A qualitative study to understand how #Ebola Virus Disease affected #nutrition in #SierraLeone—A #food value-chain #framework for improving future response #strategies (PLoS Negl Trop Dis., abstract)

[Source: PLoS Neglected Tropical Diseases, full page: (LINK). Abstract, edited.]


A qualitative study to understand how Ebola Virus Disease affected nutrition in Sierra Leone—A food value-chain framework for improving future response strategies

Stephen R. Kodish , Frank Bio, Rachel Oemcke, James Conteh, Jean Max Beauliere, Solade Pyne-Bailey, Fabian Rohner, Ismael Ngnie-Teta, Mohammad B. Jalloh, James P. Wirth

Published: September 10, 2019 / DOI: https://doi.org/10.1371/journal.pntd.0007645




This study sought understand how the 2014–2016 EVD Virus Disease (EVD) outbreak impacted the nutrition sector in Sierra Leone and use findings for improving nutrition responses during future outbreaks of this magnitude.


This qualitative study was iterative and emergent. In-depth interviews (n = 42) were conducted over two phases by purposively sampling both key informants (n = 21; government stakeholders, management staff from United Nations (UN) agencies and non-governmental organizations (NGO)), as well as community informants (n = 21; EVD survivors, health workers, community leaders) until data saturation. Multiple analysts collaborated in a team-based coding approach to identify key themes using Dedoose software. Findings are presented as both quotations and tables/figures.


The EVD outbreak effects and the related response strategies, especially movement restriction policies including 21-day quarantines, contributed to disruptions across the food value-chain in Sierra Leone. System-wide impacts were similar to those typically seen in large-scale disasters such as earthquakes. Participants described an array of direct and indirect effects on agricultural production and food storage and processing, as well as on distribution, transport, trade, and retailing. Secondary data were triangulated by interviews which described the aggregate negative effect of this outbreak on key pillars of food security, infant and young child feeding practices, and nutrition. During the humanitarian response, nutrition-specific interventions, including food assistance, were highly accepted, although sharing was reported. Despite EVD impacts across the entire food value-chain, nutrition-sensitive interventions were not central to the initial response as EVD containment and survival took priority. Culturally-appropriate social and behavior change communications were a critical response component for improving health, nutrition, and hygiene-related behaviors through community engagement.


Infectious diseases such as EVD have far-reaching effects that impact health and nutrition through interrelated pathways. In Sierra Leone, the entire food value-chain was broken to the extent that the system-wide damage was on par with that typically resulting from large natural disasters. A food value-chain approach, at minimum, offers a foundational framework from which to position nutrition preparedness and response efforts for outbreaks in similar resource constrained settings.


Author summary

The 2014–2016 EVD outbreak has greatly impacted the population health and nutrition of affected countries in West Africa, including that of Sierra Leone. Since this recent outbreak, the humanitarian community acknowledges the need for improved solutions to better prepare for, and respond. Despite the importance of nutrition during outbreaks, there has been little systematic research conducted for understanding lessons learned and improving upon the typical nutrition response options currently available. This study used qualitative interviews to collect in-depth narratives from government officials, front-line health workers, non-government organization management, and community members including local leaders and EVD survivors. Findings reveal the unprecedented magnitude of this outbreak, which had systems-wide impacts not dissimilar to those felt by natural disasters. Interviews with people who lived through this event in Sierra Leone described EVD effects which revealed the importance and fragility of multiple, interconnected systems comprising the food value-chain for optimal nutrition in Sierra Leone. Findings across the food value-chain reveal how this interconnected system was impacted at every level with consequences for population-level nutrition. In preparation for future outbreaks of this magnitude, such a framework may prove useful for policy and planning, including improved guidelines development for employing coordinated nutrition-specific and nutrition–sensitive approaches that address immediate and underlying determinants of nutritional status.


Citation: Kodish SR, Bio F, Oemcke R, Conteh J, Beauliere JM, Pyne-Bailey S, et al. (2019) A qualitative study to understand how Ebola Virus Disease affected nutrition in Sierra Leone—A food value-chain framework for improving future response strategies. PLoS Negl Trop Dis 13(9): e0007645. https://doi.org/10.1371/journal.pntd.0007645

Editor: Ruth Kutalek, Medizinische Universitat Wien, AUSTRIA

Received: May 15, 2017; Accepted: July 19, 2019; Published: September 10, 2019

Copyright: © 2019 Kodish et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: Data are available from Groundwork. Because the original audio files cannot be anonymized, participant confidentiality is at risk should the files be made publicly available. Therefore, only anonymized transcripts can be shared with interested parties upon request by emailing contact@groundworkhealth.org.

Funding: UNICEF funded this research project. UNICEF supported both Groundwork and FOCUS 1000 research team members during study design, data collection and analysis, decision to publish, and preparation of this manuscript.

Competing interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: JMB and IN-T are employees of UNICEF and SP-B is a Ministry of Health official in Sierra Leone.

Keywords: Ebola; Sierra Leone; Food safety; Society.



Conjugative IncX 1 #plasmid harboring #colistin #resistance gene #mcr-5.1 in #E coli isolated from #chicken rice retailed in #Singapore (Antimicrob Agents Chemother., abstract)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]

Conjugative IncX 1 plasmid harboring colistin resistance gene mcr-5.1 in E. coli isolated from chicken rice retailed in Singapore

Siyao Guo, Moon Y.F. Tay, Aung Kyaw Thu, Kelyn Lee Ghee Seow, Yang Zhong, Lee Ching Ng, Joergen Schlundt

DOI: 10.1128/AAC.01043-19



Colistin is regarded as one of the last resort antimicrobials to Gram-negative bacterial infection (1).…


Copyright © 2019 American Society for Microbiology. All Rights Reserved.

Keywords: Antibiotics; Drugs Resistance; Colistin; MCR5; Plasmids; Food Safety; Singapore.


#Toxigenic potential and #antimicrobial susceptibility of #Bacillus cereus group #bacteria isolated from #Tunisian #foodstuffs (BMC Microbiol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

BMC Microbiol. 2019 Aug 24;19(1):196. doi: 10.1186/s12866-019-1571-y.

Toxigenic potential and antimicrobial susceptibility of Bacillus cereus group bacteria isolated from Tunisian foodstuffs.

Gdoura-Ben Amor M1,2, Jan S3, Baron F3, Grosset N3, Culot A3,4, Gdoura R5, Gautier M3, Techer C4.

Author information: 1 Laboratory Research of Toxicology-Microbiology Environmental and Health LR17ES06, Sciences Faculty of Sfax, University of Sfax, Sfax, Tunisia. marwagdoura50@yahoo.fr. 2 Equipe Microbiologie, Agrocampus Ouest, INRA, UMR1253 Science et Technologie du Lait et de l’Œuf, Rennes, France. marwagdoura50@yahoo.fr. 3 Equipe Microbiologie, Agrocampus Ouest, INRA, UMR1253 Science et Technologie du Lait et de l’Œuf, Rennes, France. 4 Mixscience, Rue des Courtillons, ZAC Cissé Blossac, 35712, Bruz, France. 5 Laboratory Research of Toxicology-Microbiology Environmental and Health LR17ES06, Sciences Faculty of Sfax, University of Sfax, Sfax, Tunisia.




Despite the importance of the B. cereus group as major foodborne pathogens that may cause diarrheal and/or emetic syndrome(s), no study in Tunisia has been conducted in order to characterize the pathogenic potential of the B. cereus group. The aim of this study was to assess the sanitary potential risks of 174 B. cereus group strains isolated from different foodstuffs by detecting and profiling virulence genes (hblA, hblB, hblC, hblD, nheA, nheB, nheC, cytK, bceT and ces), testing the isolates cytotoxic activity on Caco-2 cells and antimicrobial susceptibility towards 11 antibiotics.


The entertoxin genes detected among B. cereus isolates were, in decreasing order, nheA (98.9%), nheC (97.7%) and nheB (86.8%) versus hblC (54.6%), hblD (54.6%), hblA (29.9%) and hblB (14.9%), respectively encoding for Non-hemolytic enterotoxin (NHE) and Hemolysin BL (HBL). The isolates are multi-toxigenic, harbouring at least one gene of each NHE and HBL complexes associated or not to bceT, cytK-2 and ces genes. Based on the incidence of virulence genes, the strains were separated into 12 toxigenic groups. Isolates positive for cytK (37,9%) harbored the cytK-2 variant. The detection rates of bceT and ces genes were 50.6 and 4%, respectively. When bacteria were incubated in BHI-YE at 30 °C for 18 h and for 5 d, 70.7 and 35% of the strains were shown to be cytotoxic to Caco-2 cells, respectively. The cytotoxicity of B. cereus strains depended on the food source of isolation. The presence of virulence factors is not always consistent with cytotoxicity. However, different combinations of enterotoxin genetic determinants are significantly associated to the cytotoxic potential of the bacteria. All strains were fully sensitive to rifampicin, chloramphenicol, ciprofloxacin, and gentamycin. The majority of the isolates were susceptible to streptomycin, kanamycin, erythromycin, vancomycin and tetracycline but showed resistance to ampicillin and novobiocin.


Our results contribute data that are primary to facilitate risk assessments in order to prevent food poisoning due to B. cereus group.

KEYWORDS: Antibiotic resistance; Bacillus cereus; Cytotoxicity; Foodstuffs; Virulence genes

PMID: 31445510 DOI: 10.1186/s12866-019-1571-y

Keywords: Antibiotics; Drugs Resistance; Bacillus cereus; Food Safety; Tunisia.


#Antibiotic Use in #Food #Animals in the #World with Focus on #Africa: Pluses and Minuses (J Glob Antimicrob Resist., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Glob Antimicrob Resist. 2019 Aug 8. pii: S2213-7165(19)30198-5. doi: 10.1016/j.jgar.2019.07.031. [Epub ahead of print]

Antibiotic Use in Food Animals in the World with Focus on Africa: Pluses and Minuses.

Van TTH1, Yidana Z2, Smooker PM3, Coloe PJ4.

Author information: 1 Biosciences & Food Technology Discipline, School of Science, RMIT University, Australia. 2 Biosciences & Food Technology Discipline, School of Science, RMIT University, Australia; Kintampo Health Research Centre, Kintampo, Ghana. 3 Biosciences & Food Technology Discipline, School of Science, RMIT University, Australia. Electronic address: peter.smooker@rmit.edu.au. 4 College of Science, Engineering and Health, RMIT University, Australia.



Antibiotics are sometimes used in food animal production in developing countries to promote the well-being and growth of the animals. This practice provides some economic benefits to producers and consumers at large. Nevertheless, this practice is associated with a number of concerns. A major concern has been that repeatedly exposing these animals to small doses of antibiotics contributes significantly to antibiotic resistance, since a good fraction of the antibiotics used are the same or surrogates of antibiotics used in human therapeutic practices. Studies over decades have shown an explicit relationship between antimicrobial use and antimicrobial resistance in veterinary science. Many antibiotics can be purchased over the counter in African countries and antibiotic resistance is an important issue to address in this region. This review examines some of the risks and benefits associated with antibiotic use in food animals. We conclude that the use of antibiotics in food animal production constitutes a major contributing factor to the current antibiotic resistance crisis and they should only be used for treatment of sick animals based on prior diagnosis of disease.

Copyright © 2019. Published by Elsevier Ltd.

KEYWORDS: Africa; Antibiotic; Antibiotic resistance; Bacteria; Food animals; Growth promoters

PMID: 31401170 DOI: 10.1016/j.jgar.2019.07.031

Keywords: Antibiotics; Drugs Resistance; Poultry; Cattle; Food Safety; Africa.


#Biocide tolerant #Listeria monocytogenes isolates from #German #food production #plants do not show cross-resistance to clinically relevant #antibiotics (Appl Environ Microbiol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Appl Environ Microbiol. 2019 Aug 2. pii: AEM.01253-19. doi: 10.1128/AEM.01253-19. [Epub ahead of print]

Biocide tolerant Listeria monocytogenes isolates from German food production plants do not show cross-resistance to clinically relevant antibiotics.

Roedel A1, Dieckmann R2, Brendebach H1, Hammerl JA1, Kleta S1, Noll M3, Al Dahouk S1, Vincze S4.

Author information: 1 German Federal Institute for Risk Assessment, Max-Dohrn-Str. 8-10, 10589 Berlin, Germany. 2 German Federal Institute for Risk Assessment, Max-Dohrn-Str. 8-10, 10589 Berlin, Germany Ralf.Dieckmann@bfr.bund.de. 3 University of Applied Sciences and Arts, Institute for Bioanalysis, Friedrich-Streib-Str. 2, 96450 Coburg, Germany. 4 German Federal Institute for Risk Assessment, Max-Dohrn-Str. 8-10, 10589 Berlin, Germany Szilvia.Vincze@bfr.bund.de.



Contamination of food during processing is recognized as main transmission route of Listeria (L.) monocytogenes To prevent microbial contamination, biocides are widely applied as disinfectants in food processing plants. However, there are concerns about the development of antimicrobial resistance in foodborne pathogens due to widespread biocide usage.In our study, 93 L. monocytogenes isolates from German food production facilities were i) tested for biocide and antibiotic susceptibility using broth microdilution assays, ii) analyzed for links between reduced biocide susceptibility and antibiotic resistance, and iii) characterized by whole-genome sequencing including the detection of genes encoding for biocide tolerance, antibiotic resistance, and other virulence factors. Fifteen L. monocytogenes isolates were tolerant to benzalkonium chloride (BAC) and genes conferring BAC tolerance were found in 13 of them. Antibiotic resistance was not associated with biocide tolerance. BAC tolerant isolates were assigned to 6 MLST clonal complexes and most of them harbored internalin A pseudogenes with premature stop codons or deletions (n=9).Our study demonstrated a high genetic diversity among the investigated isolates including genotypes that are frequently involved in human infections. Although in vitro adaptation studies to biocides have raised concerns about increasing cross-resistance to antibiotics, our results do not provide evidence for this phenomenon in field isolates.



Foodborne pathogens such as L. monocytogenes can persist in food production environments for a long time causing perennial outbreaks. Hence, bacterial pathogens are able to survive cleaning and disinfection procedures. Accordingly, they may be repeatedly exposed to sublethal concentrations of disinfectants, which might result in bacterial adaptation to these biocides. Furthermore antibiotic co- and cross-resistance is known to evolve under biocide selection pressure in vitro Hence, antimicrobial tolerance seems to play a crucial role in resilience and persistence of foodborne pathogens in the food chain and might reduce therapeutic options in infectious diseases.

Copyright © 2019 Roedel et al.

PMID: 31375490 DOI: 10.1128/AEM.01253-19

Keywords: Antibiotics; Drugs Resistance; Food Safety; Listeria; Biocides; Germany.


Characteristics of #MRSA from #broiler #farms in #Germany are rather lineage- than source-specific (Poult Sci., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Poult Sci. 2019 Aug 3. pii: pez439. doi: 10.3382/ps/pez439. [Epub ahead of print]

Characteristics of methicillin-resistant Staphylococcus aureus from broiler farms in Germany are rather lineage- than source-specific.

Kittler S1, Seinige D1, Meemken D2, Müller A1, Wendlandt S3, Ehricht R4, Monecke S4,5, Kehrenberg C6.

Author information: 1 Institute for Food Quality and Food Safety, University of Veterinary Medicine Hannover, Foundation, Bischofsholer Damm 15, 30173 Hannover, Germany. 2 Institute of Food Safety and Food Hygiene, Section Meat Hygiene, Department of Veterinary Medicine, Freie Universität Berlin, Königsweg 67, 14163 Berlin, Germany. 3 Department of Clinical Microbiology, Medical Care Centre SYNLAB Leverkusen GmbH, Paracelsusstraße 13, 51375 Leverkusen, Germany. 4 Leibniz-Institute of Photonic Technology (Leibniz-IPHT), Albert-Einstein-Str. 9, 07745 Jena, Germany. 5 Institute for Medical Microbiology and Hygiene, Technical University of Dresden, Fiedlerstr. 42, 01307 Dresden, Germany. 6 Institute for Veterinary Food Science, Faculty of Veterinary Medicine, Justus-Liebig-University, Frankfurter Str. 92, 35392 Giessen, Germany.



Methicillin-resistant Staphylococcus aureus (MRSA) are a major concern for public health, and broiler farms are a potential source of MRSA isolates. In this study, a total of 56 MRSA isolates from 15 broiler farms from 4 different counties in Germany were characterised phenotypically and genotypically. Spa types, dru types, SCCmec types, and virulence genes as well as resistance genes were determined by using a DNA microarray or specific PCR assays. In addition, PFGE profiles of isolates were used for analysis of their epidemiological relatedness. While half of the isolates belonged to spa type t011, the other half was of spa types t1430 and t034. On 3 farms, more than 1 spa type was found. The most common dru type was dt10a (n = 19), followed by dt11a (n = 17). Susceptibility testing of all isolates by broth microdilution revealed 21 different resistance phenotypes and a wide range of resistance genes was present among the isolates. Up to 10 different resistance phenotypes were found on individual farms. Resistance to tetracyclines (n = 53), MLSB antibiotics (n = 49), trimethoprim (n = 38), and elevated MICs of tiamulin (n = 29) were most commonly observed. Microarray analysis detected genes for leucocidin (lukF/S), haemolysin gamma (hlgA), and other haemolysines in all isolates. In all t1430 isolates, the egc cluster comprising of genes encoding enterotoxin G, I, M, N, O, U, and/or Y was found. The splitstree analysis based on microarray and PCR gene profiles revealed that all CC9/SCCmec IV/t1430/dt10a isolates clustered apart from the other isolates. These findings confirm that genotypic patterns were specific for clonal lineages rather than for the origin of isolates from individual farms.

© 2019 Poultry Science Association Inc.

KEYWORDS: MRSA; PCR; antimicrobial resistance; broiler; clonal complex

PMID: 31376346 DOI: 10.3382/ps/pez439

Keywords: Antibiotics; Drugs Resistance; MRSA; Staphylococcus aureus; Food safety; Poultry; Germany.


Complete nucleotide #sequences of #mcr-4.3-carrying #plasmids in #Acinetobacter baumannii ST345 of #human and #food origin from the #Czech Republic; first case in Europe (Antimicrob Agents Chemother., abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

Complete nucleotide sequences of mcr-4.3-carrying plasmids in Acinetobacter baumannii ST345 of human and food origin from the Czech Republic; first case in Europe.

Ibrahim Bitar, Matej Medvecky, Tereza Gelbicova, Vladislav Jakubu, Jaroslav Hrabak, Helena Zemlickova, Renata Karpiskova, Monika Dolejska

DOI: 10.1128/AAC.01166-19



Here we describe two plasmids carrying mcr-4.3 in two Acinetobacter baumannii strains isolated from imported food and a clinical sample. The comparative analysis of these plasmids, with two other plasmids reported in NCBI database, highlighted the common origin of the plasmidic structure carrying mcr-4.3. This is the first case of mcr-4.3 gene in A. baumanniistrain isolated from a clinical case in Europe. We hypothesize that food import is initiating the spread in Czech Republic.

Copyright © 2019 American Society for Microbiology. All Rights Reserved.

Keywords: Antibiotics; Drugs Resistance; Colistin; MCR4.3; Acinetobacter baumannii; Human; Food safety; Czech Republic; Plasmids.