Fw: [BITES-L] bites Sep. 14/10
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bites Sep. 14/10
L.A. County wants food trucks to carry health letter grades
Raw egg mayo sickens 170 with salmonella at AUSTRALIAN restaurant, fined $1300
US: Egg-loving salmonella bacteria have been sickening people for decades
BANGKOK street fruit often contaminated
HONG KONG: Results of tests on mooncakes
UK: Boxing host loses claim over Fat Duck illness
FLORIDA: Oyster lovers: It may be an 'R' month, but the Gulf is still warm
US: Government food safety scientists report political, corporate interference
UK: Aldi recalls some Stonemill ground coriander
IRELAND: Largest outbreak in recent years linked to Salmonella on duck eggs
How international co-operation curtailed a salmonella outbreak
U.S. Meat farmers brace for limits on antibiotics
TEXAS: Beaumont restaurant inspection scores are in
Observed hand cleanliness and other measures of handwashing behavior in rural Bangladesh
The epidemiology of infectious gastroenteritis related reactive arthritis in U.S. military personnel: a case-control study
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L.A. County wants food trucks to carry health letter grades
13.sep.10
barfblog
Doug Powell
http://www.barfblog.com/blog/144101/10/09/13/la-county-wants-food-trucks-carry-health-letter-grades
Why not? Wherever people eat, they should be able to get publicly-funded information about food safety; the smart operators will market their excellent food safety.
Los Angeles County public health officials are asking the Board of Supervisors to expand to food trucks the county's popular letter grading system that evaluates safe food handling practices. The vote, originally scheduled for Tuesday, has been pushed back a week.
If approved, 6,000 full-service catering trucks and 3,500 hot dog, churro and other limited food service carts would be covered by the ordinance. If the supervisors approve it, enforcement would first begin in unincorporated areas of the county.
Dr. Jonathan Fielding, director of the county Department of Public Health, said,
"Even before this trend, we felt people were asking us: We go to a restaurant, we like the grading system, but what about all these trucks that are coming? How do we know? We've been looking at this for some time."
Public health officials said the current program does not meet annual inspection goals because they cannot locate food vehicles that move constantly. The new ordinance will require vendors to give information about their vehicle whereabouts and mandates that the trucks be inspected twice a year.
Erin Glenn, chief executive officer of Asociacion de Loncheros, an association of lunch trucks, said,
"As long as enforcement is fair, and the inspectors treat local food vendors with respect, just like they do with the brick-and-mortar establishments, hopefully the inspection standards are the same, I think the regulations are fine. I think it's a step in the right direction to improve public health, and we're all for it."
http://latimesblogs.latimes.com/lanow/2010/09/la-county-wants-food-trucks-to-carry-health-letter-grades.html
Raw egg mayo sickens 170 with salmonella at AUSTRALIAN restaurant, fined $1300
14.sep.10
barfblog
Doug Powell
http://www.barfblog.com/blog/144102/10/09/14/raw-egg-mayo-sickens-170-salmonella-australian-restaurant-fined-1300
ABC News reports an Albury take-away restaurant has been fined $1,300 over a salmonella outbreak early this year.
One hundred and seventy people got sick in January when they ate a contaminated home-made raw egg mayonnaise from the Albury Burger Bar.
The New South Wales Food Authority says the business has been fined for selling unsafe food and handling food in an unsafe manner.
It has been placed on the department's "name and shame" list.
http://barfblog.foodsafety.ksu.edu/blog/139189/10/01/25/it-was-aioli-australian-salmonella-toll-albury-rises-111-linked-raw-egg
http://www.abc.net.au/news/stories/2010/09/14/3011077.htm
US: Egg-loving salmonella bacteria have been sickening people for decades
14.sep.10
Washington Post
David Brown
http://www.washingtonpost.com/wp-dyn/content/article/2010/09/13/AR2010091303594.html
The unfolding story of how salmonella bacteria infected two giant egg operations in Iowa this summer is the latest chapter of a mysterious narrative about how a minor bacterial annoyance took off 35 years ago to become the second most common cause of food-borne illness in the United States.
Like the things that cause AIDS, Lyme disease, Legionnaire's disease and West Nile fever, the egg-loving germ (whose formal name is Salmonella enterica serovar Enteritidis) is a classic "emerging infectious agent." Sometimes called SE, it's a microbe that has been around a long time and has found a new or better way to reach its human victims.
For more than three decades, the strain of salmonella bacteria with a fondness for eggs has taken advantage of changes in this country's animal husbandry, food distribution and eating habits.
Along the way, scientists and public health officials have paid increasing attention to it, culminating recently in the Food and Drug Administration's 71-page "egg safety rule," which took effect in July. The federal government hopes those regulations will prevent 80,000 of the 142,000 cases of egg-related salmonella infection that occur in the United States each year (out of an estimated 1.54 million cases of food-borne salmonella illness). They hope the rule will cut the number of infected "table eggs," currently estimated at 2.3 million of the 47 billion produced each year. The new standards might even reduce health-care costs by $1.4 billion.
But they are unlikely to eradicate the problem.
BANGKOK street fruit often contaminated
14.sep.10
barfblog
Doug Powell
http://www.barfblog.com/blog/144103/10/09/14/bangkok-street-fruit-often-contaminated
The Associated Press reports that a survey of fruit available via ubiquitous street carts in Thailand's capital, Bangkok, found unsafe levels of bacteria and chemicals that help keep it looking fresh in the city's tropical heat.
The Prime Minister's Office launched a one-month campaign Monday to encourage fruit vendors and their suppliers to improve hygiene and provide consumers with safe, clean fruit. Authorities warned another survey will be taken at the end of the month after which vendors selling contaminated fruit will face up to two years in prison and fines of 20,000 baht ($650).
The study conducted throughout August by Bangkok City Hall, the Thai Food and Drug Administration and other health agencies sampled fruit from 38 vendors across the capital, where baggies packed with watermelon or pineapple sell for 10 baht (30 cents) and pricier guava costs 25 baht (80 cents).
Results of the study found that 67 percent of 153 samples of fresh fruit contained unsafe amounts of coliform bacteria. Coliform bacteria is common in digestive tracts and does not necessarily cause sickness, but its presence may indicate fecal matter, E. coli and other disease-causing organisms.
http://www.nytimes.com/aponline/2010/09/14/world/AP-AS-Thailand-Forbidden-Fruit.html?_r=1&partner=rss&emc=rss
HONG KONG: Results of tests on mooncakes
13.sep.10
HKSAR Government
http://7thspace.com/headlines/356968/results_of_tests_on_mooncakes.html
Hong Kong -- The Centre for Food Safety (CFS) collected more than 200 mooncake samples under a Seasonal Food Surveillance Programme and the results were all satisfactory. A spokesman for the CFS said today (September 13) that 250 samples, covering traditional, snowy, ice-cream and other types of mooncakes, had been collected from various retailers and food factories recently. Samples were taken for chemical and microbiological tests.
The chemical tests included colouring matters such as sudan dyes, preservatives such as sulphur dioxide, antioxidants, pesticides, heavy metals, aflatoxins and mineral oil. The microbiological tests covered total bacterial count, coliform organisms and pathogens such as Salmonella, Staphylococcus aureus and Listeria monocytogenes. Despite the satisfactory results of all samples, the spokesman reminded the food trade to purchase food ingredients from reliable suppliers.
"They should adhere to 'good manufacturing practice' and comply with the legal requirements when using food additives," he said. "Snowy and ice-cream mooncakes, which do not undergo a baking process at high temperature, need to be handled hygienically during processing, transportation and storage to avoid contamination and growth of food poisoning germs," he said. He also advised the public to observe the "five keys to food safety" in the purchase, storage and consumption of mooncakes to prevent food-borne illnesses.
The "five keys" for mooncake consumers are as follows: * Buy mooncakes from reliable outlets, check whether the mooncakes are properly packaged, pay attention to the expiry dates and eat them within the recommended period; * Store the mooncakes in a refrigerator immediately after purchase (snowy mooncakes should be kept at four degrees Celsius or below, and ice-cream mooncakes at minus 18 degrees Celsius or below) and consume them as soon as possible after taking them out from the refrigerator; * Use an icebox to carry snowy or ice-cream mooncakes outdoors and consume them as soon as possible; * Wrap mooncakes properlyand keep separately from raw food when storing in refrigerator; and * Maintain good personal hygiene. Wash hands properly with liquid soap and running water before handling mooncakes. The spokesman reminded people to eat mooncakes in moderation, as they are mostly high in sugar and fat, and to maintain a balanced diet.Patients with chronic illnesses should consult physicians or dietitians before eating mooncakes.
The public may browse the CFS website ( www.cfs.gov.hk ) for information on the test results and the food safety tips.
UK: Boxing host loses claim over Fat Duck illness
14.sep.10
The Independent
Tom Morgan
http://www.independent.co.uk/news/uk/home-news/boxing-host-loses-claim-over-fat-duck-illness-2079151.html
Boxing TV host Jim Rosenthal lost a legal bout with chef Heston Blumenthal today as a judge ruled he should not be refunded for a £1,300 meal which left him "disastrously" sick.
The veteran ITV presenter, also known for fronting the channel's coverage of football and motor racing, was one of more than 500 guests who fell ill during the norovirus outbreak at the award-winning Fat Duck last year.
District Judge Tim Parker dismissed Rosenthal's claim at Oxford County Court after hearing he and his dinner companions had already received £6,000 compensation for pain suffered in the wake of the meal.
Rosenthal and his guests were struck down by jelly oysters served as part of a food and wine-tasting evening at the "prestigious" restaurant.
He and his wife, who had been eating with boxing promoter Frank Warren and three other guests, spent a total of £1,346.33 on a "gastronomic evening" in February last year which turned to "catastrophe", the court heard.
The oysters which made them ill had a market value of just 78p each, Rosenthal's counsel, Andrew Sheriff, said.
They were among more than 500 diners who fell ill, forcing the two week closure of the three Michelin starred Fat Duck, in Bray, Berkshire.
FLORIDA: Oyster lovers: It may be an 'R' month, but the Gulf is still warm
14.sep.10
Herald Tribune
Barbara Peters Smith
http://pulse.blogs.heraldtribune.com/10014/oyster-lovers-it-may-be-an-r-month-but-the-gulf-is-still-warm/
The Florida Department of Health is warning Floridians with certain health conditions – basically heavy drinkers and people with liver damage — to avoid eating raw oysters or exposing open wounds to our still-warm Gulf and bay waters, which can harbor nasty bacteria called Vibrio vulnificus.
Healthy people can also be affected, but their illnesses tend to be less severe.
So far this year, six deaths from Vibrio vulnificus infection have been reported in Florida. The DOH has determined that at least two of the deaths were attributed to raw oyster consumption. Eight wound infections have been reported, but none were fatal.
Thoroughly cooking oysters — frying, stewing, or roasting them — eliminates harmful bacteria and viruses, says the DOH.
US: Government food safety scientists report political, corporate interference
14.sep.10
Los Angeles Times
Kim Geiger
http://www.latimes.com/news/nationworld/nation/la-na-scientists-obama-20100914,0,4245034.story
Scientists and inspectors at the federal agencies responsible for food safety say they face political and corporate interference with their work, according to a survey released Monday by the Union of Concerned Scientists, a nonpartisan advocate for unbiased science in government.
The survey suggests a continuation of problems that government scientists had complained about during the George W. Bush administration, despite Obama administration pledges not to let politics intrude on scientific conclusions. And it comes more than a year after the administration promised to issue new rules to protect scientific integrity.
More than 1,700 scientists and inspectors at the Food and Drug Administration and the Department of Agriculture responded to the survey, which was conducted by the Center for Survey Statistics and Methodology at Iowa State University.
The survey found only a slight improvement in perception of the agencies' approach to science under the Obama administration.
UK: Aldi recalls some Stonemill ground coriander
14.sep.10
Food Standards Agency
http://www.food.gov.uk/news/newsarchive/2010/sep/salmonella
Aldi has recalled some of its own-brand Stonemill Group Coriander with a 'best before' date of 14 October 2012, because the product is contaminated with salmonella. Salmonella is a bacterium that causes food poisoning. The Agency has issued a Product Recall Information Notice.
Product details
The product being recalled from customers is:
* Aldi Stonemill Ground Coriander, 40g jar
* Best before: 14 October 2012
* Batch code: 14.10.12 C2
Product recall notices will be shown in stores that sell the product, explaining why the product has been recalled and how customers can get a full refund. Product recall notices will also appear in the press on Thursday 16 September 2010.
About product withdrawals and recalls
If there is a problem with a food product that means it should not be sold, then it might be 'withdrawn' (taken off the shelves) or 'recalled' (when customers are asked to return the product). The Food Standards Agency issues Product Withdrawal Information Notices and Product Recall Information Notices to let consumers and local authorities know about problems associated with food. In some cases, a 'Food Alert for Action' is issued. This provides local authorities with details of specific action to be taken on behalf of consumers.
You can get FSA alerts about product recall and withdrawals either by email or SMS text. Visit the Get Alerts page at the link towards the bottom of this page to find out how.
You can also subscribe to our Really Simple Syndication (RSS) feed for food and allergy alerts. RSS is a format for distributing news content and is a simple way to keep up to date with the latest news on a website.
When we publish via RSS, you can automatically get the updated content via a 'news aggregator' or 'news reader'. Our RSS feed will contain a brief summary and link back to our web content. Click on 'What is RSS' on the left of this page for more details.
IRELAND: Largest outbreak in recent years linked to Salmonella on duck eggs
14.sep.10
FSAI
http://www.fsai.ie/14092010.html
The investigation into the current outbreak of Salmonella Typhimurium DT8 linked with the consumption of duck eggs is ongoing, with five new cases in August. This brings the total number of confirmed cases to date to 24 and it is now the largest food poisoning outbreak of salmonellosis recorded in recent years in Ireland. In light of this, the Food Safety Authority of Ireland (FSAI) today reiterated its advice on the safe consumption of duck eggs. The people infected have ranged from 5 months to 80 years of age. The latest cases tend to be linked with the consumption of duck eggs from small backyard flocks / private farms. The confirmed cases are nationwide. Hens eggs are not implicated in this outbreak.
The FSAI advises to only consume duck eggs that have been thoroughly cooked and to cease using raw duck eggs in any dishes that will not be cooked thoroughly prior to eating. It also cautions on the importance of good hygiene practices being followed, such as washing hands and preparation surfaces after handling or using duck eggs.
"We are advising caterers, retailers and consumers to treat duck eggs in the same way as they would raw chicken. We all know that we should never eat raw chicken. This is a risk that is well understood by everyone, both in term of ensuring it is cooked thoroughly and also by maintaining good hygiene practices, thereby preventing cross contamination between raw food and ready-to-eat food. However, people may have forgotten that duck eggs have been associated with Salmonella in the past and therefore, are not taking the correct precautions today. The fact that the outbreak is ongoing, underlines the huge importance attached to maintaining stringent hygiene practices when handling raw duck eggs. Even when duck eggs look clean, they may still have Salmonellae on the outside of the shell and sometimes carry it on the inside of the egg," said Prof Alan Reilly, Chief Executive, FSAI.
"The symptoms of Salmonella Typhimurium DT8 infection vary from mild discomfort due to vomiting and diarrhoea, to life threatening illness. Infants, pregnant women, the frail elderly and the sick are most at risk from food poisoning. Anyone who may have these symptoms and suspects it may have been from recently eating duck eggs should contact their doctor for advice," continued Prof Reilly.
The FSAI is working in collaboration with the Department of Agriculture, Fisheries and Food on control measures for commercial flocks and also smaller backyard flocks on private farms. A code of practice has been published for commercial flock owners and also guidelines have been published for producers of small quantities of duck eggs – backyard flocks. Work is also underway by Bord Bia to develop a new quality assurance scheme to ensure a safe source of duck eggs in the future.
The FSAI is continuing to work closely with the Health Protection Surveillance Centre; the Department of Agriculture, Fisheries and Food; and various local authorities to control this outbreak and to prevent further cases of illness.
How international co-operation curtailed a salmonella outbreak
14.sep.10
Health Protection Agency
http://www.hpa.org.uk/NewsCentre/NationalPressReleases/2010PressReleases/100914cooperationcurtailedsalmonellaoutbreak/
Contaminated eggs from a single flock of hens on a Spanish farm were implicated in an upsurge in Salmonella food poisoning notifications in England and Wales over a 16 week period between September and December 2009, delegates to the Health Protection Agency's annual conference - Health Protection 2010 - at the University of Warwick will hear.
Dr. Kulsum Janmohamed, one of the HPA's Public Health Registrars described the detective work, inter-agency and pan-European co-operation that identified and closed down the source of infection.
Presenting her report in the conference's Foodborne Illnesses Symposium, Dr. Janmohamed said: "We were notified about 16 local outbreaks and we tested samples, including egg samples, from these and from sporadic cases. We found that 489 people were infected with Salmonella Enteritidis phage type (PT) 14b. The strains were indistinguishable from egg isolates, suggesting that a single source of infection was likely.
"S. Enteritidis PT 14b with a similar resistance profile has historically been associated with contaminated eggs supplied to the catering sector.
"Epidemiological and microbiological investigations had linked the outbreaks to a number of different catering establishments and to a residential care home. A case-control study confirmed the hypothesis that the infections were linked to food eaten outside the home and to eggs that had been eaten within five days of the onset of symptoms."
Co-operation from egg wholesalers who had supplied restaurants associated with the outbreaks resulted in the identification of eggs that were contaminated with S. Enteritidis PT14b. These eggs had been sourced from a single flock on a Spanish farm.
"We notified the Food Standards Agency (FSA) of all our findings and the FSA in turn notified the European Commission. European authorities alerted the appropriate agencies in Spain and eggs from this source were withdrawn from the market. The European withdrawal of the implicated eggs resulted in our outbreak being contained and we saw a rapid decline in cases in England and Wales," Dr. Janmohamed said.
Justin McCracken, HPA's chief executive, said: "This was a massive investigation at local, national and international level. It's successful outcome was largely a result of successful working partnerships between the HPA's local specialists and their Environmental Health colleagues in local authorities, painstaking work in the laboratories, including the Agency's Salmonella Reference Laboratory, and support from the Food Standards Agency and other partners.
"It was important to alert health professionals and to give advice to the public. The HPA and the National Public Health Service for Wales alerted GPs and other professionals and enlisted their help in identifying new cases. Articles were published in the HPA's Health Protection Report. The FSA posted advice for the public on its website and several national newspapers published reports on the outbreak, all of which helped considerably with our investigation.
"The EEC and the Spanish authorities gave the issue the priority it deserved and their prompt action effectively removed a significant public health risk.
"An important lesson from this episode is that it is vitally important for caterers to heed the well established advice on the safe use of eggs."
U.S. Meat farmers brace for limits on antibiotics
14.sep.10
New York Times
Eric Eckholm
http://www.nytimes.com/2010/09/15/us/15farm.html?_r=1&partner=rss&emc=rss
RALSTON, Iowa -- Piglets hop, scurry and squeal their way to the far corner of the pen, eyeing an approaching human. "It shows that they're healthy animals," Craig Rowles, the owner of a large pork farm here, said with pride.
Mr. Rowles says he keeps his pigs fit by feeding them antibiotics for weeks after weaning, to ward off possible illness in that vulnerable period. And for months after that, he administers an antibiotic that promotes faster growth with less feed.
Dispensing antibiotics to healthy animals is routine on the large, concentrated farms that now dominate American agriculture. But the practice is increasingly condemned by medical experts who say it contributes to a growing scourge of modern medicine: the emergence of antibiotic-resistant bacteria, including dangerous E. coli strains that account for millions of bladder infections each year, as well as resistant types of salmonella and other microbes.
Now, after decades of debate, the Food and Drug Administration appears poised to issue its strongest guidelines on animal antibiotics yet, intended to reduce what it calls a clear risk to human health. They would end farm uses of the drugs simply to promote faster animal growth and call for tighter oversight by veterinarians.
The agency's final version is expected within months, and comes at a time when animal confinement methods, safety monitoring and other aspects of so-called factory farming are also under sharp attack. The federal proposal has struck a nerve among major livestock producers, who argue that a direct link between farms and human illness has not been proved. The producers are vigorously opposing it even as many medical and health experts call it too timid.
TEXAS: Beaumont restaurant inspection scores are in
13.sep.10
The Harbour
http://theharbour-beaumont.myaptportal.com/food/beaumont-restaurant-inspection-scores-are-in/
What's your favorite Beaumont restaurant? If you're anything like me, you love to eat out.
Beaumont has got a lot of great food options to offer the food lovers that are also very close to The Harbour Apartments.
The September Leger's Restaurant Report Cards are in. Find out how well your favorite local restaurant fared.
Paige Seafood, located less than 5 miles from home, scored an 86 with "bins and shelves in the kitchen needed cleaning, the facility not properly sanitized."
Gator's West, located less than 3 miles from our apartment home, also finished with a score of 86. The inspector "found mold in the ice machine, poor hygiene and improper sanitizing."
Gino's Restaurant, located less than 1 mile from The Harbour Apartments, also scored an 86 with "poor hygiene, poor general housekeeping and improper sanitizing and slight mold on soda nozzles. "
Your Team at The Harbour want you to be safe, wherever you're eating.
Bistro Lemonde, located just under 2 miles from our community, is the Blue Ribbon Award for Perfect Score from Beaumont Health Department, finishing with a 97.
And
Peking Chinese Restaurant, located under 2 miles from home, finished with a score of 100!
Eat fresh and eat well.
For the rest of the scores and reports from Ledger's Restaurant Report Card, check out the story from kfdm.com.
Observed hand cleanliness and other measures of handwashing behavior in rural Bangladesh
09.sep.10
BMC Public Health 2010, 10:545
Amal K Halder, Carole Tronchet, Shamima Akhter, Abbas Bhuiya, Richard Johnston and Stephen P Luby
http://www.biomedcentral.com/1471-2458/10/545/abstract
Background
We analyzed data from the baseline assessment of a large intervention project to describe typical handwashing practices in rural Bangladesh, and compare measures of hand cleanliness with household characteristics.
Methods
We randomly selected 100 villages from 36 districts in rural Bangladesh. Field workers identified 17 eligible households per village using systematic sampling. Field workers conducted 5-hour structured observations in 1000 households, and a cross-sectional assessment in 1692 households that included spot checks, an evaluation of hand cleanliness and a request that residents demonstrate their usual handwashing practices after defecation.
Results
Although 47% of caregivers reported and 51% demonstrated washing both hands with soap after defecation, in structured observation, only 33% of caregivers and 14% of all persons observed washed both hands with soap after defecation. Less than 1% used soap and water for handwashing before eating and/or feeding a child. More commonly people washed their hands only with water, 23% after defecation and 5% before eating. Spot checks during the cross sectional survey classified 930 caregivers (55%) and 453 children (28%) as having clean appearing hands. In multivariate analysis economic status and water available at handwashing locations were significantly associated with hand cleanliness among both caregivers and children.
Conclusions
A minority of rural Bangladeshi residents washed both hands with soap at key handwashing times, though rinsing hands with only water was more common. To realize the health benefits of handwashing, efforts to improve handwashing in these communities should target adding soap to current hand rinsing practices.
The epidemiology of infectious gastroenteritis related reactive arthritis in U.S. military personnel: a case-control study
13.sep.10
BMC Infectious Diseases 2010, 10:266
Jennifer A Curry, Mark S Riddle, Robert P Gormley, David R Tribble and Chad K Porter
http://www.biomedcentral.com/1471-2334/10/266/abstract
Background
Reactive arthritis (ReA) is a recognized sequela of infectious gastroenteritis (IGE). However, the population-based incidence of IGE-related ReA is poorly defined, and the risk of disease has not previously been characterized in a military population. The intent of this study was to provide estimates of the incidence and morbidity associated with IGE-related ReA in the U.S. military population.
Methods
Using active duty US military medical encounter data from the Defense Medical Surveillance System, we conducted a matched case-control study to assess the risk of ReA following IGE. Both specific and nonspecific case definitions were utilized to address ICD-9 coding limitations; these included specific ReA (Reiter's Disease or postdysenteric arthritis) and nonspecific arthritis/arthralgia (N.A.A) (which included several related arthropathy and arthralgia diagnoses). Incidence was estimated using events and the total number of active duty personnel for each year.
Results
506 cases of specific ReA were identified in active duty personnel between 1999 and 2007. Another 16,365 cases of N.A.A. were identified. Overall incidence was 4.1 (95% CI: 3.7, 4.5) and 132.0 (95% CI, 130.0-134.0) per 100,000 for specific ReA and N.A.A, respectively. Compared to the youngest age category, the incidence of both outcomes increased 7-fold with a concurrent increase in symptom duration for cases over the age of 40. Specific IGE exposures were documented in 1.4% of subjects. After adjusting for potential confounders, there was a significant association between IGE and ReA (specific reactive arthritis OR: 4.42, 95% CI: 2.24, 8.73; N.A.A OR: 1.76, 95% CI: 1.49, 2.07).
Conclusions
Reactive arthritis may be more common in military populations than previously described. The burden of ReA and strong association with antecedent IGE warrants continued IGE prevention efforts.
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