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Wednesday, September 1, 2010 -- Salmonella
Dr. J scared Kevin out of the studio today with our talk about the massive egg recall and salmonella. Click to hear his segment from the show:
Here is some more information:
Egg Recall Expands; CDC Expects More Illnesses
Daniel J. DeNoon
August 20, 2010 — As the nationwide egg recall expands, the FDA has activated its emergency command center to direct its "extensive" investigation.
So far, some 380 million eggs have been recalled -- a number that is "evolving," Sherri McGarry, emergency coordinator for the FDA's Center for Food Safety and Applied Nutrition, said today at a joint FDA/CDC news teleconference.
"We would certainly characterize this as one of the largest shell egg recalls in recent history," McGarry said.
Through July 17, the CDC has received some 2,000 reports of illness due to Salmonella Enteritidis, the bacteria causing the outbreak. That’s nearly three times more salmonella illness than is usually seen in late summer, says Christopher R. Braden, MD, acting director of the CDC division responsible for food-borne illness.
"I think we will see more illnesses reported," Braden said at the teleconference.
And reported illnesses represent only a fraction of true infections. In 2004 , the CDC estimated that there were 193,463 Salmonella Enteritidis illnesses with 2,004 hospitalizations and 60 deaths.
This strain of salmonella is extremely common. It accounts for about a fifth of all salmonella infections. In 2000 there were 50 outbreaks, but since 2002 there have been 26 to 35 outbreaks a year.
Shell eggs are by far the most common source of Salmonella Enteritidis illness in the U.S. Of the 47 billion shell eggs Americans eat as table eggs each year, the USDA estimates that 2.3 million are contaminated with this salmonella strain.
The FDA investigation is centered on five plants operated by the Iowa firm Wright County Egg. The firm distributes the eggs nationwide. Eggs included in the recall include a number of prominent brands. Those brands are listed below, but some of the eggs may have been repackaged and sold under different brand names.
The Wright County Egg recall includes eggs in six-, 12-, and 18-egg cartons. The cartons carry a "Julian date" referring to the day of the year and a plant number. Dates and codes can be found stamped on the end of the egg carton or printed on the case label. The plant number begins with the letter P and then the number. The Julian date follows the plant number, for example: P-1720 223.
The Aug. 18 recall includes eggs with Julian dates ranging from 136 to 229 and plant numbers 1720 and 1942. They were sold under the brand names:
•Albertson
•Boomsma's
•Farm Fresh
•Glenview
•James Farms
•Kemps
•Lund
•Mountain Dairy
•Pacific Coast
•Ralph's
The Aug. 13 recall includes eggs with Julian dates ranging from 136 to 225 and plant numbers 1026, 1413, and 1946. They were sold under the brand names:
•Albertson
•Boomsma's
•Dutch Farms
•Farm Fresh
•Hillandale
•Kemps
•Lucerne
•Lund
•Mountain Dairy
•Ralph's
•Shoreland
•Sunshine
•Trafficanda
Dutch Farms says that it does not distribute eggs from Wright County Eggs, but that some of its packaging was mistakenly used to pack eggs distributed only to Walgreen's stores in Iowa, Minnesota, Kansas, Nebraska, Missouri, South Dakota, and Arkansas. The FDA is investigating this claim.
Ironically, the FDA's new egg safety rule went into effect on July 9, just after the Wright Egg contamination was discovered. That rule, if followed, might well have averted or lessened the extent of the current outbreak, Braden and McGarry said.
How to Avoid Food Poisoning From Eggs
This salmonella outbreak comes from eggs of salmonella-infected hens that carry the bacteria in their ovaries and pass it to eggs as they are being formed.
Eggs that appear to be fresh and normal may actually harbor salmonella.
If you like your eggs prepared over easy, you may want to change your egg-eating habits. Here's the CDC's advice on how to avoid food poisoning from eggs:
•Don’t eat recalled eggs or products containing recalled eggs. Recalled eggs might still be in grocery stores, restaurants, and homes. People who have recalled eggs should discard them or return them to their retailer for a refund.
•People who think they might have become ill from eating recalled eggs should consult their health care providers.
•Keep eggs refrigerated at least to 45 degrees F at all times.
•Discard cracked or dirty eggs.
•Wash hands, cooking utensils, and food preparation surfaces with soap and water after contact with raw eggs.
•Eggs should be cooked until both the white and the yolk are firm and eaten promptly after cooking.
•Do not keep eggs warm or at room temperature for more than two hours.
•Refrigerate unused or leftover egg-containing foods promptly.
•Don't eat raw eggs.
Avoid restaurant dishes made with raw or undercooked, unpasteurized eggs. Restaurants should use pasteurized eggs in any recipe (such as Hollandaise sauce or Caesar salad dressing) that calls for raw eggs.
Consumption of raw or undercooked eggs should be avoided, especially by young children, elderly people, and people with weakened immune systems or debilitating illness.
Dr. Kathryn Leskis, child psychologist with the Carle Physician Group
Dr. Leskis stopped by the studio to talk to us about dealing with grief and how to talk about death with your children. Click to listen to her segment from the show:
Here's some information Dr. Leskis shared and some useful websites:
The following is what Hospice of Southern Illinois believe children need when a loved one is dying or has died.
Children need truth, though sometimes perhaps not the whole truth Match the amount of facts with the child’s ability to understand. Using appropriate words is important. Telling a child that “Grandpa has gone to sleep” could create fear of bedtime. Children need to know they will be safe Let the child know what is going on and what to expect. Try to stick to a regular routine as much as possible. Let them know someone will always be there to take care of them. Children need to know the difference between illness and terminal illness Explain to children, in simple language, that when they get ill, they will likely get better and that terminal illness is much different. Children need a way to contribute The way they contribute will depend upon their age. Perhaps they can draw a picture for the bedside or hold a hand. Children have unique gifts and talents and may come up with their own ideas on how to help if given the opportunity. Children need to have ways to cope with unfamiliar feelings It is important for children to know that all of their feelings are accepted. Children model the behavior of adults. If you avoid your feelings so will the child. Encourage them to share their memories.
Children need to know that grief is a process that changes over time Children may feel overwhelming grief today and assume this is the way it will always be. Assure them that it will get better. Children need to have a voice Let the children have a voice in decision-making. If a child asks to go to the funeral, perhaps plans can be made to allow the child to go, but also have a back-up plan if the situation becomes overwhelming. Children need to know death is natural In our society, we tend to disregard the fact that we will all die. We tend to attempt to protect our children from this fact by shielding them from people who are near death, when in fact letting them be present is more likely to equip children with the coping skills they need to manage this inevitable occurrence in their own lives. Children need to face death Death is a natural and inevitable end to life and children will have to cope with it no matter how much we attempt to shield them. When we include children in the dying process, it prepares them more gently for death and empowers them to cope with death.
Wednesday, August 25, 2010 -- Gestational Diabetes
Dear Dr. J,
I have just been diagnosed with gestational diabetes. This came as a HUGE shock as I have been carefully watching what I eat and have never had problems before with my blood sugar levels. I am 27 years old and maintain a healthy weight and healthy lifestyle. I don't smoke or drink and make sure I exercise 4-5 times a week. This is my second child. I did not have gestational diabetes with my first child, nor has anyone in my family ever had diabetes. He was born at 37 weeks old and was just under 6 lbs. I am currently 32 weeks pregnant and have gained around 13 pounds. My doctor said for my height and weight I could gain any where from 25-35 pounds. I have read about gestational diabetes and the complications that can arise during birth, one of which is having a large baby. I am absolutely terrified that I am going to have an abnormally large baby. What are the chances of that happening, given my previous child wasn't even 6 pounds? My doctor does not want to do another ultrasound unless I start having complications. I am not a very big person and am very nervous about giving birth to this child. Any advice you can give would be appreciated. Thanks!
Dear Dr. J,
My 6 year old daughter had a CT Scan of her abdomen because there was suspicion of appendicitis. The scan was negative for that, but catching the lower part of the lungs revealed a few pulmonary nodules. I don't know what the sizes were, but the radiologist was concerned about the size of one of them to reccomend a CT Scan of her chest. I've read a lot of information on the Internet regarding these, but not so much information on children. What is the incidence of finding these in children. Can persistant asthma and one bought of pneumonia cause nodules? How large does one have to be in a child to be of concern? Thanks for your help.
From Dr. J's email to our listener:
Here is a quick thing I found. You are correct, most of the internet stuff has to do with adults, because these are uncommon in kids, and most of the kid stuff is for kids who have a KNOWN cancer and then have nodules, which your child does NOT....
So most likely a CT scan and review those findings with your child's doctor or a pediatric lung specialist, and then if everything looks ok, routine monitoring of the nodules to monitor their size.Click to hear Dr. J's answer from the show:
Click to hear the rest of Dr. J's answer from the show:
Wednesday, August 4, 2010 -- congestion
Dear Dr. J,
My 3 month old son has been having congestion issues. At some points it almost sounds like he's drowning and at others, he has a very dry snort. My wife and I have tried the baby saline solutions, dusting and a humidifier which don't seem to do much good. We have also cut down on ceiling fans at night. None of this seems to do much good. The symptoms come and go in short periods but seems like it's been getting worse here lately. Do you have any advice? Thanks.
