Food Poisoning at Geyland Singapore

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Campylobacter is one of the most common bacterial causes of gastro intestinal diarrheal sickness in the United States of America. The vast majority of these cases occur as isolated and sporadic events and not as part of recognized epidemic like outbreaks. Ongoing surveillance by FoodNet demonstrates that about thirteen cases are diagnosed each year for each 100,000 persons in the population. Many more cases go undiagnosed or unreported, and campylobacteriosis is estimated to affect more than 2.4 million persons each year, or 0.8% of the total population of the USA. This disease is also very common in Europe, the Middle East and Asia. Campylobacteriosis occurs far more frequently in the summer months than in the winter months. The organism is isolated from infants and young adults more frequently than from persons in other age groups and from males more frequently than females. Although Campylobacter does not commonly cause death, it has been estimated that approximately 124 persons with Campylobacter infections die each year in the USA.

Campylobacter organisms are spiral-shaped bacteria that can cause disease in humans and animals. Most human illness is caused by one species, called Campylobacter jejuni, but human illness can also be caused by other species. Campylobacter jejuni grows best at the body temperature of a bird, and seems to be well adapted to birds, who carry it without becoming ill. These bacteria are fragile. They cannot tolerate drying and can be killed by oxygen. They grow only in places with less oxygen than the amount in the atmosphere. Freezing reduces the number of Campylobacter bacteria on raw meat.

Almost all persons infected with Campylobacter recover without any specific treatment. Patients should drink extra fluids as long as the diarrhea lasts. In more severe cases, antibiotics such as erythromycin or a fluoroquinolone can be used, and can shorten the duration of symptoms if given early in the illness. Your doctor will decide whether antibiotics are necessary.

Most people who get campylobacteriosis make a complete recovery within two to five days after the onset of symptoms, although sometimes in more serious cases recovery can take up to 10 days. Rarely, Campylobacter infection results in long-term consequences. Some people may develop arthritis. Others may develop a rare disease called Guillain-Barré syndrome that affects the nerves of the body which begins several weeks after the onset diarrheal illness. This occurs when a person’s immune system is triggered to attack the body’s own nerves which results in temporary paralysis that lasts several weeks and usually requires an intensive care regime. It is estimated that approximately one in every 1,000 reported Campylobacter illnesses leads to Guillain-Barré syndrome. As many as 40% of Guillain-Barré syndrome cases in this country may be triggered by campylobacteriosis.Campylobacteriosis usually occurs in single, sporadic cases, but it can also occur in outbreaks, when a number of people become ill at one time. Most cases of campylobacteriosis are associated with eating raw or undercooked poultry meat or from cross-contamination of other foods by these poultry items. Infants may get the infection by contact with poultry meat wrappings in shopping carts. Outbreaks of Campylobacter are usually associated with unpasteurized milk or contaminated water. Animals can also be infected, and some people have acquired their infection from contact with the stool of infected dogs or cats. The organism is not usually spread from one person to another, but this can happen if the infected person is producing large volumes of diarrhea and/or vomit. A very small number of Campylobacter organisms (fewer than 500) can cause illness in humans. Even one drop of juice from raw chicken meat can infect a person. One way to become infected is to cut poultry meat on a chopping board, and then use the unwashed chopping board and knife or other utensils which came into contact with the raw meat to prepare vegetables or other raw or lightly cooked foods. The Campylobacter organisms from the raw meat can by these means spread to the other food products.

Many chicken flocks are infected with Campylobacter but may very well show no signs of illness. Campylobacter can be easily passed from bird to bird through a common water source or through contact with infected feces of other birds. When an infected bird is slaughtered, Campylobacter organisms can be transferred from the intestines to the meat. Likewise, the bacteria can infect a whole batch of birds via the presence of the bacteria being present on equipment and on the hands and/or the gloves of the slaughter house workers who do not wash hands between each bird they handle. In 2005, Campylobacter was present on 47% of raw chicken breasts tested through the FDA-NARMS Retail Food program. Campylobacter is also present in the giblets, especially the liver.

Unpasteurized milk can become contaminated if the cow has an infection with Campylobacter in her udder or milk which has been contaminated with manure. Surface water and mountain streams can become contaminated from infected feces from cows or wild birds. This infection is common in the developing world, and travelers to foreign countries are also at risk for becoming infected with Campylobacter.

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When visiting China or any other country with a Chinese orientated culture it can be very challenging to try some of the exotic culinary preparations on offer. People of Chinese origin eat just about anything that is a source of protein. Local delicacies may include insects, reptiles, amphibians, all types of seafood and shellfish, many types of mamals and just about anything else you can think of.

Food poisoning among adventurous western tourists is quite common simply because of the fact that they have no or little awareness of the things which a local can stomach but would be very problematic for them. The prospect of being able to come home and show family and friends pictures of yourself munching on freshly fried cockroaches may be appealing but it may also turn out to be a mistake you might regret for a very long time.

Locals may have a much higher resistance to various food toxins and allergens that you. Their immune systems may well recognize and destroy bacteria which would make you very sick. Remember, they have been exposed to these things all their lives whereas for you it is completely new.

Many good hotels will keep lists of hotels which they feel that it is safe for tourists to eat and in addition they may also have a residential general practitioner on duty or be able to call a reputable GP within a very short space of time.

A good rule of thumb when eating in Chinese restaurants is only to eat in respectable busy places. Only accept your food it it is sizzling hot and do not order anything which your stomach is not used to. Also, never accept fruit which has been peeled for you, always opt to peel it yourself. Never eat salads. In fact, there are no salads in Chinese cuisine. Is it a coincidence that they all eat their food piping hot? Food for thought!

If you do fall sick in China or South East Asia always go to a doctor who has been recommended to you by a respectable establishment. Street doctors are often not qualified by internationally recognized medical schools and may make bad mistakes in diagnosis. Also some doctors may recommend unnecessary treatment and prescribe drugs that you do not need and which may do you more harm than good. It is also most unadvised to go to traditional practitioners because many of the herbal remedies which they prescribe may be infected with mold and cause more harm than good.

Common sense is an absolute must when eating of receiving medical treatment in China. The Chinese government itself are now organizing themselves to bring in a national standards authority which will act upon identical lines to those practiced in Eu regulations and the American FDA. The Chinese government has fully accepted that to continue to operate as they have until now is contrary to the Chinese national interest and prosperity of the Chinese nation. Please, be careful what you eat in China.

animal-1238375_1920Rodents can be a nightmare for all food businesses. It seems like they appear out of nowhere and disappear into thin air at random. Or do they? Environmental hygienists tell us that in the western world we are never more than ten feet away from a rat, on average. This is quite startling news because this means that rat concentrations may be higher than ever before in history. With the reported upsurge in the levels of reported food poisoning, particularly with reference to salmonella, e. coli and lysteria, the presence of rodents must be controlled professionally within food preparation areas.

In the days when sewers ran open in the middle of the streets of all towns to see rats scurrying around everywhere was no great thing. Nowadays, many of us get very fearful when we see a rat or mouse. It may be common to see rats around farm houses in the countryside but in urban domestic environments if a rat is seen indoors emergency calls will be made to the exterminator.

Rats are not fun to have around the house. They leave the smell of their urine in places they hide and the smell is very hard to get rid of. My house was once targeted by a rat when it was being renovated and we had a real job getting rid of the thing. It decided to set up shop in a washing machine of all places. The smell coming from the washing machine was so bad that I decided to buy a new one and have the old one taken away by the trash collectors.

Like any animal species rodents need an environment upon which they can thrive. They need warmth, food, water and a place to live. Rodents are social animals and do not like to live solitary lives. This means that any environment they decide to live in must be able to support several individuals.

It is our common belief that rodents will come because a slice of bread was left out or because there were a few crumbs that spilled on the floor. This notion is not quite true. Rodents need more than just a solitary piece of food.

Food businesses can be ideal places for rodents to thrive because they can find environments suitable to support whole colonies around food outlets. By using the term environment I relate to the following. Your premises, the neighbouring premises, the drainage system, your roof, the garbage collection area, your store rooms, other store rooms in your immediate area such as bakeries, butchers, vegetable stores, the condition of housing around your business and many other possible factors. All of these elements go towards creating an environment in which rodents can thrive.

There is one thing you must know about rodents. Anywhere they can squeeze their head through they can get their whole body through in a matter of a couple of seconds. Rats will swim through a drain water to trap to squeeze through the grate of a drain. They have no problem doing this.

Highly populated areas are good environments in which to open all sorts of food businesses but they are also perfect environments for rodents. As humans we have developed the ability to control environments and the critical point about pest control in food businesses is the control of the environment around your business.

This is no short order. As I have already suggested there are many factors which contribute to the environment in which your business is situated, from the perspective of a rat or mouse. Firstly there is the question of resident rodent infestation. Is your business situated upon an existing rodent problem? It is a lot harder to get rid of rodents that have inhabited your surroundings for decades than it is to prevent the infestation of rats and mice. This is due to the fact they have the advantage of knowing the terrain like the back of their little fury hands whereas you may be new to the lay of the land.

Infrastructure includes the following areas, drains and sewers, outside walls and piping, rendering, wall cavities, areas under roofs, ovens (especially ovens with insulation), cellars, dry store rooms, trash can areas, box collection areas, vegetation around your areas including trees, neighboring businesses of all types, boxes with stored equipment especially if it is not often used, linen areas, service cupboards and toilet areas.

The places that rodents can inhabit are countless. The key to controlling the presence of rodents in your business is as I have already said to control THEIR potential environment. You must think from the rodents perspective. You must control everything that goes on both in and around your business. Another good indicator to the presence of rats is the presence of cats. Cat are another pest that will inhabit environments which can support them. More often than not they share these environments quite happily with rats. Alley cats are not good ratters because they don’t need them for food. Why should they fight a rat if they have scraps to fed off?

Controlling the environment in which your business is situated is all about a working system and having the staff to do it. Chefs and waiters must not deal in pest control. They must never contaminate themselves by cleaning contaminated areas. All responsible businesses must hire general staff to make sure the area inside and outside the area is kept spotless at all times. Chefs waiters and sore workers must also insure that areas under their direct responsibility and hygiene level are kept hygienic and tidy at all times. Any restaurant team that finishes their shift just ten minutes before going home cannot clean the business properly. At least one hour of solid cleaning is required, twice daily at least, to keep a food preparation business environments clean and controlled from a vermin aspect.

Also, pest control contractors must make fortnightly visits to appraise the vermin presence in and around your business. Likewise drain pumps must be carried out at least once a month by an authorized contracting or municipal authority.

Only when you pay attention to every detail concerning the hygienic state in around your business can you be reasonably assured that you are protecting your customers against disease which is transmitted by rodents and other pests.

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Scombroid fish poisoning is a toxic reaction caused by the decaying flesh of fish of the scombroid family. Fish of this family include bonito, tuna, sardines, anchovies, mahi,mahi, mackerel, king butterfly fish and kahawai.

All of these fish have dark flesh. Other types of fish may also be responsible for this reaction as well as the above mentioned. Scombroid fish contain a chemical substance called histadine within the meat. If the flesh of the fish reaches temperatures of above fifteen degrees celsius after being caught bacteria that are present in the skin of the fish convert the histadine in to scrombrotoxin. Market stalls are particularly susceptible to this through improper or no cooling facilities The primary component of scombrotoxin is another substance called histamine which causes the toxic reaction known as scombroid fish poisoning.

All forms of cooking have little or no effect in reducing the levels of histamine within an affected piece of fish even if all the bacteria that caused the histamine to be produced have been destroyed. Scombroid fish poisoning varies to other forms of fish poisoning in that the areas of flesh that were most decomposed will contain the highest levels of histamine and therefore only the people who eat from that particular area of flesh will feel ill. Others eating flesh from different areas of the same fish will feel no ill effect whatsoever.

Scombroid fish poisoning is not infectious and it is not an allergic reaction either. The person who was affected by this form of poisoning will have no ill effect from eating this type of fish or fish of the same family on future occasions provided it is caught fresh and stored in proper refrigerated conditions.

Symptoms
Symptoms will start to be felt in thirty minutes to one hour after eating the poisoned fish. Primary symptoms include warm flushes followed by the development of a profuse bright red rash starting on the neck or lower jaw and spreading to the lower abdominal area including the back. The rash is hot and itchy but unlike rashes in allergic reactions there is no swelling of the skin. Other symptoms may include any number or all of the following: a burning feeling in the mouth, a pounding headache, nausea, raised heart beat, dizziness, collapse caused by the lowering of the blood pressure, abdominal pain and diarrhea.

Symptoms may persist for a number of hours after which they will normally subside. In some cases, particularly in children and the elderly symptoms may take longer to disappear.

Prevention of this disorder lies solely in the correct handling of fish. All fish should either be cooked promptly after being caught or refrigerated at a constant temperature at four degrees Celsius until used. Removal of the skin also helps to prevent formation of the toxin by reducing the number of bacteria around the flesh of the fish.

Treatment of this condition is usually quite simple. Oral anti histamine is usually enough to eleviate the symptoms. Expert medical advise should be saught and the patient should receive a full medical exam in an emergency unit to eliminate any complications.

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Below is an article which is a continuation to the tragic food poisoning events that occurred in a Greyland market stall a few days ago.

The article states that the National environmental agency is prepared to get tougher on food business that lax food hygiene standards by revoking licences to do business. What is important to remember and seems to be lacking in the content of this article is that some offences of food hygiene are blatant breeches of public trust (licences are given by autorities which represent the public interest), knowingly placing members of the public at risk , disregard for legal process and crimanal neglegence. All of these are serious crimes and, in my opinion require much sterner punishment than the mere revoking of a licence. I would like to invite you to read the article and to see it you agree with my analysis.

It is my opinion that all food businesses should keep record of all purchaces of materials used in their business and that there be penalties for buying from any supplier who is not an authorized business operator himself. I believe that the othorities of markets should be placed in charge of checking these issues and that every market should have a resident and qualified round the clock governmental food hygiene inspector. The cost of this should come out of the taxes paid by the market stall operators.

SINGAPORE: The National Environment Agency (NEA), which is responsible for issuing licences for food stalls to operate, says it is satisfied with its current system.

Giving this assurance in the light of the Geylang Serai market food poisoning incident, NEA stressed that it is prepared to get tough with enforcement if unhygienic standards become more rampant.

The NEA manages 109 hawker centres with 5,600 cooked food stalls and another 9,000 market produce stalls.

To get a licence, food handlers have to attend and pass the basic food hygiene course and undergo the necessary medical screenings and inoculations.

Those above 35 years old also have to go through screening for tuberculosis.

But the agency noted an increasing number of hawkers have been issued tickets for food hygiene offences.

102 tickets were issued in 2006, 408 in 2007 and 730 last year.

Khoo Seow Poh, NEA’s director-general of public health, said: “For certain offences, currently we give a warning for a first offence. But if the situation of those kinds of offences becomes more rampant, then we may do away with the warning and straight away go for ticketing.”

Nineteen food stalls were suspended last year after they chalked up the maximum demerit points.

An average of four food poisoning incidents has been reported each year for the past three years. And at least three people were affected in each case.

Mr Khoo said: “As far as stallholders and stall assistants are concerned, it is their responsibility to make sure that the food that is served is safe, and on our part, following this incident, NEA will continue to work with stallholders and hawker associations to see how we can further improve and tighten hygiene regime.”

The NEA says the various hawker centre associations have devised a timetable for the spring cleaning procedures for the various food centres.

In fact spring cleaning is done at least two to three times a year.

Meanwhile NEA officers also check each individual stall at least once in six to eight weeks.

The Geylang Serai temporary market had its last round of spring cleaning last October.

But that did not get rid of the rats there.

Since last Friday, 41 rats have been killed by pest companies.

So is setting up a temporary market a good option?

Mr Khoo said: “It depends on the needs of the stallholders. If the upgrading period is long, some stallholders may need to make a livelihood to operate.

“Of course, NEA does provide them with vacant stalls for them to operate but some of them prefer to stay put to operate in the same area, because they want their regular customers to come back to them. We have to work with them to fulfil that.”

The new Geylang Serai market is expected to be ready by the end of this year.

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Below you will find a story where a native Singapori woman died after eating Rojak salad at a renound Indian food stall. The lady in question and many others like her made a point of stopping for their favorite treat whilst doing their shopping.

After eating at this stall many times previusly the lady had no idea that this would be her final visit. This is a story with a tragic end. What could have caused this catastrophie to occur? Could it be that the stall owner unwittingly bought contaminated produce. Could it be that he bought cheap supplies knowing that it was not up to standard? Could it be that that there was some type of cross contamination in the market place? Possibly, but I doubt this because so many people were taken ill.

In my opinion this salad may well have been contaminated with a Yerisinia or staphilococcus aureus toxin. I come to this conclusion due to the speed at which the bacteria acted within the body of the victim. The article is quite shocking and put accross the importance of knowing the source of what you eat.

SINGAPORE The Geylang food poisoning outbreak claimed its first victim on Monday. 57 year old canteen assistant Aminah Samijo died at 6.50am.

A statement from the Changi General Hospital (CGH) said Mdm Aminah suffered from acute renal failure as the infection had affected her kidneys.

She was hospitalised on Friday at 11.45pm after she became unconscious after eating Indian rojak salad at a Geylang Serai market stall.

CGH said she was unresponsive and had breathing difficulties. She had a fever and was diagnosed with severe gastroenteritis.

CGH said Mdm Aminah was treated with antibiotics and put on a ventilator support. She was also given medications for low blood pressure and diarrhoea. Mdm Aminah passed away without regaining consciousnesses.

CGH said it is unable to comment on the cause of her death as it is now under a coroner’s inquiry.

As of Monday, the hospital has treated 77 patients who came down with food poisoning. 16 of them are currently hospitalised at CGH and are in a stable condition. They were admitted for diarrhoea and dehydration and were treated with antibiotics and intravenous infusion.

Meanwhile, a 38 year old woman miscarried after contracting food poisoning from eating rojak from the same stall. Rosiah Samat lost her two month old foetus over the weekend.

Her husband had bought the rojak for her on Friday. While eating, the housewife noticed that the gravy tasted slightly off. She fell ill hours later and was sent to KK Hospital that evening.

Madam Rosiah has two other daughters. One is twelve years old, whilst the other is eight.

Another pregnant woman, Madam Sarina, is now recuperating at KKH after eating the same rojak. Her sister in law, a Madam Sharifah, said she is now four months pregnant.

Madam Sharifah said: “My sister in law was admitted to KKH with stomach cramps and she had diarrhoea and she was vomitting. From what I understand, the gynaecologist had to do a thorough medical checkup and he checked whether the baby was ok. The heartbeat is alright. So the baby is pretty safe at this point in time.

“But they are keeping a very close watch on her. She is still totally bed ridden. In her ward, there are other women who are also down with the same (condition) — diarrhoea, due to the same stall. She is still very weak.

More than 100 people fell sick after eating from Stall number 302, Rojak Geylang Serai.

The National Environment Agency said investigations are ongoing.

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