Do Not Eat Tomalley In Maine Lobsters, Warns FDA

Just in time to ruin your summer vacation to Bar Harbor and other locations on the beautiful Maine coast comes this warning from our friends at the U.S. Food & Drug Administration (FDA):

Avoid eating tomalley in American Lobster (Maine Lobster), regardless of where the lobster was harvested, because of potential contamination with dangerous levels of the toxins that cause Paralytic Shellfish Poisoning (PSP).

American lobster, also known as Maine lobster, are harvested from the waters of the Atlantic Ocean from Northeastern Canada to South Carolina, inclusive.

The FDA advisory applies only to tomalley, the soft, green substance found in the body cavity of the lobster that functions as the liver and pancreas. Cooking does not eliminate the PSP toxins. However, studies have shown that, even when high levels of PSP toxins are present in lobster tomalley, lobster meat itself is typically unaffected.

Symptoms of PSP include tingling and/or numbness of the mouth, face or neck; muscle weakness; headache; and nausea. In extreme cases, when large amounts of the toxin are consumed, these symptoms can lead to respiratory failure and death. Symptoms usually occur within two hours of exposure to the toxin. Anyone experiencing these symptoms should seek medical attention.

For more, go to the FDA here.

Food Safety in the United States - A Letter to Congress

Here is a letter that I sent to all members of the US Senate and House Agriculture Committees

RE: Food Safety in the United States

Dear U.S. Congress Member:

I am writing to you because the American people are losing confidence in the U.S. government’s ability to keep our food supply safe.

As you know, there is presently an outbreak of a Salmonella strain known as Saintpaul that has made more than 1,250 people sick in forty-three states, put 228 in hospitals, and contributed to the deaths of two elderly men. It is the largest fresh produce outbreak in two decades. The source of the outbreak remains, in part, a mystery. A two-month-long federal investigation has been able to tell us only that jalapeño peppers (and possibly tomatoes and cilantro) are causing part of the outbreak.

However, the present multi-state E. coli O157:H7 outbreak is even more dangerous and demands the Agriculture Committee’s full attention. Omaha’s Nebraska Beef Ltd. has spread E. coli contaminated beef across the country to its various suppliers, all under the guise that existing USDA policy supposedly states that it is all right to sell tainted meat as long as it was ‘intact’ when it left the plant. So far, there are nearly sixty ill in Michigan, Utah, Georgia, New York, Indiana and Ohio. Some women in Georgia and Michigan have been in the hospital for over a month. 5.3 million pounds of meat has been recalled.

From 2003 until 2007, E. coli illnesses from fresh produce - spinach, lettuce, and sprouts - dominated my practice. After ConAgra recalled 19.3 million pounds of hamburger in 2002, I thought that E. coli in beef had been brought under control. In 2006, federal recalls involved just 181,000 pounds of meat, down from 23 million pounds in 2002. However, since the spring of 2007, we’ve seen an explosion of nearly 40 million pounds of beef recalled because it was contaminated with E. coli O157:H7. That’s nearly twenty thousand tons. Hundreds have been sickened and I am back in the beef business.

I fear we are at a tipping point. If this situation is allowed to further deteriorate, the public harm is going to be immeasurable – both in terms of lives damaged and businesses lost.

After the 1993 Jack-in-the-Box outbreak that killed four children and sickened nearly 700 in several states, the Food Safety & Inspection Service responded by creating and aggressively enforcing the Mandatory Risk Management System. Based on the research and practices of the U. S. space program, the new risk management system established check points at every phase of meat processing. And more importantly, the presence of E. coli was defined as an adulterant under the Federal Meat Inspection Act. It took years for those changes to be adopted and accepted, but progress - significant progress - was made. Until the spring of 2007, E. coli-related illnesses were falling and recalls became a rarity.

We need immediate and aggressive Congressional oversight and support of the Food Safety & Inspection Service of USDA, the U.S. Food and Drug Administration, and the Centers for Disease Control. Here are my suggestions for where Congress should focus its efforts:

Improve disease-surveillance so that we can better identify and trace what foods are making people sick. The frontlines of the medical community need to be encouraged to routinely test for foodborne pathogens and promptly report findings to local and state health departments and the CDC.

Government agencies, at all levels, need to learn to “play well together.” Turf battles like those we see between state health departments and the USDA need to stop so we can track illness to its source. Without effective traceback, companies are not held responsible, and thus have no incentive to stop selling tainted food.

Increase inspections. While domestic production remains a problem, imports pose an increasing risk, especially if terrorists get into the act. Food must be inspected before it enters our country, and we need more inspectors, better technology, and better training to do this effectively.

Reform federal, state and local agencies to be more proactive, and less reactive. This will require agencies to be properly funded, and also held accountable.

Modernize food safety statutes by replacing the present conflicting laws and regulations with one uniform food safety law that puts public safety first.

Increase legal consequences for causing foodborne illness and death. We don’t need to impose the death penalty, as China did recently. But we should impose serious consequences for companies who don’t do enough to keep their products safe, especially if they are repeat-offenders.

Use advanced technology to make food traceable from farm-to-table. Then, when an outbreak occurs, authorities can quickly identify the source, limit the numbers of people injured or killed, and stop the disruption to our economy.

Promote university research to develop better technologies to make food safe, and for testing foods for contamination.

Provide economic incentives, like tax breaks, to companies that push food safety, and invest in research and training.

Improve consumer understanding of the risks of food-borne illness.

I hope that you will act upon these recommendations. The 76 million Americans who suffer from food-borne illnesses annually—including 325,000 who require hospitalization, and the families of the 5,000 who die—would all be grateful.

Sincerely,

William D. Marler

E. coli O157:H7 is a powerful and deadly bacterium

You cannot see it, taste it, or smell it. 250,000 E. coli O157:H7 (E. coli) bacteria will fit on the head of a pin. Ten to 50 will kill your child or your grandmother.

More likely due the expertise of Children’s Hospitals, and other top medical centers around the country, deaths at times are avoided, however, often not before Hemolytic Uremic Syndrome (HUS) nearly kills. HUS, a complication from an E. coli infection, can cause severe damage to kidneys, intestines, and pancreas. Falling into a coma and suffering further from cognitive impairment are all too common.

I’ve seen the inside of too many of those Intensive Care Units with families who are scared senseless as they watch their children or mother shutdown. For 15 years, this has been my world. When I was an undergraduate, I read Upton Sinclair’s, The Jungle. That book took the American public on a tour of the contaminated underbelly of the meat industry and they were sickened. It led to the Pure Food & Drug Act and the Federal Meat Inspection Act, versions of which are still in place today.

Until 1993, I thought—because of those laws—that the United States had a safe and secure food supply. But, then came the Jack-in-the-Box E. coli outbreak. It killed four, and sickened hundreds, including many who were gravely ill with HUS and related complications. Many of those victims became my clients.

Once again, there was a public outcry for safe meat. The Food Safety & Inspection Service responded by creating and aggressively enforcing the Mandatory Risk Management System. Based on research and practices of the U.S. Space Program, the risk management system established checkpoints at every phase of meat processing.

The presence of E. coli was defined as an adulterant under the Federal Meat Inspection Act. I continued to sue “Big Meat” as most of my clients up to 2002 were children who were made sick by eating E. coli contaminated meat. I recovered over $350 million during this period from the meat industry and the restaurants they supplied in verdicts and settlements on behalf of those clients. In 2003 recalls of meat laced with E. coli began to decline. After 24 million pounds of contaminated beef were recalled in 34 separate incidents in 2002, recalls dropped off to just over a million pounds a year for the next three years, and then to just 181,900 pounds in 2006. The Centers of Disease Control and Prevention saw E. coli – related illnesses drop 48%.

But then came Spring 2007. E. coli, which begins its life in the hindgut of a cow, mounted a surge on its home court. And, it came back with a vengeance. Thirty-three million pounds of beef would be recalled in 22 incidents. All over the country, slaughterhouses, packing and distribution centers, retail outlets, and restaurants were once again testing positive for E. coli and people-mostly children-were getting seriously sick.

The American meat supply, which had again been touted as safest in the world, tumbled back into disarray. But, why?

As with any unexplained mystery, theories abound. Could it really just be meat industry complacency? Did everyone respond to the good numbers in 2006 by taking a long nap? Did meat processors slack off—consciously or unconsciously—and relax their testing procedures?

Or could it be better reporting? Doctors are more aware of E. coli now, and perhaps when patients present symptoms of food poisoning; tests are more likely to be ordered. When the presence of E coli is found and reported, a recall is triggered.

There’s always global warming. Seriously though – very smart people have posited that droughts in the southeast and southwest have launched more fecal dust into the air, which then finds its way into beef slaughtering plants. It has also been suggested that the deluging rainfall in other areas created muddy pens—an ideal environment for E. coli.

While we’re at it, why not blame high oil prices? High gas prices have fueled (sorry) the growth of ethanol plants. These plants are often built next to feedlots, and a byproduct of the ethanol production process—distiller’s grains—is considered an excellent (and cheap) alternative to corn for cattle feed. Unfortunately, research at Kansas State University associates the use of distiller’s grains as feed with an increase in the incidence of E. coli in the hindguts of cattle.

Another controversial issue may affect the meat supply. The New York Times reported that immigration officials began a crackdown at slaughterhouses across the country in the fall of 2006. Experienced—albeit undocumented—workers have been cleared out and replaced with unskilled, inexperienced labor.

And then there’s Darwin. Another theory holds that interventions have caused the wily E. coli microbes to adapt, selecting pathogens that are more resistant to detection or intervention. E. coli back in our meat cannot be tolerated. We’ve got a lot of summer of 2008 left. Summer has always been kind to the E. coli bug. More than 5.6 million pounds of E. coli contaminated beef has been recalled so far in 2008, most supplied by Nebraska Beef Ltd., via the Kroger Grocery chain. All of which is responsible for a multi-state outbreak of E. coli that again is filling up the ICU’s in Hospitals in the seven states.

What is being done? Not much.

Congress has held some hearings, but the only new reform is that the names of retail stores that received meat and poultry involved in recalls with high health risk will be made public. Good as far as it goes.

However, despite 76,000,000 American’s being sickened, 325,000 hospitalized and 5,000 deaths each year, food safety has not made it as a Presidential campaign issue. Congress, Democrats and Republicans, have about run out its clock. But E. coli is back in our meat and we better care.

Solutions?

Might I suggest:

* Improve surveillance of bacterial and viral diseases. First responders - ER physicians and local doctors - need to be encouraged to test for pathogens and report findings directly to local and state health departments and the CDC promptly. Right now, for every person counted in an outbreak there are some 20 to 40 times those that are sick but never tested. The more we test, the quicker we know we have an outbreak and the quicker it can be stopped.

* These same governmental departments, whether local, state or federal, need to learn to “play well together.” Turf battles need to take a back seat to stopping an outbreak and tracking it to its source. That means resources need to be provided and coordination encouraged so illnesses can be promptly stopped and the offending producer - not an entire industry - are brought to heal.

* Require real training and certification of food handlers at restaurants and grocery stores. There also should be incentives for ill employees not to come to work when ill. We should impose fines and penalties on employers who do not cooperate.

* Stiffen license requirements for large farm, retail and wholesale food outlets, so that nobody gets a license until they and their employees have shown they understand the hazards and how to avoid them.

* Increase food inspections. While domestic production has continued to be a problem, imports pose an increasing risk, especially if terrorists were to get into the act. Points of export and entry are a logical place to step up monitoring. We need more inspectors - domestically and abroad - and we need to require that they receive the training in how to identify and control hazards.

* Reorganize federal, state and local food safety agencies to increase cooperation and reduce wasteful overlap and conflicts. Reform federal, state and local agencies to make them more proactive, and less reactive. This too requires financial resources and accountability. We also need to modernize food safety statutes by replacing the existing collection of often conflicting laws and regulation with one uniform food safety law of the highest standard.

* There are too few legal consequences for sickening or killing customers by selling contaminated food. We should impose stiff fines, and even prison sentences for violators, and even stiffer penalties for repeat violators.

* We need to use our technology to make food more traceable so that when an outbreak occurs authorities can quickly identify the source and limit the spread of the contamination and stop the disruption to the economy. When I buy a book on line I can track it all the way to my mailbox. However, we have yet to find the source of a tomato (or salsa) outbreak after months of sickening hundreds.

* Promote university research to develop better technologies to make food safe and for testing foods for contamination. Provide tax breaks for companies that push food safety research and employee training. Greatly expand irradiation of raw hamburger and other high-risk products.

* Improve consumer understanding of the risks of food-borne illness. Foster a popular campaign similar to Mothers Against Drunk Driving, which uses consumer power to promote a no-tolerance policy toward growers and companies that produce tainted food.

* Provide Presidential leadership on a topic that impacts every single one of us.

Why Late Friday Aftenoon Treatment For Great Policy Change By Secretary Schafer?

Every once in a while, we do have to wonder what the folks who run the public affairs section at the United States Department of Agriculture are thinking.  The latest example of where they poorly served both the public and their boss, US Secretary of Agriculture Ed Schafer, came late Friday when a real improvement in recall policy was announced too late to get much attention.

The policy change is that beginning August, USDA will start listing retail stores receiving meat and poultry products involved in Class I recalls - those of the most serious concern to public health.

Why such an important improvement in recall policy was given the old Washington late Friday afternoon treatment is puzzling.   The food industry finds out such things immediately, so the only purpose would seem to limit attention from the consumer press.    In that, they may have succeeded.

Anyway, here's some good news for the eating public from USDA's big boss:

"The identity of retail stores with recalled meat and poultry from their suppliers has always been a missing piece of information for the public during a recall," said Schafer. "People want to know if they need to be on the lookout for recalled meat and poultry from their local store and by providing lists of retail outlets during recalls, USDA's Food Safety Inspection Service will improve public health protection by better informing consumers."
USDA's Food Safety Inspection Service (FSIS) will post on its Web site a list of retail stores that receive products subject to Class I recalls, the highest risk category, generally within three to ten business days of issuing the recall release.

A Class I recall is one that involves a reasonable probability of serious health consequences or death for those with weakened immune systems.

Retail stores include supermarkets or other grocery stores, convenience stores, meat markets, wholesale clubs and big box food stores.  However, FSIS will not identify distribution centers, institutions or restaurants, since those types of outlets prepare food for immediate consumption without packaging that is identifiable or available to consumers.

The Chino slaughterhouse scandal last year, which resulted in the largest beef recall in U.S. history, increase public demand for a list of receiving stores.    There some irony in fact that this policy change would not have produced such a list in the Chino case because it was a Class II recall.

Go here for USDA's complete release.

FDA & CDC Now Hot After Hot Peppers As Outbreak Investigation Mounts New Charge

The U.S. Food & Drug Administration(FDA) and the Centers for Disease Control & Prevention (CDC) held a joint media conference call this afternoon.   It came shortly after CDC posted new numbers of culture confirmed cases of Salmonella Saintpaul.

We cover that in great detail over on the Salmonella Blog.   Check out Salmonella Saintpaul Makes More Than 1,000 Sick: CDC Putting Focus On Peppers, Cilantro As Well

From their session with the media, we think its fair to say that "hot" peppers have taken their place as equals along side tomatoes in the ongoing hunt for the source of the Salmonella Saintpaul outbreak. 

But anyone who thinks either FDA or CDC will be treating "hot" peppers like they did tomatoes is missing the wisdom of something Emerson once said:  "foolish consistency is the hobgoblin of little minds."

For example, there is no warning going out to the general public about "hot" peppers.   Instead, there's this posted tonight on FDA's website:

Although epidemiological and other evidence continues to have a strong association with certain raw tomatoes, a recent case control study and disease cluster information provided by the Centers for Disease Control (CDC) indicate that not only tomatoes, but also raw jalapeno and serrano peppers may be linked to illnesses in this continuing outbreak.

At this time, the FDA is advising people in high risk populations such as elderly persons, infants and people with impaired immune systems to avoid eating raw jalapeno and raw serrano peppers.

In addition, the FDA continues to advise consumers to avoid eating raw red plum, red Roma, or red round tomatoes except for those grown in the areas listed (see extended reading area) below. Tomatoes grown in those areas have not been associated with the outbreak.

Nor will there be any list of safe "hot" pepper growing areas as with tomatoes.  Dr. David Acheson, FDA's associate commissioner for foods, says the safe list sort of grew up when some growing areas pointed out the Salmonella Saintpaul outbreak started before they were producing a crop.

What FDA and CDC are doing is working their tracebacks hard.   They've been helped by having more clusters to work with as the outbreak has continued.  And, the two agencies aren't worried about any oversight this outbreak might bring them.

"Our mission is to protect public health," said Acheson.



 


Tomatoes, Jalapeños and Cilantro on Suspect List for Salmonella Saintpaul

The CDC reports this evening that "fresh tomatoes, fresh hot chili peppers such as jalapeños, and fresh cilantro are the lead hypotheses. However, at this point in the investigation, we can neither directly implicate one of these ingredients as the single source, nor discard any as a possible source".

Since April, 971 persons infected with Salmonella Saintpaul with the same genetic fingerprint have been identified in 40 states, the District of Columbia, and Canada. These were identified because clinical laboratories in all states send Salmonella strains from ill persons to their State public health laboratory for characterization. No new states report ill persons. The number of ill persons identified in each state is as follows: Alabama (2 persons), Arkansas (10), Arizona (45), California (8), Colorado (12), Connecticut (4), Florida (2), Georgia (24), Idaho (4), Illinois (93), Indiana (14), Iowa (2), Kansas (17), Kentucky (1), Louisiana (1), Maine (1), Maryland (29), Massachusetts (22), Michigan (7), Minnesota (8), Missouri (12), New Hampshire (4), Nevada (11), New Jersey (9), New Mexico (98), New York (28), North Carolina (10), Ohio (7), Oklahoma (23), Oregon (10), Pennsylvania (8), Rhode Island (3), South Carolina (1), Tennessee (8), Texas (381), Utah (2), Virginia (29), Vermont (2), Washington (4), Wisconsin (10), and the District of Columbia (1). Four ill persons are reported from Canada; three appear to have been infected while traveling in the United States, and one illness remains under investigation.

Tomatoes, Cilantro, Jalapeño Peppers, Serrano Peppers, Scallions and Bulb Onions Now Being Investigation in Salmonella Saintpaul Outbreak - nearly 38,000 sickened

Really?  According to the CDC, for every one person who is a stool-culture positive victim of salmonella in the United States, there a multiple of 38.5 who are also sick, but remain uncounted. (See, AC Voetsch, “FoodNet estimate of the burden of illness caused by nontyphoidal Salmonella infections in the United States, ”Clinical Infectious Diseases 2004;38 (Suppl 3):S127-34). That means that we are close to poisoning 38,000 people and we do not even know the vector.

Also according to CNN
, “starting Monday, health inspectors will halt the shipment of ingredients common to Mexican cuisine from Mexico to the United States” – this will include cilantro, jalapeño peppers, Serrano peppers, scallions and bulb onions. I assume that it may still include tomatoes?

As for illnesses, the CDC reports that 943 persons infected with Salmonella Saintpaul with the same genetic fingerprint have been identified in 40 states, the District of Columbia, and Canada. Nearly 150 have been hospitalized. The number of ill persons identified in each state is as follows: Alabama (2 persons), Arkansas (10), Arizona (45), California (8), Colorado (12), Connecticut (4), Florida (2), Georgia (24), Idaho (4), Illinois (93), Indiana (14), Iowa (2), Kansas (17), Kentucky (1), Louisiana (1), Maine (1), Maryland (29), Massachusetts (22), Michigan (7), Minnesota (8), Missouri (12), New Hampshire (4), Nevada (11), New Jersey (9), New Mexico (98), New York (28), North Carolina (10), Ohio (7), Oklahoma (23), Oregon (10), Pennsylvania (8), Rhode Island (3), South Carolina (1), Tennessee (8), Texas (356), Utah (2), Virginia (29), Vermont (2), Washington (4), Wisconsin (10), and the District of Columbia (1). One ill person is reported from Ontario, Canada.

Be Careful Out There! Eating on 4th Could Be More Dangerous Than Fireworks!

As Americans go into the 4th of July weekend, they will not be getting a break.  Fear the hamburger.  Pass on the tomatoes.  Fireworks, but better skip the salsa.   We are experiencing another year just like the last one, awash in food-borne illness.

Last year was so obvious.   Topps was reeking in E. coli O157:H7.  There was undercover video tape of the Chino slaughterhouse.  This year, there is mystery.  More than usual.   The rare Salmonella Saintpaul has had its way with America for six weeks leaving our blue-chip food safety agencies without a clue as to where its coming from.

About the 4th of July,  John Adams said: "It ought to be solemnized with Pomp and Parade, with Shews, Games, Sports, Guns, Bells, Bonfires and Illuminations from one End of this Continent to the other from this Time forward forever more."  Kroger customers who are recovering from E. coli O157:H7 probably won't feel much like celebrating.

Maybe those good folks will spend time contemplating why the near 2,500-store Kroger chain is still buying from the notorious Nebraska Beef Ltd.   You would think Kroger would have a sufficient sense of corporate responsibility to check out the background of its beef suppliers.

From the Centers for Disease Control & Prevention (CDC), here's the latest on the nation-wide Salmonella Saintpaul and Michigan/Ohio E. coli outbreaks.

SALMONELLA SAINTPAUL

Since April, 869 persons infected with Salmonella Saintpaul with the same genetic fingerprint have been identified in 36 states and the District of Columbia. These were identified because clinical laboratories in all states send Salmonella strains from ill persons to their State public health laboratory for characterization.

The number of ill persons identified in each state is as follows: Arkansas (10 persons), Arizona (41), California (10), Colorado (11), Connecticut (4), Florida (1), Georgia (20), Idaho (3), Illinois (91), Indiana (11), Kansas (14), Kentucky (1), Maine (1), Maryland (29), Massachusetts (21), Michigan (6), Minnesota (2), Missouri (12), New Hampshire (3), Nevada (11), New Jersey (6), New Mexico (90), New York (26), North Carolina (5), Ohio (7), Oklahoma (23), Oregon (10), Pennsylvania (8), Rhode Island (3), Tennessee (6), Texas (346), Utah (2), Virginia (22), Vermont (2), Washington (4), Wisconsin (6), and the District of Columbia (1).

Among the 588 persons with information available, illnesses began between April 10 and June 20, 2008, including 179 who became ill on June 1 or later. Many steps must occur between a person becoming ill and the determination that the illness was caused by the outbreak strain of Salmonella; these steps take an average of 2-3 weeks.

Therefore, an illness reported today may have begun 2-3 weeks ago. Patients range in age from <1 to 99 years; 48 percent are female. The rate of illness is highest among persons 20 to 29 years old; the rate of illness is lowest in children 10 to 19 years old and in persons greater than 80 years old. At least 107 persons were hospitalized.

No deaths have been officially attributed to this outbreak. However, a man in his sixties who died in Texas from cancer had an infection with the outbreak strain of Salmonella Saintpaul at the time of his death. The infection may have contributed to his death.

Only 3 persons infected with this strain of Salmonella Saintpaul were identified in the country during the same period in 2007

E. COLI O157:H7

We will continue with information on the E. coli O157:H7 outbreak involving Kroger and Nebraska Beef in the extended reading section.