February 2011

merlesfoodpoisoning.jpgTomorrow we will file suit on behalf of a Cook County Resident who was infected by Clostridium perfringens in an outbreak that the Evanston City Health Department linked to Merle’s Smokehouse

The Outbreak:

On Thursday, February 17, 2011 the City of Evanston Health Department was contacted by Evanston School District 65 regarding 30 individuals becoming ill after eating food catered by the defendant at a Parent/ Teacher Conference held on Wednesday February 16, 2011.

After being notified, the Evanston Health Department began an immediate investigation and was able to collect samples of the catered food, which were sent to the Illinois Department of Public Health (IDPH) Laboratory in Springfield, Illinois for testing. Health inspectors also went to the defendant’s restaurant facility at 1727 Benson Avenue to collect food samples and perform a detailed inspection with regards to food handling, storage and transportation.  The health department sited poor food handling, storage, and temperature control practices as a cause of the outbreak

Results of testing by IDPH revealed Clostridium perfrigens as the causative agent in the people sickened on or about February 16, 2011 by food catered by the defendant.


Beatrice Jenkins works as a part-time employee at Haven Middle School in Evanston. She also volunteers regularly at the school.  On February 16, 2011, Merle’s catered a meal at the school, where it was consumed by teachers, volunteers, and other guests.

Ms. Jenkins and her daughter were among the volunteers and guests who consumed the food at Haven Middle School. Both became ill the morning of February 17, 2011, and ultimately had to be seen in the emergency department at Evanston Hospital.  Ms. Jenkins continues to suffer from symptoms related to her illness.

taylorfarmsbroccoli.jpgTaylor Farms Pacific is voluntarily recalling broccoli items with a best if used by date of 2/7/11 to 3/7/11.  Taylor Farms issued the recall after the Washington State Department of Health detected Listeria monocytogenes in a random sample of product.  The recalled cases were distributed by Taylor Farms to 6 states, including; CA, AZ, NV, OR, UT, WA. Distribution dates were from February 7 to February 24.  A complete list of recalled products can be seen at the FDA recall notice.

Listeria monocytogenes is a bacterium that can cause foodborne illness in a person who eats a food item contaminated with it. Symptoms of infection may include fever, muscle aches, gastrointestinal symptoms such as nausea or diarrhea. Most healthy adults and children rarely become seriously ill. The illness primarily impacts pregnant women and adults with weakened immune systems. 

The Colorado House Judiciary committee has recommended that HB 11-1190 be “postponed indefinitely.”  The bill, introduced by state Rep. Jerry Sonnenberg and state Sen. Cheri Jahn, would have changed Colorado law by absolving food retailers, as opposed to manufacturers, of liability in situations where the manufacturer isn’t subject to the jurisdiction of Colorado courts.  The bill was postponed “at the request of the sponsor,” and the committee voted 10-1 to accept the requested postponement.

salmonella.jpgA story out of South Australia gives one woman’s account of her battle with Salmonella.   Her words help provide some understanding of the severity of even an uncomplicated bout with Salmonella, one that comes without any of the less common but frightening complications that can occur.

Ms. Norma Kent, of Toorak Gardens, Australia, was one of at least 100 persons sickened in a Salmonella outbreak attributed to pastries.   Ms. Kent ended up spending a week in the hospital.  She had these recollections of her illness:

“This is the worst illness I have ever experienced,” she said.”I didn’t know what was wrong with me, it was like my insides were falling out … my body felt like it was exploding.

Ms. Kent suffered four days of severe diarrhea, nausea, and headaches prior to her week of hospitalization.  She was treated for dehydration and lost over ten pounds.  As is common, she remains tired and lacks energy more than a month later.

Beyond severe food poisoning, Salmonella can cause complications such as post-infectious irritable bowel syndrome and reactive arthritis.

foodpoisoningmerles.jpg2010 hit Illinois hard when it came to foodpoisoning outbreaks.  (2011 just got worse with the announcement of the Merle’s BBQ clostridium perfringens outbreak)  

merlesfoodpoisoning.jpgClostridium perfringens has caused an outbreak of food poisoning illnesses at Merle’s BBQ in Evanston, Illinois, sickening more than 30 people.  Actually, the implicated meal was catered by Merle’s for the parent/teacher conferences at Haven Middle School on Feb. 16.  “The outcome of the investigation revealed unsafe food handling and temperature storage at both Merle’s BBQ Restaurant and Haven Middle School and it is therefore unlikely that the exact cause of the outbreak will be determined,” said Evanston Health Director Evonda Thomas. 

What is Clostridium perfringens?

Clostridium perfringens a bacterium that is widely distributed in the environment. Most outbreaks of this “bug”are associated with undercooked meats prepared for large groups of people. Meat products such as stews, casseroles, and gravy are the most common sources of illness from Clostridium perfringens. Most outbreaks come from food whose temperature is poorly controlled. If food is kept between 70 and 140 F, it is likely to grow Clostridium perfringens bacteria.

What is the illness caused by Clostridium perfringens typically like?

People generally experience symptoms of Clostridium perfringens infection 6 to 24 hours after consuming the bacteria or toxins. Clostridium perfringens toxins cause abdominal pain and stomach cramps, followed by diarrhea. Nausea is also a common symptom. Fever and vomiting are not normally symptoms of poisoning by Clostridium perfringens toxins.

New Market Poultry, a New Market, Va., establishment, is recalling approximately 3,339 pounds of ice-packed, whole chicken products that may be adulterated due to leaking cooler condensate, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The problem was identified Feb. 24, 2011 when the company discovered product under USDA retention had been shipped. On Feb. 23, 2011 FSIS personnel observed standing water with unidentified black specks pooling on the box lids of the packed chickens stored in a company cooler. The palletized boxes, which contain drainage holes, were retained by FSIS and should not have been shipped.

The products subject to recall include:

* Approx. 60-pound boxes of “New Market Poultry 2007, LLC, EVISCERATED POULTRY, For Further Processing Only, Some Parts Missing” bearing case code of “05412.”

Each box bears the establishment number “P-4602A” inside the USDA mark of inspection. The chicken products were produced on Feb. 23, 2011 and inadvertently shipped the same day to six distribution centers in the Bronx, Brooklyn and Farmington, N.Y.

glob warm 2.bmpThe American Medical Association (AMA) and the American Public Health Association (APHA) yesterday held a conference call to explain how global warming has “taken a toll on human health and will continue to cause food-borne illnesses, respiratory problems, and deaths unless policy changes are enacted.”

According to a report on the call,  “The ‘evidence has only grown stronger’ that climate change is responsible for an increasing number of health ills, including asthma, diarrheal disease, and even deaths from extreme weather such as heat waves, said Georges Benjamin, MD, executive director of the APHA.

Perry Sheffield, MD, MPH, assistant professor in the Department of Pediatrics and the Department of Preventive Medicine at the Mount Sinai School of Medicine noted that “Salmonella outbreaks also increase when temperatures are very warm.” 

Four counties in Maine have joined many other states in proposing legislation intended to liberalize sales of raw milk or lighten the regulatory load on certain producers of other food products.  Rich Hewitt at the Bangor Daily News wrote today:

Small, local farm operations in recent years have faced increasingly stringent state regulations that, farmers say, threaten their farms and the rights of local residents to buy local food.

Now, they are pushing back.

A group of Hancock County farmers has proposed an ordinance in four towns that would exempt small farms from new state licensing and inspection requirements as long as the farm products are sold directly to a customer for home consumption. The ordinance is mirrored in two bills introduced this session by state Rep. Walter Kumiega, D-Deer Isle.

. . . At the heart of the ordinance is the concern that small, diversified farms in the state face a growing number of requirements to build and maintain facilities that are geared to larger “industrial agriculture” operations.

The state rules, based on federal regulations, are complicated, restrictive and costly to small, local farmers, according to ordinance supporters. They make it more difficult for small farms to get started and stay in business, and thus also curb local access to locally grown goods, according to Heather Retberg of Penobscot, one of the organizers of the ordinance movement.

Should there be an additional ordinance proposed requiring these producers to disclose to their customers that these products were produced by farmers and producers who are not subject to inspection or licensing requirements?  If these ordinances pass into law, full disclosure should be made.

pepperssalmonella.jpgGovernments’ foodborne disease investigating agencies (CDC, FDA, USDA-FSIS, and the many state, local, and tribal units) are not infallible, but yesterday’s release in the New England Journal of Medicine of a collaborative study on the 2008 Salmonella Peppers outbreak is not nearly the indictment of the methods and conclusions of that outbreak that United Fresh Produce Assocation said it was today.  In truth, the lessons to be taken from the outbreak, and the mistaken identification of tomatoes as the culprit, lie just as heavily with the produce industry.

One confounding factor in many outbreaks–something that inhibits the rapid identification of the contaminated food item–is products that are widely consumed amongst all ages and populations, particularly when the contaminated product is so heavily contaminated that it causes illnesses in nearly every state in the country.  Moreover, when the product is peppers that are very rarely a menu item in themselves, but are instead used as only one ingredient in many extremely common food items (and often in appetizers like salsa that people sometimes forget about in recounting their meal), that identification problem is exacerbated even further. 

This outbreak was identified in late May, and immediately many top epidemiological units in the country (many were members of the ten state FoodNet group) jumped into the investigation.  From what the journal article and study say, in depth case control studies were undertaken in a separate but coordinated fashion in several different geographic regions nationally. 

The problem was neither the work, the people doing it, or the methods they were using.  It was that they were dealing with some extremely difficult epidemiological circumstances, and were further inhibited by not only the commonality of the product (and the problem that poses with traceback efforts once a suspect item is identified), but also the fact that the industry was only marginally helpful in being able to trace their products all the way back to the source.  This is important not only because full traceback inhibits further shipment of the contaminated product, but also because finding a suspect product that came from a single source is a major epidemiological point that suggests that the suspect product might be the right one. 

Here is what an in depth read of the article, rather than latching onto a misstep in the process that, admittedly, had serious consequences for the tomato industry, will reveal:

Environmental assessments conducted as part of the epidemiologic investigations of nine restaurant clusters did not identify recent diarrheal illness among food handlers. A total of 12 tracebacks of raw Roma and red, round tomatoes were completed: 8 tracebacks from 7 sporadic cases and 4 tracebacks from restaurant clusters. These tracebacks did not converge on any one geographic location, grower, or supplier. All tomato tracebacks included sources from Mexico, Florida, or both. Environmental investigations were conducted at five farms or packing firms in Mexico and three in Florida. Only one firm was packing tomatoes in Mexico at the time of the investigation, and all farms in Mexico and Florida had finished harvesting. The FDA analyses of approximately 183 domestic and imported tomato samples and 113 environmental swabs from tomato operations in Florida and Mexico did not identify salmonella.

Tracebacks to farms from 13 restaurant clusters were completed for jalapeño peppers from five states, including 3 restaurants (cluster D, consisting of two restaurant locations, and cluster G) in which jalapeño peppers were implicated. All 13 tracebacks led to distributors in Texas and Mexico that received jalapeño peppers from Mexico. The outbreak strain was isolated from a jalapeño pepper sample obtained from a produce importer in Texas that received jalapeño peppers from a packing facility in Nuevo Leon, Mexico. The traceback from the packing facility was complex, with commingling of products and a network of interrelated distribution points.

The FDA investigated two farms in Mexico (Farm A and Farm B) that supplied peppers to the packing facility (Figure 2). Traceback records identified other farms that also supplied the facility during this period. Farm A, which grew Roma tomatoes in addition to jalapeño and serrano peppers, harvested all three crops between late April and late July and was an indirect supplier to the packing facility. Farm B supplied the same packing facility both through direct shipments and also indirectly through distributors. Farm B, located approximately 100 miles from Farm A, was this packing facility’s main pepper supplier. Agricultural water samples from Farm A yielded salmonella but not the outbreak strain. The FDA did not collect tomatoes at Farm A. The outbreak strain was isolated from two environmental samples, agricultural water, and serrano peppers on Farm B, which grew jalapeño peppers and serrano peppers, but not tomatoes, and harvested produce from mid-April to mid-June. The Colorado Department of Public Health and Environment isolated the outbreak strain from a jalapeño pepper collected from the home of a case subject in Colorado and traced this pepper from the grocery store where it had been purchased to another distributor in Texas. The source of these jalapeño peppers was not determined.

United Fresh CEO Tom Stenzel had the following to say:

“The study in this week’s New England Journal of Medicine underscores the fact that temporal associations based on memories of what someone has eaten weeks earlier can be useful, but not definitive, in these investigations. It’s clear from the study that many sick individuals recalled eating a salsa product, but failed to recognize the peppers that were contained as an ingredient. By prematurely jumping to the conclusion that tomatoes were causing the outbreak, officials may have unwittingly allowed the outbreak to continue.”

The reality is that the peppers outbreak was tough.  It caused 1,500 people to fall ill with confirmed infections, maybe 50,000 to fall ill with unconfirmed illnesses, and caused at least two deaths.  The government isn’t to blame for these consequences; not even close.  Mistakes may have been made in the process of identifying peppers, but under the circumstances, I doubt very seriously that those mistakes were due to inattention or incompetence.  More likely the hypothesis generation during the outbreak was just incredibly complex.  It may have been easier if the produce industry did a better job in delivering the full traceability that it knows it needs to, or in preventing the contamination in the first place.