Four hundred samples of milk and milk products were obtained over a 5-month period from different retail outlets in Madison, Wisconsin, and were examined for presence and number of Bacillus cereus. B. cereus was isolated from 9,35, 14 and 48% of raw milk, pasteurized milk, Cheddar cheese and ice cream samples, respectively. No. B. cereus was recovered from yogurt. The level of contamination with B. cereus did not exceed 100/ml in raw milk, 1000/ml in pasteurized milk, 200/g in Cheddar cheese and 3800/g in ice cream.

Background The Syrian conflict has produced one of the largest refugee crises in modern times. Lebanon has taken in more Syrian refugees per capita than any other nation. We aimed to study the burden of surgical disease and access to surgical care among Syrian refugees in Lebanon. Methods This study was designed as a convenient cross-sectional cluster-based population survey of all refugee camps throughout the Bekaa region of Lebanon. We used a modified version of the Surgeons OverSeas Assessment of Surgical Need to identify surgical conditions and barriers to care access. The head of household of each informal tented settlement provided demographic information after which two household members were randomly chosen and administered the survey. Results A total of 1,500 individuals from 750 households representing 21 camps were surveyed. Respondents had a mean age of 36.6 (15.0) years, 54.6% were female, and 59% were illiterate. Nearly 25% of respondents reported at least one surgical condition within the past year, most commonly involving the face, head, and neck region (32%) and extremities (22%). Less than 20% of patients with a surgical condition reported seeing any healthcare provider, > 75% due to financial hardship. Conclusions The prevalence of surgical disease among Syrian refugees is very high with a fourth of refugees suffering from one or more surgical conditions over the past year. The surgical needs of this vulnerable population are largely unmet as financial reasons prevent patients from seeking care. Local and humanitarian efforts need to include increased access to surgical care.

Two lots of yogurt were prepared to contain two different strains of Yersinia enterocolitica (E675 serotype 0:3 and 2653 serotype 0:8) at an initial inoculum of 2 × 106 cells/ml, and then were refrigerated at 5±1°C for 7 d. Numbers of Y. enterocolitica, as well as pH value of yogurt were determined every 24 h. Y. enterocolitica survived until the end of the week at a population of 8,000 and 10,000 cells/ml for each strain, respectively. The pH value of yogurt decreased sharply from 6.3 to 4.5 by the end of preparation, and a low value of 4.2 was reached at the end of refrigerated storage.

Raw milk (100 samples) and pasteurized milk (100 samples) were assayed for presence of Yersinia enterocolitica, using four different enrichment and post-enrichment techniques. Isolation of Y. enterocolitica was made on MacConkey agar and Cefsulodin-Irgasan-Novobiocin (CIN) agar directly from incubated broths containing the milk, and after treatment of enrichment broths with a potassium hydroxide solution. Twelve samples of raw milk and one of pasteurized milk contained Y. enterocolitica. Nearly all isolates were found after KOH treatment. All isolates except that obtained from the pasteurized milk sample produced detectable levels of heat-stable enterotoxin. However, none of the 13 isolates agglutinated in WA-SAA, an antiserum specific for virulent Y. enterocolitica.

Domiati cheese was prepared from unsalted raw milk and from raw milk with 5 or 10% added sodium chloride, Milks were inoculated with enterotoxigenic Staphylococcus aureus strain 100 (produces enterotoxin A) before addition of salt and rennet. Cheeses were stored in whey containing 15% sodium chloride; were held at 30°C and were examined periodically for S. aureus count, aerobic plate count, DNase and moisture and salt contents. Numbers of S. aureus increased rapidly during preparation of cheese. There was a rapid decrease in number of viable S. aureus during storage of cheese made from unsalted milk and cheese made from milk with 5% added salt. In cheese from milk with 10% added salt, S. aureus survived until the fourth week. An increase in salt content and a decrease in the pH value of all cheeses occurred during storage in salted whey. DNase was detected only in cheese made from salted milk, but these samples did not contain a detectable amount of staphylococcal enterotoxin either after cheeses were made or after they were stored for 1 week.