A Strong Evidence Outbreak of Salmonella Enteritidis in Central Italy Linked to the Consumption of Contaminated Raw Sheep Milk Cheese

Salmonellosis is the second most commonly reported gastrointestinal infection in humans after campylobacteriosis, and an important cause of foodborne outbreaks in the EU/EEA. The vast majority (72.4%) of the salmonellosis foodborne outbreaks reported in EU in 2019 were caused by Salmonella Enteritidis, even if their total number due to this serovar decreased. In spring 2020, a foodborne outbreak of S. Enteritidis occurred in the Marche region (Central Italy), involving 85 people. The common exposure source was a cheese, pecorino “primo sale”, produced with raw sheep milk. The cheese batches were produced by two local dairies, with a livestock production facility, also including a sheep farm, being part of one dairy. Bacteriological analysis of samples collected allowed the detection of S. Enteritidis in animal faeces, environmental samples, raw-milk bulk tanks and milk taken from single animals. These data confirm that, despite the scarce scientific evidence, S. Enteritidis can infect sheep and be shed into the animals’ milk. Hence, this is a real risk for public health when unpasteurized milk is used in production of such cheese. The present paper describes the results of the investigations conducted to clarify this outbreak.

The occurrence of Campylobacter spp., Listeria monocytogenes and Shiga toxin-producing Escherichia coli in Norwegian dairy cattle farms; a comparison between free stall and tie stall housing systems.

Aims: This study explores how different dairy farm operating systems influence the occurrence of zoonotic bacteria in raw milk. Methods and Results: Samples from bulk tank milk, milk filters, feces, feed, teats and teat milk were collected from eleven farms with loose housing and seven with tie-stall housing every second month over a period of 11 months and analyzed for the presence of Campylobacter spp., L. monocytogenes and STEC. Campylobacter spp., L. monocytogenes and STEC were abundant in samples from the farm environment and were also detected in 4%, 13% and 7% of the milk filters, respectively, and in 3%, 0% and 1% of bulk tank milk samples. Four STEC isolates carried the eae gene, which is linked to the capacity to cause more severe human disease. Conclusion: The results indicate a higher prevalence of L. monocytogenes and Campylobacter spp. in samples collected from loose housed herds compared to tie-stalled herds suggesting that the operating system can influence the food safety of raw milk. Significance and Impact of the study: This study highlights that zoonotic bacteria can be present in raw milk independent of hygienic conditions at the farm and what hosing system is used. Altogether, this study provides an important knowledge base for evaluating the risk of drinking unpasteurized milk.

Penyebaran Penyakit Brucellosis di Wilayah Koasistensi Administrasi Dinas dan Kesmavet

Brucellosis is a Brucella bacterial infectious disease that is spread from animals to humans, generally through consumption of milk, especially unpasteurized milk, or other dairy products. Veterinary public health has an important role in preventing transmission of disease to humans through both animals and foodstuffs of animal origin or other animal origin ingredients. Brucellosis is one of the problems often faced by the Animal Husbandry Department, especially at the Animal Health Unit. Handling and controlling about Brucellosis is very vital to maintain animal health and reduce the level of economic losses of farmers due to Brucellosis experienced by livestock owned. This study aims to determine the spread of Brucellosis disease by mapping in the Administrative and Service Coordination areas, to know the handling and control actions carried out by the Animal Husbandry Service throughout the implementation of the Administrative Coordination Office and Veterinary Public Health. The results of the mapping of the spread of Brucellosis in the District of Veterinary Public Health and Public Service Administration Coordination can be divided into 3 groups with the number of cases <10, 10 - 66, and> 66. The number of cases between the range of 10 - 66 there are 3 regions, while the number of cases> 66 there are 2 regions. Keywords : Brucellosis; Mapping; Handling and Control; Descriptive Statistics

Microbiological Characteristics and Behavior of Staphylococcus aureus, Salmonella spp., Listeria monocytogenes and Staphylococcal Toxin during Making and Maturing Cotija Cheese

Cotija cheese is an artisanal matured Mexican cheese from unpasteurized milk. This work determined the microbiological characteristics and behavior of Staphylococcus aureus, Salmonella spp., Listeria monocytogenes and staphylococcal toxin during cheese elaboration and ripening. Sixteen 20-kg cheeses were used, eight inoculated with 6 log CFU/mL of each pathogen, and eight uninoculated, and samples were taken at each stage of the process. In the uninoculated samples, the survival of S. aureus and L. monocytogenes decreased after 30 days of ripening. The average counts of S. aureus in milk, curd, and serum were 7 log MPN /mL, and 8.7 log MPN /g in cheese, decreasing from day 15. Salmonella spp. counts (initial inoculum: 7.2 log MPN /mL) decreased after 24 h, and L. monocytogenes counts (8.7 log MPN/g at 24 h) decreased from day 15 in the cheese. Salmonella spp. and L. monocytogenes were not detected in any sample after 60 days of ripening, unlike S. aureus, which was detected at the end of the study. Lactic acid bacteria counts were 9 log CFU/mL in milk and whey and 7.2 log CFU/g in cheese. Pathogens behavior during the ripening process reduces the health risks by consuming products made with unpasteurized milk when subjected to ripening.

Brucella terminal ileitis: a rare cause of intestinal obstruction about a case

Brucellosis is a bacterial zoonosis transmitted by contact with fluids from infected domestic animals, by consumption of unpasteurized milk products, or by inhalation of infected aerosols. Systemic infection has clinical manifestations from asymptomatic cases to those that are fatal. Focal infections occur in 30% of cases and affect any organ. Gastrointestinal manifestations are rare and unspecific. We reported the case of a patient with antithrombin III deficiency who presented with a clinical picture of abdominal pain at the emergency department, with failure of conservative treatment and with progression to acute abdomen, for which surgical treatment was offered, resolving the condition of intestinal obstruction and taking a biopsy that confirmed terminal brucella ileitis, antibiotic treatment and intestinal rest were indicated with successful results. Brucella terminal ileitis is an unusual manifestation of brucellosis. History of consumption of unpasteurized milk and derivatives and contact with livestock should be carefully examined in patients with acute abdomen in Brucella endemic countries. This will lead to a full and uncomplicated recovery from this disease.

Chapter 12a: Epidemiology by country – an overview

TBE is a flavivirus infection of the central nervous system (CNS), transmitted by ticks and in some instances by ingestion of unpasteurized milk. It is diagnosed in the forested belts of Northern Eurasia ranging from the UK, eastern France, The Netherlands and Norway down to Italy through central and Eastern Europe, Russia, Kazakhstan, and China to Japan. About 10,000 cases of TBE are reported annually, likely a significant underestimate as serological testing is more sporadic than complete and, in some countries, (like Japan) not even available. The European Centers for Disease Prevention and Control (ECDC) have put TBE on their list of notifiable diseases. Their case definition requires clinical symptoms of CNS infection plus virological or serological confirmation of the infection, usually by detection of specific immunoglobulins IgG and IgM. Vaccination against TBE is on the World Health Organization’s List of Essential Medicines. the safest and most effective medicines needed in a health system. Surveillance of TBE and the TBEV is incomplete. Reported incidences do not reflect actual risk since this fluctuates annually as a result of changes in exposure, vaccine uptake, intensity of case finding and reporting, climate factors, reservoir animals and ticks – just to mention the most relevant factors. For largely unknown reasons (including human behavior, improved diagnostics, or climate change) TBEV appears to be spreading north, east, west, even south and to higher altitudes to areas that were previously believed to be free of the virus.

Human Milk from Previously COVID-19-Infected Mothers: The Effect of Pasteurization on Specific Antibodies and Neutralization Capacity

Background: Since the outbreak of coronavirus disease 2019 (COVID-19), many put their hopes in the rapid availability of effective immunizations. Human milk, containing antibodies against syndrome coronavirus 2 (SARS-CoV-2), may serve as means of protection through passive immunization. We aimed to determine the presence and pseudovirus neutralization capacity of SARS-CoV-2 specific IgA in human milk of mothers who recovered from COVID-19, and the effect of pasteurization on these antibodies. Methods: This prospective case control study included lactating mothers, recovered from (suspected) COVID-19 and healthy controls. Human milk and serum samples were collected. To assess the presence of SARS-CoV-2 antibodies we used multiple complementary assays, namely ELISA with the SARS-CoV-2 spike protein (specific for IgA and IgG), receptor binding domain (RBD) and nucleocapsid (N) protein for IgG in serum, and bridging ELISA with the SARS-CoV-2 RBD and N protein for specific Ig (IgG, IgM and IgA in human milk and serum). To assess the effect of pasteurization, human milk was exposed to Holder (HoP) and High Pressure Pasteurization (HPP). Results: Human milk contained abundant SARS-CoV-2 antibodies in 83% of the proven cases and in 67% of the suspected cases. Unpasteurized milk with and without these antibodies was found to be capable of neutralizing a pseudovirus of SARS-CoV-2 in (97% and 85% of the samples respectively). After pasteurization, total IgA antibody levels were affected by HoP, while SARS-CoV-2 specific antibody levels were affected by HPP. Pseudovirus neutralizing capacity of the human milk samples was only retained with the HPP approach. No correlation was observed between milk antibody levels and neutralization capacity. Conclusions: Human milk from recovered COVID-19-infected mothers contains SARS-CoV-2 specific antibodies which maintained neutralization capacity after HPP. All together this may represent a safe and effective immunization strategy after HPP.

Epidemiology and pathophysiology of hemolytic uremic syndrome associated with shiga toxin (literature review)

Hemolytic uremic syndrome (HUS) associated with shiga toxin E. coli(STEC) is one of the most common causes of acute kidney injury in young children. The share of STEC-HUS among all HUS variants is up to 90%. Not all STECs are pathogenic to humans, and those that cause disease (hemorrhagic colitis, HUS) are referred to as enterohemorrhagic E. coli(EHEC). The main pathogens causing STEC-HUS include the serotype E. coliO157: H7, less often serotypes O26, O80, O103, O121, O145. EHEC exist as normal microbiota in cattle, but can also be found in goats, sheep, pigs, chickens, dogs, and rats. Infection can occur when using undercooked ground beef, unpasteurized milk, water, including tap water and from open ponds and pools, from an infected person and when visiting farms and zoos. The epidemiological history should be carefully assessed in each patient with HUS, taking into account the annual outbreaks of this disease in different regions of the world. In recent years actively discussed the issue of the transfer of shiga toxin (Stx) from the intestine to the blood and from the blood to target organs in the form of microvesicles, the wall of which is the outer shell of E.coliand blood cells. This allows Stx to escape the response of the human immune system. The article describes in detail the mechanisms of infection and expression of pathogenic genes of EHEC, the effect of Stx on endothelial cells, on expression of adhesion molecules and inflammatory chemokines, activation of the alternative complement pathway, which determine the development of HUS.

Quality Characteristics and Consumer Acceptance of High-Moisture Mozzarella Obtained from Heat-Treated Goat Milk

High-moisture mozzarella is a pasta filata cheese manufactured from cow or buffalo milk that has spread all over the world. Its manufacturing from the milk of small ruminants (goat and sheep) has been recently proposed to innovate this ailing sector. Previously, a protocol was reported for making goat mozzarella from unpasteurized milk but, according to legislation, the microbiological safety of raw milk fresh cheeses is not guaranteed. In the present research, two new protocols were tested for producing mozzarella from pasteurized milk prepared by two different low-temperature long-time treatments (67 °C or 63 °C × 30 min). The obtained cheeses were subjected to physical–chemical and microbiological analyses and to consumer testing. The results showed that the heat treatments caused longer coagulation times than those reported in the literature, despite pre-acidification (at pH 5.93 or 6.35) having been performed to counterbalance the expected worsening of the coagulation aptitude. The obtained products showed differences in the chemical composition, texture, proteolysis, and lipolysis. Both pasteurization and pre-acidification played a role in determining these variations. Consumer testing indicated that mozzarella obtained from milk heated at the lower temperature and coagulated at a higher pH reached a good level of appreciation (62%).