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

It turns out that feces contaminated food can lead not only to the usual array of foodborne illnesses, like E. coli or salmonella, but also to something much more unexpected.  Rosemary Alvarez found that out first hand when a surgeon operating on her brain for what was initially believed to be a tumor instead found...drum roll please...a worm!  Actually, it was a tapeworm called Taenia solium to be exact.

Lauren Cox from ABC news reports that, according to Rosemary's doctor, someone, somewhere, had served her food that was tainted with the feces of a person infected with the pork tapeworm parasite.

"We've got a lot more of cases of this in the United States now," said Raymond Kuhn, professor of biology and an expert on parasites at Wake Forest University in Winston-Salem, N.C. "Upwards of 20 percent of neurology offices in California have seen it."

So will a marked increase in similar parasitic infections finally be the trigger to motivate the US government into taking food safety seriously?

Check out the full article, including video footage and details of Rosemary's predicament, here.

As you know, we have repeatedly made calls for more research into the public health risk known as foodborne pathogens.  Yesterday, the World Health Organization (WHO) unequivocally agreed (although the question of funding still remains). 

At a conference in Geneva, WHO's direct of food safety, Jorgen Schlundt, announced that more research is needed to determine how much sickness and death stems from contaminated food, such as the tainted Chinese milk that caused kidney problems in more than 50,000 children and killed four, and the U.S. salmonella outbreak that made more than 1,400 people ill.

An estimated 30 percent of new infectious diseases originate in bacteria, viruses, parasites, chemicals and toxins introduced along food production chains, he told an experts' meeting.  "There are some indications that the foodborne disease burden is increasing. But there is not very good data, it is difficult to say exactly what is happening," Schlundt said.

About 2.2 million children die each year from diarrheal illnesses including cholera caused by dirty water, food, and poor sanitation, according to the United Nations agency.  Food products needed to be monitored at every stage of their handling, Schlundt said.  "If you want to deal with food safety you have to go from the 'farm to the fork'. The notion that you can deal with it at the end of the food chain is clearly wrong," he said.  In many countries, regulatory authorities fail to work together, he said.  "In China there are 16 different authorities involved in some way in dealing with the melamine crisis," he said.

Julie Ingelfinger, a Harvard Medical School professor and pediatric nephrologist, said many people had overlooked the seriousness of complications caused by contaminated food.  For instance, E.coli poisoning can cause hemolytic-uremic syndrome, a cause of kidney failure in children, she said.  "Research into the long-term effects of foodborne disease is increasingly important because it is unquantified and goes on for decades," she said.

David Heymann, WHO assistant director-general for health, security and the environment, told the meeting that rich and poor countries were both vulnerable to foodborne diseases.  "Foodborne diseases occur on every continent and in every country really. We never know where these events will happen," he said.

The recent salmonella outbreak in the United States -- its worst in a decade -- was an example of the changing picture of foodborne diseases, according to the WHO.  Although salmonella is often linked to poultry, eggs and dairy products, recent outbreaks have been tied to fresh produce, it said. Tomatoes were suspected in the U.S. outbreak before the salmonella was traced to peppers from Mexico.

Nancy Donley, president of the U.S. non-profit group S.T.O.P. (Safe Tables Our Priority), said food safety needed to be taken more seriously as a public health concern.  "It's crucial to keep foodborne disease prevention as a top priority in the world," said Donley, whose 6-year-old son Alex died in 1993 from e.coli-contaminated meat. "Behind every statistic is a face, a name, a life." (Editing by Laura MacInnis and Angus MacSwan)

While most of my postings here on the food poison blog tend to be less than joyous (but necessary given the serious nature of our business), I thought I'd take a moment and post a somewhat lighter article.

The next month and a half will bring many folks together to celebrate the holidays with family and friends.  I thought it would therefore be a good idea to remind everyone of some basic turkey preparation and cooking techniques to ensure your gatherings are as successful as possible and minimize the risk of you or a loved one being one of the 76 million unlucky Americans who fall ill to a foodborne illness each year.

Food Thermometer Essential When Stuffing a Turkey

For optimal safety and uniform doneness, cook stuffing separately. However, if stuffing a turkey, it's essential to use a food thermometer to make sure the center of the stuffing reaches a safe minimum internal temperature of 165 °F.

Cooking a home-stuffed turkey is riskier than cooking one not stuffed. Even if the turkey itself has reached the safe minimum internal temperature of 165 °F as measured in the innermost part of the thigh, the wing and the thickest part of the breast, the stuffing may not have reached a temperature high enough to destroy bacteria that may be present.

Bacteria can survive in stuffing that has not reached 165 °F, possibly resulting in foodborne illness.

Frozen Turkeys Stuffed at the Plant under USDA Inspection

The USDA does not recommend buying retail-stuffed, uncooked turkeys from a store or restaurant.

However, some turkeys purchased frozen have been stuffed at a plant under USDA inspection. These turkeys should be safe when cooked from the frozen state. Follow the manufacturer's package directions.

1. Prepare Stuffing Safely
If you plan to prepare stuffing using raw meat, poultry, or shellfish, you should cook the ingredients before stuffing the turkey to reduce the risk of foodborne illness from bacteria that may be found in raw ingredients. The wet ingredients for stuffing can be prepared ahead of time and refrigerated. However, do not mix wet and dry ingredients until just before spooning the stuffing mixture into the turkey cavity.

If stuffing is prepared ahead of time, it must be cooked immediately and refrigerated in shallow containers. Do not stuff whole poultry with cooked stuffing.

2. Stuff Loosely
Do not cool the stuffing. Spoon it directly into the turkey cavity right after preparation. Stuff the turkey loosely — about 3/4 cup of stuffing per pound. The stuffing should be moist, not dry, because heat destroys bacteria more rapidly in a moist environment.

Do not stuff turkeys to be grilled, smoked, fried, or microwaved.

3. Cook Immediately
Immediately place the stuffed, raw turkey in an oven set no lower than 325 °F.

4. Use a Food Thermometer
For safety and doneness, check the internal temperature of the turkey and stuffing with a food thermometer.

If the temperature of the turkey and the center of the stuffing have not reached a safe minimum internal temperature of 165 °F, further cooking will be required. Do not remove the stuffing from the turkey before it reaches 165 °F because the undercooked stuffing could contaminate the cooked meat.

Continue to cook the turkey until the stuffing is safely cooked.

5. Let It Rest
Let the cooked turkey stand 20 minutes before removing the stuffing and carving.

6. Refrigerate Promptly
Refrigerate the cooked turkey and stuffing within 2 hours after cooking. Place leftovers in shallow containers and use within 3 to 4 days. Reheat leftovers to a safe minimum internal temperature of 165 °F.

http://www.fsis.usda.gov/Fact_Sheets/Turkey_Basics_Stuffing/index.asp

Not have an outbreak in the first place!

That was the theme at the recent Fresh Summit 2008 conference, "Food Safety: Keeping Your Business Healthy," where attendees heard from panelists about the latest in regulations and safety initiatives as well as how to consider food safety investments in a return-on-investment perspective.

Bob Whitaker, PMA’s Salinas, Calif.-based chief science officer, said the industry must continue its food safety diligence and try to stay ahead of the curve and anticipate possible future food safety issues.

“I see the industry is demonstrating the will to go forward by having the courage to act and to act now and to get involved in industry food safety activities,” Whitaker said. “And the industry has character to ask what we need to do further to make our programs better.”

Whitaker said the industry is better overall after the outbreaks and said he has noticed many positive changes bubbling under the surface during the past 1½ years. More PMA members, he said, are asking him for technical information.

The industry, Whitaker said, is putting more funding into food safety research and global standards are arising.

“There have been inconsistencies between buyers and suppliers,” Whitaker said. “Often, a supplier that invested heavily in food safety competed in the marketplace with someone who didn’t. What we’re seeing today is an increased awareness on both sides.”

Last year we saw a huge rise in the number of beef recalls due to E. coli O157:H7 contamination.  While there were eight beef recalls in the US in 2006, the number jumped to an astounding 21 beef recalls in 2007, including the second largest beef recall in US history from Tops Meat Company.  About a third of the recalls were prompted by reports of human illness, while none of the 2006 recalls were.  According to a recent Washington Post article by staff writer Annys Shin, researchers at Kansas State University may have found the reason.

The study found higher levels of E. coli O157:H7 in the feces of cattle fed a diet that included an ethanol product called distillers grain.

Distillers grain is what is left after the starch from corn is removed to make ethanol. It has been around for decades, but its popularity as a feed ingredient has surged in recent years. One reason is that demand for ethanol, fueled by rising gas prices and federal mandates and subsidies, has pushed the price of corn -- and in turn, corn feed -- to record levels, said Darrell Mark, an economist at the University of Nebraska at Lincoln.

Distillers grain is also cheaper than corn and is high in the proteins and fats that help cattle put on more weight, said David M. Smith, a University of Nebraska researcher. For cattle ranchers, who are being squeezed by lower beef consumption and higher prices for fuel and grazing land, such benefits are important.

The researchers at Kansas State followed up with another study in which they inoculated calves with E. coli O157:H7 (which is harmless to cattle) using a modified form of the bacteria that was easier to track. They found that calves fed distillers grain had higher levels of the bacteria than those that were not. The USDA findings appear to back them up.

But the connection between distillers grain and E. coli is still far from conclusive, researchers said, for several reasons. Another study done by researchers at the University of Nebraska found that cattle fed a diet of up to 25 percent distillers grain actually had less of the bacteria than the control group, while those fed a diet that was 40 percent or more distillers grain had more of the bacteria. Another study done at Kansas State found no statistically significant increase in the bacteria in distillers-grain-fed cattle compared with the control.

T.G. Nagaraja, one of the Kansas State researchers, suggests that the variation in results may be due to differences in the distillers grain, which can depend on where it was produced.