significantly more preventative actions than SMEs; the Healthcare sector had significantly better COVID-19 mitigation measures in place than Construction projects; and organizations with a health and safety management system had significantly more prevention actions in place. CONCLUSIONS: ILO provided a good framework to support risk assessment of COVID-19, however only half the organizations were undertaking the necessary biological hazard control actions to prevent COVID-19 at work. There remains a need to understand the inaction of organizations who do not risk assess despite being in a pandemic.

Assessment of the Impact on Human Health of the Presence of Norovirus in Bivalve Molluscs: What Data Do We Miss?

In the latest One Health ECDC EFSA technical report, Norovirus in fish and fishery products have been listed as the agent/food pair causing the highest number of strong-evidence outbreaks in the EU in 2019. This review aims to identify data gaps that must be filled in order to increase knowledge on Norovirus in bivalve molluscs, perform a risk assessment and rank the key mitigation strategies for this biological hazard, which is relevant to public health. Virologic determinations are not included in any of the food safety and process hygiene microbiologic criteria reflected in the current European regulations. In addition, the Escherichia coli-based indices of acceptable faecal contamination for primary production, as well as the food safety criteria, do not appear sufficient to indicate the extent of Norovirus contamination. The qualitative risk assessment data collected in this review suggests that bivalve molluscs present a high risk to human health for Norovirus only when consumed raw or when insufficiently cooked. On the contrary, the risk can be considered negligible when they are cooked at a high temperature, while information is still scarce for non-thermal treatments.

ATR-FTIR spectrum analysis of saliva samples from COVID-19 positive patients

The coronavirus disease 2019 (COVID-19) is the latest biological hazard for the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Even though numerous diagnostic tests for SARS-CoV-2 have been proposed, new diagnosis strategies are being developed, looking for less expensive methods to be used as screening. This study aimed to establish salivary vibrational modes analyzed by attenuated total reflection-Fourier transform infrared (ATR-FTIR) spectroscopy to detect COVID-19 biological fingerprints that allow the discrimination between COVID-19 and healthy patients. Clinical dates, laboratories, and saliva samples of COVID-19 patients (N = 255) and healthy persons (N = 1209) were obtained and analyzed through ATR-FTIR spectroscopy. Then, a multivariate linear regression model (MLRM) was developed. The COVID-19 patients showed low SaO2, cough, dyspnea, headache, and fever principally. C-reactive protein, lactate dehydrogenase, fibrinogen, d-dimer, and ferritin were the most important altered laboratory blood tests, which were increased. In addition, changes in amide I and immunoglobulin regions were evidenced in the FTIR spectra analysis, and the MLRM showed clear discrimination between both groups. Specific salivary vibrational modes employing ATR-FTIR spectroscopy were established; moreover, the COVID-19 biological fingerprint in saliva was characterized, allowing the COVID-19 detection using an MLRM, which could be helpful for the development of new diagnostic devices.

1537Fighting against the pandemic or threatening the environment? Unforeseen challenges during COVID-19 pandemic

Background In the current scenario of COVID-19 outbreak whereby the virus spreads through fomites and aerosols, there has been a huge increase in the use of soaps, sanitizers and personal protective equipment’s (PPEs) which in turn is causing huge amount of liquid and solid waste generation. We briefly describe here as how this pandemic is causing an impact on global environment. We also provide a rationale of using a modelled treatment framework using a reverse logistic network as temporary waste management measure during this pandemic. Methods We systematically searched Medline, Cochrane library, Google Scholar, Embase for articles published in English language describing the increased Biomedical waste generation in the current COVID-19 pandemic. Results As of July 2020, the volume of the COVID biomedical waste generated across India was 101 metric tons per day where Maharashtra was the largest producer of biomedical waste with about 17.5 metric tons per day. Conclusions Rationale use of personal protective equipment according to the exposure level of the biological hazard should be ensured by health workers and communities. Awareness regarding the proper disposal of the personal protective equipment and other biomedical wastes generated should be created. Also, proper segregation of biomedical wastes from the point of generation to the point of disposal and treatment should be done. Key messages Inappropriate usage and disposal of PPEs in the current COVID-19 pandemic is a huge hazard to the environment.

EFFECTIVENESS OF AN EDUCATIONAL PROGRAM ABOUT BIOLOGICAL HAZARD SAFETY MEASURES KNOWLEDGE AMONG CRITICAL CARE NURSES

Background: communicable and contagious diseases and exposure to blood-borne pathogens make critical care nurses expose to biological work place hazard. The aim of the study was to assess the effectiveness of an educational program on critical care nurses' knowledge about safety measures of biological hazard. Methodology: It was a pre/post interventional, hospital-based study, study subjects were 200 intensive care nurses (34 males 17% and 166 females 83%) working for one year or more in critical care settings (8 units) in ve public hospitals, Khartoum state, Sudan. A structured face to face questionnaire was used pre and posttest. A program done by lectures about biological hazard, causes, and safety measures, sitting group's discussion and direct individual educational sessions, interview was carried with each hospital's matron. Results: Knowledge about biological hazard as work place hazards was 100% in both pre and post results. Regarding preventive measures of biological hazard, participants showed different values in answer like uses of personal protective equipment (PPE) mentioned by 99% in preprogram test while hand washing was mentioned by 49.5% in pretest evaluation, Personal protective equipment was poorly provided. Conclusion: The educational program for critical care nurses had efcient results, as the noticeable improvement of results of critical care nurses' knowledge about universal precautions.

Using environmental sampling to evaluate the effectiveness of decontamination methods to reduce detection of porcine epidemic diarrhea virus RNA on feed manufacturing surfaces

Porcine epidemic diarrhea virus (PEDV) is a possible biological hazard in feed mills. If the virus enters a feed mill, it becomes widely distributed and is difficult to decontaminate from both feed contact and non-feed contact surfaces. The objective of this study was to evaluate a variety of liquid and dry decontamination treatments that could be used to reduce the amount of PEDV found on feed manufacturing surfaces. This experiment was designed as a 5 × 10 factorial with 5 different feed manufacturing surfaces and 10 decontamination treatments with 3 replicates of each combination. Surfaces included stainless steel, solid polyethylene, woven polypropylene tote bag, rubber, and sealed concrete coupons. One mL (1×10 5 TCID50/mL) of stock PEDV was applied to each surface and allowed to dry completely for 60 min. Next, for decontamination requiring surface application, the application was performed and allowed 15 min contact time. The quantity of PEDV RNA was determined using quantitative reverse transcription PCR. A decontamination treatment × surface interaction was observed (P < 0.0001), indicating the efficacy of treatment is dependent upon the surface in which it is applied. Within the cement surfaces, the sodium hypochlorite resulted in the greatest (P < 0.05) cycle threshold (Ct) value, followed by formaldehyde which had a greater (P < 0.05) Ct value compared to remaining treatments. Within polyethylene, rubber, and stainless steel surfaces, the formaldehyde treated surfaces had the greatest Ct values (P < 0.05), followed by the sodium hypochlorite treatment, with other treatments all having lower Ct values (P < 0.05). For the woven polyethylene surfaces, the formaldehyde and sodium hypochlorite treatments had greater Ct values compared to all other treatments (P < 0.05). Additional research is necessary to identify the role of decontamination treatment on PEDV infectivity and develop methods for decontamination of feed manufacturing facilities.

ATR-FTIR Spectrum Analysis of Saliva Samples from COVID-19 Positive Patients

The coronavirus disease 2019 (COVID-19) is the latest biological hazard for the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Numerous diagnostic tests for SARS-CoV-2 have been used, which are expensive and require specialized personal. So, new diagnosis strategies are being developed, looking for less expensive methods which could be used as screening for better spread control. Many researchers have described the use of saliva as a potential indicator of COVID-19, and even the same patient could carry out its collection. In this sense, this study aimed to establish specific salivary vibrational modes analyzed by attenuated total reflection-Fourier transform infrared (ATR-FTIR) spectroscopy to detect COVID-19 biological fingerprints that allow the discrimination between COVID-19 and healthy patients. Previous written informed consent, clinical dates, laboratories, and saliva samples of COVID-19 patients (n = 255) and healthy persons (n = 1209) were obtained and analyzed through ATR-FTIR spectroscopy. Then, a multivariate linear regression model (MLRM) was developed. The COVID-19 patients showed low SaO2, cough, dyspnea, headache, and fever principally. Obesity was the main comorbidity. Various laboratory blood tests were altered. In the FTIR spectra analysis, changes in amide I and immunoglobulin regions were evidenced, and the MLRM showed clear discrimination between both groups. Specific salivary vibrational modes employing ATR-FTIR spectroscopy were established; moreover, the COVID-19 biological fingerprint in saliva was characterized, allowing the detection for COVID-19 using an MLRM, once it helps to reduce the number of variables, which could be helpful in the future development of diagnostic devices in a faster and cheaper way.

Determination of the Toxicity Cause by Trace Metals on Zebrafish (Danio rerio) Embryo

Water quality deterioration due to inorganic and organic pollutant is a serious issue and the presence of toxic trace metals cause a serious threat to the aquatic ecosystem. Fish embryos have gained interest in risk assessment because of their high sensitivity to pollutants and the ecological relevance. This study investigated the acute toxicity effect of trace metals Arsenic (As), Cadmium (Cd), Mercury (Hg), Lead (Pb), Copper (Cu) and Zinc (Zn) on zebrafish (Danio rerio) embryo. Embryos were exposed to ten different concentrations of individual trace metals and lethality rate was recorded at 24, 48, 72 and 96 hours based on the coagulation of fertilized egg, lack of somite formation, lack of detachment of the tail and lack of heart beat. The results indicated a significant difference between the control and trace metal treated embryo (P< 0.05) and higher mortality rate along the increase of trace metal concentration. Along with the increase of exposure time for Cu, Zn and As, the mortality rate became slower. Sub-lethal and teratogenic deformities such as growth retardation, lack of tail development, lack of eye lens (placode), yolk sac edema, pericardial edema, hemorrhages, shrinkage of chorion and scoliosis were observed in most of the trace metal treated embryos. The results showed the toxic effects to aquatic biota due to trace metals emphasizing the usefulness of zebrafish embryo model for integrated biological hazard assessment.