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YucaLandia


May 9, 2010, 6:17 AM

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Risks of Salmonella, Worms, Amoebas, & Protozoans

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Hello All,
I've noted a number past posts on how people got sick when visiting Mexico and even some articles on how some long-time residents "never" got sick while living here, which inspired to me to present a few findings we've collected over the years.

Montezuma's Revenge? . . . . . . . . . . . . Moctezuma's Revenge?
Reasons to take antibiotics or OTC semi-annual parasite treatments?
Here are a few observations from nationwide studies conducted by the US CDC, NIH, Mexican hospitals, and Mexican Medical Schools that suggest why both tourists and ex-pats NOB hygiene habits don't always work so well here in the Tropics, including ineffective Microdyne/Bacdyne/etc vegetable soaks and quick hand washes.
http://www.cdc.gov/...nt/14/3/pdfs/429.pdf
http://www.journals.uchicago.edu/doi/abs/10.1086/498508

Over 40% of Yucatecans have no bathroom / septic system facilities, 25% are basically illiterate, and across Mexico:



http://www.cdc.gov/eid/content/14/3/images/07-1057_1b.gif
These study results showed that meat sold in typical Mexican grocery stores had equivalent or higher levels of salmonella contamination than was found in local animal intestine fecal samples. (Detailed analyses of the salmonella genotypes pointed to butchering practices as the most likely source of the contamination.)

These results for Mexico sure seem troubling, but are actually roughly 3X less contaminated than US commercial grocery store chicken: 83% of which nationally was found to be contaminated by either Salmonella or Campylobacter. (http://www.consumerreports.org/cro/magazine-archive/2010/january/food/chicken-safety/overview/chicken-safety-ov.htm)

If US chicken et al have similar or higher levels of commercial raw meat contamination, why would there be higher risks of getting food poisoning , worms, amoebas, or parasites in Mexico?

The CDC/Horan authors go on to say: "...in the other states (like Yucatan), Salmonella spp. infections are probably acquired by other modes of transmission aside from contaminated food, such as from person to person or by contact with animal feces. In settings with greater fecal-oral transmission, asymptomatic infections would not directly reflect contamination rates in the retail meat."

It is worth noting that these Salmonella were also resistant to most common antibiotics (except Cipro) in about 15% - 20% of the cases.

And then they put a nice bow onto this little present describing typical Yucatecan households:
Population >15 yr. old, who are illiterate or with incomplete primary education: 40.1%
Households with no toilet or latrine: 24.6%
Households with no sewage system: 40.8%
Percentage of kindergartners with endemic asymptomatic salmonella infections: 16%
(Sonora, Michoacan, & San Luis Potosi were only nominally better.)

Before we criticize too heavily, how many people with NOB habits wash their hands for 20 seconds of vigorously rubbing soapy suds on our hands? How many (likely illiterate) food service workers know what's needed to stop salmonella transmission?

How many expats and visitors from NOB know how to properly disinfect fruit and veg, counters, cutting boards, floors, etc?

Past NIH tests of fecal coliform contamination of commercial fruits and veg, in Mexico City consistently found high levels of salmonella in almost all samples, due to the use of "organic" (fecal) fertilizers and contaminated irrigation water = the wonders of Organic Farming. http://www.ncbi.nlm.nih.gov/pubmed/17061512

So, just what works, and what doesn't, if you want to keep yourself and your family safe and healthy?

A major NIH study evaluating Mexican vegetable contamination found that the silver colloid based disinfectants (like microdyne, biodyne, etc) lowered fecal coliform (pooh bacteria) counts, but did not eliminate them, and these same silver colloid products did not remove salmonella typhi risks in any samples. They found that bleach-based disinfectant solutions** were effective against all three major families of microbial contaminants tested (killing fecal coliforms, salmonella, and various pathogenic mesophillic microorganisms).

After having Walmart/Chederaui/Soriana/Mega-Commercial meat sometimes go bad in as little as 2 days, I started watching meat handling practices at these stores, checking out different stores to try to find a good one, and I found that employees routinely pack and un-pack the cases, leaving the meat sit out, warm, in carts 1 - 2 hr at all of these stores.

I really hate food poisoning, since I've been more susceptible after a number of really wicked bouts in Ukraine after the break-up of the Soviet Union, so, I began feeling the packages in the cold cases of each store, and often find the meat warm - room temp - to the touch. The meat department in every single store mentioned (here in Merida) has smelled absolutely awful at least once in the past 3 years, much worse than anything I'd experienced in 40 years of shopping in the States. We've had similar issues with the Deli sections of the aforementioned stores, with occasional ham and bacon going bad within 24 hrs of purchase (due to the meat sitting out warm during some earlier point). The only reliable solution we've found is to buy meat that is still frozen, as it is sold at Super Aki, and to prepare and cook things carefully. Some people rely on fresh-killed meats from local butchers, but all it takes is one fly to land on that, blow a few of their regurgitated bubbles, and even that meat has surface contamination.

Fortunately, typical bacterial contamination is only on the outside of meat (though not true for hamburger and ground meats where the grinding process distributes the contamination throughout the meat). This means that well cooked meat (thoroughly maintained at temperatures above 145ºF for at least 3 minutes) is safe from bacterial, protozoan, and amoebic contamination. One might also note that the lime juice used to prepare ceviche does not kill worms nor their encysted forms, potentially important as past studies have found roughly 80% of ocean fish have some sort of parasites.

Walk barefoot on the beach, enjoy the surf, eat some ceviche or local sashimi/sushi, & as a bonus: take home some extra "special souvenirs". (Souvenirs that your local NOB physician likely has no idea of how to diagnose or treat.)

The remaining kitchen/prep problems are solved by immediate careful disinfection** of cutting & handling tools, disinfection of cutting boards, & anything touched by the raw meat, (disinfect using dilute bleach**), followed by thorough hand washing (20 seconds of soapy suds using an antibacterial soap).
http://www.cdc.gov/...content/14/3/429.htm from Emerging Infectious Diseases

It's also worth noting that the high %'s of salmonella on retail meat should also translate to salmonella on the outside of the meat packages. To avoid contaminating your hands, then touching the handle of the shopping cart, and your car's steering wheel, if you shop for your fruit and veg first, you have a chance to pick up some extra plastic bags. If you slip the bag over your hand, pick out your meat, and then invert the bag over your meat package, you can keep your hands, the shopping cart handle, and your car door handles and steering wheel reasonably clean.

It also helps the clerk if you insert the meat package with the $$$ sticker close to the open end of the baggie, so, they can easily flip back the baggie to scan the sticker. Don't get me started thinking about other shoppers handling the meat, and then touching the cart handles, which we then touch, and then we go out to our cars and handle the steering wheel...

Post Script to keep things in perspective:
US Turkey was no better in past USDA studies: roughly 50% of US retail turkey had salmonella.
US Chicken has been worse: 65% - 83% of retail chicken tested had salmonella and or campylobacter.
US Beef and Pork were far cleaner @ under 5% with salmonella.
Walking barefoot (on the beach?) clearly exposes people to hookworms both in Mexico & the US.
Since the early 1970's roughly 15% of all people in the US South (from Texas to Florida) have asymptomatic intestinal worms, and estimates run as high as 70% for Mexicans who do not get semi-annual treatments for worms and parasites.

All of this means that illiterate food service workers very likely transmit low levels of microbes and parasites to unsuspecting diners, and that if you rely on Microdyne, Bacdyne, etc, they just don't work. (and no, even though their names imply having iodine as an ingredient: they actually use colloidal silver). Short hand washes also don't work, but learning to not touch your mouth, nose, and eyes does help.

A few final thoughts:
Soap and hot water do not disinfect things nor do they kill microbes. Soap and water simply remove dirt, grease, and biofilms that offer places for microbes to grow.

To kill microbes (disinfect things) & eliminate the hazards described above it takes either:
  • harsh chemicals (like dishwasher soap) and high temperatures (3 minutes @ 145ºF or 65ºC) or chemical disinfectants (like dilute bleach solutions**) or
  • crown ethers (like in bar-glass washing solutions),
  • triclosan, as in antibacterial soaps, or
  • peroxide, or
  • alcohols like the hand disinfectants popular since H1N1 flu outbreaks.

**Bleach Dilution Schemes:

  • Stored Water Treatment (tinacos etc): 10 mL (1 tsp) bleach per 100 L of non-turbid clear water or 1/4 cup of bleach per 275 gal tinaco makes water microbially safe in 15 minutes.
  • Toilets and Sinks: Apply bleach without dilution via spray or brush for 10 minutes and rinse.
  • Drinking water: 2 drops of bleach per liter of clear water (20 drops per mL) and wait 15 min.
  • Fruits and Vegetables: Wash & scrub thoroughly first to remove dirt, then 10 drops bleach per liter of water and soak for 5 minutes. Rinse thoroughly.
  • Floors and bathroom surfaces (tub & shower): 1/4 cup (60 mL) bleach per gal of wash water and leave it on the surface for 5 minutes before rinsing.
  • Children's Plastic Toys: Remove dirt first with soap and water, then use 1/4 cup (60 mL) bleach per liter of water and soak for 5 minutes and rinse.
  • Baby Bottles & Nipples: 1 drop of bleach per liter, soak for 2 minutes and rinse.
  • Other Plastic Objects: Apply straight bleach for 5 minutes and rinse - note that this might cause a permanent bleaching of some plastics.
  • Glasses and Plates: 1/4 cup (60 mL) per gallon of dish washing soapy water, scrub off food residues, and allow to soak for 5 minutes.
Notes:
- Only use unscented normal bleach for these purposes: do not use scented nor non-splash bleach.
(Blanqueador de Ropa)
- NEVER COMBINE BLEACH WITH ANY BASE (higher pH chemical)
- NEVER MIX BLEACH SOLUTIONS WITH AMMONIA PRODUCTS OR DRIED URINE (concentrated UREA),
because Base + Bleach = Toxic Chlorine Gas.
Some people report that regular dosing with freeze dried probiotic mixtures of beneficial bacteria and fungi can overseed our GI systems with microbes that put out the "No Vacancy" sign to incoming pathogens.

There is no joy in Mudville...
(We take no glee in describing these risks.)
But with knowledge, you can improve your chances.
steve

*If you liked this kind of post/article, check out our blog.
-
Read-on MacDuff
E-visit at http://yucalandia.com

(This post was edited by YucaLandia on May 9, 2010, 8:03 AM)



Anonimo

May 9, 2010, 8:01 AM

Post #2 of 31 (8867 views)

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Re: [YucaLandia] Risks of Salmonella, Worms, Amoebas, & Protozoans

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Interesting post, thanks, but somewhat overly fearful, IMO. If a person were to follow all the measures listed, they'd end up living like Howard Hughes in his later years. :-)

We cook our meat and never eat such things as Carne Apache (Mexican chopped raw beef "cooked" in lime juice.)
We buy the meat at our local two favorite carnicerías. The meat is cut to order. Beef and pork are ground to order while I watch. I will say, however, that Carnicería "A" is a lot more well organized and apparently cleaner than carnicería "B".

Yes; I do occasionally eat ceviche and aguachil de camarones as well as tiritas de pescado al limón. No noticeable ill efects yet. I'm not recommending this to everyone, just describing what I feel comfortable with.

I also wash meat before cooking and we are very careful to wash, in hot, soapy water all surfaces such as cutting boards and knives.

We do use Microdyn. Seems to work fine for us. Years ago, we would carry a small bottle of bleach on our Mexico vacations. We would use it to disinfect water in the pitcher in the hotel room. It was making us slightly but chronically ill. When we stopped using the bleach, we felt better. Maybe we were overdosing the water. Then again, it could have been that the pitcher was contaminated. Now, we drink only bottled water and other bottled beverages.

We wash our hands well before eating (with occasional forgetful lapses) and that includes at home as well as eating out.

That way, whatever sufaces we touched before eating such as doorknobs and shopping cart push handles, become a non threat.



Saludos,
Anonimo

(This post was edited by Anonimo on May 9, 2010, 8:09 AM)


YucaLandia


May 9, 2010, 8:17 AM

Post #3 of 31 (8840 views)

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Re: [Anonimo] Risks of Salmonella, Worms, Amoebas, & Protozoans

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Anonimo,
It's all good.

Most people with parasites and even many with salmonella never realize it.

If we can learn to not touch our eyes, nose, and mouth and to use a little disinfectant on kitchen items that come in contact with raw meat, and wash vigorously with soapy suds for 20 seconds, you're 90% of the way there. (Is that stuff too difficult or scary?)

You might also note that our mom's and grandma'a advice about soap and hot water washing simply does not kill harmful bacteria or pathogens - but soap and water does keep down ant and roach populations. It takes scalding hot water (145ºF) for 3 minutes to kill pathogens.

Grinding meat while we're watching might be fun, but since bacteria and microbes are invisible, watching them grind it... keeps them from slipping in a bit of extra fat?

Sushi/sashimi prepped by experienced personnel can be safe - as good quality raw fish has been screened for parasite cysts and worms by placing the fish on a light-box and cutting out the cooties.
enjoy!
steve
-
Read-on MacDuff
E-visit at http://yucalandia.com


Rolly


May 9, 2010, 8:24 AM

Post #4 of 31 (8830 views)

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Re: [YucaLandia] Risks of Salmonella, Worms, Amoebas, & Protozoans

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Very interesting. Thanks for the hours of work putting this together. And thanks for confirming what I have long thought about Microdyne -- over hyped.

Rolly Pirate


Vichil

May 9, 2010, 9:00 AM

Post #5 of 31 (8806 views)

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Re: [YucaLandia] Risks of Salmonella, Worms, Amoebas, & Protozoans

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Just got back from Oaxaca and Puebla where a friend of mine got very sick from amoebas. The Puebla doctor told us many people get sick from the air at this time of the year. As you mention many people do not have proper sanitation at their houses and dried fecal matter is all over the place.
In Mexico unlike the US many of the poorest live in the hills and all of that nice fecal matter descents on the valleys.
It is known in San Cristobal that the air makes you sick right before the rains come. Same with any city in valleys surrounded by poor areas, especially in Southern Mexico, you can wash all you want and be super clean and still get sick, that is life in the tropics where sanitation is poor, just get used to it.
The doctor recommended Daxon at least twice a year to get rid off parasites. It protects you somewhat against amoebas but not totally as they are larger than other parasites according to this doctor.
Some people are asymptomatic so do not suffer from the parasites but transmit them to the environment.


stevebrtx

May 9, 2010, 9:19 AM

Post #6 of 31 (8792 views)

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Re: [Vichil] Risks of Salmonella, Worms, Amoebas, & Protozoans

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I see the reference to Daxon which was my first question as to what should be used periodically to be cleansed. The microdyne/bleach thing is a problem, if you use bleach and then "rinse", what do you rinse with? You'd need a large amount of bottled water (assuming it's clean). My neighbor has been a world traveler for years and spends winters here and has always used microdyne and isn't aware of any problems.
http://www.chapalaweather.net


Hound Dog

May 9, 2010, 10:18 AM

Post #7 of 31 (8768 views)

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Re: [stevebrtx] Risks of Salmonella, Worms, Amoebas, & Protozoans

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The doctor said that microdyne etc , bleach are ok .
The Daxon is to deparasite you. She said we should take it at least every six month or more often if we are in higher risks area like Chiapas or Oaxaca.
Since you can get e-Coli, amoebas and other goodies via breathing there is no much point worrying about it too much. Just clean the food, disinfect it the usual way and forget about it.
Lakeside is no surrounded by shanty towns so I would imagine the risks are much less than poor places in Southern Mexico.
Being a world travelers does not mean anything, your system is strong or not. Some people have problems some do not.
I ate the same thing as my friend , breathed the same air, she got sick, I did not.
Two months ago in the Tacana area both my husband and I got sick, I had twice the count on salmonella and amoebas he had. Who knows why.
oops Vichil


(This post was edited by Hound Dog on May 9, 2010, 10:19 AM)


Anonimo

May 9, 2010, 11:12 AM

Post #8 of 31 (8744 views)

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Re: [YucaLandia] Risks of Salmonella, Worms, Amoebas, & Protozoans

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This got me thinking, so for a start, I looked up Daxon. Remember this is only a start. I want to find out more about this.

Quote
DAXON®

Tabletas, tabletas
dispersables y suspensión

(Nitazoxanida)

FORMA FARMACÉUTICA Y FORMULACIÓN:

Cada TABLETA contiene:



Nitazoxanida

500 mg



Cada TABLETA DISPERSABLE contiene:

Nitazoxanida

200 mg



Frasco con suspensión de 30 ml, 60 ml y 100 ml

Cada 5 ml contienen:





Nitazoxanida

100 mg



INDICACIONES TERAPÉUTICAS: Amebiasis intestinal aguda o disentería amebiana causada por Entamoe ba histolytica. DAXON® está indicado en el tratamiento de la giardiasis causada por Giardia lamblia.

Helmintiasis: DAXON® es un antihelmíntico efectivo contra nematodos, cestodos y trematodos, indicado en el tratamiento de Enterobius vermicularis, Ascaris lumbri­coides y Strongyloides stercoralis. Necator americanus, Ancy lostoma duodenale, Trichuris trichiura, Taenia saginata, Taenia solium, Hymenolepis nana y Fasciola hepatica, Isospora belli, Cryptosporidium parvum, absceso hepático amebiano. DAXON está indicado en el tratamiento de la tricomo niasis sintomática en mujeres y hombres con presencia confirmada de Trichomonas vaginalis en el laboratorio. Tricomoniasis asintomática, cuando el organismo se asocia con endocervicitis, cervicitis y erosiones cervicales.

En la pareja sexual asintomática, ya que la tricomoniasis vaginal se considera una enfermedad sexualmente transmitida, la pareja sexual debe ser tratada simultánea­mente.

(There's a lot more. Read about the side effects of the treatments.)
Source: http://www.libreriamedica8a.com/productos/512.htm

Oh; the reaon I watch the butcher grind the meat is so I see what goes into ito it, that it at least hadn't fallen on the floor before I see it, and so forth. "What the eyes don't see, the stomach doesn't suffer." Don't believe that.

I think it's good practice to seek hygienic food sources and to take precautions in our own kitchens. But it's impossible to safeguard against all risks to our health, unless one can live in a totally protected evironment. I certainly can't. If I could or had wanted to, my handle would have been "Bubble Boy".



Saludos,
Anonimo


YucaLandia


May 9, 2010, 12:32 PM

Post #9 of 31 (8712 views)

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Re: [Anonimo] Risks of Salmonella, Worms, Amoebas, & Protozoans

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Niazoxanide (sold as Daxon or Mitafar) is relatively good stuff.

The common OTC anti-parasite drugs Amoebriz or Vermox (combinations of Mebendazole and Quinfamida) are effective at killing GI worms, and some amoebas, but Niazoxanide (Daxon or Mitafar) is effective with amoebas & common worms, and it also works on many additional common GI and liver parasites, including Cryptosporids. Please note that if you are on blood thinners, like Warfarin or Cumarin, Daxon/Mitafar should not be used. People with reduced or compromised liver function should definitely consult their physician first before any anti-parasite treatments.

Many Mexican physicians recommend that residents take anti-parasite treatments every 6 months, as long as they check with their physician first for the possibility of liver issues or drug interactions and contraindications.

These physicians also advise their patients that when one family member is found to have GI parasites, they should also simultaneously treat ALL family members (all people living under the same roof), including treating with over-the-counter meds without asking them to come in for repeat visits, other than an initial check & approval to use these OTC medications - as should be done with any new medication.

One final note: unless you see worms or eggs in your toilet or stools, the best way to actually know if you have parasites is to get lab test s, including an O&P (Ova and Parasite) and possibly other tests, since most infested people do not show symptoms. e.g. Roughly 80% of Southeast Asian peoples have parasites (esp. worms) from eating fish or from walking in rice paddies, but they have no symptoms.
-
Read-on MacDuff
E-visit at http://yucalandia.com

(This post was edited by YucaLandia on May 9, 2010, 12:58 PM)


Reefhound


May 9, 2010, 1:44 PM

Post #10 of 31 (8694 views)

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Re: [YucaLandia] Risks of Salmonella, Worms, Amoebas, & Protozoans

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In Reply To

These study results showed that meat sold in typical Mexican grocery stores had equivalent or higher levels of salmonella contamination than was found in local animal intestine fecal samples. (Detailed analyses of the salmonella genotypes pointed to butchering practices as the most likely source of the contamination.)

These results for Mexico sure seem troubling, but are actually roughly 3X less contaminated than US commercial grocery store chicken: 83% of which nationally was found to be contaminated by either Salmonella or Campylobacter. (http://www.consumerreports.org/cro/magazine-archive/2010/january/food/chicken-safety/overview/chicken-safety-ov.htm)


Just to point out a little statistical sleight of hand here (and not to diminish the many worthwhile points made), note that you are comparing contamination by salmonella alone in Mexico
(rates around 30% to 40%) with contamination of salmonella AND campylobacter in the USA. The rate for salmonella alone in the USA was 14%. Not sure where you got that 83% number anyway, the article said two thirds and then later "Campylobacter was in 62 percent of the chickens, salmonella was in 14 percent, and both bacteria were in 9 percent. Only 34 percent of the birds were clear of both pathogens"


YucaLandia


May 9, 2010, 2:53 PM

Post #11 of 31 (8659 views)

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Re: [Reefhound] Risks of Salmonella, Worms, Amoebas, & Protozoans

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Reefhound,
Good points about the differing statistics for Salmonella and Campylobacter.

The CDC & NIH studies did not look for Campylobacter in Mexico - so direct comparisons are more difficult.

My goal was to help people make good choices when figuring out how to avoid Moctezuma's Revenge, and the 83% figure best represented the products that most people buy.

The Consumer Reports study found that 83% of national commercial brands of chickens were contaminated with pathogenic bacteria (Salmonella & Campylobacter): Tyson and Foster Farms. When Consumer Reports included cleaner organic chickens and other cleaner smaller brands like Perdue, the overall average contamination rate was 2/3. e.g. only 44% of Perdue chickens were contaminated, but Perdue is not a big nationwide brand and we have not found Perdue here in Merida.

So, yes, the numbers can be sliced and diced in different ways, but the risks still remain high both North and South of the Border: CDC reports that salmonella and campylobacter from chicken and other food sources infect 3.4 million Americans, send 25,500 to hospitals, and kill about 500 people every year.
http://www.consumerreports.org/cro/magazine-archive/2010/january/food/chicken-safety/overview/chicken-safety-ov.htm

The problem is actually even more widespread because many people who get sick with "the 24 hr flu" don't seek medical care and are not tested for food borne infections. Viral flu does not last for just one day or two, making the commonly reported days off work due to "flu" greatly over-reported.

It is also worth noting that among all brands and types of broilers tested, 68 percent of the salmonella and 60 percent of the campylobacter organisms Consumer Reports analyzed showed resistance to one or more antibiotics.

I mentioned the high contamination rates (over 80%) for the most common brands that people buy, because we also find those same two highly contaminated brands (Tyson & Foster Farms) here in Merida at Walmart, Bodega Aurrera, Sam's Club, Costco, Chederaui, Soriana, & Mega Commercial - which makes the 83% number more applicable for both Mexican buyers and US buyers of US chicken products.

Does reporting the numbers for the brands that more/most people eat = sleight of hand?
steve
-
Read-on MacDuff
E-visit at http://yucalandia.com


Reefhound


May 9, 2010, 3:08 PM

Post #12 of 31 (8653 views)

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Re: [YucaLandia] Risks of Salmonella, Worms, Amoebas, & Protozoans

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What I clearly said was sleight of hand was "comparing contamination by salmonella alone in Mexico
(rates around 30% to 40%) with contamination of salmonella AND campylobacter in the USA."

Whether the combined USA number is 66% or 83% is immaterial as there is no apples to apples Mexican number for it to be compared against. So stating the number for the two most common brands is not what is misleading, it's comparing that number to another number which is measuring something different that is misleading.

Not to mention is the question of whether the health threat from campylobacter is equivalent to that from salmonella.


YucaLandia


May 9, 2010, 3:47 PM

Post #13 of 31 (8639 views)

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Re: [Reefhound] Risks of Salmonella, Worms, Amoebas, & Protozoans

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Both Campylobacter and Salmonella present significant health threats NOB and for Mexicans using US chicken products, like Tyson and Foster Farm brands.

Re relative risks from Campylobacter and Salmonella:
NIH reports: "In the United States, Campylobacter is the most common cause of bacterial diarrhea, with over a million people estimated to be affected annually [Centers for Disease Control and Prevention (CDC) 2005]. . . . antimicrobial therapy is essential for elderly, pregnant, and immunocompromised patients for whom hydration and electrolyte maintenance may be insufficient (Allos 2001)."
http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1289%2Fehp.10050


In 2008, CDC reports 7,444 Salmonella infections per 100,000 population and 5,825 Campylobacter infections per 100,000. Sorting the data by age: the percentage of persons hospitalized was highest in persons aged >50 years: Salmonella (40.0%) and Campylobacter (20.5%). http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5813a2.htm?s_cid=mm5813a2_e
So, Campylobacter causes the most diarrhea and requires higher usage of antibiotics and Salmonella hospitalizes more people over age 50 in the USA = modestly similar health threats & both worth avoiding.

Fortunately, the same kitchen disinfection practices, thorough cooking practices, and personal hygiene practices are effective at reducing the health threats from both regardless of whether we are North or South of the Border.
-
Read-on MacDuff
E-visit at http://yucalandia.com

(This post was edited by YucaLandia on May 9, 2010, 4:19 PM)


Reefhound


May 9, 2010, 6:13 PM

Post #14 of 31 (8604 views)

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Re: [YucaLandia] Risks of Salmonella, Worms, Amoebas, & Protozoans

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Modestly similar threats? Are you really equating hospitalization with the inconvenience of diarrhea and taking an antibiotic? That's like saying a small cut treated at home with a bandaid is "modestly similar" to a deep gash requiring stitches at the ER.

Salmonella cause more infections and twice as many hospitalizations despite the fact that campylobacter is four times as common (62% versus 14% contamination rates in the chicken).

Sounds to me like salmonella is dramatically more dangerous than campylobacter.


YucaLandia


May 10, 2010, 6:52 AM

Post #15 of 31 (8528 views)

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Re: [Reefhound] Risks of Salmonella, Worms, Amoebas, & Protozoans

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R-Hound,
Good points.
Fortunately, both have morbidity and mortality rates of less than 1%, both often live asymptomatically in many humans, both blow through relatively quickly, & neither causes permanent harm - not like Rotovirus, giardia, cryptosporids, et al.

The point in the original post was that there are significant and similar risks of GI upset - Montezuma's Revenge - both North and South of the Border. It seems clear that poverty and illiteracy play significant roles in allowing amoebic parasites, protozoan parasites, worms, and bacterial GI illnesses to spread.

All these items point to how such illnesses can disrupt a trip but should not terrorize travelers, and that they can be avoided both NOB and SOB with a few practical precautions.

  • Wear footwear on the beach;
  • Wash hands vigorously for 20 sec w/soapy suds before eating;
  • Avoid touching your nose, mouth, & eyes;
  • Use disinfectant wipes on commonly touched surfaces like home & car door handles, light switches, car steering wheels, computer key boards, etc;
  • Disinfect knives, cutting boards, plates, etc that contact raw meat with dilute bleach;
  • Eat only well-cooked meats - avoiding ceviche, sashimi/sushi, carne-crudo;
  • Consider taking anti-parasite meds semi-annually if you live in the Tropics;
  • Avoid restaurant salads in the Tropics;
  • Street foods: eat basically sterile things - e.g. things that go straight from the hot oil into clean paper/plastic to your mouth - served by people who keep the cash handling separate from the food handling (cash is often filthy).
Any other tips from other savvy travellers?
steve
-
Read-on MacDuff
E-visit at http://yucalandia.com


Reefhound


May 10, 2010, 7:40 AM

Post #16 of 31 (8508 views)

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Re: [YucaLandia] Risks of Salmonella, Worms, Amoebas, & Protozoans

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Ok, back to hygiene.

I hate how most bathroom doors open inwards, meaning to exit right after washing your hands you have to grab the filthy handle with your clean hands and pull, along with everyone else (those who washed and those who didn't). Same for manual faucet handles and towel dispensers. Touch free appliances and air dryers are more sanitary but probably won't ever be too common SOB except in top hotels. Use the towel you just dried with to open the door handle when exiting.

I'm pretty lax about beyond basic hand washing but my wife will bring her own pillow cases and plastic liners when traveling. Pillows are huge germ traps.

So is cash. Good point on the money handling. Few think about that and I don't think I've ever seen a street cart vendor who separated the two functions.

However, all this disinfecting sounds good but I wonder if it simply lowers your immunity. I have a young niece whose mother raised her with impeccable hygiene habits in a nearly germ-free home and the kid seems like she is always sick. My kids wash their hands but other than that we don't especially worry about it and they are never sick.


Anonimo

May 10, 2010, 9:00 AM

Post #17 of 31 (8490 views)

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In Reply To
Reefhound wrote:

Ok, back to hygiene.
I hate how most bathroom doors open inwards, meaning to exit right after washing your hands you have to grab the filthy handle with your clean hands and pull, along with everyone else (those who washed and those who didn't). Same for manual faucet handles and towel dispensers. Touch free appliances and air dryers are more sanitary but probably won't ever be too common SOB except in top hotels. Use the towel you just dried with to open the door handle when exiting.

I'm pretty lax about beyond basic hand washing but my wife will bring her own pillow cases and plastic liners when traveling. Pillows are huge germ traps.

So is cash. Good point on the money handling. Few think about that and I don't think I've ever seen a street cart vendor who separated the two functions.

<cut>.

• I grab a paper towel and use it to pull the handle on inward opening bathroom doors.

• I'm not that concerned about hotel pillow cases, but I've read that in many U.S. hotels, the bedspread (covers) are changed as infrequently as once a month.

• Food vendors and money handling: with very few exceptions, the street and market food vendors I patronize either have a separate person to handle the money, or if no, they slip their hand into a plastic bag to do so. You can observe before deciding to eat at not. It quickly becomes obvious whther hygienic practices are being followed. If not, I won't eat there.

•• Keep in mind, that cilantro, used as an uncooked condiment on tacos and soups, is often not disinfected but merely trimmed and washed. I watched the cilantro prep this last week at my favorite birrería, Don Prsici's, in Pátzcuaro.

•• What about the wooden chopping block and the cleaver used to cut the meat at the birrería or barbacoa place? How often is it washed, let alone sanitized? (To tell the truth, that really doesn't worry me.)

•• I have placed certain establisments on my No Eat List. First are carts selling Carne Apache. Not only is it raw, it's unrefrigerated!! Gaahh!

Is Médula Viríl (bovine spinal cord) served cooked or uncooked? Have any cases of Enfermedad Vaca Loca been reported in México? I have, in the past, enjoyed it in soups. Note the use of a white coat and a cap, in the following photo. It was taken on the Libramiento Ignacio Zaragoza, on the outskirts of Pátzcuaro.


•• Not quite so obvious are the mariscos carts around the Plaza Chica in Pátzcuaro. Exposure to street dust, combi exhaust fumes and possible canine waste vectors; plus deft stunts such as chopping onions or tomatoes, and use of block ice delivered by dropping it curbside, unwrapped make the risk totally unacceptable to me.



•• I don't even want to look at the shaved ice, Diablitos y Raspados carts, for fear of falling into temptation. (They put on quite a show.)

I've already exceeded my daily word quota, so I'll stop.

Saludos, Gesündheit,
Anonimo

PS: I have been to more than one party, where the designated, venerable expat bartender used his bare hands to put ice in the glasses. After one such party, we were sick with colds afterwards.


Gringal

May 10, 2010, 9:15 AM

Post #18 of 31 (8480 views)

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"Baby lies at my feet on a sterilized sheet, cutting teeth on the tip of my shoe".

There have been some great suggestions on this thread; some stuff I never thought of. You definitely need to watch those salad makings.
We went to one of the ladeda new "gourmet" French eateries here in Ajijic (before they closed) for lunch. One of their popular offerings was "real" Caesar salad, for two or four. All four wanted it, and since we could observe the process.......we noted that a family member left the premises and came back a few minutes later with the lettuce. Our salads were served about three minutes later. Somehow, we didn't connect the time gap with the cleaning process.
Omigod, were we all sick later that day. Yes, we all were. Tasted good, but NOT worth it. Later, I've heard that springtime around here is not a good time to have salads. Something about bugs on the dust and the wind. Makes sense to me.


YucaLandia


May 10, 2010, 3:52 PM

Post #19 of 31 (8442 views)

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Gringal,
Sorry to hear that you all got sick.
The big problem with lettuce salads and leafy vegetables like spinach is that it is really difficult to remove all the dirt from all the nooks and crannies, unless you separate it all into individual leaves, and then scrub each leaf and then disinfect each leaf.

Since most commercial Mexican lettuce & spinach farms spray/use "reclaimed" irrigation water, it almost guarantees at least some level of (pathogenic) microbial contamination in the nooks and crannies of leafy vegetables - and only scrubbing and then soaking in dilute bleach for 5 minutes cleans it thoroughly.

Given the cleaning & contaminated irrigation water hurdles, I'm not sure that bugs and dust in the wind explain the whole picture,
steve
-
Read-on MacDuff
E-visit at http://yucalandia.com

(This post was edited by YucaLandia on May 10, 2010, 3:53 PM)


esperanza

May 10, 2010, 4:01 PM

Post #20 of 31 (8436 views)

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In Reply To
"Baby lies at my feet on a sterilized sheet, cutting teeth on the tip of my shoe".

There have been some great suggestions on this thread; some stuff I never thought of. You definitely need to watch those salad makings.
We went to one of the ladeda new "gourmet" French eateries here in Ajijic (before they closed) for lunch. One of their popular offerings was "real" Caesar salad, for two or four. All four wanted it, and since we could observe the process.......we noted that a family member left the premises and came back a few minutes later with the lettuce. Our salads were served about three minutes later. Somehow, we didn't connect the time gap with the cleaning process.
Omigod, were we all sick later that day. Yes, we all were. Tasted good, but NOT worth it. Later, I've heard that springtime around here is not a good time to have salads. Something about bugs on the dust and the wind. Makes sense to me.

Did you notice all the ingredients that went into your Caesar salad dressing? Normally 'real' house-prepared Caesar salad dressing contains at least one raw egg yolk. I betcha fi'dollah that your illness was related to the egg yolk, not the lettuce.

Caesar Salad Dressing

Whisk together or blend in blender:
3-4 anchovy filets
1-2 pressed cloves garlic
1 tbsp. Dijon mustard
1-2 raw egg yolks
1/4 c. red wine vinegar
1 c. olive oil
Salt and pepper

Toss with 1/4 cup Parmesan cheese. Pour over romaine lettuce and serve with home made toasted garlic croutons.

http://www.mexicocooks.typepad.com









Anonimo

May 10, 2010, 4:24 PM

Post #21 of 31 (8427 views)

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Quote
Did you notice all the ingredients that went into your Caesar salad dressing? Normally 'real' house-prepared Caesar salad dressing contains at least one raw egg yolk. I betcha fi'dollah that your illness was related to the egg yolk, not the lettuce.


Caesar Salad! That has inspired me to make it tomorrow for our lunch. Any tips on how to get around the risk of the raw egg yolk? Coddling, perhaps?



Saludos,
Anonimo


chinagringo


May 10, 2010, 4:29 PM

Post #22 of 31 (8426 views)

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Re: [Anonimo] Risks of Salmonella, Worms, Amoebas, & Protozoans

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I thought that the danger in using a raw egg came from the shell and not the yolk?
Regards,
Neil
Albuquerque, NM



Hound Dog

May 10, 2010, 4:30 PM

Post #23 of 31 (8426 views)

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Re: [esperanza] Risks of Salmonella, Worms, Amoebas, & Protozoans

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Yes the salmonella probably came from the raw egg. If the egg was not disinfected before breaking it, here you go.
I eat a lot of raw eggs but I always put them in chlorinated water before handling them otherwise the salmonella comes back to haunt you. The salmonella is on the outside of the egg so all you have to do is disinfect the shell.
I use raw egg white in floating islands, break eggs on top of Iranian style rice and use them in Caesar salad dressing but always disinfect them first. My husband soft boils the eggs before using them in the Caesar salad dressing.
vichil


(This post was edited by Hound Dog on May 10, 2010, 4:32 PM)


Gringal

May 10, 2010, 5:05 PM

Post #24 of 31 (8408 views)

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Re: [Hound Dog] Risks of Salmonella, Worms, Amoebas, & Protozoans

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Let me put it this way: This was a so-called family run French restaurant with allegedly high standards and prices to match. What I noticed is that there was simply no TIME for them to have cleaned those lettuce leaves properly before they served them.
Now, the raw egg could have been the culprit, alternatively.
In any case.........we never returned.

Meanwhile, there's a lot to be said for eatin' ta home.


chinagringo


May 10, 2010, 6:32 PM

Post #25 of 31 (8375 views)

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Having lived in China, Japan, Philippines, India and traveled extensively throughout the world during the 40's, 50's, & 60's during a period when sanitation and general food issues were not at the forefront, there may be something to be said for one's body to build up a natural immunity from exposure. Sure I had the pleasure of contracting malaria, tape worm, dysentery, hepatitis and various other maladies, but along the way it seems our bodies do build up a form of immunity. My mother was a clean freak but she was always the one that got sick from everything.

For us traveling and eating in MX has always been relatively simple and uneventful. We carry "Wash and Wipes" or some variation of same and are fairly diligent about using them prior to eating a meal. In over 10 years of traveling the Country, neither of us has experienced any major issues.
Regards,
Neil
Albuquerque, NM

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