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Regulation 2017/625 allows and encourages the use of rating schemes as a means to increase transparency in the agri-food chain. Since its implementation, a need for greater fairness, consistency, transparency, and objectivity in official controls has been reported by member states. The present study compares the results of inspection activity concerning food hygiene principles in ethnic and traditional butcheries. The sample consists of 50 food business activities randomly selected from traditional and ethnic butcheries subject to official control in Turin from January to June 2019. Our two objectives were to evaluate the degree of awareness and training of food business operators (FBOs) and to compare the written records drawn up by the competent authorities (CAs) during official inspections to evaluate their completeness and uniformity. The presence of old equipment is a common finding in both traditional and ethnic butchers. This could lead to ineffective cleaning operations and inappropriate functioning, which in turn could lead to a dangerous loss of control over products’ temperatures. Ethnic butchers showed a higher number of non-compliances for documentary examination, the presence/correctness of self-control plans, and management aspects such as by-product disposal and personnel hygiene. Training is the key point for both CAs and FBOs; inspectors must maintain their professionalism but also adhere to harmonized and intellectually supported criteria, and FBOs must prevent improper behavior. Eventually, we propose strategies to increase the efficacy and homogeneity of records, together with suggestions on how to implement training both for consultants and operators.

Early diagnosis of coronavirus disease 2019 (COVID-19) is crucial to early treatment and quarantine measures. In this narrative review, diagnostic tools for COVID-19 diagnosis and their main critical issues were reviewed. The COVID-19 real-time reverse transcriptase-polymerase chain reaction (RT-PCR) test is considered the gold standard test for the qualitative and quantitative detection of viral nucleic acid. In contrast, tests can be used for epidemiological surveys on specific communities, including occupational cohorts, but not for clinical diagnosis as a substitute for swab tests. Computed tomography (CT) scans can be useful for the clinical diagnosis of COVID-19, especially in symptomatic cases. The imaging features of COVID-19 are diverse and depend on the stage of infection after the onset of symptoms. CT sensitivity seems to be higher in patients with positive RT-PCR. Conventional chest sensitivity shows a lower sensitivity. An important diagnostic screening tool is ultrasounds, whose specificity and sensitivity depend on disease severity, patient weight, and operator skills. Nevertheless, ultrasounds could be useful as a screening tool in combination with clinical features and molecular testing to monitor disease progression. Clinical symptoms and non-specific laboratory findings may be useful if used in combination with RT-PCR test and CT-scanning.

The sanitary survey is aimed at classifying and monitoring the production areas of live bivalve molluscs (LBM) and it is performed using standards that are provided by the Centre for Environment, Fisheries and Aquaculture Science’s Guide to Good Practice. In this study, data from the sanitary survey carried out by the Asl5 Spezzino on the production areas of the gulf of La Spezia during the period 2015-2017 were analysed. The number and type of the analysis performed both on the total sampling and on the individual target species, as well as the number and type of found non-compliance (assessed on both mandatory parameters and on parameters fixed by the local monitoring plan) were considered. Data were also compared with those from the sanitary survey 2012-2014. Appropriate statistic tests were used to evaluate data from E. coli and Norovirus monitoring. Overall, 4306 analysis were performed, especially on the species M. galloprovincialis (89%) and they were mostly focused on to the search of biological agents. 160 NC were detected. Most of the NC concerns the Norovirus’s positivity (93.75%) in M. galloprovincialis and C. gigas. A correlation between the levels of E. coli and rainfall/ seasonality (higher levels in the colder months) was proved, especially in the sampling points located in the inner part of the dam and in the Portovenere Bay. Class B was reconfirmed for M. galloprovincialis, the production areas of C. gigas were reclassified as A and those of V. verrucosa were definitively closed. The sanitary survey was therefore confirmed as a useful tool for reclassification and for monitoring LBM production areas.

We present here the case of a 30-year-old man with a long term history of nephrotic syndrome (NS) who developed an episode of acute left main pulmonary artery thrombosis complicated by a lung abscess. During the hospital admission was also identified a concomitant hyperhomocysteinemia. After an atypical resection of the left upper pulmonary lobe and the starting of long term anticoagulation the patient was discharged but did not attend the planned follow up visits until one year later when he was seen again for severe dyspnea and exercise intolerance. At this time chronic thromboembolic pulmonary hypertension (CTEPH) was diagnosed by lung perfusion scintigraphy and right heart catheterization. He initially refused the surgical treatment but, after six months, for the presence of worsening dyspnea was referred for bilateral pulmonary endarterectomy followed by a cardio-thoracic rehabilitation program. After a follow-up of seven years the patient is alive and in stable conditions. NS and hyperhomocysteinemia are both known risk factors for pulmonary embolism (PE), but their association with CTEPH is extremely rare. We discuss here the possible mechanisms linking these conditions. CTEPH must be suspected in any patient with NS, with or without hyperhomocysteinemia, and unexplained dyspnea.

Hypomagnesemia is defined by having a serum magnesium level of less than 1.7 mg/dL. The magnesium balance is tightly regulated by the concerted actions of the intestine, bone and kidneys. This balance can be disturbed by a wide variety of drugs. Recently, we observed a case of severe hypomagnesemia caused by proton pump inhibitor therapy. We conducted a retrospective study of an intrahospital population to evaluate the prevalence of hypomagnesemia and the relationship with associated drugs. Among 181 patients with hypomagnesemia only 29 were found to have hypomagnesemia with specific causes, such as chronic diarrhea, vomiting, and so on. In the remaining patients, 120 have taken proton pump inhibitors and/or diuretics and/or metformin. Clinicians should consider proton pump inhibitors as a possible causative agent when investigating hypomagnesemia and they should be especially attentive with patients who take proton pump inhibitors, especially in cases of long-term therapy (≥1 year) and/or concomitant administration of other agents that may lower magnesium levels (e.g., diuretics or metformin).

This communication reports the results of audit activity on a number of food processing plants pertaining to ASLTO5. The activities, undertaken between 2008 and 2010, are related to an audit programme planning, implemented with 2 official controls for each plant, in 48 premises recognized under the Regulation (CE) 854/2004, among those, 34 processing plants (cutting and processing of food of animal origin) and 14 abattoirs. Data included in audit reports have been analyzed with Excel software, classifying detected non compliances (n.c.) in 8 categories linked to specific food safety risk factors (structure, operative hygiene, personnel hygiene, pest control, temperature control, management of by-products, traceability, HACCP/records). By the time of the audit 83% of the inspected premises showed structural n.c.; structural aspects are the most critical point (121 n.c. out of 264), followed by operative hygiene (25% of total n.c.) and pest control (13.6%). By the time of the second audit series, however, occurred a significant reduction of n.c. in both processing plants and abattoirs, falling from 264 to152, with a reduction of n.c. detection of more than 40%. The best response capacity among operators is related to pest control and HACCP plan/records. The audit procedure implemented, a part from providing a comprehensive and objective evaluation method of the food safety management system put in place by the operators, allowed, if compared to former procedures, a more objective and comprehensive evaluation of the n.c. trend and therefore of the food safety risk factors, estimating the efficacy of the control activity.

This study was aimed at collecting data on presence, dissemination and persistence of Pseudomonas in small-scale dairy farms. Six farms (located in Piedmont) were visited three times over 2014: 116 waters (wells and different faucets/pipes) and 117 environmental samples (milking equipments and drains) were collected. Enumeration of Pseudomonadaceae was performed, 3-5 colonies/samples were selected for identification via 16SrDNA/oprI polymerase chain reaction (PCR), and typed by enterobacterial-repetitive- intergenic-consensus (ERIC)-PCR. Pseudomonadaceae were detected in 77% of samples. No statistical differences were found among proportions of positives across farms, sample typologies and seasons. Most isolates were Pseudomonas fluorescens (45%), and ERIC-PCR showed 32 persistent types diffused across farms. All in all, Pseudomonas spp. represents a challenge, considering its presence over time in water as well as in teat cups, indicating a continuous source of contamination. Moreover, persistency of strains may indicate biofilm-formation and/or sanitisers resistance, therefore emphasising the role of primary production for preventing milk contamination by Pseudomonas spp.

The research was aimed at collecting information on food safety knowledge by operators of small and less developed food businesses. This will allow to reveal what are the real drawbacks in HACCP application in these realities. Fifty meat producing plants located in Piedmont region were involved. In all the plants a questionnaire with questions on HACCP system was submitted. The analysis of the collected answers, evidenced that 42% of the operators needed to perform structural modifications in order to address the HACCP measures, whereas 40% applied modifications in working procedures. The most frequent shortcoming (44% of the answers) of the HACCP system was represented by the applicability of Good Manufacturing Practices, and the most difficult control measure to be applied was the prevention of the cross-contaminations (40% of the answers). The information gathered within this project allowed to evidence the real needs of the micro businesses in the application of HACCP plan. These results can be useful for the institutions, which could elaborate HACCP alternative systems, able to better fulfil food safety requirements and Food Business Operator needs.

Considering that Listeria monocytogenes represents a concern in the production of Gorgonzola PDO cheese, this study was aimed to investigate the presence of Listeria along one Gorgonzola PDO production chain. L. monocytogenes subtype diversity was also investigated in order to identify possible reservoirs and dissemination routes. One dairy plant and its conferring farms (N=20) were selected and samples were collected in 4 visits in order to investigate seasonal variability. In each of them, producer tank milk (N=80), Gorgonzola producer tanks (N=12), Gorgonzola producer environmental samples (N=108) were collected, for a total of 200 samples. L. innocua was isolated from 3 milk samples (4%); L. monocytogenes alone was detected in 3 environmental samples (16%) and L. innocua in 11 (58%). Both species were present in 5 samples. All Listeria strains isolated were typed through ERIC and REP PCRs. For each samples, if possible 5 colonies were selected for typing, for a total of 76 isolates. The analyses allowed the differentiation of L. monocytogenes and L. innocua in 9 and 7 PCR profiles (P), respectively. The former showed an overall similarity value of 75% and the latter of 81%. P1 (N=3) of L. monocytogenes was present in multiple sources (ripening surfaces and salting equipment) and P5 (N=6) in different sampling rounds (January and June 2009). P1 (N=25) and P2 (N=15) of L. innocua were found in multiple sources (performing equipment, ripening surfaces, salting equipment, moving carts) and in multiple sample rounds (P1: May 2008, January and June 2009; P2: June and October 2009). The presence of a few highly similar strains of L. monocytogenes in the production chain, as suggested by the profiles retrieved from different sources/sampling rounds, indicates the presence of persistent and niche-adapted strains. However, no profile was shared between raw milk and environmental samples, suggesting that the plant environment, not the incoming raw milk, is the source of strains contaminating Gorgonzola cheese.

Ready to use fresh sauces are among Ready to Eat foods for which producers need to respect the 100 UFC/g limit for the presence of L. monocytogenes. In the current research a Challenge test was performed on fresh mushroom and cheese sauces. Both were placed at two storage temperatures and the L. monocytogenes potential growth (d) was evaluated. Only cheese sauce stored at 8°C showed a δ> 0,5 log10 UFC/g. However, considering the limited initial contamination it can be excluded that the product could reach 100 UFC/g by the expiration date.

During 2010 many cases of discoloration in mozzarella, popularly termed as blue mozzarella, have been reported to the attention of public opinion. Causes of the alteration were bacteria belonging to the genus Pseudomonas. The strong media impact of such cases has created confusion, not only among consumers, but also among experts. In order to help improving the knowledge on microbial ecology of this microorganism a study has been set up with the collaboration of a medium-sized dairy plant producing fresh mozzarella cheese, with occasional blue discoloration, conducting surveys and sampling in the pre-operational, operational and post-operational process phase, milk before and after pasteurization, water (n=12), environmental surfaces (n=22) and the air (n=27). A shelf life test was conducted on finished products stored at different temperatures (4-8°C). Among the isolates obtained from the microbiological analysis of the samples, 60 were subjected to biomolecular tests in order to confirm the belonging to Pseudomonas genus and to get an identification at species level by the amplification and sequencing of the gyrB gene. The results of microbiological tests demonstrated the presence of microorganisms belonging to the genus Pseudomonas along the entire production lane; molecular tests showed 7 different species among the 40 isolates identified. One particular species (Pseudomonas koreensis) was isolated from blue discolored mozzarella cheese and was indicated as the most relevant for the production plant, both for the distribution along the processing chain and for the consequences on the finished product.

The ability of Listeria monocytogenes to survive in different environments and establish persistent contaminations is an important issue for food producers. This study aimed to assess the environmental contamination level in an Italian salami producing plant and to identify possible sources of contamination using pulsed field gel electrophoresis (PFGE) on L. monocytogenes isolates obtained from environmental (n=54) and meat samples (n=9) collected over 9 months. Detection of L. monocytogenes was performed using the UNI EN ISO 11290-1 procedure and every isolate was characterised with PFGE, using AscI and ApaI restriction enzymes. The environmental detection frequencies were constant both in the first (22%) and the second (27%) visit, thus suggesting the presence of strains adapted to the processing plant. Equipments can represent a reservoir of L. monocytogenes from which it can spread into the whole producing plant. The reservoir was documented by PFGE results which showed several persistent strains. Moreover, PFGE proved the cross-contamination between surfaces and semiprocessed products like pastes, which furthermore have been contaminated by L. monocytogenes in 100% of samples in the first two visits and in 33% in the last visit. This study gave evidence that detection methods and PFGE characterisation can be effective tools to detect possible sources and routes of contamination.

This study was aimed at investigating the knowledge of pregnant women on food safety with particular attention to the effectiveness of the informative material (pamphlet and poster) prepared in a previous study. To this scope, a questionnaire composed by 8 questions (Likert scaled) was used except for one which was a Y/N question. Themes of the questionnaire were: level of concerns on food safety, and knowledge on foodborne diseases (salomonellosis, toxoplasmosis and listeriosis), risk factors and preventive measures. Results indicate that knowledge increased in respect to that of the previous study, but in relation to informative material previously distributed.

Consumers nowadays play a critical role in the prevention of food poisoning. For this reason, the present research was planned to collect data on how aware about food safety consumers are. A questionnaire considering food labelling, hygiene, transport, storage, preparation and kitchen hygiene was designed and submitted to consumers (health district ASL TO5). After questionnaire analysis, a training course was prepared to address specific problems. Kitchens of consentient participants were visited and data on hygiene (check-lists, samples from equipment and fridge surfaces), and fridge temperatures were collected. Questionnaires showed a lack of knowledge on correct food storage, handling, and kitchen hygiene. Households visits showed fridge temperatures above 4°C, highly contaminated washing sponges, and the presence of Listeria spp. in a fridge of a high risk consumer. These results evidence the role of consumer training in reducing foodborne diseases incidence.