Our Latest Perspectives Posts

Enjoying Reptiles and Amphibians while Avoiding Salmonella
Written by Fred M. Reiff, P.E.

Children love to explore the great outdoors.  Spotting turtles, frogs, lizards and snakes in the wild is fun and can help build an appreciation of the wonders of wildlife.  To help keep the experience healthy, parents and guardians should be aware that reptiles and amphibians can harbor Salmonella bacteria that are easily transmitted to people handling them.  That includes wild as well as pet store varieties of these animals.

According to the US Centers for Disease Control and Prevention (CDC), Salmonella outbreaks from contact with reptiles and amphibians have caused hundreds of people to become ill in recent years; many of these outbreaks are linked to small turtles. Children under five years old are the most commonly affected, which is why CDC recommends parents prevent their young children from contacting reptiles and amphibians. CDC notes, in fact, that since 1975 the Food and Drug Administration has banned the sale and distribution of turtles with a shell length of less than four inches in size as pets.

Salmonella in the Family Room?

It may come as a surprise that Salmonella, a bacterium commonly associated with foodborne illness, can be transmitted by the colorful gecko or the lumbering turtle inhabiting the family room aquarium. Parents may purchase these pets for their relative ease of care, unaware of the invisible risk of Salmonella infection. Young children should neither handle these pets, nor make contact with their indoor habitats because Salmonella may be present on the animals’ skin or on any surface they touch.  That includes aquariums, terrariums, cages, and water and food dispensers. If animals are permitted to roam outside of their enclosures throughout the household, any surface with which they make contact can become contaminated with Salmonella.

A Guide to Safe Handling Reptiles and Amphibians1

  1. Do not permit children less than five years of age or people with weakened immune systems to make contact with reptiles or amphibians or their habitats.
  2. Wash hands thoroughly with warm water and soap after handling a reptile or amphibian or any surface with which the animal had contact.
  3. Do not eat or touch your mouth while handling a reptile or amphibian.
  4. Do not let these animals roam freely though the household; in particular, avoid their entering areas in which food is stored or prepared.
  5. If possible, remove aquariums, terrariums, cages and containers to an outdoor area for cleaning. Wear disposable plastic gloves and avoid emptying water containers and wash water in indoor sinks used for food preparation or drinking water.
  6. If indoor bathtubs or sinks must be used for cleaning, they should be thoroughly cleaned and disinfected afterward. Use a chlorine bleach solution to disinfect a sink, bathtub, or other place where habitats are cleaned.
  7. To prevent cross-contamination, and if animal bathing is in order, bathe the animal in a small plastic tub or bin that is dedicated for animal use only.
  8. Wash any clothing that contacts reptiles and amphibians or their indoor habitat.

Preserving the Wonder

Older children can be taught to handle and care for reptile and amphibian pets appropriately.  Parents are the best judges of when their children are ready to undertake those responsibilities. As for the under-five set, an outdoor excursion into the wild is the perfect setting for enjoying frogs, turtles, lizards and snakes.  But at that tender age, it is best to appreciate the visual wonder while avoiding the touch.

The Pet Industry Joint Advisory Council offers a downloadable poster on Healthy Herp Handling at:  https://www.pijac.org/HealthyHerpHandling.

Click here to download this article.

Fred Reiff, P.E., is a retired official from both the U.S. Public Health Service and the Pan American Health Organization, and lives in the Reno, Nevada area.

1 This guide is based on CDC recommendations.


Listeria: Thriving in the Cold
Written by Chris Wiant, M.P.H., PhD

Graph from CDC website: 2011 Estimates of Foodborne Illness in the United States

The equivalent of 15 semi-truckloads of Jeni’s Splendid Ice Cream was recalled earlier this year due to possible contamination with Listeria bacteria.  The recall cost the company $2.5 million, but it was the right response.  Another ice cream producer, Blue Bell Creameries, recalled all of its products made at all of its facilities after Listeria was found in its Chocolate Chip Cookie Dough Ice Cream.  According to a CDC update, as of May 7, 2015, ten patients from four states had been infected with Listeria from Blue Bell Creameries ice cream.  Three patients from Kansas have died.

CDC estimates that each year one in six Americans—about 48 million of us—experience “food poisoning.”   128,000 are hospitalized and 3,000 die.  Although only about 1600 people get sick from Listeria each year, it is the third leading cause of death from food poisoning after Salmonella and Toxoplasma gondii.

Listeria monocytogenes is a gram-positive*, rod-shaped bacterium that lives in soil, water, mud, silage, domestic and wild animals and humans.
Image from CDC website

1In 2011, a Listeria outbreak associated with cantaloupe killed 33 people, caused one miscarriage, and sickened over 147 people in 28 states, according to CDC.  The outbreak was traced to unsanitary post-harvest processing on a Colorado farm, including discontinuing washing cantaloupe with a chlorine-based disinfectant solution.  Cantaloupe can harbor soil and bacteria in the grooves of its irregular exterior, which can be transferred into the fruit upon slicing it with a knife.

Listeria Loves the Cold

Listeria thrives in cold environments.  An article in Infection Control Today notes that Listeria may infect “ready-to-eat deli meats and hot dogs, refrigerated meat spreads, unpasteurized milk and dairy products, soft cheese made with unpasteurized milk, refrigerated smoked seafood, and raw sprouts.”   Kansas State University food safety specialist Fadi Aramouni explains that although the pasteurization process destroys Listeria in ice cream, the bacteria can survive elsewhere in an environment, aided by poor sanitation procedures.  In such environments, Listeria may persist in cool, moist areas of condensation, such as drains and light fixtures. He also points out that in the ice-cream making process, “inclusions” such as cookie dough and pecans are added post-pasteurization, presenting a potential opportunity to introduce pathogens that would not be subject to pasteurization.

On Guard for Listeria

Listeria becomes a greater risk to health as people age into their senior years.  Other at-risk populations include pregnant women and their newborns, young children and people with weakened immune systems.  CDC reports that Listeria can cause miscarriage and meningitis.

There is no way to know by inspecting it that Listeria has contaminated your food.  Here are some tips based on FDA advice for avoiding Listeria in foods:

  • Respect Recalls: Pay close attention to food recalls and discard or return any recalled products to the market.  The US Food and Drug Administration offers a free email subscription service that reports all food recalls.
  • Reheat Lunch Meats: At risk individuals should reheat hot dogs and lunch meats until steaming hot.
  • Avoid Unpasteurized Products: Avoid unpasteurized milk and soft cheeses such as feta, brie, camembert, blue-veined cheeses, “queso blanco,” “queso fresco” or Panela, unless they are made with pasteurized milk.
  • Wash all Fresh Fruits and Veggies: Wash produce under running water just before eating, cutting or cooking, even if you plan to peel the produce first. Scrub firm produce such as melons and cucumbers with a clean produce brush.
  • Keep Refrigerated Foods Cold: Chilling food properly is an important way of reducing risk of Listeria infection. Although Listeria can grow at refrigeration temperatures, it grows more slowly at refrigerator temperatures of 40 degrees F or less.
  • Use precooked and ready-to-eat foods as soon as you can: The longer they are stored in the refrigerator, the more chance Listeria has to grow.
  • Discard leftovers after three days.
  • Cover or Contain Refrigerated Foods: Don’t let foods (especially meat and poultry) leak juices onto other foods.  If you have a leak or spill in the refrigerator, use paper towels to absorb juices and then clean and sanitize (see below).
  • Clean and Sanitize the Refrigerator Shelves and Walls Regularly: Clean the inside walls and shelves of your refrigerator with warm water and liquid soap, then rinse.  You can make your own sanitizer by combining 1 teaspoon of unscented regular bleach to one 1 quart of water, flooding the surface and letting it stand for 10 minutes. Then rinse with clean water. Let surfaces air dry or pat them dry with fresh paper towels. Bleach solutions get less effective with time, so discard unused portions daily.

Chris Wiant, M.P.H., Ph.D., is president and CEO of the Caring for Colorado Foundation. He is also chair of the Water Quality & Health Council.

Click here to download this article

1*Gram-positive bacteria are bacteria that contain a thick cell wall that absorb a violet dye when the Gram Stain Test is administered and the cells are viewed through a microscope. In contrast, gram-negative bacteria, characterized by thinner cell walls but inner and outer cell membranes, do not retain the dye, and appear red or pink in the Gram Stain Test.  Gram-negative bacteria cause a wide range of infections.



Avoiding Plant Disease in the Backyard Vegetable Garden
Written by Linda Golodner

In springtime, hope springs eternal for a bountiful harvest from the backyard vegetable garden.  One risk to productivity, however, is pathogens (disease-causing microbes) transferred from contaminated planting pots and garden tools to vegetables, a form of cross-contamination.  Here are some tips for avoiding crop loss due to cross-contamination.

Recycle Planting Pots, Not Pathogens

Do you reuse plastic and clay containers for starting seeds indoors? According to the Philadelphia County Master Gardeners website, by recycling these containers, you may be recycling pathogens, mineral and salt deposits, and last year’s weeds.  These experts say a visual inspection of a planting pot is not enough Read More


Hantavirus in North America: Rare but Deadly
Written by Ralph Morris, MD, MPH

The Deer Mouse is one of at least four rodents known to spread hantavirus
(photo courtesy of CDC)

Spring cleaning time is here, and chores may include sweeping out garages, basements, sheds, cottages and cabins.  Keep in mind that these environments may contain rodent droppings, which can present a rare but deadly health risk from hantavirus.  Hantavirus was first recognized in North America in May, 1993 in The Four Corners area of Arizona, New Mexico, Colorado and Utah. The first case probably occurred in Utah in 1959.  It has since been found in other states and other countries.

According to the Centers for Disease Control & Prevention (CDC) website, people become infected with hantaviruses through contact with infected rodents, their urine or their droppings.  To date, CDC has identified Deer Mice, Cotton Rats, Rice Rats and White-footed Mice as hantavirus carriers. Descriptions of these rodents and maps showing their distribution throughout North America are available on the CDC website. Read More


Does Exposure to Bleach Cause or Help Prevent Childhood Infections?
Written by The Water Quality & Health Council

A short report in the journal Occupational & Environmental Medicine concludes passive exposure to weekly use of bleach in the home could promote some infections in school-age children. The report is poorly documented, highly speculative and although the researchers recommend exercising caution when interpreting their results, some in the media have erroneously interpreted the findings as definitive, with headlines such as: “How cleaning with bleach can make children ill: Those living in super clean houses are 20% more likely to catch flu, tonsillitis and pneumonia.”
Read More


Easter Egg Safety
Written by Water Quality & Health Council

Dyeing Easter eggs and organizing Easter egg hunts are treasured traditions in many families. Enjoying these traditions safely—without foodborne illness—is a matter of following a few commonsense guidelines.  We provide the following Easter egg safety tips based on US Department of Agriculture (USDA) recommendations with our wishes for a healthy, enjoyable holiday.

Buying Eggs

Buy eggs from a refrigerated case.  Open the carton and inspect for clean, uncracked shells. The egg carton should be imprinted with a USDA grade shield and indicate a future “sell by” date (see photos below). Read More


Fighting Antibiotic Resistance at Home and Globally
Written by Water Quality and Health Council

The conclusion of a series of articles on the challenge of antimicrobial resistance

We all have a stake in the outcome of the battle against antimicrobial resistance. Everyone, from the global public health expert to the ordinary citizen, can play a role in reversing a dangerous trend in the balance of power between humans and pathogens.

Antimicrobial resistance has the potential to erase the astonishing gains made possible by the use of antibiotics over the past 70 years.  According to a report from the Infectious Diseases Society of America, although the widespread availability and effectiveness of antibiotics has positively impacted surgery, care of premature infants, cancer chemotherapy, care of the critically ill, transplantation medicine, and even our ability to respond to bioterrorism and pandemics, that widespread availability along with misuse has resulted in antimicrobial resistant pathogens.  This unintended consequence is already exacting a toll on both human health and wealth, as highlighted in a new UK report.  The toll will skyrocket if we fail to respond to the challenge of antimicrobial resistance over the course of the next several decades.

The Promise of New Discoveries

Researchers recently announced the preliminary discovery of a new class of antibiotics that may be effective against a wide range of drug-resistant bacteria for decades. The new class of drugs was identified using innovative culturing techniques. These antibiotics attack fat molecules in bacteria cell walls. A similar mechanism is responsible for 30 years of successful use of the antibiotic vancomycin before antimicrobial resistance developed against it.

Despite some encouraging new discoveries (see sidebar), pharmaceutical innovation has not kept pace with the ever-evolving resistance of our microscopic enemies.  Factors favoring development of antimicrobial resistance include overuse and misuse of antibiotics for both man and animals.  Inadequate attention to appropriate disinfection measures also contribute, as evidenced by recent news that a lack of wastewater treatment in Rio de Janiero, could result in the exposure of Olympic athletes to resistant superbugs in water venues chosen for the coming 2016 Olympic sailing and wind-surfing events.

What Everyone Can Do to Fight Antimicrobial Resistance

Each of us can turn our concern over antibiotic resistance into action.  First, we can focus on preventing the illnesses that require antibiotics by adopting a healthy life style.  Promote a strong immune system with a healthy diet, regular exercise and adequate rest, and make sure family members and other close contacts are up to date with vaccinations and flu shots.  Implement safe disinfection practices in the home when a family member develops an infectious illness.  Isolating sick individuals and disinfecting frequently touched surfaces helps prevent the spread of infection to others.  Safe food handling is also extremely important in preventing infectious illness.  Consumers can consider purchasing meat and egg products that indicate animals were raised on a diet without unnecessary antibiotics.  The U.S. Food and Drug Administration, for example, is working with industry to promote only the appropriate use of antibiotics in animal agriculture as described on its website, “Judicious Use of Antimicrobials”.

If antibiotics are prescribed, they should be taken exactly according to directions.  Antibiotic use should not be discontinued until the entire prescribed dose is taken (unless otherwise instructed by a doctor), and antibiotic prescriptions should not be shared with others.  If any medication remains, it should be disposed of properly – returned to the pharmacy, not flushed down the toilet.

Antimicrobial Resistance as a Sustainable Development Goal

Antimicrobial resistance is beginning to be recognized as a global challenge.  Currently, representatives of the world community are developing a set of global Sustainable Development Goals1 for the UN’s “post-2015 agenda”.  To date, the UN General Assembly has accepted a set of 17 proposed Sustainable Development Goals as a starting point for the post-2015 agenda.  The goals encompass everything from poverty eradication to building resilient infrastructure and providing safe drinking water and sanitation. We suggest Goal #3, to “Promote healthy lives and ensure well-being for all at all ages,” include a target that promotes best practices to combat antimicrobial resistance, including responsible use of antibiotics, policies that encourage drug innovation and infection control and prevention.

When it comes to antimicrobial resistance, we stand at a crossroads:  The next steps determine the future.

Click here to download this article

1 These goals will further the progress achieved under the UN’s Millennium Development Goals (2000-2015).


Superbugs and the 2016 Summer Olympics
Written by Water Quality and Health Council

The second of a series of articles on the challenge of antimicrobial resistance

An antimicrobial resistant “superbug” could give sailors and windsurfers competing in the 2016 Summer Olympics more to worry about than their athletic performance.  Evidence of superbugs–bacteria resistant to common antibiotics—have been found in the sewage-laden Carioca River, which flows into Guanabara Bay, the planned site of Olympic sailing and windsurfing events.

A new study1 by Rio’s Instituto Oswaldo Cruz identifies a superbug enzyme at three points along the heavily polluted Carioca River. Infections from antimicrobial resistant superbug bacteria require stronger than normal antibiotics and could require hospitalization, according to the study’s coordinator (see RT article).  Additionally, carriers of antimicrobial resistant bacteria can spread serious infections to others.

A Dirty State of Affairs

Wastewater Treatment Basics

In the first steps of wastewater treatment, known as primary treatment, particles are physically removed by screening, settling and flotation. Secondary treatment includes bubbling air through wastewater to allow bacteria to metabolize pollutants. Next, much of the bacterial load is removed by settling in a chamber known as a secondary clarifier. In the final step, municipal wastewater is disinfected, but sometimes only on a seasonal basis or if the receiving stream is to be used for recreation.

Rio de Janeiro is the third largest metropolitan area in South America after Sao Paulo and Buenos Aires. The city’s population is estimated at 6.35 million (see World Population Review), but the population of the metropolitan area is nearly double that.  A very large portion of Rio’s sewage remains untreated before discharge, and much of it flows into Guanabara Bay resulting in a threat to human health and well-being. Beaches are unsuitable for swimming and fish die-offs signal environmental deterioration.

Organizers have promised to reduce Guanabara Bay pollution by 80 percent before the start of the Olympics, but Rio’s mayor admitted in June, 2014 that the city would not meet that target.

Reducing Opportunities for Superbugs

Wastewater treatment is of paramount importance for at least two reasons:

First, releasing untreated sewage into Rio’s waterways degrades the aquatic environment.  As organic substances in sewage biodegrade, water is depleted of dissolved oxygen, killing fish and other aquatic life.  Water is rendered disagreeable for recreational and aesthetic uses.  Second, untreated wastewaters contain microorganisms that can cause disease.  Scientists know that bacteria may share genes that impart antibacterial resistance. Are the dirty waters of the Carioca River spawning the superbugs recently identified? Are superbugs evolving even in treated wastewater that is not disinfected year-round?  What is the appropriate level and type of wastewater disinfection needed to avoid promoting superbug development?

Looking Ahead

Research is being conducted to understand how various wastewater treatment techniques affect antibiotic resistant bacteria.2  The ultimate goal is to eliminate or at least reduce antibiotic resistant bacteria to safe levels in effluent released into the environment, not just in Brazil, but everywhere because antimicrobial resistance has become a global problem.  We encourage Rio de Janeiro officials to work with Instituto Oswaldo Cruz and others to determine and implement the most effective action to address this public health aspect of water pollution.

The Water Quality and Health Council hopes that the intersection of the prospect of the 2016 Summer Olympics and the appearance of superbugs in the Carioca River will catalyze an appropriate response to a serious water quality problem in Rio de Janeiro.  We commend those who already are striving to clean up Guanabara Bay and wish them the greatest success, but we also hope that efforts being made to adequately treat Rio’s sewage prior to discharge do not wane after the Olympics.  While healthy waters many not be a reality by the time of the summer games, having a serious long-term plan in place could be the first step in a shining example of recovery.

Click here to download this article

1 The study is available in Portuguese only.

2 See, for example, “Urban wastewater treatment plants as hotspots for antibiotic resistant bacteria and genes spread into the environment: a review” (abstract)



Antibiotic Resistance: Standing at a Critical Juncture
Written by Water Quality and Health Council

The first of a series of articles on a looming global crisis

German philosopher Friedrich Nietzsche famously said:  “That which does not kill us makes us stronger.” If the many pathogens that are becoming immune to antibiotics could speak, Nietzche’s quote would be their battle cry.  These disease-causing germs are gaining the upper hand as they become increasingly resistant to the very weapons—antibiotics—that humans developed to kill them.  A new UK report1, titled “Antimicrobial Resistance:  Tackling a crisis for the health and wealth of nations,” explores the issue of antibiotic resistance with the goal of averting what the report calls “a looming global crisis”.

Antibiotics Changed the World

Sir Alexander Fleming’s accidental discovery of penicillin from a mold culture in 1928 is one of the most significant medical breakthroughs of all time. Penicillin helped cure tuberculosis and pneumonia, once common killers. Surgery and wound treatment became much more successful with the advent of antibiotic “wonder drugs”.

A Costly Health Threat

Antibiotic resistance undermines our ability to fight infectious diseases and manage the infectious complications common in patients undergoing chemotherapy, dialysis and surgery.  The US Centers for Disease Control and Prevention (CDC) calls antimicrobial resistance one of our most serious health threats, and notes that at least 23,000 people in the US die each year as a direct result of antibiotic-resistant infections.  CDC points out in a 2013 report2 that antibiotic use in food-producing animals may also contribute to the problem as animals and their droppings serve as carriers of resistant bacteria, transmitting them to humans through the food supply (see graphic below).

Resistant pathogens spread with ease throughout our highly interconnected world, and therefore the problem of antibiotic resistance must be tackled internationally. The UK report notes that antibiotic resistance results in an estimated 500,000 deaths globally each year, a figure that could rise to 10 million by 2050, outpacing all other major causes of death, including cancer, diabetes, diarrheal disease and road traffic accidents.  Economic costs could reach $100 trillion by 2050, with disproportionate impacts on the emerging economies of Brazil, Russia, India and China.

The Making of a Crisis

The authors of the new report cite several factors leading to the current state of affairs regarding antibiotic resistance, including:

  • Antibiotic use has outpaced the development and approval of new antibiotics.
    Pathogens naturally evolve resistance to antibiotics over time. Key to overwhelming the “moving target” of pathogen evolution is a steady supply of new antibiotics—something we have failed to produce due to a variety of economic and policy disincentives.  The Generating Antibiotics Incentives Now (GAIN) Act (see FDA blog), signed by President Obama in July, 2012, provides incentives to developing new antibacterial drugs.  The new antibiotic Zerbaxa®, for example, was approved recently under this Act.  Zerbaxa® will be used to combat infections of resistant Gram-negative pathogens, which currently represent a serious public health threat.
  • There is widespread excessive and unnecessary use of antibiotics.
    Unwarranted antibiotic use exacerbates antimicrobial resistance.  In some countries, antibiotics are available without a prescription.  In addition, prescribing practices vary from place to place, and “counterfeit and sub-standard antimicrobials” further complicate the picture.
  • The availability of antibiotics may have reduced our focus on infection prevention.
    Instead of investing sufficient resources on infection control and prevention, we may have become overly dependent on antibiotics to combat pathogens.  A renewed focus on prevention, through immunization, hygiene and disinfection, is simpler, and preferable to treating human infection.

The discovery of antibiotics changed the world, combating a host of deadly infections that once shortened lifespans and reduced human productivity.  We now stand at a critical juncture:  Will we take the collective actions needed to preserve the use of antibiotics, or will we lose this precious technology at great human and economic cost?

Excerpt from CDC graphic in the report, “Antibiotic Resistance Threats in the United States, 2013”

For more information on antibiotic resistance, please see the CDC website:  Antibiotic/Antimicrobial Resistance.

Click here to download this article

1 Antimicrobial Resistance:  Tackling a crisis for the health and wealth of nations, December, 2014.
2 US Centers for Disease Control and Prevention, 2013. “Antibiotic Resistance Threats in the United States, 2013”


Thanksgiving Stress: What Rates High on Your Meter?


Thanksgiving is meant to be a delightful day centered on family, friends, and food. Traditions play a big role on this day, whether it is a brisk pre-dinner hike, watching football on TV, or giving everyone at the table a chance to express what he or she has been most grateful for this year.

Thanksgiving is not necessarily a stress-free holiday, however:  Cooks feel pressure to produce a special feast; travelers are forced to deal with transportation and traffic delays; and increasingly, advertisers tempt us to shorten our Thanksgiving celebration and start our holiday shopping on Thanksgiving or in the wee hours of “Black Friday.”  A survey we conducted a few years ago found more than one-third of Americans polled were concerned about “being around an annoying relative” on Turkey Day.  In fact, more folks were concerned about sitting next to crazy Uncle Joe (37%) than they were about getting sick from improperly prepared food (31%).

We can’t help you with your traveling, shopping or interpersonal skills, but we can offer a concise bit of advice on avoiding foodborne illness as the kitchen is activated for holiday cooking.  Just remember: Clean, Separate, Cook and Chill. See the box below for details:

Avoiding Foodbore Illness this Thanksgiving

Clean – wash all food contact surfaces with hot, soapy water followed by sanitizing with 1/2 tablespoon regular strength or 2 teaspoons of high strength chlorine bleach in 1/2 gallon of water. Do this before and after working with raw foods.

Separate – keep fresh fruits and vegetables separate from raw meat, poultry and seafood.

Cook – to kill any bacteria that might be present, thoroughly cook meat, poultry and eggs to the appropriate temperature.

Chill – refrigerate leftover perishables at 40 degrees within 2 hours of cooking or serving.

The Water Quality & Health Council wishes you a safe, healthy
and thoroughly enjoyable Thanksgiving!


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