Food Poison Journal - Food poisoning outbreaks and litigation: surveillance and analysis

A worker at a Cheesecake Factory restaurant in east Phoenix was diagnosed with hepatitis A, and the Maricopa County Public Health Clinic is providing Immune Globulin (IG) shots for all patrons of the restaurant who may have been exposed to the hepatitis A virus after eating at Cheesecake Factory.  The clinic is located at 1645 E. Roosevelt St. in Phoenix. 

The Arizona Republic reported today that 150 people have received IG shots to prevent infection since the announcement that the worker had been diagnosed with hepatitis A.  From the article:

The sick person worked at the restaurant at 24th Street and Camelback Road. Some patrons may have been exposed, but the health department says the risk of exposure is low.

People who ate at the restaurant July 20 are being offered the shot. Information: (602) 747-7500.

Two Hawaii men have sought medical treatment after eating canned chili products contaminated with Clostridium botulinum, the bacterium that causes botulism.  Both men purchased Cattle Drive brand canned chili at Costco in Kahului, Maui, and one was hospitalized with suspected botulism.  The Centers for Disease Control and Prevention is running tests to determine whether the men did, in fact, have botulism. 

The Honolulu Advertiser reported on the first man's illness on Saturday:

[Jon] Stockton said he bought an eight-pack of Cattle Drive canned chili at Costco in Kahului three weeks ago. That was before manufacturer Castleberry's Food Co. of Augusta, Ga., and the federal Food and Drug Administration announced a voluntary product recall July 18 and an expanded recall last Saturday that included 88 canned meat products under various brand names and four varieties of canned dog food under the Natural Balance Eatables brand.

Stockton said he had heard about the recall but didn't realize he had bought one of the suspect brands of chili.

"I heard something about Castleberry but never connected it to Cattle Drive chili. I thought it was a different company," he said.

The Sunday edition of the Advertiser included a follow-up story, after a second man had been sought medical treatment at an emergency room for botulism.  The Advertiser by that time had reached a spokesperson for Costco, who provided an update on its involvement in the Castleberry's recall.

Costco stores nationwide pulled the Castleberry's products the same day the recall was announced, said Craig Wilson, the company's assistant vice president for food safety in Kirkland, Wash.

"The building on Maui pulled it, and everything was done on time," he said yesterday.

He said Costco is assisting the the investigation by the U.S. Centers for Disease Control and Prevention by tracking down Stockton's purchase and has identified 250,000 others who bought the canned food that was the subject of the recall and sent letters to those customers advising them to discard the items.

The second man diagnosed with botulism, Keith Regan, expressed the same concerns as Jon Stockton in an article for the Honolulu Star-Bulletin:  Consumers are not aware that Castleberry's makes a number of brands of chili products, so were not aware that the products they had purchased were contaminated or were subject to recall.

On Friday, Keith Regan, 35, checked into the Maui Memorial Medical Center, where he was told that he has a mild case of botulism. He was released that afternoon.

"It's kind of a shock," he said. "I just wish there'd been more warnings with the (food) labels that are familiar to us in Hawaii."

Regan, of Wailuku, last ate a can of Cattle Drive chili on July 20, a day before the chili maker, Castleberry's Food Co., recalled more than 90 brands of chili, stew and other food products that could contain the poisonous bacteria.

Forbes.com carried a story written by Associated Press reporter Andrew Bridges, published today, that warns consumers - again - to throw out canned Castleberry's products.  It is a message that Public health officials have used repeatedly since discovering Castleberry's products were contaminated with Clostridium botulinum, the bacterium that causes botulism.

"We're not talking here about a bug that lands you in the bathroom for a few days with diarrhea. We're talking about a toxin that puts you in the intensive care unit," said Dr. David Acheson, the FDA's lead food safety expert. "This is foodborne illness with an extra kick in it, big time."

Public health officials are even more concerned than ever, though, now that cans of Castleberry's products have begun exploding.  Bridges wrote:

Cans of recalled food are bursting, swollen with bacteria that cause botulism.

The bursting cans were among those being held by Castleberry's Food Co., which last week announced a massive recall that now includes more than 90 potentially contaminated products, including chili sauces and dog foods.

News about the bursting cans gives new urgency to warnings from federal health officials to get rid of the recalled cans from pantries and store shelves.

Spot checks by the Food and Drug Administration and state officials are turning up recalled products for sale in convenience stores, gas stations and family-run groceries.

On July 18, 2007, the Food and Drug Administration and United States Department of Agriculture (USDA) announced that Castleberry's Food Company was recalling multiple products with "best by" dates from April 20, 2009 - May 22, 2009 due possible botulism contamination. The two agencies warned consumers to throw away the product due to the health risks of botulism poisoning, which can lead to paralysis and death. In its botulism recall announcement, FDA stated that two children in Texas and an Indiana couple who ate Castleberry products had been hospitalized with botulism poisoning.

• July 18 FDA Recall Announcement
• July 18 USDA Recall Announcement

On July 21, USDA announced that Castleberry's was expanding its recall of products that fell under the agency's jurisdiction, and on July 23, FDA announced that Castleberry's was expanding its botulism recall of products under that agency's jurisdiction, as well. The expanded recall notices are available here:

• July 23 FDA Botulism Recall Announcement
• July 21 USDA Botulism Recall Announcement

A New York Times editorial from today begins:

President Bush took a potentially useful step last week, appointing a cabinet-level committee to find ways to ensure the safety of imported food and other products. But his actions would be a lot more credible if the administration had not been cutting the staff and budget of food safety programs at the Food and Drug Administration while also planning to eliminate half of the agency’s laboratories.

Hearings before a House oversight subcommittee raised serious questions about the F.D.A.’s ability to protect the public against contaminated or adulterated foods. William Hubbard, a former top agency official who consults for a coalition of industry and consumer groups, told the committee that the F.D.A. has lost some 200 food scientists and 700 field inspectors over five years, exactly the wrong direction when food imports are skyrocketing. He also noted that the small budget increase the White House has proposed for food safety next year would be a decrease after accounting for inflation.

Details behind the potential closure of food testing laboratories and inspections of imported foods are further discussed in the editorial, which is titled:  Is It Safe to Eat?
Increasing fears over foods imported from China and other countries, and the FDA's assertions that only one percent of food imports are inspected every year are major concerns surrounding the safety of the American food supply.  And it's not just the federal government and food safety advocates who are speaking up about their issues with the safety of the American food supply.  Bill Marler posted the following email he received from a client who became ill after eating E. coli-contaminated spinach on his blog recently:

Please pass this on: I am 55 years old and having been married for 37 years, so I have been grocery shopping for at least that long. I got sick from spinach; last month I opened a can of Geisha brand peaches (from China but distributed from New York) only to find a dead fly in the can; and this past week I purchased 2 cans of Castleberry's hot dog chili sauce distributed from Augusta, GA that have been recalled. Am I being paranoid or is someone out there trying to kill Americans with the food chain, or just me in particular? What's going on here and how can we protect ourselves other than reverting back to growing our own food. I know growing up if we didn't shoot it, reel it in or grow it, we didn't eat it (ie; deer meat, fish (lots & lots of fish) and fresh vegetables & fruits grown by family members.) What's going on here with the food chain is scaring the h_ _ _ out of me. Too many things happening in a very short time frame to me.

Castleberry’s Food Company today announced that it is taking extra steps to ensure public safety by voluntarily expanding its recall originally announced on July 18 due to the risk of botulinum toxin, a bacterium which can cause botulism.  The recall originally announced on July 18 affected only 10 products with ‘best by’ dates from APR30 2009 through MAY22 2009. The extended recall now includes the following canned products in the following sizes with all ‘best by’ and code dates:

Austex Onion Hot Dog Chili Sauce, 10 oz can (UPC 3030097101)
Austex Hot Dog Chili Sauce, 10 oz can (UPC 3030099533)
Austex Beef Stew, 15 oz can (UPC 3030090815)