Sabah Bidawid

Human noroviruses in swine and cattle.

Detection of GII.4 norovirus sequences in animal fecal samples and retail meats demonstrates that noroviruses may be transmitted zoonotically.

Enterobacter sakazakii: Infectivity and Enterotoxin Production In Vitro and In Vivo

Enterobacter sakazakii has been implicated as the causal organism in a severe form of neonatal meningitis, with reported mortality rates of 40 to 80%. Dried infant formula has been identified as a potential source of the organism in both outbreaks and sporadic cases. In this study, clinical and foodborne isolates of E. sakazakii were evaluated for enterotoxin production by the suckling mouse assay. In addition, suckling mice were challenged both orally and by intraperitoneal injection. Of 18 E. sakazakii strains evaluated, four were found to test positive for enterotoxin production. All strains of E. sakazakii were lethal to suckling mice at 10(8) CFU per mouse by intraperitoneal injection, while two strains caused death by the peroral route. In in vitro assays, CHO, Vero, and Y-1 cells demonstrated both cell lysis and rounding when exposed to E. sakazakii strain LA filtrates. This is the first report describing any putative virulence factors of E. sakazakii.

Norovirus Cross-Contamination during Food Handling and Interruption of Virus Transfer by Hand Antisepsis: Experiments with Feline Calicivirus as a Surrogate †

While there is good epidemiological evidence for foods as vehicles for norovirus transmission, the precise means of spread and its control remain unknown. The feline calicivirus was used as a surrogate for noroviruses to study infectious virus transfer between hands and selected types of foods and environmental surfaces. Assessment of the potential of selected topicals in interrupting such virus transfer was also made. Ten microliters of inoculum of feline calicivirus deposited onto each fingerpad of adult subjects was allowed to air dry and the contaminated area on individual fingerpads was pressed (10 s at a pressure of 0.2 to 0.4 kg/cm2) onto 1-cm-diameter disks of ham, lettuce, or brushed stainless steel. The virus remaining on the donor and that transferred to the recipient surfaces was eluted and plaque assayed. Virus transfer to clean hands from experimentally contaminated disks of ham, lettuce, and stainless steel was also tested. Nearly 46 +/- 20.3, 18 +/- 5.7, and 13 +/- 3.6% of infectious virus was transferred from contaminated fingerpads to ham, lettuce, and metal disks, respectively. In contrast, approximately 6 +/- 1.8, 14 +/- 3.5, and 7 +/- 1.9% virus transfer occurred, respectively, from ham, lettuce, and metal disks to hands. One-way analysis of variance test showed that pretreatment (washing) of the fingerpads either with water or with both topical agent and water significantly (P < 0.05) reduced virus transfer to < or = 0.9%, as compared with < or = 2.3 and < or = 3.4% transfer following treatments with either 75% (vol/vol) ethanol or a commercial hand gel containing 62% ethanol, respectively. Despite wide variations in virus transfer among the targeted items used, intervention agents tested reduced virus transfer significantly (P < 0.05) when compared with that without such treatments (71 +/- 8.9%). These findings should help in a better assessment of the potential for cross-contamination of foods during handling and also assist in developing more effective approaches to foodborne spread of norovirus infections.

A feline kidney cell line-based plaque assay for feline calicivirus, a surrogate for Norwalk virus

Feline calicivirus (FCV) has been used by researchers as a surrogate for Norwalk virus (NV), since they share a similar genomic organization, physicochemical characteristics, and are grouped in the same family, Caliciviridae. Unlike NV, however, FCV can grow in established cell lines and produce a syncytial form of cytopathic effect. In this report, we describe the development and standardization of a plaque assay for FCV using monolayers of an established line of feline kidney (CrFK) cells in 12-well cell culture plates. The assay method has demonstrated reproducibility, ease of performance and resulted in clear plaque zones, readable in 24 h after virus inoculation. The infectivity titre of the virus by this plaque assay agreed well with tissue culture infectious dose(50) (TCID(50)) determinations. The described plaque assay would be a valuable tool in conducting various quantitative investigations using FCV as a model for NV and Norwalk-like viruses (NLV).

Heat inactivation of hepatitis A virus in dairy foods.

Experiments were performed to determine the thermal resistance of hepatitis A virus (HAV) in three types of dairy products containing increased amounts of fat content (skim milk, homogenized milk; 3.5% MFG, and table cream; 18% MFG). HAV-inoculated dairy products were introduced into custom-made U-shaped microcapillary tubes that in turn were simultaneously immersed in a waterbath, using custom-made floating boats and a carrying platform. Following exposure to the desired time and temperature combinations, the contents of each of the tubes was retrieved and was tested by plaque assay to determine the reduction in virus titer. Our data indicated that < 0.5 min at 85 degrees C was sufficient to cause a 5-log reduction in HAV titer in all three dairy products, whereas at 80 degrees C, < or = 0.68 min (for skim and homogenized milk), and 1.24 min (for cream) were needed to cause a similar log reduction. Using a nonlinear two-phase negative exponential model (two-compartment model) to analyze the data, it was found that at temperatures of 65, 67, 69, 71, and 75 degrees C, significantly (P < 0.05) higher exposure times were needed to achieve a 1-log reduction in virus titer in cream, as compared to skim and homogenized milk. For example, at 71 degrees C, a significantly (P < 0.05) higher exposure time of 0.52 min (for cream) was needed as compared to < or = 0.18 min (for skim and homogenized milk) to achieve a 1-log reduction in virus titer. A similar trend of inactivation was observed at 73 and 75 degrees C where significantly (P < 0.05) higher exposure times of 0.29 to 0.36 min for cream were needed to cause a 1-log reduction in HAV in cream, as compared to < or = 0.17 min for skim and homogenized milk. This study has provided information on the heat resistance of HAV in skim milk, homogenized milk, and table cream and demonstrated that an increase in fat content appears to play a protective role and contributes to the heat stability of HAV.

Inactivation of hepatitis A virus (HAV) in fruits and vegetables by gamma irradiation

Abstract Doses of gamma (60Co) irradiation ranging between 1 and 10 kGy were used to investigate the inactivation of hepatitis A virus (HAV) inoculated onto lettuce and strawberries at ambient temperature. The number of surviving viruses at a given dose of radiation was determined by a plaque assay. Data analysis by a linear model indicated that D10 values of 2.72±0.05 and 2.97±0.18 kGy were required to achieve a 1-log reduction in HAV titre in lettuce and strawberries, respectively. These data indicate that gamma irradiation doses between 2.7 and 3.0 kGy would be required to achieve ≥90% kill in HAV populations on fruits and vegetables.

Survival of calicivirus in foods and on surfaces: experiments with feline calicivirus as a surrogate for norovirus.

Although there is a large body of evidence incriminating foods as vehicles in the transmission of norovirus, little is known about virus survival in foods and on surfaces. Feline calicivirus was used as a surrogate for norovirus to investigate its survival in representative foods of plant and animal origin and on metal surfaces. Known concentrations of feline calicivirus in a natural fecal suspension were deposited onto lettuce, strawberries, ham, or stainless steel and incubated for 7 days at refrigeration or room temperatures. Virus was recovered at 1-day intervals, and the titers of the virus were determined by plaque assay. Infectious virus was recoverable until day 7 from lettuce, ham, and stainless steel. Statistically higher titers of feline calicivirus (P < 0.05) were recovered from ham under all conditions than from lettuce, strawberries, or stainless steel. These data provide valuable information for epidemiological and monitoring purposes as well as for the development of food processing practices and appropriate strategies to inactivate norovirus and control its transmission via foods and surfaces.

Rapid concentration and detection of hepatitis A virus from lettuce and strawberries.

Immunomagnetic beads-PCR (IM-PCR), positively-charged virosorb filters (F), or a combination of both methods (F-IM-PCR) were used to capture, concentrate and rapidly detect hepatitis A virus (HAV) in samples of lettuce and strawberries experimentally contaminated. Direct reverse transcriptase-polymerase chain reaction (RT-PCR) amplification of the collected HAV-beads complex showed a detection limit of 0.5 plaque forming units (PFU) of the virus present in 1-ml of wash solution from the produce, which was several hundred-fold more sensitive than that demonstrated by RT-PCR. In separate trials, virus-containing wash solutions from the produce were passed through the filters and the captured virus was eluted with 10 ml volumes of 1% beef extract. Of the 62% filter-captured HAV, an average of 34.8% was eluted by the 1% beef extract. PCR amplification of 2 microl from this eluate failed to produce a clear positive band signal. As little as 10 PFU, present on each piece of the lettuce or strawberry, was detectable by the F-IM-PCR, which was almost 20 times less sensitive than the detection limit of 0.5 PFU by the IM-PCR. However, considering the large volumes (< or =50 ml) used in the F-IM-PCR, the sensitivity of detection could be much greater than that of the IM-PCR, which was restricted to < or =20 ml volumes. These data indicate that the F-IM-PCR method provides the potential for a greater sensitivity of detection than the IM-PCR, since low levels of virus could be detected from large volumes of sample than possible by the IM-PCR method. Although positively-charged filters captured a greater amount of virus than both the IM-PCR and F-IM-PCR methods, direct PCR amplification from beef extract eluates was not successful in detecting HAV from produce.

Enteric Viruses in Ready-to-Eat Packaged Leafy Greens

To the Editor: Fresh produce increasingly has been implicated in viral disease outbreaks (1). In some instances, lettuce was contaminated before wholesale distribution (1). Enteric viruses can be introduced in the field if produce is exposed to human waste. Processed and packaged produce can be contaminated if equipment or wash water is not effectively sanitized. Fewer than 10 infectious viral particles are sufficient to cause disease (2), and these organisms are resistant to disinfectants at concentrations that reduce bacterial levels (3). Contamination of fresh produce could pose a health risk to humans because fresh produce is eaten raw. High levels of viral contamination can result in large outbreaks, but intermittent contamination of fresh produce accounts for some sporadic cases of norovirus and rotavirus gastroenteritis. During April 27–November 23, 2009, we performed viral testing on 328 samples of packaged leafy greens (representing 12–14 different lots from 3–6 companies per week; no samples were taken on weeks with a statutory holiday) for norovirus or rotavirus RNA. Packaged leafy greens were purchased from retail stores in southern Ontario, Canada. Shipments maintained an average temperature of 3.8°C during transit to the testing laboratory. Each 25-g sample was spiked with 106 PFU of feline calicivirus (FCV) as a sample process control (4). Virus was concentrated by using an adsorption-elution-ultrafiltration filtration protocol (4). Recovery of FCV was quantified from an RNA standard curve. FCV process control recovery was 0.01% of the FCV was observed for the remaining 273 (83%) samples. Two samples from which FCV was not recovered were positive for norovirus (CE-V-09–0138) and rotavirus (CE-V-09–0129); they were considered true positive results. Of these 275 samples, 148 (54%) were positive for norovirus by real-time reverse transcription–PCR (RT-PCR) (5), and 1 (0.4%) was positive for rotavirus group A by RT-PCR (6). To confirm detection of norovirus RNA, we amplified a second norovirus target by RT-PCR of region C (5). Only 40 samples (15% of total) produced a band of the expected size for this second norovirus amplicon. Of these 40 amplicons, only 16 (6% of total) could be sequenced to confirm norovirus RNA. The rotavirus-positive sample was confirmed by sequencing. For some sample dates, multiple lots were positive; for others, no positive samples were identified (Figure). Multiple detections on the same date were not caused by cross-contamination; partial capsid sequencing showed different genetic types on dates when multiple samples were positive (Figure). Results were positive from 5 different brands, and no organic samples were confirmed positive for enteric virus contamination. Of the 16 norovirus strains confirmed, 13 belonged to genogroup I (GI) and 3 to genogroup II (GII) (Figure). All were strain types known to be human pathogens. The group A rotavirus was not subtyped; group A rotaviruses can be human or animal pathogens. Figure Phylogenetic analysis of the partial capsid sequence from genogroup I (A) and genogroup II (B) norovirus strains detected on leafy greens samples, Ontario, Canada, 2009, compared with the ViroNet Canada reference set for this region. Dates in parentheses ... Most noroviruses detected belonged to GI. Previous reports indicate that GI norovirus are more frequently identified in foodborne or waterborne outbreaks; GII.4 noroviruses are more common in large outbreaks spread person to person (7). Identification of GI norovirus is consistent with occasional contamination of produce or wash water. Disinfectants and sanitation agents are used in wash water at low concentrations, at which they have limited efficacy against norovirus (3). Washing and disinfecting produce before eating it can reduce the risk for infection by reducing the viral load by 10- to 1,000-fold (8). The median level of confirmed contamination in this study was ≈500 RNA copies for norovirus (range 1.4 copies to 9 × 106 copies). A limitation of our findings is the inability to determine the association between molecular detection results and infectious virus. No outbreaks were related to the sequences detected here. There is no routine cell culture system for the laboratory growth of human norovirus. Genomic RNA can persist after the virus has been inactivated (9). The new ViroNet Canada network, which went online in April 2010, will monitor strains detected in leafy greens and other food products together with strains from community outbreaks to identify outbreaks linked to contaminated foods. Our comprehensive surveillance study identified norovirus and rotavirus contamination of packaged leafy greens. We detected noroviruses on 6% and rotavirus on 0.4% of lots tested from retail markets in southern Ontario. Packages with confirmed positive samples were both imported into Canada and had been conventionally grown. Noroviruses have a low infectious dose (2), and detection of viral RNA is associated with human health risk in oysters, another commodity that is eaten raw (10). Our results suggest a possible risk for foodborne transmission of norovirus and rotavirus from packaged leafy greens.

Foodborne spread of hepatitis A: Recent studies on virus survival, transfer and inactivation.

Hepatitis A virus (HAV) is responsible for considerable morbidity and economic losses worldwide, and is the only reportable, foodborne viral pathogen in Canada. Outbreaks caused by it occur more frequently in settings such as hospitals, daycare centres, schools, and in association with foods and food service establishments. In recent years, the incidence of hepatitis A has increased in Canada. Many factors, including changing lifestyles and demographics, faster and more frequent travel, and enhanced importation of foods from hepatitis A-endemic regions, may be behind this increase. Despite its increasing significance as a human pathogen, not much was known until recently about the survival and inactivation of HAV, and even less was understood about the effectiveness of measures to prevent and control its foodborne spread. Studies conducted in the past decade have shown that HAV can survive for several hours on human hands and for several days on environmental surfaces indoors. The virus can also retain its infectivity for several days on fruits and vegetables which are often consumed raw, and such imported items have already been incriminated in disease outbreaks. Casual contact between contaminated hands and clean food items can readily lead to a transfer of as much as 10% of the infectious virus. HAV is also relatively resistant to inactivation by heat, gamma irradiation and chemical germicides. In view of these findings, better approaches to prevent the contamination of foods with HAV and more effective methods for its inactivation in foods, on environmental surfaces and on the hands of food handlers are needed.