William Marler Oped - If I were a CEO of the Salmonella Egg producer, what would I do?

Imagine that the phone call comes or an email pops into your inbox--"Sir, we have been contacted by (you pick: CDC, FDA, USDA, or a state or local health department), and they say your product (lettuce, raw milk, a frozen dinner or now eggs) has been linked to illnesses. What do we do?"

So, what do you do?

After being involved in every major (and a few minor) food poisoning outbreaks since the Jack in the Box outbreak of 1993, I have seen it all. I have seen good CEOs act badly and make their and their company's problems worse and I have seen bad CEOs handle the outbreak with such aplomb that they become associated with both food safety and good PR. So, what do you do?

Of course, it is always best to avoid the outbreak to begin with. When I have spoken to CEOs or their Boards--generally, pre-outbreak and pre-lawsuit--I always pitch them on "why it is a bad idea to poison your customers." Putting safe food as the primary goal--yes, alas, even before profits--will (absent an error) give you a very, very good chance of never seeing me on the other side of a courtroom.

But, what if despite your best efforts, or what if you simply did not care, and an outbreak happens, what do you do?

First, have a pre-existing relationship with the folks that regulate you. If someone holds your business in the palm of his or her hand, you should at least be on a first name basis. No, I am not suggesting that you can influence your way out of the outbreak, but knowing who is telling you that your company has a problem allows you the ability to get and understand the facts. Do regulators and their investigators make mistakes? Perhaps, but not very often and not often enough to waste time arguing that your company did not poison customers.

Second, stop production of the implicated product and initiate a recall of all products at risk immediately. This procedure should have been practiced, and practiced, and practiced before. All possibly implicated suppliers should be alerted and all retailers should be offered assistance. Consumers need to be engaged too. The goal now is to get poisoned product out of the marketplace and certainly out of the homes of consumers.

Third, launch your own investigation with two approaches, and at the same time. Are the regulators correct? And, what went wrong? Tell everyone to save all documents (you have to anyway). The goal here is to get things right. If it really is not your product, what has happened is bad, but survivable. If it really was your product, then learning what happened helps make sure it is likely to never happen again. More than anything, be transparent. Tell everyone what you find--good or bad.

Fourth, assuming that the outbreak is in fact your fault, publicly admit it. If it is not your fault, then fight it. However, pretending that you are innocent when you are actually at fault will get you nowhere. Asking for forgiveness is not a bad thing when you have something to be forgiven for. Saying you are sorry is not wrong when you are in fact wrong.

Fifth, do not blame your customers. If you food has a pathogen it is not your customers responsibility to handle it like it will likely kill them or a member of their family. Hoping that the consumer will fix your mistake takes your eye off of avoiding the mistake in the first place.

Sixth, reach out to your customers and consumers who have been harmed. Offering to pay legitimate losses will save money and your company's reputation in the long run.

Seventh, teach all what you have learned. Do not hide what you have learned. Make your knowledge freely available so we all limit the risk that something similar will happen again.

Yes, you can do all of the above and still get sued. And, I might be the one to sue you. Yet, companies who have followed the above find their passage through an outbreak, recall, and litigation temporary. The companies that struggle for unfounded reasons will seldom exist in the long run, or they will simply pay me more money.

Wright County Egg Owner Has Long History of Violations

Against a backdrop of a recall of 380 million eggs and thousands of Salmonella illnesses nationwide, numerous commentators have been pointing out the long history of violations amassed by Wright County Egg owner Jack DeCoster.

Yesterday ABC news reported on DeCoster's past.   There have been labor problems:

In the summer of 1996 when DeCoster was made to pay more than $3 million in fines after the U.S. Labor Department found dead chickens being picked up by workers with bare hands. The complaint also stated that DeCoster's workers also lived beside manure and rat-infested trailers, according to the Associated Press. The complaint led to a boycott of DeCoster's eggs by several major supermarkets.

Former National Secretary of Labor Robert Reich added these comments:

Thirteen years ago when I was Secretary of Labor, DeCoster agreed to pay a $2 million penalty (the most we could throw at him) for some of the most heinous workplace violations I’d seen.

There have been environmental violations:

In 2000, the Iowa attorney general dubbed DeCoster a "habitual violator" of the state's environmental laws and ordered him to pay a $150,000 fine. DeCoster had failed to properly dispose of the hog and chicken manure and had let it run into a nearby creek.

And sexual harassment as well:

In 2002 the U.S. Equal Employment Opportunity Commission fined DeCoster’s operation $1.5 million for mistreating female workers. The charges included rape, sexual harassment, and other abuses.

And let's not leave out animal cruelty from this fine resume:

Earlier this year, DeCoster pleaded guilty to 10 counts of animal cruelty over his company's treatment of its chickens. In June, DeCoster was ordered to pay more than more than $100,000 in fines and restitution, a ruling that is considered one of the landmark animal cruelty cases in history.

The extent of the damage caused by the current Salmonella outbreak will be difficult to fully assess.   The actual number of ill will dwarf those recognized through positive stool cultures.  For each of those ill people, what will the medical expenses be?  The lost production and work days? 

Salmonella Recall - Goya Frozen Fruit Pulp.

The FDA announced today that Goya Foods, Inc. of Secaucus, NJ, is recalling its 14 ounce packages of Frozen Mamey Pulp, due to a potential health risk from Salmonella.   The FDA states that the recalled Goya brand Mamey Pulp was distributed in the states of AK, AZ, CA, CO, HI, NM, NV, OR, TX, UT, and WA through retail stores.  To date, no illnesses have been reported to date in connection with Goya brand Mamey Pulp.

Salmonella is a bacteria that causes severe food-poisoning type symptoms.  Symptoms of Salmonella infection include diarrhea, vomiting, nausea, abdominal cramps, and/or fever.  In severe cases, the diarrhea may be frequent and bloody.  While most cases of Salmonella resolve, it is associated with long term complications like reactive arthritis.   

The product comes in a 14 ounce plastic package and is not marked with a lot number or expiration date. The UPC is 041331090803.

The recall resulted from a positive test taken by the FDA in a sample of Goya brand Mamey Pulp collected in Las Vegas, NV.  

As of August 12, 2010, a total of 7 confirmed and 2 probable individuals infected with a matching strain of Salmonella serotype Typhi have been reported from 2 states since May 25, 2010. Confirmed cases are persons with illness on or after January 1, 2010 and a DNA fingerprint matching the outbreak strain. Probable cases are persons with a Salmonella Typhi infection and a strong epidemiologic link to the outbreak. The number of ill persons identified in each state with this strain is as follows: CA (3 confirmed and 2 probable) and NV (4 confirmed).

CDC and public health officials in two states conducted an epidemiologic study comparing foods eaten by ill and well persons. Among interviewed ill persons, 5 (71%) of 7 reported consuming frozen mamey fruit pulp in a milkshake or smoothie, also called a “batido” or “licuado.” Upon further investigation, it was found that 4 (80%) of 5 ill persons consumed Goya brand frozen mamey fruit pulp. Among well persons, 0 (0%) of 33 reported exposure to frozen mamey fruit pulp. No other food was found to be associated with illness. These results suggest that eating frozen mamey fruit pulp is a likely source of these illnesses. This investigation is ongoing. CDC and its public health partners will update the public on the progress of this investigation as information becomes available.
Mamey, also called “zapote” or “sapote,” is a tropical fruit grown primarily in Central and South America. It is prepared by removing the inner seed and consuming the flesh raw, or adding it to milkshakes, jellies, or other foods or beverages. When preparing frozen mamey fruit pulp, it is peeled and mashed, and then consumed as a shake or smoothie. Frozen mamey fruit pulp can be purchased in grocery stores throughout the U.S., and packages have a 2-3 year shelf life.

Salmonella Typhi is the bacterium that causes typhoid fever. Typhoid fever is a very rare illness in the United States among non-international travelers and can cause serious symptoms, often times requiring hospitalization. Typhoid fever is contracted when food and water are contaminated by an infected individual and are then consumed by other people.

More on the Pros and Cons of Raw Milk

Straight From The Farm Can Take You Straight To The Hospital

July 30, 2010

Lindsey Coblentz, Associate Editor Food Manufacturing

Farm fresh is all the rage these days, and phrases like “certified organic” are the buzzwords of foodies who desire the healthiest, purest forms of produce. While the natural food craze is mainly harmless — and even good for you — the growing popularity of raw milk is sending scores to the hospital — all in the name of good health.

Unpasteurized milk is touted by fans as a “cure-all” for conditions such as lactose intolerance, tooth decay, autism and even cancer. However, none of these benefits have actually been proven by scientific evidence.

What has been confirmed about raw milk is its ability to carry a host of dangerous bacteria, including Brucella, Campylobacter, Listeria, Salmonella and E. coli just to name a few. These bacteria can cause illnesses as mild as a stomach ache or so virulent they result in hospitalization or even death. According to the Center for Disease Control and Prevention (CDC), there were 85 outbreaks of human infections resulting from raw milk consumption reported from 1998 to 2008, including 1,614 reported illnesses, 187 hospitalizations and two deaths.

So why are people still drinking it?

Click here to find out.

New England Journal of Medicine on Nationwide Salmonella Outbreaks

An excellent piece authored by Dennis G. Maki, MD. discussing food safety and seeking lessons learned in recent national Salmonella outbreaks was recently brought to my attention.  Dr. Maki's piece from the March 2009 New England Journal of Medicine looked back over two outbreaks in particular, the 2008 Salmonella Saintpaul outbreak linked to peppers, and the 2009 Salmonella Typhimurium outbreak in PCA peanut butter products. 

Dr. Maki pointed to an important lesson from the Salmonella Saintpaul outbreak- the importance to both consumers and industry alike of good traceability:

Initial epidemiologic investigations by state health departments and the CDC suggested that contamination of tomatoes grown in the southwestern United States was the cause, although this was never proved microbiologically. Predictably, tomato consumption plummeted, and the industry lost an estimated $200 million. After several months of investigation, the outbreak strain was isolated from jalapeño and serrano peppers that had been grown on one Mexican farm.

With respect to the PCA outbreak, Dr. Maki focused on the well-publicized, yet still remarkable, alleged failures of the producer:

Investigations have revealed that salmonella had been isolated from the implicated company's peanut butter or peanut paste in its internal quality-control sampling program on at least 12 occasions during the past year, but no action was taken to investigate the source of contamination, review sterilization procedures, or reclean the production machinery. The company is now under criminal investigation.

Both of these outbreaks involved staggering amounts of confirmed illnesses - over 1400 with the peppers, over 600 connected to peanut butter.  The article points out though, as we have here, that the total number of ill individuals was likely much larger. "It has been estimated that in large salmonella outbreaks, for every case identified by clinical culture, there are approximately 38 additional undetected cases — meaning that these two outbreaks may each have affected more than 20,000 persons."

The article did provide a number of recommendations aimed at stemming the tide of ongoing large scale illness outbreaks tied to commercial food.

A first step was the improved design and implementation of HACCP (Hazard Analysis, and Critical Control Point)  programs by food producers.   Dr. Maki also called for a nationwide expansion of FoodNet, a food safety surveillance program.  He also recommended speeding up the reaction time of the CDC's PulseNet's program.  This program finds genetic links between reported illnesses, and is key to identifying an implicated food product.  

Dr. Maki also called for improved monitoring by the FDA and USDA.  This step is long overdue, and has been called for here and by Mr. Marler

The article also called for an "international moratorium on the incorporation into animal feeds of growth-promoting antibiotics, which have been linked to greatly increased antimicrobial resistance in bacterial enteropathogens."

Dr. Maki's plea concluded with a call for increased reliance of irradiation of food.  The article is an excellent overview of the challenges facing our food production and distribution system, and an insightful look at much needed improvements.

Risk of Food-Poisoning from Re-Usable Grocery Bags Questioned

A little more than a month ago, a report was issued stating that reusing grocery bags presented the risk of cross-contamination with foodborne pathogens.   Yesterday, folks at Consumer Reports called the conclusions of that study into question.  They have three main points.

First, they question the impartiality of those who funded the study, the American Chemistry Council.  I liked the quote:

The American Chemistry Council is the trade group that advocates on behalf of plastic-bag manufacturers. Now why would the folks who make plastic grocery bags want to cast doubts on the safety of reusable grocery bags? Oh, right.

Second, Consumer Reports points out that the study had a very small sample size - 84 bags.  More importantly, CR makes a key distinction - the bacteria they found were not those associated with significant illness, "The researchers tested for pathogenic bacteria Salmonella and Listeria, but didn’t find any, nor did they find strains of E. coli that could make one sick."   It's a good point.   While E. coli O157:H7, and its other pathogenic brethren, are subtypes of E. coli, it is NOT at all the case that the presence of generic E. coli is the equivalent to finding these much more dangerous "bugs."

Finally, just as I did on local TV here in Seattle CR does recognize that the issue of cross-contamination in the home IS an important issue.   So, remember:

  • keep cutting boards, knives and other utensils for raw meat separate from those for use with ready to eat items;
  • store raw meat items separately from ready to eat foods;
  • wash your hands frequently, and always after touching raw meat, and before touching ready to eat items.

"Five Second Rule" and Food Poisoning

Your tasty bagel falls on the floor.  You hate to waste food, and you'd rather not toast a new one.  Can you call "five second rule" and consume it without risk of food-poisoning?   Not according to research from Clemson scientists reported in National Geographic.  Here is the somewhat frightening heart of the story:

According to food-science research at Clemson University, there is no five-second rule. It's the zero-second rule. Writes Catherine Barker, "salmonella and other bacteria can survive up to four weeks on dry surfaces and transfer to food immediately upon contact."

Other studies had suggested less risk, but with a quote like that, it seems smart to be on the safe side.  Interestingly, your own kitchen (and bathroom of course, but just don't eat in there) is probably one of the riskiest place to drop food.  

So, hold on tight to your bagel, and think twice before giving it a second chance.

Fair and Balanced? Half the Raw Milk Story in Nebraska

I just finished reading on online article at the Lincoln (NE) star journal, "You don't have to own a cow to have raw milk," by Erin Duerr.   In the article she proclaims that the "best" way to get your dairy is "raw milk at the source."  She does manage to mention that raw milk "comes with conflicting information about the health benefits or dangers."   The article though, contains only a link to the website for Weston A. Price, unabashed raw milk supporters. 

In the interest of fairness and education, how about a link to some of the information about the risks involved, like www.realrawmilkfacts.com.  In 2010 alone, there have been more than 8 outbreaks of illness associated with raw milk and raw dairy products.   Just seems to me that the readers (and their children) might want an opportunity to get the whole story.

Daycare E. coli Outbreak Shows Risk of Secondary Infections

Eight confirmed and two suspected cases of E. coli bacteria were reported Friday in Ellensburg by the Kittitas County Public Health Department, an increase of three from Thursday.  Eight of the 10 cases were in children who attend Creative Kids Learning Center or Little Tot Town day care centers, which the health department closed Wednesday.  About 120 children attend the two facilities, and nearly 70 of them are awaiting test results. Before they can return to any day care facility, the state Department of Health is requiring one negative test. Two negative tests are required from those exhibiting E. coli symptoms in the past three weeks.

"We may never know the source [primary case] of the outbreak," said Amy Diaz, public information officer for the health department. "(The cause) is more difficult to isolate when you have person-to-person spread of the illness."

Far from being rare,person-to-person, or "secondary infections" in which children pass the bug to other children they play with are common.  That is why what you or your neighbor feeds a child may impact others in the community.

The Battle of Over Raw Milk Heats Up

Food Safety Advocate Bill Marler educates the public about the potentially deadly risks of drinking raw milk

The debate over raw milk is heating up. Advocates of the fresh-from-the-farm, raw dairy product, claim that it is rich in disease-fighting nutrients, which they believe are lost in the pasteurization process. Meanwhile, the United States government and food safety advocates, including Bill Marler, remain firm in their scientifically viable stance that raw milk’s dangers outweigh any believed benefits.

Bill Marler, who started his crusade for food safety as the lead attorney for victims of the Jack in the Box Outbreak in 1993, has turned much of his attention to the dangers of raw milk. “Through my experience I have found that raw milk produced in small dairy farms is unavoidably contaminated,” said Marler. “We need to make sure milk goes through pasteurization so we don’t risk our children’s health.”

Pathogens like Salmonella, Campylobacter and E. coli O157:H7 that are originally contained in the manure of an infected animal, can contaminate raw milk and the products that are made from it due to unclean udders, milking equipment, or a generally unsanitary milking environment. Pasteurization is the only way to ensure that these dangerous bacteria do not contaminate products that will be consumed raw.

It is already illegal to sell raw milk in 28 states, but a small, yet passionately devoted raw milk following is trying to loosen the states’ regulatory grip in spite of the long history of outbreaks associated with the product. “I cringe at the anti-science blather protesting that all outbreaks linked to raw milk never happened, or were caused by something else, or were part of some dark conspiracy designed to discredit what is really a wonder-product,” said Marler. “The truth is these outbreaks do happen, including 10 since January alone.”

The outbreaks that Marler references have occurred in 9 different states, including Washington, Utah, Minnesota, Nevada, Pennsylvania, New York, Michigan, Indiana and Illinois. Washington and Utah have each seen two raw milk outbreaks since the beginning of the year. Health officials from the affected states have counted over 50 confirmed illnesses from infection by Salmonella, E. coli, and Campylobacter, and one victim of the Pennsylvania outbreak developed Guillain-Barre Syndrome (GBS) and is still hospitalized.

In March, the debate boiled over in our nation’s “dairy state” when a hearing turned into a rally on the Raw Milk Act. While it was eventually vetoed, this bill in the Wisconsin Legislature would have allowed the state’s dairy farmers to sell raw milk directly to consumers.

Marler was one of several concerned food safety advocates and industry representatives who had who consulted with Wisconsin’s governor about the bill.

Marler’s crusade against raw milk is personal – he never again wants to see a client like Chris Martin, who, at age seven, developed an infection from exposure to E. coli O157:H7 that almost took his life after he drank raw milk.

In addition to his influence on the Wisconsin bill, Marler played a similar role in convincing the California governor, Arnold Schwarzenager, to veto a bill that would have liberalized the production and sale of raw milk.

But Marler sees that the problem is much bigger than proposed bills in a couple of states. “A level of education needs to happen. There is so much misinformation about the benefits of raw milk—it’s been touted as a cure-all for everything from allergies to asthma. This is simply not true and whatever possible good comes from raw milk is greatly outweighed by the fact that it can kill you.”

This spring, Marler helped spearhead the collaborated launch of RealRawMilkFacts.com (www.realrawmilkfacts.com), a new website that reveals the benefits as well as the risks of consuming raw milk, and gives up-to-the-minute coverage on all raw milk-related news, including contamination outbreaks and related recalls. Marler collaborated with scientists, food safety advocates and health educators from university, government, industry, and professional organizations, on the website’s content. The site provides clarity on evidence-based studies, presentations, commentaries, regulations, and position statements on the beverage and its use.

Marler also launched the Foodborne Illness Outbreak Database (www.outbreakdatabase.com), a web-based, searchable database of illness outbreaks caused by consumption of contaminated food or water, exposure to animals, or contact with persons ill with a food or waterborne disease. The site includes outbreaks related to raw milk, and provides comprehensive details, including the dairies or farms that sold the product.

“Consumers need outbreak information available to them so they can make informed decisions about what they eat and drink, in the case of raw milk. Businesses that poison their customers need to have a light shone on them so both policy makers and other business can learn from the mistakes”, said Marler, “Our free market does not function if information about the safety of our food is hidden from us.”

FDA Issues Draft Guidance on the Judicious Use of Medically Important Antimicrobials in Food-Producing Animals

The U.S. Food and Drug Administration today issued draft guidance intended to help reduce the development of resistance to medically important antimicrobial drugs used in food-producing animals.

Today’s draft guidance outlines the FDA’s current thinking on strategies to assure that antimicrobial drugs that are important for therapeutic use in humans are used judiciously in animal agriculture. The FDA acknowledges the efforts to date by various veterinary and animal producer organizations to institute guidelines for the judicious use of antimicrobial drugs, but the agency believes additional steps are needed.

The draft guidance summarizes a number of published reports on antimicrobial resistance and states that the overall weight of evidence available to date supports the conclusion that using medically important antimicrobial drugs for production or growth enhancing purposes (i.e., non-therapeutic or subtherapeutic uses) in food-producing animals is not in the interest of protecting and promoting the public health.

The document recommends phasing in measures that would limit medically important antimicrobial drugs to uses in food-producing animals that are considered necessary for assuring animal health and that include veterinary oversight or consultation. These steps would help reduce overall use of medically important antimicrobial drugs, thereby reducing the pressure that generates antimicrobial resistance.

The FDA recognizes the importance of antimicrobial drugs for addressing the health needs of animals. Antimicrobial drugs have been widely used in human and veterinary medicine for more than 50 years with benefits to both human and animal health. The development of resistance to these drugs, and the resulting loss of their effectiveness, poses a serious public health threat.

“Using medically important antimicrobial drugs as judiciously as possible is key to minimizing resistance development and preserving the effectiveness of these drugs as therapies for humans and animals,” said Bernadette Dunham, D.V.M., Ph.D., director of the FDA’s Center for Veterinary Medicine. “FDA is committed to working with animal drug sponsors, the veterinary and public health communities, the animal agriculture community, and all other interested stakeholders in developing a practical strategy to address antimicrobial resistance concerns that is protective of both human and animal health.”

The agency invites comments on the draft guidance, available online and titled The Judicious Use of Medically Important Antimicrobial Drugs in Food-Producing Animals.

Report: Many Airline Meals Prepared in Unsanitary Conditions

Comedians have been getting "mileage" out of airline food jokes for years, but news today raises much more serious concerns about the safety of the food.   A report by Gary Stoller at USA Today states that:

Many meals served to passengers on major airlines are prepared in unsanitary and unsafe conditions that could lead to illness...FDA inspectors have cited numerous catering facilities that prepare airline food for suspected health and sanitation violations following inspections of their kitchens this year and last, according to inspection reports obtained through the Freedom of Information Act.

The cited caterers included  LSG Sky Chefs, Gate Gourmet, and Flying Food Group.

The food generated by these three caterers alone reaches a large number of people - serving 100 million meals annually, including both U.S. and foreign airports.  The reports were not pretty:

The FDA reports say many facilities store food at improper temperatures, use unclean equipment and employ workers who practice poor hygiene. At some, there were cockroaches, flies, mice and other signs of inadequate pest control.

The caterers responded, saying that they work hard to ensure safety, and include monitoring systems: 

LSG Sky Chefs has "comprehensive and multilayered quality-control standards in place to ensure our customers receive safe, healthy and high-quality food," says spokeswoman Beth Van Duyne.

Norbert van den Berg of Gate Gourmet says findings are taken "very seriously" and the company uses an independent auditor for quality assurance. Glenn Caulkins of Flying Food Group also says his company's facilities are independently audited for quality assurance.

The sheer volume of meals served by the airline caterers make this an important food safety issue.

Report on UK Petting Zoo E. coli O157:H7 Outbreak Warns that Risk Continues

In 2009, 93 people, mostly young children, were sickened in an outbreak of E. coli O157:H7 linked to the Godstone Farm in Surrey, U.K.  A year later, an independent inquiry into the matter has produced a report that concluded that dozens of cases of E. coli O157:H7 "could have been prevented if authorities had acted earlier and taken the outbreak more seriously" according to press reports.   Outbreaks of E. coli O157:H7 at petting zoos are not new.

Professor George Griffin, professor of infectious diseases at St George's University London, chaired the inquiry.  He warned that "regulations governing petting or 'open' farms were not robust enough to prevent a similar outbreak occurring again." 

The report was critical of medical practitioners and government officials alike:

The 250-page report said some local GPs did not recognise the illness as a medical emergency, telling parents their children would get better on their own only for them to deteriorate rapidly.

There were 'unacceptable delays' by the Health Protection Agency in setting up an outbreak control team and a 'failure in public health leadership', the report said.

It added: "If action had been taken sooner to stop all contact with ruminants (cows and sheep), a substantial number of the E.coli 0157 cases could have been prevented."

8 of the ill persons developed cases of HUS serious enough to need dialysis to survive.   Some victims may need a kidney transplant in the future.  Because HUS is much more likely to develop among children exposed to E. coli O157:H7, outbreaks at petting zoos are particularly damaging.  Such a sudden spike in children needing kidney treatment stretches medical care thin as well:

The outbreak was so severe that every specialist hospital bed to treat children with serious kidney problems in London and the South East was filled with cases from Godstone Farm.

The report suggested that thousands were permitted to visit the farm after the local Health Protection Agency was aware of at least cases of illness linked to the farm.  The report did not call for a ban on human/animal contact at such fairs:

Prof. Griffin said the report was in favour of common sense approach and not draconian measures. He said it was perfectly possible for children to pet animals on a farm safely if the animals are kept clean, on fresh bedding and handwashing facilities are readily available and well supervised.

In the U.S. the CDC has published guidelines created by the National Association of State Public Health Veterinarians for public animal exhibits.

Marler Clark Donates $25,000 to Cold Springs, MN High School

Beyond our own passion in representing those seriously injured in foodborne illness outbreaks, we also enjoy encouraging others to become involved in food safety.

Many readers of FPJ are also aware of our client, Stephanie Smith, who became severely injured following consumption of a hamburger contaminated with E. coli O157:H7.  With Stephanie in mind, our firm has donated $25,000 to her alma mater, Rocori High School in Cold Springs, Minnesota, to endow an annual scholarship of $1,250 to $1,500.

David Unze, at the St. Cloud Times, writes today:

The Seattle law firm that represents clients nationwide in food-borne illness cases has donated $25,000 to Rocori High School for science scholarships.

Marler Clark, which represented Rocori graduate Stephanie Smith in an E. coli case against Cargill, donated the money to encourage and support students interested in science, especially in food safety and the treatment of food-borne disease, attorney Bill Marler said.

The donation will endow an annual scholarship of $1,250 to $1,500, Marler said. His firm occasionally donates to similar causes, and the partners in the firm have set up scholarships like the one at Rocori at their high schools, Marler said.

Marler represented Smith when she became ill after eating a hamburger tainted with E. coli. Smith nearly died after contracting the disease in 2007 and later sued Cargill.

Marler said that Smith was aware of the donation, although she has been focused on her recovery.
“She’s got a long way to go, cognitively and physically,” Marler said of Smith. “She’s more focused on learning how to walk again.”

The case against Cargill has since settled, and a court hearing scheduled for today in St. Paul is intended for a federal judge to review and approve the terms of the settlement.

Marler represents numerous plaintiffs in food-borne illness cases across the country. He also has lobbied Congress for a food-safety bill to provide more money for the Food and Drug Administration to inspect and improve the safety of the nation’s food supply.

Listeria, Brucellosis Cases Linked to Raw Dairy in Delaware

Delaware Health and Social Services issued a press release yesterday regarding one case each of Listeriosis and  Brucellossis with links to raw dairy products:

The Delaware Division of Public Health (DPH) has identified simultaneous cases of Brucellosis in a 58 year old female New Castle County resident and Listeriosis in a 44 year old male in Sussex County. These illnesses are both bacterial infections which primarily affect those consuming or coming into contact with contaminated animals or animal products, most commonly the consumption of raw food or dairy products. In both instances, these patients had consumed raw dairy products prior to becoming ill, and the individual with Listeria had also been handling raw poultry products. No other risk factors have been identified. The Brucella case was hospitalized and discharged. The Listeria case is still admitted but stable.

The sale of raw dairy products is prohibited in Delaware.   Raw milk has been connected with multiple outbreaks of illness in the U.S. this year, most recently an E. coli O157:H7 outbreak in Minnesota.  Both of the ill persons appear to be recovering, although the person with Listeria remains hospitalized.   Dr. Karyl Rattay, DPH director had this to say:

"It could have been much worse.  These cases can serve as an unfortunate reminder that we are vulnerable to certain bacteria and should take precautions to protect ourselves. People will still need to handle affected animals or work with animal products but they should be aware of the dangers and the illness prevention measures. In addition, we should all be reminded that consuming questionable food items is not worth the risk to your health."

According to DPH, Brucellosis primarily affects farm workers, veterinarians and laboratory workers.  Brucellosis is not common in the United States - nationally the average is less than 200 cases annually - as person to person transmission is rare. Brucellosis is most frequently transmitted by eating or drinking raw milk and cheese made with unpasteurized dairy products yet can also be contracted through inhalation or touch.

Listeria can be spread by several different methods, but is commonly transmitted through the ingestion of unpasteurized milk or contaminated vegetables.

Agency Report on U.K. Petting Zoo E. coli O157:H7 Outbreak Due

A report on last summer's outbreak of E. coli O157:H7 , traced to the Godstone Farm in Surrey, U.K. is due shortly, according to the BBC.   Ninety-three people, mostly young children, were sickened in the outbreak.  

The inquiry was ordered by the Health Protection Agency.  The Agency was criticized for a slow response to the problem.  According to BBC:

The independent inquiry looked into how the outbreak occurred and the role of the regulatory agencies.  The farm was not closed until a month after the first case .During this time tens of thousands of people would have passed through it.  Some of the people affected are still ill with kidney damage and a group of parents are preparing to launch legal action for damages.

Outbreaks of zoonotic disease, generally, and E. coli O157:H7 in particular, has been a problem in both the U.K. and the U.S. that has been documented for over 20 years.  

California Study on Raw Milk Consumption Rates

Despite an ever-growing list of food poisoning outbreaks tied to raw milk, there have simultaneously been a number of media reports claiming that the beverage is gaining in popularity. 

In 1997, researchers in California published the results of a study of consumers gauging the consumption rates for raw milk.  At the time of the study, 3.2% of the 4000 California residents polled reported drinking raw milk in the past year.  Both then and now, the retail sale of raw milk was legal in California. 

The report's publishers, Marcia Headrik, DVM MPH; Badgaleh Timbo MD, DrPh;Karl Clontz, MD MPH; and S. Benson Werner, MD noted the history of illness and bacterial pathogens associated with raw milk.   They also noted that raw milk consumers were more likely to be under the age of 40 than non-consumers.

Because it was a phone study asking consumers directly of their habits, rather than of their family members, there was no published data on consumption rates by minors (under 18 years of age.) 

Infant Botulism Risk From Honey

Although it is a rare illness, infant botulism is incredibly serious.  For this reason, parents of newborns are being reminded to refrain from feeding honey, even the smallest amount, to any child under the age of 1.

If the botulism spores are ingested, they begin to multiply in the infant's gastrointestinal tract, producing a toxin.  The toxin interferes with muscle control and nerve pathways, and can lead to paralysis and possible death.

Why risk it?  Be safe, and just wait until your child is over the age 1 and has developed sufficient "good" bacteria in his or her gastrointestinal tract to fight off the potentially lethal toxin.

Raw Milk Fight Still at the Forefront

The raw milk controversy continues to generate press- both in print and in the "blogosphere."  Last Thursday on my layover in Minneapolis, this article was on the front page of the Star Tribune.   On June 4, the New York Times ran an Op-Ed from Michael Feldman discussing the Wisconsin Governor's veto of a bill that would have allowed retail sales of raw milk.   Finally, Marion Nestle weighed in as well. 

The Star-Tribune article was following up on an outbreak of E. coli O157:H7 linked to raw milk at Hartmann's dairy.   Last week, Minnesota health officials announced that the strain of E. coli O157:H7 associated with the illnesses was found at "multiple sites" on the farm. 

In the NY Times, Feldman painted a picture of the passion of raw milk advocates, while expressing some skepticism at their claims, "Standard pasteurization, they claim, kills a dubious-sounding 99.999 percent of milk’s good, bad and indifferent microorganisms..."

Nestle explained her personal choice not to consume raw milk.  She suggested that readers visit www.realrawmilkfacts.com, and stated "Putting a child at risk of hemolytic uremic syndrome from toxic E. coli just doesn’t make sense to me."

As usual, the comment sections of raw milk stories on line are active.   Before I go, I want to address a personal favorite of mine.  Over and over again, I see raw milk advocates explaining that the safety of raw milk is simply about "knowing your farmer."   I just don't see how this really changes the equation.  Does your farmer have the ability to spot microscopic bacteria?  Bacteria that are NOT pathogenic to cows, and present in the intestinal tracts of healthy animals?  We have represented the families of sick children who knew their farmer.  It did not remove the E. coli O157:H7 from the milk.

Despite Spate of Outbreaks, Many Illnesses Still Not Connected to Source

In the past weeks, we have seen outbreaks of Salmonella in sprouts and lettuce, E. coli O145 in lettuce, E. coli O157:H7 in raw milk, Salmonella in raw milk, and campylobacter in raw milk.  Still, as Lynn Terry wrote Friday in the Oregonian, many severe food poisoning incidents are never connected with their source. 

Terry reported on the Valenzuela family, whose young son suffered a severe E. coli O157:H7 infection:

Stephen and Sarah Valenzuela....described how their son Jet  fell violently ill when he was 3. He was hospitalized on and off for nine months. He suffered acute renal failure, was in a medically induced coma for a week, underwent dialysis and four surgeries. He almost died two times.

"We're just lucky we got him back," said Sarah Valenzuela. Health officials never found the food that sickened him.

It is likely that the majority of food poisoning incidents are never conclusively tied to their sources.   In addition, even in reported outbreaks, the number of recognized cases is likely only a fraction of the actual illnesses.  In fact, in reference to Salmonella, the CDC has previously estimated that there are 38.6 illnesses for each confirmed case in an outbreak.

E. coli Presence Low Among California's "Salad Bowl" Region Wildlife Population

The findings of an E. coli O157:H7 study conducted by the Western Institute for Food Safety and Security at UC-Davis were recently presented by lead author, Michele Jay-Russell, and the results suggest the infamous bacteria is actually not common in California's "salad bowl" region.  As reported by Don Schrack in The Packer:

Over a two-year period, a research team collected and tested more than 1,130 fecal samples from wild birds and mammals at nearly 40 farms in Monterey, San Benito and San Luis Obispo counties, a region often called California’s salad bowl.

The bacterium was found in 20 samples from cowbirds (2), crows (5), coyotes (2), feral pigs (10) and one deer mouse. Samples from deer, opossums, raccoons, skunks, squirrels and other bird and mouse species tested negative, according to the study.

A total of 200 samples came from feral pigs, with 5% testing positive for the E. coli strain. Feral pigs were commonly found in the area where the spinach in the 2006 outbreak was grown, although a 6-month investigation into the cause of the outbreak didn’t establish a definitive link.

An earlier Centers for Disease Control and Prevention study found about 15% of feral pigs tested from the area were positive for that E. coli strain, as were 34% of cattle. One of the four farms implicated in the outbreak was about a mile from a [grass-fed beef operation].

According to Ms. Jay-Russell, there are a number of things to take away from the study's findings, including:

  • growers should take prompt action if wildlife is present in large numbers;
  • follow good agricultural practices to protect crops from contamination during production and harvest; and
  • maintain proper refrigeration along the entire chain, including at the consumer's home.

In addition, consumers also can exacerbate the problem when trying to prevent possible pathogen contamination, therefore “if a product is triple-washed, we don’t recommend another wash in the home, because it opens the possibility of cross contamination,” Jay-Russell said.

BP Blames Illnesses in Clean-Up Workers on Food Poisoning

Officials at BP are saying that a group of illnesses among oil spill clean-up workers resulted from food poisoning, according to reports.  A group of people working to clean the massive spill reported nausea, headaches and chest pain.  The workers were apparently using chemical dispersants to counter the spill.

BP CEO Tony Hayward was quick to place the cause of the workers' illnesses elsewhere:  

"I'm sure they were genuinely ill, but whether it was anything to do with dispersants and oil, whether it was food poisoning or some other reason for them being ill," Hayward said. "You know, food poisoning is clearly a big issue when you have a concentration of this number of people in temporary camps, temporary accommodation. It's something we have to be very, very mindful of. It's one of the big issues of keeping the army operating. You know, armies march on their stomachs."

Even with the hopeful presumption that the illnesses are not serious, the incident is a good example of the disruption that food poisoning can cause.   Missed work time and productivity is just one cost.   The USDA recently released estimates of yearly costs associated with two prominent pathogens that cause food poisoning, Salmonella and E. coli O157:H7.  USDA estimated those yearly costs at $2,649,413,401 and  $478,381,766 respectively.

New E. coli Reporting Rules for Missouri DNR a Year After Scandal

A year ago, high levels of E. coli in the Lake of the Ozarks went unreported over a busy holiday weekend, for reasons that are still debated.   The Kansas City Star eventually reported on the failure to report the issue, and the apparent cover up.   Who was to blame still depends on who you ask.  It looks like some good has come of it though, as Missouri Department of Natural Resources (DNR) now has a better reporting plan in place:

The Department of Natural Resources has overhauled the way it sends an alarm about E. coli, which the government calls a serious health hazard. Also, a task force has been formed to consider a centralized sewer district around the lake, where thousands of septic tanks overflow into the water.

Reporting E. coli levels in public swimming places is important.   E. coli is the generic term for a family bacteria that includes E. coli O157:H7, and other pathogenic forms of E. coli.   The pathogenic forms of E. coli cause severe foodpoisoning symptoms, including bloody diarrhea and abdominal cramps.  In some cases, especially in children and the elderly, it can lead to hemolytic uremic syndrome (HUS).  HUS is a potentially fatal complication that can also cause permanent kidney damage.

Despite an increased awareness of the issue, the problem with the lake continues:

Recent readings show the E. coli problem has not gone away. Bacteria continues to spike, especially after rains wash feces into the lake.  While one major beach there remains open this weekend, Public Beach 1 at Lake of the Ozarks State Park has now been closed for two weekends.

In addition, a new focus on wastewater treatment plants in Missouri has uncovered more problems, but has not led to widespread action:

Inspectors cited 208 violations at 154 treatment facilities and this spring began a second sweep. As of May 21, inspectors had gone back to 142 facilities and issued 70 additional citations.  Some facilities voluntarily cleaned up their mess, state officials said. As for the rest, only two facilities have agreed to pay a total of $2,250 in penalties pending cleanup. Two others had $5,750 in penalties that were suspended pending the outcome of their cleanup.Only 26 cases so far have been referred to Attorney General Chris Koster for further action. The rest of the cases are pending, a DNR official said.

With summer just beginning, there is hope that the new warning system will at least keep swimmers away from the known dangerous locales.

Looking for Data on Food Poisoning Outbreaks? - See www.outbreakdatabase.com

We are getting closer to finalizing www.outbreakdatabase.com.  Thanks for all the input - keep it coming.

E. coli O157:H7 and Raw Milk AGAIN - Illnesses in Washington State

The Washington State Department of Health (WDOH) announced today that two recent E. coli O157:H7 infections are connected to the consumption of "raw" unpasteurized milk.  According to WDOH  "The two cases confirmed this month bring the count of infections this year associated with one Bellingham dairy to eight."

Washington State Department of Agriculture (WSDA) is also involved in the investigation:

The two new patients say they drank raw milk produced by Jackie’s Jersey Milk in Whatcom County. WSDA has conducted additional testing of the firm’s product, but has not found E. coli in the milk. WSDA continues to work with the farm to review the dairy's production and producthandling practices.

The firm issued a product recall notice in February after WSDA found E. coli during routine sampling of the farm’s raw milk. Soon after the February recall, six patients with E. coli infections reported drinking the dairy’s product. People who were sick said they got the milk at retail stores in King, Snohomish, and Skagit counties.

Its getting hard to count all the raw milk outbreaks.  There is another currently being reported in Minnesota that has left a toddler in the hospital.

2010 Raw Milk Scoreboard - E. coli, Salmonella, and Campylobacter

Still not half way through 2010, and we have already seen at least six outbreaks of illness, involving three different dangerous pathogens, tied to raw milk.  There have been outbreaks in Minnesota, Nevada, Utah (2), and Pennsylvania, as well as a single outbreak that included illnesses in Michigan, Indiana, and Illinois.  Raw milk consumers have been sickened with E. coli O157:H7; Salmonella, and Campylobacter

For those of you scoring at home:

Just today, health department officials in Minnesota have reported three cases of E. coli O157:H7 illness linked to raw milk from a dairy farm in Gibbon, MN. The Minnesota Department of Health and the Minnesota Department of Agriculture are continuing to investigate the illnesses.  All of the sick share a strain of the bacteria that have the same “pulsed field gel electrophoresis” (PFGE) patterns, or DNA fingerprint.   One of the ill persons has developed HUS.  

Earlier this month, Nevada health officials reported that a child became seriously ill with a Campylobacter infection after eating homemade cheese that was illegally sold door-to-door.    The cheese was not properly pasteurized. 

In April, Utah was the site of Salmonella and Campylobacter outbreaks tied to raw milk. According to a Utah Public Health Press Release, there were two separate clusters of illness linked to the consumption of raw milk. The first cluster included nine reported cases of Campylobacter infection among residents in Weber, Davis and Cache Counties. This outbreak was linked to the Ropelato Dairy.  The second cluster, linked to the Redmond Dairy,  included six reported cases of Salmonella infection in residents in Utah, Salt Lake and Wasatch Counties. 

In March, raw milk caused at least 17 culture confirmed Campylobacter infections in Michigan, Illinois, Indiana.   Three cases were from Indiana, one from Illinois, and 13 from Michigan. 

Another outbreak of Campylobacter was reported in February in Pennsylvania. State health officials there said approximately 10 people became ill after drinking raw milk from Pasture Maid Creamery. One of the ill developed Guillain - Barre Syndrome, and became paralyzed.

Also, see www.realrawmilkfacts.com for more information.

Food Poisoning Cost 3 Billion Annually - Salmonella and E. coli O157:H7 Alone

The USDA, on a new website on May 13, unveiled a cost of food poisoning calculator.  To date, the only two pathogens with reported yearly costs estimates are Salmonella and E. coli O157:H7.  The combined cost estimate for those two?  In excess of $3 Billion. 

According to the USDA, the estimates "include assumptions about disease incidence, outcome severity, and the level of medical, productivity, and disutility costs."  The calculator allows a user to input different assumptions and see how the total cost would be affected. 

The calculator will apparently be updated in the future to include additional pathogens and estimates, including Campylobacter, Listeria, and non-O157:H7 strains of shiga toxin producing E. coli. 

The site estimates the number of non-O157:H7 E. coli illnesses at over 31,000 annually.  An example of such a pathogen is E. coli O145, the cause of an recent outbreak of illness connected to romaine lettuce. 

Study of E. coli O157:H7 in California Wildlife Set to be Released

Following the completion of a "massive field study" researchers have reported the presence, albeit uncommon, of E. coli O157:H7 in wildlife in California's central coast region.  The findings were reported yesterday at the annual meeting of the American Society for Microbiology in San Diego. The occasional presence of E. coli O157:H7  in fecal samples of wildlife species including cowbirds, coyotes, crows, mice and feral pigs was reported. 

The impetus for the study was the 2006 outbreak of E. coli O157:H7 in bagged spinach grown and processed in the region.   The outbreak caused at least 205 illnesses and five deaths.

“The study helps us better understand the possible risk of crop contamination from wildlife and allows us to compare that to the risk of contamination from other possible sources such as livestock and irrigation water,” said lead study author Michele Jay-Russell, a veterinarian at UC Davis’ Western Institute for Food Safety and Security.

The incidence of E. coli O157:H7 in the tested wildlife was perhaps somewhat lower than expected:

From 2008 through 2009, the team collected and tested 1,133 fecal samples from wild birds and mammals on 38 private properties in Monterey, San Benito and San Luis Obispo counties in California. All three counties are home to farms that grow fresh spinach, lettuce and other produce.

Laboratory tests revealed that E. coli O157:H7 was present in samples from two cowbirds, two coyotes, five crows, one deer mouse and 10 feral pigs. Samples from deer, opossums, raccoons, skunks, ground squirrels and other bird and mouse species all tested negative for the bacterium.

The relatively low incidence of the bacteria in wildlife stands in contrast to the large number of E. coli O157:H7 outbreaks tied to leafy greens from the area.  Thus, researchers are left to ponder other potential sources and explanations. 

Salmonella Outbreak in Alfalfa Sprouts - 23 Sick in 10 States

At least 23 persons have been sickened in 10 states in an another outbreak of Salmonella linked to alfalfa sprouts, according to the Oregonian.  Included in the ill was a baby boy in Multnomah County, Oregon, who was hospitalized in May, but has reportedly recovered.

The outbreak,  which apparently began in March, was traced to "alfalfa sprouts sold under several labels that were produced by Caldwell Fresh Foods of Maywood, California."

Caldwell Fresh Foods is recalling all of its sprouts.   The recalled brands include: Caldwell Fresh Foods, Nature's Choice and California Fresh Exotics brands.  A complete list of where the sprouts were sold is not currently available.   In Oregon, the implicated sprouts were sold at Trader Joe's and Walmart, and possibly other locations.

Very unsurprisingly, Oregon health officials are among those leading the way:

William Keene, senior epidemiologist withe the state Public Health Division, said the sprouts were sold in at least 19 states in the West, Midwest and the South. The outbreak includes cases in Oregon, Idaho, California, Nevada, Arizona, Colorado, Missouri and Wisconsin.

This is the 12th time since 1995 that alfalfa sprouts have caused an outbreak of food poisoning, prompting health officials to issue warnings.  Keene told the Oregonian, "We want people to understand that it is a relatively high-risk food.  They need to consider that if they eat it."

Food Poisoning May Rise With Global Warming

Incidences of food poisoning are likely to rise with increased global temperatures, according to a report from the WHO and Malta's Infectious Disease Prevention and Control Unit.  According to the report, a study on the health effects of climate change in the Maltese islands warns that rising temperatures increase the likelihood of food-borne diseases like salmonella.

The study found 450 cases of diarrheal illness in Malta occurring each day, at a cost of 16 million Euros.  It was also reported that cases of diarrheal illness increase in May, with the rise in temperature, peaking in the summer months.  The study looked at an 18 year period of illnesses from 1990-2008.  Part of the increase was blamed on increased outdoor activities involving food such as barbecues.

In view of the increased risks caused by climate change the study calls for "increased public awareness on food safety, hygiene and food preparation."

The study was authored by Dr Anthony Gatt from the Infectious Disease Prevention and Control Unit and Dr Neville Calleja director of the Health Information and Research Directorate.

Campbylobacter in Drinking Water on 10 Year Anniversary of Walkerton E. coli Outbreak

With Utah officials investigating an apparent outbreak of campylobacter linked to public drinking water, this week marks the 10 year anniversary of the Walkerton E. coli O157:H7  outbreak.  The outbreak, the largest outbreak of E. coli O157:H7  in North American history, began unfolding in Walkerton, Ontario, Canada in May, 2000. CBC news provided this at times chilling timeline – detailing the failures of public water officials to notify the public of contamination in the water system. The contamination of the public drinking water eventually led to 2,300 illnesses and 7 deaths.

According to CBC, illnesses were first reported on May 17, 2000. Public utilities officials had confirmation of E. coli contamination in the water on May 18, but took no action. In fact, when health agencies began investigating and looking for a cause of the outbreak, the public utilities commission (PUC) assured investigators that the water was safe. Five days after the positive sample was drawn, 40 people had been reported ill, and the PUC was assuring the public that the water was safe.

Thankfully, health officials took matter into their own hands, and conducted independent tests of the water that return positive. When confronted, PUC finally admitted the positive result, and conceded that chlorination equipment had not been working for some time.

Health officials at that point warned residents not to drink the water. It was too late. The first four deaths, 3 adults and a baby, were reported. Civil and criminal investigations ensued. Evidence was presented that sampling as far back as January had showed evidence of coliform bacteria in the water, an indicator of contamination and the possibility of the presence of E. coli.

PUC manager Stan Kobel was eventually sentenced to a year in prison. His brother Frank, ex-foreman at PUC, received nine months of house arrest. Ontario Superior Court Judge Bruce Durno stressed that “there was never any intent on the part of the Koebels to harm anyone” but found them “negligent in discharging their duties.”

Hopefully the painful lessons of the Walkerton outbreak will spur officials to full and immediate disclosure in any future outbreaks.

Raw Milk Salmonella Outbreak in Utah Confirmed

The Utah County Health Department (UCHD) has confirmed that six Salmonella illnesses in April were linked to raw milk sold at Real Foods stores in Orem and Heber City, Utah.  All the individuals were ill with Salmonella Newport, and each reported consuming the raw milk.   Now it is reported that UCHD tested samples of the milk from the dairy, and found Salmonella:

Six people, ages 2 to 56, were diagnosed with a specific type of salmonella called Newport in April, said Utah County Health Department spokesman Lance Madigan. Four of the cases were in Utah County, with one each in Salt Lake and Wasatch counties. When investigators went through their where-have-you-been, what-have-you-eaten studies, they found all six had consumed raw milk bought from Real Foods stores in Orem and Heber City. That led them to Redmond Farms in Sevier County, where the raw milk was produced, he said.

Real Foods and Redmond stopped selling the unpasteurized milk while the investigation was conducted. And officials found salmonella in several of the milk samples it tested that were dated between April 5 and 22.

"New" milk is apparently testing negative for the moment and is back on the shelves.  Shouldn't the grocery stores be thinking twice at this point?

New Web Site Provides Factual Look at "Raw-Mik"

A group of food-safety advocates from a broad spectrum of backgrounds has launched realrawmilkfacts.com to provide potential consumers with information about unpasteurized milk.    The website draws contributions from "Scientists, food safety advocates and health educators from universities, government, industry, and professional organizations."  

There have been numerous media reports lately of the growing popularity of raw milk. Also growing has been the debate over the true risks and benefits associated with the product.  The website is designed to address that controversy:

While on the surface raw milk might sound like a healthy alternative to the commercial product, the pasteurization process was developed to eradicate potentially deadly pathogens such as E. coli 0157:H7, Salmonella, and Campylobacter, which can be transferred into milk from the animal and farm surroundings.

The site is also designed to provide updated coverage of raw-milk issues, including contamination outbreaks and related recalls.

E coli Contaminated Water Sickens 14 in Missouri

The Missouri Department of Health and Senior Services (DHSS) has announced that at least 14 people are ill as a result of drinking water at a sports complex. The illnesses have been linked to E. coli in water at Class Act Sports Complex in Jackson, Missouri.   

DHSS reports that:

Officials with the Cape Girardeau County Public Health Center tested water from a drinking fountain and a faucet within the facility and confirmed the presence of E. coli in both samples. The sports complex, which is served by a private well, shut off its water last Thursday at the urging of local health officials.

Four of those sickened have been hospitalized.  The DHSS announcement does not make clear which strain of E. coli has been implicated.   Most reported cases of illness from the bacteria are linked to E. coli O157:H7.   The recent E. coli outbreak linked to romaine lettuce, however, is linked to E. coli O145. 

Freshway Lettuce E. coli O145: More Recalls, Second Strain of E. coli

The number of confirmed and probable E. coli O145 infections remained steady at 29 today, but additional recalls were announced as evidence of additional contaminated product surfaced.  CIDRAP reported on developing news on a number of fronts:

  • Location of the outbreak strain of E. coli O145 in Freshway bagged romaine lettuce:  "the New York State Public Health Laboratory found the outbreak strain in an unopened bag of shredded romaine distributed by Freshway."
  • Freshway recall, update on products and states:  Freshway has now recalled "72 different types of bagged lettuce" in 23 states.
  • Yuma, AZ farm implicated, second firm recalls lettuce from same farm:   "Vaughan Foods of Moore, Okla., said it was recalling bagged romaine with a sell-by date of either May 9 or May 10."  CIDRAP reports that FDA has confirmed this link.
  • Second, independent strain of pathogenic E. coli isolated in Freshway bag:  "the Ohio Department of Agriculture has also tested bagged lettuce implicated in the outbreak and found a second, unrelated strain of E. coli in a bag of shredded romaine from Freshway."
  • Second strain leads to additional recall of lettuce:  Andrew Smith Co. of California launched a recall of "1,000 cartons or about 23,000 pounds of lettuce sold to Vaughan Foods and to an unidentified third firm in Massachusetts.

Perhaps most remarkable, given the broad impact and the number of illnesses, is the likelihood that investigators are only seeing the tip of the iceberg.  "The CDC said last week that many clinical laboratories do not test for O145 because the assay is more difficult to perform, and that therefore cases caused by the strain may be underreported."

E. coli in Lettuce - A Study of Yuma Lettuce Production, 2006

With 29 confirmed and probable cases of E. coli O145 infection linked to Freshway brand romaine lettuce, investigators continue their search to confirm the lettuce's place of origin.   A possible answer is the farms in Yuma, Arizona:  "A potential location has been identified in Yuma," Kurt Nolte, Yuma County Cooperative Extension director and agriculture agent, said Friday.

The long history connecting leafy greens to outbreaks of pathogenic E. coli is well documented.  The potential for contamination of lettuce from the Yuma area was investigated previously.  At a conference in November, 2006, following on the heels of the Dole spinach outbreak, Jorge M. Fonseca, of the University of Arizona, Yuma Agricultural Center, Department of Plant Sciences, gave this informative presentation.

Among the issues looked at- soil quality; water source; wildlife intrusion; and proximity to cattle farms.  Mr. Fonseca noted that very few animals were noted in Yuma lettuce fields, with the exception of migratory birds.   It was also reported that the farms draw their water from the Colorado River, almost exclusively.  At the time of the report cattle farming in the area was apparently limited, although domestic cattle could be found in the area.

With E. coli O145 Illnesses in New York, Ohio and Michigan, a Refresher Course on the Enemy is in Order

Escherichia coli (E. coli) are members of a large group of bacterial germs that inhabit the intestinal tract of humans and other warm-blooded animals (mammals, birds). More than 700 serotypes of E. coli have been identified. Their “O” and “H” antigens on their bodies and flagella distinguish the different E. coli serotypes, respectively. The E. coli serotypes that are responsible for the numerous reports of contaminated foods and beverages are those that produce Shiga toxin (Stx), so called because the toxin is virtually identical to that produced by another bacteria known as Shigella dysenteria type 1 (that also causes bloody diarrhea and hemolytic uremic syndrome [HUS] in emerging countries like Bangladesh) (Griffin & Tauxe, 1991, p. 60, 73). (download brochure)

The best-known and most notorious Stx-producing E. coli is E. coli O157:H7. It is important to remember that most kinds of E. coli bacteria do not cause disease in humans, indeed, some are beneficial, and some cause infections other than gastrointestinal infections, such urinary tract infections. Shiga toxin is one of the most potent toxins known to man, so much so that the Centers for Disease Control and Prevention (CDC) lists it as a potential bioterrorist agent (CDC, n.d.). It seems likely that DNA from Shiga toxin-producing Shigella bacteria was transferred by a bacteriophage (a virus that infects bacteria) to otherwise harmless E. coli bacteria, thereby providing them with the genetic material to produce Shiga toxin.

Although E. coli O157:H7 is responsible for the majority of human illnesses attributed to E. coli, there are additional Stx-producing E. coli (e.g., E. coli O121:H19, E. coli O145, etc) that can also cause hemorrhagic colitis and post-diarrheal hemolytic uremic syndrome (D+HUS). HUS is a syndrome that is defined by the trilogy of hemolytic anemia (destruction of red blood cells), thrombocytopenia (low platelet count), and acute kidney failure. Stx-producing E. coli organisms have several characteristics that make them so dangerous. They are hardy organisms that can survive several weeks on surfaces such as counter tops, and up to a year in some materials like compost. They have a very low infectious dose meaning that only a relatively small number of bacteria, less than 50, are needed “to set-up housekeeping” in a victim’s intestinal tract and cause infection.

The Centers for Disease Control and Prevention (CDC) estimates that every year at least 2000 Americans are hospitalized, and about 60 die as a direct result of E. coli infections and its complications. A recent study estimated the annual cost of E. coli O157:H7 illnesses to be $405 million (in 2003 dollars), which included $370 million for premature deaths, $30 million for medical care, and $5 million for lost productivity (Frenzen, Drake, and Angulo, 2005). E. coli O157:H7 was first recognized as a foodborne pathogen in 1982 during an investigation into an outbreak of hemorrhagic colitis (bloody diarrhea) associated with consumption of contaminated hamburgers (Riley, et al., 1983). The following year, Shiga toxin (Stx), produced by the then little-known E. coli O157:H7 was identified as the real culprit. In the ten years following the 1982 outbreak, approximately thirty E. coli O157:H7 outbreaks were recorded in the United States (Griffin & Tauxe, 1991). The actual number that occurred is probably much higher because E. coli O157:H7 infections did not become a reportable disease (required to be reported to public health authorities) until 1987 (Keene et al., 1991 p. 60, 73). As a result, only the most geographically concentrated outbreaks would have garnered enough attention to prompt further investigation (Keene et al., 1991 p. 583). It is important to note that only about 10% of infections occur in outbreaks, the rest are sporadic. The CDC has estimated that 85% of E. coli O157:H7 infections are foodborne in origin (Mead, et al., 1999). In fact, consumption of any food or beverage that becomes contaminated by animal (especially cattle) manure can result in contracting the disease. Foods that have been sources of contamination include ground beef, venison, sausages, dried (non-cooked) salami, unpasteurized milk and cheese, unpasteurized apple juice and cider (Cody, et al., 1999), orange juice, alfalfa and radish sprouts (Breuer, et al., 2001), lettuce, spinach, and water (Friedman, et al., 1999).

Wappingers Central School District Reports Two Students with Hemolytic Uremic Syndrome

According to the Poughkeepsie Journal, Freshway Foods shredded romaine lettuce sent from the Wappingers Central School District to the New York state Health Department tested positive for E. coli O145 bacteria and led to a national recall AFTER several students were sickened. Two students from the district were hospitalized at Westchester Medical Center last month with hemolytic uremic syndrome (HUS). Two others were hospitalized. The students go to Roy C. Ketcham High School, John Jay High School Wappingers Junior High School and Van Wyck Middle School.

About Hemolytic Uremic Syndrome

Hemolytic uremic syndrome is a severe, life-threatening complication of an E. coli bacterial infection that was first described in 1955, and is now recognized as the most common cause of acute kidney failure in childhood. E. coli O157:H7 is responsible for over 90% of the cases of HUS that develop in North America. In fact, some researchers now believe that E. coli O157:H7 and other shiga toxin E. coli, like O145, are the only cause of HUS in children.

HUS develops when the toxin from E. coli bacteria, known as Shiga-like toxin (SLT), enters cells lining the large intestine. The Shiga-toxin triggers a complex cascade of changes in the blood. Cellular debris accumulates within the body’s tiny blood vessels and there is a disruption of the inherent clot-breaking mechanisms. The formation of micro-clots in the blood vessel-rich kidneys leads to impaired kidney function and can cause damage to other major organs.

What are the Symptoms associated with Hemolytic Uremic Syndrome?

About ten percent of individuals with E. coli O157:H7 infections (mostly young children) goes on to develop Hemolytic Uremic Syndrome, a severe, potentially life-threatening complication. HUS is an extremely complex process that researchers are still trying to fully explain.

Its three central features describe the essence of Hemolytic Uremic Syndrome: destruction of red blood cells (hemolytic anemia), destruction of platelets (those blood cells responsible for clotting, resulting in low platelet counts, or thrombocytopenia), and acute renal failure. In HUS, renal failure is caused when the nephrons, or filtering units, become occluded (blocked) by micro-thrombi, which are tiny blood clots. In almost all cases, the filtering ability of the kidneys recovers as the body of the patient slowly dissolves the micro-thrombi within the microvessels.

A typical person is born with about one million filtering units, called nephrons, in each kidney. The core of the nephron is a bundle of tiny blood vessels, called a glomerulus, where osmotic exchange allows for the filtration of wastes that eventually collect in the urine and are excreted. During Hemolytic Uremic Syndrome, the lack of blood flow to the nephrons can cause them to die or be damaged, just as heart muscle can die as the result of coronary vessel occlusion during a heart attack. Dead nephrons do not regenerate.

In general, the longer a patient suffers kidney failure, the greater the loss of filtering units as a result. At some point, the damage to the kidneys’ filtering units can be so severe that the patient will, over a period of years, lose kidney function and suffer end-stage renal disease (ESRD), which requires chronic dialysis or transplantation.

HUS can also cause transient or permanent damage to other organs, which include the pancreas, liver, brain, and heart. The essential pathogenic process is the same regardless of the organ affected: microthrombi inhibit necessary blood flow and cause tissue death or damage. During the acute stage of Hemolytic Uremic Syndrome, patients must be carefully monitored for these extra-renal complications. It is very difficult to predict the severity and course of HUS once it initiates.

The active stage of Hemolytic Uremic Syndrome may be defined as that period of time during which there is evidence of hemolysis and the platelet count is less than 100,000. In HUS, the active stage usually lasts an average of six days (range, 2-16 days). It is during the active stage that the complications of HUS per se usually occur.

What are the complications and long-term risks associated with Hemolytic Uremic Syndrome?

Continue Reading...

Marler Clark, food safety advocates and lawyers, provide consumer informational site on E. coli O145 complication - hemolytic uremic syndrome (HUS)

Ongoing outbreak and recall of Romaine Lettuce tainted with E. coli O145

Freshway Foods and the Food and Drug Administration announced yesterday. An a press release, Freshway Foods said the E. coli O145 - tainted Romaine Lettuce was sold to wholesalers, food service outlets, in-store salad bars and delis in Alabama, Connecticut, District of Columbia, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Virginia, West Virginia and Wisconsin. The affected lettuce has a "best if used by" date of May 12 or earlier. The recall also affects "grab and go" salads sold at Kroger, Giant Eagle, Ingles Markets and Marsh grocery stores.  The recall of Romaine Lettuce was prompted after illnesses were reported in Michigan, Ohio and New York - primarily impacting students at University of Michigan, The Ohio State university and Daemen University. The Food and Drug Administration reported the E. coli O145 illnesses included 12 people who have been hospitalized and with Hemolytic Uremic Syndrome (HUS).

What is Hemolytic Uremic Syndrome?  See, www.about-hus.com.

Hemolytic Uremic Syndrome is a severe, life-threatening complication that occurs in about 10 percent of those infected with E. coli O157:H7 or other Shiga toxin-producing E. coliHUS was first described in 1955, but was not known to be secondary to E. coli infections until 1982. It is now recognized as the most common cause of acute kidney failure in infants and young children. Adolescents and adults are also susceptible, as are the elderly, who often succumb to the disease.

Ongoing Outbreak Investigation

Given the time of the year, the most likely area for growing Romaine Lettuce is Arizona – likely Yuma. The investigation is likely hampered by the failure of health departments throughout the United States from actually testing ill persons stools for E. coli O145.  For a bit(e) of history on lettuce and E. coli, visit www.outbreakdatabase.com.

More Information on E. coli O145

In 2009, Marler Clark Petitioned the USDA to define E. coli O145 and other Shiga toxin-producing E. coli as adulterants.  The Petition has a very complete explanation of the dangers of E. coli O145.

Fight Over Raw Milk "Buying Clubs" in Massachusetts

Massachusetts is another battleground between advocates of raw-milk and those who point out its association to outbreaks of pathogens like E. coli O157:H7, Salmonella, and Campylobacter.  Massachusetts officials have been making efforts to enforce a ban on the sale of raw milk outside of the producing farm:

The Boston Globe's Alex Beam writes:

It is legal in Massachusetts to buy raw milk at a farm but not in a store. However, the federal Food and Drug Administration and the state’s Department of Public Health discourage raw milk consumption, because pasteurization removes potentially harmful bacteria, such as listeria and salmonella. A few years ago, a top FDA official likened drinking raw milk to “playing Russian roulette with your health.’’

Massachusetts health officials explain that a majority of dairy related illness outbreaks are from raw milk, even though it is only a fraction of the dairy consumption:

“We don’t want people to think this is a safe product to consume,’’ says Suzanne Condon, a DPH executive. “Sixty-eight percent of all dairy-related, food-borne outbreaks relate to raw milk consumption.’’ Earlier this year, one of her subordinates sent a letter to the state Department of Agricultural Resources alerting it to the existence of “buying clubs,’’ large groups of raw milkies who circumvented the buy-at-the-farm rule by arranging for deliveries to consumers who don’t live near farms. The MDAR promptly sent cease-and-desist letters to four clubs, stirring up a hornet’s nest.

As usual, raw milk advocates see conspiracy theories at work:

[advocates] detect the extended hoof of Big Moo: “The conventional dairy industry may be feeling some of the effects of the growing popularity of raw milk as part of the demand for locally produced, unprocessed foods,’’ says Needham’s David Gumpert, author of “The Raw Milk Revolution: Behind America’s Emerging Struggle Over Food Rights.’’

Maybe instead public health officials are hoping to avoid more people having stories to tell like these victims?

Marler Clark - Parent Food Safety Guide for Listeria

Click on below to download:

Non-E. coli O157:H7 Bacteria, like E. coli O145, have been at issue for some time

Non-O157 Shiga Toxin–Producing Escherichia coli Infections in the United States, 1983–2002

Foodborne Illness Outbreak Database Still Being Upgraded

We have continued to upgrade and improve www.outbreakdatabase.com and nearly are ready for launch. We have a few "bugs" to work out and we are going to link to the CDC and CSPI databases too. We would still love any input, advise or criticism.

 

NOAA closes fisheries in oil spill area to ensure safety of seafood

NOAA is restricting fishing for a minimum of ten days in federal waters most affected by the Deepwater Horizon oil spill, largely between Louisiana state waters at the mouth of the Mississippi River to waters off Florida's Pensacola Bay (see map). The closure is effective immediately. Details can be found here: http://sero.nmfs.noaa.gov/. Fishermen who wish to contact BP about a claim should call 800-440-0858.

"NOAA scientists are on the ground in the area of the oil spill taking water and seafood samples in an effort to ensure the safety of the seafood and fishing activities," said Dr. Jane Lubchenco, NOAA Administrator, who met with more than 100 fishermen in Louisiana's Plaquemines Parish on Friday night. "I heard the concerns of the Plaquemines Parish fishermen as well other fishermen and state fishery managers about potential economic impacts of a closure. Balancing economic and health concerns, this order closes just those areas that are affected by oil. There should be no health risk in seafood currently in the marketplace."

"We stand with America's fishermen, their families and businesses in impacted coastal communities during this very challenging time. Fishing is vital to our economy and our quality of life and we will work tirelessly to protect it," said Secretary of Commerce Gary Locke. NOAA is a bureau of the U.S. Department of Commerce.

NOAA says that federal and state governments have strong systems in place to test and monitor seafood safety and to prohibit harvesting from affected areas and keeping oiled products out of the marketplace. NOAA Fisheries is working closely with the U.S. Food and Drug Administration and the States to ensure seafood safety, by assessing whether seafood is tainted or contaminated to levels that pose a risk to human health.

"There are finfish, crabs, oysters and shrimp in the Gulf of Mexico near the area of the oil spill," said Roy Crabtree, NOAA Fisheries Southeast Regional Administrator. "The Gulf is such an important biologic and economic area in terms of seafood production and recreational fishing."

According to NOAA, there are 3.2 million recreational fishermen in the Gulf of Mexico region who took 24 million fishing trips in 2008. Commercial fishermen in the Gulf harvested more than 1 billion pounds of finfish and shellfish in 2008.

NOAA is working with the state governors to evaluate the need to declare a fisheries disaster in order to facilitate federal aid to fishermen in these areas. NOAA fisheries representatives in the region will be meeting with fishermen this week to assist them. The states of Louisiana and Mississippi have requested NOAA to declare a federal fisheries disaster. BP will be hiring fishermen to help clean up from the spill and deploy boom in the Gulf of Mexico. Interested fishermen should call 425-745-8017.

NOAA says it will continue to evaluate the need for fisheries closures based on the evolving nature of the spill and will re-open the fisheries as appropriate. NOAA will also re-evaluate the closure areas as new information that would change the dimension of these closed areas becomes available.

Salmonella Risk? Judge Orders FDA to Reconsider Turtle Ban

A Federal District Court Judge has ordered that the FDA must reconsider its ban on selling small turtles, according to this AP report.  Sales of turtles with shells less than 4 inches long have been banned by the FDA since 1975.   The turtles have reportedly been connected to outbreaks of Salmonella

Turtle farmers are fighting the ban, and apparently feel good about there chances:

"This is a firefight this time," said Eddie Jolly, president of the Independent Turtle Farmers of Louisiana. "This has got teeth. We're going to win this one."

The judge ruled that FDA did not give enough consideration to several arguments, such as that "larger turtles and other pets that carry salmonella can legally be sold in the United States."  Also, turtle farmers argue that "new products, such as antibacterial soap, can reduce the risk."

Turtle farmers point to a study showing that:  "A sampling of more than 67 million turtles raised in Louisiana from 1996-2005 by Southern Diagnostic Laboratory in Gilbert found 98.9 percent to be salmonella-free."

I am not sure this study really helps the farmers.  By my quick and dirty math, that means that roughly 750,000 turtles in the study were NOT Salmonella free.    That's a lot of potential illness.   And the risk of illness is precisely what the FDA and other health advocates point to in response.   For example, a Salmonella outbreak in 2007-08 sickened 107 people, most of them children, in 34 states; one-third of the patients had to be hospitalized.

E coli Outbreak at Colorado Prison

A report out of Colorado today indicates that as many as 11 residents of a correctional facility may be ill with E coli infections.  The report does not make clear whether the strain has been confirmed to be E. coli O157:H7, or a different pathogenic strain of the bacteria:

Colorado Department of Corrections spokeswoman Katherine Sanguinetti says three cases have been confirmed, with eight more suspected cases at Four Mile Correctional Center.  Officials were working with the state health department to prevent the spread of the bacteria among inmates at the minimum security prison.  Sanguinetti says initial inspections of the kitchens have found no problems.

The origin of the outbreak is under investigation, but is not known at this time.

Real Raw Milk Facts dot com Seeks to Bring Science to the Raw Milk Debate

A new website has launched in an effort to bring unbiased information into the often heated discussions about raw (unpasteurized) milk. RealRawMilkFacts.com was developed and reviewed by scientists and health educators in universities, government, industry, and professional organizations. Additionally, the site serves as a clearinghouse for evidence-based studies, presentations, commentaries, regulations, and position statements on raw milk. Comments and materials were also solicited from raw milk consumers.

Unpasteurized milk—often referred to as raw milk—is at the center of nationwide controversy which has been brought into sharp focus in the Pittsburgh area after a local man was infected with Campylobacter from raw milk, and then developed Guillain-Barre Syndrome (GBS), which has left him paralyzed.

The controversial product can contain bacteria, like E. coli, Salmonella and Campylobacter, which can severely sicken those who consume it—bacteria removed by the pasteurization process. Advocates believe the pasteurization process also removes healthy aspects of the milk, and want the right to produce, sell, and consume it without regulation.

Ten Pennsylvanians were sickened with Campylobacter after drinking raw milk from the Pasture Maid Creamery in Lawrence County. The dairy has since had its permit suspended, and consumers have been advised to discard any product they might have and contact the health department if they become ill.

Beltex Co. Recalls Beef Trim - E. coli O157:H7

Days after the expansion of Winco's E. coli O157:H7 ground beef recall, Beltex Co, of Fort Worth, TX, has recalled approximately 135,000 pounds of beef trim products due to E. coli O157:H7.  The recall followed an FSIS Food Safety Assessment performed at the establishment.   The establishment’s methods for analyzing samples for E. coli O157:H7 in beef products raised concerns about the safety of the product.

The product was sold to wholesalers in Georgia, Louisiana, Ohio, Oklahoma, Texas, Washington and Wisconsin.

The products subject to the recall are:

• Various pound boxes of “FRONTIER MEATS BEEF BONELESS NAVEL”
• Various pound boxes of “FRONTIER MEATS BEEF TRIMMING 50/50”
• Various pound boxes of “FRONTIER MEATS BEEF TRACE TRIM”
• Various pound boxes of “FRONTIER MEATS BEEF COMBO BNLS”
• Various pound boxes of “FRONTIER MEATS BEEF KIDNEY FAT”
• Various pound boxes of “FRONTIER MEATS BEEF COMBO TRIM 75/25”
• Various pound boxes of “FRONTIER MEATS BEEF COMBO TRIM 85/15”
• Various pound boxes of “FRONTIER MEATS BEEF 115A BNLS CHUCK 2PCS”
• Various pound boxes of “FRONTIER MEATS BEEF TRIMMING 85/15 VAC PACK”
• Various pound boxes of “FRONTIER MEATS BEEF B-90 TRIMMINGS 91-CTRN”
• Various pound boxes of “FRONTIER MEATS BEEF COMBO BNLS NAVEL SOAKED AND SALTED”
• Various pound boxes of “FRONTIER MEATS BEEF TRIM XF SOAKED AND SALTED”
• Various pound boxes of “FRONTIER MEATS BEEF TRIM REGULAR SOAKED AND SALTED”
• Various pound boxes of “FRONTIER MEATS BEEF COMBO TRIM 85/15”
• Various pound boxes of “FRONTIER MEATS BEEF COMBO BNLS 80/20”
• Various pound boxes of “FRONTIER MEATS BEEF COMBO BONELESS NAVEL”

Each box bears the establishment number "EST. 07041B" inside the USDA mark of inspection on a label. The products were produced on Oct. 28, 2009, Nov. 20, 2009, Feb. 19, 2010, or April 2, 2010.

FSIS Progress Report on Salmonella in Meat and Poultry

In 1996, the USDA's Food Safety and Inspection Service established the HACCP (hazard analysis and critical control points) rule to verify that establishments have consistent process control for preventing, eliminating, or reducing the contamination of raw meat and poultry products with disease-causing bacteria like Salmonella, E. coli O157:H7, and campylobacter.  The rule, in part, sets performance standards for foodborne pathogens that slaughter establishments, and establishments that produce raw ground products, need to meet.  

The FSIS recently released its 2009 progress report for Salmonella, specifically, on raw meat and poultry products:

In calendar year 2009, FSIS analyzed 29,116 verification samples across eight meat and poultry product classes with the following percent positive rate of Salmonella per product class: broilers (7.2%), market hog (2.3%), cow/bull (0.6%), steer/heifer (0.2%), ground beef (1.9%), ground chicken (18.2%), ground turkey (10.7%) and turkey (3.8%).

Sounds like a lot of salmonella, particularly on broilers, ground chicken, and ground turkey.  As for broilers, the 7.2% contamination rate is actually a reduction, down from 7.3%, 8.5%, and 11.4% in 2008, 2007, and 2006, respectively.  Ditto for ground chicken and ground turkey, though the percentage of those raw products that are contaminated remains quite high.  The figure below tracks the incidence of salmonella in raw product over the course of the last decade.

 

 

Tracing Listeria Monocytogenes in a Commercial Chicken Cooking Plant

A recent study, conducted over a period of 21 months at a commercial chicken cooking plant, finds that the route by which the cooking environment, not to mention finished products, became contaminated was the introduction of bacteria (specifically Listeria monocytogenes) on incoming raw chicken.  The USDA's research arm, the Agricultural Research Service, wrote as follows regarding the study and its results:

Incoming raw poultry is the primary source of Listeria monocytogenes contamination in commercial chicken cooking plants, according to a 21-month study conducted by Agricultural Research Service (ARS) scientists and their collaborators at the University of Georgia.

The study’s results will help these facilities more sharply focus their sanitation processes to reduce cross-contamination. L. monocytogenes is a bacterial human pathogen that is sometimes found in fully cooked, ready-to-eat processed meat and poultry products.

By testing a brand-new commercial cooking facility before and after processing began, the research team was able to track sources of contamination. The research team was led by ARS microbiologist Mark Berrang of the Bacterial Epidemiology and Antimicrobial Resistance Research Unit at the agency’s Richard B. Russell Research Center in Athens, Ga.

Because the pathogen is prevalent in the environment and in various forms, there were several potential sources of contamination, including employees, incoming fresh air, raw meat and the surrounding environment.

Potential sources of L. monocytogenes were tested by taking samples of soil and water around and near the facility exterior, and by testing heavily traveled floor surfaces following personnel shift changes. Samples were also collected and tested from incoming air from air vent filters and from monthly swabs of incoming raw meat. The plant was free of L. monocytogenes when first constructed; floor drains in the facility were sampled approximately monthly to determine at what point the plant would become colonized with the bacteria.

Within four months of operation, L. monocytogenes was detected in floor drains, indicating that the organism had been introduced from some outside source. No L. monocytogenes was recovered from any floor samples in the plant entryways, locker room or cafeteria. Likewise, the organism was not detected on air vent filters during the survey. The only tested source found to be consistently positive for L. monocytogenes was incoming raw poultry meat.

Quality assurance in the test plant was exceptional and included an extensive proactive sampling plan to assure food safety. L. monocytogenes can become prevalent in food processing environments; sanitation, biosafety and product sampling protocols are in place in these facilities to prevent shipping contaminated product.

Florida Tomato Safety Law Passes House - to Governor

A quick update on a story I posted on before.  The tomato food safety bill that passed the Florida State Senate in March has now passed the house, and is now headed to Governor Crist for signature.  It was reported that the bill continues to receive virtually unanimous support:

The measure, which was written with the help of local tomato farmers, passed 114-0 with just a brief explanation from its sponsor.  The bill has already passed, 35-1, in the Senate, and now goes to the governor for his approval.  Local tomato farmers favored the measure because it sets food safety standards that would apply to everyone who grows, distributes or handles tomatoes.

The bill follows on the heels of a 2008 outbreak of Salmonella Saintpaul, which for a time was linked to tomatoes by public health officials.  The outbreak had significant economic consequences for Florida tomato growers.

CDC Reports Decline in Foodborne Illness

How about a little good news for a change?   The CDC announced today, in the Morbidity and Mortality Weekly Report (MMWR), the results of a study indicating a decline in the incidence of a number of high-profile foodborne pathogens:

In comparison with the first 3 years of surveillance (1996--1998), sustained declines in the reported incidence of infections caused by Campylobacter, Listeria, Salmonella, Shiga toxin-producing Escherichia coli (STEC) O157, Shigella, and Yersinia were observed.

On the other hand, incidence of Vibrio infection continued to rise.   In addition, vulnerable populations, in particular the young and those of advanced age, continued to suffer disproportionate effects of foodborne illness:  "For most infections, reported incidence was highest among children aged <4 years; the percentage of persons hospitalized and the case fatality rate (CFR) were highest among persons aged ≥50 years."

The CDC also provided incidence rates, per 100,000 population for several pathogens, for 2009, encompassing a total of 17,468 culture confirmed illnesses in the tracked pathogens:

  • Salmonella (7,039; 15.19).
  • Campylobacter (6,033; 13.02).
  • Shigella (1,849; 3.99).
  • Cryptosporidium (1,325; 2.86).
  • STEC O157 (459; 0.99).
  • STEC non-O157 (264; 0.57).
  • Vibrio (160; 0.35).
  • Listeria (158; 0.34).
  • Yersinia (150; 0.32).
  • Cyclospora (31; 0.07)

The Real Face of Hemolytic Uremic Syndrome (HUS)

Kyle Wolden, a nine year old boy from Mount Vernon, Washington and the son of a baseball coach at Stanwood High School, got to run the bases at Safeco Field before the Seattle Mariners' game yesterday.  45,876 fans of Seattle Mariners baseball became even bigger fans of Kyle's, and now probably have a better understanding of what E. coli O157:H7 and hemolytic uremic syndrome are. 

Kyle fell ill from an E. coli O157:H7 infection a little over a year ago, which developed into a very severe HUS illness.  HUS is a condition that occurs in 10-15% of E. coli O157:H7 infections--most often in children and the elderly--and is characterized by kidney failure, anemia, and platelet destruction. 

HUS illnesses do not frequently result in kidney transplantation during the acute phase of the disease; more frequently, HUS causes problems for its victims later in life, when transplantation or maintenance dialysis is necessary because the kidney's filtering units, which have no capacity to regenerate or repair themselves, can no longer perform their multifaceted job. 

HUS illnesses are a frequent cause of death in children and the elderly; and other, life-altering illnesses and conditions as well.  Stephanie Smith is another HUS victim who was sickened by E. coli O157:H7 in an outbreak linked to Cargill ground beef.  Stephanie can no longer walk.  Michael Moss, a journalist with the NY Times, just won a Pulitzer Prize for his in depth story on Stephanie's illness and the contaminated ground beef that caused it.  Read a short summary of Stephanie's HUS illness and resulting injuries

In Kyle's case, the damage during the acute phase of his HUS illness was extreme.  Ultimately, he required kidney transplantation for survival; and survive he did, having already progressed to the point that he's apparently able to compete for a spot on the Seattle Mariners' baseball team (the M's are 3 and 6; last in the AL West).

Bill Marler Wins 2010 Food Safety Leadership Award

NSF International announced today that Bill Marler is a recipient of a 2010 Food Safety Leadership Award.  NSF is an "independent, not-for-profit organization committed to protecting and improving public health and safety."  Tomorrow, Marler will be presented the annual award for Innovation in Education, at  the Food Safety Summitt in Washington D.C.

NSF created the yearly awards to "encourage the development of innovative technologies and learning programs that advance food safety efforts."

NSF praised Marler's committment to food safety, and food safety education:

For over 17 years, foodborne illness attorney Bill Marler has helped thousands of people suffering from serious disabilities caused by foodborne illness. Using the power of information, Marler devotes his time and effort to keeping awareness high by way of the Internet, media, public appearances and newsletters. This includes informational blogs and websites that educate the public about foodborne pathogens, including E-coli, salmonella and hepatitis, Marler’s Marlerblog.com and the web-based newsletter foodsafetynews.com. In 1998, Marler and his partners at Marler Clark founded Outbreak, Inc., a non-profit dedicated to training companies on how to prevent foodborne illness. Marler frequently speaks on the topic of food safety to public and environmental health groups and participates in panels, forums and symposiums to share food safety information. Through his efforts, Bill Marler has helped transform people’s experiences with foodborne illness into advocacy and his passion for educational outreach has proven to be one of the best tools for change.  

Knowing Bill, it won't be enough for him to "single task" while he is D.C.   No doubt he will also be working to push forward the Food Safety Modernization Act, Senate Bill 510.   Hopefully, the bill will make its way to the Senate floor this week. 

Day Care Remains Closed - New Details on E. coli O157:H7 Outbreak Surface

The day care in Vancouver, Washington associated with the recent outbreak of E. coli 0157:H7 is to remain closed while workers continue to undergo testing, according to a report in the Clark County Columbian: 

Dr. Alan Melnick, county health officer, said Fletch Family Daycare will remain closed until staff members who have tested positive for E. coli or displayed symptoms have two negative E. coli tests separated by 24 hours.

The day care center was closed on April 2, and the original closure was intended to span 10 days.  County officials are requiring that children with either a positive culture for E. coli O157:H7 or symptoms of an infection must also have two negative tests with the requisite 24 hour separation before returning to any day care.

New details about the outbreak and the investigation have come to light.   While there were four children hospitalized with E. coli O157:H7 infections, it has been reported that seven people who did not show sign of illness also tested positive for E. coli O157:H7.   Cases such as these, termed "asymptomatic"  infections, are not unheard of.   It is difficult to determine, however, how often such asymptomatic infections occur.  One study reported:

Cases of asymptomatic E. coli O157:H7 infection have occasionally been detected in outbreaks, but the incidence rates are difficult to estimate because stool samples from asymptomatic persons are rarely obtained for culturing. In an outbreak in Canada that involved kindergarten children, 31% of those exposed to the implicated source (19 of 62) were asymptomatic.  Fifty-three percent of the asymptomatic children (10 of 19) had laboratory evidence of E. coli O157:H7.    

Thankfully, Dr. Melnick believes the threat is over, saying, “At this point, health officials believe that the outbreak has been contained and does not pose a threat to others in the community." 

Michael Moss (NY Times) Wins the Pulitzer Prize for E. coli Story

Michael Moss has won the Pulitzer Prize for his article detailing the E. coli O157:H7 illness of Stephanie Smith and the outbreak, linked to Cargill ground beef, that changed her life forever.  Mr. Moss's article, published in October 2009 (two years after the Cargill outbreak), was titled "The Burger that Shattered Her Life." 

Mr. Moss's investigative reporting detailed the path of the ground beef that was eventually purchased by Stephanie Smith’s family. The burger she ate was contaminated with E. coli O157:H7, and her illness was so severe that she was put into a medically induced coma for months. When doctors were able to bring her out of the coma, she was paralyzed and suffered organ failure and cognitive damage. Two years later, Stephanie remains in rehab, trying to walk again.  Stephanie Smith's E. coli O157:H7-induced HUS illness was the most severe we have ever seen. 

2000 Daycare E. coli O157:H7 Outbreak - Improper Sanitation

It is a fact of life that little kids get sick.  As any parent knows, there will be days when clean-up is job one.   A good parent also knows how important thorough and proper clean-up and sanitation is for preventing the spread of illness from one child to another.

Sanitiation is particularly important in daycare settings.   In August, 2000, an E. coli O157:H7 outbreak was linked to the Kindercare facility in Folsom, California. An investigation revealed that the outbreak began when the probable “index case” – a child who unknowingly brought the bacteria into the facility – experienced “explosive diarrhea at the daycare on August 3.  It was the failure to deal properly with this event that led to four additional illnesses.

The four other children that attended the daycare became infected with E. coli O157:H7 on successive days, the 6th, 7th, 8th and 9th of August.  According to the Facility Evaluation Report by the Department of Social Services dated November 7, 2000, “the cause of the  outbreak was the use of  a sponge for both for wiping down a [diaper] changing table and wiping down a table used for serving meals."

Children are particularly susceptible to severe outcomes when infected with E. coli O157:H7, as well as other pathogens.  Those who care for children must take thorough precautions and follow all sanitation guidelines in order to limit the spread of illness.

Kroger Endorses Rapid Recall Exchange and Encourages All Suppliers to Join Exchange

The Kroger Co. (NYSE: KR) today announced its endorsement of the Rapid Recall Exchange, an online service that standardizes and accelerates food and product recalls and withdrawals. Kroger will be the first national retail chain to encourage its suppliers to subscribe to this industry-leading program.

The Rapid Recall Exchange, developed by GS1 US in collaboration with the Food Marketing Institute and Grocery Manufacturers Association, is the industry's only online standardized recall notification system. Using consistent forms and processes, retailers receive the same complete information, including product images and handling instructions, when a recall is issued.

"Using Rapid Recall Exchange provides Kroger with timely and accurate recall data. The need for speed is crucial in recall situations and this will help us be more efficient in removing recalled product from our shelves and communicating with our customers about recalls," said Dr. Payton Pruett, vice president of corporate food safety for Kroger.

Kroger is asking all suppliers to subscribe by July 1, 2010. Suppliers using the Rapid Recall Exchange can provide all critical recall information in one communication – 24 hours a day, seven days a week – quickly alerting retailers. This enables retailers like Kroger to quickly remove recalled products and reach out to customers about recalls.

Kroger is an industry leader in recall communication efforts. Using its customer loyalty database, Kroger is able to notify customers via register receipts and phone calls about recalls of products they may have purchased. Kroger has a 24-hour, seven-day-a-week process in place to coordinate recalls, and works quickly and effectively to remove from sale products that have been recalled or withdrawn.

Whole Foods Recalls Tuna Due to Histamine Contamination, Potential for Scombroid Poisoning

The FDA has announced that Whole Foods Market is recalling its frozen "Whole Catch Yellow fin Tuna Steaks" with a best by date of Dec 5th, 2010 because of possible elevated levels of histamine.  The elevated levels histamine may cause symptoms within minutes to an hour after consumption.  

The FDA provided this identifying information on the recalled product:

The product was sold in twelve ounce bags with Best by Date: exp 05 DEC 2010 with Lot Code: 4853309157A and displays the following UPC code:
0-99482-42078-9 Whole Catch Yellow fin Tuna Steaks (Frozen) 12 oz.

The allergic reaction caused by high levels of histamine is referred to as scombroid poisoning.  The FDA states that the most common symptoms of scombroid poisoning are:  "tingling or burning sensation in the mouth, facial swelling, rash, hives and itchy skin, nausea, vomiting or diarrhea." 

So far, two persons who consumed the product have reported such symptoms.  The recalled product was distributed to 28 states plus the District of Columbia including Texas, Oklahoma, Louisiana, Illinois, Indiana, Kansas, Ohio, Wisconsin, Minnesota, Missouri, Michigan, Maryland, Virginia, Pennsylvania, Florida, Alabama, Georgia, Kentucky, South Carolina, Tennessee, North Carolina, Connecticut, Nebraska, New Jersey, New York, Maryland, Rhode Island, Maine and Washington, D.C.

Federal Government Seeks Permanent Injunction Against Texas Egg Roll Manufacturer

Failure to correct violations prompts FDA to seek court action against Chung's Products LP

The U. S. Department of Justice, in an action initiated by the U.S. Food and Drug Administration, is seeking a permanent injunction against Chung's Products LP ("Chung's"), an egg roll manufacturer in Houston, Charlie A. Kujawa, the company's president, and Gregory S. Birdsell, the firm's director of quality assurance.

The complaint, filed in the U.S. District Court for the Southern District of Texas, charges the defendants with violating the Federal Food, Drug, and Cosmetic Act (the "Act") by preparing, packing and holding shrimp egg rolls under insanitary conditions, whereby they may have become contaminated with filth and rendered injurious to health. The complaint concerns Chung's fish and fishery products. It does not include Chung's other food products.

"The agency has previously warned the company that corrective actions need to be taken in this facility," said Michael Chappell, the FDA's acting associate commissioner for regulatory affairs. "This FDA action is aimed at protecting the public health."

The shrimp egg rolls produced by Chung's are sold in grocery stores and large retail stores nationwide.

FDA inspections have revealed significant deviations from the seafood Hazard Analysis and Critical Control Point (HACCP) requirements, which are designed to protect the public from food safety hazards in fish and fishery products. Failure to comply with the seafood HACCP regulations renders food adulterated under the Act.

A 2009 FDA inspection of the firm showed significant deficiencies with the firm's HACCP plan, including the continued failure to control for the risk of Clostridium botulinum ("C. botulinum") toxin formation in its shrimp egg rolls that are packaged in modified atmospheric packaging at refrigerated temperatures.

Ingestion of C. botulinum toxin can cause botulism, a potentially fatal disease. Although the incidence of botulism is very low, the disease can cause paralysis and has a high mortality rate if treatment is not prompt and appropriate.

The 2009 inspection also found the presence of Listeria monocytogenes ("L. mono") in the firm's egg roll processing environment. L. mono can cause listeriosis, a disease that can be very serious, even fatal, for high-risk groups such as unborn babies, newborns, the elderly, and those with impaired immune systems.

Hepatitis A - Parent Guide for Food Safety

Marler Clark has produced a Parent Food Safety Guide for Hepatitis A.

Hepatitis A (formerly known as infectious hepatitis) is an acute infectious disease of the liver caused by the hepatitis A virus (HAV), which is most commonly transmitted by the fecal-oral route via contaminated food or drinking water. Every year, approximately 10 million people worldwide are infected with the virus. The time between infection and the appearance of the symptoms, (the incubation period), is between two and six weeks and the average incubation period is 28 days.  Click on below:

From our Friends at www.barfblog.com - List of Raw Milk Outbreaks

The mastermind of www.barfblog.com has been kind enough to keep track of raw milk outbreaks over the years.  Click on image below:

Unpasteurized Milk: A Continued Public Health Threat

Clinical Infectious Diseases 2009; 48:93–100; Jeffrey T. LeJeune and Paivi J. Rajala-Schultz

SUMMARY

Although milk and dairy products are important components of a healthy diet, if consumed unpasteurized, they also can present a health hazard due to possible contamination with pathogenic bacteria. These bacteria can originate even from clinically healthy animals from which milk is derived or from environmental contamination occurring during collection and storage of milk. The decreased frequency of bovine carriage of certain zoonotic pathogens and improved milking hygiene have contributed considerably to decreased contamination of milk but have not, and cannot, fully eliminate the risk of milkborne disease. Pasteurization is the most effective method of enhancing the microbiological safety of milk. The consumption of milk that is not pasteurized increases the risk of contracting disease from a foodstuff that is otherwise very nutritious and healthy. Despite concerns to the contrary, pasteurization does not change the nutritional value of milk. Understanding the science behind this controversial and highly debated topic will provide public health care workers the information needed to discern fact from fiction and will provide a tool to enhance communication with clients in an effort to reduce the incidence of infections associated with the consumption of unpasteurized milk and dairy products.


Senator Tester Introduces Traceback Bill

Yesterday, Montana Senator Jon Tester introduced a bill to amend the Federal Meat Inspection Act (FMIA) to require the USDA to conduct traceback investigations whenever a pathogen (called an "adulterant" under the FMIA) is found in meat distributed, or intended for distribtuion, in interstate commerce.

(Incidentally, in case anybody ever wondered about the significance of "interstate commerce," it is effectively the jurisdictional hook that gives federal agencies (here the USDA) the power to enact and enforce regulatory measures.  Article 1, section 8, clause 3 states that the US Congress shall have the power "To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes."  This "commerce clause" has become a particularly potent regulatory enabler due, in large part, to the broad reach of the Constitution's "necessary and proper clause," (Article I, section 8, clause 18) which authorizes the Congress "To make all laws which shall be necessary and proper for carrying into Execution the foregoing powers," including the power to regulate interstate commerce.)

But back to the meat of Senator Tester's bill.  The essential modifications to the existing regulatory framework set forth in the FMIA are two:  first, to trace any meat sample that tests positive for any adulterant back to its original source--not the cow or herd that originally harbored the bacteria, but the establishment that slaughtered and prepared the cow for introduction into the food supply.  And second, for any establishment that produces a product that does test positive for an adulterant, to require a 15 day (consecutive) period of product testing after the date on which the original positive test was generated. 

This is good legislation.  It's certainly not the answer to the problem of contamination in our meat supply, but it helps sharpen our focus to the original point of contamination, which is a major step in forcing slaughter establishments to clean up their act.  By and large, these establishments will not do it on their own.  Almost two decades have passed since the Jack in the Box outbreak that put E. coli and beef on everybody's radar screen, and companies like Nebraska Beef still treat the USDA, its regulatory framework, and its officials much like a fly buzzing annoyingly around its ear.  For the full story on the impunity with which Nebraska Beef has acted over the last decade, read this

New Florida Tomato Safety Legislation- Good for Business

In the summer of 2008 over 1,400 persons were confirmed ill with Salmonella, eventually traced to jalapeno peppers grown in Mexico.   In the early stages of the investigation, FDA and other health officials raised concerns that the implicated product might instead be tomatoes.  As a result, U.S. tomato growers, particularly in Florida, were hard hit as sales and shipments slowed.  

Apparently in recognition of the threat to the State's tomato growers a foodborne pathogen outbreak would present, the Florida Senate has passed a tomato food safety bill, in a near unanimous vote.  According to businessweek.com:

"The measure that won approval Tuesday would set minimum safety standards and authorize the Department of Agriculture and Consumer Services to inspect farms, greenhouse and packing facilities."

This marks a fine example of why food safety legislation is not simply a matter of consumer protection.   It is industry protection as well, and judging from the near global support this bill has, it is apparent that the Florida tomato industry is on board. 

Raw Milk Sales - Retailer Knowledge of Risk and Liability

The comments posted on line following most news stories related to "raw milk" are both voluminous, and fairly predictable.  Raw milk supporters are nothing if not committed and vocal, and it seems they miss few opportunities to have themselves heard.  This recent article, including a quote from Bill Marler, is no different.

The continuing proliferation of information concerning raw milk, though, may well serve to turn up legal pressure on retailers who chose to carry raw milk.   For example, in many states, Washington being one, retailers who do not manufacture a product are not generally held to the strict liability standards applied to the manufacturer.  (R.C.W. 7.72.040).   In such cases though, retailers will be held liable for negligence.   As a general rule, negligence is defined as falling below the standard of care of a reasonable person, or in this case retailer.   Irrespective of which "side" of the fence a retailer stands on the raw milk debate, it gets harder and harder to claim reasonableness in the face of quotes like this:

  • Rob Tauxe, a deputy director at the Centers for Disease Control and Prevention:   'unpasteurized milk "was the No. 1 food safety problem in the nation."
  • Bill Keene, senior epidemiologist, Oregon Division of Public Health: "If you pass a law that makes it easier to buy raw milk, you certainly will have more instances of illnesses and deaths. That's inevitable. I think after a few dead kids, people will lose their enthusiasm for raw milk.  We know that raw milk is a high-risk product, and that a low-risk alternative (pasteurized milk) was introduced 80 years ago. So if you are trying to thumb your nose at medical science, then good luck to you."
  • FDA official John Sheehan:  "Raw milk is inherently dangerous. It should not be consumed by anyone, at any time, for any reason."
  • The American Medical Association (AMA): "all milk sold for human consumption should be pasteurized."

Raw milk supporters see these quotes, and many more like them, as evidence of a conspiracy spurred on by big dairy.  Retailers have to recognize though, that a jury is not likely to be so quick to dismiss these mainstream agencies, associations, and officials in this manner.   

The retail price that raw milk will bear on the marketplace is no doubt an incentive to retailers to carry the product.   Before they do so, however, they should think long and hard about their liability for doing so.

Is raw, unpasteurized milk safe? You decide.

That is the question that the Seattle Times posed in this morning’s thought-provoking story. It is worth a read (the comments are getting interesting too).  And, the pictures and below video are worth a look:

I think what was missing in the article was a longer discussion on the number of the outbreaks that have in fact happened:

http://www.marlerblog.com/2009/10/articles/legal-cases/raw-milk-outbreaks-do-happen-despite-what-the-weston-a-price-foundation-and-the-complete-patient-aka-david-gumpert-say/

And, the results of those outbreaks on the consumers:

http://www.foodpoisonjournal.com/2009/12/articles/food-poisoning-information/before-you-consider-drinking-raw-milk-please-read-this-and-watch-these-videos/

Information About Shigella and Shigellosis During Lombard Subway Outbreak and Litigation

About Shigella

Shigella is a family of bacteria that can cause sudden and severe diarrhea (gastroenteritis) in humans. Shigellosis – the illness caused by the ingestion of Shigella bacteria – is also known as bacillary dysentery. It can occur after ingestion of fewer than 100 bacteria, making Shigella one of the most communicable and severe forms of the bacterial-induced diarrheas.

Shigella thrives in the human intestine and is commonly spread both through food and by person-to-person contact. Most Shigella infections are passed through the fecal-oral route. This happens when basic hygiene and handwashing habits are inadequate and can happen during certain types of sexual activity. Transmission is particularly likely to occur among toddlers who are not fully toilet-trained. Family members and playmates of such children are at high risk of becoming infected.

Food may become contaminated by infected food handlers who don’t wash their hands with soap after using the bathroom. Vegetables can become contaminated if they are harvested from a field with sewage in it. Flies can breed in infected feces and then contaminate food.

Water may become contaminated with Shigella bacteria if sewage goes into it or if someone with shigellosis swims in or plays with the water (especially in splash tables, untreated wading pools, or shallow play fountains used by daycare centers). Shigella infections can then be acquired by drinking, swimming in, or playing with the contaminated water.

The number of shigellosis cases reported annually to the Centers for Disease Control and Prevention (CDC) has varied over the past several years, from more than 17,000 during 1978–2003, to an all-time low of 14,000 in 2004, to almost 20,000 in 2007. Many cases go undiagnosed and/or unreported, however. The CDC estimates that 450,000 total cases of shigellosis occur in the U.S. every year.

Shigella is the third most common pathogen transmitted through food. During 2006, a total of 1,270 foodborne-related outbreaks from 48 states in the U.S. were reported. Although Shigella was responsible for only 10 (1%) of those outbreaks, 183 confirmed cases of shigellosis were reported. This contrasts with an average of 659 cases annually in the previous five years. Shigella has also responsible for a substantial portion of foodborne outbreaks on cruise ships.

Symptoms of Shigella infection

Most people who are infected with Shigella develop diarrhea, fever, and stomach cramps after they are exposed to the bacteria. Symptoms may start within 12 to 96 hours after exposure, usually 1 to 3 days. Diarrhea is bloody 25 to 50 percent of the time and most often contains mucus. Rectal spasms, medically termed “tenesmus,” are common. The diarrhea may range from mild to very severe diarrhea. Shigellosis usually resolves in 5 to 7 days.

A severe infection with high fever may be associated with seizures in children less than two years old. Some persons who are infected may have no symptoms at all, but may still pass the Shigella bacteria to others. Persons with shigellosis in the U.S. rarely require hospitalization, although the hospitalization rate has been estimated to be in excess of 50,000 per year. The hospitalization rate tends to be highest among older individuals.

Detection and treatment of Shigella infection

Shigella infections are diagnosed with a laboratory test (stool culture) on a person’s stool specimen. Prompt processing of specimens and use of appropriate culture media increases the likelihood of isolating the bacteria. The laboratory can also do special tests to tell which species of Shigella the person has and which antibiotics would be best to treat it; antibiotic sensitivity tests are important since Shigella is often resistant to multiple antibiotics. More advanced methods, such as plasmid profiling and chromosomal fingerprinting using pulsed-field gel electrophoresis (PFGE) are two molecular techniques that can help to characterize Shigella isolates in food and human samples. These tests can assist in determining whether cases are isolated or associated with outbreaks.

Although shigellosis is usually a self-limited illness, antibiotics can shorten the course, and in the most serious cases, might be life saving. The antibiotics commonly used for treatment are ampicillin, trimethoprim/sulfamethoxazole (also known as Bactrim or Septra), ceftriaxone (Rocephin), or, among adults, ciprofloxacin. Some Shigella bacteria have become resistant to one or more antibiotics. This means some antibiotics might not be effective for treatment. Using antibiotics to treat shigellosis can sometimes make the germs more resistant. Therefore, when many persons in a community are affected by shigellosis, antibiotics are sometimes used to treat only the most severe cases.

Antidiarrheal agents such as loperamide (Imodium) or diphenoxylate with atropine (Lomotil) can make the illness worse and should be avoided. The best way to determine which antibiotic is effective is to obtain a stool culture and antibiotic sensitivity tests.

Persons with diarrhea caused by S. sonnei in particular usually recover completely, although it may be several months before their bowel habits are entirely normal. About 2% of persons who are infected with S. flexneri later develop pains in their joints, irritation of the eyes, and painful urination. This is called post-infectious arthritis (see the Marler Clark sponsored site on Reiter's Syndrome for more information). Other complications of shigellosis include severe dehydration, seizures in small children, rectal bleeding, invasion of the blood stream by the bacteria (bacteremia or sepsis), proctitis, rectal prolapse, toxic megacolon, and hemolytic uremic syndrome (HUS). Once someone has had shigellosis, they are not likely to get infected with that specific type again for at least several years. However, they can still get infected with other types of Shigella.

In the U.S., it is estimated that about 700 persons die yearly from shigellosis. Young children and the elderly are at greatest risk of death from a Shigella infection. More than one million deaths occur in the developing world yearly due to infections with Shigella; the victims are mostly children.

How can a Shigella infection be prevented?

Shigella bacteria remain active during the illness and for a week or two after an infected individual recovers. It is possible for a person to carry Shigella without developing symptoms, but then pass the illness to others. The spread of Shigella from an infected person to other persons can be avoided by frequent and careful handwashing with soap. Frequent and careful handwashing is important among all age groups. Handwashing among children should be frequent and supervised by an adult in daycare centers and homes with children who have not been fully toilet trained.

If a child in diapers has shigellosis, everyone who changes the child's diapers should be sure the diapers are disposed of properly in a closed-lid garbage can, and should wash his or her hands and the child’s hands carefully with soap and warm water immediately after changing the diapers. After use, the diaper changing area should be wiped down with a disinfectant such as diluted household bleach, Lysol, or bactericidal wipes. When possible, young children with a Shigella infection who are still in diapers should not be in contact with uninfected children.

Basic food safety precautions and disinfection of drinking water prevents shigellosis from food and water. However, people with shigellosis should not prepare food or drinks for others until they have been shown to no longer be carrying the Shigella bacteria, or if they have had no diarrhea for at least 2 days. At swimming beaches, having enough bathrooms and handwashing stations with soap near the swimming area helps keep the water from becoming contaminated. Daycare centers should not provide water play areas.

Simple precautions taken while traveling to the developing world can prevent shigellosis. Drink only treated or boiled water, and eat only cooked hot foods or fruits you peel yourself. The same precautions prevent other types of traveler's diarrhea.

At swimming pools, maintaining a chlorine level of at least 0.5 PPM will kill Shigella. At swimming beaches, children not yet toilet trained should be excluded from public swimming areas; stay clear if this rule is broken. Children with diarrhea should never be taken to public swimming areas.

Hydrolyzed Vegetable Protein Containing Products Salmonella Recall List

Bouillon Products

Herbox

Dressing and Dressing Mix Products

Follow Your Heart

Reser's

Trader Joe's

Flavoring Base and Seasoning Products

Garden Harvest

Minor's

Publix

Frozen Food Products

Casa Solana

E-Z Eats!

El Pasado

Giant Eagle

Jose Ole

Posada

Tornados

Gravy Mix Products

McCormick

Publix

Prepared Salad Products

Reser's

Ready-to-Eat Meal Products

Follow Your Heart

Sauce and Marinade Mix Products

Durkee

French's

Weber

Snack and Snack Mix Products

Austinuts

Barcel

CVS

Great Nut Supply

HK Anderson

Hawaiian

Herr's

National Pretzel Company

President's Choice

Pringles

Quaker

Rouses Louisiana's Best

Safeway

Spec's Wines & Fine Foods

Sunflower Markets

Soup/Soup Mix and Dip/Dip Mix Products

Castella

Concord Foods

Culinary Circle

De la Casa

Dean's

Delicioso

Follow Your Heart

Fresh Food Concepts

Great Value

Healthwise

Homemade Gourmet

Johnny's Fine Foods

Kroger

McCormick

Mrs. Gerry's

Oak Lake Farms

Produce Valley

Publix

Reser's

Rojo's

T. Marzetti

Spread Products

Mrs. Gerry's

Spreadables

Stuffing Products

McCormick

Full List

FDA seeks permanent injunction against Louisiana sprout company

Sprouts are a food item that have been associated with outbreaks of foodborne disease on multiple occasions in the past decade, including a major Salmonella saintpaul outbreak between February and April of 2009.  In the 2009 outbreak, the CDC counted 235 confirmed outbreak victims, and likely thousands more people across the country were sickened. 

Today,the FDA issued a press release on a Louisiana sprout company that is doing its sprout-growing brethren across the country a major disservice by staying in business.  Hopefully, the FDA's actions will shut the company down permanently.  The press release states as follows:  

The Department of Justice, in an action initiated by the U.S. Food and Drug Administration, is seeking a permanent injunction against A Chau Sprouting Co., a sprout grower in Gretna, La., company owner and manager Quang “Mike” Trinh, and Hue Nguyen, the company production manager.

The complaint, filed on March 16, 2010, in the U.S. District Court for the Eastern District of Louisiana, charges the defendants with violating the Federal Food, Drug, and Cosmetic Act by preparing, packing, and holding sprouts under insanitary conditions, where they may have become contaminated with filth.

“The agency has repeatedly warned the company over several years that corrective actions need to be taken in this facility,” said Michael Chappell, acting associate commissioner for regulatory affairs at the FDA. “While no illnesses have been reported to date, this action is necessary to ensure that it remains that way.”

The ready-to-eat sprouts are distributed to wholesale suppliers, who in turn distribute them to customers located in Gulf Coast states, including Louisiana, Mississippi, Alabama, Florida, and Texas.

Five FDA inspections over the past nine years, including an inspection conducted between August 2009 and September 2009, revealed that the defendants failed to implement basic food sanitation principles and practices for their sprout growing operation, according to the complaint.

The complaint alleges violations that include equipment and facilities that were unclean or unable to be sufficiently cleaned, insanitary employee practices, and a poorly maintained facility.

Canadian Cattle Producers Willing to Make Changes to Prevent E. coli O157 Contamination on their Farms

Bioniche Life Sciences Inc. (TSX: BNC), a research-based, technology-driven Canadian biopharmaceutical company, today announced that a survey conducted among a random sample of 771 Canadian beef and dairy farmers in all regions of Canada showed that the majority are willing to implement changes on the farm to prevent contamination by E. coli O157.

Bioniche Life Sciences Inc. has developed and licensed (in Canada) the world's first vaccine to reduce the shedding by cattle of E. coli O157. Econiche(TM) received full licensing approval from the Canadian Food Inspection Agency (CFIA) in October, 2008 and is available for unrestricted use by Canadian cattle producers and their veterinarians. The United States Department of Agriculture (USDA) cleared the path for a conditional license for the vaccine in February, 2008, and the Company is awaiting issuance of that license.

In the independently conducted survey, just over half of the producers surveyed expressed a willingness to vaccinate, but there was sensitivity to the potential cost of a vaccination program. Those surveyed believe the cost of a national vaccination program, if it were to be implemented, should be shared between government and producers, with 88% of respondents expressing willingness to vaccinate if the vaccine was provided free of charge. Their main reasons for supporting vaccination were: Food safety, the potential impact of recalls, and access to export markets.

"The use of chlorinated water, bacteriophages and probiotics help control the organisms, but vaccination provides the greatest reduction in fecal shedding," said Dr. Roy Lewis, a large animal veterinarian in Westlock, Alberta (in the January, 2010 issue of Canadian Cattlemen magazine). "With the vaccine, you are hitting the problem at its very source, before the bacteria numbers get too high."

Added Dr. Lewis: "Vaccination, together with all the other preventive steps, will hopefully keep this dreaded disease to a minimum and keep consumer confidence in our beef as high as possible."
Econiche is a Canadian discovery developed by Bioniche Life Sciences Inc. The vaccine has the potential to significantly reduce the amount of E. coli O157 shed into the environment by beef and dairy cattle. This organism does not cause illness in cattle, but cattle are the primary reservoir for it. Most strains of E. coli are harmless but some, like O157:H7, can cause severe illness and even be fatal when ingested by humans from contaminated meat, vegetables or water. Vaccination of cattle with Econiche can help reduce the risk of food and waterborne contamination with E. coli O157.
On-farm interventions to reduce the shedding of E. coli O157 by cattle, such as simple vaccination of cattle with Econiche, have the potential to reduce food and water contamination and the consequences associated with human infection with the deadly bacteria.

The United States Department of Agriculture (USDA)'s Food Safety and Inspection Services (FSIS) developed a risk assessment method to estimate how much human illness caused by E. coli O157 can be prevented through the use of "pre-harvest interventions" such as vaccination (Streamlined Analysis for Evaluating the Use of Preharvest Interventions Intended to Prevent Escherichia coli O157:H7 Illness in Humans, Foodborne Pathogens and Disease, Volume 6, Number 7, 2009). Researchers created two economic production functions where the input was the number of vaccinated cattle and the output was human illness prevented. Although this was a hypothetical case study, it showed that, "... vaccinating the entire U.S. herd at a cost of between $2.29 and $9.14 per unit (depending on overall effectiveness of the vaccine) would be a cost-effective intervention for preventing E. coli O157:H7 illness in humans."

Human exposure and infection with E. coli O157:H7 can result in serious health consequences, including abdominal pain and severe bloody diarrhea. In severe cases, kidney damage can occur and progress to serious complications and even death. In one of the reported outbreaks, in Nestle Toll-House cookie dough, 76 persons from 31 states in the U.S. have been infected with E. coli O157:H7, with 35 of these hospitalized and 11 with Haemolytic Uremic Syndrome (HUS) (see below).
Econiche is manufactured in the Bioniche production facility in Belleville, Ontario, where a $25-million expansion is taking place, supported by the Ontario and Canadian governments. Vaccine supply will be limited during this manufacturing expansion period.

Whole Foods in California, Washington, Pennsylvania, and Connecticut to Stop Raw Milk Sales

According to David Gumpert, blogger at the Complete Patient, and confirmed by raw milk dairyman, Mark McAfee, owner of Organic Pastures Dairy, Whole Foods will stop raw milk sales in California, Washington, Pennsylvania, and Connecticut.

Mr. Gumpert quoted Mr. McAfee:

The reason for the action He says he was told the order came from Whole Foods' corporate based on difficulties the company had gaining insurance coverage. "The insurance will not cover any liability if they include raw milk," according to McAfee.

There is some speculation that the cessation of sales had something to do with a Marler Blog post several months ago - "Risky Business - Why would a retailer, like Whole Foods, sell Raw Milk?" However, it most likely is simply that Whole Foods values its customers like:

Margot Standish was seven years old in June 2008, when she became infected with E. coli O157:NM as the result of consumption of raw milk. Her symptoms began in late June, with diarrhea, vomiting, and abdominal cramps. Her regular physician treated Margot over the period of more than a week, but her condition began to deteriorate, and she was admitted to the hospital on July 8. Laboratory tests conducted that day provided evidence that Margot had been suffering from hemolytic uremic syndrome (HUS). Thankfully, Margot’s renal insufficiency did not deepen to the point that dialysis was required. She remained hospitalized through July 14. Medical bills exceeded $30,000. As a result of her HUS, Margot will need to have her renal function monitored regularly for the rest of her life.

And, Kalee Prue, a 27-year-old mother of one, became infected with E. coli O157:NM in June 2008, as the result of consumption of raw milk. Her symptoms began in early July, and intensified for several days. On two occasions, Kalee sought treatment in the emergency room. On July 12, it became apparent that she was developing hemolytic uremic syndrome (HUS). She was then admitted to the hospital on July 13. Kalee’s renal failure was complete and prolonged, and she required plasmapharesis from July 13 through August 11. Severe anemia necessitated repeated transfusions with packed red blood cells as well. By the time she was released from the hospital on August 14, she had incurred over $230,000 in medical bills. Kalee has not recovered full renal function. She is at severe risk for long-term renal complications, including end stage renal disease (ESRD), dialysis, and transplant.

Both Margot and Kalee where part of the same E. coli O157:NM Outbreak. The milk they consumed was purchased at Whole Foods.

More on HVP: bad news for Basic Food Flavors

Today, yet another company had to recall products due to Salmonella-contaminated hydrolyzed vegetable protein (HVP) manufactured by Basic Food Flavors, a Las Vegas, Nevada company.  Today's recall was by Ruiz Foods, Inc., a Denison, Texas establishment, who had to recall 115,700 pounds of a ready-to-eat beef product that contained HVP as an ingredient.   

But Ruiz Foods is just another casualty in what is shaping up to be a long list of incredible recall-related losses for many, many companies.  How will the many companies who have had to recall products, including Ruiz Foods, take the news that their HVP supplier may have known about the salmonella contamination in their Las Vegas plant but decided to continue to manufacture and sell HVP for nearly a month afterward, until, apparently, one of their customers discovered the Salmonella contamination and issued a recall?  

See the FDA's report written after inspections at Basic Food's plant. 

FDA Says Basic Food Flavors Sold HVP After Postitive Salmonella Tests

The Wall Street Journal is reporting that Basic Food Flavors  "continued to make and distribute food ingredients for about a month after it learned the bacteria salmonella was present at its processing facility, according to a Food and Drug Administration report."

The recall of products containing hydrolyzed vegetable protein, announced last week involves more than 100 food items.   To date, no illnesses have been conclusively associated with the recalled food items.  WSJ also reported on the FDA inspection of the Basic Food Flavors' plant:

FDA officials inspected Basic Food's plant for about two weeks starting in mid-February and found the company didn't adequately clean equipment and store foods to protect against the growth of contaminants such as salmonella, according to the inspection report.

The inspectors noted that "light-brown residue" and "dark-brown liquid" was observed on or around where Basic Food makes flavor-enhancing ingredients used in foods. The inspectors said brown residue was also found in a plastic pipe used in making food ingredients. 

The scenario - ignoring positive tests for a dangerous pathogen- is disturbingly similar to the events that lead to the PCA Salmonella outbreak last year.  That outbreak, though, led to over 700 confirmed illnesses and 9 deaths.  PCA officials reportedly continued to ship product despite multiple positive product tests for Salmonella

Hydrolyzed Vegetable Protein Containing Products Recall List Hits 101

FDA's Expanding Recall List

Bouillon Products
Herbox

Dip and Dip Mix Products
Concord Foods
De la Casa
Delicioso
Follow Your Heart
Fresh Food Concepts
Great Value
Johnny's Fine Foods
McCormick
Oak Lake Farms
Reser's
Rojo's
T. Marzetti

Dressing and Dressing Mix Products
Follow Your Heart
Reser's
Trader Joe's
Gravy Mix Products
McCormick

Pre-Packaged Meal Products
Follow Your Heart
Prepared Salad Products
Reser's

Snack and Snack Mix Products
CVS
Great Nut Supply
HK Anderson
Hawaiian
National Pretzel Company
President's Choice
Rouses Louisiana's Best
Safeway
Spec's Wines & Fine Foods
Sunflower Markets

Soup Mix Products
Castella
Homemade Gourmet

Stuffing Products
McCormick

Restaurant Shigella Poisoning Nothing New - 200 Ill, One Dead in 2000

Illnesses continue to be reported in the Shigella outbreak tied to the Subway restaurant in Lombard, Illinois.   Restaurant based Shigella outbreaks, though, are nothing new.  Sometimes, the results can be tragic.  In the fall of 2000, Shigella sickened hundreds, and left one person dead, in an outbreak at a Mexican restaurant in Northern California. 

The outbreak was investigated by health officials with the State of California.  The Division of Communicable Disease Control Branch reported that:

Between October 19 and 24, approximately 221 individuals became ill after eating at the Viva Mexico restaurant in Redwood City, CA. One death occurred in a female who ate at Viva Mexico on October 19. Symptoms included fever, vomiting, abdominal cramps, diarrhea (sometimes bloody) and dehydration. Seventy persons were culture confirmed with Shigella Sonnei. Analysis of data from a case-control study completed by San Mateo County Communicable Disease Control staff of all patients, completed by San Mateo County Communicable Disease Control staff of all patients, revealed a statistically significant association with salsa served at the table.

As is often the case, an environmental assessment of the restaurant uncovered conditions that may have contributed to the outbreak. 

An environmental assessment was conducted by sanitarians with San Mateo County Environmental Health on October 24. Due to multiple violations of the California Uniform Retail Food Facility Law, the restaurant was closed by San Mateo County sanitarians on October 24, 2000.

Additionally, the environmental assessment made by the county health made the following observations:

  • no soap in the women’s restroom;
  • no sanitizer on the premises;
  • on site thermometer was reading temperatures 10°F off;
  • improper cooling of foods – meet, poultry, and beans – with core temperatures from 50-70°F after 18 hours of cooling;
  • cross contamination of foods – meat residue on knives used to cut produce.

As long as restaurants fail to heed sanitation principles, illnesses will result.

Reser's products now included in HVP recall

HVP UPDATE:

Today, Reser's Fine Foods, Inc. of Beaverton, OR, became the latest company to announce a recall of food products because they contain salmonella-contaminated hydrolyzed vegetable protein (HVP).  The contaminated HVP was supplied to Reser, among many other companies, by Basic Food Flavors, Inc., a Las Vegas, Nevada company. 

The recall linked to contaminated HVP from Basic Foods is already big, including at least 56 different food products distributed nationally.  But the question that we don't know the answer to yet is just how big this recall will get.  High government says that this recall may turn into one of the biggest food recalls in recent memory.  The reason is that HVP is a flavor enhancer used in many, many widely distributed products; and Basic Foods had a lot of customers.

In a conversation with Jeff Farrar, associate commissioner for food protection at the FDA, the Washington Post reported:

Officials believe the public health risk is low, and no one is known to have fallen ill as a result of the contamination. But manufacturers voluntarily recalled 56 products Thursday, and that number is expected to balloon in the coming weeks into what could be one of the largest food recalls in U.S. history.

"We don't know precisely how large this recall will get," said Jeff Farrar, associate commissioner for food protection at the FDA. "The potential amount of products . . . is very large."

This country is, of course, no stranger to very large food recalls.  In one of the most famous outbreaks, which had devestating consequences, many of the biggest American produce companies recalled baby spinach due to a rash of E. coli O157:H7 illnesses.  Ultimately, the only company whose products actually were contaminated was Dole, who ultimately recalled many thousands of bags of baby spinach.  The resulting economic impact on the produce industry was a tough hit to absorb:  an estimated $350 million in losses.  Five people died in the outbreak, including Ruby Trautz, June Dunning, and Betty Howard. 

But an even larger outbreak in 2009, in terms of the number of confirmed cases (around 700), was the 2009 Salmonella typhimurium outbreak linked to peanut products distributed to multiple companies nationally by Peanut Corporation of America.  The resulting recall included almost 4,000 different products that contained peanuts, or further processed peanut ingredients, in retail foods.  Hundreds of different companies were involved in the massive recall.  It is estimated that the PCA recall resulted in $1.5 billion in industry losses. 

Norovirus on Cruises - Keeping Ill From Ever Leaving Port

Some new facts on the most recent high profile nororivus outbreak on a cruise line raise an interesting question - whose job is it to keep people who are already ill from starting the cruise in the first place?  And how could that task be accomplished?

CNN reported new details today on the outbreak aboard the Celebrity Cruises' Mercury vessel.  The ship returned to port in Charleston, South Carolina, early, "from a sailing during which more than 20 percent of passengers -- about 400 -- fell ill."

An investigation by the CDC has identified norovirus, as the culprit.  According to CNN, illnesses appeared on the ship almost immediately:

"There were cases on the first day that were passenger cases, and there certainly is a connection with respect to increased norovirus in South Carolina. So it could have been from a passenger," said Capt. Jaret Ames, branch chief of the Vessel Sanitation Program, which works with the cruise industry to prevent and control gastrointestinal illnesses.

Given the incubation period for norovirus, this could suggest that passengers may have entered the ship already ill.  This raised a question- does the cruise industry make any efforts to limit this phenomenon?   What education, if any, do they give the passengers regarding not embarking on the cruise if they are ill?  Do they provide information about what symptoms to be on the lookout for?   

Also, if a potential cruise passenger comes forth admitting symptoms or illness before they leave, can they get a refund?  If they can't, common sense suggests they will be a lot more likely to believe they can tough it out for a day or two, not realizing they are putting fellow passengers at risk.

The report also indicate that the rate of incidence of norovirus on land correlated to the incidence on cruises:

High rates of norovirus illness on shore typically translate to cruise ships, Ames said. Outbreaks also frequently occur in other confined areas, including schools and nursing homes.  South Carolina's Department of Health and Environmental Control has reported more than twice the usual number of norovirus outbreaks or unknown outbreaks that appear to be norovirus since early January.

Might it make sense for the cruise industry to monitor norovirus incidence in its port cities, to know when to be on increased watch for ill passengers starting their journey?

Once the cruise is underway with ill persons on board, the likelihood of additional exposures is high.   It makes sense to explore all available ways from limiting the pathogen's access to passengers in the first place.

Long Term Renal Risks Associated with HUS, E. coli O157:H7

Hemolytic uremic syndrome (HUS) is a potentially fatal complication of E. coli O157:H7 infection, most common in children. At Marler Clark, we too often have to explain HUS to the lawyers and insurers for companies that have sold contaminated food.

Acute renal failure is one of the signature elements of HUS. Many of those who develop HUS must receive dialysis to survive. Most of those that survive the acute phase of HUS regain enough renal function to abandon dialysis, at least for a time.

One of the most disheartening aspects of the syndrome, however, is the irreversible damage done to the kidneys during the acute stage. The damage sustained in the short term then places the patient at risk for long term renal complications, including end stage renal disease (ESRD). That damage to the kidney is referred to as a "hyperfiltration injury."

Hyperfiltration injury is a term used to describe chronic, progressive damage in kidneys that have already sustained a severe acute injury (such as in HUS) that results in the destruction of a substantial percentage of nephrons.   Nephrons are the functional units of the kidney and are comprised of glomeruli connected to renal tubules.

The remaining functional glomeruli attempt to adapt to their reduced number by enlarging (hypertrophy) and by hyper- filtrating (i.e., the remaining glomeruli work extra hard) in an attempt to meet the needs of the body. For a time, they are usually able to compensate, but they are being “over worked”, and their “cry for help” is manifested by the spillage of protein (albumin) in the urine (proteinuria).

As time passes, the hyperfiltration injury causes progressive loss of the remaining glomeruli due to fibrosis (scar tissue formation). And, in time, once the remaining functional nephron population drops below 10 percent, the person’s survival requires initiation of “renal replacement therapy”.

The use of an angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) is usually helpful in slowing the fibrotic process, but no known treatment can stop it. ESRD, also known as stage 5 kidney disease, eventually occurs.

Once ESRD is reached there are two survival options, neither enticing. The patient must then receive long-term dialysis treatment or a renal transplant.

French Dip Powdered Au Jus recall due to Salmonella contamination

Yet another food recall due to Salmonella contamination.  This one was announced this morning by Johnny's Fine Foods, a Tacoma, Washington food company, who is recalling powdered au jus due to potential contamination by Salmonella.  The FDA recall notice states as follows:

To date no known illnesses have been associated with this product.

Johnny's French Dip Powdered Au Jus is distributed nationwide and is sold in retail stores.

Johnny's French Dip Powdered Au Jus 6oz is packaged in a clear plastic bottle with a red, white and blue label. The expiration date for this product is 0332. Johnny's French Dip Powdered Au Jus 1.1oz is packaged in a red, white and blue foil packet. The expiration date for this product is 02212.

The product was made using hydrolyzed vegetable protein manufactured by Basic Food Flavors, Inc. Las Vegas, Nevada. Basic Food Flavors initiated a recall of the hydrolyzed vegetable protein due to Salmonella contamination.

 

Recall after recall after recall.  Food companies are failing in 2010.  There is no other way to put it. 

Over 400 Sickened with Norovirus on Cruise

 The Centers for Disease Control (CDC) has announced that  norovirus was the cause of over 400 illnesses that forced a Celebrity Cruise's ship back to Charleston, South Carolina during a voyage to the Caribbean.

According to CNN, the Celebrity Cruises' outbreak sickened 435 of 1,838 passengers, as recounted by Cynthia Martinez, Celebrity spokeswoman.

According to the CDC norovirus "can spread from contact with contaminated food or drink, by touching objects infected by people who are already sick, or through close contact with people who are infected."

Outbreaks of gastrointestinal illness, and norovirus in particular, are not new to the cruise industry.   In fact, the phenomenon prompted the CDC to create and oversee a "vessel sanitation program (VSP)."  The VSP "assists the cruise ship industry to prevent and control the introduction, transmission, and spread of gastrointestinal illnesses on cruise ships."

Usual symptoms of norovirus infection include nausea, vomiting, diarrhea, and abdominal pain.  Headache and low-grade fever may also accompany this illness.

The illness caused by norovirus is usually brief.  It develops 24 to 48 hours after contaminated food or water is ingested and lasts for 24 to 60 hours.  People infected with norovirus usually recover in two to three days without serious or long-term health effects.  In some cases, though, severe dehydration, malnutrition, and even death can result from norovirus infection, especially among children and among older and immunocompromised adults in hospitals and nursing homes.

Strange bedfellows (maybe not) in the fight over Wyoming residents' "fundamental right to eat whatever they want"

Tongue firmly planted in his cheek, Bill Marler recently teed off on a Wyoming legislator's (Sue Wallis (R-Recluse, WY)) sponsorship of a bill that would exempt food producers in Wyoming from licenses, inspections and certifications when selling directly to consumers.  Ms. Wallis asserts that Wyoming citizens have "the fundamental right . . . to eat whatever they want to eat."  (Incidentally, neither case law or either of the applicable constitutions--Wyoming or US constitution--would support this fundamental right; in fact, it is well within the regulatory powers of both the state and federal government to impose regulatory measures on the sale and consumption of food).  And now Ms. Wallis seems to be hearing it from all quarters, including Chuck Jolley, a freelance journalist who writes on a wide variety of agricultural topics, including all things beef. 

Chuck's stance on Sue Wallis's bill is easy to discern.  He writes:

Wallis’ bill would allow all cottage foods, even those that are potentially hazardous, to be sold at farmers markets and roadside stands. No inspections or licensing required. Momma can sell anything she can make in her kitchen to anybody that wants to buy it. So can any idiot. Critics fear an increased risk for foodborne illness outbreaks if House Bill 54 is passed into law.

Food safety experts opposing the bill support inspection and licensing because it allows inspectors to help cottage businesses minimize the risk of distributing foods contaminated with foodborne pathogens, which cause foodborne illness. It also allows them to identify and pinpoint outbreaks.

In other words, if state authorities aren’t aware of a food production facility, even if it is Momma’s kitchen, illness and death can occur and no one will be the wiser. And the inescapable truth is every home kitchen is not as safe and well-run as your Mother’s kitchen. Some, to be painfully blunt, are absolute disasters.

Bottom Line: House Bill 54 is an incredibly bad idea and should be stopped in its tracks. Bill Marler has enough money and he needs to stay out of Wyoming and your Momma’s bank account.

Chuck and Bill.  Strange bedfellows?  After all, one makes his living writing about agriculture, and beef, and the other makes his living suing beef manufacturers.  Maybe not.  The better reasoned argument is that both do their jobs, including calling out certain ridiculous, misguided actions of industry and government, that will inevitably lead to bad law, major injuries, and more lawsuits. 

USDA-FDA joint statement on produce safety

Yesterday, the USDA and FDA released a joint statement on their intent to coordinate efforts to achieve better produce safety.  See Salinas Valley, Leafy Green Vegetables, and E. coli for a description and summary of the problem.  The joint statement reads as follows:

The U.S. Department of Agriculture (USDA) and the Food and Drug Administration are working together to achieve the goals of enhancing the safety and quality of fresh produce in ways that take into account the wide diversity of farming operations. We are committed to leveraging the expertise of our partner agencies and working together to ensure that our current produce safety and quality activities are complementary and consistent. While USDA’s Agricultural Marketing Service (AMS) is in the midst of evaluating a proposed marketing agreement for the leafy green industry, the FDA is currently developing a proposed produce safety regulation. It is our expectation that these products will take into account the diverse nature of farming operations and that any marketing agreement would conform to any regulations that may be promulgated by FDA.

The success of these efforts depends on the feedback and comments we receive from growers and other produce safety stakeholders. AMS will continue to review the comments that have been submitted to USDA on the proposed marketing agreement. To further inform its planned rulemaking, the FDA is announcing today the establishment of a docket to receive information about current practices and conditions for the production and packing of fresh produce and practical approaches to improving produce safety. The FDA will work with AMS to have the testimony from the AMS hearings placed in the FDA docket for consideration by the FDA. The FDA encourages all interested persons to submit information they believe will inform the development of safety standards for fresh produce at the farm and packing house, as well as strategies and cooperative efforts to ensure compliance with those standards.

Why Traceability Matters- Recalled Ground Beef in Schools?

As reported here earlier, "On February 12, 2010, Huntington Meat Packing, Inc., expanded its January 18, 2010 beef recall to include approximately 4.9 million pounds of beef and veal products that it produced in 2009 and the first few days of this year. "

Now Kalamazoo TV station, WWMT, reports that schools in that area are endeavoring to figure out whether or not that meat is on the menu in the local school lunch program.  It is not always so easy to determine, and is another strong reminder of why being able to trace our food back from fork to farm is so important.  Different school districts have had different reactions:

Grand Rapids Public Schools says its beef is unaffected, while Kalamazoo Schools have pulled its beef products until it's sure they're not at risk.  Portage Schools does get its beef from a supplier connected to the recall, and has pulled beef from the menu

Portage Schools cafeterias are supplied by a subsidiary of Huntington called Chartwells, and to err on the side of caution, the district says for the time being, students will not be eating any beef products associated with the Huntington brand.

According to WWMT, Chartwells has released a statement about the situation, which stated, in part:

Chartwells top priority is the health and safety of our students, faculty and staff of the school districts we serve. Products that may be affected include; ground beef, beef burrito filling mix, ground beef patties, veal patties, diced beef, and sliced beef.

Calls for immediate public release of thorough and accurate distribution lists for recalled products are common here, and at marlerblog.  This is just another example of why the issue deserves so much attention. 

Accomplishing this requires two things.  First, that corporations know both where they shipped products, and where the products they received came from.   While better traceability regulations are needed, there are already regulations on the books that require this.   Compliance with the regulations is a problem. 

Second, public agencies must  actively seek this information disclose the information as soon as they have it.

Retail distribution list for recalled Huntington Meat Packing beef products

On February 12, 2010, Huntington Meat Packing, Inc., expanded its January 18, 2010 beef recall to include approximately 4.9 million pounds of beef and veal products that it produced in 2009 and the first few days of this year. This expanded recall brings the grand total of beef products recalled since November 2009 (just 3 and a half months) to 5,672,000 pounds.

Today, the USDA's Food Safety and Inspection Service released a retail distribution list, which states that the recalled product was distributed to only two businesses nationally.  One is Castel and Cooke Cold Storage in Vernon, California, and the other is Rastelli Fine Foods in Swedesboro, New Jersey. 

It is unclear if these entities truly are the only businesses that received recalled product.  That would be a lot of beef and veal products--4.9 million pounds--for just two establishments.  More to come?

Lawsuit Filed Against Fairbank Farms Over E. coli O157:H7 Ground Beef

Marler Clark filed a lawsuit today on behalf of Alice Smith against Fairbank Farms in Federal District Court in Maine.   Ms. Smith, 88 years old, was hospitalized for weeks with an E. coli O157:H7 infection after consuming ground beef contaminated with the bacteria produced by Fairbank.

In late October 2009, Fairbank Farms recalled 545,699 pounds of ground beef contaminated with toxic E. coli O157:H7. A joint investigation between the Centers for Disease Control (CDC), the Food Safety and Inspection Service (FSIS), and several state health departments determined that the contaminated meat was responsible for 2 deaths and at least 25 E. coli illnesses in 10 states, most of them in New England.

Ms. Smith was hospitalized for several weeks, during which time she suffered from renal failure.  She has not returned to her prior state of health.  

Marler Clark previously filed lawsuits in Maine and Massachusetts on behalf of other victims of the Fairbank Farm outbreak.

MeatPoultry.com - Dr. Elisabeth Hagen - Undersecretary of Agriculture for Food Safety

MeatPoultry.com, February 2, 2010 by Steve Bjerklie

One of the meat industry’s most respected yet sharpest and, arguably, its most litigious, critics says he is “hopeful” about the nomination of Dr. Elisabeth Hagen to the crucial post of undersecretary of agriculture for food safety.

“I am very hopeful she will do the kind of job that needs to be done,” attorney Bill Marler told MEATPOULTRY.com. “Like a lot of people, I am certainly looking forward to working with her.”

Marler and his firm, Marler Clark in Seattle, Wash., have successfully sued the industry dozens of times in food-safety and, in particular, E. coli cases. He first made his name in food-safety litigation by successfully negotiating a huge settlement with the Jack in the Box chain following the outbreak of E. coli traced to Jack in the Box outlets in 1993. Since then he has been at the forefront of virtually every case involving E. coli adulteration of U.S. food.

Dr. Hagen, who had been teaching and practicing medicine as an infectious disease specialist before joining USDA in 2006 and eventually becoming the Department’s chief medical officer, is the first medical doctor to be nominated for an executive-level food-safety position at USDA. “I think having a medical doctor in this position makes a lot of sense,” said Marler, who added that he doesn’t know Dr. Hagen personally. “The clear mission of FSIS is a public-health mission.” He said he thinks career-level employees at FSIS, who are crucial in implementing effective regulations, “will give her their full support.”

The previous undersecretary for food safety, Dr. Richard Raymond, has become a vocal critic of certain USDA policies, and has been especially critical of the long time it has taken the Obama Administration to name a new undersecretary. “I think that toward the end of his term, Richard was beginning to understand the job and what really needs to be done,” said Marler. “Since he left office he’s been very outspoken – surprisingly outspoken, in fact – about it.”

As reported this week by the Washington Post, Dr. Hagen is the Administration’s third choice for the USDA position. Dr. Michael Doyle had been the first choice, “but the day before the announcement was to be made in May, his nomination collapsed. The White House wanted Doyle to divest his financial interest in a patented microbial wash for meat that he had developed. Doyle offered to defer his interests until his government service was completed but the Administration refused,” the Post reported. A second choice, according to the newspaper, was Carolyn Smith DeWaal, the director of food safety at the Center for Science in the Public Interest, who is often considered the industry’s best-informed critic. But she was ruled out because she’s a registered lobbyist, violating the Administration’s policy against hiring lobbyists for policy-making positions.

Marler’s own name had appeared on several speculative lists for the job. “I don’t know who was first, second, third, fourth, fifth or sixth choice,” he told MEATPOULTRY.com. “The bottom line is Dr. Hagen is the president’s pick.”

CORRECTION TO THIS ARTICLE

The article said the administration decided against nominating Caroline Smith DeWaal for the post in August because of its policy against hiring registered lobbyists. Although that was the administration's reasoning, and she was registered as a lobbyist at the time, her employer later acknowledged that the listing was incorrect. The Center for Science in the Public Interest, where she is director of food safety, had a policy of registering all of its officials who spend time on Capitol Hill as lobbyists. After she had been passed over for the Agriculture Department job, the organization amended its filings to reflect the fact that she was not a lobbyist. The article also incorrectly referred to DeWaal as Dewaal. And in one instance it referred to her nomination; she was never nominated.

USA Today Reports Sweeping Changes in Beef Acquisition for School Lunches

Blake Morrison and Peter Eisler report in today's edition of the USA Today:

The U.S. Department of Agriculture announced sweeping steps Thursday to "assure the safety and quality of food" purchased for the National School Lunch Program.

The measures include tightening requirements on companies that supply ground beef to schools, testing the beef more often and more thoroughly, and improving communications within the USDA to "identify potential food safety issues" before children get sick.

The initiatives come in the wake of a USA TODAY investigation that revealed failures in government programs intended to protect students from food-borne illnesses. More than 31 million children participate in the school lunch program.

The newspaper found that McDonald's and other fast-food chains are far more rigorous than the government in checking for bacteria and dangerous pathogens in beef. USA TODAY also found that the government lacks ways to quickly alert schools when products have been recalled or implicated in safety investigations.

The measures outlined Thursday are intended to address each of those points, bringing the standards and testing protocols in line with those used by the most selective restaurants and retailers. "It's a big deal," food safety consultant David Theno said of the USDA measures. He said the moves will push companies to "play to a higher standard" if they want to continue to supply food to schools.

The USDA also pledged to review the safety records of its school lunch suppliers more carefully and bar companies that have had repeated problems with their commercial products.

Such a move could affect companies such as Beef Packers, a Fresno company that recalled 826,000 pounds of ground beef last summer because it contained a drug-resistant strain of salmonella. Public health officials warned consumers to discard products from the company, which had a history of salmonella problems, but USA TODAY found that the USDA paid Beef Packers hundreds of thousands of dollars for 450,000 pounds of ground beef made during the period covered by the commercial recall.

FDA Releases Update on Salmonella, Black Pepper, Salami

The FDA posted an update on the outbreak of Salmonella Montevideo related to salami and black pepper today, February 4, 2010.

The update includes the newest CDC statistics on the outbreak:   207 people have been infected with a matching strain of Salmonella Montevideo in at least 42 states and the District of Columbia.

In addition, the FDA update contains a link to the analysis of the empidemiologic study that links these illnesses to salami produced by Daniele International Inc, as well as a link to the list of recalled products.

The FDA provided some detail about positive Salmonella testing in the  black pepper incorporated in Daniele's product:  

Recent samples of black pepper collected by the Rhode Island Department of Health at Daniele International Inc. tested positive for Salmonella. One sample from an open container matched the outbreak strain. 

The FDA is apparently still trying to determine whether black pepper "poses a risk to consumers:"

The FDA is actively investigating the supply chain of the black pepper used in the manufacturing of the recalled meat products to see if it poses a risk to consumers...If FDA identifies a public health risk associated with black pepper, or any other product, the Agency will take the appropriate action necessary to protect the public's health.

Finally, the FDA closed by urging customers to make sure their homes were free of the recalled products, which have a shelf life of one year.

Genetic Risk Factors for Post-Infectious Irritable Bowel Syndrome Following a Waterborne Outbreak of Gastroenteritis

Abstrac: j.gastro.2009.12.049

Alexandra-Chloé Villani, Mathieu Lemire, Marroon Thabane, Alexandre Belisle, Geneviève Geneau, Amit X. Garg, William F. Clark, Paul Moayyedi, Stephen M. Collins, Denis Franchimont, John K. Marshall

Background & Aims:

Acute gastroenteritis is the strongest risk factor for irritable bowel syndrome (IBS). In May 2000, more than 2300 residents of Walkerton Ontario developed gastroenteritis from microbial contamination of the municipal water supply; a longitudinal study found that more than 36.2% of these developed IBS. We used this cohort to study genetic susceptibility to post-infectious (PI)-IBS.

Methods:

We screened 79 functional variants of genes with products involved in serotoninergic pathways, intestinal epithelial barrier function, and innate immunity and performed fine mapping in regions of interest. We compared data from Walkerton residents who developed gastroenteritis and reported PI-IBS 2–3 years after the outbreak (n=228, cases) with data from residents that developed gastroenteritis but did not develop PI-IBS (n=581, controls).

Results:

Four variants were associated with PI-IBS, although the association was not significant after correction for the total number of SNPs. Two were located in TLR9, which encodes a pattern recognition receptor (rs352139, P545P, p =0.0059 and rs5743836, -T1237C, p =0.0250; r2<0.14); 1 was in CDH1, which encodes a tight junction protein (rs16260, -C160A, p =0.0352); and 1 was in IL6, which encodes a cytokine (rs1800795, -G174C, p=0.0420). Denser mapping of these 3 regions revealed 1 novel association in IL6 (rs2069861, p =0.0069) and 14 associations that could be accounted for by linkage disequilibrium with the 4 original variants. The TLR9, IL6, and CDH1 variants all persisted as independent risk factors for PI-IBS when controlling for previously identified clinical risk factors.

Conclusion:

This is the first descriptive study to assess potential genetic determinants of PI-IBS. Genes that encode proteins involved in epithelial cell barrier function and the innate immune response to enteric bacteria are associated with the development of IBS following acute gastroenteritis.

Salinas Valley, Leafy Green Vegetables, and E. coli

On February 5, 2004, the FDA wrote a letter to the lettuce and tomato industries to voice its concern about the frequent outbreaks linked to those products. In the letter, the FDA counted 14 such outbreaks since 1996 that it had investigated. Among other things, the letter stated:

In view of continuing outbreaks associated with fresh lettuce and fresh tomatoes, we strongly encourage firms in your industries to review their current operations in light of the agency’s guidance for minimizing microbial food safety hazards in fresh lettuce and fresh tomatoes, as well as other available information regarding pathogen reduction or elimination on fresh produce. We further encourage these firms to consider modifying their operations accordingly, to ensure that they are taking the appropriate measures to provide a safe product to the consumer. Since the available information concerning some of the recent outbreaks does not definitively identify the point of origin of the contamination, we recommend that firms from the farm level through the distribution level undertake these steps.

On September 30, 2005, a year and a half after the FDA’s 2004 letter to the lettuce industry, the Minnesota Department of Health issued a press release stating that 11 Minnesota residents had been infected by E. coli O157:H7 from contaminated Dole romaine lettuce. Two days later, the FDA issued a nationwide public health alert regarding Dole pre-packaged salads. Further investigation indicated that 22,321 cases of potentially contaminated Dole romaine lettuce had been sent to market from a processing facility in central California. Ultimately, at least 32 people were sickened in the outbreak.

Continue Reading...

Washington State Health Officials Discuss Salmonella Salami Outbreak

The size and breadth of the Salmonella outbreak linked to Daniele Salami - 202 people in 42 states since last July - is a big part of the reason the source of the illnesses has been pinpointed.  The CDC has estimated that there are 75 million cases of food-poisoning in the U.S. each year.  Only a fraction of these illnesses are ever tied to a specific food item.

The epidemiological work of local and state health officials that respond to reports of illness is the first step to a connection.   State laws require that positive lab results for Salmonella  (among other pathogens) be reported to health officials.   Once alerted, health officials then contact the ill individual and attempt to determine his or her potential exposures.   In an isolated case, making determinations can be tricky.   When multiple people share the same bacteria strain however, looking for a common exposure factor can be more fruitful.   

A spokesman for the Washington State Department of Health explained some of its involvement in the national investigation in response to a report of a Jefferson County man who was one of 15 Washington residents reported as part of the outbreak:

Donn Moyer, state Department of Health spokesman, said the outbreak was unique in that a national study actually pinpointed the source of the salmonella montevideo contamination. "Often you don't find the source," he said. "In this case you've got a number of people exposed to the same source. That's why this was an outbreak."

Moyer stated that  a review of shopping receipts verified that 13 cases showed purchases of the same salami variety pack before getting sick.

The investigation also relied upon laboratory evidence, both from private and public labs, in Washington and elsewhere.  These tests not only confirmed the presence of Salmonella in the Daniele product, but also suggested the product was contaminated with multiple strains:

A private Washington state lab tested a different salami product, also produced by Daniele, and found it contained another type of salmonella.  A bacterial culture from the private lab, but not the salami product, was provided to the Washington State Department of Health for additional testing.Results from the state lab tests of that bacterial culture on Monday identified two types of the bacteria. One type matched the findings of the private lab, and the other matched the outbreak strain of salmonella montevideo.

Study of Walkerton, Ont. Outbreak Provides Clues on Genetics and IBS

In 2000, the drinking water in the Ontario town of Walkerton was contaminated with E. coli O157:H7 and campylobacter.  7 people died, and roughly 2,300 suffered illness as a result.   The large number of people involved in the outbreak has provided doctors and scientists an opportunity to look at the long term impacts of foodborne illness. 

According to this report, studies on Walkerton survivors are now revealing genetic risk factors associated with the likelihood of developing post-infectious irritable bowel syndrome:

Of the 2,300 people who were sickened, 36 per cent developed post-infectious irritable bowel syndrome or PI-IBS.

Patients suffer from chronic abdominal pain and discomfort, bloating, and defecation problems that develop suddenly after an episode of acute gastroenteritis or inflammation of the stomach and intestines. Doctors diagnose PI-IBS after ruling out structural and biochemical abnormalities and other known disorders like Crohn's disease or ulcerative colitis.

The study, which linked three particular genes to an increased risk of post-infectious irritable bowel syndrome, will be published in the March edition journal Gastroenterology.

Salami/Pepper Salmonella outbreak: FSIS updated list of implicated retail locations

Updated list of retail locations who may have received Salmonella-contaminated sausage products, including salami/salame, from Daniele International, Inc.:

1.  Albertsons:  AZ, CO, ID, LA, MT, NM, OR, TX, UT, WA, WY

2.  Beverages & More:  CA

3.  Bi-Lo:  SC, TN

4.  BJ's:  All stores nationwide

5.  Bloom:  MD, NC, SC, VA

6.  Bottle King:  NJ

7.  Brookshire Bros.:  TX

8.  Costco:  All stores nationwide

9.  D'Agostino Supermarket:  NY

10.  Dave's Market:  RI

11.  Earth Fare:  NC, TN

12.  Food Emporium:  NJ

13.  Fred Meyer:  AK, ID, OR, WA

14.  Fresh Fields:  TX

15.  Fry's Food and Drug/Fry's Marketplace:  AZ

16.  Giant Food Store:  MA, PA, VA, WV

17.  Haggen:  OR, WA

18.  Harris Teeter:  DC, DE, MD, NC, SC, TN, VA

19.  Hilander:  IL

20.  Kings:  NJ, PA

21.  Kroger:  AL, GA, IL, IN, KY, PKG, LA, MI, MO, NC, OH, SC, TN, TX, VA, WV

22.  Market Basket:  MA, NH, NJ

23.  Martins Food Market:  MD, PA, VA, WV

24.  Pathmark:  NJ, NY, PA

25.  Piggly Wiggly:  SC

26.  Quality Food Center/QFC-Fresh Fare:  OR, WA

27.  Ralphs/Ralphs Fresh Fare:  CA, NY

28.  Roche Bros.:  MA

29.  Sams Club:  All stores nationwide

30.  Scotts:  IN

31.  Shoppers Market:  MD, VA

32.  Shop-Rite:  NJ

33.  Smith's/Smith's Marketplace:  AZ, ID, MT, NM, NV, UT, WY

34.  Stop and Shop/Super Stop and Shop:  CT, MA, NH, NJ, NY, RI

35.  Super K-Mart:  IL, IN, MI, NY, OH, PA, SC

36.  The Fresh Market:  NC

37.  Top Food:  WA

38.  Waldbaums:  NY

39.  Walmart:  All stores nationwide

40.  Wegmans:  NY

41.  Weis:  MD, NJ, NY, PA

42.  Whole Foods:  TX

Parkers Farm Resumes Operation After Listeria Recall

Three weeks ago, Parkers Farm of Coon Rapids, MN initiated a recall of some of its cheese and peanut products due to potential contamination with listeria monocytogenes.  The recall was then expanded to cover all of the firm's products on shelves in many grocery chains nationwide.   

Now, Parkers Farm has reportedly been declared safe by state health officials.  The firm is set to resume  production.  

According to startribune.com:

State officials say it remains unclear whether Parkers Farm will be fined for violating health regulations and allowing the listeria monocytogenes bacteria to contaminate the production plant.

Thankfully, no illnesses have been linked t the firm's product.  An interesting question raised in the Star Tribune's coverage:  will grocery stores go back to stocking Parkers Farm Products?  If they do, I hope those grocery stores ask for and receive more information than the public has:

Parkers Farm officials have not returned repeated phone calls, and details about the privately owned company's operations are sketchy.

At least one commentator thinks Parkers' items will be back:

Whether the recall will affect the company's future sales remains to be seen. Jean Kinsey, director of the Food Industry Center and an applied economics professor at the University of Minnesota in St. Paul, said that because no one was injured and the recall was handled promptly, grocery stores and consumers are likely to be willing to accept Parkers Farm products again.

If they are back on shelves, I hope it is because regional and national retailers have done their homework, and independently evaluated the firm's plant and procedures.   Consumers today rely on the buying power of the big stores and chains.   To justify that trust (and their customers spending) these stores cannot simply take a producers word that food safety procedures are being followed.

FSIS List of Stores that May Have Received Recalled Salami

The USDA's Food Safety and Inspection Service (FSIS) just published its current list of retailers who may have received recalled salami implicated in the national salmonella outbreak. 

1.  Costco--all stores nationwide

2.  Fred Meyer--Stores in Alaska, Idaho, Oregon, and Washington

3.  Fry's Food and Drug--Stores in Arizona

4.  Haggen--Stores in Oregon and Washington

5.  Hilander--Stores in Illinois

6.  Kroger--Stores in Alabama, GZ (???, FSIS, do you mean GA for Georgia?), Illinois, Indiana, Kentucky, Louisianna, Michigan, Missouri, North Carolina, Ohio, South Carolina, Tennessee, Texas, Virginia, and West Virginia

7.  Market Basket--Stores in Massachusetts and New Hampshire

8.  Quality Food Center (QFC)-Fresh Fare--Stores in Oregon and Washington

9.  Ralphs-Ralphs Fresh Fare--Stores in California

10.  Sam's Club--All stores nationwide

11.  Scotts--Stores in Indiana

12.  Smiths-Smith's Marketplace--Stores in Arizona, Idaho, Montana, New Mexico, Nevada, Utah, and Wyoming

13.  Stop and Shop--Stores in New Jersey and New York

14.  Top Food--Stores in Washington

15.  Waldbaums--Stores in New York

16.  WalMart--All stores nationwide

17.  Weis--Stores in Maryland, New Jersey, New York, and Pennsylvania

Dr. Elisabeth Hagen to be USDA Under Secretary for Food Safety

President Obama today announced his intent to nominate Dr. Elisabeth Hagen as the U.S. Department of Agriculture's Under Secretary for Food Safety. Hagen will serve with Agriculture Secretary Tom Vilsack.

"There is no more fundamental function of government than protecting consumers from harm, which is why food safety is one of USDA's top priorities," said Vilsack. "We can and must do a better job of ensuring the safety of meat and poultry products regulated by USDA, and Dr. Hagen brings the background, skills, and vision to lead USDA's efforts to make sure that Americans have access to a safe and healthy food supply."

The Food Safety mission of USDA includes the Food Safety and Inspection Service (FSIS), which is the public health agency in the U.S. Department of Agriculture responsible for ensuring that the nation's commercial supply of meat, poultry, and egg products is safe, wholesome, and correctly labeled and packaged. When the President announced the creation of the Food Safety Working Group last March, he said, "In recent years, we've seen a number of problems with the food making its way to our kitchen tables....That is a hazard to public health. It is unacceptable." President Obama charged Secretary Vilsack and Health and Human Services (HHS) Secretary Kathleen Sebelius, the co-chairs of the Food Safety Working Group, with working to upgrade our food safety laws for the 21st century; foster coordination throughout government; and ensure that we enforce these laws to keep the American people safe. As part of this effort, Secretary Vilsack has instituted a top-to-bottom review of USDA's food safety regulations.

Dr. Elisabeth Hagen is currently the USDA's Chief Medical Officer, serving as an advisor to USDA mission areas on a wide range of human health issues. Prior to her current post, she was a senior executive at FSIS, where she played a key role in developing and executing the agency's scientific and public health agendas. She has been instrumental in building relationships and fostering coordination with food safety and public health partners at the federal, state, and local level.

Before joining the federal government in 2006, Hagen taught and practiced medicine in both the private and academic sectors, most recently in Washington, DC. She holds an M.D. from Harvard Medical School, and a B.S. from Saint Joseph's University. Dr. Hagen completed her specialty medical training at the University of Texas Southwestern and the University of Pennsylvania, and is board certified in infectious disease. She is married and lives with her husband and two young children in Northern Virginia.
 

Endocarditis a Very Rare and Dangerous Complication of Salmonellosis

Salmonella is back in the news again on the heels of 187 illlnesses in 39 states linked to Daniele Italian Sausage Products.  Salmonella is generally associated with gastrointestinal symptoms, including diarrhea, vomiting, fever, and abdominal cramps.   Salmonella infection carries with it, however, the risk of complications.  One of these, endocarditis, is a very rare, but  serious complication.

According to wikipedia, endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves.  Endocarditis can be both infectious and non-infectious in etiology. Salmonella infection is associated with infectious endocarditis. The infectious type is particularly problematic, in part because immune response to the heart valves is blunted due to a lack of dedicated blood supply.

There have been a number of reports of a connection between salmonella infection and endocarditis over the years.  The complication is thankfully very rare, but each time the number of infected goes up, the risk of serious complications like this one go up with it.

Dr. Elisabeth Hagen Nominated to be U.S. Department of Agriculture's Under Secretary for Food Safety

President Obama today announced his intent to nominate Dr. Elisabeth Hagen as the U.S. Department of Agriculture's Under Secretary for Food Safety. Hagen will serve with Agriculture Secretary Tom Vilsack.

"There is no more fundamental function of government than protecting consumers from harm, which is why food safety is one of USDA's top priorities," said Vilsack. "We can and must do a better job of ensuring the safety of meat and poultry products regulated by USDA, and Dr. Hagen brings the background, skills, and vision to lead USDA's efforts to make sure that Americans have access to a safe and healthy food supply."

The Food Safety mission of USDA includes the Food Safety and Inspection Service (FSIS), which is the public health agency in the U.S. Department of Agriculture responsible for ensuring that the nation's commercial supply of meat, poultry, and egg products is safe, wholesome, and correctly labeled and packaged. When the President announced the creation of the Food Safety Working Group last March, he said, "In recent years, we've seen a number of problems with the food making its way to our kitchen tables....That is a hazard to public health. It is unacceptable." President Obama charged Secretary Vilsack and Health and Human Services (HHS) Secretary Kathleen Sebelius, the co-chairs of the Food Safety Working Group, with working to upgrade our food safety laws for the 21st century; foster coordination throughout government; and ensure that we enforce these laws to keep the American people safe. As part of this effort, Secretary Vilsack has instituted a top-to-bottom review of USDA's food safety regulations.

Dr. Elisabeth Hagen is currently the USDA's Chief Medical Officer, serving as an advisor to USDA mission areas on a wide range of human health issues. Prior to her current post, she was a senior executive at FSIS, where she played a key role in developing and executing the agency's scientific and public health agendas. She has been instrumental in building relationships and fostering coordination with food safety and public health partners at the federal, state, and local level.

Before joining the federal government in 2006, Hagen taught and practiced medicine in both the private and academic sectors, most recently in Washington, DC. She holds an M.D. from Harvard Medical School, and a B.S. from Saint Joseph's University. Dr. Hagen completed her specialty medical training at the University of Texas Southwestern and the University of Pennsylvania, and is board certified in infectious disease. She is married and lives with her husband and two young children in Northern Virginia.

Marler Clark calls on Daniele to name Black Pepper Supplier and to Pay Customers Medical Bills and Lost Wages

The CDC has announced that 184 people have been sickened in 38 states with Salmonella Montevideo caused by “a widely distributed contaminated food product.” The FSIS and Daniele have now recalled 1,240,000 pounds of ready-to-eat varieties of Daniele Italian sausage products, including salami/salame, because they may be contaminated with Salmonella. The products were sold online and at Costco, Kroger (including Fry's, QFC, Ralphs, Fred Meyer, and Smith's Food & Drug), Wal-Mart, Sam’s Club, Stop & Shop, Amazon, ShopRite and Giant/Martin's). The FSIS noted that Daniele voluntarily recalled all products associated with black pepper, which, according to the FSIS, the company believes is a possible source of contamination. If in fact it is the black pepper will the FDA soon be involved too?

1. Daniele, the CDC and FSIS say that the products are carried at a wide variety of delicatessens and grocers. Daniele must disclose fully all retail outlets that may have sold the potentially contaminated products.

2. Daniele believes that black pepper is a possible source of contamination – What facts does it rely on? Who is the black pepper supplier? What country did the black pepper come from?

3. Daniele should offer to pay the medical bills and lost wages of those sickened individuals that are linked to Daniele’s products.

Since the Jack in the Box E. coli outbreak in 1993, Bill Marler has represented thousands of E. coli and Salmonella victims against corporations such as AFG, Bauer Meats, BJ’s Wholesale Club, Byerly’s, ConAgra, Cub Foods, Dole, Emmpak, Excel, Finley School District, Fresno Meat market, Gold Coast Produce, Habaneros, Interstate Meats, Jack in the Box, Karl Ehmer, Applebee’s, Kentucky Fried Chicken, King Garden, Kroger, Lunds, McDonalds, Odwalla, Natural Selections, Nebraska Beef, Olive Garden, Peninsula Village, Pat & Oscar’s, PM Beef Holdings, Sam’s Club, Sizzler, Spokane Produce, Sodexho, Supervalu, Taco Bell, Taco John’s, Topps, United Food Group (UFG), Walmart, Wendy’s and Whole Foods. Total recoveries on behalf of victims have been in excess of $500,000,000.00.  Several times a month Marler, through the non-profit OutBreak, Inc., speaks to industry and government throughout the United States, Canada, China and Australia on why it is important to prevent foodborne illnesses. He is also a frequent commentator on food litigation and safety.

2,880,000 pounds of beef and sausage recalled since November 2009

Counting Friday's sausage recall by Daniele International, Inc., food companies have recalled at least 2,880,000 pounds of meat products since November 2009 due to contamination by E. coli or Salmonella. 

Friday's recall:  (from FSIS press release)

Daniele International Inc., an establishment with operations in Pascoag and Mapleville, R.I., is recalling approximately 1,240,000 pounds of ready-to-eat (RTE) varieties of Italian sausage products, including salami/salame, in commerce and potentially available to customers in retail locations because they may be contaminated with Salmonella, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today.

The Daniele Inc. sausage outbreak, due to contamination by Salmonella Montevideo, has caused at least 184 illnesses in residents of 38 states. 

On January 18, 2010, the USDA's food inspection branch (FSIS) announced the recall of 846,000 pounds of ground beef products produced by a California company called Huntington Meat Packing, Inc., due to potential contamination by E. coli O157:H7.

On January 11, 2010, Adams Farm Slaughterhouse, LLC., an Athol, Mass., establishment, recalled approximately 2,574 pounds of beef products that was potentially contaminated with E. coli O157:H7.  The beef was the cause of infection in at least one Massachusetts resident. 

On December 24, 2009 (The Christmas Eve sneak), an Oklahoma company called National Steak and Poultry recalled 248,000 pounds of tenderized beef products due to contamination by E. coli O157:H7.  The outbreak is known to have sickened at least 21 people in 16 states.  Last week, Marler Clark filed the first lawsuit arising from the outbreak on behalf of a Utah resident.

And in November 2009, A New York company called Fairbank Farms recalled 545,699 pounds of ground beef due to E. coli O157:H7 contamination. The outbreak caused resulted in 26 E. coli O157:H7 illnesses, nineteen hospitalizations, and five who developed hemolytic uremic syndrome (HUS). 

 

 

Recall basics for food products

We hear about them so often these days--recalls of all kinds of products, from foods, to medications, to kids toys--that "recall" has become a working concept in everybody's vocabulary.  But what is a recall?  Who has the legal obligation to announce them?  And what legal ramifications are there ot being involved in one?  

First, despite not having the legal authority to actually recall products, the FDA and USDA are frequently involved.  In fact, the USDA's Food Safety and Inspection Service (the agency arm responsible for ensuring the safety of meat, poultry, and eggs) sets the standards for when, and what kind of, a recall is required.  

The FSIS defines three kinds of recall actions that can fairly be included under the same umbrella.  A "Class I recall" should occur in "a situation in which there is a reasonable probability that the use of or exposure to a violative product will cause serious adverse health consequences or death."  (Editor's note: "should" is italicized because sometimes food product manufacturers do not issue class I recalls even when circumstances require it.)  Under this definition, a Class I recall should occur any time a food product is known or suspected to be contaminated with any foodborne pathogen, whether bacterial or viral.  The reason:  bacteria and viruses make people sick, and as a result, food contaminated by them will make people sick.

A "Class II recall" should occur in "a situation in which use of or exposure to a violative product may cause temporary or medically reversible adverse health consequences or where the probability of serious adverse health consequences is remote."  This is a little less clear than the definition of a Class I recall, but I certainly believe that the consequences of foodborne disease are simply too extreme for food companies to play fast and loose under these definitions.  A Class I recall should occur every time a food manufacturer knows, or has reason to know, that a product it has produced is or may be contaminated with a foodborne pathogen.  Every time.

Finally, a "market withdrawal"

occurs when a product has a minor violation that would not be subject to FDA legal action. The firm removes the product from the market or corrects the violation. For example, a product removed from the market due to tampering, without evidence of manufacturing or distribution problems, would be a market withdrawal.

A "market withdrawal" has no place in the world of food contamination.  Again, salmonella and e. coli and campylobacter and hepatitis and every other foodborne pathogen are simply too dangerous for companies to try to avoid their obligations by calling what should be a recall a "market withdrawal"--something done purely to avoid the media ramifications of saying that you're product has been recalled.  This has been done before under circumstances where a Class I recall was surely warranted. 

Continue Reading...

Dave Theno had it right - Secretaries Vilsack and Sebelius should pay attention

Lauren Beth Rudolph died on December 28, 1992 in her mother’s arms due to complications of an E. coli O157:H7 infection - Hemolytic Uremic Syndrome. She was only 6 years, 10 months, and 10 days old when she died. Her death, the deaths of three other children, and the sicknesses of 600 others, were eventually linked to E. coli O157:H7 tainted hamburger produced by Von’s and served at Jack in the Box restaurants on the West Coast during late 1992 and January 1993. Roni Rudolph, Lauren’s mom, I have known for 17 years.

Dave Theno became head of Jack in the Box’s food safety shortly after the outbreak. I too have known Dave for 17 years. However, I only learned recently a significant fact about Dave – one that made me admire him even more – one that I think, not only that all leaders in corporate food safety should emulate, but one that both Secretaries Vilsack and Sebelius should pay attention too.

Dave and I shared the stage at the Nation Meat Association annual convention a few months ago. The NMA is an association representing meat processors, suppliers, and exporters. Dave, spoke just before I did and was rightly lauded as someone who takes food safety to heart. However, it was his story about Lauren Rudolph and his relationship with Roni that struck me. Dave told the quiet audience about Lauren’s death. Dave also told us that the death of Lauren and his friendship with Roni had changed him. He told us all that he had carried a picture of Lauren in his brief case everyday since he had taken the job at Jack in the Box. He told us that every time he needed to make a food safety decision – who to pick as a supplier, what certain specifications should be – he took out Lauren’s picture and asked, “What would Lauren want me to do?”

I thought how powerful that image was. The thought of a senior executive holding the picture of a dead child seeking guidance to avoid the next possible illness or death is stunning, but completely appropriate. I wonder if Secretaries Vilsack and Sebelius do anything similar when they do their work on President Obama’s Food Safety Working Group? If they do not, perhaps they should?

Secretaries Vilsack and Sebelius right now there are hundreds of families struggling right now due to illnesses and death related to food that you oversee that has been tainted with E. coli O157:H7.

A few months ago, I spent time with a family in South Carolina whose 4 year old ate cookie dough and suffered months of hospitalizations, weeks of dialysis and seizures. She faces a lifetime of complications. And, there is a woman in Nevada who is still hospitalized, who has lost a portion of her large intestine, was on dialysis until a few days ago. She faces months if not years of rehabilitation. Both ate cookie dough that was watch over by Secretary Sebelius’s FDA.

I recently sat across the kitchen table with a family who lost their only daughter because she died from an E. coli O157:H7 infection from meat inspected by Secretary Vilsack’s USDA/FSIS. I then visited families in a Cleveland hospital whose children are struggling in their battle against Hemolytic Uremic Syndrome – again E. coli O157:H7 tainted hamburger is to blame.

Secretaries Vilsack and Sebelius you should be like Dave Theno. Run your departments like Dave ran food safety at Jack in the Box. Go meet these families. Sit across their kitchen tables. Go to their child’s hospital room and see more tubes and wires than you can count. Understand what these people have lived though. Take their stories into your heart. It is hard, very hard, but it will give you a real reason to do your jobs.

Retail meat linked to urinary tract infections: Strong new evidence

McGill researcher discovers strong evidence of link between eating contaminated chicken and the E. coli that cause urinary tract infection.

Chicken sold in supermarkets, restaurants and other outlets may place young women at risk of urinary tract infections (UTI), McGill researcher Amee Manges has discovered. Samples taken in the Montreal area between 2005 and 2007, in collaboration with the Public Health Agency of Canada and the University of Guelph, provide strong new evidence that E. coli (Escherichia coli) bacteria originating from these food sources can cause common urinary tract infections.

Eating contaminated meat or food does not directly lead to a UTI. While some E. coli such as O157:H7 can cause serious intestinal disease, these E. coli bacteria can live in the intestine without causing problems. In women however, the bacteria can travel from the anus to the vagina and urethra during sex, which can lead to the infection.

The research team is also investigating whether livestock may be passing antimicrobial-resistant bacteria on to humans. This is due to the use of antibiotics to treat or prevent disease in the animals and to enhance their growth, which may lead them to develop resistance to the medication. When animals are slaughtered and their meat is processed for sale, the meat can be contaminated with these bacteria.

“These studies might open the door to discussions with policymakers,” Manges said, “about how antibiotics are used in agriculture in Canada. It’s certainly something we need to continue studying”.

The public should not be alarmed. Manges advises that consumers should cook meat thoroughly and prevent contamination of other foods in the kitchen. Although some infections caused by these E. coli are resistant to some antibiotics, the infections can still be treated. Manges hopes that understanding how these bacteria are transmitted will help reduce infections. She also hopes more attention will be focused on how meat is produced in Canada. Her research is part of a broader study concerning food safety and is financed through funding by the Government of Canada, Public Health Agency of Canada, in collaboration with the Laboratory for Foodborne Zoonoses, specifically the Canadian Integrated Program for Antimicrobial Resistance Surveillance, and also the Division de l'inspection des aliments, Ville de Montréal.

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On the Web: www.mcgill.ca/epi-biostat-occh/
www.cdc.gov/eid/content/16/1/88.htm

More progress in the detection of E. coli in beef

TradingMarkets.com reports another development in the food industry's fight against E. coli contamination:

Strategic Diagnostics Inc., a leading provider of biotechnology-based detection solutions for food safety and life science applications, today announced that its recently improved RapidChek(R) E. coli O157 (including H7) System has earned Performance-Tested Methods(SM) certification from the AOAC Research Institute (License Number # 070801) for testing composite samples of raw beef including ground beef and boneless beef trim.

Tim Lawruk, SDI Food Safety Marketing Manager, said about the test method:

"With the recent announcements of E. coli O157:H7 contamination in beef products, SDI has been working with leaders in the beef industry and regulatory agencies to understand testing requirements based on new sampling practices and industry testing concerns. The newly improved AOAC-certified RapidChek E. coli O157 test system, which includes improved materials and reagents, is designed to offer several advantages over competitive testing methods, including greater accuracy, faster results, reduced testing costs, and increased confidence in test results. This certification also confirms SDI's commitment to provide the food market with superior, complete pathogen testing solutions that provide rapid and accurate results."

Good timing for progress.  This announcement comes right on the heels of yesterday's announcement by the State of Wisconsin that the state is investigating a cluster of six E. coli O157:H7 illness in Belgium, Wisconsin

More Nuts Recalled for Salmonella- Hines Nut Company Pine Nuts

The FDA announced Friday that Hines Nut Company of Dallas, Texas has recalled of 270 packages of Pine Nuts, due to potential contamination with Salmonella.   The nuts were packaged under the brand name Harris Teeter Farmers Market.   According to the FDA press release:

The recalled product was sold in 8 oz foam trays wrapped in cellophane and carry the UPC code 0 72036 88121 0. The Pine Nuts were distributed solely to Harris Teeter Markets in North Carolina. Consumers who purchased this product between December 30, 2009, and January 14, 2010 should contact Hines Nut Company for information on how to return the product for a refund.

There have been no complaints or any reported illnesses related to the products to date.

The problem was discovered through routine sampling by the supplier, Red River Foods in Camarillo, CA.
 

Nestle Change for Safer Ingredients in Cookie Dough to Slow Production

There is something about the term "cookie dough shortage" that doesn't quite sound serious.  Still, the recent events that may lead to such a storage are just that.  Elizabeth Weise of the USA Today is reporting that Nestle's cookie dough may be in short supply after making a change in its process to increase safety.

Nestle recently announced a move to heat treating the flour used in the cookie dough after two recent positive tests for E. coli O157:H7.    Last year an outbreak of the dangerous pathogen linked to Nestle cookie dough sickened at least 72 people in 30 states.

One issued raised by the developments is the level of risk of bacterial contamination of flour.  Ms. Weise states:

In general, flour is not considered dangerous. However, a 2007 study published in the Journal of Food Protection did find salmonella contamination in 0.14% to 1.32% of wheat flour samples. A 1993 study in the journal Cereal Foods World found that 12.8% of wheat samples were positive for generic E. coli, which is harmless but can indicate contamination with animal fecal matter.

One of our biggest food safety challenges is staying ahead of which foods are the most risky, and most in need of monitoring.  Some aspects of not-yet-passed food safety legislation tie the level of inspection required to the level of risk associated with the product.   To carry out such a regulatory scheme, however, we must first understand where our risks are coming from.

Tylenol recall expands

So how does the principle of strict liability--i.e. liability without regard to fault--which is applicable in foodborne illness cases, apply to bottles of Tylenol that make people sick?  The answer:  very well.

For some background, Johnson & Johnson today expanded its recall of various Tylenol products, which, like many food items, are regulated by the FDA, due to potential contamination with a substance that produces a chemical odor that has made a bunch of people ill with gastrointestinal symptoms.  (see primer on strict liability). 

Despite some differences in the way the fifty states apply the doctrine, strict liability holds manufacturers of defective products liable to people injured by the product defect.  It's pretty simply applied in food cases.  A beef company that produces ground beef, or any meat, contaminated with E. coli O157:H7 is liable to the people who become ill because contaminated ground beef is defective.  Similarly, a restaurant that serves a meal that became contaminated with Salmonella because an infected foodworker prepared it is liable to the customer who then contracts the disease.  In both situations, it does not matter whether the defendant (i.e. the beef producer and the restaurant) was negligent.  Simply making and selling contaminated food makes the defendant liable. 

Tylenol, whether the bottle it is sold in or the indvidual pills themselves, that is contaminated with a substance that makes people ill is also defective.  Johnson and Johnson is strictly liable to the people who have become ill, as would be the company that made the pallets that were contaminated with the substance that has made people sick.  Both produced a defective product in the eyes of the law.

This concept sounds offensive to some people. But when you pause for a moment to think where the safety of our food and pharmaceutical supply might be without the media attention that these recalls and outbreaks have gotten, and without lawsuits that put the immense costs of illnesses and medical treatment squarely back in the food producer's hands, the concept begins to seem a little less grim.

Unacceptable level of Campylobacter on retail chicken

Trent Rowe reported yesterday on TheLedger.com about the disturbing prevalence of campylobacter on chicken purchased at retail. 

Most of the chickens we buy in supermarkets are contaminated with Salmonella and/or Campylobacter bacteria. They make us sick.

Consumer Reports checked 382 chickens from 100 stores around the country and found the bacteria in about two-thirds of the birds.

Only 34 percent of the birds had neither bugs.

Figures from the Centers for Disease Control and prevention show that the bacteria from food sources infect 3.4 million Americans a year, resulting in 25,500 hospital cases and 500 deaths.

 

Unfortunately, odds are, the uncooked chicken you've got in your refrigerator or freezer at home is contaminated with something that can make you very sick, or kill you if you're a particularly susceptible person.  But it doesn't have to be this way.  Campylobacter and chicken, just like E. coli O157 and beef, is not a bacteria found in the animal's muscle tissues.  Chickens and cows alike harbor the bugs that can make us sick in their gastrointestinal tract.  So, just like E. coli and beef, the problem boils down to food manufacturers keeping feces off of edible meats. 

This is exactly what the Food Safety and Inspection Service (FSIS), which is the branch of USDA responsible for meat, eggs, and poultry, is trying to achieve with its newly adopted performance standards in chickens and turkeys.  Even though we won't get to zero, it seems like the industry should be able to lower the contamination level from "most of the birds you buy are contaminated." 

Think Twice Before Drinking a Glass of Raw Milk

 

Chris Martin, then age seven, developed an E. coli O157:H7 infection in September 2006 following consumption of raw milk. He was hospitalized beginning on September 8, suffering from severe gastrointestinal symptoms, including bloody diarrhea. Shortly thereafter, he developed hemolytic uremic syndrome (HUS). In an effort to properly treat his rapidly deteriorating condition, Chris was moved to multiple medical facilities, twice by life-flight. His HUS was remarkably severe, marked by prolonged renal failure, pancreatitis, and severe cardiac involvement. He required 18 days of renal replacement therapy. On two occasions his cardiac problems became so severe that he was placed on a ventilator. At several junctures, the possibility that he might not survive was very real. Ultimately he was hospitalized through November 2, after incurring over $550,000 in medical bills. Renal experts have opined that Chris is likely to develop severe renal complications in the future. These complications include end stage renal disease (ESRD) and kidney transplant.

I urge people to read - Comparing the Food Safety Record of Pasteurized and Raw Milk Products.

Investigation and Traceback Continues in Adams Farm E. coli Recall

Federal and Massachusetts State officials continue to investigate the circumstances that led to the recall of 2,574 pounds of beef products from Adams Farm in Athol, Massachusetts.   The USDA announced the recall on Monday, January 11, saying the recall resulted from a ground beef sample that tested positive for E. coli O157:H7 during an illness investigation.  

The products involved were not Adams' own retail brand, but rather ground beef and other beef products produced at Adams' slaughterhouse for three farms/retailers.  The USDA stated:

The following products are subject to recall:

1,025-pounds of "Beef Cuts and Ground" packed for Mazzarese. (Warren, MA)
697-pounds of "Beef Cuts and Ground" packed for Side Hill Farm. (Ashfield, MA)
852-pounds of "Beef Cuts and Ground" packed for Sweet Water Farm. (Petersham, MA)

A follow up article in the Worcester Telegram yesterday focused on investigators' attempts to determine at which farm the E. coli O157:H7 "originated"  The two farms whose representatives provided comment for the story both indicated that they did not think their farm was the culprit:

Nicole Burton, a manager at Sweetwater Farm in Petersham, said state and federal health officials have not determined whether the beef came from a farm or the slaughterhouse.   “I want to be clear that tests have not been done on our farm or investigated,” Ms. Burton said.

Sidehill farm representatives had a similar message:

Amy Klippenstein, owner of Sidehill Farm in Ashfield, said someone from the USDA told her that someone got sick from the beef from an animal at a different farm.  “We have all the beef, and none of it has been sold,” Ms. Klippenstein said. “We are not concerned about people eating our beef.” 

New information in the Telegram  today does seem to point toward the third farm as the original source of the implicated beef:

Jennifer L. Manley, a spokeswoman for the state Department of Public Health, said that on Jan. 7, 13 meat samples from a family that received a quarter cow share from a farm in Warren [presumably Mazzarese] were tested. She said ground beef samples and a representative selection of the intact cuts tested positive for E. coli. DNA analysis needed to determine where the animal came from will not be completed until either tomorrow or Monday. 

The focus on the source of the actual cattle is interesting.  It is a well known fact that a significant portion of cattle harbor E. coli O157:H7.   The regulations and HACCP plans in place to eliminate E. coli O157:H7 from retail products are not currently aimed or designed at preventing such contamination at the farm level.  To the contrary these regulations and safety plans essentially ask that slaughterhouses work under the assumption of the presence of E. coli O157:H7 in cattle, and then call for steps to prevent the contamination of meet with the bacteria during the slaughtering process.

In other words, presumptively identifying the farm where the E. coli O157:H7 came from is not the end of the story.   Rather, what needs to be determined is why was this bacteria allowed access to finished raw product during the manufacturing process.  

Mandatory Food Code Adoption by the States: one of many good projects for FDA and Michael Taylor

 As the newly appointed deputy commissioner for food safety at the FDA, Michael Taylor has a lot on his plate.  Many different things to accomplish, not least of which a ramped up, more proactive approach to food safety within the agencies of government.  Perhaps the creation of a unified governmental body for all things food safety?  Maybe giving the USDA and FDA the legal authority to recall products themselves, rather than rely on conflicted food manufacturing companies to do it themselves when they learn about a problem.  Stiffer penalties, including personal liability, for reckless or willful corporate conduct that ends up causing an outbreak?

Another idea went up on foodsafetynews.com today:  the mandatory and continuous adoption of the FDA's Model Food Code, by the states, as a baseline regulatory scheme.  See A Call for Uniform Model Food Code Adoption.  As was stated in the article:

It is time for greater uniformity in our regulatory system. There are more than three thousand state, local, and tribal agencies responsible for regulating the retail foodservice industry, which includes over a million foodservice establishments in the United States. It is time for a federal mandate making the FDA's Model Food Code (the Code) compulsory as a baseline regulatory scheme on all states, territories, and tribal jurisdictions. The FDA apparently agrees, stating on its website: "Adoption of the Food Code represents a successful federal/state/local partnership in improving food safety." 

"FDA and [the Association of Food and Drug Officials'] goal is the prevention and reduction of foodborne illness and death from food produced at the retail level. Adoption of the Food Code by all food safety agencies at the federal, state, local and tribal levels establishes a sound regulatory foundation and legal framework for uniformity in achieving such a reduction."

Response to FSN article calling for Uniform Application of the Model Food Code

Jim Mann, the executive director of Handwashing for Life Institute, emailed the following response to the Food Safety News article titled "A Call for Uniform Model Food Code Application":

Uniformly good vs. Uniformly enforceable. Of these two choices, I believe the FDA favors the latter.

You make some very good points in your article. I do think the adopting of uniform baseline standards is a good idea but can be overstated.

First, the far and away leading pathogen identified in outbreaks is norovirus. What uniform laws would you suggest to eliminate the predominant fecal-hand-oral pathway? Wear gloves and put them on with contaminated hands? When to change gloves ... when soiled as measured by "sight and touch"?

Continue Reading...

Fecal Bacteria in Fountain Drinks - More Fallout

I originally posted about this new study last Friday that reveals the unpleasant presence of fecal bacteria in nearly half of the fountain drinks tested.  As noted then:

Tests were conducted on 90 fountain beverages, from both self-service and store-personnel dispensers. 48% of the beverages tested positive for coliform bacteria. The tests revealed the presence of Escherichia Coli in 11% of the samples.  Also found were Klebsiella, Staphylococcus, Stenotrophomonas, Candida, and Serratia. Further, a majority of the bacteria tested showed resistance to at least some bacteria.

The study has apparently caught the interest of the public and has drawn continued attention in the media.   CNN's coverage of the study today provides some lessons about some real gaps in our food safety knowledge and responsibility overall. 

One striking aspect of the coverage is the knee-jerk, "everything is ok - please quickly go back to business as usual" from industry representatives.   From the National Restaurant Association:

"While the results of this study are disconcerting, we feel that it isn't representative of our industry and that our guests can safely enjoy beverages from dispensers and single-serve containers alike."

Ok, so why is the study not "representative" of the industry?  Is there some opposing research that suggests that fountain sodas do not have fecal bacteria?  Is there some evidence that the levels of bacteria found by this study are not harmful?   We would be better served trying to answer these questions than to blithely instruct consumers to go back to their beverage dispensers.

The American Beverage Association is more strident:

"Fountain beverages are safe. Consumers can rest assured that our industry's fountain beverages pose no public health risk."

Well, this would be comforting if it was accompanied by some explanation.  Again, it would be nice to know the basis (if there is one) for such a statement.

All of this begs the question- assuming this study is in some way representative of a larger phenomenon - are people getting sick from drinking fountain soda?   And the answer is we don't know.   We really wouldn't have much way of knowing, because we don't track foodborne illness very well. 

The CDC has previously estimated 76 million cases of foodborne illness in the U.S. each year, but only a fraction of these are reported.   Only a few bacterial and viral illnesses must be reported to public health agencies - and that presumes that the pathogen is ever found in the first place.  It is likely that  a majority of ill people are either never tested for pathogens, or are tested for only a select handful.  

So, as this story continues to garner attention from the public, we can only guess as to the whether the findings reflect something of true importance.   We don't have the data to evaluate the potential risk.  And, as usual, industry is quick to sound the all clear - with or without a basis to do so. 

Author Michael Pollan visits Washington State University

Pollan is the John S. and James L. Knight Professor of Journalism at the University of California at Berkeley. He is a former executive editor of Harper’s magazine and a regular contributor to the New York Times Magazine. He has authored several books; “Omnivore’s Dilemma” was named one of the best books of 2006 by the New York Times and the Washington Post newspapers. He is a frequent guest on television talk-shows and has appeared in recent films on food and related topics.

“The Sun Food Agenda,” according to his publicists, “(involves) change at the level of the farm, the marketplace and the culture, (promising) to improve our health, cut our dependence on fossil fuel and help solve the climate crisis.”

“WSU’s research and faculty provided a rich base for discussion in fall about food-related issues, and we’ve been very pleased that our more homegrown events in the fall have been attended by more than 2,000 students," said Karen Weathermon, co-director of the WSU Pullman Common Reading Program and director of Learning Communities/Freshman Focus in the University College. "Common reading programming will continue throughout spring semester.

“Michael Pollan’s visit is a wonderful complement to the year’s programming," she said. "Not everyone agrees with his views, but his books have certainly increased the public’s interest in and awareness of the implications of our food choices.”

Pollan’s visit to WSU was made possible by a gift from WSU alumnus William D. Marler, a Seattle-based personal injury lawyer who focuses on foodborne illness and food-safety issues.

Enterobacter sakazakii Blog Updated ("E. sak," Cronobacter sakazakii): Infections Associated with Powdered Infant Formula

Enterobacter sakazakii was first described as a new bacterial species in 1980, and over a hundred scientific papers have been written about it. From 1980 to 2007 it was known as Enterobacter sakazakii, but in 2007 there was a proposal to reclassify it into a new genus Cronobacter as Cronobacter sakazakii.  For simplicity and for the reasons mentioned later, this discussion will continue to use the original name Enterobacter sakazakii. The proposed alternative classification is given as a section at the end and includes a discussion of the problems and the need for future studies.

Enterobacter sakazakii is a Gram-negative rod-shaped bacterium classified in the family Enterobacteriaceae. It has been isolated from three types of infection -- devastating meningitis in very young babies (neonates), bacteremia (blood steam infection) in older babies, and a wide variety of infections (or colonization) in older babies, children and adults. The majority of infections reported in the peer-reviewed literature have described neonates—newborn infants, including premature infants, post-mature infants, and full-term newborns—with sepsis, meningitis, or necrotizing enterocolitis. Although it has been isolated from cases of necrotizing enterocolitis, its causative role is unclear.

For more information, visit Enterobacter sakazakii Blog.

Governor's Food Safety Council Holds First Meeting of 2010

Council Members Discuss Impact of Proposed Federal Food Safety Legislation

HARRISBURG, Pa., Jan. 8 /PRNewswire-USNewswire/ -- Agriculture Secretary Russell C. Redding and Health Secretary Everette James co-chaired a meeting of the Governor's Food Safety Council on Tuesday, Jan. 5, and led a discussion of the potential impact of proposed federal legislation on Pennsylvania's robust agriculture and food production sectors and public health protection.

Established by Governor Rendell in 2009, the Food Safety Council advises the Governor on the development and implementation of food safety and defense protocols and practices in the state.

"Ensuring that Pennsylvanians have access to a safe food supply from the farm to the fork is a critical part of the Department of Agriculture's mission," said Redding. "By bringing together partners that represent the entire food chain, we can strengthen our ability to protect consumers and support the state's food industry."

"Pennsylvania's vision in bringing together the departments of Health and Agriculture with major stakeholders to address food safety in a systemic manner is unique among other states," noted James. "Coordinating our food safety efforts is one of the best ways to assure our 12.5 million citizens that the food produced and served in the commonwealth is as safe and healthy as possible."

The council was briefed on proposed federal legislation, including changes the legislation would drive within the U.S. Food and Drug Administration and the potential impact on Pennsylvania farms, agribusinesses and food firms. Discussions on the legislation and its impact at the state level will be used to create the framework for a state response to national food safety proposals and mandates.

One of the major objectives of the council is to provide the Governor with advice and insight on local, state and federal policy. This is a rare opportunity to put forward a unified voice for food safety measures, ensuring that Pennsylvania's diverse agriculture, food production and food processing sectors are represented at the highest levels of government while policy is being made. This communication and coordination at the state level is key to protecting our citizens and millions more who consume Pennsylvania products.

For more information about food safety in Pennsylvania, or to view restaurant inspection reports, visit www.agriculture.state.pa.us; search "Food Safety."

Fecal Bacteria in Fountain Soft Drinks - Study

This is the truth.  The lunch special from the cafeteria downstairs today included a drink, so I had just finished a fountain soda when I was forwarded a link to this study.  Yikes.  A study published this month in the International Journal of Food Microbiology reported on the presence of coliform bacteria in nearly 50% of the beverages tested.  Abstract.

Tests were conducted on 90 fountain beverages, from both self-service and store-personnel dispensers.  48% of the beverages tested positive for coliform bacteria.   The tests revealed the presence of Escherichia Coli in 11% of the samples.    Escherichia Coli is the general name for a family of bacteria that includes E. coli O157:H7.    The presence of Escherichia Coli, generally, does not necessarily indicate the presence of the more dangerous E. coli O157:H7.  Also found were Klebsiella, Staphylococcus, Stenotrophomonas, Candida, and Serratia.  Further, a majority of the bacteria tested showed resistance to at least some bacteria.

What impact the presence of the bacteria is having on public health is unclear.  In its coverage of the story, ABC noted only one outbreak of illness in the previous 10 years linked to fountain soda.   Potential illnesses linked to the beverages may be hard to track, as not all coliform bacteria have an infectious dose as low as higher-profile pathogens like E. coli O157:H7.   Also other of these bacteria may cause illness, but may not be routinely tested for by doctors.    

About Shigella and Shigella Blog Updated

About Shigella and its companion Shigella Blog were updated once again after extensive revisions by experts in the field and the staff and lawyers at Marler Clark, LLP PS, the only law firm in the United States that focuses its entire practice on foodborne illness litigation.

Shigella is a family of bacteria that can cause sudden and severe diarrhea (gastroenteritis) in humans. Shigellosis – the illness caused by the ingestion of Shigella bacteria – is also known as bacillary dysentery. It can occur after ingestion of fewer than 100 bacteria, making Shigella one of the most communicable and severe forms of the bacterial-induced diarrheas.

Shigella thrives in the human intestine and is commonly spread both through food and by person-to-person contact. Most Shigella infections are passed through the fecal-oral route. This happens when basic hygiene and handwashing habits are inadequate and can happen during certain types of sexual activity. Transmission is particularly likely to occur among toddlers who are not fully toilet-trained. Family members and playmates of such children are at high risk of becoming infected.

Food may become contaminated by infected food handlers who don’t wash their hands with soap after using the bathroom. Vegetables can become contaminated if they are harvested from a field with sewage in it. Flies can breed in infected feces and then contaminate food.

Water may become contaminated with Shigella bacteria if sewage goes into it or if someone with shigellosis swims in or plays with the water (especially in splash tables, untreated wading pools, or shallow play fountains used by daycare centers). Shigella infections can then be acquired by drinking, swimming in, or playing with the contaminated water.

The number of shigellosis cases reported annually to the Centers for Disease Control and Prevention (CDC) has varied over the past several years, from more than 17,000 during 1978–2003, to an all-time low of 14,000 in 2004, to almost 20,000 in 2007. Many cases go undiagnosed and/or unreported, however. The CDC estimates that 450,000 total cases of shigellosis occur in the U.S. every year.

Shigella is the third most common pathogen transmitted through food. During 2006, a total of 1,270 foodborne-related outbreaks from 48 states in the U.S. were reported. Although Shigella was responsible for only 10 (1%) of those outbreaks, 183 confirmed cases of shigellosis were reported. This contrasts with an average of 659 cases annually in the previous five years. Shigella has also responsible for a substantial portion of foodborne outbreaks on cruise ships.

For more information on Shigella, visit www.about-shigella.com and keep up to date on Shigella News at www.shigellablog.com.

AP Reports: "Customers Back Ammonia-Treated Beef after Report"

The AP reports today that "Restaurant chains and beef processors defended their products' safety Thursday after a report that an ammonia treatment thought to kill harmful germs in meat isn't as effective as the industry and regulators believed. . . . Fast-food chains McDonald's Corp. and Burger King Holdings Inc. and agricultural conglomerate Cargill Inc. all use the meat in their hamburgers. All said they'll keep using the meat and that their products are safe."

. .. . . . I'm not sure that these corporations are the "customers" we should be concerned about re-affirming their commitment to the consumption of ammonia.  Maybe I'm old fashioned though.

Meat Trade News Daily misses only a couple

The Meat Trade News Daily misses only a couple major food safety issues (i.e. outbreaks) in yesterdays summary of ten major food stories in 2009.  In the blog post, titled "USA - Food Safety a Bloody Disgrace," MTND includes: 

1.  Stephanie Smith's E. coli O157:H7 and HUS illness from eating a contaminated Cargill ground beef patty.  Stephanie has sued Cargill for $100,000,000.

2.  Linda Rivera's E. coli O157:H7 and HUS illness from eating contaminated Nestle cookie dough.

3.  Peanut Corporation of America's Salmonella Typhimurium outbreak, remarkable for a lot of things, not least of which the depth of its seemingly utter disdain for the wellbeing of consumers.

4.  The Salmonella Newport (an antibiotic resistant strain) outbreak linked to Cargill ground beef.

5.  President Obama's failure to nominate somebody, despite having served for almost a year--a year marked by, well, see above and below--for the position of Undersecretary of Food Safety at the USDA.

6.  The Milan, Illinois McDonald's Hepatitis A outbreak, lacking only an ounce of intent in its comarability to the actions of PCA and Stewart Parnell.

7.  The Organic Pastures E. coli O157:H7 outbreak linked to raw milk.

8.  The E. coli O157:H7 outbreak linked to JBS beef.

9.  A Chinese court's acceptance of the first lawsuit to arise from the 2008 melamine scandal linked to tainted milk, which killed 6 babies and sickened about 300,000.

10.  The "food fight" sparked by the Center for Science in the Public Interest's report on the ten riskiest foods regulated by the FDA.

A good list.  I would add many more if there was room in a list of ten, but two are certainly worthy of emphasis:

1.  The E. coli O157:H7 outbreak, announced in a Christmas Eve press release, linked to tenderized beef products produced by National Steak and Poultry.

2.  The large Salmonella Saintpaul outbreak from January through April linked to contaminated sprouts.  Ultimately, at least 228 people were sickened in the outbreak from 13 states.

The Pathogenic Dangers of . . . Wooden Shipping Pallets?

Yes, even wooden shipping pallets.  These days, it seems that nothing is immune from being linked to an outbreak of foodborne disease.  Spinach, lettuce, sprouts, peanut butter, cookie dough, pizza, shellfish . . . everything.  And now, a pharmaceutical recall highlights the potential risks posed by something as seemingly innocuous as wooden shipping pallets. 

This news comes in the midst of a recall, by McNiel Consumer Healthcare, of Tylenol arthritis pain caplets that were shipped on wooden pallets treated with a chemical known to cause potentially severe gastrointestinal symptoms.  But this particular Tylenol recall highlights the broader problem of potential bacterial or viral contamination of products during the shipping process.  On December 16, 2009, Intelligent Global Pooling Systems announced that,

a random sampling of wood pallets used to ship food in Portland, ME, and Philadelphia, PA, numerous pallets tested positive for Listeria and abnormally high counts of bacteria that could potentially create health hazards for consumers. The new data bolster the findings of previous wood pallet testing conducted in the Washington-Baltimore area, further illustrating the unsanitary conditions and unacceptable risks to our nation’s food supply from wood pallets.

"How much more evidence does Congress and the FDA need?," Bob Moore, IGPS Chairman and CEO asked in an article on PR Newswire.  "The TYLENOL recall proves wooden pallet shipping platforms are a dangerous threat to the pharmaceuticals we depend on, while recent independent studies we've commissioned in four cities demonstrate the dangers they pose to our food supply," 

"The one to two billion wood pallets in circulation in the United States are the common denominator in the supply chain - practically every product we ingest is shipped on a wood pallet. Congress and FDA cannot afford to overlook them any longer as they consider ways to strengthen our national food safety law."

Well said.  The risks are clear, particularly for the select few (actually, pretty much all of us) who participate in an integrated, international food supply.  And even for locavores who would rather not rely on the spotty food safety records of foreign producers, the food still has to be shipped a certain distance.  Odds are, there's a wooden pallet somewhere in the chain. 

Carino's Italian Voluntarily Removes Recalled Meat At All Restaurants Supplied By National Steak and Poultry

From a Company Press Release:

AUSTIN, TX--(Marketwire - December 31, 2009) - Carino's Italian has voluntarily removed and safely disposed all meat products provided by its supplier, National Steak and Poultry (NSP). Carino's Italian took immediate steps and followed the appropriate safety procedures in the removal and disposal of all potentially affected meat products as soon as NSP notified the company of the USDA's Food and Safety Inspection Service (FSIS) request for the broad recall.

"Food safety, as well as the health and well-being of our guests and employees, are our number one priority," said Warren Chang, president of Fired Up, Inc., owner Carino's Italian. "We are actively monitoring this situation and participating with NSP's and USDA's ongoing investigation of this recall."

To date, Carino's Italian has not been notified of any illnesses associated with the one steak product provided by NSP. The steak product that has been associated with Carino's Italian was used in limited time offers and is no longer being offered. None of the products that were supplied to Carino's Italian tested positive for any contamination.

"We assure our guests that Carino's Italian has one of the strictest quality control procedures in the industry and we only use ingredients of the highest quality in our dishes. We stand by the food we serve," added Mr. Chang.

NMA Responds to New York Times

From a NMA Press Release:

New York Times reporter Michael Moss, in a lengthy article, has questioned the technology developed and used by Beef Products, Inc. to ensure improved safety of beef and beef trimmings in today’s publication. Beef Products, Inc is a long-time member of NMA.

The company’s President, Eldon Roth, has developed technology to improve the safety of beef, and beef trimmings, over a span of more than 35 years, applying technology using ammonia, the basic refrigerant used in all major cold storage establishments in the food industry worldwide. The NYT story is a very limited, one-sided view of the technology.

The innovative technology developed by BPI is fully set forth on the company’s website, and has been hugely effective in improving the safety of meat and meat trimmings. It has also been effective at reducing any pathogens that may be present to non-detectable levels by adjusting the alkalinity of the product. Pathogens such as E. coli O157:H7 and Salmonella do not survive in an alkaline pH environment

Mr. Roth and his team are to be commended for their very substantial contributions to ensuring the safety of meat. They have done so openly, presented their research and technology for scrutiny by the USDA and other scientists, and have demonstrated through their back-up testing that the technology is working.

Dr. David Theno who was quoted in the NYT notes that the story failed to mention Mr. Roth’s unwavering support for food safety initiatives, and that he has held his team at BPI to the highest standards possible for food safety.

NMA’s Director Emeritus Rosemary Mucklow, who has known Mr. Roth for over 35 years, said: Eldon Roth has been a strong leader in finding new innovative ways to ensure meat safety. The technology he developed thirty years ago revolutionized the safety of raw materials with the effective application of refrigeration. He has never ceased to try to improve food safety, and he has done so with developmental genius and transparency. He is to be highly commended for his commitment.

National Meat Association is a non-profit trade association. Since 1946, NMA has represented meat packers and processors, equipment manufacturers and food suppliers who provide services to the meat industry. The association has members throughout the United States, as well as in Canada, Australia and Mexico.

Food Safety News - Emerging Food Safety Issues for 2010

Over at Food Safety News, we have been working on what we think are the issues that face the Food Safety community in 2010:

Laws

The U.S. Congress and Legislatures in most of the 50 states will all be back in session as 2010 begins. In Washington D.C., work should resume on food safety reform. To get through to the President's desk, the Senate must adopt S. 510, conference with the House, and then see the compromise bill passed by both houses.

If all that takes until spring, look for the President to sign the bill in the First Lady's new White House Kitchen Garden.

State laws are always all over the map, and 2010 will be no different. Look for some agricultural states to follow Georgia in making it a felony to knowingly ship contaminated food.

Look for several states to close loopholes that are used to peddle overpriced raw milk to an unsuspecting public while advocates push for more liberal laws so raw milk can be sold with fewer restrictions.

Regulations & Enforcement

The major regulatory decision that could come down in 2010 is the one that would make all enterohemorrhagic shiga toxin-producing serotypes of Escherichia coli (E. coli), including non-O157 serotypes, adulterants within the meaning of the Federal Meat Inspection Act (21 U.S.C. § 601[m][1]).

Seattle food safety attorney Bill Marler and some of the victims of non-O157 E. coli infections, who he represents, petitioned the U.S. Department of Agriculture's (USDA's) Food Safety and Inspection Service (FSIS) for the regulatory change. Not since President Bill Clinton's FSIS declared E. coli O157:H7 an adulterant after the 1993 Jack-in-the-Box outbreak has there been such a dramatic action out of the agency that regulates big beef.

About 2,700 state and local health agencies are the foundation of the food safety regulations and enforcement system. The Center for Science in the Public Interest has been tracking those agencies, and recently reported the number of outbreak investigations is falling and the number of investigations where the source is identified is dropping.

The investigative capacity of these important agencies is unlikely to increase during 2010, a year that will see state budgets more hard-pressed than at any time since the Great Depression. Most state and regional agencies count on their Legislatures for their budget support.

Meat Industry

As 2009 ended, Brazil-based JBS rescued Pilgrim's Pride from bankruptcy court, making its creditors whole. In doing so, it joined Tyson and Cargill in the top three of the U.S. meat industry. (See "JBS Takeover of Pilgrim's Pride Approved," Oct. 17, 2009).

Together the three behemoths control more than 80 percent of the U.S. meat market, and unlike times in the past, it is a nameless, faceless industry sector. Whether anyone in the Cargill, Tyson, and JBS line-up steps up in 2010 will be interesting to watch.

Since 2007, there's been an explosion in the number of pounds of beef recalled for E. coli O157:H7 contamination. The industry's only answer has been its petition for whole carcass irradiation without labeling. Antibiotic-resistant Salmonella showing up in ground beef brings more silence and kicking the dirt by big meat. And how about your odds of getting out of any grocery store in America with a chicken that is NOT contaminated by either Salmonella or Campylobacter or both?

With such a line-up of major issues negatively impacting the industry, some think 2010 will be the year big meat re-tools and steps forward with some new leadership.

Superbugs

This is a subject that should make the hair on the back of your neck stand up.

Superbugs, bacteria that are resistant to normally prescribed antibiotics, are increasingly in the news. For example, late in 2009, came the report that a new E. coli strain has "emerged with rapid global speed."

Superbugs are the flip side of the coin to the low dose use of antibiotics in animal feed to promote the growth of pigs, sheep, chickens, and cattle. As long ago as 1963, British researchers linked drug resistant strains of Salmonella to antibiotics fed to cattle.

Out West last summer, people who ate ground beef produced by Denver-based King Soopers and Fresno-based Beef Packers Inc. were infected with strains of Salmonella that did not respond to normally prescribed antibiotics.

This means treatment, if possible, starts to get very costly. Longer hospital stays were required for those Colorado victims last summer, and it will cost $150 per day, per person to treat victims of ST131 if it ends up running wild throughout the third world.

Also in 2009, the late Sen. Edward Kennedy, D-MA, and Sen. Olympia Snow, R-ME, introduced the "Preservation of Antibiotics for Medical Treatment Act," which in two years would end animal use of antibiotics deemed "important to human health."

FDA, which 50 years ago approved the use of antibiotics in low doses to help animals grow faster, could conceivably impose a ban on its own. That could be on the table in 2010.

Local Food

In 2009 the local food movement in the United States picked up a major benefactor, First Lady Michelle Obama. It was not long after her interest was known, that the entire U.S. Department of Agriculture joined in with its "Know Your Farmer, Know Your Food" program.

In fact, USDA did do much more than some re-branding and re-organizing itself for a new constituency--all those small, local, and organic farmers who want to sell their goods to nearby folks.

By measures available, growth in farmers markets and in so-called Community Supported Agriculture (CSAs), the local food movement is real.
 In cities and suburbs, people love going to the nation's nearly 5,000 farmers markets, many held on Saturday mornings during the growing seasons.

And buying some "shares" from a CSA farmer in the winter can get you deliveries of a basket of fruits and vegetables all summer. Keeping your dollars flowing in your local community is almost always a good idea.

Under the Farm Bill, USDA is even going to allow some state-inspected slaughter houses to sell across state lines in 2010.

For sure, 2010 will be another year of growth for local food. Will it embrace its responsibility for food safety and come to understand that standards and regulations are in its best interest? This is a time of change and reform, and local food needs to be at the table, not sneaking out the back door.

Large unemployment throughout the country is also giving the local food movement an opportunity to be responsible in another way--getting leftovers to food banks. Just do it safely!

Vaccines

Since some states--like Texas--have made Hepatitis A vaccines mandatory for school children, there has been a dramatic disease reduction. Similar reductions might be in the offing if vaccine trials conducted in 2010 are successful.

First on the non-human front, vaccines for E. coli in cattle are going to be tested in a big way by the two companies that are out front in the research. They are Willmar, MN-based Epitopix and Canada's Bioniche Life Sciences.

The two companies should know by year-end if they have an economically viable vaccine, one that might reduce E. coli O157:H7 in cattle by 65 to 75 percent.

In human drug trials should be a vaccine against the pathogen Campylobacter jejuni, at the U.S. Naval Medical Research Center in Silver Spring and Canadian scientist Mario Monteiro. It has successfully protected against infection in monkeys and is now slated for human clinical trials.

Then there's Dr. Mahdi Saeed's vaccine for Enterotoxigenic E. coli, the bug responsible for traveler's diarrhea that has killed millions of children in the third world. The Michigan State University researcher's vaccine has such promise it was picked by Discovery Magazine as one of the top 100 stories of 2009.

If any of these vaccines are successful, it will be a top story for 2010.

Food Imports

In late 2009, the "Import Safety Commercial Targeting and Analysis Center" (CTAC) was opened by the Department of Homeland Security (DHS) to make sure food imported to the U.S. is safe.

Imported food and its safety are going to get a lot of attention in 2010. The Import Safety CTAC came out of the President's Food Safety Working Group, which is charged with advising on how to "modernize the beleaguered U.S. food safety system."

Food imports, especially fresh produce from outside U.S. borders, are coming in for attention after the past few years of spectacular growth.

In 2008, Chinese imports reached $5.2 billion, making China the third-largest source of U.S. food imports. About 41 percent of this import value was from fish and seafood, most of it farm-raised. Juices and pickled, dried, and canned vegetables, and fruit accounted for the other 25 percent.

According to the USDA, about 60 percent of all American apple juice, 50 percent of garlic, 10 percent of shrimp and 2 percent of catfish are imported from China.

A July 2009 report by the Economic Research Service of the USDA said it is often difficult to ensure that suppliers in far-flung locations operate according to the high U.S. safety standards and tight quality controls.

Traceability

The Produce Traceability Initiative is the grower-vendor answer to events like the outbreaks involving spinach and (FDA thought) tomatoes. With bar codes and radio frequency tags and ways to link all the information in the supply chain, those behind traceability want to be able to drive to the specific field, walk down the right row, and reach over and pick up whatever the problem is.

They want a system with no fuss, no muss that will prevent financially devastating recall costs and outbreaks that make more people sick. They've been at it for a couple of years now and the next important deadline is approaching in Oct. 2010 when it is supposed to be possible to read the labeling involved.

The industry wants FDA to enforce the so-called "one up and one down" requirements of the PTI, but not impose anything that's not already in the plan. FDA opted to end 2009 without putting out its own traceability regulations on the table.

On occasion, FDA Commissioner Margaret Hamburg has been critical of volunteer food safety efforts. So the tension of birthing fresh produce traceability is sure to carry into the 2010.

It will be the subject on a Jan. 21-22 summit conference in Denver being organized by the Colorado Springs-based Traceability Institute LLC.

"The reason we set up this summit is we see a huge need by vendors of the traceability system for some kind of communication within the whole supply chain," Cristian Barcan, managing partner and founder of the Traceability Institute told the industry publication, The Packer.

American Diet

There was a lot of talk during all the health care debating about "bending the cost curve." With too many Americans unable to even bend over, it's doubtful we are going to bend that cost curve at anytime soon and what they call the "Standard American Diet (SAD)" is a major contributor to this sad reality.

In 2010, we are predicting more attention to the American diet than ever before. It will come from the food industry, consumer groups, and government. The problem is clear.

The SAD is high in animal fats, high in unhealthy fast food, high in saturated and hydrogenated fats, low in fiber, high in processed foods, low in complex carbohydrates, and low in plant-based foods.

The medical community often points out that people in countries that eat the reverse of the SAD--high in plants, high in complex carbohydrates, and high in fiber--are experiencing lower cancer and heart disease rates by far.

It could cause debate over just what is a foodborne illness?

Scombroid Poisoning Associated with Consuming Certain Fish

Here at Marler Clark, we are currently investigating an instance of probable scombroid poisoning for a client that contacted us recently.   We are not contacted by victims of scombroid poisoning with the same frequency as E. coli O157:H7, Salmonella, and Hepatitis- A.  Still, we have handled a number of these claims in the past.

According to the CDC, scombroid poisoning is named for a particular family of fish, "Scombridae," which includes tuna and mackerel.  The illness, though, can occur "after ingestion of any dark-fleshed nonscombroid species containing high levels of free histidine."  

The problem stems from improper refrigeration.  When not properly stored, free histidine is broken down to histamine by surface bacteria.

Unlike some foodborne illness that can take many hours, if not days, to take effect, scombroid poisoning begins "minutes to hours after ingestion of the toxic fish."   The CDC identifies symptoms as resembling a  "histamine reaction and frequently include dizziness, headache, diarrhea, and a burning sensation or peppery taste in the mouth. Facial flushing, tachycardia, pruritus, and asthma-like symptoms can also occur."

The FDA has established 50 mg/100g of histamine as a hazardous level in tuna.   Unfortunately, cooking toxic fish will not prevent illness.   The CDC states, therefore, that  the key to prevention of scombroid poisoning is "continuous icing or refrigeration of all potentially scombrotoxic fish from the time they are caught until they are cooked."

Thankfully, symptoms of scombroid poisoning are generally short lived.  Because the illness is associated with improper handling of fish, often at the retail level, outbreaks are generally limited in numbers.   The CDC has previously reported that the median number of cases per outbreak is two.

Is Meat the Source for the E. coli Infection in your Urinary Tract?

Urinary tract infections (UTI) are a serious health problem affecting millions of people each year.  In fact, they are the second most common type of bodily infection, accounting for about 8.3 million doctor visits annually.  Escherichia coli--a family of bacteria that includes E. coli O157 and other shiga-toxin producing strains, as well as certain generic strains that can reside quite peacefully in the human colon--is the most common cause of urinary tract infections.  New research suggests that, even for strains associated with UTI rather than gastrointestinal disease, meat may be the ultimate reservoir. 

Researchers from Denmark conducted the study, and will soon publish the results in the publication "Foodborne Pathogens and Disease."  In the study, abstract available here, researchers studied the serogroups and antimicrobial resistance characteristics of E. coli isolates (pure bacteria examined for genetic characteristics and uniqueness) from various sources, including community-dwelling humans, broiler chicken meat, broiler chickens, pork, and pigs.

A total of 964 geographically and temporally matched E. coli isolates from UTI patients (n=102), community-dwelling humans (n=109), Danish (n=197) and imported broiler chicken meat (n=86), Danish broiler chickens (n=138), Danish (n=177) and imported pork (n=10), and Danish pigs (n=145) were tested for phylogroups (A, B1, B2, D, and nontypeable [NT] isolates) and antimicrobial susceptibility. Phylogroup A, B1, B2, D, and NT isolates were detected among all groups of isolates except for imported pork isolates. Antimicrobial resistance to three (for B2 isolates) or five antimicrobial agents (for A, B1, D, and NT isolates) was shared among isolates regardless of origin.

Using cluster analysis to investigate antimicrobial resistance data, the researchers found that UTI isolates always grouped with isolates from meat and/or animals. Researchers detected B2 and D isolates, that are associated to UTI, among isolates from broiler chicken meat, broiler chickens, pork, and pigs. Although B2 isolates were found in low prevalences in animals and meat, these sources could still pose a risk for acquiring uropathogenic E. coli. Further, E. coli from animals and meat were very similar to UTI isolates with respect to their antimicrobial resistance phenotype. The researchers believe that the study provides support for the hypothesis that a food animal and meat reservoir might exist for UTI-causing E. coli.

 

My Steak has been needle or blade penetrated or hammered - Really? What about E. coli?

My email box is filling up following yet another FSIS recall – this time the issue is “mechanically tenderized” steaks contaminated with E. coli O157:H7 linked to illnesses in several states.

So, how often are our steaks penetrated or hammered? As you can imagine, that information is not that readily available. It is hard to see that as a positive spin on the menu at your favorite restaurant.

But, how often?  According to A Risk Assessment of E. coli O157:H7 in Tenderized Beef Steaks, “the majority of steaks and roasts destined for hotel, restaurant, and institutional use in the U.S. may be subjected to ‘mechanical tenderization.’” Also, some 18% of steaks are tenderized in retail and 25% of steaks are consumed in restaurants.

And, Why?  According to another industry publications, tenderness is the most important factor affecting consumer ratings of beef. Beef tenderness is affected by two primary factors called background tenderness and protein (muscle fiber) tenderness.

So what is it?  Mechanical tenderization is a method whereby fine incisions are made in the meat by closely spaced, specially designed knives (also, hammering and needling) which cut the connective tissue. The mechanical tenderization process takes less than one minute with a roller type tenderizer or a crank type hand operated tenderizer. Meat, which has been treated in this manner, is immediately tenderized without the use of chemicals or other artificial means or the need to wait for natural bacterial action to take place. The depth and the spacing of the knives and the number of times the meat is passed through the tenderizer permits the degree of tenderization to be determined, thus controlling the amount of tenderizing. Almost every grade of meat can be tenderized without danger of meat fabric deterioration or granulation.

Why should we care? 
A 2005 study found the incidence of E. coli O157:H7 on surfaces of beef cuts intended for blade/needle tenderization by Warren-Serna et al. (2002) revealed a 0.2% occurrence on 1,014 cuts from six packing plants or purveyors geographically dispersed throughout the U.S. The fact that E. coli O157:H7 does (albeit rarely) occur on beef primal/subprimal cuts generates risk of its entry into cuts when blade/needle or moisture-enhancement tenderization technologies are used, and its probability of occurrence is dramatically increased if improper cleaning/sanitizing of equipment is practiced. Gill and McGinnis (2004) collected 25 samples from four grocery stores, two of 100 samples, both from the same store, had detectable levels of E. coli on the internal surface of the product, further indicating that the risk of transferring E. coli O157:H7 to the interior of muscle samples is low and often dependent on site specific cleaning and sanitation programs. Blade tenderization has been found to transfer 3 to 4% (Hajmeer et al., 2000; Phebus et al., 2000) or 1 to 7% (Lambert et al., 2001) of surface contamination to the interior of the muscle; needle injection (during enhancement) results in 4 to 8% translocation of surface contamination to the center of the cut (Lambert et al., 2001).

What to do about it?  As a result of the work of the Blade Tenderization Committee of the CFP, needle tenderized steaks... aka "pinning" or Jacquard processing, must be cooked to 155 degrees F, same as ground meats and injected meats, and is included as such in the 2009 FDA Food Code.

So, what does the Government Say? Keep reading:

Continue Reading...

Hemolytic uremic syndrome (HUS) and E. coli O157:H7

Every time an E. coli O157:H7 outbreak occurs, we get yet another reminder how devastating the bacteria can be, particularly when it causes hemolytic uremic syndrome (HUS).  See www.about-hus.com..  And every time we represent a young child with HUS, I am reminded of the story of Regan Erickson, who was sickened in the spinach E. coli outbreak in September 2006 (We represented over 100 victims, including nearly 30 who suffered kidney failure and hemolytic uremic syndrome). 

Tiffany and Russ Erickson were just like most Americans until September 2006. Their four-year-old son Regan (pronounced "Ree-gun") was one of many young kids whose future was unalterably and forever changed by spinach. What appears below is Regan's story. It is a little long, but that must be forgiven. Regan's illness very nearly cost him his life.

ONSET OF ILLNESS:

Regan's mother, Tiffany, and his sister, Emma, were both sickened during the Spinach outbreak as well. Tiffany actually fell ill first, on August 28. It felt like cruel timing, given that it was only three days before Emma’s birthday and little more than a week since discovering that she was pregnant with her third child, Maggie, but Tiffany took everything in stride. She had no reason to suspect that she was dealing with anything more than a run-of-the-mill flu, and her primary concern was with the health of her unborn child.

After twenty-four hours or so, however, thoughts began to change about the nature of Tiffany’s illness. Her bouts of diarrhea had grown more frequent and severe, and her abdomen was beset by cramps more severe than labor pains. Then, the evening of August 29, after a particularly painful bout of diarrhea, Tiffany noticed that the toilet bowl was streaked with blood. Up until this point, Tiffany had endured everything with resolute confidence, but this symptom suggested something that she had never before reckoned with.

Tiffany soon underwent a diagnostic procedure called an endoscopy to shed light on what was wrong. Of his wife’s illness, before his thoughts turned to Regan alone, Russ recalls:

We left the urgent care facility and gave the drugs some time to work, but the pain continued to be unbearable. As my concern shifted from the baby to Tiffany I couldn’t stand seeing her in that much pain, tired from lack of sleep, and not able to get comfortable.

Meanwhile, Regan had begun to develop symptoms, and Emma soon would. “We didn’t realize that the illnesses could be related,” Russ recalls, “since Regan couldn’t express his pain as well as Tiffany. He just knew his ‘tummy’ hurt and he began having diarrhea.” Emma’s symptoms began the very next day, September 1.

Russ recalls:

Everyone in the family was sick, tired, and the children being so young, not knowing how to tell or deal with the symptoms like diarrhea, I was continually cleaning, comforting, and helping where I could, all without Tiffany’s help who is usually the stalwart caregiver. We knew that we had some kind of ‘bug’ but not how severe yet. It presented a lot like flu symptoms, but we began to know it was more serious as the kids, just as Tiffany, began to have blood in their stool, and then blood instead of stool. That is a scary, unnerving experience to see blood when your 3 and 4 year olds are using the bathroom.

Compared to four year-old Regan, the illnesses that Tiffany and Emma Erickson suffered were nothing more than a small current in a raging sea. Nevertheless, to hear Russ describe what his wife and daughter endured is to fully comprehend the aggressive nature of this virulent pathogen. Emma endured many days of an illness more acutely painful than anything her parents had ever seen. But as sick as she was, her older brother was fast-becoming critically ill, and her parents thoughts and attention soon went solely and exclusively to Regan.

 

Continue Reading...

NICE: Food Safety News Issues Second Part of its 2009 Naughty and Nice List

List Follows Yesterday’s Naughty Entries

Food Safety News, the web-based newspaper that covers all things food safety, today released the second part of its 2009 Food Safety Naughty and Nice list. The web-based newspaper’s “Naughty” list was published yesterday and included food safety missteps, missed opportunities, and downright dirty deeds. But it won’t be all coal in Food Safety stockings this year – the “Nice” list is full of good ideas and hard work, which will certainly mean lots of (very safe) treats for the following:

  • Rep. Rosa DeLauro and Sen. Kirsten Gillibrand for being consumer champions and persistent advocates of food safety reform.
  • Food & Drug Administration Commissioner Margaret Hamburg for improving public access to information, including “Warning Letters” and 483 Reports.
  • Secretary of Agriculture Tom Vilsack for USDA’s new outreach programs, like “Know your farmer, know your food.”
  • New York Times writer Michael Moss for his Pulitzer-worthy article on the dark origins of ground beef and the terrible impact of E. coli O157:H7.
  • The quick work of the U.S. House Energy and Commerce Committee, whose members worked quickly and got their hands on incriminating email traffic between the PCA executives, who took the Fifth Amendment when called to testify.
  • President Obama for setting up the Food Safety Working Group.
  • The public, for an outpouring of support for WSU’s Common Reading Program (hat tip, Food Democracy Now).
  • Sen. Dick Durbin for being the driving force behind food safety legislation in the Senate and the HELP Committee for passing S. 510 out of committee with bipartisan support.
  • The makers of Food, Inc, who introduced the country to the underside of food production, and made a very watchable – if frightening – film about it.
  • Michele Obama, for planting a kitchen garden at the white house, and getting kids involved in (very) local food and for getting a local DC farmer’s market through the red tape.
  • FDA for getting a guilty plea by Mark McAfee of OPDC to criminal charges of misbranding raw milk and selling across state lines as "pet food."
  • Marion Nestle for, among other things, her persistent and common sense critique of how junk food and soda is marketed to children.
  • Mike Taylor and Don Kraemer at FDA for boldly putting public health ahead of Gulf Coast oyster industry profits.
  • That consumer and public health groups have joined with produce growers and food processors and retailers to support FDA reform legislation, making its passage possible.
  • Dedicated writers whose excellent articles gave insight and context to food safety issues: Lyndsey Layton of the Washington Post for her piece on Linda Rivera’s struggle with E. coli O157:H7 from cookie dough, Peter Eisler, Elizabeth Weise, and others of USA Today for their reporting on school lunches, and Nick Grube of the Daily Triplicate for his three-part series on Mari Tardiff’s struggle to recover from the Campylobacter infection and ensuing Guillain-Barre Syndrome she got from drinking raw milk.
  • Food Bloggers – Simple, Good and Tasty, Cold Truth, Ag and Food Law, Civil Eats, Grist, Weaversway, Food Politics, Ethicurean, La Vida Locavore, Obamafoodorama, Food Shield, efoodalert, Fanatic Cook, Fresh Talk, Center for a Liveable Future, Chuck Jolley, Food Law, Buy Safe Eat Well and Barf Blog.

Comments over at www.foodsafetynews.com.

Just in time for Christmas - The Complete Food Safety Naughty and Nice List

Naughty

-  Stewart Parnell, President of Peanut Corporation of America, for asking for nearly $1 million from his bankrupt business for his own criminal defense fund after shipping peanuts his own tests showed were contaminated with Salmonella that sickened over 700 and killed at least nine.

-  President Obama for NOT appointing a new permanent U.S. Department of Agriculture Under Secretary for Food Safety. ALSO NAUGHTY: USDA Secretary Tom Vilsack for making excuses about it.

-  Some raw milk, small and sustainable agriculture advocates who confused the entire food safety debate by making and circulating false claims about the bills. It really is about food safety, and is not a gigantic conspiracy by Monsanto to wipe out organic and backyard farms!

-  FDA's Office of Criminal Investigations and the U.S. District Attorney in Georgia for moving so slowly with the criminal investigations of the Peanut Corporation of America and its executives, including Stewart Parnell.

-  President Obama and Vice-President Biden for ordering undercooked hamburgers for the Press Corps at a DC restaurant with less than stellar inspection reports.

-  Washington State University for removing Michael Pollan's "Omnivore's Dilemma" from the Common Reading Program.

-  The FDA for caving to political pressure and backing down on oyster regulations.

-  The Senate for being too slow on health care reform to pass meaningful--and decades overdue - food safety legislation before the Holidays.

-  Weston A. Price Foundation for more denial of outbreaks and giving consumers false information about raw milk safety.

-  FDA for its failure to control ridiculous health claims like Kellogg's claiming that Cocoa Krispies are a "Smart Choice" because it "helps support your child's immunity."

-  J. Patrick Boyle of the American Meat Institute for trying to dynamite the Senate food safety bill even though it doesn't have anything to do with the meat industry.

-  State public health department officials attending the Interstate Shellfish Sanitation Conference in October who put industry profits ahead of public health.

-  Rep. Charlie Melancon for declaring the death of 15 people a year is not too high a price to pay for a U.S. Senate seat in an oyster growing State.

-  Secretary Vilsack and White House for trying, in the name of free trade, to roll over Rep. Rosa DeLauro's efforts to assure that the US does not permit poultry processors from shipping raw poultry meat from the US to China for processing and shipping back to the US for sale until USDA has determined that China's inspection program is equivalent to ours.

-  FDA Commissioner Margaret Hamburg for urging Congress to give the Agency authority to reduce the intensity of inspections if they don't get all the money they ask for.

-  The FDA staff that keeps appealing to consumer advocates, "don't set us up to fail," when consumer advocates push for more inspection. They never say, "help us get the law and resources we need to protect people."

Nice

-  Rep. Rosa DeLauro and Sen. Kirsten Gillibrand for being consumer champions and persistent advocates of food safety reform.
Food & Drug Administration Commissioner Margaret Hamburg for improving public access to information, including "Warning Letters" and 483 Reports.

-  Secretary of Agriculture Tom Vilsack for USDA's new outreach programs, like "Know your farmer, know your food."

-  New York Times writer Michael Moss for his Pulitzer-worthy article on the dark origins of ground beef and the terrible impact of E. coli O157:H7.

-  he quick work of the U.S. House Energy and Commerce Committee, whose members worked quickly and got their hands on incriminating email traffic between the PCA executives, who took the Fifth Amendment when called to testify.

-  President Obama for setting up the Food Safety Working Group.

-  The public, for an outpouring of support for WSU's Common Reading Program (hat tip, Food Democracy Now).

-  Sen. Dick Durbin for being the driving force behind food safety legislation in the Senate and the HELP Committee for passing S. 510 out of committee with bipartisan support.

-  The makers of Food, Inc, who introduced the country to the underside of food production, and made a very watchable - if frightening - film about it.

-  Michelle Obama, for planting a kitchen garden at the White House, and getting kids involved in (very) local food and for getting a local DC farmer's market through the red tape.

-  FDA for getting a guilty plea by Mark McAfee of OPDC to criminal charges of misbranding raw milk and selling across state lines as "pet food."

-  Marion Nestle for, among other things, her persistent and common sense critique of how junk food and soda is marketed to children.

-  Mike Taylor and Don Kraemer at FDA for boldly putting public health ahead of Gulf Coast oyster industry profits.

-  The consumer and public health groups that have joined with produce growers and food processors and retailers to support FDA reform legislation, making its passage possible.

-  Dedicated writers whose excellent articles gave insight and context to food safety issues: Lyndsey Layton of the Washington Post for her piece on Linda Rivera's struggle with E. coli O157:H7 from cookie dough, Peter Eisler, Elizabeth Weise, and others of USA Today for their reporting on school lunches, and Nick Grube of the Daily Triplicate for his three-part series on Mari Tardiff's struggle to recover from the Campylobacter infection and ensuing Guillain-Barre Syndrome she got from drinking raw milk.

-  Food Bloggers - Simple, Good and Tasty, Cold Truth, Ag and Food Law, Civil Eats, Grist, Weaversway, Food Politics, Ethicurean, La Vida Locavore, Obamafoodorama, Food Shield, efoodalert, Fanatic Cook, Fresh Talk, Center for a Liveable Future, Chuck Jolley, Food Law, Buy Safe Eat Well and Barf Blog.

Wisconsin veterinary group opposes bill to allow raw milk sales

DVM NEWSMAGAZINE

Madison, Wis. -- The Wisconsin Veterinary Medical Association (WVMA) is taking a stand against a proposed state law that would allow the sale of raw milk, citing public health concerns.

The "Raw Milk Bill" under consideration by state leaders would allow farmers to sell raw milk directly from the farm. WVMA opposes the bill because of the potential for contamination by several types of harmful bacteria including E. coli, Listeria and Coxiella.

"It is the opinion of the Wisconsin Veterinary Medical Association that only pasteurized milk and milk products should be sold for human consumption," WVMA says. "The simple, yet vitally important, process of pasteurization kills bacteria and makes milk safe, protecting both public health and consumer confidence in dairy products."

Senate Bill 434 was introduced Dec. 21 and immediately referred to the Wisconsin Committee on Agriculture and Higher Education.

Study Finds Majority of Commercial Chicken Has Bacterial Contamination

Consumer Reports has unveiled the results of a study that provide a frightening look at commercially sold uncooked chicken in the U.S. - two thirds of the chicken tested was positive for either Salmonella, Campylobacter, or both. 

The consumer organization tested 382 chickens from 100 different stores in 22 states.  Here are a few of their findings:

  • Campylobacter was in 62 percent of the chickens, salmonella was in 14 percent, and both bacteria were in 9 percent.

  • Store-brand organic chickens had no salmonella at all, showing that it's possible for chicken to arrive in stores without that bacterium riding along...57 percent of those birds harbored campylobacter.

  • The cleanest name-brand chickens were Perdue's: 56 percent were free of both pathogens.

  • Most contaminated were Tyson and Foster Farms chickens. More than 80 percent tested positive for one or both pathogens.

  • Among all brands and types of broilers tested, 68 percent of the salmonella and 60 percent of the campylobacter organisms we analyzed showed resistance to one or more antibiotics.

No doubt that some confronted with these findings will dismiss it - "everyone knows that you have to cook chicken before you eat it."  Such an attitude understates the problem associated with these eye-opening findings.   

First, the risks of cross-contamination in the home are not often fully appreciated.   Any contact between these raw products and other surfaces - knives, hands, counter tops- that will then come in contact with ready-to-eat foods, puts consumers at risk.

Second, the severity of the risk is likely under-appreciated.  The bacterial pathogens on these chickens can cause severe illnesses.  The 2008-2009 Salmonella outbreak associated with PCA peanut butter killed nine people.   Campylobacter infections are a known cause of Guillain-Barre Syndrome (GBS).  GBS  is a disorder in which the body's immune system attacks part of the peripheral nervous system. It often leads to paralysis, and can be fatal. 

Food Safety News Naughty List 2009

by Suzanne Schreck at Food Safety News | Dec 23, 2009

After much thought and consideration, here is the Food Safety News Naughty list for 2009:



  • NAUGHTY: Stewart Parnell, President of Peanut Corporation of America, for asking for nearly $1 million from his bankrupt business for his own criminal defense fund after shipping peanuts his own tests showed were contaminated with Salmonella that sickened over 700 and killed at least nine. (See "PCA Executives To Divide $875,000," Dec 11, 2009)
  • NAUGHTY: President Obama for NOT appointing a new permanent U.S. Department of Agriculture Under Secretary for Food Safety. ALSO NAUGHTY: USDA Secretary Tom Vilsack for making excuses about it. (See "FSIS Remains Leaderless," Oct. 16, 2009)
  • NAUGHTY: Some raw milk, small and sustainable agriculture advocates who confused the entire food safety debate by making and circulating false claims about the bills. It really is about food safety, and is not a gigantic conspiracy by Monsanto to wipe out organic and backyard farms! (See "Small Ag Organizes to Amend Senate Bill," Nov. 17, 2009)
  • NAUGHTY: FDA's Office of Criminal Investigations and the U.S. District Attorney in Georgia for moving so slowly with the criminal investigations of the Peanut Corporation of America and its executives, including Stewart Parnell. (See "One Year Later, Still no Charges for PCA," Nov 07, 2009)
  • NAUGHTY: President Obama and Vice-President Biden for ordering undercooked hamburgers for the Press Corps at a DC restaurant with less than stellar inspection reports.
  • NAUGHTY: Washington State University for removing Michael Pollan's "Omnivore's Dilemma" from the Common Reading Program.
  • NAUGHTY: The FDA for caving to political pressure and backing down on oyster regulations. (See "Under Pressure, FDA Puts Oyster Policy On Hold," Nov 14, 2009)
  • NAUGHTY: The Senate for being too slow on health care reform to pass meaningful--and decades overdue--food safety legislation before the Holidays.
  • NAUGHTY: Weston A. Price Foundation for more denial of outbreaks and giving consumers false information about raw milk safety.
  • NAUGHTY: FDA for its failure to control ridiculous health claims like Kellogg's claiming that Cocoa Krispies are a "Smart Choice" because it "helps support your child's immunity." (See "Do Krispies Boost Kids' Immune Systems?" Nov 01, 2009)
  • NAUGHTY: J. Patrick Boyle of the American Meat Institute for trying to dynamite the Senate food safety bill even though it doesn't have anything to do with the meat industry.
  • NAUGHTY: State public health department officials attending the Interstate Shellfish Sanitation Conference in October who put industry profits ahead of public health.
  • NAUGHTY: Rep. Charlie Melancon for declaring the death of 15 people a year is not too high a price to pay for a U.S. Senate seat in an oyster growing State. (See "Under Pressure, FDA Puts Oyster Policy On Hold," Nov 14, 2009)
  • NAUGHTY: Secretary Vilsack and White House for trying, in the name of free trade, to roll over Rep. Rosa DeLauro's efforts to assure that the US does not permit poultry processors from shipping raw poultry meat from the US to China for processing and shipping back to the US for sale until USDA has determined that China's inspection program is equivalent to ours. (See "Deal Reached on Poultry Imports," Sep 27, 2009)
  • NAUGHTY: FDA Commissioner Margaret Hamburg for urging Congress to give the Agency authority to reduce the intensity of inspections if they don't get all the money they ask for.
  • NAUGHTY: The FDA staff that keeps appealing to consumer advocates, "don't set us up to fail," when consumer advocates push for more inspection. They never say, "help us get the law and resources we need to protect people."


This list is a compilation of submissions from the Food Safety News publisher, staff, readers, and food safety experts.

Raw Milk Facts in Short Supply As Proponents Stage Wisconsin Rally

Unpasteurized milk—often referred to as raw milk—is at the center of a rally and court appearance today in Viroqua, Wisconsin. The controversial product can contain bacteria, like E. coli, Salmonella and Campylobacter, which can severely sicken those who consume it—bacteria removed by the pasteurization process. Advocates believe the pasteurization process also removes healthy aspects of the milk, and want the right to produce, sell, and consume it without regulation. One of those advocates has organized a rally and workshop around his court appearance, featuring supporters from around the country. What is not being discussed is the very dark down side of raw milk.

“The virulence of the bacteria in the modern food supply has made even the most careful producers unable to eliminate it completely, and it only takes a microscopic amount to put someone in a wheelchair, on a respirator, or with damaged kidneys for life. In my opinion, drinking raw milk is like playing Russian roulette. I have the sad task of representing those who sought out raw milk to improve their health, but found themselves with the loaded chamber. Their lives have never been the same, and will never be the same,” said Bill Marler, food safety advocate and foodborne illness attorney.

“Do you wear a seat belt?” ask Marler. “Most of us do, but some wouldn’t unless it was required by law. Seat belts have saved many, many lives, and that is what food regulation is trying to do—save lives. Some see the requirement to wear seatbelts as an assault on their personal choices, but as a society, we see the greater benefit—especially for those who can’t make their own choices, like children. Children are also most vulnerable to the bacteria in unpasteurized milk, as their immune systems are not fully formed and cannot fight it.”

Consumer Resource: Comparing the food safety record of pasteurized and raw milk products

Before you consider drinking raw milk, PLEASE read this and watch these videos

Over the last years I have tried to bring some level of rationality to the debate over the consumption of raw milk. I first published on my blog a summary of the findings of a review of peer-reviewed literature on the topic of the "pros" of the consumption of raw milk. Several people from both sides of the raw milk debate have told me that the “pros” review is one of the most comprehensive compilations of peer-reviewed literature examining the potential benefits of raw milk beyond basic nutrition. I then posted about the "cons." What about the “cons?” As I said, the overwhelming “con” of drinking raw milk according to the literature relates to food safety hazards. Below are the realities of those “con’s.”

I would ask the proponents – small dairy farmers trying to make a buck, retailers trying to make even more, the Weston A. Price Association, the Complete Patient, people who believe that drinking raw milk cures everything from asthma, autism, eczema, and erectile dysfunction, to policy makers considering allowing the sales of raw milk – PLEASE read the above links, "Comparing the Food Safety Record of Pasteurized and Raw Milk Products," and read what happened in outbreaks to consumers, including watching the below videos.

Organic Pastures

Chris Martin, then age seven, developed an E. coli O157:H7 infection in September 2006 following consumption of raw milk. He was hospitalized beginning on September 8, suffering from severe gastrointestinal symptoms, including bloody diarrhea. Shortly thereafter, he developed hemolytic uremic syndrome (HUS). In an effort to properly treat his rapidly deteriorating condition, Chris was moved to multiple medical facilities, twice by life-flight. His HUS was remarkably severe, marked by prolonged renal failure, pancreatitis, and severe cardiac involvement. He required 18 days of renal replacement therapy. On two occasions his cardiac problems became so severe that he was placed on a ventilator. At several junctures, the possibility that he might not survive was very real. Ultimately he was hospitalized through November 2, after incurring over $550,000 in medical bills. Renal experts have opined that Chris is likely to develop severe renal complications in the future. These complications include end stage renal disease (ESRD) and kidney transplant.

Herb Depot/Autum Olives Farms

Larry Pedersen had just turned one year old when he developed an E. coli O157:H7 in May 2008. When his diarrhea turned bloody, his parents took him for medical treatment. He was admitted to the hospital on May 8. Shortly thereafter, Larry developed hemolytic uremic syndrome (HUS) and was transferred to a specialty care facility. As is typical of HUS, Larry was then suffering from acute renal failure. He was started on dialysis, which was necessary at that point for his survival. He required 15 days of dialysis before his kidneys recovered enough to function on their own. Larry was discharged on May 29, to continue recovery and treatment on an outpatient basis. The medical bills associated with his care approached $90,000. As the result of damage to his kidneys suffered during his bout with HUS, Larry is at significant risk for severe renal complications in the future. These complications include end stage renal disease (ESRD) and kidney transplant.

Nicole Riggs developed an E. coli O157:H7 infection in May 2008 from consumption of raw goat’s milk. She was nine years old at the time. Nicole suffered from symptoms typical of E. coli O157:H7 infections – bloody diarrhea, cramping, and nausea – that quickly intensified and led to her hospitalization on May 8, 2008. Once hospitalized, Nicole developed renal failure, anemia, and thrombocytopenia (low platelet count) indicating that she was developing HUS. She was transferred to a Children’s hospital and started on dialysis in order to save her life. She received dialysis for 18 days. Nicole’s renal function slowly returned to the point that she was deemed healthy enough for discharge on June 1. After discharge, she remained under the care of a nephrologist. In addition, damage suffered during her HUS has required that her gall bladder be removed. Medical costs to this point exceed $180,000. As the result of damage to her kidneys suffered during her bout with HUS, Nicole is at significant risk for severe renal complications in the future.

Alexandre EcoDairy Farm

Mari Tardiff was one of those sickened in the 2008 outbreak of campylobacter connected to raw milk sold by Alexandre EcoDairy Farm. As a result of her campylobacter infection, Mari developed Guillain Barré syndrome, or GBS, a potentially fatal inflammatory disorder. GBS is an infrequent, but well-known risk of campylobacter infection. By the time she was hospitalized in mid June, Mari was essentially paralyzed. On June 15, Mari was intubated and placed on mechanical ventilation. For weeks on end, Mari’s condition remained unchanged. She was heavily sedated, unable to move, and entirely dependent on mechanical ventilation for survival. In August, there were indications of slight improvement, and the very slow process of weaning Mari off mechanical ventilation began. At the outset, it was not clear that the process was successful. Through incredible effort on Mari’s part, she was fully weaned off mechanical ventilation by August 20, and discharged to a rehabilitation facility. She spent more than two months at the rehabilitation facility diligently attempting to re-acquire the ability to speak, breathe, and move her arms and legs on her own. She was discharged home on November 1, still in need of essentially 24-hour care. Since that time, she has worked every day toward achieving her goal, as yet unreached, of walking again. Medical expenses to date exceed $1,000,000.

Whole Foods and Simsbury Town Farm Dairy

Kalee Prue, a 27-year-old mother of one, became infected with E. coli O157:NM in June 2008, as the result of consumption of raw milk. Her symptoms began in early July, and intensified for several days. On two occasions, Kalee sought treatment in the emergency room. On July 12, it became apparent that she was developing hemolytic uremic syndrome (HUS). She was then admitted to the hospital on July 13. Kalee’s renal failure was complete and prolonged, and she required plasmapharesis from July 13 through August 11. Severe anemia necessitated repeated transfusions with packed red blood cells as well. By the time she was released from the hospital on August 14, she had incurred over $230,000 in medical bills. Kalee has not recovered full renal function. She is at severe risk for long-term renal complications, including end stage renal disease (ESRD), dialysis, and transplant.

The Videos:

Hazelnuts Recalled For Possible Salmonella Contamination

The FDA has announced that 114,350 pounds of shelled hazelnuts have been recalled due to concerns that they may be contaminated with Salmonella.  The nuts  were marketed by Willamette Shelling of Newberg, Oregon.  To this point, no illnesses have been reported.

The FDA provided this information on identification of the products involved:

All products subject to recall were packed in 25 lbs. and 50 lbs. corrugated boxes with lot code numbers 296091A, 299091A, 300091A, VH3696BO, and 310091A. Those corrugated boxes bore the following brand names: Kunze Farms, Evonuk Oregon Hazelnuts, Canadian Hazelnuts, and Firestone Farms.

In the past decade, nuts of various types have been more widely recognized as potential sources for Salmonella contamination, following a number of outbreaks:  PCA peanut butter, 2009; ConAgra peanut butter, 2007; raw almonds, 2004.   There have been other nut recalls as well, including a recall of pistachios in 2008. 

County Reaches Agreement With Dairy After Raw Milk Outbreak

Walworth County (WI) and Zinninker Farm have reached a settlment regarding potential fines following an outbreak of campylobacter jejuni linked to raw milk sold by the farm.  The Janesville Gazette reports:

The district attorney’s office filed 24 citations against Zinniker Farm, N7399 Bowers Road, charging the sale of non-compliance milk. The citations carry a total maximum penalty of $24,000.  As part of the agreement, the Zinnikers admitted the violations but the case will be held open and they will not be fined.  If Mark and Petra Zinniker were again caught selling raw milk, they would be fined the maximum—$24,000—and would lose their license to sell milk.

The Zinnikers apparently sold some or all of the milk using a "cow-share" program.  In such programs consumers theoretically purchase a portion of the cow (which they don't receive) but not the milk (which they do.)  As is true in many states, Wisconsin officials do not recognize these programs as effective measures to circumvent state raw milk regulations. 

Our office recently resolved a claim by a woman who developed Guillain-Barre Syndrome resulting from a campylobacter infection acquired from raw milk.  This raw milk, too, was purchased through a cow-share program.   Ms. Tardiff was hospitalized for months, and remains in a remarkable and valiant struggle to regain her former health. 

New Tests Confirm Wood Pallets Harbor Deadly Food Poisoning Bacteria

Tests Highlight Need for Congress to Address Shipping Platforms in Food Safety Bill

Press Release Source: Intelligent Global Pooling Systems (iGPS) On Wednesday December 16, 2009.

In a random sampling of wood pallets used to ship food in Portland, ME, and Philadelphia, PA, numerous pallets tested positive for Listeria and abnormally high counts of bacteria that could potentially create health hazards for consumers. The new data bolster the findings of previous wood pallet testing conducted in the Washington-Baltimore area, further illustrating the unsanitary conditions and unacceptable risks to our nation's food supply from wood pallets.

The new round of tests were commissioned by Intelligent Global Pooling Systems (iGPS Company LLC), operator of the world's first pallet rental service providing shippers and receivers with all-plastic pallets with embedded RFID tags. iGPS gathered samples from wood pallets located at lobster and fishing docks in Portland, ME, and outdoor food markets in Philadelphia, and submitted them to an independent scientific laboratory for testing. iGPS videotaped the unsanitary wood pallets in Portland, and is making that video available today to the news media. Click here to view video.

In Portland, five of 30 pallets tested positive for Listeria. Three of the five pallets tested positive for the most serious strain of Listeria, called Listeria monocytogenes, which is the causative agent for Listeriosis. Responsible for approximately 2,500 illnesses and 500 deaths in the United States annually, Listeriosis is the leading cause of death among food borne bacterial pathogens, with fatality rates exceeding even Salmonella and Clostridium botulinum.

The two other pallets testing positive for Listeria carried strains called "Seeligeri/Welshimeri" and "Seeligeri/Ivanouii," which can be pathogenic for mice and may have been associated with a small handful of illnesses in seriously compromised individuals in the past.

In Philadelphia, 15 of the 30 wood pallets tested by iGPS had abnormally high bacteria counts that exceeded 100,000 colonies or counts/gram. Nearly half (14 of 30) of the wood pallets tested in Maine had bacteria plate counts that exceeded 100,000 counts/gram. High bacteria counts typically are evidence of unsanitary conditions.

"This is an indication of unsanitary surfaces and could potentially create a health hazard for consumers," said Dr. Peter Kmieck, Director of Kappa Laboratories, Inc., which conducted the independent tests. "It's clear from the tests we've conducted in Philadelphia and Portland, Maine that wooden pallets can harbor a lot of bacteria, and even pathogens, because of wood's propensity to retain moisture," Dr. Kmieck said.

iGPS commissioned the new round of tests after submitting a limited random sampling of wood pallets gathered in the Washington-Baltimore area to another independent scientific laboratory for testing. The lab, Environmental Systems Service in Bedford, VA, found Salmonella, E. coli, Listeria or extremely high bacteria counts – as much as 6.8 million spores per gram – in more than one-third of the wood pallets tested. Click here to view press release.

"There is a growing body of evidence that wood pallets pose unacceptable risks to our nation's food supply. We are sharing the data from these tests with the FDA and are once again asking the agency to conduct a comprehensive investigation and adopt appropriate measures to mitigate the risks presented by wood pallets," said Bob Moore, Chairman and CEO, iGPS.

Wood pallets often contain broken wood pieces that puncture packaging materials, exposing food to contamination from both the pallet and other potential sources. Food is also exposed to contamination when packaging materials are torn by rusting and protruding nails that are often contained in wood pallets.

"There are more than one billion wood pallets used in the United States, so it's critical to understand the role they play in outbreaks of food poisoning," added Moore. "We also need an effective way to track and trace wood pallets in the supply chain so that FDA and USDA can identify the source of food contamination and quickly stop the spread of food borne illnesses. For example, iGPS plastic pallets have microchips embedded in the resin that allow us to pinpoint shipments anywhere in the supply chain and provide a complete history of all goods moved on any one pallet. There is no effective way to identify individual wood pallets.

"As Congress works to strengthen food safety measures, we urge Members to examine the data and consider the role wooden shipping platforms play in food contamination," Moore added.

Testing Procedures

In the tests, iGPS collected used, in-circulation wood pallets from lobster and fishing docks in Portland, and from outdoor food markets in Philadelphia. Using proper handling and chain of custody procedures, the field-testing team gathered the samples and shipped them in refrigerated packages to Kappa Laboratories, Inc., in Miami, Florida. Kappa Laboratories is a full-service chemical and microbiology lab that has been inspected and previously recognized by the U.S. Department of Agriculture (USDA Microbiology-#0093, Chemistry-#1282). It has been certified by the National Environmental Laboratory Accreditation Program (NELAP), and is registered with the U.S. Food and Drug Administration (FDA-#1039389). Kappa Laboratories is an FDA Accepted Laboratory for Import Testing and is currently a Contract Laboratory to the U.S. Centers for Disease Control (CDC).

Food Borne E. coli A Source of Urinary Tract Infections

New research suggests a connection between foodborne E. coli bacteria and urinary tract infections.   This report details the findings of Professor Amee R. Manges, McGill University, on the link.  The study was recently published in the January issue of Emerging Infectious Diseases.

E. coli is the generic term for a family of bacteria that includes a number of strains, most prominently E. coli O157:H7, that are known to cause severe food poisoning, as well as the risk of serious complications, in humans.   Dr. Manges research is now also suggesting a link to urinary tract infections: 

Researchers have found the same strains of the bacteria in chicken from stores and restaurants and in women with the infections.  In their study, Manges and her research colleagues wanted to find out if the same strains of E. coli were present in both meat and in women with urinary tract infections.  They studied 353 samples from Canadian women, ages 18 to 45, who had suspected urinary tract infections. They also examined samples of chicken and honeydew melon from stores and restaurants in Canada. The researchers found that several strains of E. coli found in the women and in the food were indistinguishable or closely related.

It does not appear that the bacteria was transmitted directly from the food into the urinary tract.  Rather,  "It's possible for bacteria to travel from the anus to the vagina and urethra, and that's where it ultimately causes the infection," Manges reports.  

Urinary tract infections of this sort are a particular risk in older people: 

Urinary tract infections caused by transmission from feces "are most common in older and debilitated individuals in whom the risk of fecal contamination of the urethral orifice is a significant risk, especially in a setting of fecal incontinence," added Dr. Pascal James Imperato, dean of the School of Public Health at the State University of New York Downstate Medical Center in Brooklyn, N.Y.

This report is more evidence that the breadth of the risk associated with contaminated foods is generally under-reported and under-rated.   Certainly more research is warranted.  Still, if any significant portion of urinary tract infections in the US are food related,  the impacts of food poisoning have not been fully tabulated.

Parent Food Safety Guide for E. coli

Click on image below to download Safety Guide. E. coli – www.about-ecoli.com

Escherichia coli (E. coli) are members of a large group of bacterial germs that inhabit the intestinal tract of humans and other warm-blooded animals (mammals, birds). More than 700 serotypes of E. coli have been identified. Their “O” and “H” antigens on their bodies and flagella distinguish the different E. coli serotypes, respectively. The E. coli serotypes that are responsible for the numerous reports of contaminated foods and beverages are those that produce Shiga toxin (Stx), so called because the toxin is virtually identical to that produced by another bacteria known as Shigella dysenteria type 1 (that also causes bloody diarrhea and hemolytic uremic syndrome [HUS] in emerging countries like Bangladesh) (Griffin & Tauxe, 1991, p. 60, 73).

The best-known and most notorious Stx-producing E. coli is E. coli O157:H7. It is important to remember that most kinds of E. coli bacteria do not cause disease in humans, indeed, some are beneficial, and some cause infections other than gastrointestinal infections, such urinary tract infections. Shiga toxin is one of the most potent toxins known to man, so much so that the Centers for Disease Control and Prevention (CDC) lists it as a potential bioterrorist agent (CDC, n.d.). It seems likely that DNA from Shiga toxin-producing Shigella bacteria was transferred by a bacteriophage (a virus that infects bacteria) to otherwise harmless E. coli bacteria, thereby providing them with the genetic material to produce Shiga toxin. Although E. coli O157:H7 is responsible for the majority of human illnesses attributed to E. coli, there are additional Stx-producing E. coli (e.g., E. coli O121:H19) that can also cause hemorrhagic colitis and post-diarrheal hemolytic uremic syndrome (D+HUS). HUS is a syndrome that is defined by the trilogy of hemolytic anemia (destruction of red blood cells), thrombocytopenia (low platelet count), and acute kidney failure. Stx-producing E. coli organisms have several characteristics that make them so dangerous. They are hardy organisms that can survive several weeks on surfaces such as counter tops, and up to a year in some materials like compost. They have a very low infectious dose meaning that only a relatively small number of bacteria, less than 50, are needed “to set-up housekeeping” in a victim’s intestinal tract and cause infection.

The Centers for Disease Control and Prevention (CDC) estimates that every year at least 2000 Americans are hospitalized, and about 60 die as a direct result of E. coli infections and its complications. A recent study estimated the annual cost of E. coli O157:H7 illnesses to be $405 million (in 2003 dollars), which included $370 million for premature deaths, $30 million for medical care, and $5 million for lost productivity (Frenzen, Drake, and Angulo, 2005). E. coli O157:H7 was first recognized as a foodborne pathogen in 1982 during an investigation into an outbreak of hemorrhagic colitis (bloody diarrhea) associated with consumption of contaminated hamburgers (Riley, et al., 1983). The following year, Shiga toxin (Stx), produced by the then little-known E. coli O157:H7 was identified as the real culprit. In the ten years following the 1982 outbreak, approximately thirty E. coli O157:H7 outbreaks were recorded in the United States (Griffin & Tauxe, 1991). The actual number that occurred is probably much higher because E. coli O157:H7 infections did not become a reportable disease (required to be reported to public health authorities) until 1987 (Keene et al., 1991 p. 60, 73). As a result, only the most geographically concentrated outbreaks would have garnered enough attention to prompt further investigation (Keene et al., 1991 p. 583). It is important to note that only about 10% of infections occur in outbreaks, the rest are sporadic. The CDC has estimated that 85% of E. coli O157:H7 infections are foodborne in origin (Mead, et al., 1999). In fact, consumption of any food or beverage that becomes contaminated by animal (especially cattle) manure can result in contracting the disease. Foods that have been sources of contamination include ground beef, venison, sausages, dried (non-cooked) salami, unpasteurized milk and cheese, unpasteurized apple juice and cider (Cody, et al., 1999), orange juice, alfalfa and radish sprouts (Breuer, et al., 2001), lettuce, spinach, and water (Friedman, et al., 1999).

For more information on E. coli, see www.about-ecoli.com.

For more information on Hemolytic Uremic Syndrome (HUS), see www.about-hus.com.

A Risky Drink - Raw Milk Consumption Does Cause E. coli and Campylobater Infections

I know my friends over at Weston A. Price Association and the Complete Patient think I spend all my time beating up on raw milk (hmm, did they notice what I did to Cargill last week?). What really gets to me about the "raw milkies," is their religious passion for their personal freedom trumping the fact that people get very sick from drinking raw milk on more than a few occasions. It also drives me a bit crazy how they see everything as a evil conspiracy - that all the outbreak investigations are wrong - or that there must have been something wrong with the victim. I also wonder why a retail outlet would take the risk of selling it.  It is a time for a big cold glass of reality. Here is a shortened version of what happened in the Campylobacter and E. coli raw milk outbreaks that I have been involved with:

Grace Harbor Farms

M.S. acquired an E. coli O157:H7 infection from consumption of raw milk in September, 2006. He developed a fever, nausea, and severe diarrhea. When the diarrhea turned bloody, M.S. was taken to his physician. Out of concern that he was at risk for the development of hemolytic uremic syndrome (HUS), M.S. was transported to the local children’s hospital. M.S. was admitted to the hospital on September 22. There, MS was treated for his ongoing infection and monitored for signs of HUS. The severity of his symptoms required that MS be hospitalized through October 2. Thankfully, MS did not develop HUS. Medical bills for the hospitalization exceeded $30,000.

Organic Pastures

Chris Martin, then age nine, developed an E. coli O157:H7 infection in September, 2006 following consumption of raw milk. He was hospitalized beginning on September 8, suffering from severe gastrointestinal symptoms, including bloody diarrhea. Shortly thereafter, he developed hemolytic uremic syndrome (HUS). In an effort to properly treat his rapidly deteriorating condition, Chris was moved to multiple medical facilities, twice by life-flight. His HUS was remarkably severe, marked by prolonged renal failure, pancreatitis, and severe cardiac involvement. He required 18 days of renal replacement therapy. On two occasions his cardiac problems became so severe that he was placed on a ventilator. At several junctures, the possibility that he might survive was very real. Ultimately he was hospitalized through November 2, after incurring over $550,000 in medical bills. Renal experts have opined that Chris is likely to develop severe renal complications in the future. These complications include end stage renal disease (ESRD) and kidney transplant.

Lauren Herzog developed an E. coli O157:H7 infection in September, 2006, as the result of consumption of raw milk. She was 11 years old at the time. Lauren was hospitalized beginning on September 11. Shortly thereafter, Lauren began to developed hemolytic uremic syndrome (HUS) and was transferred to specialty care facility. Lauren’s bout with HUS was severe. Her renal failure was prolonged, and she required 20 days of dialysis. She also suffered from pancreatitis and persistent high blood pressure. In late September, her kidneys finally began producing urine again, and she was gradually prepared for discharge. She was then discharged on October 3, but only briefly. A seizure led to a re-admittance to the hospital from October 6 through October 14. Since her second discharge, Lauren has continued to show residual kidney deficiency, and remains under the care of a nephrologist. To date, medical expenses exceed $280,000. Renal experts believe that Lauren is likely to suffer severe renal complications in the future. These complications include end stage renal disease (ESRD) and kidney transplant.

Herb Depot/Autum Olives Farms

Larry Pedersen had just turned one year old when he developed an E. coli O157:H7 in May 2008. When his diarrhea turned bloody, his parents took him for medical treatment. He was admitted to the hospital on May 8. Shortly thereafter, Larry developed hemolytic uremic syndrome (HUS) and was transferred to a specialty care facility. As is typical of HUS, Larry was then suffering from acute renal failure. He was started on dialysis, which was necessary at that point for his survival. He required 15 days of dialysis before his kidneys recovered enough to function on their own. Larry was discharged on May 29, to continue recovery and treatment on an outpatient basis. The medical bills associated with his care approached $90,000. As the result of damage to his kidneys suffered during his bout with HUS, Larry is at significant risk for severe renal complications in the future. These complications include end stage renal disease (ESRD) and kidney transplant.

Nicole Riggs developed an E. coli O157:H7 infection in May, 2008 from consumption of raw goat’s milk. She was nine years old at the time. Nicole suffered from symptoms typical of E. coli O157:H7 infections – bloody diarrhea, cramping, and nausea – that quickly intensified and led to her hospitalization on May 8, 2008. Once hospitalized, Nicole developed renal failure, anemia, and thrombocytopenia (low platelet count) indicating that she was developing HUS. She was transferred to a Children’s hospital and started on dialysis in order to save her life. She received dialysis for 18 days. Nicole’s renal function slowly returned to the point that she was deemed healthy enough for discharge on June 1. After discharge, she remained under the care of a nephrologist. In addition, damage suffered during her HUS has required that her gall bladder be removed. Medical costs to this point exceed $180,000. As the result of damage to her kidneys suffered during her bout with HUS, Nicole is at significant risk for severe renal complications in the future. These complications include end stage renal disease (ESRD) and kidney transplant.

Noah Ennis developed an E. coli O157:H7 infection in May, 2008 after consumption of raw goat’s milk. He was two years old at the time. He suffered from bloody diarrhea, nausea, vomiting, and painful cramps. He received medical treatment on multiple occasions at both his regular physician’s office, and the emergency room. Medical bills totaled over $1,600.

Alexandre EcoDairy Farm

Mari Tardiff was one of those sickened in the 2008 outbreak of campylobacter connected to raw milk sold by Alexandre EcoDairy Farm. As a result of her campylobacter infection, Mari developed Guillain Barré syndrome, or GBS, a potentially fatal inflammatory disorder. GBS is an infrequent, but well known risk of campylobacter infection. By the time she was hospitalized in mid June, Mari was essentially paralyzed. On June 15, Mari was intubated and placed on mechanical ventilation. For weeks on end, Mari’s condition remained unchanged. She was heavily sedated, unable to move, and entirely dependent on mechanical ventilation for survival.

In August, there were indications of slight improvement, and the very slow process of weaning Mari off mechanical ventilation began. At the outset, it was not clear that the process was successful. Through incredible effort on Mari’s part, she was fully weaned off mechanical ventilation by August 20, and discharged to a rehabilitation facility. She spent more than two months at the rehabilitation facility diligently attempting to re-acquire the ability to speak, breathe, and move her arms and legs on her own. She was discharged home on November 1, still in need of essentially 24 hour care. Since that time, she has worked every day toward achieving her goal, as yet unreached, of walking again. Medical expenses to date exceed $800,000.

Dee Creek

Nicole and Megan Beyers both suffered E. coli O157:H7 infections linked to raw milk consumption in December, 2005. Nicole fell ill first, and by December 6, both girls were suffering from diarrhea, nausea, and cramps. On December 10, the girls were treated in the emergency room, and tests indicated that Nicole was likely suffering from hemolytic uremic syndrome (HUS). Nicole was then transferred to a hospital better equipped to handle her serious condition. Nicole remained hospitalized through December 15. Her renal function will have to be monitored for the rest of her life. The girls’ medical expenses were approximately $20,000.

Annalise Selby was one year old in December of 2005 when she developed an E. coli O157:H7 infection from consumption of raw milk. Annalise was treated on multiple occasions at her family physician and the local urgent care center between December 5 and December 13. At that point, concerns over unusual lab results and possible HUS prompted consultation with a pediatric nephrologist. Annalise was accordingly admitted to the hospital from December 13 through December 15. Fortunately, her condition did not deteriorate further. The cost of medical treatment exceeded $8,000.

Simsbury Town Farm Dairy

Margot Standish was seven years old in June, 2008, when she became infected with E. coli O157:NM as the result of consumption of raw milk. Her symptoms began in late June, with diarrhea, vomiting, and abdominal cramps. Margot was treated over the period of more than a week by her regular physician, but her condition began to deteriorate, and she was admitted to the hospital on July 8. Laboratory tests conducted that day provided evidence that Margot had been suffering from hemolytic uremic syndrome (HUS). Thankfully, Margot’s renal insufficiency did not deepen to the point that dialysis was required. She remained hospitalized through July 14. Medical bills exceeded $30,000. As a result of her HUS, Margot will need to have her renal function monitored regularly for the rest of her life.

Kalee Prue, a 27 year old mother of one, became infected with E. coli O157:NM in June, 2008, as the result of consumption of raw milk. Her symptoms began in early July, and intensified for several days. On two occasions, Kalee sought treatment in the emergency room. On July 12, it became apparent that she was developing hemolytic uremic syndrome (HUS). She was then admitted to the hospital on July 13. Kalee’s renal failure was complete and prolonged, and she required plasmapharesis from July 13 through August 11. Severe anemia necessitated repeated transfusions with packed red blood cells as well. By the time she was released from the hospital on August 14, she had incurred over $230,000 in medical bills. Kalee has not recovered full renal function. She is at severe risk for long term renal complications, including end stage renal disease (ESRD), dialysis, and transplant.

For a complete discussion, see:

Comparing the Food Safety Record of Pasteurized and Raw Milk Products

Raw Milk "Cons" - Literature Review

Raw Milk "Pros" - Literature Review

Comparing the Food Safety Record of Pasteurized and Raw Milk Products

What We Feed Our School Kids They Would Not Serve At A Fast Food Joint

Schoolchildren around the U.S. are eating meat that falls short of the safety standards of many fast food restaurants, the USA Today reported Wednesday.

The U.S. Department of Agriculture maintains the meat it buys for the National School Lunch Program "meets or exceeds standards in commercial products."

But the paper's investigation revealed fast food chains including McDonald's, Burger King, Jack in the Box and KFC have much more stringent quality requirements for the food they serve, with some of them testing meat for dangerous pathogens up to 10 times more a day than the USDA.

USDA-purchased meat ends up on the plates of 31 million students a day, worrying some that children's still-developing immune systems are more susceptible to potentially deadly bacteria like salmonella and E. coli.

The USDA's standards for meat sent to schools exceed minimum standards for meat sold at supermarkets, but fast food restaurants have raised the bar when it comes to quality control, the report notes.

While the government has a zero tolerance policy for meat that tests positive for salmonella or E. coli O157:H7, fast food chains' more stringent standards also test for "indicator" pathogens that could indicate more dangerous bacteria is present in the meat.

Government officials are looking at beefing up safeguards for school food. Congress will reexamine the Child Nutrition Act, which governs the lunch program, next year. And in light of the USA Today investigation, Agriculture Secretary Tom Vilsack has pledged to launch an independent review of testing standards of ground beef sent to schools.

Slim Fast Cans Recalled Due to Potential Bacterial Contamination

All cans of Slim Fast have been voluntarily recalled by their manufacturer, Unilver, due to potential contamination with a bacteria called Bacillus Cereus, according to this report on  MSNBC. com.  The bacteria can cause nausea, vomiting, and diarrhea in humans.   The recall reportedly affects roughly 10 million products.   

According to MSNBC:

An unknown number of people have gotten sick about six to 15 hours after consuming the diet drink, but have recovered within about 24 hours.

The contamination seems to have occurred during the manufacturing process. Unilever discovered the pathogen and notified the FDA on Wednesday.

 Unilever's U.S. arm, based in Englewood Cliffs, N.J., says the products were sold nationwide. They came in cartons of four, six or 12 steel cans, 11 ounces in size, and they were also sold individually. The recall covers all Slim-Fast products in cans, regardless of flavor, best-by date, lot code or UPC number. No other Slim Fast products are affected by this recall, including powdered shakes, meal bars or snack bars

The FDA has a press release on its website.   The FDA calls the company's action a "nationwide voluntary recall of all Slim-Fast® ready-to-drink (RTD) products in cans."  FDA further states that Bacillus cereus is a "micro-organism, which may cause diarrhea and possibly nausea and/or vomiting."   

Lettuce E. coli lawsuit to be filed tomorrow

Tomorrow morning, we will file a lawsuit on behalf of Kelly and Matthew Cobb.  Kelly was one of at least ten people infected with E. coli O157:H7 in May 2008 after eating contaminated lettuce.  Kelly ultimately developed hemolytic uremic syndrome as a result of her infection, and she had to be hospitalized for two weeks.  Of course, a big part of Kelly's story is that her husband, Matt, was fighting with the marines in Iraq at the time she became ill, leaving Kelly home alone to care for their two children. 

The lawsuit tomorrow will be filed against multiple entities, all of whom played a role in manufacturing the lettuce that made Kelly sick.  The companies, all from California, are as follows:  Church Brothers, LLC; Premium Fresh Farms, LLC; True Leaf Farms, LLC; Andrew Smith Company; and Paul's Pak, Inc.

Safeway -- the First Major Supermarket Chain to Offer iPura From Global Food Technologies

Global Food Technologies ("GFT"), a California-based life science company specializing in food safety, today announced the commencement of deliveries of its iPura brand tilapia to Safeway. iPura, the world's first food safety brand, will be in the service counter of Safeway supermarkets by the end of the month.

"We are thrilled to have the opportunity to become a supply partner for Safeway because of their unrivaled reputation for leadership in food safety and environmental responsibility," stated Keith Meeks, President of GFT. "iPura was designed to provide greater control over the processing and distribution phases by implementing proprietary extraordinary precautions, thereby earning the trust of food distributors, retailers and consumers. This is especially important with seafood sourcing where over 80 percent of the seafood consumed in the US originates overseas. We provide the technology, hardware and manpower on-site to achieve what we refer to as The Highest Standard in Food Safety," Meeks added.

Aaron Ormond, VP of Food Safety for GFT, explained, "iPura contracts with premier aquaculture producers to assure we start with high quality products, which marks only the beginning of our commitment to provide the best quality seafood in the industry. With our unique 'boots on the ground every day' approach, the iPura on-site food safety and quality assurance team, including microbiologists, system operators, technicians, and quality assurance personnel, execute extraordinary science-based controls to mitigate and reduce the proliferation of pathogens and spoilage organisms on both the raw material and within the processing environment. iPura assures safety and quality at a level unmatched in the industry."

"Food safety and quality are the main concerns of food executives and iPura has taken food safety and quality to a new level with patented organic technologies and security controls throughout the supply chain. iPura is a fantastic solution to many of today's critical supplier issues," stated Tom DeMott, COO of Encore Associates, a sales and marketing advisory group.

iPura tilapia was launched in March at the International Boston Seafood Show. GFT has plans to introduce striped pangasius, steelhead, salmon and shrimp under the iPura label. "We have over a dozen regional distributors and I think we can expect to see iPura products in more stores and on many restaurant menus in the very near future," commented Robert Clark, Director of Marketing for GFT, who was also quick to point out, "iPura isn't just about health and sustainability; iPura also won the American Masters of Taste gold medal as the best tasting tilapia in the US."

For more information about iPura visit www.iPura.com

Bankruptcy Claims Against Peanut Corporation of America Total 154 in Salmonella Outbreak

AP reports today that the bankruptcy trustee says claims have been filed for 154 people who say they were sickened by a salmonella outbreak traced to a Virginia peanut company.  Peanut Corp. of America filed for Chapter 7 bankruptcy amid fallout from the outbreak, which left about 700 people sick and was linked to at least nine deaths. The outbreak was traced to the company’s plants in Georgia and Texas.  The trustee, Roanoke attorney Roy Creasy, said Thursday that the total number of claims includes some that have trickled in after the Oct. 31 deadline, as well as some that are being withdrawn. So it’s unclear how many ultimately will be eligible for compensation from a $12 million fund approved by a bankruptcy judge in Lynchburg.  The fund will use money from Peanut Corp. insurance policies.

FDA Stops Cargill Canola Oil From Canada Due to Salmonella

The FDA refused 19 shipments of Canadian canola meal from Cargill in October after finding they contained the harmful bacteria salmonella, according to Reuters.   According to the report:

The shipments all come from Cargill's Clavet, Saskatchewan canola-crushing plant, according to reports posted on the FDA's website. The plant was already under shipping restrictions from the FDA for earlier canola meal shipments with salmonella.

Cargill did not provide a statement or response for the story.

Rep. DeLauro - E. Coli Ground Beef Sampling Plan is Insufficient

Fairbank Farms recently recalled over 500,000 pounds of ground beef due to contamination with E. coli O157:H7.   The contaminated beef led to 25 illnesses, including two deaths, in 10 states.  In light of this Rep. Rosa DeLauro (D. Conn) is calling for an investigation into the method of sampling ground beef for the deadly bacteria currently approved by the USDA. 

The sampling method, referred to as N-60, dictates what proportion of ground beef is sampled in a company's E. coli O157:H7 testing program.  According to Agriculture Online, Rep DeLauo says:  "I am troubled by the shortcomings of the N-60 test ... and that is why I am requesting an investigation into the scientific merits of this beef-testing protocol."    DeLauro says that even though  Fairbank Farms "samples product every 10 to 20 minutes to check for contamination ... it was not enough to prevent contamination."

The meat industry defended its practice to Agriculture Online:

James Hodges, executive vice president of the American Meat Institute, said the AMI doesn't oppose an investigation, but he stressed the testing method is sound. He called the testing method "a scientifically recognized statistical sampling method that is widely used in the industry to test for the presence of pathogens in meat products."

Fairbank Farms linked to at least two prior hamburger recalls

October 31, 2009 - Fairbank Farms, an Ashville, NY, establishment, is recalling approximately 545,699 pounds of fresh ground beef products that may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today.

May 12, 2008 - Fairbank Reconstruction Corp., an Ashville, NY, establishment, is voluntarily recalling approximately 22,481 pounds of ground beef products that may contain pieces of plastic, the U.S. Department of Agriculture's Food Safety and Inspection Service announced today.

September 5, 2007 - Fairbank Reconstruction Corp., doing business as Fairbank Farms, an Ashville, N.Y., establishment, is voluntarily recalling approximately 884 pounds of ground beef products because they may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture’s Food Safety and Inspection Service announced today.

Produce Safety Project - States need more resources to track foodborne illnesses

A survey of state health departments regarding their capacity to track produce-related foodborne illnesses found that the response and investigation of outbreaks varies greatly and can lead to delays in public-health response.

The survey was commissioned by the Produce Safety Project (PSP), an initiative of The Pew Charitable Trusts at Georgetown University, and conducted by Safe Tables Our Priority (S.T.O.P.). Thirty-nine of the 51 state and District of Columbia health departments responded to the survey, which asked about the types of questions and questionnaires administered to victims of foodborne illness, the time frame in which they were completed, and how states collected and stored the resulting data for calendar year 2007.

Despite the increase in the number of multi-state outbreaks of illnesses linked to fresh produce over the past several years, the data show that only 25 of the 39 states responding to the PSP/S.T.O.P. survey asked victims about specific produce items - even if the item was associated with a past outbreak.

"It is important to learn from our experience, and so it is surprising that many states are failing to ask about fruits and vegetables on their questionnaires given to foodborne illness victims," said Jim O'Hara, PSP director.

"The lack of food attribution data and especially attribution to produce is astounding considering the large burden of foodborne illness in the U.S.," said Donna Rosenbaum, the Executive Director of S.T.O.P. "And it all starts with finding out what the person ate. The public health system cannot find what it's not looking for or asking about. We certainly cannot fix the food safety system when we don't know exactly where and how the contaminated produce makes it into the marketplace and onto consumers' plates."

Nearly 60% (23 out of 39) of the responding states indicate that they are unable to electronically link their investigative data for analysis. An improved food safety system would include data from multiple sources in a single system that investigators can analyze quickly and efficiently.

"A critical step in improving our food safety system is better coordination on the types of information collected and better integration of that data at the state and local level," O'Hara said.

"There are important lessons learned in the data we collected which can lead to best practices being adopted, and ultimately to lives saved," Rosenbaum added.

For a copy of the executive summary and survey, visit producesafetyproject.org.

About the Produce Safety Project (PSP):

The Produce Safety Project at Georgetown University, an initiative of the Pew Charitable Trusts, seeks the establishment by the Food and Drug Administration of mandatory and enforceable safety standards for domestic and imported fresh produce, from farm to fork. Our families need to have confidence that federal food safety regulation is based on prevention, scientifically sound risk assessment and management, and coordinated integrated data collection. For more information online, visit www.producesafetyproject.org.

About Safe Tables Our Priority, Inc. (S.T.O.P.): S.T.O.P. - Safe Tables Our Priority is a national, nonprofit, public health organization dedicated to preventing illness and death from foodborne pathogens. In 2009, S.T.O.P. will achieve its mission by advocating changes in public policy, educating and doing outreach, providing victim assistance, and formalizing a victims of foodborne illness registry in order to study the long-term consequences of foodborne disease. S.T.O.P. has been supporting families who have suffered from foodborne diseases nationwide since the Jack in the Box outbreak of 1993. For more information, visit www.safetables.org.

San Link Inc. Issues an Alert on Uneviscerated Vacuum Pack Dried Krasnoperka (Fish).

San Link Inc at 54B Marjorie Street Staten Island, NY 10309 is recalling Vacuum Pack Dried Krasnoperka (fish) because the product was found to be uneviscerated.

The recalled Vacuum Pack dried Krasnoperka (fish) was distributed in New York State, New Jersey State and Connecticut State in vacuum pack containers. The Vacuum Pack Dried Krasnoperka (fish) is a product of Russia.

The Vacuum Pack Dried Krasnoperka (fish) was sampled by a New York State Department of Agriculture and Market Food Inspector during a routine inspection. Subsequent analysis of the product by New York State Food Laboratory personnel confirmed that the Vacuum pack dried Krasnoperka (fish) was not properly eviscerated prior to processing.

The sale of unevicerated fish is prohibited under New York State Agriculture and Market regulations because Clostridium botulinum spores are more likely to be concentrated in the viscera than any other portion of the fish. Unevicerated fish have been linked to outbreaks of botulism poisoning.

The product may be contaminated with Clostridium botulinum spores, which can cause Botulism, a serious and potentially fatal food-bourne illness. Symptoms of botulism include blurred or double vision, general weakness, poor reflexes, difficulty in swallowing and respiratory paralysis.

Recall Announced in Mass./R.I. E. coli O157:H7 Outbreak

New information on the cluster of E. coli O157:H7 illnesses among Rhode Island students sickened through consumption of ground beef at a camp in Massachusetts, as reported on by the Rhode Island Department of Health:

The Rhode Island Department of Health (HEALTH) advises Rhode Islanders that the South Shore Meat packing plant in Brockton has initiated a voluntary recall on certain ground beef products based on confirmed laboratory evidence of the presence of E. coli O157:H7 in leftover ground beef samples obtained from Camp Bournedale in Plymouth, Massachusetts. The ground beef was tested by the Massachusetts Department of Public Health (MDPH) after more than 20 students and chaperones from Lincoln Middle School became ill.

Still no indication where else the ground beef may have gone, or what lot codes or production days might be involved.   As a result, this ground beef may still be on shelves and in freezers in consumers' homes.

 

Raw Milk Editorial Leaves Questions Unanswered

An editorial appearing on sheboyganpress.com fails to get at the heart of important issues surrounding the commercial sale of raw milk in the U.S.  The article does take notice of some the risks associated with consuming raw milk:

 It has been linked to outbreaks of E-coli and salmonella-based illnesses, including at least 35 people in southern Wisconsin who became ill after drinking raw or unpasteurized milk in August...The FDA says the milk is inherently dangerous, and it has been linked to 45 E-coli and salmonella outbreaks from 1998 to 2005.

The editorial then notes the ongoing debate between supporters and detractors of commercial raw milk sales, particularly in Wisconsin:

The two sides are coming head to head over whether raw milk should be sold to the public. Raw milk supporters recently hired a lobbyist to try to change state law that prohibits raw milk sales. Meanwhile, the state Department of Agriculture, Trade and Consumer Protection wants to crack down on farmers who disregard the law and sell it anyway.

The author's proposed solution - stick a warning on it and let consumers decide- leaves  too many issues unresolved.   First of all, many of those consuming raw-milk are children.   Not only are these children not making their own individual informed decision, they are more susceptible to the tragic outcomes associated with foodborne pathogens that may be present in raw milk.   The bulk of clients represented by Marler Clark in a number of E. coli O157:H7 outbreaks linked to raw milk have been kids.   At least four of these have suffered from the life-threatening condition, HUS

In addition, a warning label may not be sufficient where raw milk supporters do their best disavow those same warning labels.  Take a peak around the web at sites espousing the consumption of raw milk.   Are they admitting significant risks, and asking the consumer to make a truly informed decision?   Or are they attempting to discredit the public health agencies that have repeatedly found a link between raw milk and illness outbreaks?

Marler Clark Calls on USDA and Massachusetts Department of Agriculture to Recall Tainted Meat Linked to Camp Bournedale E. coli Illnesses

The Massachusetts camp where food made Rhode Island middle school children ill has said that officials linked the illnesses to hamburger, but no recall has yet been issued for the tainted meat. Foodborne illness expert and attorney Bill Marler today called upon the USDA and Massachusetts Department of Agriculture to share their findings with consumers and ensure that all the contaminated meat is removed from the food supply.

"As the parents of these sick children know, E. coli O157:H7 is a very dangerous pathogen," said Marler. Unfortunately, it is not surprising that hamburger meat is the vehicle. What is surprising is that public health officials have not taken the crucial next step of issuing a recall so that other businesses or consumers who may have purchased this meat are aware of the severe health hazard."

Students from Lincoln Middle School in Rhode Island attended Camp Bournedale in nearby Plymouth, MA from October 13-16. Fifteen of the sixth-grade students have reported diarrheal illness. Two of the ill were confirmed to have contracted E. coli O157:H7 and have been hospitalized.

"In 2006, it seemed that the meat industry had gotten a handle on E. coli," continued Marler. "But with 41 million pounds recalled since then-and over a half-million pounds just this year-that is clearly not the case."

Many benign strains of E. coli (Escherichia coli) live in the intestinal tracts of humans and other mammals. Infection with one of the toxic strains, most notably E. coli O157:H7,can cause serious illness, organ failure, and even death. E. coli is often contracted by consuming food or beverage that has been contaminated by animal (especially cattle) manure. The majority of foodborne E. coli outbreaks has been traced to ground beef; however leafy vegetables, sprouts, unpasteurized dairy or juice products or even water can become tainted with the pathogen.

Antibiotic Resistant Salmonella Isolated in Retail Meats in U.S.

Ok, I admit that even the abstract from this article goes a bit over my head.   What I can decipher is scary enough - "Our findings indicate a varied spectrum of co-resistance traits is present in [antibiotic resistant] Salmonella in the U.S. meat supply."  The study was conducted on strains of Salmonella detected in retail meat in the U.S. between 2002-2006.

The presence of antibiotic resistant Salmonella in the U.S. meat supply is an ongoing threat to consumer health.  Earlier this year, Cargill was forced to recall over 800,000 of ground beef due to contamination with antibiotic resistant Salmonella Newport.

Entire Oregon Coast now closed to mussel harvesting

The Oregon Department of Agriculture and the Oregon Department of Fish and Wildlife announce the closure of the entire Oregon Coast to recreational mussel harvesting, from the mouth of the Columbia River to the California border, due to elevated levels of paralytic shellfish toxins (PST).

The north and central coast had already been closed to mussel harvesting. The latest announcement includes closing the area from Bastendorf Beach near Charleston to the California border.

Coastal scallops are not affected by this closure when only the adductor muscle is eaten. The consumption of whole recreationally harvested scallops is not recommended. Crab and oysters are not affected by this level of toxin and are safe to eat. Razor clamming along the Oregon coast remains open.

Shellfish contaminated with PST can cause minor to severe illness or even death. The symptoms usually begin with tingling of the mouth and tongue. Severe poisoning can result in dizziness, numbness and tingling in the arms and legs, paralysis of the arms and legs, and paralysis of the muscles used for breathing. Shellfish contaminated with PST can cause minor to severe illness or even death. PST cannot be destroyed by cooking, by adding baking soda, or by any other method of processing.

Shellfish toxins are produced by algae and usually originate in the ocean. ODA will continue to test for shellfish toxins weekly, as tides permit. Reopening of an area requires two consecutive tests in the safe range.

For more information, call ODA's shellfish safety information hotline at (800) 448-2474, the Food Safety Division at (503) 986-4720 or visit the ODA shellfish closures Web page.

Report on Turtle Salmonella Outbreak Published in "Pediatrics"

Earlier this week, we reported here on the multi-state outbreak of Salmonella linked to pet turtles.   107 people were sickened in the outbreak, primarily children.   A report on the outbreak was published this week in the medical journal "Pediatrics."   Here is a link to the abstract of the article.   

The basics of the outbreak:

We identified 107 patients with outbreak-strain infections. The median patient age was 7 years; 33% were hospitalized. Forty-seven (60%) of 78 patients interviewed reported exposure to turtles during the week before illness; 41 (87%) were small turtles, and 16 (34%) were purchased in a retail pet store.

Why Food Traceability Is so Important

It's not much good to announce the recall of 4,000 pounds of ground beef for E. coli O157:H7 contamination when no one knows where the beef went.  According to this report, state health officials in Texas are working with the owner of Culebra Meat Market No. 1 in San Antonio to determine which restaurants purchased meat there that may be contaminated with E. coli O157:H7.  The report states that:

State health services officials said a routine lab test detected E. coli O157:H7 in samples collected from the meat company.  The volume of beef in recall is about 4,000 pounds, the Texas Department of State Health Services said in a statement, and includes three cuts: beef asada, beef stew meat and ground beef produced by the company from Oct. 2 through Saturday.

Likely because there is uncertainty as to where the meat went, a list of restaurants that may have purchased the beef has not been released.  This is a common problem with recalls that greatly reduces their effectiveness in getting full information to consumers.

The products involved, according to the report:

  • Products sold to consumers at the company's retail store were packaged in various weights and wrapped in white butcher paper with no markings.
  • Products sold to restaurants were packed in 10-pound boxes labeled with the company and product names and lot codes 100209 through 101709. The boxes have the inspection label “TEXAS INSP. & PSD. 740” located inside an outline of the state of Texas.

Food Safety: Majority in U.S. feel food industry doesn't do enough

On the heels of the largest product recall in U.S. history, an American Society for Quality survey reveals that although the majority of the food industry may be following safe production procedures, the majority of the public doesn’t feel it does enough. Food safety is still igniting widespread concern according to the survey of U.S. adults conducted by Harris Interactive on behalf of ASQ.

ASQ conducted the survey to gauge how consumers feel about food safety, food recalls and where responsibility lies when it comes to tainted food. The survey finds:

1. 93 percent of adults say food manufacturers, growers or suppliers should be held legally responsible when individuals are fatally sickened by tainted food.
2. 61 percent of U.S. adults feel the U.S. food recall process is only fair or poor.
3. 73 percent of adults say they are as equally concerned about food safety as the war on terror.
4. 82 percent of adults believe that the food industry should be required to follow international standards on food safety.

“The United States overall does have a safe food supply,” said Steven Wilson, member of ASQ’s board of directors and ASQ food safety expert. “However, whether food manufacturers have process controls in place or not, some have plant sanitation issues that they need to address.”

Wilson said there are also other issues to consider. “The problem lies with a specific outbreak. Determining its root cause is often difficult and necessary, otherwise correcting the root cause and preventing future outbreaks can’t be achieved.”

Government’s Role in Food Safety

Eighty percent of adults believes that the federal government should select the agencies that inspect the facilities of food manufacturers. Interestingly, less than half (48 percent) said that they actually trust the government’s ability to ensure the safety of food products. Also, only half believe the federal government does a good job enforcing laws that ensure our nation’s food supply is safe.

Concern Over Product Recalls Remains High

Ninety-three percent of adults are aware of instances of food recalls due to health and safety concerns in the last three years. This is up from a 2007 Harris Poll showing 79 percent were aware of food recall occurrences in the last three years.

1. Food recalls have become even more of a serious concern for adults (47 percent) vs. the 2007 Harris Poll data (29 percent). A total of 92 percent of Americans are at least somewhat concerned about recalls.
2. When recalls on brands adults usually purchase do occur, 47 percent would temporarily purchase another brand and then purchase the recalled brand once it was safe. This is down from 55 percent in 2007.
3. Twenty-seven percent of adults would avoid using any brand made by the manufacturer of a recalled product. This is up from 21 percent in 2007.

Wilson also says “The cost of a recall does not just concern lost revenue and charges for the recall but also in loss of respect for the brand or the product. In this way, all members of the food chain are hurt by the actions of bad players. A majority of recalls can be prevented with due diligence by all parties, including following their implemented control systems and communicating with the other segments of the food chain.”

About the study

This survey was conducted online within the United States by Harris Interactive on behalf of ASQ from February 25-27, 2009, among 2,078 adults ages 18 and older. This online survey is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated. For complete survey methodology, including weighting variables, contact Lynda Nicely at 414-298-8789 x7587.

About ASQ

ASQ, www.asq.org, has been the world’s leading authority on quality for more than 60 years. With more than 90,000 individual and organizational members, the professional association advances learning, quality improvement and knowledge exchange to improve business results and to create better workplaces and communities worldwide. As a champion of the quality movement, ASQ offers technologies, concepts, tools and training to quality professionals, quality practitioners and everyday consumers, encouraging all to Make Good Great. ASQ has been the sole administrator of the prestigious Malcolm Baldrige National Quality Award since 1991. Headquartered in Milwaukee, ASQ is a founding partner of the American Customer Satisfaction Index (ACSI), a prominent quarterly economic indicator, and also produces the Quarterly Quality Report.

Senator Gillibrand Proposes Anti - E. coli Legislation

Senator Gillibrand of New  York has unveiled new legislation, entitled the "E. coli Eradication Act" according to this report from the North Country Gazette.  The legislation is aimed at eliminating E. coli O157:H7 from the U.S. food system.  In previous years, outbreaks linked to lettuce, spinach, ground beef and even cookie dough have called the safety of U.S. food into question.  Senator Gillibrand is a member of the Senate Agriculture Committee.  Gillibrand is quoted as saying:

“In America, in 2009, it is unconscionable that food is still going straight to our kitchens, school cafeterias and restaurants without being properly tested to ensure its safety. It’s spreading too many diseases and costing too many lives. We need to do a better job of catching contaminated food before it ever comes close to a kitchen table. My plan addresses the gaps in the inspection process and improves recalls and public education, so parents have the information to keep their families safe.”

Key aspects of the proposed legislation include:

  • Improve Testing of Ground Beef, including mandatory testing for E. coli O157:H7.
  • Improve Regulation Of All Other Food
  • Focus on Prevention, requiring all facilities to establish preventive plans to address hazards upfront, prevent adulteration, and give the FDA access to all of these plans and procedures.
  • Expand Access to Records, giving the FDA access to the records of all food processing facilities.
  • Establish Oversight of High Quality Testing Laboratories, by granting the FDA authority to check the credibility of the laboratories testing the safety of food, requiring the labs to report all of their findings to the FDA, and certify that foreign food facilities comply with U.S. food safety standards.
  • Improve Detection, by increasing inspections at all food facilities, including annual inspections of high-risk facilities, and inspections of all facilities once every four years.
  • Enhance U.S. Food Defense Capabilities by helping food companies protect their products from intentional contamination, and commence a national strategy to protect our food supply from terrorist threats, and rapidly respond to food emergencies.
  • Increase FDA Resources, increasing federal investments to give the FDA all the resources it needs to implement comprehensive food safety improvements.
  • Improve Recall Response, especially for school lunches.   Make recalls of contaminated food mandatory.
  • Improve Public Education 

Salmonella Illnesses Linked to Pet Turtles

According to the AP, 107 people in 34 states were part of an outbreak of Salmonella linked to pet turtles.  The outbreak occurred in 2007-2008.  Most of those sickened were children, and roughly one-third of those involved required hospitalization. 

Few parents recognize the risks posed by pet turtles:

Despite a 1975 ban on selling small turtles as pets, they continue to be sold illegally.  The American Veterinary Medical Association estimates that the number of pet turtles nationwide doubled from 950,000 in 1996 to almost 2 million in 2006.

Investigation into the outbreak was keyed by examination of the illnesses of two North Carolina girls who swam in a pool with a pet turtle:

Authorities began investigating in September 2007 after a Union County, N.C., teen swam in her backyard pool with two pet turtles and a friend from South Carolina. Both girls developed bloody diarrhea, vomiting, fever and stomach cramps; one developed kidney failure and spent eight days in the hospital.

Salmonella bacteria traced to those turtles matched salmonella later found in three other North Carolina children. Other cases turned up elsewhere, many involving direct contact with turtles, including children kissing turtles or putting them in their mouths.

Pennsylvania Food Safety Director: "Think Hard" Before Selling Raw-Milk

Some interesting quotes and figures from Bill Chirdon, director of Pennsylvania Department of Agriculture's Bureau of Food Safety regarding the sale of raw milk, as reported in the American Agriculturalist.    Chirdon warned potential sellers to closely examine the decision, addressing the sellers liability for sales of contaminated product:

It's an enormous risk....There are times when insurance companies don't even know producers are marketing raw milk. Producers need multi-million-dollar coverage, and it's very expensive.

Bill Marler recently took an in depth look at the risks involved in retailing raw milk, here. Chirdon also had some compelling statistics on bacterial testing of raw milk in Pennsylvania.   According to Chirdon, in 2007, 8.4% of (Pennsylvania) raw milk tested positive for pathogenic bacteria.  He reports a decrease in positive results this year, at less than 2%, and touts this as improvement.  No doubt 2% is less than 8%, but to have 1 in 50 samples of a food product testing positive for pathogenic bacteria ought to be giving consumers, retailers, and insurers reason to rethink their choice. 

Hospital in Milan, Illinois to Help Pay for Hepatitis-A Shots

WQAD reports that Trinity Regional Health System is making an $80,000 "contribution" toward the cost of Rock Island County's vaccination expenses arising out of this summer's Hepatitis-A outbreak.   The outbreak, which sickened more than 30 people, was traced to an ill worker at the Milan, Illinois McDonald's.  In an effort to limit illness, the County provided more than 5,000 vaccinations to people exposed at the restaurant.  WQAD reports that:

 Rock Island officials asked Trinity to pay for expenses after an investigation into the outbreak concluded that Trinity and a metro lab failed to report the first case of Hepatitis A in June. The county determined the outbreak originated from a sick worker at the McDonald's restaurant in Milan, Illinois and eventually spread to more than 30 people.

Michael Pollan Lists His 20 Favorite Food Rules

After issuing a request for readers of the New York Times to submit their favorite rules about eating well, author Michael Pollan, of The Omnivore's Dilemma fame, has posted twenty of his favorites.  He starts with my personal favorite, "Don't eat egg salad from a vending machine."  No really, please don't.

Check out the other nineteen here.

CDC - Hamburger Handling in Restaurants is Risky

CDC posted on its website recently - Ground Beef Handling Practices Study

Objective: To evaluate ground beef handling practices and the use of irradiated ground beef in restaurants.

Study Results: Interviews and observations in restaurants that handle raw ground beef revealed that risky ground beef handling practices were pervasive in restaurants. Sixty-four percent of restaurants reported they never took the temperature of fresh ground beef upon delivery, and 50% reported they never took the final cook temperature of hamburgers. Observations indicated that in 49% of restaurants, hands were not washed after handling raw ground beef, and in 60% of restaurants, hands were wiped on wiping cloths or aprons after handling raw ground beef. Only 1% of restaurants reported always or sometimes purchasing irradiated ground beef, and 29% reported that they had never heard of irradiated ground beef. These results indicate the need for food worker educational campaigns that focus on hand hygiene, avoiding cross-contamination, and verification of the final cook temperatures of ground beef.

Center for Science in the Public Interest urges US Senate to Pass Food Safety Modernisation Act

Leafy greens, eggs, and tuna are on the top of a list of 10 riskiest foods regulated by the US Food and Drug Administration. Those and seven other foods account for nearly 40 per cent of all food-borne outbreaks linked to FDA - regulated food. "That's no reason to forego the occasional salad Niçoise," said the Center for Science in the Public Interest (CPSI), which authored the report, "nor needs one pass up tomatoes, sprouts, and berries, even though those foods are also on the list." But the non-profit watchdog group says the presence of so many healthy foods on such a list is exactly why the United States Senate should follow the House and pass legislation that reforms the fossilised food safety laws.

The FDA is responsible for regulating produce, seafood, egg and dairy products, as well as typical packaged foods such as cookie dough and peanut butter - nearly 80 per cent of the food supply. More than 1,500 separate, definable outbreaks were associated with the top 10 riskiest FDA-regulated foods, causing nearly 50,000 reported illnesses. Since most food-borne illnesses are never reported, these outbreaks are only the tip of a large, hulking iceberg.

"Outbreaks give the best evidence of where and when the food safety system is failing to protect the public," said CSPI staff attorney Sarah Klein, the lead author of the report. "It is clearly time for FDA's reliance on industry self-regulation to come to an end. The absence of safety plans or frequent inspections unfortunately means that some of our favourite and most healthful foods also top the list of the most risky."

CSPI identified 363 outbreaks linked to iceberg lettuce, romaine, spinach, and other leafy greens, variously contaminated with E. coli, Norovirus, or Salmonella, and causing 13,568 cases of illness. Manure, contaminated irrigation water, or poor handling practices are all possible culprits in those outbreaks. The FDA does not currently require farms and processors to have written food safety plans, nor does it provide specific safety standards for even the largest growers to meet.

Eggs were linked to 352 outbreaks and 11,163 illnesses; tuna to 268 outbreaks and 2,341 cases of illness, and oysters - despite their limited consumption - to 132 outbreaks causing 3,409 illnesses. Outbreaks involving potatoes don't seem to make headlines, but nevertheless they are linked to 108 outbreaks and 3,659 cases of illness. Cheese, ice cream, tomatoes, sprouts, and berries round out the top 10 list. The data come from CSPI's Outbreak Alert! Database, which includes outbreaks from 1990 to 2006, using data collected from the Center for Disease Control and Prevention and other sources.

In July, the House of Representatives passed the Food Safety Enhancement Bill with broad, bipartisan support. That measure would give FDA authority to require food processors to design and implement food safety plans, provide specific safety standards that growers would have to meet, and require FDA to visit high-risk facilities every 12 months or less, and most other facilities every 3-4 years. In the Senate, similar legislation, sponsored by Sen. Richard Durbin (D-IL), is pending.

"As consumers, we don't have the power to check on these products," said Kathleen Chrismer, whose 9-year-old daughter Rylee Gustafson was hospitalised for a month after becoming seriously ill from eating spinach salad contaminated with E.coli O157:H7. "Without a better system to protect us, we are totally at the mercy of the next outbreak."

Salmonella and Campylobacter Increase Chances of IBD

A newly published report provides more evidence of the long-term risks associated with foodborne pathogens Salmonella and Campylobacter.  Research by Dr. Lyn Sue Kahng was published in the journal "Gastroenterology" looking at the connection between these bacterial infections and Irritable Bowel Disease (IBD).  IBD is, according to the Mayo clinic:

"a common disorder that affects the large intestine (colon). [IBD] commonly causes cramping, abdominal pain, bloating gas, diarrhea and constipation."

Dr. Kahng's study finds that those that suffer Salmonella and Campylobacter infections are significantly more likely to develop IBD than the population at large.  Marler Clark has represented numerous individuals that have developed IBD, most commonly following Salmonella infections.   Some of these foodborne illness victims have slowly recovered their previous health, but many have been left chronically ill. 

Florida Woman Petitions Whole Foods to Continue Selling Raw Milk

 A Florida woman who runs an organization called Miami Real Food has petitioned Whole Foods, one of the nation's largest organic grocers, to continue selling raw milk.  See the entire petition here.  The petition states, in part, 

[R]aw milk from grass-fed cows is infinitely healthier than those that are kept in confinement dairies. Times have changed and modern stainless steel tanks, milking machines, refrigerated trucks and inspection methods make pasteurization absolutely unnecessary for public protection.

Our firm's thoughts on the sale and consumption of raw milk have been stated loudly and clearly for years.  If you haven't read the first two parts of Bill Marler's recent four part series on the safety of pasteurized milk versus raw (unpasteurized) milk, please do so.  See Part I, and Part II.  The reality , and the reason why so many states have made the sale of raw milk illegal, is that there really is no way to produce the product safely.  

Think about where milk comes from, and the proximity of that anatomical area to where E. coli O157:H7 and other pathogens in a cows digestive tract comes from.  And aside from this admittedly simplistic analysis, occasionally some of these harmful bacteria cause mastitis (infection and inflammation of the udder), and may be shed directly into the milk.  Moreover, milk is not always drawn from a cow or other animal in a sterile environment--particularly in the case of raw milk, which is often produced and sold by small-scale, oftentimes unlicensed farmers, who simply do not have the resources to ensure that their product is being produced in a sterile, safe environment.  

My point is not that small, local farms should be targeted or branded as unsafe, or unconcerned with the production of safe food products.  I'm sure that the truth is exactly the opposite, for the most part.  But that does not alter the truth about raw milk, and it doesn't make the product any safer if the farmer who produced it simply lacked the resources to ensure a safe and sanitary milking environment.  

Thus, returning to the Florida woman's petition to Whole Foods to continue selling raw milk, she shouldn't be begrudged for having a devotion to more natural foods.  But her petition is indisputably misleading.  "Times have changed," true enough, but not so much that the production methods employed by many raw milk producers "make pasteurization absolutely unnecessary for public protection."  

Bacteria in Leafy Greens - Following the Light?

New research conducted in Israel suggests that the method that some bacteria, including Sallmonella, are enetering leafy greens is connected to light exposure, as reported today on an L.A. Times blog

The new study was published in the journal "Applied and Environmental Microbiology."  The findings, as reported by the L.A. Times:

Salmonella penetrates the lettuce leaf's deeper surfaces by entering little pores called stomata. These are the pores plants use to obtain and release gases during photosynthesis--the vital process by which light energy is captured and turned into sugars. There are rather nasty pictures in the article of rod-like salmonella clustered all around these stomata, seemingly going down into them and thus into the inner parts of the leaf.

The infromation could prove useful in limiting bacteria's access to leafy greens.  Such a step might help stem the tide of foodborne illness outbreaks tied to spinach, lettuce and other greens, involving pathogens like E. coli O157:H7, Salmonella, and Hepatitis A.

Missouri Gov. Nixon (double) Speaks On E. coli, Lake of the Ozarks

I guess it's hardly news when a politician doesn't give straight answers, but this is double-speak, or non-speak, at its best.   Check some excerpts from this Kansas City Star interview with Gov. Nixon on the Missouri Department of Natural Resources' (DNR) delay in releasing E. coli warnings for the Lake of the Ozarks to the public:

Can you guarantee the people of Missouri that there will be no more disclosures about your office knowing earlier than you previously admitted about the DNR report?

NIXON: We’ve seen challenges with the water at the Lake of the Ozarks over this year. In May and June, a number of reports required the DNR to close the beaches. That's a challenge for everybody.

We’re in the process of moving through and inspecting all 408 of the permanent facilities around there. We’re going to work very, very hard to make sure that water is cleaned up.”

What did you know and when did you know it?

The bottom line is obviously I think that there could've probably been more precise communication.

But the bottom line is it wasn't a secret that there were challenges down there. That’s why those beaches were closed in May and in June, and the slowness of that report, once it came to decision-making situation we said get it out.

Check the link for the rest of the interview.  You have to read it to believe it.

Story of Listeria Survivors Highlights Food Safety Issues

A well written piece in the Washington Post today by Jennifer LaRue Huget details the story of two twins, Luke and Chloe Bennett, who survived a listeria infection at birth.  Listeria is the common name for the pathogenic or disease-causing bacterium known as Listeria monocytogenes. It is a foodborne illness that when ingested causes an infection known as listeriosis.  Approximately 2,500 illnesses and 500 deaths are attributed to listeriosis in the United States annually.

The story details the Bennett children's harrowing illness:

Bennett's [the twins' mother] premature labor and subsequent illness were caused, a quick-thinking nurse recognized, by listeria, food-borne bacteria that most commonly taint deli meats and soft cheeses.

The contamination caused Bennett's body to go into sepsis; her son, hit harder than his sister, suffered seizures, for which he needed medication for months. The Bennetts waited five days after the babies were born to spread the news, so uncertain were they that both would live.

Listeria infections can be difficult to recognize and to trace-back.   The incubation period is comparatively long, up to 70 days.   Second, while most bacteria grow poorly when temperatures fall below 40°F, Listeria survives at temperatures from below freezing to body temperature, and grows best at the 0°F to 50°F range, which includes the temperature range used for freezing and refrigeration.

UK Study: Rise in Clostridium Difficile Illnesses Attributable to . . . Evolution

Clostridium difficile, colloquially known as "C Diff," is an increasing public health risk, particularly in hospital settings, but also as a foodborne pathogen.  Researchers from the United Kingdom, who compared historical strains of C Diff to the strain involved in a large outbreak at Stoke Mandeville Hospital in 2003, say that one of the reasons is that the bug is evolving, and becoming more dangerous. 

Clostridium difficile is a bacterium that causes diarrheal illness in human beings.  Actually, however, it is a bug that is naturally, and quite frequently, present in the gastrointestinal tracts of even healthy humans.  In fact, the bug is present in as many as 3% of adults and 66% of infants.  It typically becomes pathogenic (i.e. capable of causing illness) when the normal intestinal flora in the GI tract is altered, typically as a result of antimocribial treatment in a hospital setting. 

But C Diff is not dangerous because it causes only a couple days of diarrhea. A  2002 study showed that the incidence of patients with C. Diff in hospital settings who suffered life-threatening symptoms increased from 1.6% to 3.2%. Forty-four patients required a colectomy and 20 others died directly from C. difficile colitis.  The UK study concluded that the bacteria has become more virulent because it has acquired genes which enable it to survive better in the environment, spread more easily and make patients more severely ill.

Thus, for more reasons than just that C. Diff is causing more and more illnesses, the recent UK study finding that the bug is evolving is more than a little disturbing.  At the risk of stating the obvious, hospitals are where sick people go . . . people who can least afford to become infected, or succumb to illness from, a bacteria that is becoming more and more virulent. 

Hot Interviews at Food Safety News - Dr. Nestle and Dr. Raymond

The Washington DC Bureau and Denver Bureau caught up with two more Food Safety Leaders in the last week for some Q & A.  More interviews are coming over the next several weeks as we take the temperature from people who know.

Nestle on Food Safety Politics

Marion Nestle is an authority on food politics and policy. Nestle, a professor of public health and sociology at New York University, has written several books--all must reads for anyone concerned about the food system. From Food Politics: How the Food Industry Influences Nutrition and Health to her most recent book Pet Food Politics: The Chihuahua in the Coal Mine, Nestle informs the discussion on issues ranging from nutrition to labeling to food safety.

Former Under Secretary For Food Safety Speaks Up

President Obama is too prone to making inflammatory remarks about food safety and it is "unnatural" to go this long without a "Senate-confirmed" Under Secretary for Food Safety at the U.S. Department of Agriculture. So says the soft-spoken country doctor who until a year ago held USDA's top food safety job under Secretaries of Agriculture Mike Johanns and Ed Shafer in the Bush Administration.

Missouri DNR Spokewoman Testifies on E. coli Cover-up

New information in a continuing story we have been following here: Susan Medley, the former spokeswoman for the Missouri Department of Natural Resources (DNR)  told Senate investigators that the delay in the release of information about high bacteria levels at Lake of the Ozarks "stemmed from a department failure to quickly gather information to put the contamination levels into a historical context" according to a Columbia Daily Tribune report.

I am nor really sure what that is supposed to mean.  It has been previously reported that the delays were aimed at protecting local businesses.  Medley did say she was in contact during the delay in the release of the information with officials at Gov. Jay Nixon's office. 

Also according to the report:

The delay in releasing the data was caused, Medley said, by the failure of other DNR officials to provide additional data she sought — information on rainfall that could affect the samples and a history of the data collection. Medley said that despite repeated requests to DNR Director Mark Templeton and then-deputy director Joe Bindbeutel, she didn't get the information she needed. Bindbeutel has since left the agency and has said he made a mistake by not getting the information out sooner.

E. coli is the term for a family of bacteria that include the dangerous and pathogenic E. coli O157:H7.   Generally, water testing conducted to ascertain levels of E. coli is not specific enough to differentiate among various strains. 

Food Safety News - Great Interviews of Food Safety Leaders

Food safety News has some great interviews and more to come.

Paralytic Shellfish Poisoning shut mussel and clam harvesting in Oregon

The State Department of Agriculture has closed the entire Oregon coast to recreational mussel and clam harvesting because of the risk of toxins that cause paralytic shellfish poisoning. Agency spokesman Bruce Pokarney said Monday that most of the north and central coast had already been closed to mussel harvesting and the state has banned razor clam harvesting since midsummer for conservation reasons.

The conservation closure ends Oct. 1, but clamming will remain off-limits until toxin levels subside. The agency will test for toxins weekly, as tides permit. Shellfish contaminated with PSP toxins can cause minor to severe illness. Symptoms usually start with the tingling of the mouth and tongue. Severe poisoning can result in dizziness, numbness and paralysis.

Survey reports food safety costs doubled for California leafy greens growers

Seasonal food safety costs for California leafy greens growers more than doubled in the year after the September 2006 outbreak of E. coli in spinach, according to a survey by the University of California Small Farm Program. On a per-acre basis, these costs were lowest for the largest farms.

Information from the survey will be presented at hearings in consideration of a national leafy greens food safety program, to be held by the U.S. Department of Agriculture beginning Tuesday, Sept. 22.

The UC Small Farm Program survey is the first to ask leafy greens growers specifically about food safety costs after the implementation of the California Leafy Green Products Handler Marketing Agreement (LGMA).

The LGMA was created in 2007 as a response to the 2006 E. coli 0157:H7 spinach outbreak. The marketing agreement is a voluntary program for California handlers of lettuce, spinach and other leafy greens. Farmers who want to sell their leafy greens to LGMA handlers must also comply with LGMA food safety provisions. An estimated 99 percent of leafy greens sold in California are covered under the LGMA requirements.

Many small-scale leafy greens growers who only sell directly to consumers, chefs and independent grocers are not subject to the LGMA.

In the survey, growers reported their seasonal food safety costs increased 127 percent, from an average of $24.04 per acre to $54.63 per acre. Because it appears that growers may have ignored some costs when responding to the survey — e.g., some labor costs and owner's time — the combined real costs of seasonal and one-time food safety improvements could exceed $100 per acre.

The survey also found that costs per acre were consistently lowest for the largest-sized growers with revenues over $10 million, who were also more likely to hire food safety specialists to manage their farms' compliance.

“In California, we see that smaller farms are at a cost disadvantage under LGMA to the largest leafy greens growers — specifically those that have annual revenues over $10 million,” said Shermain Hardesty, director of the UC Small Farm Program and co-author of the study.

To view the full study, visit http://ucanr.org/sfp/leafy-greens.

New Grant for Research on Treatment of Shigella and C. difficile

The National Institutes of Health (NIH) has awarded a group of researchers $2.87 million for preclinical development of an oral drug to treat Shigella and C. difficile.

Shigella is a bacterium that belongs to a small group of pathogens (including E. coli O157:H7 and Cryptosporidium) that can infect the gut after the ingestion of relatively few organisms, and can cause sudden and severe diarrhea (gastroenteritis) in humans. About 25,000 laboratory-confirmed cases of shigellosis are reported each year in the U.S. Many cases go undiagnosed and/or unreported, however, and the CDC estimates that 450,000 total cases of shigellosis occur in the United States every year.

Clostridium difficile (C. difficile) is a spore-forming, gram-positive anaerobic bacillus that produces two toxins: toxin A and toxin B. These toxins typically cause gastrointestinal disease, often with severe complications.

The new research will focus on Ceragenin™ technology, which is a class of antimicrobial compounds that mimic functions of the body’s own innate immune system. The technology was invented by Paul B. Savage, Ph.D., professor at BYU.

Risk Posed by Non-O157 E. coli Greater Than Recognized

According to the results of a study recently published by the CDC, the incidence of dangerous and under-reported non-O157 E. coli infection is on the rise. E. coli is the term given to a large family of bacteria. Within that family, E. coli O157:H7 has been recognized as pathogenic to humans. As a result, E. coli O157:H7 is a reportable disease in the U.S. The dangerous pathogen is credited with more than 70,000 illnesses, over 2,000 hospitalizations and 61 deaths each year.

This may only be half the story. There is mounting evidence that other non-O157 strains of E. coli are responsible for a significant numbers of illnesses in the U.S. These other strains, referred to as non O157 STECs, or shiga-toxin producing Escherichia coli, cause illness just like E. coli O157:H7, but are currently under-reported, and, as a result, under-regulated.

The study, conducted by a team of scientists lead by Sarah Lathrop, consisted of a review of data collected in New Mexico from 2004 to 2007. The results revealed that non-O157 STEC present a significant threat to public health:

The data collected by New Mexico's FoodNet surveillance network indicate that sporadic STEC cases increased substantially from 2004 through 2007. Reports of STEC O157 infection doubled from 7 to 14 from 2004 to 2006 but dropped to 9 in 2007. However, the number of non-O157 STEC cases continued to climb and accounted for most of the increase in overall STEC rates in New Mexico during this time, similar to rates in Connecticut.

The study also noted that non-O157 STEC made up a majority of all of STEC infections identified: “Non-O157 STEC infections ranged from 52% to 74% of all Shiga toxin–positive cases diagnosed each year and 64% of all identified STEC cases."

Information indicating that Non-O157 STECs might make up half, or more, of all STEC infection, is consistent with previously reported results from Europe.

What does this mean? It means that we are likely tracking and responding to only a fraction of actual STEC illness in the U.S. To adequately protect the population, non-O157 STEC needs to be treated like the equally dangerous, and apparently equally common O157:H7 strain.

Another Petting Zoo in UK Closes as E. coli Fears Spread

The "World of Animal Life" exhibit in Devon, England, has closed as health officials investigate links to  three more people with E. coli O157:H7 infections.   According to a BBC report

In a statement, the Health Protection Agency said: "East Devon District Council and the Health Protection Agency this afternoon advised the precautionary closure of the World of Country Life farm, Exmouth, acting on information that potentially linked the farm with three individuals with confirmed E.coli O157 infection.

The exhibit is the fourth to shut in recent days.   As reported on this blog, 49 cases of E. coli O157:H7 have been linked to the Godstone Farm in Surrey.  A related farm shut over hygiene concerns.  The fourth farm was closed pending an investigation of an apparently unrelated cluster of illnesses.

Outbreaks of E. coli O157:H7 at petting zoos are far from a new phenomenon.  More than two dozen outbreaks of illness from various pathogens have been linked to animal exhibits in the U.S. and U.K.  For more information see www.fair-safety.com

The Ugly Side of Foodborne Illness

I haven't been in half as many living rooms as the partners at Marler Clark have, but I've certainly seen a lot of suffering over the past six years, doing what we do.  Kids on dialysis; adults suffering in the miserable comfort of a hospital bed after having big pieces of their intestines surgically removed; and the permanently reddened eyes of elderly widows who have lost their World War II hero husbands of 50 years.  And, today I visited Stephanie Smith.  

When you see in living color what these people have endured, you can't help but think what life would be like had things turned out just a little different--if I had chosen one package of ground beef or spinach over another; or if it was my mom or dad who had died.  What if I was the one who could no longer do something as simple as run my dogs after getting home from work?

More often than not, when I think about the people we represent at Marler Clark, I can't help but frame my thoughts against the backdrop of one particular remark that I overheard from an executive of a national organic grocery chain.  It was during the legislative debate in California over the passage of a bill concerning bacteria levels in raw milk.  

I was lucky enough to sit two chairs away from him, and unlucky enough to hear what he said quietly to his friend beside him in response to testimony questioning the health benefits of raw milk.  After somebody testified about the particular vulnerability of the young, elderly, or immune-compromised, the guy said with a roll of his eyes, "Oh here we go, the straw man argument"--as if it were junk science of the sort typically espoused over the "benefits" of consuming raw milk.  

My guess is that this particular person had never seen the inside of an intensive care unit.  He's never seen a young mother who was just told that her first born will lose his kidneys by the time he's 21, and he's sure as hell never come face to face with a girl who can't even walk because she ate a hamburger.

Though it may not sound like it, I certainly don't fault food manufacturers for their typically human responses.  It's natural, sometimes, for people to fail to be moved until they are forced to confront an uncomfortable reality.  And I also admit to being more than a little on edge as I write this on the plane back to Seattle after visiting Stephanie Smith.

But I do fault the people, like the executive from the raw milk hearing in California, who apparently are simply unwilling to confront the reality of foodborne disease--that people do get more than a few days of diarrhea, and that young and old people, and sometimes even supremely healthy teenagers, can suffer devastating, life-altering injuries.  The truth of the matter is that there is no room for even the slightest bit of jocularity or passivity when it comes to this stuff. 

Marler Explains New News Site - Food Safety News

Q & A with Bill Marler, managing partner of Marler Clark LLP:

Q: What is Food Safety News?

A: Food Safety News (FSN) is a daily online newspaper dedicated to covering food safety news--all the news that's fit to eat! FSN writers will be reporting on everything from foodborne illness outbreaks to food politics to international food safety policy. We have bureaus in Seattle, Denver, and Washington, DC and have invited contributors from government, industry, academia, and consumer groups to share their viewpoints on food safety-related issues. It's a one-stop shop for all things food safety.

Q: Why are you creating an online newspaper dedicated to food safety?

A: Though the top food safety agencies disseminate food recall and outbreak information, and state, local, and regional health departments make an effort to inform their constituents, there is no up-to-date one-stop place for food safety information. I've also been disappointed to see reporters on the food, health, and product safety beats lose their jobs to the fall of print journalism and the rise of consolidated media. I think food safety is an important beat to cover, especially as food policy issues begin to take center stage in our national discourse. FSN can offer a forum for discussion on these issues for consumers, industry leaders, and public health officials alike.

Q: Will Food Safety News be balanced in its coverage of food safety issues?

A: Yes, our FSN team is dedicated to ensuring we have balanced reporting. Our reporters will be reaching out to a variety of stakeholders and experts as they report the daily food safety news. We have also invited a wide variety of experts and food safety leaders to contribute to the site.

Q: What do you hope readers will take away from Food Safety News?

A: Whether you're a parent or a public health official, food safety is a pertinent issue. We hope readers will get their fill of food safety-related news from FSN on a daily basis. We aim to be the go-to place for anyone looking for information on the issues of the day, whether they pertain to foodborne illness outbreaks, recalled products, or food politics. FSN will have something for everyone. When there is something going on in the food supply, FSN will be serving up the top news.

Salmonella in Austraila Linked to "Pawpaw"

They say you learn something new everyday, and even though its not lunchtime, I am ahead of that pace today.   The Sydney Morning Herald is reporting that several Salmonella illnesses in Western Australia have been linked to "pawpaw.":

West Australians have been warned to thoroughly wash pawpaw following several cases of food poisoning, including one in which a person required hospital treatment. The WA Department of Health issued a statement on Tuesday saying seven cases of salmonella poisoning linked to the tropical fruit had been uncovered over the past six weeks.

The first question in my mind, upon reading, was what is "pawpaw?"   Thanks to Al Gore's Internet, I have some ideas.   Turns out that at least two fruit go by the name "pawpaw."  The first, according to its "wiki" is native to the U.S.:

Pawpaw (Asimina) is a genus of small clustered trees with large leaves and fruit, native to North America. The genus includes the largest edible fruit indigenous to the continent. They are understory trees found in well drained deep fertile bottomland and hilly upland habitat. Pawpaw is in the same family (Annonaceae) as the custard-apple, cherimoya, sweetsop, ylang-ylang and soursop, and it is the only member of that family not confined to the tropics.

Since this didn't seem like the culprit, I pressed on to find in Australia the tropical papaya, or Carica papaya, is referred to as the "pawpaw".

So, if you have been as ignorant of these facts as I have, note a few things.  First, that there is a pawpaw fruit in the U.S.  Also, in Western Australia, the papaya is referred to as "pawpaw."  And right now, it makes sense to make very sure your Western Australia "pawpaw" is thoroughly washed, or perhaps avoided altogether for a few days.

Future Economic and Physical Costs for Victims of Foodborne Illness

The CDC estimates that foodborne pathogens cause 76 million cases of gastrointestinal illness every year.  325,000 of these illnesses require hospitalization, and about 5,000 people die annually.  (See Paul S. Mead, et al., Food-Related Illness and Death in the United States, 5 Emerging Infect. Dis. (No. 5) 607, 614 (1999)).  It is estimated that the five most common foodborne pathogens alone cause a loss of $6.9 billion annually in medical expenditures, productivity losses, and the costs of premature death.  (See Crutchfield, S.R. and T. Roberts, “Food Safety Efforts Accelerate in the 1990s,” FOOD REVIEW, 23,3:44-49,(2000))  But what these staggering statistics don't account for are the personal economic costs and physical losses that some victims of foodborne disease (i.e., the permanently injured) face in the future.  These losses can be astronomical, both economically and personally.

In those cases of severe foodborne disease that don't end in death, likely the most costly condition that we regularly see is hemolytic uremic syndrome (HUS).  Post-diarrheal Hemolytic Uremic Syndrome (D+HUS) is a severe, life-threatening complication that occurs in about 10% of those infected with E. coli O157:H7 or other Shiga toxin (Stx) producing E. coli. It is now recognized as the most common cause of acute kidney failure in infants and young children.

In a significant subset of HUS victims, the spectrum of long-term kidney complications runs from fairly benign conditions to end stage renal disease (ESRD), an inexorable process by which the kidneys lose their filtering capacity until the patient requires dialysis or kidney transplantation to survive.  Many such victims will suffer from myriad physical complications before, during, and after kidney transplantation, including:  (1) alterations in calcium and phosphate balance, known as renal osteodystrophy, that cause the bones to become weak and soft, resulting in bone pain and susceptibility to fracture; (2) anemia —which is characterized by a low red blood cell count and consequent lack of energy; (3) growth failure caused by the damaged kidney’s inability to properly regulate the calcium necessary for bone growth; and (4) high blood pressure, which, among other things, stresses the heart and can lead to coronary artery disease, heart attack, and stroke.

Following transplantation, the victim will require immunosuppressive medications for the rest of her life to prevent rejection of the transplanted kidney. Medications used to prevent rejection have considerable side effects. Corticosteroids are commonly used following transplantation. The side effects of corticosteroids are Cushingnoid features (fat deposition around the cheeks and abdomen and back), weight gain, emotional instability, cataracts, decreased growth, osteomalacia and osteonecrosis (softening of the bones and bone pain), hypertension, acne, and difficulty in controlling glucose levels. The steroid side effects, particularly the effects on appearance, are difficult for children, particularly teenagers, and non-compliance with the treatment regimen is a problem with teenagers due to unsightly side effects.

Clearly, the physical impediments to leading a normal life for victims of severe HUS are many.  The economic losses that frequently result in such cases are correspondingly staggering.  We have represented many people, mostly children, in these unfortunate circumstances.  A brief review of three such cases selected at random reveals an average cost of $5,776,352 for medical care and future income losses. 

2006 Spinach E. coli Outbreak Revisited

 The 2000 movie called “The Perfect Storm” loosely chronicled the destruction of an Atlantic nor’easter that formed due to the random convergence of several destructive weather patterns. Twelve people died in the storm, including six sword fishermen aboard the Andrea Gail (captained by George Clooney’s in the movie). Today is September 14, 2009, marking three years since the convergence of another set of tragic circumstances, ending in hundreds of millions of dollars in damages, many lives lost, and many more lives changed forever:  the 2006 Spinach E. coli outbreak.

Though there were no rough-hewn sword fishermen dying in the Grand Banks, perhaps more than any other outbreak of foodborne disease that we have seen, the spinach outbreak in September 2006 really was the perfect storm. The vehicle, Dole baby spinach, was a nationally-distributed, high-volume product eaten raw by people in every age group, including the young and the old. Contamination on the product was widespread, as is apparent from the severity and number of illnesses caused. And the strains of shiga-toxin producing E. coli involved, again as judged by the severity and number of illnesses caused, were simply more virulent than the strains we typically see.

But just like George Clooney’s movie, the spinach outbreak is truly memorable because of the suffering it caused. Ultimately, the outbreak cost the leafy greens industry over $175 million, maybe more, ruining a brand name; and more importantly, over 200 people were sickened, 102 were hospitalized, and at least thirty-one people developed HUS, five of whom died. Among the five who passed away were Betty Howard, Ruby Trautz, and June Dunning. All three were beloved mothers and grandmothers, and all three died undeservedly shameful, protracted deaths.

The deaths of these three women have been described often enough, however. So it is thus in tribute to Betty, Ruby, and June, and their families, on this third anniversary of the spinach outbreak, that we remind everybody just briefly about these wonderful ladies’ lives.

Betty Howard was born on September 14, 1923 in Sharon Springs, Kansas. She graduated high school in Salina, Kansas in 1941. Like others of the GI Generation, during World War II Betty did her part by working in a gunpowder plant in Oklahoma. After the war, she moved to Yakima, Washington, where she met John W. Howard. The striking young couple married on February 26, 1947.

John and Betty Howard raised four sons: Kim, Paul, Brian, and Darryl. Kim, the Howard’s first son, died in 1998. Paul, Brian, and Darryl are independent, successful men with families of their own. And to a man, each reflects on his childhood, and his mother more specifically, as idyllic in both appearance and reality.

The Howard boys’ mother left an indelible impression on each from day one, most significantly the way in which she lived and conducted her life. Darryl Howard eulogized his mother on February 1, 2007. He stated:

As I thought back this morning, it reminded me of the movie Second Hand Lions.

Two uncles raise a son of a relative. They tell him of their unbelievable adventures. Adventures in the Foreign Legion, tales of saving a girl, and wittingly getting a reward of gold offered for their own heads from a Saudi Prince.

In the end after the two 90-year old uncles pass away by flying their bi-plane into a barn, the boy returns to the farm and this helicopter lands. There is the son of the Saudi Prince with his son. They had heard of the uncles’ passing. The Prince looks over at a large yacht in a small pond and comments: “I see they spent my father’s money well.” Hearing this, the Prince’s son exclaims “So the stories grandfather told of the men are true, they really lived.” To which the boy who the uncles raised, now a man, says: “Yeah, they really lived, boy how they lived.”

My mom and dad really lived.

June Dunning was born on June 20, 1920 in Catford, England. She met her future husband, Arthur Gordon Dunning, a US citizen born to British parents, some years later while working in London. Arthur was then working at Scotland Yard. June and Arthur married in Sussex, England on April 24, 1943.

Arthur thereafter joined the U.S. Army, and he and June spent the majority of the next 20 years living in and around Europe. Their army life resulted in frequent moves, and June held numerous jobs over the years at various Army Base stores. They were eventually transferred to Fort Ritchie, Maryland, where Arthur retired. June and Arthur moved to Hagerstown, Maryland in the mid seventies.

For the last seven years of her life, June lived in Hagerstown, Maryland with her daughter, Corinne Swartz, and her son-in-law, Warren Swartz. Corinne recalls her mother as “a proper British lady that loved her tea, meticulously cared for her flowers and plants and adored our Yorkshire Terrier ”Roxie” whom she walked almost every day until the day she became ill. Neighbors often commented on how they enjoyed watching her walk around the neighborhood with the Yorkie by her side."

June remained independent to the last. She enjoyed heading into town on her own. In fact, Corinne and Warren purchased their home at its location in part due to its proximity to a Hagerstown bus stop. This allowed June to pack a bag for the day, scurry to the bus stop, make a transfer in the downtown square and then ride a second bus to the Mall for a day of shopping, or for an evening of Bingo.
“She never complained about anything,” Corinne recalls, “unless it was raining. The rain always made her mad because she would probably not go out that day. She was an avid shopper. I’m sure the department stores at the Mall have felt the effects of the sudden lack of sales. Finding bargains was a favorite past-time of hers. She often came home after riding the bus from the mall with her arms full of the day’s ‘good buys’.”

Ruby LaFon Trautz was born in the back seat of a car on February 2, 1925 in Manzanar, California. She was the second of four girls born to working class parents, Maude and Paul LaFon. Typical of the era, Maude was a homemaker and Paul, Ruby’s much-beloved father, worked construction.

Ruby and her sisters lived their formative years in a home on Settle Avenue in San Jose, California. The girls sprouted from their humble origins to become cultured, ambitious young women. The personal history of each is remarkable; and Ruby’s, in particular, shows an early bent toward the vibrant and confident persona that she carried throughout her life.

Characteristically, Ruby was not enamored with many of the “social constraints” extant during her adolescent and early adult years. She was, and so remained until the day she died, determined to shape her own life. Thus, she was consistently employed from her adolescent years, through high school, and, after a respite of fifteen years to care for her two girls, consistently until retirement at age 65. Most of her early jobs were military in some fashion, or related to the war effort at least, and she quickly found her calling in the nursing field.

Ruby began training for her nursing career at Santa Clara County Hospital in 1943. She would remain there until 1946, when she transferred to a program at Queen of Angels Hospital in Los Angeles, where she worked in obstetrics and orthopedics. The picture below is of Ruby shortly after graduation from nursing school. Afterward, she returned to Santa Clara County Hospital, where she worked in surgery until commissioned as a 1st Lieutenant in the Air Force in 1950.

It was in her capacity as an Air Force Lieutenant that Ruby served as a flight nurse aboard planes flying wounded Korean War soldiers from base to base—a role that Ruby considered the single-most important of her distinguished medical career. By chance, or perhaps provenance, Ruby’s thoughts about the time she spent in that critical role are memorialized. Students from Conestoga School District in Murray, Nebraska recorded them in an interview several years ago about female war veterans:

Ruby’s job was to help the wounded [] soldiers get on the planes and to help medically while they were transported back to a hospital closest to their homes to continue their medical care or to die. The soldiers would come in on Navy planes to Travis AFB, CA and the nurses would fly on Navy or Air Force planes to get them closer to homes.

The nurses were very much in charge once the patients were on the plane. . . . Nurses essentially had power over the pilots because they could request that the pilots find an airfield to land at anytime if they felt a patient needed to be at a hospital or with a doctor. She requested a plane be taken down to Ft. Knox, KY.

Ruby would often sign in at 3 a.m. and take off at 7 a.m. Her days were typically 12-14 hours. They would land in 7-8 places a day. Sometimes nurses were left at the last stop and it might take 2-3 days to hitch a ride on another plane home. . . .

I asked Ruby what the injury types were. She said it was very sad, they were young kids. They usually had bad injuries like amputations, gun shot wounds, and schizophrenia caused by the war.

Many who knew Ruby Trautz would say that she remained vibrant until she was sickened in the spinach outbreak. Confident, independent, and informed are other adjectives not unfamiliar to Ruby’s description—some might even say feisty. To a person, however, no matter the adjective used, everybody who knew Ruby Trautz agrees that, even at age 81, she remained the dominant force in her own life. As Polly Costello, one of Ruby’s two daughters stated, “my mom was living her life, not waiting for death.”

Food Safety Hazards Associated with Consumption of Raw Milk

FOODBORNE PATHOGENS AND DISEASE Volume 6, Number 7, 2009
Review by Stephen P. Oliver, Kathryn J. Boor, Steven C. Murphy, and Shelton E. Murinda

Abstract

An increasing number of people are consuming raw unpasteurized milk. Enhanced nutritional qualities, taste, and health benefits have all been advocated as reasons for increased interest in raw milk consumption. However, science-based data to substantiate these claims are limited. People continue to consume raw milk even though numerous epidemiological studies have shown clearly that raw milk can be contaminated by a variety of pathogens, some of which are associated with human illness and disease. Several documented milk borne disease outbreaks occurred from 2000–2008 and were traced back to consumption of raw unpasteurized milk. Numerous people were found to have infections, some were hospitalized, and a few died. In the majority of these outbreaks, the organism associated with the milk borne outbreak was isolated from the implicated product(s) or from subsequent products made at the suspected dairy or source. In contrast, fewer milk borne disease outbreaks were associated with consumption of pasteurized milk during this same time period. Twenty-nine states allow the sale of raw milk by some means. Direct purchase, cow-share or leasing programs, and the sale of raw milk as pet food have been used as means for consumers to obtain raw milk. Where raw milk is offered for sale, strategies to reduce risks associated with raw milk and products made from raw milk are needed. Developing uniform regulations including microbial standards for raw milk to be sold for human consumption, labeling of raw milk, improving sanitation during milking, and enhancing and targeting educational efforts are potential approaches to this issue.  Development of pre-harvest and post-harvest control measures to effectively reduce contamination is critical to the control of pathogens in raw milk. One sure way to prevent raw milk–associated food borne illness is for consumers to refrain from drinking raw milk and from consuming dairy products manufactured using raw milk.

Click on image to download:

High Levels of E. coli in Lake of the Ozarks- This Time the Public is Warned

Water samples taken from the Laurie Hollow area of the Lake of the Ozarks has tested positive for elevated levels of E. coli, according to the Kansas City Star.    The star reports that:

Fifty water samples were taken this week from the lake, and only the one from Laurie Hollow was high. In that sample, the E. coli level exceeded standards for swimming.

The "good news" is that the Missouri Department of Natural Resources saw fit to alert the public of the results this time around.  In May, test results showing high levels of E. coli were hidden from the public, in an apparent attempt to protect tourism and local businesses.  The Missouri Attorney General investigated the failure to report the problem.  Now a Missouri Senate Committee is conducting its own investigation.

E. coli is the general term for a family of fecal bacteria that includes more dangerous subtypes like E. coli O157:H7.   Pathogenic strains of E. coli can cause severe gastroenteritis in humans when consumed or swallowed.

A question about the FDA's Reportable Food Registry

 On Tuesday, the FDA certainly took a step in the right direction by implementing the Reportable Food Registry, under federal regulations codified at 21 USC 350f.  The FDA's action essentially requires any food producer who knows of a microbial risk (e.g. bacteria or virus that can make you sick) in a food it produced, processed, packed, or held to report the problem to the FDA via the Reportable Food Registry.  As a somewhat necessary evil in drafting legislation or binding regs, the FDA regulations contain some big words that will, unfortunately, leave dedicated compliance to the food producer.  

Actually, I use the phrase "food producer who knows of a microbial risk" above more than a little loosely.  The actual wording, set forth at 21 USC 350, requires a food producer to report "an article of food (other than infant formula) for which there is a reasonable probability that the use of, or exposure to, such article of food will cause serious adverse health consequences or death to humans or animals."

Well, what constitutes a "reasonable probability?"  I can think of more than one instance where a food producer, either in PR statements or through their attorneys in litigation, has offered the excuse to liability that "so and so's E. coli [or any other pathogen] positive stool sample was only presumptively positive."  In other words, initial testing detected the presence of the bacteria, but the bacteria was not conclusively (more loose words) identified as the pathogen de jure by further confirmatory testing.  

The problem would unfold under the Reportable Food Registry very simply . . . something like this:  lettuce producer A generates a positive test for Salmonella in a certain lot of product intended for shipment to grocery stores.  Producer A's positive test came from its own private lab, or any independent third party laboratory--doesn't really matter.  Producer A does not report the initial, presumptively positive test because it believes, realistically or not, that a presumptive positive does not constitute a "reasonable probability that the use of [the lettuce] will cause serious adverse health consequences."  After all, it's only a presumptive positive, not confirmed as something dangerous until the confirming test occurs.  

Well, in this example, the confirming test does, in fact, occur, and it does, in fact, confirm that the bacteria that looked liked salmonella, walked like salmonella, and talked like salmonella was actually . . . salmonella.  In the meantime, the product has been shipped and sold by the grocery stores.  Consumers have eaten it and become ill.  Producer A does finally report the confirmed positive test, but not until after all the damage is done.  

I will point out here that this is not an impossible scenario.  Just last month, a strange sequence of events occurred where more than two weeks passed after a positive test until Melon Acres farm recalled cantaloupes that it had received a salmonella-positive test on.  Now the situation is not identical, but it illustrates the point that delays in testing, and reporting the results of tests, are not unheard of.  I'm sure we'd all be shocked to know how many positive tests actually occur on the food we consume generally.  

And lest we forget, we're only a few short months removed from the massive salmonella outbreak associated with peanuts from Peanut Corporation of America.  If you're reading this, you'll no doubt recall that PCA did not report or recall lots of product for which it received an initial positive test result for Salmonella.  Read this for a brief refresher on this despicable situation.  

In the end, just like the ultimate responsibility for producing safe food, the onus will rest squarely on the shoulders of the food producer to take necessary action to prevent people from getting sick from a product that the producer knows, or really should know, contains a microbial risk.  I admit to being a little biased, maybe even jaded in my confidence that all producers will fully and honestly discharge their obligations under the FDA's new regs.  Time will tell.  

Editor’s note:

According to the FDA press release: “The reporting requirement applies to all foods and animal feed regulated by the FDA (Excludes all beef, poultry, lamb and swine) …. The requirements apply to any person who has to submit registration information to the FDA for a food facility that manufactures, processes, packs, or holds food for human or animal consumption in the United States …. Facilities that manufacture, process or hold food for consumption in the United States now must tell the FDA within 24 hours if they find a reasonable probability that an article of food will cause severe health problems or death to a person or an animal …. Some examples of reasons a food may be reportable include bacterial contamination, allergen mislabeling or elevated levels of certain chemical components (So, if companies limit or stop end product testing? What you do not know will not hurt you? Customer’s perhaps?) …. These people are termed responsible parties.” A responsible party:

1. Must investigate the cause of the adulteration if the adulteration of food may have originated with the responsible party (So, if your supplier causes the contamination, you need to do nothing?) ….

Here is my major beef with this press release: “A responsible party is not required to report if it found the problem before the food was shipped, and corrected the problem or destroyed the food.” So, if a plant tests a sample of the product, but has not yet shipped it, no reporting required? Consider this, sample product testing does not assure that the product is NOT contaminate, only that the sample is. Sample product testing is a method of testing whether your manufacturing process is working. So, if you are getting positive sample tests, you have a problem – a problem that does not need to be reported? A few years ago, we had a case where a manufacturing facility tested end product for E. coli O157:H7 and found positives – for 30 days in a row. The company retained and destroyed those tested lots. However, it was a very small portion of a day’s production. Guess what happened? But, no reporting required?

Verocytotoxin-producing Escherichia coli O26 in raw water buffalo (Bubalus bubalis) milk products in Italy.

Lorusso V, Dambrosio A, Quaglia NC, Parisi A, La Salandra G, Lucifora G, Mula G, Virgilio S, Carosielli L, Rella A, Dario M, Normanno G.

J Food Prot. 2009 Aug;72(8):1705-8.

Department of Health and Animal Welfare--Faculty of Veterinary Medicine Str. Prov. Per Casamassima Km 3, 70010 Valenzano, Italy.

Escherichia coli 026 is known as a verocytotoxin-producing E. coli (VTEC) organism that causes severe foodborne diseases such as hemorrhagic colitis and hemolytic uremic syndrome. Although cattle are the most important reservoir of VTEC, only a few reports on the role of water buffalo (Bubalus bubalis) as a reservoir of VTEC and on the presence of these organisms in their milk are available. However, in Southern Italy, where water buffalo are intensively reared, an outbreak of hemolytic uremic syndrome due to E. coli 026 has recently been reported, in which the consumption of typical dairy products was considered to be a common risk factor. The aims of this work were to assess the prevalence of E. coli O26 in raw water buffalo milk, to characterize the virulence gene profiles of the isolates, and to evaluate their phenotypic antimicrobial resistance pattern. Of 160 analyzed samples, 1 (0.6%) tested positive for E. coli O26, and the isolate showed the stx1+/stx2+/eae-/hlyA+ genotypic profile. The strain showed resistance against glycopeptides, macrolides, and penicillins. The presence of VTEC organisms in raw water buffalo milk could be considered to be a potential threat to consumers; however, the strict adherence to the processes used in the preparation of the most common buffalo dairy products could strongly mitigate the foodborne risk. To our knowledge, this article reports the first isolation and characterization of E. coli O26 VTEC in raw water buffalo milk.

Potential E. coli Illness in Lab Worker at North Dakota State?

A lab worker at the Center for Nanoscale Science and Engineering at North Dakota State who works with E. coli has developed a gastrointestinal illness, according to "In Forum" out of Fargo, North Dakota.

There has not been confirmation as to whether the illness is in fact an E. coli infection.   University officials, are however, taking precautions.

E. coli is a family bacteria, some of whose members cause severe gastrointestinal illness.  Best known among these is E. coli O157:H7.   E. coli O157:H7 infection can lead to a complication known as hemolytic uremic syndrome (HUS).   HUS is a potentially fatal condition that also may leave survivors with permanent kidney injury.

I was not able to find evidence of a reported incidence of E. coli infection linked to laboratory research previous to this potential case.

Recall Advice for ground Beef, cantaloupes . . . well any contaminated food

In my last post regarding a recent recall of cantaloupes in the upper midwest due to Salmonella contamination, you can tell that I was struck by the sequence of events being reported.  Melon Acres' recall notice went up on August 27; the FDA reported the Salmonella-positive test result on which the recall was based on August 21, a full six days before Melon Acres' recall notice; and the FDA's salmonella-positive test actually occurred on August 11.  Problem is, the melons were shipped to grocery stores, and maybe into consumers homes, on August 13 or 14.

We don't know all the details yet, but I'm not sure how many ways there are to spin this.  The bottom line appears to be that the Salmonella positive test result occurred more than two weeks before Melon Acres issued its recall notice, by which point the cantaloupes had certainly been distributed . . . and very likely sold to consumers. 

When seeing this, my immediate thought was, "what's the shelf life for cantaloupes after harvest" Pragmatism dictates that we at least look at whether the delays were justified, or not as big a deal as they appear to be at first blush.  I googled it and found an answer that, although a bit dependant on ripeness at harvest and other factors, the shelf life is not long enough to explain away a more than two week delay in recalling affected product.  Ripe cantaloupes should be consumed in not more than a few days.  Thus, there is much more than a theoretical risk that contaminated product will be consumed, particularly considering that these melons were distributed on August 13 or 14. 

Maybe nobody will get sick from these bad melons.  No way to tell yet because, if people did get sick, the epidemiological data is certainly not in the public domain yet.  But this episode is nonetheless distressing.  If a company's motivation for delaying recalls boils down to dollars and cents, they should take a lesson from companies, in fact entire industries, who have recently felt the economic impact of massive product recalls (PCA peanut recall cost the industry 1.5 billion dollars).  

Companies faced with a potential recall situation should consider this:  What really generates the damage are illnesses caused, not whether a notice goes up on the FDA website.  The reason is that illnesses, not simply recall notices, are what drive the sometimes frenetic media response.  

The media attention and other buzz that affects the bottom line will be much less significant if there are no illnesses, and I assure you that the best way to avoid making people sick, assuming that you know your product is contaminated, is to take it off of store shelves if you've got the chance.  Indeed, the only way for a food seller to protect its consumers is know the risks, and effectively communicate those risks to the public.  

Green Onion Recall due to Potential Salmonella Contamination

Ocean Mist Farms, a Castroville, California vegetable company, has issued a voluntary recall of iceless green onions due to potential contamination by Salmonella bacteria.  The company decided to issue the recall after confirmation from federal regulators of a positive test for salmonella on green onions supplied by Circle Produce to several shippers, including Ocean Mist Farms.

“The health and safety of our customers and their consumers always comes first. As soon as we learned of the positive test, it became our immediate responsibility to begin a voluntary recall of the product in the interest of protecting public health,” said Ed Boutonnet, president, Ocean Mist Farms. “We quickly traced back the product using our tracking system and will work closely with our customers and officials.”

Ocean Mist states that they have not yet been notified by, or heard of, any illnesses occurring as a result of the contamination.  Ocean Mist indicates, however, that It is possible that a small amount of product has already been purchased by consumers.

The recalled iceless green onion pack styles and code dates are as follows:

• 4 x 12 count
• 2 x 24 count
• 36 count 5.5 oz Cello Bag
• 40 count 5.5 oz Cello Bag

Trace Back Code: 95ONCP7G
Production Dates: 80309; 80709; 80809; 81109; 81209; 81309

Green onions and foodborne pathogens.  Certainly not the the first rodeo for this pair.  In late-October 2003, Chi-Chi's mexican restaurant in Pennsylvania was the sight of  a massive hepatitis A outbreak linked to raw green onions.  Ultimately, 650 people were confirmed to have been infected and multiple people died.  We represented about 50 people in the outbreak, including a gentleman named Richard Miller who had a liver transplant as a result of his illness.  Read more.
 

E. Coli O157:H7 Illnesses Close Daycare in UK

The majority of the E. coli O157:H7 cases we pursue involve the consumption of contaminated food or drink.   It is possible though, for E. coli O157:H7 to be transmitted from person to person, through fecal-oral transmission.   Such transmission is more likely in a day-care settings. 

BBC news is reporting on the closure of the "Going Places Day Nursery" in the UK after 3 children fell ill with E. coli O157:H7 infections.  One child is hospitalized.

The apparent link between these E. coli O157:H7 infections and the day-care do not rule out contaminated food or drink as the source.  Food or drink served at the day-care may be the source.   It is also possible, though, that the illness was spread among ill children.  A third possibility is that illnesses can be attributed both to contaminated food (in one or more primary illnesses) followed by person-to-person (secondary) illnesses. 

The nursery says "an inspection had shown no links to the nursery kitchen "or any of our procedures".

Marler Clark has previously represented the families of children that developed E. coli O157:H7 infections in day-care settings.

E. coli and Food Recalls: Progress, Really?

The Wisconsin State Journal recently published an excerpt from an interview on the increased number of food recalls we have seen in the last few years.  In the interview, Dr. Kathleen Glass of the Food Research Institute at UW-Madison concluded, in part at least, "That the food-safety system is working, even though the number of recalls is rising."  This inspired me to respond with a slightly different take on the safety of our food safety system as a whole.

Over the last several years—in fact, beginning with the infamous Dole baby spinach outbreak in September 2006—fully 90% of the people we, at Marler Clark, have represented have been victims of severe E. coli O157:H7 infections, sometimes resulting in hemolytic uremic syndrome. And aside from approximately 100 spinach victims, close to 95% of these folks were sickened by contaminated ground beef. This may be nothing more than a real world application of non-scientific fact. Whatever the case, it sure doesn’t jibe well with Dr. Glass’s optimism about our food safety system, as a whole, or ground beef more specifically.

Certain sectors expressed sentiments similar to Dr. Glass’s as recently as the beginning of 2007, touting that the incidence of E. coli O157 in meat had plummeted since the 1990s, dropping nearly 80%. The rate of actual illnesses in people, it was said, was also way down. It appeared, by both statistics and the profiles of our clients, that the meat industry had indeed cleaned up its act—that big beef finally would put Bill Marler and his firm in Seattle out of business.

If the first several years of this millennium showed progress by the beef industry, 2007, 2008, and 2009 are years that it would rather forget. Beef companies recalled over twenty-nine million pounds of meat in 2007. 2008 saw at least sixteen recalls of beef products, totaling at least 2,361,295 pounds of meat. And to date in 2009, beef companies have recalled close to one million pounds of product, including the recent recall of 825,000 pounds due to possible Salmonella contamination. True enough, these are just bare numbers—courtesy of the USDA website—but a simple contrast with the first five or six years of this millennium is illustrative. Progress? Optimism? I don’t see it.

Ultimately, these numbers may serve Dr. Glass’s points directly: more recalls may mean more testing, but it does not necessarily mean more illness. To that, all we can really say is that, well, we’ve sure as heck seen a lot more sick people in the last three years than we did the six previous ones. Indeed, there are more than a few families that I can think of around the country who would be shocked—probably even dismayed—to learn that our “food-safety system is working, even though the number of recalls is rising.”

Let me make a different assessment; perhaps it will be a better platform from which to build a national, and international, food-safety system that’s more in keeping with what consumers expect: no, we are not making good enough progress; and no, I don’t agree that the increased number of food recalls (ground beef in particular) is just because of better testing, and more surveillance within the public health community. Take it for what you will, but we have represented more victims of foodborne disease in the last three years alone that we did in the entirety of this firm’s first decade of existence. 

Campylobacter: the King of Foodborne Disease in the US

It is a wonder that Campylobacter doesn't get more attention as a public health scourge.  It has long ruled the international kingdom of diarrhea as the most prevalent foodborne disease worldwide--the United States too--yet the average person walking down the street has probably never heard of it.  Nonetheless, Campylobacter continues to cause more illnesses than any of its bacterial brethren. 

Campylobacter, like E. coli, is a family of bacteria; and there are multiple strains of it that can make you sick.  Campylobacter jejuni is the most common.  The illnesses that Campylobacter infections cause are called Campylobacteriosis.  The CDC receives about 10,000 reports a year, but it is estimated that between two and four million people are infected annually.  The effects of Campylobacteriosis, like pretty much any foodborne pathogen, can run the gamut from several days of "flu-like" symptoms to, in extreme cases, death.  CDC monitoring shows that approximately 124 people die every year from Campylobacteriosis.  Moreover, recent studies have shown that infection by certain bacteria, including Campylobacter, significantly increases a victim's risk of developing ongoing, or permanent gastrointestinal problems, including post-infectious Irritable Bowel Syndrome, or even Irritable Bowel Disease (including Crohns).  Finally, It is conservatively estimated that Campylobacteriosis illnesses cost $1 billion annually for medical care, lost wages, and other productivity losses.

Food is, of course, the most common vehicle for the spread of Campylobacter, and chicken is the most common food implicated.  But an important fact to understand is that, even in chickens, Campylobacter is not a muscle-born bug--i.e. the bacteria lives in the intestines of chicken.  Thus, contamination of chicken meat results, ultimately, from contact with chicken feces. 

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Botulism: Equal Parts Public Health Scourge and Cosmetic Miracle?

It may surprise some people to learn that the often-lethal toxins produced by the Clostridium botulinum bacteria, which cause botulism illnesses, are a chief ingredient in certain cosmetic/medical products.  In fact, the FDA recently updated its safety warnings about medical products that contain botulism toxins.  The FDA advisory concerns four drugs specifically: Botox, Botox Cosmetic, Myobloc, and Dysport.  The safety warning states, in part, as follows: 

The boxed warning cautions that the effects of the botulinum toxin may spread from the area of injection to other areas of the body, causing symptoms similar to those of botulism. Those symptoms include potentially life-threatening swallowing and breathing difficulties and even death.

These symptoms have mostly been reported in children with cerebral palsy being treated with botulinum toxin for muscle spasticity, a use of the drugs that has not been approved by FDA. Symptoms have also been reported in adults treated both for approved and unapproved uses.

***

No definitive serious adverse event reports of distant spread of toxin effect have been associated with dermatologic use of Botox/Botox Cosmetic at the recommended doses (for frown lines between the eyebrows or severe underarm sweating). As well, no definitive serious adverse event reports of distant spread of toxin effect have been associated with Botox when used at approved doses for eyelid twitches or for crossed eyes.

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Marler Op-ed - Open Letter to an Under Secretary for Food Safety - FSIS - The End of E. coli Conservatism

In April 2007, Rick Perlstein penned a piece entitled “E. coli Conservatism.” His bottom line was the “Conservatism has been killing Americans. The recent food safety crisis is only one case study.” Perhaps he is in part right. However, whatever the political reasons for the “food safety crisis,” it has been long in coming and the system needs to be fixed.

E. coli is a powerful and deadly bacterium. You cannot see it, taste it, or smell it. 250,000 E. coli bacteria will fit on the head of a pin. Ten to 50 will kill your child or your grandmother. Most 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, liver and pancreas. Falling into a coma and suffering further from cognitive impairment are all too common.

I have seen the inside of too many of those Intensive Care Units with families who are scared senseless as they watch their child or mother shutdown. For 16 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.

Although, the presence of some E. coli in hamburger 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% between 2002 and 2006.

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. Forty-four million pounds of beef have been recalled in 25 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?

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Seattle Voices with Bill Marler - Interview with Food Poisoning Lawyer

Bill Marler is a national expert on foodborne illness. He has been deeply involved in issues related to food companies whose contaminated products have caused serious injury and death. His advocacy for better food regulation and his work as a lawyer has led to invitations to address local, national, and international gatherings on food safety, including recent testimony to the U.S. Congress' Committee on Energy and Commerce.  Click on below to view interview:

Op-ed - William D. Marler, Esquire - Speech Before the House of Lords - How one Peanut Company caused $1.5 Billion in Losses?

The recall of Salmonella-tainted peanuts and peanut products processed and produced by the Peanut Corporation of America has caused one of the largest food recalls in US history; almost 4000 products made by hundreds of companies have been withdrawn, and the number is still growing. The 700 culture-confirmed cases of Salmonella indicate a much higher number of unreported illnesses – the actual number is probably close to 25,000. At least nine lost their lives. Beyond this terrible human toll, the financial toll on businesses and the American food supply has been staggering.

How did it happen? How did a single peanut processor in rural Georgia cost the American economy over a billion dollars? The two factories run by PCA only processed 2.5% of the annual US peanut crop, but their actions had huge repercussions. The investigations into the actions of the Peanut Corporation of America have revealed that PCA repeatedly retested product until a clean sample was obtained, shipped product that they knew was contaminated, and did not act on recommendations from the FDA to clean up their act.

It’s too easy to point to the company as a “bad actor” - an isolated case. There was a similar widespread outbreak of Salmonella in peanut butter two years earlier, centered not 75 miles from the Georgia plant. Unbelievably, this did not appear to affect how PCA ran its business, or how they were inspected or regulated so it can - and may - happen again.

Let’s start with the human toll, which is what I know best. My firm represents over 100 people who were sickened by the Salmonella and two families who lost a family member to it. One of our clients, Clifford Tousignant, won three purple hearts in the Korean War, but lost his life to peanut butter. Another family’s three-year-old son got sicker and sicker as his pediatrician allowed him his favorite food during his illness - the peanut butter crackers that later turned out to be the source of his infection. Hundreds of families spent time and money in emergency rooms and Intensive care units as their family members struggled with their illnesses. Although no one can put a price tag on human suffering and loss, these claims will probably settle in the range of 30-35 million dollars. That’s serious money, but most of it will be covered by insurance. Those settlements will be, well, peanuts, compared to the other costs surrounding the nationwide recall.

Recalling tainted food is the right thing to do – for legal and ethical reasons as well as basic public relations. But recalls come with astounding costs. One of my good friends in the food-processing industry estimates that the peanut recall will cost well over $500 million. It’s impossible to assign precise numbers, but you can start with the costs of tracking down, retrieving and transporting millions of items, most of which have already found their way onto retail shelves and kitchen cabinets. Kellogg, just one of the companies that recalled products recently, has estimated those costs at $75 million – for just one company.

Then there are the lost sales – not just of the tainted products themselves, but also of related peanut products that may be completely safe. The tomato-Salmonella recall last year resulted in $100 million in lost tomato sales – even though the real culprit proved to be peppers. In 2006, E. coli-tainted spinach cost that industry over $175 million - even though the outbreak was linked to just one fifty-acre farm in California. Peanut sales already have plummeted by more than 25 percent. Demand is down and peanut fields are lying fallow. The peanut industry estimates the loss is over one billion dollars in lost production and sales.

Let’s not forget the costs of advertising and public relations aimed at restoring consumer confidence. We have already seen expensive newspaper ads from peanut butter-makers, reassuring readers that their product is safe. What about the cost of restoring tainted brands?

Those in the chain of distribution are feeling the effects as well. Suppliers may or may not have to reimburse retail stores for lost sales. Large retailers like Wal-Mart include such reimbursement in their contracts; small businesses probably don’t do that, but suppliers may reimburse them anyway. And, then there are the losses to stock prices. One major food processor lost $1 billion in stock value following an E. coli outbreak. Imagine what’s happening to peanut stocks these days.

The Big Guys – the Kelloggs and ConAgras and Jack-in-the-Boxes – can sustain those losses. Not so the smaller retailers. My heart goes out to mom-and-pop businesses like Betsy Sanders of Santa Clara, California whose small business supplies cookies for local Parent Teacher Association and marching band fundraisers, and who now has to reimburse her customers for recalled products that contained peanut butter from PCA.

Is anyone keeping track of the math? Let’s call it $1.5 billion - just because of the actions of one small player in the peanut industry. The likely costs of compensating their sickened customers are a tiny part of that number; virtually none of the rest of that $1.5 billion will be covered by insurance. In an economy already battered by failing banks, lost jobs and scarce credit, people will be driven out of business. And, it was preventable.

As I was preparing this speech, the Food and Drug Administration announced that President Obama’s 2010 proposed budget included an increase of almost 20% for the FDA, including almost $260 million for better food safety. That sounds like big money, but if it can prevent a single billion-dollar recall and prevent citizens from being sickened, it’s a step in the right direction. However, there are a few other things that I would suggest.

First, be honest with the American Public. With 76,000,000 foodborne illness cases yearly, 325,000 hospitalizations and 5,000 deaths, our food supply might be safer than some – but it is not safe enough.

Second, put food safety on the “front burner” and turn up the heat. It is time that we commit to the American Public to get animal feces out of our food. How to do it - Here are my “top ten” ideas to combat this recurring epidemic:

- 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.
- 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.
- 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.
- We need to 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 in the US. We don’t need to impose the death penalty, as China did recently. But, 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.
- We need to promote university research to develop better technologies to make food safe and for testing foods for contamination.
- We need to provide tax breaks for companies that push food safety research and employee training.
- And, we need to improve consumer understanding of the risks of foodborne illness.

Last year I testified before the US Congress and laid out the above 11 points. I told them the time has come to act and not continue simply to react. Consumers, Farmers, Suppliers, Manufacturers, Retailers, Regulators and Politicians need to work together to make our food supply safe, profitable and sustainable. When a quarter of our population is sickened yearly by contaminated food, when thousands die, we do not have the “safest food supply in the world.” We should, must, and can do better.

Wrong but not Illegal? How Comforting.

I wrote on this site previously about the decision of the Missouri Department of Natural Resources not to release information about dangerously high levels of E. coli in the Lake of the Ozarks until after a busy tourist weekend.

Good reporting by the Kansas City Star brought the issue to light, and the Missouri Attorney General opened an investigation.   According to the Star, the AG report is out now.    Karen Dillon and Chad Day report:

A Missouri agency made a mistake but broke no laws when it didn’t release Lake of the Ozarks water quality data for weeks, according to an investigation released Thursday.

Attorney General Chris Koster said Missouri Department of Natural Resources employees did not violate the state’s Sunshine Law when they failed to release data that showed dangerously high levels of E. coli, a bacteria, earlier this summer.

The response to the AG's toothless reaction has not been supportive:

Open records advocates and environmentalist were quick to criticize the report Thursday.

“It raises the question of whether you can violate the Sunshine Law at all,” said Charles Davis, executive director of the National Freedom of Information Coalition and an associate professor at the Missouri School of Journalism.

“We are getting a little too technical when we are splitting hairs about whether something in a request says ‘Sunshine request,’ ” Davis said. “It’s not like it needs a magic sticker on top of it.”

Ken Midkiff, chairman of the Missouri Clean Water Campaign, who filed the open records complaint with the attorney general’s office, said he was “extremely disappointed” in the report’s conclusions.

“It now appears that the AG’s office conducted the investigation in a shabby manner and in a partisan snow job fashion,” Midkiff said in a press release.

The issue really isn't a "sunshine law" or freedom of information issue, though.  Whatever regulations govern the DNR with respect to E. coli testing ought simply to require immediate public disclosure when levels are high.  It doesn't matter how or when reporters asked for the information - the DNR should be actively educating the public on the results.    Why are they even testing if they aren't going to alert the public when there is a problem?   

Canadian Health Officials Warn of Salmonella in Green Onions

The Canadian Press is reporting that the Canadian Food Inspection Agency has issued a salmonella warning about green onions sold at six stores in the Windsor-Essex area of southwestern Ontario.

The report states:

The agency is warning people not to eat the jumbo green onions imported by Vitale Produce of Windsor, because they could be contaminated with salmonella.

The onions were sold at Food Basics in downtown Windsor, Isaac's Foodtown in Comber, Sanford and Son in Harrow, The Stoney Point Supermarket, and Westside Foods and Vitale Produce in Windsor.

To this point, no illnesses have been reported.   Green onions have been connected to outbreaks in the past, including the notorious Hepatitis-A outbreak at a Chi-Chi's restaurant in the Pittsburgh area in 2003.

McDonald's Is Responsible for the Illinois Hepatitis-A Outbreak

As the number of Hepatitis A illnesses in and around Milan, Illinois climbs, media coverage has been focusing on the alleged failure of a local hospital to report the initial case to the health department. That criticism may be well deserved.   From both a legal and policy standpoint though, the McDonald’s restaurant and those that operated it are responsible for the outbreak.

First of all, the first employee of McDonalds who tested positive for Hepatitis A, whose positive test was apparently not timely reported, has stated that she notified McDonalds of her illness, but was allowed to, or told to, keep working. If she was not allowed to return to work, this outbreak is avoided. 

Second, even an infected worker is unlikely to spread illness if proper hygiene practices are followed. For example, it was discovered that a worker at a Houlihan’s restaurant in Geneva, Illinois had worked while sick with Hepatitis A in January of 2007.   Ultimately, though, no additional illnesses were reported as a result.   Likely, this was a combination of good hygiene at the restaurant, and a little good luck. Thus, even with a sick worker on site, illnesses are not automatic - and good hygiene can reduce or eliminate those illnesses.

Third, McDonalds could have ensured that none of its workers ever got Hepatitis A in the first place.   Marler Clark has been calling on restaurants, especially those with a workforce the size of Mc’Donald’s, to vaccinate employees against Hepatitis-A for years.   Had this simple recommendation been followed, the hospital never even gets the chance to drop the ball on reporting – because the worker never falls ill. 

Finally, the applicable legal standard for the sale of food must be remembered.   When McDonald’s sells food to a member of the public, it effectively makes a legal promise that the food is safe for its intended purpose – you know, eating it. If eating that food either makes you ill, or forces you to take medical action to avoid falling ill (a shot), then that promise has been broken. Under legal doctrines like strict liability, breach of warranty, and negligence, McDonald’s is liable for the results of the consumption of its food – no matter what.

Focusing attention on the proper reporting of foodborne and communicable illness is a good thing – but let’s not lose the forest for the trees.

McDonald's Hepatitis A Case Count Rises to 30

The Quad City Times reports today that the number of Hepatitis-A cases related to the Milan, Illinois McDonald's has risen to 30 individuals.  The article states:

The Illinois Department of Public Health and the Rock Island County Health Department reported the total number of cases, saying they are all related to people who visited a McDonald's restaurant at 400 W. 1st St., Milan, Ill., this summer.

In addition to these illnesses, more than 5000 were required to receive vaccinations after being exposed to Hepatitis A at the restaurant.   

Rock Island County Sheriff Slams Healthcare Providers for Dropping Ball on Hepatitis A

The Rock Island County Sheriff's Department has released a report stating that Trinity Regional Health System failed to properly notify county health officials of the first of at least 26 Hepatitis A illnesses related to the outbreak at the Milan McDonald's.  The outbreak also required over 5,000 McDonald's patrons to obtain shots to avoid falling ill.  The Quad City times reported on the statements of County Board Chairman Jim Bohnsack: 

"Trinity dropped the ball," Bohnsack said during a news conference Monday at the County Board conference room in Rock Island.

"I'm confident that Trinity will step up and do what's right," he said. Bohnsack added that he hopes the hospital system will reimburse the county for some of the estimated $159,000 spent to help contain the outbreak. The disease was traced to a McDonald's restaurant in Milan, Ill., where some employees who handled food were diagnosed with hepatitis A.

For their part, Trinity did not seem to have much of an explanation for the failure:

Kathleen Cunningham, Trinity's vice president of hospital operations, said later Monday that there are many people responsible for reporting diseases such as hepatitis. She added that the hospital system has made internal changes to its reporting system since the problem came to light and is in a continuing dialogue with Rock Island County officials.

"Our joint aim is to look at this whole process and find opportunities for change," she said.

The illness was first recognized in testing done at Metropolitan Medical Laboratory on June 17, and should have been reported on that day.   Trinity allegedly notified the County on June 26, but used an "incorrect" report form.  The County did not become aware of the report until July 13, when "a staffer in the county health department returned from vacation."

Trinity's apparent failure in this instance underscores the importance of the reporting of communicable diseases.   When labs and hospitals follow regulations and make timely reports of foodborne illness and communicable disease, it allows health apartments to take the steps necessary to reduce or eliminate the threat to the public.  Without that information, health agencies' ability to protect the public is restrained.

So, why is E. coli O157:H7 considered an adulterant, but other shiga-toxin E. coli not? Why is Salmonella not considered an adulterant, even when the Salmonella is antibiotic-resistant Salmonella Newport?

William D. Marler - Op-ed

Personally, as I said to the Los Angeles Times a few days ago, “I think that anything that can poison or kill a person should be listed as an adulterant” [in food].

According to the CDC, E. coli O157:H7 is the source of an estimated 73,000 illnesses, 2,000 hospitalizations, and 60 deaths in the United States every year. Correctly so, USDA/FSIS has considered this nasty pathogen an adulterant on and in beef (at least hamburger) since 1994.
However, despite causing serious injury and death, other shiga-toxin producing E. coli, such as E. coli O111 and E. coli O21:H19 have not been considered an adulterant by the USDA/FSIS. In fact, we have found pathogenic E. coli in retail hamburger in private lab tests. So, we know it is there and USDA/FSIS does too. Ignoring this makes no sense.

Ignoring Salmonella in meat also makes little, if any, sense. Even after a Court’s twisted opinion in Supreme Beef v. USDA, where it found Salmonella to be “not an adulterant per se, meaning its presence does not require the USDA to refuse to stamp such meat 'inspected and passed," our government’s failure to confront the reality of Salmonella, especially, antibiotic-resistant Salmonella, is inexcusable. See, www.foodpoisonjournal.com for a bit(e) of history. The Wisconsin Supreme Court in Kriefall v Excel called it as it saw it:

“The E. coli strain that killed Brianna and made the others sick is a “deleterious substance which may render [meat] injurious to health.” There is no dispute about this. Thus, under the first part of 21 U.S.C. § 601(m)(1), meat that either “bears or contains” E. coli O157:H7 (the “deleterious substance”) is “adulterated.” That E. coli O157:H7 contamination can be rendered non-“injurious to health” by cooking thoroughly, as discussed below, does not negate this; Congress used the phrase “may render,” not “in every circumstance renders.” Moreover, if the E. coli bacteria is not considered to be “an added substance,” because it comes from some of the animals themselves and is not either applied or supplied during the slaughtering process (although we do not decide this), it cannot be said that the E. coli strain “does not ordinarily render [the meat on or in which it appears] injurious to health.” Accordingly, meat contaminated by E. coli O157:H7 is also “adulterated” under the second part of § 601(m)(1)."

Now, why would Salmonella be different?

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Devastation of E. coli O157:H7 "Across the Pond" as Well

BBC news is reporting that a 32 year old woman who suffered an E. coli O157:H7 infection is "improving."  Still, her current condition is testimony to the level of risk associated with the bacteria.  The woman's mother provided this update:

"They have lightened the sedation and are hoping to bring her off the ventilator.  She's now able to nod and shake her head but I don't think she's fully aware of what's happened to her.  She's off the dialysis now but she may need further dialysis in future. The doctors say it's two steps forward, one step backwards."

The 32 year-old woman has an 11 week old son, and is one of four people connected to the outbreak according to Wales health officials.

The investigation is focusing on a "chip shop," the Llay Fish Bar in Wrexham, Wales.

Milford, Massachusetts Under Boil Order, Tap Water Positive for E. coli

Residents of Milford, Massachusetts are under a boil order after two tests of tap water showed high levels of fecal matter, with one of the tests returning positive for E. coli.   E. coli is the term for a family of fecal bacteria that includes E. coli O157:H7.  WCVB-TV in Boston reported the following on its website:

Two out of eight water samples that were taken during routine testing on Wednesday contained high levels of fecal matter, according to Milford Water Co. manager Henry Papuga, and one of the two tested positive for E. coli. The Department of Environmental Protection put the boil water order in place on Sunday morning.

Health officials said boiled or bottled water should be used for drinking, brushing teeth, washing dishes, food preparation and making ice.

The town is using a "REVERSE-911® " call to notify town residents.  Restaurants have been instructed to use bottled water, and the town is making bottled water available to residents.  Milford Water is the private company that provides the town's water, according to the Milford daily news

Strict Liability and Food Safety

 Dr. Douglas Powell, associate food safety professor at Kansas State University, posted yesterday on www.barfblog.com about the recent announcement by the Dept of Ag and the FDA regarding their plans to increase testing of beef trim for E. coli O157:H7 (why are other shiga-toxin producing strains of E. coli not per se adulterants?) and to strengthen safety protocols for fresh fruits and vegetables.  Dr. Powell notes that "Fresh fruits and vegetables are one of, if not the most, significant sources of foodborne illness today in the U.S. – and it’s been that way for over a decade."  We're obviously talking about important stuff.

But, Dr. Powell raised another issue that, being a lawyer, I think is important.  In discussing the rather lax approach to food safety issues taken by producers of fresh fruits and vegetables (i.e. those consumed without a "kill step," meaning, for present purposes, without being cooked), Dr. Powell states:

I looked at the 2009 CSGs and the 1998 FDA guidance document – and I can’t see much of a difference in the on-farm stuf. Maybe I’m slow on the uptake; maybe guidelines are meaningless without implementation and verification; maybe growers keep asking for government babysitters so when the next outbreak happens, they can say, but we followed FDA guidelines (good luck with that).

(Notably, the parenthetical is in the original)

This is a mouthful, but an important one.  Perhaps the most important key to change, speaking broadly, is to recognize that there's really no alternative to it.  (1) It is a shocking financial drain for all of us, food companies included (to the combined tune of about $3,000,000,000 to $7,000,000,000 annually); (2) it causes unimaginable suffering (for a case in point, see the story of John McDonald); and (3) in legal terms, they are liable for injuries caused in an outbreak even if they were following FDA guidelines

As you can see, it's the parenthetical in Dr. Powell's statement that got me thinking . . . and writing.  Now he may be speaking in a more regulatory sense, but he has very simply, even if off-handedly, summed up the law of strict liability, or liability without regard to fault.  In practice, this means that a food producer will be liable for injuries that occur to consumers during an outbreak without regard to whether the producer was following the FDA guidelines.  

Having spoken to thousands of people across the country in the food industry and in public health, I know that this concept sounds offensive to some people.  But when you pause for a moment to think where the safety of our food supply might be without the media attention recent outbreaks have gotten, and without lawsuits that put the immense costs of illnesses and medical treatment squarely back in the food producer's hands, the concept begins to seem a little less grim.  Grim or not though, the law of strict liability is the law of the land.  

That said, I will offer a short anecdote that may help lessen the sting of strict liability laws to food producers.  Maybe not.  In any event, we handled a Salmonella outbreak in Georgia years ago linked to a national chain restaurant.  Around thirty people were sick, and the public health investigation never identified the precise route by which the Salmonella bacteria got into, or onto, the food (though there was a clear candidate in a piece of equipment that looked like it was last washed in the 90's).  At the deposition of the lead public health investigator in the outbreak, the defense attorney was trying to make hay of the fact that the precise vector of contamination was never found--the argument being that the plaintiffs, as a result, could not prove that the defendant did anything wrong.  "BS," or something to that effect, was the response given by this seasoned public health official.  "There's always a breakdown somewhere."  

After years now of doing this, I would agree.  The law of strict liability certainly aids the plaintiff in a food-contamination lawsuit, but I can't remember the last time we were involved in a case where I thought, at the end, "I really don't know if we could have proved a negligence case."  "There's always a breakdown somewhere."  

Increased Short and Long-Term Risk of Inflammatory Bowel Disease After Salmonella or Campylobacter Gastroenteritis

Kim O. Gradel, Hans L. Nielsen, Henrik C. Schønheyder, Tove Ejlertsen, Brian Kristensen, Henrik Nielsen, Received 12 December 2008; accepted 2 April 2009. published online 09 April 2009. Gastroenterology August 2009 (Vol. 137, Issue 2, Pages 415-418)

Background

Various commensal enteric and potentially pathogenic bacteria may be involved in the pathogenesis of inflammatory bowel diseases (IBD). We compared the risk of IBD between a cohort of patients with documented Salmonella or Campylobacter gastroenteritis and an age- and gender-matched control group from the same population in Denmark.

Methods

We identified 13,324 patients with Salmonella/Campylobacter gastroenteritis from laboratory registries in North Jutland and Aarhus counties, Denmark, from 1991 through 2003, and 26,648 unexposed controls from the same counties. Of these, 176 exposed patients with IBD before the infection, their 352 unexposed controls, and 80 unexposed individuals with IBD before the Salmonella/Campylobacter infection were excluded. The final study cohort of 13,148 exposed and 26,216 unexposed individuals were followed for up to 15 years (mean, 7.5 years).

Results

A first-time diagnosis of IBD was reported in 107 exposed (1.2%) and 73 unexposed individuals (0.5%). By age, gender, and comorbidity adjusted Cox proportional hazards regression analysis, the hazard ratio (95% confidence interval) for IBD was 2.9 (2.2–3.9) for the whole period and 1.9 (1.4–2.6) if the first year after the Salmonella/Campylobacter infection was excluded. The increased risk in exposed subjects was observed throughout the 15-year observation period. The increased risk was similar for Salmonella (n = 6463) and Campylobacter (n = 6685) and for a first-time diagnosis of Crohn's disease (n = 47) and ulcerative colitis (n = 133).

Conclusions

In our population-based cohort study with complete follow-up, an increased risk of IBD was demonstrated in individuals notified in laboratory registries with an episode of Salmonella/Campylobacter gastroenteritis.

Foodpoisoning Cases: the good and the ugly

Over the past decade, Marler Clark has recovered hundreds of millions of dollars for people grievously injured, or even killed, as a result of foodpoisoning.  And not a penny of what these people--the worst of the worst illnesses--recovered was undeserved.  

But our legal system certainly is not immune to unfortunate scenarios.  We're not too far removed--nor could we ever be--from an incident that got several late-night TV hosts lots of laughs.  And all at the expense of a lowly one inch piece of finger—uncooked—“found” in a bowl of Wendy’s chili. Claims and counterclaims have flown, but most indications point to, at best, a grotesque hoax, and perhaps more appropriately, an illegal act.

That some people see fit to bring such bogus, unsupportable claims of foodborne illness, much less expend the time and effort necessary to conjure such a ridiculous ploy, is unfortunate not only for those directly involved, but also for the people, often the very young and the very old, who really have been injured by dangerous foodborne pathogens. As a law firm that has represented thousands of people legitimately sickened or killed by pathogenic foodborne bacteria and viruses, we are uniquely situated to see and comprehend the backlash that cases like the “finger-in-my-chili” case has had. It has done nothing but drain precious resources, erode faith in our civil justice system, and waste everyone’s time; and perhaps most importantly, baseless claims like these divert health officials’ and company Food Safety Directors’ time and attention from the truly important—i.e. food-safety concerns—to the truly absurd. 

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Law School 101: the wireless paper chase

I was trying to find a parking spot in our overcrowded garage yesterday when I got an abject lesson in what certain folks think us lawyers do. I was behind an elderly lady who was going far too slow for my tastes. Nevertheless, rounding a corner in the garage, this woman broke suddenly to allow a roughly 30-year-old woman, who was walking, to get out of the middle of the driving lane. After getting out of the way, the younger woman yelled back to the elderly woman in front of me: "YOU WANT A LAWSUIT? YOU WANT A LAWSUIT?"

Honestly, I had to smile at how little this younger woman seemed to know about her rights and the other lady's potential liabilities. Who knows what a jury would have said about the liability issues, or sorted out the issue of comparative fault, but the young woman certainly seemed to think that she had the case as good as won.

This strange little vignette of Americana got me thinking. We do a lot of public speaking to health agencies about their potential liability for negligent inspections; we also represent lots of people who are foodpoisoning victims; but how much does the average person actually know about liability, much less liability in food cases? So at the risk of boring people stiff, I thought i'd take some time to explain the law we face in our "tort" cases.

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Ohio Officials Investigating Possible Link Between Day-Care Center and Shigella Illnesses

Two children in Zanesville, Ohio that both attend the same daycare have tested positive for Shigella.  The Zanesville Times Recorder reports:

Health officials are investigating a shigella outbreak after two children who attend Rufus Putnam Daycare tested positive for the infectious disease. One is a 2-year-old girl and the other is a 3-year-old girl.

"We've had two positive cultures of Shigella bacteria. Both are children at a day-care center. There are 79 children at the center so we got concerned," said Vicki Whitacre, medical director of the health department.

Approximately 15 people connected to the daycare have had a diarrheal illness, and all are being tested by health officials.  Shigella is a bacterium that belongs to a small group of pathogens (including E. coli O157:H7 and Cryptosporidium) that can infect the gut after the ingestion of relatively few organisms, and can cause sudden and severe diarrhea (gastroenteritis) in humans.

Colorado Health Officials Identify Wal-Mart as One Retailer of Recalled Cilantro

The FDA announced several days ago that Frontera Produce of Texas was recalling cilantro due to potential contamination with Salmonella.  Neither the FDA nor Frontera, however, provided the identities of the retailers where the cilantro in question had been sold.  Thankfully, state health officials in Colorado have identifed a set of Wal-Mart stores that are implicated, according to the Colorado AP.    It appears that Frontera has also now confirmed that the cilantro was sold at Wal-Mart stores in the Alamosa, Trinidad, La Junta, Cortez, and Durango areas.   Further:

State health official say people who bought the cilantro between July 20 and July 27 should check their refrigerators and toss it or return it.

The product's lot number is 118122. The cilantro bunches have a white twist tie with pink lettering spelling the word 'cilantro' and the UPC number 033383801049.

Interestingly, Wal-Mart previously claimed that Frontera was the supplier of jalapeno peppers to the Cortez, Colorado Wal-Mart that later tested positive for Salmonella Saint Paul in connection with a 2008 outbreak that sickened over 1,000 indiviudals.    

Foodborne Hepatitis and Catastrophic Liver Failure

 The recent hepatitis A outbreak at a McDonalds in Milan, Illinois, has claimed at least 26 victims, and has caused the local health departments to innoculate 5,366 people, hopefully catching these folks in the modest window of time to prevent an infected person from becoming ill.  This raises a number of questions that we plan to find answers to.  

First, at what cost does this innoculation program come to the affected counties?  Not good timing, likely, considering the budgeting woes around the country.  Second, how many people are "out of the woods"--i.e., people who were infected at McDonalds, but who received their innoculations in time to prevent the onset of symptoms.  And finally, perhaps most importantly, what is the real human toll of this outbreak.  

As is the case with an illness caused by any bacteria or virus, colloquially called "food poisoning," many people pass off even hepatitis A as some diarrhea, some vomiting, maybe a little jaundice too, and the victim recovers.  True for some, but those would be the lucky ones . . . the exceptions to the rule.  More typically, hepatitis A causes weeks, if not months, of symptoms.  Ask anybody who has been unlucky enough to fall victim.  The fatigue is debilitating.  The illness (vomiting, nausea, etc.) is sometimes so extreme for so long that people miss enough work to lose their jobs.  And the jaundice that typically signifies that "youre on the mend" sometimes causes such embarrasment that victims won't go out in public.  

But that's just the "typical" hepatitis A illness.  We have represented many people who have had not-so-typical illnesses.  Here is a brief medical synopsis of how the virus can cause catastrophic liver failure (fulminant hepatitis), requiring liver transplantation for survival, or potentially causing death.

Fulminant hepatitis kills nearly 100 people each year in the United States. Among reported cases for all ages, the fatality rate is approximately 0.3%. This figure, however, increases with age. For sufferers of fulminant hepatitis over 40 years old, the fatality rate is approximately 2%.  

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Pork Skins recalled from Salinas manufacturer

 Much has been said, and some would say done, about the problem of contaminated food, primarily lettuce and other leafy greens, coming out of the Salinas Valley, CA.  It is estimated that the 2006 spinach outbreak cost the leafy greens industry over 175 million, to say nothing of the hundreds sickened, and five dead, as a result of the outbreak.

Here is a potential contamination problem of a different stripe:  pork skins.  According to the USDA, who currently presides over the manufacture of meat, poultry, and egg products (FDA oversees other foods), Camacho's Food Processing has recalled fried pork skins because they were produced without the benefit of federal inspection.  

The recall includes approximately 1,450 pounds of ready-to-eat fried pork skins contained in 10-pound bags from "Camacho's Foods PS., URUAPAN, CHICHARRONES, (FRYED PORK SKIN)," according to the Department of Agriculture.  The products were produced between June 16 and July 29 and were repackaged for sale to consumers and distributed to retail stores in California.  There are currently no reports of illness.  

Frontera Produce Recalls Cilantro Due to Possible Salmonella Contamination

Frontera Produce, of Texas, is recalling a lot of cilantro that may be contaminated with Salmonella, according to The Packer.    Frontera is not, however, releasing  to the public the names of the retailers that received the recalled lot.  According to the story:

Frontera identified the lot as 118122, and said it was distributed to two retail chains that have stores in Texas, Oklahoma, Colorado, Louisiana and New Mexico.  Frontera did not identify the retailers.

Frontera said it has advised both supermarket chains of the situation and provided each with case tag identification.

Consumers are advised to destroy the cilantro which could have been purchased between July 20-27.

The cilantro bunches have a white twist tie with pink lettering spelling the word ‘Cilantro’ and the Universal Product Code number 033383801049. 

If Frontera is honestly trying to have consumers heed the recall, they need to provide the names of the retailers.   And FDA should be requiring the information to be public as well. 

Frontera was previously named as a defendant in litigation following last summers Salmonella Saint Paul outbreak.   In that case, the plaintiffs' left-over jalapeno peppers, purchased at Wal-Mart, tested positive for Salmonella Saint Paul.   Wal-Mart disclosed that the peppers in question were distributed by Frontera.

Fireside Coffee Co. Recalls Tea Products Over Salmonella Fears

The FDA announced today that a Michigan company is recalling several flavors of tea due to possible contamination with Salmonella.  The report states:

Fireside Coffee Co., which is based in Swartz Creek [Michigan], is recalling vanilla, decaf vanilla, chocolate and spiced chai, because their ingredients include dry milk produced by Plainview Milk Products after June 2007, the U.S. Food and Drug Administration announced today. Because of possible salmonella, the Plainview, Minn., manufacturer is recalling its instant non-fat dry milk.

At this time, no illnesses have been directly linked to the tea-products.  The FDA press release further states:

Salmonella is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.

The FDA release includes the full list of recalled lot numbers.

Kidney Trafficking Case Highlights Difficulties Facing HUS Survivors

The news media has been full of reports concerning the arrests of more than 40 people folllowing  a corruption investigation in New Jersey.  Among the more startling aspects of the story are the allegations that those arrested were involved in the trafficking of human kidneys.   An op-ed by Sally Satel in yesterday's Wall Street Journal, provided an interesting take on the story.  Satel argued that the extreme lack of available kidneys for those on transplant lists make this type of black market all but inevitable.  She wrote:

When I needed a kidney several years ago and had no donor in sight, I would have considered doing business with someone like Mr. Rosenbaum. The current law—the National Organ Transplant Act of 1984—gave me little choice. I would be a felon if I compensated a donor who was willing to spare me years of life-draining dialysis and premature death.

The illicit organ trade is booming across the globe. It will only recede when the critical shortage of organs for transplants disappears. The best way to make that happen is to give legitimate incentives to people who might be willing to donate. Instead, I fear that Congress will merely raise the penalties for underground organ sales without simultaneously establishing a legal mechanism to incentivize donors.

Satel concludes by arguing that any new legislation to crack down on organ trafficking should include incentives to increase the availability of organs for transplant recipients.

The point here is not to join the policy debate on organ donor regulation, but rather to recognize the depth of the risks faced by HUS survivors.  HUS is a somewhat rare, but devastating complication of E. coli O157:H7 infection.  Renal failure is a primary element of the acute stage of HUS.   Most of those who develop HUS recover renal function, at least temporarily.   Many, however, are left with permanent damage that can eventually necessitate placement on the long transplant lists that Satel describes.

Missouri DNR Hides Evidence of High E. coli Levels in Lake of the Ozarks

Scott Dye, program director for The National Sierra Club Water Sentinels Program was spot on today when he said “DNR stands for Do Not Release.”  The State of Missouri’s Department of Natural Resources decided not to release evidence of excessive E. coli levels in the Lake of the Ozarks in an ill-conceived and dangerous attempt to protect local revenues.

Karen Dillon, reporter for the Kansas City Star has been following the story. She writes:

The Kansas City Star reported last week that DNR withheld the report that showed almost three dozen water samples taken around the lake after Memorial Day weekend exceeded state standards. DNR did not release the report until June 26 even though the agency had received several requests.

Top DNR officials told The Star they withheld the report because of concerns over the impact on tourism and over creating a public panic.

Now, Missouri State Senator Brad Lager was calling for a thorough review of DNR’s actions. The Attorney General has also launched an investigation.   The review is important “to ensure public safety and for a healthy vibrant tourism industry,” Lager said in a statement.

Governor Jay Nixon has stated the DNR was wrong not to release the report.

E. coli is the name for a broad family of bacteria that includes E. coli O157:H7, and other shiga-toxin producing strains of the bacteria. Ordinary E. coli testing does not differentiate between strains.   Regardless of the strain or strains involved, excessive levels of E. coli pose a threat to human health.

FDA Announces Recall of Infant "Teethers" Due to Bacteria

The FDA announced today that Luv N' Care Ltd. of Monroe,  Louisiana is voluntarily recalling gel-filled "teethers" nationwide due to concerns that the gel may be contaminated with bacteria.  According to the FDA, the gel was found to contain "bacillus subtilis and Bacillus circulans bacteria."   The recalled brands are:  "Nuby," "Cottontails," and "Playshcool."

The FDA says that: 

these bacteria generally do not cause illness in adults, infants and children with weakened immune systems can experience stomach pain, vomiting, diarrhea, and uncommonly more serious disease, if the teether becomes punctured and they ingest the liquid gel.

Here is a list of the recalled items by UPC:

UPC code       Brand Name 
48526-00451   Nuby
48526-00452   Nuby
48526-00453   Nuby
48526-00454   Nuby
48526-00455   Nuby
48526-00459   Nuby
48526-00467   Nuby
48526-00472   Nuby
48526-00473   Nuby
48526-00482   Nuby
48526-00483   Nuby
48526-00487   Nuby
48526-00490   Nuby
48526-00519   Nuby
48526-00521   Nuby
41520-87115   Cottontails
50428-91511   Playschool
41520-91660   Cottontails

Is the Convenience of Bagged Spinach and Lettuce Worth the E. coli Bacteria Risk and Damage to the Environment?

A battle for the soul of agriculture is being waged in California in a new sort of green revolution -- and counter-revolution.  Jackson West

"If we want to have bagged spinach and lettuce available 24/7, 12 months of the year, it comes with costs," lawyer Bill Marler told the San Francisco Chronicle.

Marler would know -- he represented the plaintiffs that came forward after an E. coli outbreak from fresh spinach grown in California made customers sick in 2006.

But he's not talking about legal fees and court settlements. Instead, it comes in the form of environmental degradation as industrial farming attempts to fix the problems it has created.

Distributors are forcing farmers to implement guidelines that are fueled by consumer fears, not farm science.

For instance, sterile zones demanded around crops mean more rodents, which means more rodent poison, which kills the predatory birds which naturally control the rodent population.

Of course, the deadly and drug-resistant strain of E. coli that these measures are trying to prevent was created by the heavy use of antibiotics in feedlots.

"You have to think about what's the logical end point of looking at food this way," noted author Michael Pollan, who has criticized industrial agriculture in his last two books. "It's food grown indoors hydroponically."

There is some good news for greener farming. "In 16 years of handling nearly every major food-borne illness outbreak in America, I can tell you I've never had a case where it's been linked to a farmers' market," Marler added.

General Mills Recalls "Nut Clusters" on Salmonella Fears

Another day, another product pulled over Salmonella fears.   Minnpost.com is reporting that General Mills has recalled "some" of its Nature Valley Granola Nut Clusters products due to concerns over potentially contaminated pecans.  The recall includes products with the following "best if used by dates": 07MAR2010, 08MAR2010, 09MAR2010, 10MAR2010, 11MAR2010.

General Mills says in its press release: "This action is being taken as a precaution because pecans received from a supplier and used in the product may be tainted with salmonella."

Sure would be nice to know which supplier, and whether or not this supplier has any other customers beyond General Mills.  Are there more products and recalls to follow?  Is there a regulatory agency involved?

Two "Health" Products Recalled Over Salmonella Fears

This is no way to get healthy, and certainly much too dangerous of a way to lose weight.  The number of recalls related to Salmonella grew again today with the addition of two new products - "Stealth" brand powdered dietary supplement and "Weigh Down" chocolate flavor nutrition drink.  The two recalls, according to the Associated Press:   

  • Vital Pharmaceuticals Inc. is recalling 17 lots of Stealth Chocolate and Stealth Vanilla powdered dietary supplement. The supplements were available nationwide. Details: by phone at 800-954-7904.

Lewis Laboratories International Ltd. is recalling select lots of Weigh Down chocolate flavor nutrition drink mix. The recalled product has one distributor in New York and was sold online and through mail order. Details: by phone at 800-243-6020.

Thankfully, no illnesses have yet been linked to the product.

An Iowa Child hospitalized with HUS: Is JBS to Blame?

KSFY in Sioux Falls, South Dakota, reports that a one-year-old boy from Sioux Center, Iowa is currently hospitalized with hemolytic uremic syndrome at a Sioux Falls area hospital.  There are no reported "confirmed" cases in the JBS outbreak from Iowa . . . Yet.  But these outbreaks tend to evolve.  After all, we're talking about a product that many people buy and simply throw into their freezers until they're ready to consume it.  That means that these products can last months.  All the more reason for concerted public health efforts to spread the word about developing outbreaks and assist retailers in getting recalled products off their shelves . . . and out of consumers houses.

We've seen hundreds of kids in Isaiah Romero's exact medical circumstances.   I hope to see a news report soon saying that his illness was not as bad as it could have been.  Too many have gone the other way over the last few years.  In the meantime, we'll keep moving in discovery against JBS Swift in the New Mexico case that we filed yesterday (filed in Colorado). 

North Dakota Salmonella Outrbeak Traced to Unlicensed Caterer

According to the Jamestown Sun, health officials in Maclean County, North Dakota have linked an outbreak of Salmonella illnesses to an unlicensed caterer.  Aggie Jennings, who ran the catering company, has been ordered by health department officials to cease operations.   Patrons of three separate events catered by Jennings became ill last month.  According to the article:

State epidemiologist Kirby Kruger says shredded beef and pasta salad served by Jennings at a June 20 wedding have tested positive for salmonella. Taco meat from a June 13 wedding also tested positive for the salmonella strain.

Tests on the farm  found a strain of salmonella found in baby chickens. Jennings has chicks on her farm.

My guess is that  a licensed operation, inspected by trained health officials would have been less likely to have a problem.  

Wegmans Salmonella Anaheim Peppers Recalled - No Illnesses Yet Reported

Batch/UPC Code: Anaheim peppers sold since June 11, 2009.

Reason for Recall: Wegmans has removed fresh Anaheim peppers from its Produce departments due to the possibility of salmonella contamination. The FDA is currently investigating the situation.

If you still have Anaheim peppers, please throw them away. Do not return them to the store. You may go to the service desk for information on receiving a refund.

An E. coli free 4th of July

There are a few key elements to having a good 4th of July.  First, don't shoot off your fireworks by hand.  Second, illegal fireworks are fun, but they're illegal for a reason, so see #1 if you're planning to light any M 1000's.  Third, watch the Seattle fireworks from our offices, where you can simultaneously see the shows at the Space Needle, Lake Union, and maybe even Bill's house (Marler, not Gates, though Gates has been known to put on quite a show too)  Finally, and far more importantly than the size or amount of fireworks you light, grill safely.

Sounds easy, right?  Well, it may be, but you can't simply do things the way good ole dad used to do them, thinking "well, i never got sick, so none of my family will either."  Famous last words.

Take the advice of the CDC.  These are important steps to prevent the transmission of foodborne disease . . . to you and your family.  But these steps are stated so plainly as to almost, not quite, but almost lack significance when read by the casual consumer.  

Hopefully, digesting a few additional details will encourage even the casual consumer that these CDC steps to preventing foodborne disease this 4th of July are not some empty mantra.  First, consider the size and lethality of the several known STEC serotypes, including the infamous E. coli O157:H7.  "So small that a million would fit on the head of a pin."  And it is estimated that 15 to 100 individual bacteria are enough to kill you.  The point?  Don't take the issue of cross-contamination (which the CDC strangely addresses with only the example of a plate holding raw hamburgers) lightly.  Have utensils, serving pieces, in fact entire countertops or cutting boards that you use only for raw products; and have another set entirely for cooked products.  Keep in mind that it's not always bacteria on the inside of the burger that kills.

My only other "detail" before wishing you a safe 4th of July is to consider that good ole dad's methods for checking "doneness" need to be trashed along with the contaminated celophane wrap that your ground beef came in.  Color (whether its grey or pink) is not always a reliable indicator of doneness, so you should never rely on it.  What does it take, an extra 15 seconds to go get the meat thermometer and check for internal doneness (160 degrees F)?  You're not doing anything else on the 4th, so you might as well spend it making sure that your kids don't lose their kidneys.  And along with discarding the notion that color is reliable, the manufacturers instructions on pre-formed beef patties shouldn't be relied on exclusively either.  Marler Clark sponsored a very important study

How to Safely Cook a Burger (NOT according to the USDA)

   Yesterday, the USDA Food Safety and Inspection Service issued a largely useless, but still widely published, news release entitled “Independence Day: Drills for the Grill.” See News Release, www.fsis.usda.gov/News_&_Events/NR_062909_01/index.asp While notable for a cheery and reassuring tone, the information provided is, at best, unhelpful, and, at worst, is dangerously misleading. In addition to providing little in the way of substantive food safety information about how to “safely” grill a burger, the FSIS news release deceitfully soft-pedals the real risks posed by ground beef, generally, and outdoor grilling in particular. For example, the new release clumps together hamburgers, steak, chicken, hot dogs, and ribs as if all can be treated in the same way, and pose the same relative risk—which is blatantly false. And also, how can anyone at FSIS expect to educate the public about safely grilling ground beef (the real risk here) without once mentioning E. coli O157:H7, the primary risk?

  Take, for example, the introductory quote from FSIS Administrator, Alfred V. Almanza, who states: “Safe food handling is always important, but during the warm summer months — peak grilling season — there is an increased need for awareness of safe food handling practices.” Well, Mr. Almanza, why is that? Could it be because numerous research studies have shown that the incidence of E. coli O157:H7 in cattle rises significantly during the spring, and peaks during the summer months? See, e.g., Edrington, et al, 2006. Seasonal shedding of Escherichia coli O157:H7 in ruminants: a new hypothesis. Foodborne Pathog Dis 3:413-21; Hancock, et al., 1994. The prevalence of Escherichia coli O157.H7 in dairy and beef cattle in Washington State. Epidemiol Infect 113:199-207; Hancock, et al., 1997. A longitudinal study of Escherichia coli O157 in fourteen cattle herds. Epidemiol Infect 118:193-5; and Hussein, et al., 2005. Prevalence of Shiga toxin-producing Escherichia coli in beef cattle. J Food Prot 68:2224-41.  Why not level with the public and tell them that ground beef simply tends to be more dangerous in the summer, and that is when a higher than average percentage of E. coli O157:H7 infections occur?  Of course, that might make the USDA look bad, and could further depress the sales of ground beef.

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July 4th BBQ? Don't Cook to Color, Use A Thermometer for All Ground Beef

As we head into the holiday weekend, we are In the midst of another outbreak of E. coli O157:H7 related to ground beef. Remarkably, despite the prevalence of outbreaks and the severity of the risks involved, the proper messages on handling and preparing ground beef can still prove elusive.

I googled "e coli" this morning. One of the first sites up is this one, called FamilyDoctor.org. In two locations on its fact page on E. coli O157:H7 it suggests that the proper way to achieve or ascertain the safety of ground beef is to check color. (I don't mean to single these folks out, I think the message is common elsewhere, as well.) Here is the relevant text:

How can I catch E. coli infection?

Most E. coli infections come from:

•      Eating undercooked ground beef (the inside is pink

And, later on:

How can I keep from getting E. coli infection?

You can help prevent this infection by handling and cooking meat in a safe way. For your protection, follow these rules:

• Cook ground beef until you see no pink anywhere.

The problem is, we learned long ago that color is not a reliable indicator when it comes to ridding ground beef of E. coli O157:H7. Let’s get the better answer from the folks at Washington State University Extension, at their E. coli O157:H7 fact sheet site:

How Can I Safely Prepare Beef?

• Always cook ground beef patties to an internal temperature of 160ºF. When a ground beef patty is cooked to 160ºF throughout, it will be safe and tasty, regardless of color. Color is not a reliable indicator. Use an accurate instant-read thermometer inserted horizontally into the center of the burger. Ground beef is a perishable product. Use or freeze within one or two days of purchase.

So, this weekend, if you break out the grill and ground beef patties, use a thermometer, and not an unreliable visual inspection, to make sure you and yours stay healthy.

Minnesota Company Recalls Milk Products Over Salmonella Fears

The FDA announced a recall of milk products on its website yesterday:

Plainview Milk Products Cooperative, Plainview, Minn., is voluntarily recalling instant nonfat dried milk, whey protein, fruit stabilizers, and gums (thickening agents) that it has manufactured over the past two years, because they might be contaminated with Salmonella.

Fortunately, no illnesses have yet been linked to the recall.   The recall was initiated when the FDA inspected the Plainview facility and "found that some of the equipment was contaminated with Salmonella."  The FDA was inspecting the plant as a result of testing done by the USDA that found Salmonella in a company product not intended for retail sale.

Hopefully, the recall was announced in time to avoid human illness.   The sequence of events is an excellent example of why companies shouldn't be fighting tooth and nail against increased inspection and testing.   If the USDA and the FDA had not uncovered both contaminated product and equipment, it would have been much more likely that ongoing contamination of product, and therefore human illness would have eventually resulted. This recall can only rightly be viewed as the less expensive outcome for both the company, and consumers.

William Marler Opinion - Who Poisoned Our Cookies With E. coli?

What if the cookie dough E. coli outbreak actually happened this way?

At 10:00 PM last night between yet another story about Michael Jackson’s death, a foreign Network begin airing a video taken inside a manufacturing facility showing someone treating a batch of cookie dough with an unknown liquid. There is a claim that this is a terrorist act.

In the next 15 minutes, every network news operation is playing the video. The broadcast networks break into regular programming to air it, and the cable news stations go nonstop with the video while talking heads dissect it. Michael Jackson fades into the distance.

Coming on a Friday evening on the East Coast, the food terrorism story catches the mainstream Media completely off guard. Other than to say the video is being analyzed by CIA experts, and is presumed to be authentic, there isn’t much coming out of the government.

Far-fetched? Don’t count on it. I have been saying for years that a foodborne illness outbreak will look just like the terrorist act described above, but without the video on FOX News. Far-fetched?

Tell that to the 751 people in Wasco County, Oregon—including 45 who required hospital stays---who in 1984 ate at any one of ten salad bars in town and were poisoned with Salmonella by followers of Bhagwan Shree Rajneesh. The goal was to make people who were not followers of the cult too sick to vote in county elections.

Tell that to Chile, where in 1989, a shipment of grapes bound for the United States was found laced with cyanide, bringing trade suspension that cost the South American country $200 million. It was very much like a 1970s plot by Palestinian terrorists to inject Israel’s Jaffa oranges with mercury.

Tell that to the 111 people, including 40 children, sickened in May 2003 when a Michigan supermarket employee intentionally tainted 200 pounds of ground beef with an insecticide containing nicotine.

Tell that to Mr. Litvenenko, the Russian spy poisoned in the UK with polonium-laced food.

Tell that to Stanford University researchers who modeled a nightmare scenario where a mere 4 grams of botulinum toxin dropped into a milk production facility could cause serious illness and even death to 400,000 people in the United States.

The reason I bring this up is not to mark another anniversary of 9/11, not because I actually think that food terrorism really is the cause of this week’s E. coli cookie dough outbreak, but I wonder if it would have made any difference in our government’s ability to figure out there was an outbreak, to figure out the cause, and to stop it before it sickened so many.

After 9/11, Health & Human Services Secretary Tommy G. Thompson said: “Public health is a national security issue. It must be treated as such. Therefore, we must not only make sure we can respond to a crisis, but we must make sure that we are secure in defending our stockpiles, our institutions and our products.”

Before Thompson’s early exit from the Bush Administration, he did get published the “Risk Assessment for Food Terrorism and Other Food Safety Concerns.” That document, now 5-years old, let the American public know that there is a “high likelihood” of food terrorism. It said the “possible agents for food terrorism” are:

• Biological and chemical agents
• Naturally occurring, antibiotic-resistant, and genetically engineered substances
• Deadly agents and those tending to cause gastrointestinal discomfort
• Highly infectious agents and those that are not communicable
• Substances readily available to any individual and those more difficult to acquire, and
• Agents that must be weaponized and those accessible in a use able form.

After 9/11, Secretary Thompson said more inspectors and more traceability are keys to our food defense and safety. To date, we’ve made little movement to ensure this.

Would the fact of terrorists operating from inside a manufacturing facility somewhere inside the United States bring more or effective resources to the search for the source of the E. coli? If credit-taking terrorists were putting poison on our cookies, could we be certain Uncle Sam’s response would have been more robust or effective then if it was just a “regular” food illness outbreak?

Absolutely not! The CDC publicly admits that it manages to count and track only one of every forty foodborne illness victims, and that its inspectors miss key evidence as outbreaks begin. The FDA is on record as referring to themselves as overburdened, underfunded, understaffed, and in possession of no real power to make a difference during recalls, because even Class 1 recalls are “voluntary.” If you are a food manufacturer, packer, or distributor, you are more likely to be hit by lightening than be inspected by the FDA. You are perfectly free to continue to sell and distribute your poisoned product, whether it has been poisoned accidentally or intentionally.

The reality is that the cookie dough E. coli outbreak is a brutal object lesson in the significant gaps in our ability to track and protect our food supply. We are ill prepared for a crisis, regardless of who poisons us.

Somewhere between the farm and your table, our Uncle Sam got lost.

Bill Marler is husband, father of three daughters and a trial lawyer.

William Marler Opinion - E. coli O157:H7 is a deadly bacterium - How to Fight Back!

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, just last week – on Father’s Day – I met with yet another family grieving over the loss of a child to Hemolytic Uremic Syndrome (HUS). 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 16 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. Forty-five million pounds of beef would be recalled in 25 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 2009 left. Summer has always been kind to the E. coli bug. More than 5.6 million pounds of E. coli contaminated beef was recalled 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.  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.

* 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.

So, call, email and write your congressmen and senators and tell them to do something.

Bill Marler is husband, father of three daughters and a trial lawyer.

William Marler Opinion - Sellers of E. coli - Stop Blaming the Victims

“It was not the failure of the cookie dough manufacturer for not keeping cattle feces (E. coli) out of cookie dough that sickened the child, it is the fault of the parent who allowed the child to eat the dough.”

I have received several calls and emails like the above over the last few days as the country has been ensnared once again in a nationwide recall – this time cookie dough – that has sickened at least 69 in 30 States – mostly people (girls) under the age of 18.

At first I calmly tried to respond that a company that makes a profit off of selling a product that it knows is eaten raw can not blame the consumer if the product actually contains a pathogen that can severely sicken or kill a child. The reality is that cookie manufacturers know that they sell a product that is eaten raw.

From the Minneapolis Star-Tribune – “Long known to satisfy a certain longing of the brokenhearted and the children-at-heart, the dough is nearly as popular raw as it is baked. There are more than 40 cookie dough groups on Facebook -- one with more than 1.3 million members -- complete with photos and postings that read like love notes.”

From the Washington Post – “Nestle’s cookie dough is packaged with labels warning consumers not to eat it raw. But people tend to disregard the warning -- 39 percent of consumers eat raw cookie dough, according to Consumer Reports. It has become such a popular snack that many ice cream makers have developed a cookie dough flavor.”

So, the reply to my calm response has been, “the consumer should know that cookie dough may contain bacteria and they are told to cook it.”

My calmness has now faded. Think about the little labels on cookie dough that you buy in the store – the ones that tell you “cook before eating” – wink, wink. However, the labels do not say:

“THE FDA INSPECTION MEANS NOTHING. THIS PRODUCT MAY CONTAIN A PATHOGENIC BACTERIA THAT CAN SEVERELY SICKEN OR KILL YOU AND/OR YOUR CHILD. HANDLE THIS PRODUCT WITH EXTREME CARE.”

I wonder why the Cookie Industry would not want a label like that on your tub of dough. It knows that the label is truthful. Do you think it might be concerned that Moms and Dads would stop buying it? The day the Cookie Industry puts a similar label on the label is the day that I will go work for them. The reality is that the Cookie Industry and the FDA has not yet been able to assure the public that the dough we buy is not contaminated. So, instead of finding a way to get cattle feces out of our cookie dough, they blame parents when children get sick.

Consumers can always do better. However, study after study shows that, despite the CDC estimated 76 million people getting sick every year from food borne illnesses, the American public still has misconceptions and overconfidence in our Nation’s food supply.

According to a study by the Partnership for Food Safety Education, fewer than half of the respondents knew that fresh vegetables and fruits could contain harmful bacteria, and only 25% thought that eggs and dairy products could be contaminated. Most consumers believe that food safety hazards can be seen or smelled. Only 25% of consumers surveyed knew that cooking temperatures were critical to food safety, and even fewer knew that foods should be refrigerated promptly after cooking. Consumers do not expect that things that you cannot see in your food can kill you.

Consumers are being blamed, but most lack the knowledge or tools to properly protect themselves and their children. The FDA has stated, “unlike other pathogens, E. coli O157:H7 has no margin for error. It takes only a microscopic amount to cause serious illness or even death.”

Many consumers wrongly believe the Government is protecting the food supply. How many times have we heard our Government officials spout, “The US food supply is the safest in the world.”

Where is the multi-million dollar ad campaign to convince us of the dangers of uncooked cookie dough, like we do for tobacco? Most consumers learn about food safety from TV and family members – If your TV viewing habits and family are like mine, these are highly suspect sources of good information.

The industry that makes a lot of dough off of selling dough must step up and clean up their mess. They can, and someday will, if I have anything to say about it. That day will come much faster if they start working on it now, and stop blaming the victims.

Bill Marler is husband, father of three daughters and a trial lawyer.

Looking at Leftovers - Lack of Contaminated Product is Not an Alibi

We are in the midst of another sprouts recall.    Sprouts from Kowalke Organics from Culver City, California are being pulled from shelves over potential contamination with Salmonella.    According to the LA Times:  "Mike Matthews, Kowalke’s owner, told the Associated Press that only one package -- with the sell-by date of June 21 -- tested positive for salmonella, so far."   There is not yet confirmation of illness associated with this latest recall.  Still, Mr. Matthews comment brings up again how misleading statements like this can be.

A perfect example is last summer's E. coli O157:H7 outbreak traced to lettuce.  Health officials gathered overwhelming  epidemiological evidence to implicate the product.   The producer, though, kept crowing to the press about how none of the lettuce tested from its plant tested positive.  Of course, health officials were forced to point out that the product tested was CURRENT PRODUCT, i.e. the product in the plant at the time the outbreak was recognized.   Thank goodness there wasn't STILL contaminated product on hand.  The product actually implicated in the outbreak was long gone, and could not be tested.

In outbreaks involving perishable items, such as produce, finding product produced and packaged at a time that coincides with product implicated in an outbreak is very unusual.  Think about this very plausible, but hypothetical, time line.   Produce goes out, lets say lettuce, processed on July 1.   It hits the shelves on July 5.   On July 7 its purchased, and then consumed two days later on July 9.  The incubation period for E. coli O157:H7 generally runs 2 days to a week.   So let's say the consumer has onset of symptoms on July 12.  By July 14, the consumer is sick enough to go to the doctor.  If we are lucky, a stool culture is ordered the first day of medical care.  Results return 48 hours later, and now it is July 16.   A good health department is notified of the illness, and interviews the consumer for a food history immediately.  It's now July 17.  Before health officials are testing product, there usually need to be multiple illnesses that suggest a product as a culprit.  Even assuming the best time line, it is probably nearly three weeks from processing to the opportunity to test product.  By then, product processed on July 1 has been consumed or discarded.

So, the next time you hear a produce supplier tell you that "none of our product has tested positive," bear this in mind.  Such proclamations are essentially worthless at best, and more likely misleading.

The Failures of Third-Party Food Safety Audits

If everyone who takes a test is getting an A, how hard can the test be?   This is the question that occurred to me yesterday watching a fine presentation by Dr. Paul A. Hall, Ph.D.  Dr. Hall was the speaker who presented immediately before I did at the Almond Board of California's 13th Annual Food Quality and Safety Symposium.  Dr. Hall was addressing a question we have asked here many times- why have we seen a string of foodborne illness outbreaks from facilities supposedly subject to third party audits?  The recent Salmonella outbreak connected to PCA peanut products is a shining example.   

One answer? Auditors are not giving out bad marks.   Perhaps based on a desire to be hired again, auditors are handing out A's like candy on halloween.   Take a look at this chart from this study of food safety audits:  (the study was conducted in Europe)

Audit Company Score 90-100% Score 80-90% Score 70-80% Refuse certification
A 98.6 1.4 0 0
B 98.3 1.2 0.1 0.3
C 95.3 3.9 0.2 0.6
D 93.7 3.6 0 2.8
E 92.9 2.9 0 4.3
F 92.7 5.4 0.2 1.7
G 90.4 7.4 1.1 1.2
H 86.3 1.4 0 12.3
Average 93.5 5.0 0.5 1.0
         

There was an auditing company giving its highest rating to more than 98% of the time.  Overall, more than 93% of audits resulted in the highest rating.   If, as I suspect, results like this would also be found in the U.S., it would help explain why plants that have "superior" ratings are the source of food recalls.

For third-party audits to mean something, the possibility of negative feedback, and poor scores must exist.   Industry has to find a way to increae the independence and effectiveness of third-party audits.  Otherwise, they are a waste of time and money.

The chart is from "Checklist Governance,  Risk Oriented Audits to Improve the Quality of Certification Standards in the Food Sector"   F. Albersmeier, H. Shulze, A. Spiller, G. Jahn. (2009)

Another Opportunity to Talk Sprouts

In the midst of yet another sprouts recall (see Bill's recent blog-post), I received an email from a concerned sprout grower.  I will freely admit that I feel for the people, and the businesses, involved in the manfacture or sale of food products (intrinsically risky or not) who are not the immediate source of a recalled or contaminated product.  This person had the following to say about his/her company's sprout growing processes:

Alfalfa sprouts are healthy and contain a potload of vitamins. This re call involves a small grower with a few customers, here is the touchy part, you are recommending people do not eat them when there are many professional growers like ourselves who grow safe sprouts following the FDA Growing Guidelines.

We are inspected by the FDA, State and other persons. Accurate records are provided, kept and verified of the following, seed specifically grown for human consumption, handled properly, tested for salmonella and E Coli 0 157h7, then sanitized by the grower, rinsed and planted, after 48 hours, a sample of the irrigation water from all drums is tested for salmonella and E Coli 0157h7, with a Hold and Release Program, nothing gets delivered until we receive negative results.  Our sprouts are tested safe.  Now, why is there contaminated product out there from sprouters who are supposed to be following the same guidelines? Ask them.

At the risk of stating the obvious, my response to this particular grower is (1) keep up the good work because it will, hopefully, inure to the benefit of both yourself and your industry and (2) keep in mind that much good will, hopefully, soon come to sprout growers if they keep the perspective that this is an industry-wide issue/problem, not one that's confined to a bad apple or two.  With the multiple outbreaks or recalls that have happened just this year--to say nothing of the last decade--viewing this issue/problem as "somebody else's" will do no good.  It will only inhibit research and development and, as a result, keep Marler Clark in business.  

Ground beef is a case in point.  Bill Marler posted in December 2007 about the return of E. coli O157:H7.  See E. coli O157:H7--It's Back, with A Vengeance.   For present purposes, the important point is not that E. coli and ground beef have enjoyed an incredible resurgence; its that the industry managed to corral the contamination problem for many years prior to 2007.  This happened only because the industry recognized that E. coli O157 was an industry-wide problem, not one associated only with a few rogue grind operations. 

Hemolytic Uremic Syndrome (HUS) and E. coli O157:H7

We have already heard from several families whose children have developed hemolytic uremic syndrome (HUS) after contracting E. coli O157:H7 from Nestle cookie dough.  Most often, though we certainly see cases where the pathalogic process described below affects other organs, HUS affects the kidneys.  Here is a short explanation of what HUS is, and why it is so lethal. 

                                              

The toxins that are released by E. coli O157:H7 bacteria (called shiga-toxins) are so potent, in fact lethal, that the Department of Homeland Security lists it as a potential bioterrorist agent. (Although E. coli O157:H7 are responsible for the majority of cases in America, there are many additional shiga-toxin producing E. coli that can cause HUS. 

The chain of events leading to HUS begins with ingestion of E. coli 0157: H7 bacteria in contaminated food. These E. coli rapidly multiply in the intestines causing colitis (diarrhea), and tightly bind to cells that line the large intestine. This snug attachment facilitates absorption of the toxin into the circulation where it becomes attached to weak receptors on white blood cells (WBC) thus allowing the toxin to “ride piggyback” to the kidneys, or other organs, where it is transferred to numerous avid (strong) Gb3 receptors that grasp and hold on to the toxin. Organ injury is primarily a function of Gb3 receptor location and density. Receptors are probably heterogeneously distributed in the major body organs, and this may explain why some patients develop injury in other organs (e.g., brain, pancreas).

Once shiga-toxin attaches to receptors, it moves into the cell’s cytoplasm where it shuts down the cells’ protein machinery resulting in cellular injury and/or death. This cellular injury activates blood platelets and the coagulation cascade which results in the formation of clots in the very small vessels of the kidney resulting in acute kidney injury and failure. The red blood cells are hemolyized (destroyed) by shiga-toxins and/or damaged as they attempt to pass through partially obstructed microvessels. Blood platelets (required for normal blood clotting), are trapped in the tiny blood clots or are damaged and destroyed by the spleen.
 

First Lawsuit in E. coli Cookie Dough Outbreak Filed by Marler Clark

 

A young woman who was hospitalized for seven days after eating raw cookie dough made by Nestle USA filed suit today against the company in California Superior Court, San Mateo County. The lawsuit was filed on behalf of 18-year-old Jillian Collins by her attorneys, William Marler of the Seattle-based foodborne illness law firm Marler Clark and Terry O’ Reilly of the San Mateo firm O'Reilly Collins.

San Mateo resident Jillian Collins ate Nestle Toll House refrigerated cookie dough in late May, 2009. On May 26, she fell ill with painful abdominal cramps and diarrhea that soon turned bloody. Her symptoms worsened to the point where she sought urgent care. She was later admitted to the hospital, where tests revealed that she was infected with E. coli O157:H7. The genetic fingerprint of her test matched that of the outbreak strain which has infected 65 people in 29 states to date. 

This outbreak is an example of how virulent E. coli bacteria can be, and how many people can be affected when it enters the national food supply,” said Marler, who was traveling between food safety speeches. “Nestle USA is a company with a good food safety record, andupon learning of the CDC investigationthey worked very quickly to get a voluntary recall of the product started. But even that isn’t enough for those who were sickened in this outbreak. It points to how vigilant we need to be in our food safety regulation and oversight.”

The first announcement about the multi-state outbreak was made on Thursday, June 18 by the Colorado Department of Health and Environment (CDPHE), warning consumers about consuming the uncooked Nestle Toll House cookie dough product, and revealing that more than sixty were confirmed ill in 28 states. It wasn’t until late Friday, June 19 that the CDC released their outbreak information, which updated the totals to 65 ill in 29 states. 

“Nestle has stopped production at the Virginia facility that produced the cookie dough,” continued Marler. “Everyone I talk to is stumped by how a bacteria normally associated with cattle feces made its way into the facility, and then into such a highly processed product. We may not solve that mystery; what we can do is work to prevent this type of event from happening again.  The way to do that is better food safety surveillance – and that comes down to legislation and funding.” 

 

Nestle Blames Victims for E. coli O157:H7 Outbreak

With reports of 66 cases of E. coli O157:H7 across 28 states, Nestle has announced a recall of its Cookie Dough Products.  The illnesses include 25 hospitalizations, and 7 cases of hemolytic uremic syndrome (HUS).  HUS is a life-threatening complication of E. coli O157:H7 infection, that recently was reported as the cause of death in two young children in the U.S not appearing to be related to this outbreak.

On its website, Nestle apologizes, sort of, for the "inconvenience" it has caused.   Inconvenience?  Being late to work is inconvenient.   Fighting for your life on dialysis is something else. That "apology" doesn't come until after Nestle has taken the time for blaming the victims:  "Nestlé Toll House cookies made from refrigerated and frozen dough are perfectly safe for consumption when prepared according to the instructions on the label. These clearly state that the raw dough must be baked before consumption."

Here is the actual information on the label: 

Cookie Dough is Filled by Weight.   Use or Freeze by Date Indicated on the Package.  Cookie Dough Contains Raw Ingredients.  Bake Before Consuming.

None of this excuses Nestle from having a product on the shelves with E. coli O157:H7 in it.   As an initial matter, baking of the dough comes AFTER handling of the product, and therefore after exposure of the bakers (likely including families with children) to E. coli O157:H7.  More importantly, there are many products on the market right now, labeling themselves as cookie dough products, that are ready to eat, including ice cream, and breakfast pastries.  

 

This "Yahoo Answers" page, from before today's recall, shows a majority of respondents indicating that consuming raw cookie dough is just fine.   

 

All of this, and we are expected to believe that Nestle had no idea that people might be eating the dough raw?  And that Nestle was doing everything it could to discourage such a practice?

 

C'mon.

Food Safety Advocate William Marler to Address Trial Lawyers

 
MINNEAPOLIS (June 16, 2009) William Marler, food safety advocate and expert in foodborne illness litigation, will speak at the American College of Trial Lawyers (ACTL) conference in Minneapolis this week. Mr. Marler’s presentation on Contaminated Food Litigation will be 11:00 a.m., Friday, June 19 at the Minneapolis W- Foshay hotel at 821 Marquette Avenue.

“Like Minnesota’s proactive Health Department, litigation seeking fair compensation for victims of foodborne can be a crucial part in preventing the next outbreak,” said Marler from his office in Seattle. “Determining how an outbreak begins and holding businesses that poison their customers accountable are two incentives for companies to clean up. New regulations and inspections will prevent both outbreaks and lawsuits in the future. As I say to the food industry all the time ‘Make food safety a part of all you do and you will put me out of business.’”

Mr. Marler and his firm, Marler Clark, are involved in foodborne illness cases around the country and represent a number of Minnesotans who have become ill from eating contaminated food. Several Salmonella outbreaks have infected Minnesota residents, including ConAgra’s Banquet Pot Pies, Veggie Booty snacks, and food consumed at a Rochester Quiznos. In addition, the firm represents Minnesotans who have been infected with E. coli 0157:H7 in cases against Dole lettuce, Nebraska Beef, PM Beef Holdings, AFG/Supervalu, Cargill meat products, as well as Taco John’s and China Buffet restaurants.

Michigan Company Announces Recall of Cheese Due to Listeria Contamination

The FDA announced on June 13 that Torres Hillsdale Country Cheese of Reading, Michigan has recalled all lots of various types of soft Mexican-style cheeses due to potential Listeria contamination. 

According to the FDA:

Consumption of food contaminated with Listeria monocytogenes can cause Listeriosis, an uncommon but potentially fatal disease.  Listeriosis can cause high fever, severe headache, neck stiffness and nausea.  Listeriosis can also cause miscarriages and stillbirths.  The very young, the pregnant, the elderly and persons with compromised immune systems are the most susceptible to infection.  People experiencing these problems should seek immediate medical attention.

The recall was announced after the FDA tested the firm’s “queso fresco” cheese, on May 26, and discovered to it to be contaminated with Listeria monocytogenes

The products were distributed to retails stores in Illinois, Indiana, Michigan, Georgia, Tennessee, Kentucky, North Carolina, South Carolina, Ohio and Wisconsin. 

CDC Releases Report on Cryptosporidium Outbreak at Splash Park

This week's MMWR includes a report by the CDC on an outbreak of cryptosporidiosis at a "splash park" in Idaho in 2007.  Cryptosporidiosis is the illness caused by the protozoan cryptosporidium.   According to the CDC:

Symptoms of cryptosporidiosis generally begin 2 to 10 days (average 7 days) after becoming infected with the parasite. The most common symptom of cryptosporidiosis is watery diarrhea. Other symptoms include: 

  • Stomach cramps or pain
  • Dehydration
  • Nausea
  • Vomiting
  • Fever
  • Weight Loss

 Symptoms usually last about 1 to 2 weeks (with a range of a few days to 4 or more weeks) in persons with healthy immune systems. Occasionally, people may experience a recurrence of symptoms after a brief period of recovery before the illness ends. Symptoms can come and go for up to 30 days.

The 2007 outbreak in Idaho occurred in August, and involved 5 laboratory confirmed and 45 probable cases of illness associated with exposure to a "splash park"  The report states that water samples from the splash park tested positive for cyrptosporidium.  Cryptosporidium is a chlorine resistant bacteria, and therefore, the CDC says, "splash park design, operation, access to hygiene facilities, and public education" are essential to outbreak prevention. 

Splash parks have a long history of association with cryptosporidium outbreaks.   Marler Clark currently represents plaintiffs in a class action lawsuit related to an outbreak in upstate New York in 2005.

Baltimore Police Seize Turtles Linked to Salmonella Risk

They may seem harmless and look cute, but juvenile turtles carry the risk of Salmonella transmission.  Recently, police in Baltimore seized dozens of tiny turtles from vendors who were selling the animals illegally.  The sale of turtles with shells under 4 inches in length has been illegal since 1975.   According to the CDC,

This size was chosen because small children are more likely to treat smaller turtles as toys and put them in their mouths. The ban by the U.S. Food and Drug Administration (FDA) has prevented an estimated 100,000 cases of salmonellosis each year in children. Despite this ban, such turtles are available from pet stores, flea markets, street vendors, and online stores.

The CDC has also issued a report  of a  2007-2008  outbreak of Salmonella linked to turtles. 

 

Food Poison Blog Takes on New Name

As readers of this blog know, a number of new authors have recently joined our contributor list.   With all the new posts, Food Poison Blog began to look less like a blog, and more like a journal of news and notes on Food Poisoning.  With that in mind, we have changed the title to  Food Poison Journal. 

 

Readers will be able to access the Journal by the new URL (www.foodpoisonjournal.com) or by the old URL (www.foodpoisonblog.com).  Subscribers will continue to receive updates by email or RSS, and do not need to take any steps to re-subscribe.

Thanks for your interest!

 

Listeria Recalls: Dark Chocolate Spread and Smoked Salmon

Chocolate

Le Pain Quotidien is recalling a limited number of 14.15-ounce jars of Le Pain Quotidien’s Noir Belgian Dark Chocolate Spread because it might contain milk not declared on the packaging. Those who have an allergy to milk run the risk of serious or life-threatening allergic reaction if they eat the product. The New York Company said there has been one reported allergic reaction to date.

The product was sold at all Le Pain Quotidien restaurants in New York, Connecticut, California, Virginia, Maryland and Washington, D.C. The product is packaged in a glass jar. It has the lot code 9015 and UPC 5 425018 441174. The lid is labeled with production date "15.01.09" and expiration date "15.01.10."

Salmon

N.Y. Fish Inc. is recalling I (heart symbol) NY Fish brand Imperial-European style smoked salmon because it could be contaminated with Listeria monocytogenes, an organism, which can cause serious and sometimes-fatal infections in young children, frail or elderly people and others with weakened immune systems. The Brooklyn, N.Y., company said there have been no confirmed illnesses to date.

The product was distributed to wholesale distributors and retail food stores in New York, New Jersey, Pennsylvania, Massachusetts, Ohio, Indiana and Illinois. The recalled product is in vacuum packed 3-ounce, 8-ounce and 16-ounce packages as well as whole side "to be weighed at time of sale" sizes. The company is recalling all lots that begin with code 142.

USDA's Top Food Safety Post Remains Vacant; Is Vilsack Working Off A Candidate List Approved By Meat Industry? Bloggers Want To Know!

 Somebody has finally noticed.   In this case, the somebody is Tom Laskawy, a food and environment specialist, and what he has noticed is that President Obama has NOT yet nominated anybody as U.S. Department of Agriculture Undersecretary for Food Safety to run the Food Safety & Inspection Service (FSIS), the key federal agency for the integrity of meat, poultry and eggs produced by U.S. farmers and ranchers.

Apparently heading up the search for the President is USDA Secretary Thomas Vilsack, former governor of Iowa.   Congress Daily Friday reported:

President Obama has not nominated a USDA undersecretary for food safety because the administration has had a hard time finding a candidate who has not engaged in lobbying, Agriculture Secretary Tom Vilsack said Thursday.

Following testimony before the Senate Agriculture Appropriations Subcommittee on the fiscal 2010 budget, Vilsack said the administration wants to follow its rule "to make sure people haven't had lobbying experience" and is thoroughly vetting all candidates.

Lobbyists say it is hard for USDA to fully participate in congressional consideration of the food safety reform and modernization bill without an undersecretary in place. USDA handles food safety for meat, poultry and eggs and the undersecretary for food safety sets policy and handles international food safety issues.

But 48 hours earlier, Mr. Laskawy, writing on the independent Obama Foodorama blog, had raised the possibility that Secretary Vilsack is working on a short list of candidates for the vital safety post that are approved by the meat industry.  He wrote:

“It really does seem like Tom Vilsack can't find anyone to run the USDA's Food Safety and Inspection Service. You wouldn't think it would be that hard. There must be dozens of scientists and food safety experts who fit the bill. But this, of course, is the USDA we're talking about -- the poster child for regulatory capture, the phenomenon whereby a regulator acts almost entirely in the interests of its target industry rather than in the interests of the public.

“As a result, the head of the FSIS is typically a scientist or doctor with, if not direct ties to the food industry, then at least a career that puts him or her firmly in the industrial food mainstream. For example, the last two heads of FSIS have been Elsa Murano, a Texas A&M scientist who is now that institution's president and Richard Raymond who, before heading FSIS, was Nebraska's Chief Medical Officer and a senior official in its Health and Human Services department. While competent officials, these folks are not crusading reformers, which is just the way the food industry likes it.

“Indeed, the word is from within the USDA that, in the wake of the Swine Flu epidemic, USDA Chief Tom Vilsack wants to throw a bone to the livestock industry in particular with the FSIS appointment. Presumably, he's gotten a shortlist from Big Meat and has been working his way down it. The problem here isn't that they can't find a qualified candidate. The problem is that it appears the industry has embraced a particular brand of food safety, with irradiation and chemical treatment of processed meat at its core.”

Mr. Laskawy goes into much more detail, including offering his opinions on which candidates for FSIS chief would be acceptable to the meat industry and which ones would be unacceptable.  Check it all out here.

The Undersecretary for Food Safety in USDA is one of a handful of appointments that will shape Obama’s administration when it comes to protecting what consumers eat.   The other key spots, CDC Director and FDA Commissioner, are filled with savvy street-smart big city health experts, Dr. Thomas R. Frieden and Dr. Margaret Hamburg.   The FSIS vacancy, now going into it sixth month, sadly means the new administration might be less than 100 percent committed to food safety.

Baby Steps: USDA Implements Increase in E. coli O157:H7 Testing.

As I noted in an earlier post on a different blog about the USDA’s decision to, in a matter of speaking, take its head out of the sand and recognize that E. coli O157:H7 is a problem that starts (and someday will hopefully end) with the slaughter and dressing process, the agency is finally appearing to take a more reality-based (which is to say, less industry-biased) approach to ensuring food safety.  For the earlier post, see here:www.foodpoisonblog.com/2009/05/food-policy-regulation/usda-sees-the-light-on-e-coli-o157h7-and-meat/#comments

Specifically, the only way that meat gets contaminated is because insufficient care was taken during slaughter and feces or ingesta cross-contaminates the previously uncontaminated carcass. Knowledge that this cross-contamination is commonplace is what has given rise over the years to post-slaughter “interventions” like steam-pasteurization and organic acid washes. Put bluntly, there is no need to try to remove the poop on the meat if it does not end up there in the first place.

Since the Pathogen Reduction; HACCP Final Rule was issued in 1996, it has been the stated policy of the USDA that E. coli O157:H7 be reduced to an "undetectable level." This is the so-called zero-tolerance policy for this deadly pathogen, which is based on the irrefutable fact that if the “presence [of E. coli O157:H7] can be prevented, no amount of temperature abuse, mishandling, or undercooking can lead to foodborne illness.” See HACCP Final Rule, 62 Fed. Reg. at 38,962. Now, seemingly more intent at make zero-tolerance a reality, USDA yesterday issued notice that it was mandating an increase in the frequency of its in-plant testing for E. coli O157:H7 in raw ground beef. While this is an improvement, it is but a baby step, since the most frequent testing that will occur under this policy is 4 times per month, and this is only at plants that produce volumes of ground beef greater than 250,000 pounds PER DAY.


For more on this change in policy, please click on CONTINUE READING.
 

Continue Reading...

Committee Holding Public Hearing On "The Food Safety Enhancement Act Of 2009"

 The House Energy and Commerce Committee today is conducting a public hearing on the “discussion draft” of sweeping new food safety legislation.

Rep. Diana DeGette, D-Colorado, praised he “discussion draft” for including key elements of a bill she previously introduced; namely “traceability “ and mandatory recall authority.   “We need to fix this,” DeGette said. “We need to fix it now.”

Rep. Steven Buyer, R-Indiana, cautioned the committee about “unintended consequences” that may result from the biggest changes to food safety in at least 20 years.  He questioned why the “discussion draft” only addresses the Food & Drug Administration, and segments of the food safety system that lies outside the Committee’s jurisdiction.

Buyer suggested working with the Agriculture Committee on more comprehensive reforms.

As the morning continued, the Committee was taking opening statements from all members before hearing from FDA Commissioner Margaret Hamburg.

The  “discussion draft” of “the Food Safety Enhancement Act of 2009 is based on the food reforms contained in H.R. 759, the Food and Drug Administration Globalization Act of 2009, It was introduced by the Democratic leaders on the Committee who plan a “mark-up” and vote by August.

Use a thermometer to ensure proper temperatures are reached to prevent foodborne illness

I was pleasantly surprised when a friend of mine used a digital, tip-sensitive food thermometer to measure the temperature of the chicken he was preparing for our Memorial Day BBQ.  He even cooked the chicken to an internal temperature of 180°F, which exceeds the recommended 165 degree cooking temperature for chicken.  Despite this, the chicken we enjoyed was very well prepared - tasty, moist, well seasoned, and definitely safe. 

Anyone grilling this season could follow my friend's example and cook foods to 180 to ensure their safety, but in the interest of keeping burgers and other non-poultry items palatable, I have posted the USDA recommended cooking temperatures for a variety of meat products here: 

  • Beef, veal, and lamb steaks, roasts, and chops should be cooked to a minimum internal temperature of 145°F
  • Pork should reach 160°F
  • Ground beef, veal, and lamb should be cooked to 160°F
  • Poultry should be cooked to 165°F; although this temperature will assure that the meat is safe, it may not achieve a palatable texture and doneness (180°F is better for poultry in my opinion)

Remember that if meat, poultry, and other foods have been mishandled in the raw state, they may not be safe to eat even after proper cooking.  Foods left in the "danger zone" between 40°F and 140°F for extended periods of time could be unsafe before preparation.  USDA recommends refrigerating cooked or raw foods awaiting preparation before they've been out for 2 hours.  If food is sitting out at 90°F temperatures or higher, USDA recommends refrigerating after no more than one hour to ensure its safety. 

Color is not a good indicator of doneness.  Hamburgers that have reached 160°F sometimes are still pink, while hamburgers that have turned brown while cooking may not have reached a safe cooking temperature.  The only way to know whether foods have reached high enough cooking temperatures to kill pathogenic bacteria and viruses is to use a food thermometer. 

The hospitality Institute of Technology and Management is a great resource for anyone looking for information about food thermometers. 

Food Poisoning Triples Risk of Inflammatory Bowel Disease

We sometimes hear food poisoning dismissed (usually by those who are being blamed with causing it, not those suffering from it) as "just a little diarrhea."  Here is yet more evidence that such a characterization has no basis in reality.  Web MD is reporting today that Salmonella and Campylobacter infections triple the risk of Inflammatory Bowel Disease for at least 15 years.  Web MD is reporting the results of a study conducted by Henrik Nielsen, MD, of Denmark.

According to the report, Inflammatory Bowel Disease "typically refers to Chron's disease and ulcerative colitis."  Both of these disorders can cause chronic bloody diarrhea and abdominal pain. 

Carrot Producer Sues Sheep Farmer Over E. coli Concerns

Grimmway Enterprises, Inc., a carrot producer in Bakersfield, California is suing a neighboring sheep farmer afer the sheep entered Grimmway's property.  The sheep grazed on Grimmway crops, but more importantly, they did what sheep do - they defecated.  Out of resulting concern for possible E. coli O157:H7 contamination, Gimmway destroyed an alleged 75 acres of crops.

In a related story on,  Michele Jay-Russell of UC Davis' Western Institute for Food Safety and Security said the destruction of the crops made sense.  "It's a legitimate c oncern," she said.   Sheep, and other ruminants, such as cattle and goats, are known to harbor E. coli O157:H7.  An investigation of the massive 2006 E. coli O157:H7 outbreak in Dole spinach suggested that wildlife in the crop fields played in role in the outbreak.

Minnesota Star Tribune Editorial Highlights Need For Increased Foodborne Illness Surveilance

Echoing the praise in my blog post yesterday, a Minnesota Star Tribune editorial is praising Minnesota health officials and calling for more foodborne illness surveilance.  The editorial relates the story of one of the nine tragic and pointless deaths confirmed as resulting from the PCA Salmonella outbreak.   

As with many of the deaths and illnesses in the outbreak, the 72 year old woman described in the story was sickened well after many of the early cases in the outbreak had been reported.    A better funded, better prepared, and better integrated national foodborne illness surveilance program would have prevented many of  these deaths and illnesses.  It would also havesaved the industry hundreds of millions of dollars.  The editorial correctly concludes that " Lives will be saved if scientists across the nation can replicate Minnesota scientists' stellar ability to rapidly spot patterns in data, the key to detecting outbreaks and their sources. "

An E.coli O157:H7 Vaccine for Cattle - What's the Hold Up?

According to an article in Candian Cattlemen,  a Candadian firm, Bioniche Life Sciences,  has developed a vaccine that reduces colonization of cows by E. coli O157 bacteria and reduces the amount of the bacteria shed in cattle manure. One would think that reductions of this nature would in turn lead to less human expsoure to the potentially fatal pathogen.

Surprisingly though, the article states that those in the cattle industry "believe that they receive no immediate or direct benefit for spending money to vaccinate their herds against E. coli O157." 

Really?  No direct benefit from the removal of a fatal pathogen from the food you sell?  Talk about a short-sighted approach to business.  With the cattle industry's reluctance to use [i.e. pay for] such a vaccine on the farm, Bioniche is seeking support [i.e. money] from the Canadian government to implement the use of the vaccine.

If the vaccine really works, lets hope somene sees through to getting it in use, as we continue to see tragic news related to E. coli O157:H7 in hamburger.

Senator Klobuchar's Push for New Food Safety Legislation Highlights the Work of Minnesota Health Officials

Minnesota Senator Amy Klobuchar held a press conference today to announce new proposed leglisation to "promote a more rapid and effective national response to outbreaks of foodborne sickness." 

According to Klobuchar, the new act would, among other things:

  • Enhance the  Centers for Disease Control's  (CDC)  foodborne disease surveillance system.
  • Direct CDC to provide more support to state health agencies, including promoting "best practices" in food safety investigations.
  • Establish a “Food Safety Centers of Excellence.”

This last prong of the legislation owes its origins to Minnesota's own "Team D" [D for diarrhea].  Team D is a group of foodborne illness investigators from Minnesota agencies that have been previously praised here and elsewhere for being the first, and sometimes only, health officials to recognize foodborne illness outbreaks.    Among the outbreaks where Team D took the lead were the Salmonella Saintpaul outbreak in 2008, and the PCA Salmonella outbreak announced this February.

As for the content of the legislation, its good to see an emphasis on increased surveilance.   Of course, preventing illnesses in the first place is always the first choice.  Still, the overwhelming majority of foodborne illness in the U.S. goes unreported, and therefore un-investigated.  There are lessons to learn and improvements to make with every investigated outbreak.   Until we stop foodborne illness outbreaks altogether, we are best served to rezognize those that do occur, so that we can stop making the same mistakes over and over again.

Bill Aims To Return FDA To "The Gold Standard" In Protecting Public Health

The House Energy and Commerce Committee is out with a discussion draft of “the Food Safety Enhancement Act of 2009.”


Given who’s signed on to this one, it’s probably the one to watch.  Sponsors include Chair Emeritus John D. Dingell, Chairs Henry A. Waxman, Frank Pallone, and Bart Stupak, and Reps. Diana DeGette and Betty Sutton.


The new draft is based on the food reforms contained in H.R. 759, the Food and Drug Administration Globalization Act of 2009, introduced in January by Reps. Dingell, Stupak and Pallone. Favored bills get heard quickly, and this one gets its first hearing next week, on Wednesday, June 3rd.


"As evidenced by the recent widespread contaminations in our food supply, including E.coli in spinach, salmonella in peppers and the most recent outbreak of salmonella in peanut butter, it is clear that we must act now," said Rep. Pallone, Chair of the Health Subcommittee. "This draft builds on legislation introduced earlier this year and will empower the FDA with the resources and authorities it needs to ensure that our food is safe to eat. I look forward to continuing to work with my colleagues and the administration to move this crucial piece of legislation forward

"Our 10 food safety hearings in the Subcommittee on Oversight and Investigations have highlighted the need for an overhaul of our food safety laws," said Rep. Stupak, Chair of the Oversight and Investigations Subcommittee. "The American people deserve a Food and Drug Administration that has both the funding and the regulatory authority needed to protect our food supply and hold the food industry accountable. President Obama and the new FDA leadership have expressed a commitment to food safety reform and I look forward to working with them to return FDA to the gold standard in protecting the public health."

A detailed summary of the draft follows below.

 

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West Virginia Chooses Mercury Pollution Over Healthy Diets

West Virginia has recently increased the amount of allowable mercury pollution in the states lakes, rivers, and waterways.  West Virginia's new regulations are even less stringent than the minimal national standard.   As Seattle University School of Law Associate Professor Catherine O'Neill explains, this is a bad decision based on faulty logic. 

Polluted waterways are a problem, in part, because fish are such an important part of a healthy diet. In O'Neill's blog-post with the Center for Progressive Reform (CPR), she notes  a host of health benefits linked to fish:   "fish are an excellent source of protein, omega-3 fatty acids, and a host of other nutrients essential to human health....the American Heart Association recommends that adults eat two 6-ounce fish meals per week, in order to ensure cardiovascular health. The EPA and the Food and Drug Administration similarly recommend that pregnant and nursing women eat two 6-once fish meals per week, in order to ensure the healthy development of their babies."

Mercury pollution poses a serious threat to all this healthy eating.  According to O'Neill,  "Methylmercury (the form of mercury that bioaccumulates in fish) is a potent neurotoxin. Exposure to even very small amounts of methylmercury in utero or during childhood can lead to irreversible neurological damage."  

So, here is the worst part.  Why in the world would West Virginia allow an increase in this pollution?  Well, because people are eating less fish these days (according to them), so more pollution is less of a threat.  Why are people eating less fish?   Could it be because West Virginia is under a state-wide fish advisroy due to mercury poisoning that warns people against eating the fish caught there?

The circular and short-sighted thinking applied by West Virginia here boggles the mind.  O'Neill accurately argues that consumers, and child bearing age women in particular, should not have to choose between no fish and poison fish.   We all need healthy fish to remain an option.

Foodborne Illness is Just a Few Days of Diarrhea Right?

It never ceases to amaze me, particularly after the last few years and all the high-profile outbreaks that have occurred, that people still pass off "foodpoisoning" as a couple of days of diarrhea--i.e. that the victim is no worse for the wear.  There is so much that is wrong with this statement that it would be pointless to even begin assailing it with mere facts.  Instead, as I've done recently with Jacob Aggas, Kelly Cobb, and Regan Erickson, I'll tell the story of somebody who, after his Salmonella infection, would disagree wholeheartedly with the notion that "foodpoisoning" is just a couple days of diarrhea.  In fact, don't stop reading this just because you think you've seen, or heard about, every varient of a Salmonella illness.  I assure you that you've never seen one quite like this before. 

At the request of our former client, I have changed the names and locations in this narrative:

Our client, Ron, was infected with Salmonella during a sporting banquet in Indiana. His illness began on July 27, 2004. At first, he suffered from predominantly gastrointestinal symptoms that were, in light of what was to come, relatively mild.

By August 1, Ron was in the emergency room at a nearby hospital The attending physician there noted repetitive diarrhea and, though the vomiting had subsided, that Ron continued to feel “somewhat nauseous and gaggy.” Ron was re-hydrated with a liter of normal saline, and twenty-five milligrams of Phenergan, an anti-nausea medication, were introduced intravenously. He was discharged several hours later with a prescription for Ciprofloxacin, an antibiotic.

Ron’s course over the next two months is one that defies clever adjectival description: He felt generally ill pretty much all of the time. He did manage to return to work after a couple of day’s absence, but he struggled to be as productive as usual, was frequently irritable, and seemed constantly besieged by abdominal discomfort. It was during this time that Ron learned that his stool sample had cultured positive for Salmonella, group D.

The same state of ill health persisted throughout August and September. “Then,” as Ron recalls, “came the first weekend in October,” and “any thoughts I had that the first bout in July was the sickest I’d ever been faded quickly.”
 

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Are Our Food Safety Habits Slipping?

The International Food Information Council is reporting that Americans' food safety habits are getting worse, not better, despite a slew of recent high-profile illness outbreaks.

The deterioration in food safety habits appears to be across the board.  According tot he IFIC study, fewer Americans are washing hands with soap and water; washing cutting boards with soap and water or bleach; cooking foods to the proper temperature; and storing raw meat and poultry separately from ready to eat products.

The Council's CEO, David Schmidt has it right:  "It is impossible to overstate the importance of following proper food safety practices. Clearly Americans understand the need for these practices, but they still can do a better job of handling food properly at home, which potentially decreases the risk of foodborne illness.”

The study reported that another problem area was properly following microwave cooking instructions.  This is especially troubling in light of a recent New York Times article that indicated that coprorations were increasingly relying on consumers' ability to do just that to prevent foodborne illness.

Restaurant Injury Cases of a Different Breed: The Story of Jacob Aggas

I have never become accustomed to the profound nature of many of the injuries and illnesses we see at Marler Clark.  I often find myself saying to the mother, husband, or grandson of somebody who has suffered life-altering injuries that "I wish we never had to meet" . . . my only method of verbalizing the often-overwhelming sadness that I feel in talking to somebody who now must figure out how to live with a gaping hole in their heart.

I'm sure that I said the same thing to Christina Aggas when I received a phone call from her at the office on a Friday night in early 2006.  She explained that she had slipped and fell in October 2005 at a Southern California Carls Jr. restaurant.  Not a big deal most of the time, but Christina happened to be six months pregnant with her and her husband Steve's third child. 

Though they thought that she had suffered only a scary fall and bruised knee, Christina and Steve decided that it would be wise to get to the hospital and make sure that everything was okay. When they arrived at Kaiser Fontana’s emergency department in Riverside, California, nurses instructed Christina and Steve to go to labor and delivery for observation. 

Christina’s regular obstetrical visit prior to the fall had reflected a healthy fetus and a normal placenta by ultrasound. At the hospital, however, there was one disturbing finding: Christina now had a small tear in her placenta, but it appeared to be stable. The later pathology examination would reveal an “8 x 5 cm ragged tear at the periphery of the placenta."  The obstetrician told Christina that she would have to go on bed-rest for the duration of her pregnancy.

Christina was thus readying for discharge home when her first contraction struck. The obstetrician did not appear to be overly concerned but, not wanting Christina discharged prematurely, he ordered another ultrasound. This procedure revealed a developing placental abruption, or tearing away of the placenta from the wall of the uterus, the consequences of which can be catastrophic—massive hemorrhage with the loss of both the fetus and the mother. Thus, instead of discharge, Christina was rushed to the operating room where she underwent an emergency caesarean section by vertical incision, an act that saved her life as well as the life of her newborn son.

Jacob Aggas thus came into the world at a mere twenty-seven weeks gestation, more than two months early.  He weighed just over two pounds (961 g) at birth.

It would be wonderful to report that Jacob had a normal medical course over the next several months, and that he overcame that problems typically associated with premature birth.  But that is not what happened.  After birth, Jacob was admitted to the neonatal intensive care unit (NICU) at Kaiser Fontana Hospital, where he would remain for the next 70 days. His medical problems on admission included patent ductus arteriosis, bilateral pneumothorax , Respiratory Distress Syndrome, bronchopulmonary displasia , immature retina, gastroesophageal reflux disease (GERD), and most devastatingly, a grade IV brain bleed.

In the NICU, Jacob’s underdeveloped lungs soon collapsed, requiring tubes through the chest wall to inflate the lungs, and he was intubated through the mouth to allow for mechanical respiration, which continued for eighteen days. When taken off ventilator support, Jacob required oxygen via nasal cannula for the following two weeks. During the same period, he underwent placement of a peripherally inserted central catheter (PICC) line into his superior vena cava, several procedures involving extubation and re-intubation through the chest wall and mouth, and he experienced severe bradychardias, infections, anemia, and repeated oxygen desaturations.

Jacob beat all odds and survived the first two months of his life.  He was discharged home shortly after Christmas.  His parents, Steve and Christina, knew they had a tough road ahead with Jacob's many medical problems; and, as expected, they spent much of the first year of Jacob's life in and out of hospital emergency rooms.  Jacob suffered from frequent, life-threatening infections at the site of his gastrostomy tube, which was inserted directly into his stomach so that he could be fed by tube.  

We came to be involved in the Aggas family's life before the true extent of Jacob's injuries was known.  Bruce Clark and I flew down to California to be with the Aggas family the day after we received their call, and it was clear from the moment that we met him that Jacob was developmentally delayed, particularly in terms of his motor coordination.  

We eventually learned that Jacob's brain bleed, at birth, had been severe.  (Attached here is our explanation for the pathogenesis of Jacob's brain bleed and other injuries).  As time passed, Jacob missed many develpmental milestones that otherwise healthy children attain easily.  Though by all accounts a very happy little boy, it became increasingly apparent that Jacob's muscles simply weren't receiving the right messages from his brain, resulting in a general lack of physical coordination. 

The diagnosis, of course, was cerebral palsy, and the implications for the lives of every member of the Aggas family were monumental.  Jacob requires round-the-clock care, as he has since the day of his birth.  Fortunately, he is blessed with a mother and father who are as educated about their son's condition and welfare as most doctors, but the financial costs alone of life-time medical care for Jacob are staggering--estimated to be between 6 and 9 million dollars.

Jacob Aggas turns four years old in October.  He has not yet taken his first step, but I assure you that he is well on his way.  I talked with Christina and Steve recently, and I am thrilled to be able to report that Jacob is as happy as a little boy can be.  Fortunately, we were able to resolve the case, and put sufficient money in trust, that Jacob will have every conceivable medical need met over the course of his lifetime.  I will continue to post updates about the developmental progress of this remarkable young boy over the next few years. 

Death by Shopping Bag?

I received this article today from Steve Whybrew, the father of a college-age girl we represent who became infected with E. coli O157:H7 in a lettuce outbreak last year.  Steve's daughter, Heather, was hospitalized for 3 weeks.  She was also interviewed recently in an article for the New York Times about food safety. 

But back to the point of this post.  Given that the trend (very noticeably here in Seattle) is toward using reusable bags, this article provides some serious food for thought.  Among the findings recounted in the article:

The results complied in “A Microbiological Study of Plastic Reusable Bags and `First or single-use’ Plastic Bags” show that reusables are a breeding ground for bacteria and pose public health risks – food poisoning, skin infections such as bacterial boils, allergic reactions, triggering of asthma attacks, and ear infections. Over 30% of the bags had unsafe levels of bacterial contamination, 40% had yeast or mold and some of the bags had intestinal faecal bacteria embedded in their surface when there should have been 0.

What are we to do?  Do we have to choose between being environmentally responsible and getting sickened by a foodborne illness?  All I know is non-permeable surfaces make for better washability.  I'm not so sure about reusable canvas grocery bags after this article.

New Obama Policy Allows States to Be Tougher on Food Safety

During the Bush administration, and its do-anything-help-big-business approach, agencies were required to insert "preemption" language into all regulations, rules, and policies that  the agencies promulgated.  This was intended as an attempt to "protect" corporations from state laws and regulations that had the effect of imposing stricter requirements, especially with regard to product safety.  One big "win" for this approach was the U.S. Supreme Court decision in Reigel v. Medtronic, which held that people injured by a medical device "pre-approved" by the FDA could not file a lawsuit claiming that the device was defective as a matter of state law.  A not so successful attempt to use preemption for food cases was that tried by the Excel Corporation in litigation arising from an E. coli O157:H7 outbreak linked to a Milwaukee-area Sizzler restaurant. In those cases, Excel argued that its admittedly contamianted meat was neither defective nor unsafe because USDA policy at the time only prohibited this deadly pathogen from being in ground beef. (For an op-ed piece I wrote about this USDA policy, see Who does the USDA Really Protect, which can be found here: www.marlerblog.com/2008/08/articles/lawyer-oped/who-does-the-usda-really-protect-when-it-comes-to-deadly-e-coli/)

But now most of the arguments in favor of preempting state law in favor of "uniform" federal regulations are going to be undercut by a just-issued Executive Order that declares a new (or renewed) era of states rights.  The introductory paragraph of the Order is telling and compelling:

From our Nation's founding, the American constitutional order has been a Federal system, ensuring a strong role for both the national Government and the States. The Federal Government's role in promoting the general welfare and guarding individual liberties is critical, but State law and national law often operate concurrently to provide independent safeguards for the public. Throughout our history, State and local governments have frequently protected health, safety, and the environment more aggressively than has the national Government.

Not only does this Order announce a new direction, it requires the heads of all federal agencies to "review regulations issued within the past 10 years that contain statements in regulatory preambles or codified provisions intended by the department or agency to preempt State law," and to remove them.  So once more the role of the state in protecting its citizens from unsafe food and other products is restored to its rightful place.  More importantly, the next time that a big food company argues that the USDA said it was okay to poison people, it will likely get laughed out of court. Or at least we can hope so.

To read the full text of the Executive Order, please click on the Continue Reading link.

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FDA Admits Failure to Conduct Required Audits

A frankly distubring article today by Mary Clare Jalonik at the Associated Press.  According to the article, FDA "conducted only about half the state food safety audits it promised in the two years before the recent peanut salmonella outbreak."   Remarkably, the FDA conducted none of its required audits in five states during the 2007 and 2008 budget years.  In addition, there were 11 more states where the FDA was "unable to say" whether audits had been conducted in that time.  Included in those 11 were Georgia and Texas, site of the production of the peanut butter products recalled for salmonella contamination.  I am going to go out on a limb and guess that if FDA couldn't say whether or not they had done the audits, they probably weren't done.

Recent events have made clear that the food safety regulations we have on the books are inadeuqate.   When we (hopefully) enact some better food safety regulation, we also need to have a plan in place to ensure that those regulations are actually carried out.

Months Later, Recalled Peanut Butter Products Still on Shelves

The list of recalled foods linked to the PCA Salmonella typhimurium outbreak continues to expand.  Months after the recall, a Washington State dairy is adding its ice cream product to the list.

According to a story in the Bellingham (WA) Herald, Edaleen Dairy is recalling two ice creams because both contain peanut products possibly contaminated with salmonella.

Edaleen’s Tin Roof Sundae and Chocolate Peanut Butter Nut Ice Cream – in 1.75 quart cartons, 1.5 gallon tubs and 3 gallon tubs – with a manufacture date between Oct. 1, 2007, and May 8, 2009, are recalled. The manufacture dates are listed at the bottom of the carton.

Mitch Moorlag, co-owner of Edaleen Dairy and the ice cream manager said the company did not buy directly from Peanut Corporation but through a food supplier that recently added its ingredients to the recall list.

Again, we see how important the ability to quickly and accurately conducted full product traceback is.   We may never know for sure if these products caused any illness (only a fraction of Salmonella illnesses are ever confirmed and reported).  Still, this ice cream was made with recalled product, and was on the shelves months after the outbreak was recognized and reported.

E. coli Victim Speaks in Washington DC in Support of Food Safety Legislation

Lindsey Jennings (middle), our client, was a "perfectly healthy" twenty-one year old girl.  Actually, better than that, Lindsey was an avid athlete, in training for a marathon, running over 40 miles a week, all while completing her pre-med courses during her senior year at the University of Michigan in Ann Arbor, when she was unfortunate enough to eat contaminated lettuce. 

In fall 2008, Lindsey suffered an E. coli O157:H7 infection and illness the likes of which we don't often see . . . at least not in somebody so undeniably healthy and vibrant.  Lindsey was hospitalized for 12 days with a gastrointestinal illness so severe that she required replacement nutrition (total parenteral nutrition) because her gastrointestinal tract was too injured to process food or fluid.  She did not eat solid food for over a month, and actually had to continue to receive this nutrition through a tube (peripherally inserted central catheter--PICC) even after she was discharged from the hospital. 

Lindsey has continued to recover from her illness in 2009, but she has chosen not to forget about the experience of being so ill.  Along with several other Marler Clark clients, Lindsey recently spoke to members of Congress about food safety issues and the need for more vigorous legislation and regulation of the food supply.  Afterward, in an interview with Elizabeth Rackover of The Oakland Press, Lindsey stated, “It’s made me much more interested in the political side of things.”  “No one should have to go through what we’ve gone through. There are approximately 5,000 people who die every year from foodborne illnesses and almost all of it is preventable.”

FDA Takes Step One: Admits It Has A Problem

In a bit of news that is less surprising than it should be, the AP today reports that the FDA has for the last several years failed to perform a large percentage of required audits for inspections being conducted (under contract) by the States.  According to today's report (based on documents recently released to Congress:

The Food and Drug Administration conducted only about half the state food safety audits it promised in the two years before the recent peanut salmonella outbreak, according to new documents the agency sent to Congress.

The documents show the agency did not do any of the required audits of state-run food inspections in five states during those states' budget years spanning 2007 and 2008. And the FDA was unable to say whether audits were conducted at all in 11 additional states during that time, including Georgia and Texas, where salmonella was found in two peanut plants during a wide-ranging peanut recall earlier this year.

Only 14 states saw 100 percent of the audits completed.

As you will recall, the failure of state-performed inspections was a key contribution the recent nationwide Salmonella outbreak linked to contaminated peanuts processed by the Peanut Corporation of America.  Ditto the Conagra pot pie Salmonella outbreak, and the Peter Pan peanut butter Salmonella outbreak.  Double ditto the Veggie Booty Salmonella outrbeak. 

But at least the FDA seems to starting its long overdue recovery process, taking the first step by admitting it has a problem.  As the AP story reports:

Stephen R. Mason, acting assistant commissioner for legislation at the agency, said the recent salmonella outbreak "has highlighted limitations in our current approach and has prompted internal discussions on potential enhancements to the audit program." 

An agency spokesperson, trying hard to put the best spin on things, goes on to offer the following lame rationalization:

FDA spokeswoman Susan Cruzan says the agency is "evaluating approaches" for improving the audits.

"Although FDA has not been able to fulfill the goal of conducting 100 percent of the audits expected under FDA's internal auditing policy, FDA has audited each state at least once, has good knowledge of the state programs and state inspection personnel, and works to improve the programs as needed," she said.

Having admitted the problem, one can now only hope that the FDA will move on to the crucial next step: Stop Being in Denial.

Food Poisoning Is Not a Laughing Matter...

....unless you are the Simpsons.    Last night's season finale for the Simpsons was right off the front pages of Marlerblog.    The episode set up?   "Ogdenville's economy takes a stumble after tainted barley is discovered in Krusty's veggie burgers..."  The episode even featured an on-camera investigative journalism report that revealed the dark underside of the make-believe town's vital barley industry.   

Thankfully, the sickened members of the Simpson family appraently quickly recovered, as is often the case with cartoon mishaps.  In reality, the losses associated with foodborne illness are much more sobering.   Take for example the outbreak of Salmonella linked to peanut products produced by Peanut Corporation of America, a farily obvious source for last night's episode idea.   Of the 714 confirmed ill in thePCA outbreak, at least 9 deaths were reported.  Many more were hospitalized.

Not even Matt Groening or the Simpsons writers would have drawn a laugh with that story line.

Before Food Was Fast: Some Looks Back to a Time when Food was Local, Slow, and Safe

In addition to being a lawyer, I am a longtime foodie.  So my attention was definitely grabbed this morning when I was listening to NPR and there were segments on two food-related books that I defintely will be reading soon.  The first is Watching What We Eat, by Kathleen Collins.  It is a history of cooking shows, from its beginning on radio, to its current near-ubiquity on television, like on the Food Network.  Here's a link to the author's fun blog. www.watchingwhatweeat.com/

The other book that merited a segment on NPR is The Food of a Younger Land: A Portrait of American Food--Before the National Highway System, Before Chain Restaurants, and Before Frozen Food, When the Nation's Food Was Seasonal by Mark Kurlansky, who also brought us a fascinating history of a fish: Cod: A Biography of the Fish that Changed the World. Here is an except from the new book's description on Amazon:

In the 1930s, with the country gripped by the Great Depression and millions of Americans struggling to get by, FDR created the Federal Writers’ Project under the New Deal as a make-work program for artists and authors. A number of writers, including Zora Neale Hurston, Eudora Welty, and Nelson Algren, were dispatched all across America to chronicle the eating habits, traditions, and struggles of local people. The project, called “America Eats,” was abandoned in the early 1940s because of the World War and never completed.

The Food of a Younger Land unearths this forgotten literary and historical treasure and brings it to exuberant life. Mark Kurlansky’s brilliant book captures these remarkable stories, and combined with authentic recipes, anecdotes, photos, and his own musings and analysis, evokes a bygone era when Americans had never heard of fast food and the grocery superstore was a thing of the future. Kurlansky serves as a guide to this hearty and poignant look at the country’s roots.

I have not read Kurlansky's latest yet, but I have read a great book that covers the same territory, and does so really well. It's called: America Eats!: On the Road with the WPA - the Fish Fries, Box Supper Socials, and Chitlin Feasts That Define Real American Food, and its author is Pat Willard.  I highly recommend reading it.  (Did I mention that I have over 100 cookbooks?)

For an excerpt from Kathleen Collin's book, copied from the NPR website, please click on the Continued Reading link.

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Getting Word of Recalls to Consumers

A tip of the meat-thermometer to Herb Weisbaum for an excellent column on how stores could to a better job of notifying customers about recalled products.    Mr. Weisbaum points out that stores are the last line of defense in our food safety system.  He also points out that they often fail. 

California State Senator Dean Florez said his staffers found numerous recalled products on grovery store shelves when doing a spot check.  Senator Florez is introducing legislation to force stores to adopt systems to block the sales of recalled products.   Corporate food safety leader Costco already does just that.   This is especially important in light of a recent study that consumers are not generally in the habit of scanning their household for implicated products when recalls are announced. 

One place consumers can keep track of recalls is at www.recalls.gov

New York City's Health Commissioner Takes Over At CDC

We now know who will be running the Centers on Disease Control and Prevention. The President has announced his pick to lead CDC is New York City's Health Commissioner, Dr. Thomas Frieden.

Dr. Rich Besser, who has been acting director since the new Administration took office, will return to his role as head of the CDC’s Coordinating Office for Terrorism Preparedness and Emergency Response.

"America relies on a strong public health system and the work at the Centers for Disease Control and Prevention is critical to our mission to preserve and protect the health and safety of our citizens, President Obama said. "Dr. Frieden is an expert in preparedness and response to health emergencies, and has been at the forefront of the fight against heart disease, cancer and obesity, infectious diseases such as tuberculosis and AIDS, and in the establishment of electronic health records. Dr. Frieden has been a leader in the fight for health care reform, and his experiences confronting public health challenges in our country and abroad will be essential in this new role."

Dr. Frieden will actually be returning to the CDC. He left there in 2002 to head the Big Apple's health department. Dr.Frieden worked for CDC from 1990 to 2002. In the early 1990s, as a CDC Epidemiologic Intelligence Service Officer, Dr. Frieden investigated a wide range of issues including the spread of multidrug-resistant tuberculosis.

In New York, he led efforts that reduced the number of smokers by 350,000 and cut teen smoking in half. New York City has also increased cancer screening, reduced AIDS deaths by 40 percent improved collection and availability of information on community health, and implemented the largest community electronic health records project in the country.

Dr. Frieden and his team have responded effectively to several urgent health problems including cases of anthrax, plague and, most recently, H1N1 influenza.

Along with then NYC Health Commissioner and current Food and Drug Administration head nominee Dr. Margaret Hamburg, Dr. Frieden led the effort that stopped the spread of drug-resistant tuberculosis.

Following that, Dr. Frieden helped the Indian government establish a tuberculosis control program which has now saved more than one million lives.

Dr. Frieden, who received his MD and MPH degrees from Columbia University and completed infectious disease training at Yale University has written more than 200 scientific articles and received numerous awards and honors.

Peanuts and Pistachios & The New Team In Charge Of FDA

 Few would have predicted that when history is written on the first term of the Obama Administration that peanuts and pistachios would play such prominent roles.   Those unlikely products, however, will be used by historians to demonstrate the bad old ways versus the new U.S. Food & Drug Administration (FDA).

Maybe because the new President himself came from the streets of Chicago, he went to the front lines of the country's public health challenge to select Dr. Margaret Hamburg as FDA Commissioner and Dr. Joshua Sharfstein, as her deputy.   Dr. Hamburg, an expert in biological defense and disease control, was during the 1990s the youngest person in history to serve as New York City's health commissioner.  Dr. Sharfstein, a pediatrician, came to FDA directly from heading up the Baltimore Health Department.

It is really hard to overstate how unusual it is to have two top FDA officials from the gritty streets of big cities.   Almost all previous FDA Commissioners come from academic and research backgrounds.  You can go through each biography of past FDA Commissioners here

Few had any in-the-streets experience.   LBJ's last commissioner, Dr. James Goddard, came out of the Public Health Service at a time when federal doctors wore uniforms and saw patients.   And Nixon's appointee, Dr. Herbert Lay, Jr., was known for his service as an epidemiologist for our troops in Korea and Vietnam.

But that's about it.   FDA Commissioners have not been folks who got their hands dirty, knocking down the TB rate in the Big Apple as Dr. Hamburg did or taking on the dangers of over-the-counter cold and cough medicines for children under age 2 as Dr. Sharfstein did.  The typical FDA honcho creates process, not results.

So when Sharfstein took over FDA, while waiting for Hamburg to clear the Senate, it really should have come as no surprise that he opted to recall Salmonella-contaminated pistachios before anyone got sick.

The FDA has completed its inspection of Salmonella contamination in pistachios and pistachio products at Setton Pistachio of Terra Bella, Inc., Terra Bella, Calif., and presented a 483 Inspection Report to the firm.

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A Connection Between a Strain of E. coli and Colon Cancer?

A team of scientists at the University of Edinburgh are reporting on the possibility of a connection between a strain of E. coli and colon cancer.  The implicated bacteria is enteropathogenic E. coli or EPEC.   EPEC is a group of bacteria that cause gastroenteritis in humans, but lacks the shiga-toxins associated with shiga toxin producing E. coli (STEC).  The STEC family includes the notorious E. coli O157:H7 strain.

According to the report,  the study showed  a "strong" suggestion that the bacteria is able to hamper the body's fight against bowel cancer.  According to the study, the bacteria significantly reduced the levels of two key proteins needed to repair damage to DNA.  The Press Association report explains:

"The EPEC bacteria achieved this by attaching to the colon cells and inserting proteins into them which appeared to inactivate the cells' repair system.  It is known that a breakdown of this system puts the colon cells at greater risk of becoming cancerous."

Lead author of the study Dr Oliver Maddocks said: "We can't say for certain that this type of E.coli bacteria definitely cause colon cancer, as it is possible these patients acquired the bug after their tumors developed.  But our laboratory work does strongly suggest that the bacteria are able to influence colon cells in a way that might predispose them to cancer, and so there is a real chance that infection could aid the development of colon tumors."

3 Sickened With Crytposporidium Near Philadelphia

Officals in Montgomery County, Pennsylvania have anounced that 3 individuals have been confirmed with cryptosporidium.    While public swimming pools are common source of cryptosporidium outbreaks, there is reportedly no evidence of such a connection here.   None of the ill individuals had public pool exposures.  Officials are still investigating to possible source of the cluster of illnesses.

Symptoms of cryptosporidium generally occur 2 to 10 days after exposure.  Symptoms include abdominal cramps, nausea, vomiting, fever, and dehydration.   The symptoms usually last 1 to 2 weeks, although they may last up to 4 weeks.  Persons with compromised immune system are at risk for more severe complications.

Legal Lessons From the Country Cottage E. coli O111 Outbreak

In April, The Oklahoma State Health Department (OHD) published its final report on a massive outbreak of E. coli 0111 linked to the Country Cottage restaurant in Locust Grove, Oklahoma.    E. coli O111, one of the family of E. coli bacteria, is classified as an STEC, a shiga toxin producing escherichia coli.  In other words, it is, like E. coli O157:H7, pathogenic to humans and carries the potential to cause hemolytic uremic syndrome (HUS). 

The findings of the report also help illustrate an important legal point about the work we do at Marler Clark.   Despite a thorough investigation, OHD was not able to pinpoint the particular food source or sources that caused the 341 documented cases of E. coli O111.   "It could not be conclusively determined how E. coli O111 was introduced into the restaurant."   The OHD looked at a number of possibilities for the "original" source of the contamination - tainted well water; an infected food worker; contaminated food. 

From a legal standpoint, not being able to identify the "original" source of the infection is irrelevant to the customers claims against the restaurant.  Following a doctrine called "strict liabilty"  an injured customer simply has to prove that a restaurant meal caused his or her illness.  It is not necessary that the claimant be able to trace an illness to the mashed potatoes as opposed to the gravy.  In Oklahoma, the rule of "strict liability" is laid out in the case of Kirkland v. Gen. Motors, Corp (1974), but for all intents and purposes, the rule would apply anywhere in the U.S. 

Recalls Found to be Even Less Effective Than Expected

There has for a long time been valid criticism of food recalls, both with regard to how agencies like the FDA implement them, and whether recalls really work to prevent foodborne illness.  In my view, most recalls are best described as closing the barn-doors after the horses have escaped.  But that said, when a food product is determined to be contaminated, there is no avoiding the need to try to remove the product from the market.  That means recalls are necessary.  It also means that recalls need to be effective as possible at limiting the spread of foodborne disease. According to a great and interesting new study out of Rutgers' Food Policy Institute, it appears that recalls are anything but effective in prompting necessary public action.  For example, in a survey of over 1,100, the study found that only about 60 percent of the studied sample reported ever having looked for recalled food in their homes, and only 10 percent said they had ever found a recalled food product.

This is a disturbing finding, because, unless we can reliably count on the public to take the actions necessary to prevent the spread of foodborne disease, we may be assuming that recalls work when, in fact, they do not.  This study thus deserves to be read carefully by public health officials, and additional research definitely seems to be needed.

The full study can be found here: www.foodpolicyinstitute.org/docs/news/RR-0109-018.pdf

To read the full press release announcing the study, please hit the Continued Reading link.

 

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Georgia Senators Calling for More Regulation of the Food Industry

You know the landscape has changed when two senators are calling for more regulation of their home state's big business.  Georgia's two senators, Isakson and Chambliss, are calling for an overhaul of the FDA in the wake of two massive Salmonella outbreaks linked to peanut products from their home state, in 2007 and 2009.

The senators want increased inspection of food processing facilities.  They also want FDA to be given the ability to order a mandatory recall of a product where a processor is unwilling to do so.   Whether the motivation is consumer safety or the 25% drop in sales of peanut products after the outbreaks doesn't really matter.  Either way, its an opportunity to bolster U.S. food safety programs.

It is noteworhty that increased regulation is seen here as protecting the "tens of thousands" of jobs in the peanut industry in Georgia.   Too often, regulation is portrayed too quickly as anti-business.   The bottom line is that poisoning customers is bad for business, and sometimes the best (only?) way to fix an entrenched problem is through well-designed legislation. 

Honor National BBQ Month By NOT Getting Sick

In honor of National BBQ Month, now is the perfect time to post a reminder about safe food handling and cooking practices that can significantly reduce your risk of becoming ill from a foodborne pathogen like E. coli O157:H7, Salmonella, Campylobacter, or Norovirus, just to name a few. 

Thankfully, Chris Macias over at the Sacramento Bee had the same idea and just posted a great article on the subject here.

GRILLING

Don't expect to see rare meat when Christine Bruhn bites into a hamburger. She researches food safety and consumer issues at UC Davis' Department of Food Science and Technology, and she knows it doesn't take much undercooked ground beef to make a person seriously sick.

"Just 10 cells of E. coli can send a person to the hospital," says Bruhn. "Life's too precious to spend hours bent over the toilet, or worse."

Here are some tips from Bruhn to keep in mind during your cookouts:

  • Be careful of cross-contamination: "Some people use the same plate to carry both the raw and cooked (food). People might rinse the plate, but those bacteria are still there. Water is not enough. You need a clean plate."

Same goes for that burger-flipping spatula. Don't risk using it to load raw burgers – and then to remove the cooked ones. Either keep two handy or thoroughly clean the one that has touched the raw meat.

  • Don't use color as a guideline for doneness: "Many believe that meat is done when it turns brown. Color is not an adequate indicator of the thoroughness of cooking. One out of four burgers turn brown before they reach 160 degrees, which is the recommended temperature."
  • Invest in a cooking thermometer and use it: "Most people don't want to take the temperature of a hamburger because they think it's too much work. My graduate student is doing a project watching people prepare burgers, and none of them used a thermometer. They say, 'Oh, it's ready,' but a third of the burgers had not reached the proper temperature."
  • Rare steak is OK, but make sure the meat's surface is seared: "Steak is different than ground beef. With steak, the bacteria is on the surface and on the edges. So if you just sear it, you're (killing) the bacteria. With ground beef, since it's all ground and mixed up, what used to be on the surface is now on the inside."
  • Eat charred food in moderation: "Grilled veggies are so yummy and you get some of those burnt parts that taste so good. But eating too much charred food is bad. Some chemicals, eaten in sufficient quantities, can be carcinogenic. That's still eating it a lot, every day. A little charring on burgers is OK. The buildup will be low and you will naturally remove those toxins."

Internal temperature chart

Ground meat and meat mixtures

  • Beef, pork, veal, lamb – 160 degrees

Contaminated Sprouts- The Importance of Knowing the Source

There is a report today that produce supplier Los Angeles Calco is recalling its own sprout products over fears of Salmonella contamination.  There is no apparent connection between these sprouts and previously implicated sprout seeds from Caudill Seed Co. in Kentucky. 

Calco spokesperson Yue Shen Hsiao claims that the implicated sprouts actually came from a farmer in Arizona.  Hsiao says that Calco distributed the Arizona grown sprouts to help meet demand in California.   Hsiao also says Calco will not outsource again.  “I’m not putting my label on any products I don’t grow anymore,” Hsiao said. “I’m not taking that risk.”

At least Hsiao knew where the sprouts came from.  Traceability of food product back up the distribution chain from the consumer has been a large food safety issue, especially as it relates to produce.   Being able to trace back a food item to its source is helpful.  Its even better to be able to rely on those sources.   Confidence in food suppliers can be increased through review of HACCP plans, review of testing program results,  and reliable, legitimate, third-party audits. 

Food sellers who do not ensure that their suppliers are following safe food practices are at risk for ending up liable for others' failures.

FDA Traces Salmonella Outbreak to Sprout Seeds

According to this story in he Packer, the FDA has traced the recent salmonella oubreak in alfalfa sprouts to imported seeds.  Caudill Seed Co, of Kentucky, has recalled batches of seeds imported from Italy.

The recent sprout outbreak has sickened 35 persons in 7 states.

USDA Sees the Light on E. coli O157:H7 and Meat

For years, the USDA Food Safety and Inspection Service (FSIS) has allowed meat plants to divert meat that has tested positive for E. coli O157:H7 (or some other pathogen) to a further-processing facility where it is cooked for a time and at a temperature sufficient to kill the pathogens.  What FSIS has not done, however, is require immediate corrective action of the plant's slaughter and sanitary dressing procedures so as to determine how the meat came to be contaminated in the first place.  Because, let us be clear: ground beef, trimmings, an intact cuts of meat do not get contaminated with E. coli O157:H7 unless the carcass is contaminated, or cross-contaminated, druing the slaughter or carcass-dressing process.  Bottom-line: Meat is not contaminated but for the manner of its slaughter and dressing. 

So lax has been the FSIS focus on and oversight of the slaughter and dressing process that it has routinely allowed plants to send meat that has tested presumptively positive for E. coli O157:H7 to be sent for further-processing without requiring that confrimatory testing be done.  This give the plant a free pass by avoiding a confirmed positive test result for E. coli O157:H7, something that would be higly likely to prompt a comprehenisve assessment at the plant, and the requirement that the plant's HACCP plan be re-assessed and re-validated.  This also allows both the plant and FSIS to pretend that the Slaughter HACCP plan has not failed for not reduciing E. coli O157:H7 to an "undetectable level"--something that FSIS policy has required since October 7, 2002.

Now, if in reading the above the image of an ostrich with its head in the sand came to mind, then you are definitely grasping the gist of my criticism here.  But, that said, I am happy to report that FSIS finally seems to have pulled its proverbial head out of the sand and seen the light. 

Yesterday the agency issued FSIS Directive 6410.1, and it is a very good thing indeed.  For more on this, please hit the CONTINUED READING link.

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Continued Proliferation of Organic Farms in U.S.

In this last Sunday's New York Times, there was a fascinating set of maps that showed the geographic location of organic farms across the United States.  The article noted that organic vegetables now account fro five percent of all vegetables sales. 

This increase is interesting.  But what I find much more interesting is that the concentration of organic farms in the Northwest and Northwest, and in the states adjacent to the Great Lakes, indicates that, in these areas, there are large numbers of small organic farms that are selling produce directly to consumers.  To me this represents a growing desire for face-to-face transactions, and the rejection of produce products from anonymous locales and sources.  This is not necessarily a safety issue, but it is most certainly a trust issue.  And one can hardly believe that the repeated outbreaks of foodborne illness linked to produce over the last several years has done much to destroy the trust relationship with the American public.

The other thing that is fascinating about these maps is how the geographic concentration of organic farms roughly correlates to household income in the United States.  Look at this map from the U.S. Census Bureau.

So, for now at least, it does certainly seem that the market for organic produce is one restricted to higher-income households.  This is probably both a good and bad thing (depending on your perspective and role in the marketplace).  Higher prices definitely support the growth of organic farms in the absence of support from the government. (This is in huge contrast to the substantial--arguably, too substantial--support that Big Ag gets from the government.)  But on the other hand, if large portions of the populace are priced out of the organic produce market it is hard to see how organic farming will be able to grow much more without creating downward price pressure because of potential over-supply.  For the time being though, I think the proliferation of organic farming is a great thing. 

Salmonella Illness: Just a little diarrhea, right?

I guess you've got to be in this business to get frustrated when people think of foodborne disease as being akin to "an upset stomach" or what everybody calls "the flu."  That, or you've got to be unlucky enough to have known or loved somebody who developed hemolytic uremic syndrome or some other horrible manifestation of foodborne disease. 

Betty Desjarlais was a perfect example of somebody in good health whose Salmonella illness quickly killed her.  Read a brief summary of Betty's illness and her untimely death.  This is not a frequent result in Salmonella cases, but it serves well to illustrate the risks that we really do face . . . which is particularly alarming when you consider the true scope of these outbreaks--e.g. the recent sprouts outbreaks.  There are many more people who are sick than the 150 or so illnesses that investigating health authorities include in their tallies of confirmed cases.

Study Reveals Most People Can't Distinguish Pâté from Dog Food

     As someone who regularly feeds his dog food that costs more than two-bucks a can, while regularly noticing that store-brand chili at my local grocery store is often on sale for less than a dollar, I was not entirely surprised when I heard of this interesting study that found most people can’t tell the difference between gourmet pâté from dog food. I suspect, however, this tells us more about the palate of the tasters than it does pâté—but maybe there I’m wrong.

     Here’s the entertaining and enlightening opening paragraph of the study:


What qualifies as food fit for human consumption is culturally defined. In some cultures, grasshopper, snake, dog, and horse are on the menu. Elsewhere, these healthy protein sources provoke disgust. There has also been a substantial flexibility of diet within cultures over time. Lobster, once considered fit only for fertilizer and slave food in 18th Century North America, is consumed there today as an expensive delicacy. Such cultural evolution is ongoing, with comestible goods constantly moving into or out of fashion. We investigated the potential of canned dog food for human consumption by assessing its palatibility alone.

If you would like to read the study (working paper, actually) you can find it here: http://www.wine-economics.org/workingpapers/AAWE_WP36.pdf

As for the food safety angle of this, remember that in 2007 when Castleberry-brand canned chili was recalled because of botulism, also part of the recall was Natural Balance dog food, including “Irish Stew with Beef,” “Southern-style dumplings with gravy,” and “Chinese Take-out with sauce with vegetables.” And yes, the “dog” food was made in the same factory as the “human” food.

Bon appétit!
 

Interesting, Upcoming Food Safety Conference

Last fall I got the opportunity to give a guest lecture at the University of Wisconsin Law School, which is where I went to law school.  It was for an innovative class called Transnational Regulation: Increasing the Safety of Globally-Sourced Products.  The University of Wisconsin has long been the home of the Food Research Institute, which has done groundbreaking research over the years on E. coli O157:H7, among other things.  So I was especially happy to receive news of what sounds like a great conference being held this month at the University:  Food Import Safety: Systems, Infrastructure & Governance.  This one-and-a-half -day conference will be held on May 26 and 27.  For more information about the program, and how to register, click on the Continue Reading link.

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The FDA Goes High Tech

The USA Today is reporting on the depolyment of one of FDA's "mobile food-safety labs."  The lab and its inspectors spent a week in Nogales, Arizona, at the Mexican border, testing imported food.    The good news is two-fold.  First,  the inspectors did not come up with a single positive test.  Second, they were able to keep the test-and-hold time, i.e. the time a product waits for testing results before rejoining the stream of commerce, to roughly 36 hours.

The bad news is that despite the presence of the mobile labs, the percentage of imported food being tested or inspected before entering the U.S. remains very low.

Imported produce has been linked to food-borne illness outbreaks in the past.  Implicated foods have included green onions, jalapeno peppers, and cantaloupe.

 

Food Safety on Wheels

The latest food safety-themed article from the incomparable USA Today reporter, Elizabeth Weise, has just been posted, this one highlighting the FDA's mobile food safety labs.  These $3 million high-tech labs on wheels allow the FDA to set up testing facilities wherever they are needed, including at the Mexico-USA border where about three and a half billion pounds of fruits and vegetables are imported during the winter season.  These labs are equipped to test for Salmonella, E. coli O157:H7, and other foodborne pathogens that have been increasingly associated with fresh produce outbreaks.

If Inspections of Food Processors Are To Be Increased, Who Will Pay For It?

I was privileged this morning to speak at the Northwest Food Processors Association Executive Business Summitt.  I was on a panel discussing pending food safety legislation.   It was a lively discussion amongst a group of industry executives that were plainly committed to food safety.

Still, this does not mean that there was universal support for all of the pieces of pending food safety litigation.   One issue involved a significant differnece between two major pieces of legislation to be discussed by Congress this year.   Senator Durbin's Food Safety Modernization Act calls for increased inspection of food processors, but does not call for those processors to pay for that increase - the bill does not contain a provision for user or registration fees.  

Congressman Dingle's FDA Globalization Act, however, calls for such fees as part of its structuring of increased inspection.  

The sentiment from this morning's group was pretty clear - the food processors do not want to pay fees for the inspection, viewing them as a direct tax on their industry.   If industry doesn't pay, though, it can only be done through congressional appropriations - i.e. taxpayers.  This doesn't figure to be particularly popular in today's economy either. 

An unfunded or under-funded mandate to increase inspections will only hurt the food industry in the long run.   As the bills move forward and discussion becomes more focused, I hope that industry leaders can think long term, and work toward adopting the bill that will ultimately proove the most successful in increasing the safety of the U.S. food supply.

If The Kids Go To A Petting Zoo - Make Sure They Wash Their Hands, WELL.

This months MMWR contains a report on an outbreak of shiga-toxin producing E. coli O157 at a petting zoo in Florida in 2007. 

Unfortunately, this is nothing new.  The "editorial note" states that between 1991-2005, the CDC received reports of 32 outbreaks of E. coli O157 that "were associated with animals in public settings."  Beginning in 2001, the CDC and then the National Association of State Public Health Veterinarians (NASPHV) has provided a compendium of recommendations to avoid outbreaks like this.   The CDC states, however, that venues in some of these outbreaks were not in compliance with those guidelines. 

Apparantly, those failures continue.  In the 2007 petting zoo outbreak, the CDC found that attendees of the petting zoo "were not instructed in appropriate handwashing technique, and the staff member was stationed too far from the handwashing facilities to observe handwashing behavior." 

E. coli O157:H7 is generally found in ruminants, including cows, sheep, and goats.  So, if your child pets one of these animals, make sure his or her hands are washed thoroughly with soap and running water immediately after contact.   

Senator Gregg Talks Food Safety Legislation

As part of Marler Clark's work with Outbreak, Inc.  I will be speaking at the Northwest Food Processors Association Executive Summit in Bend, Oregon on Saturday.   I will be a member of a panel discussing the numerous pending food safety bills, and their potential impact.   While preparing for the talk, I found Senator Judd Gregg's (NH) Op-Ed regarding one of the more prominent pieces of pending legislation, "The Food Safety Modernization Act." 

Bill has discussed much of the pending legislation on his blog.   One of the focuses of the Food Safety Modernization Act is increased inspection at food processing plants.   Part of the proposal would base the frequency of inspection on the level of risk purportedly associated with the particular food being produced.   The hope is that by prioritizing inspection based on perceived risk, that limited regulatory dollars will be well spent.

I wonder what incentives such a system would create.  On the positive side, a business would be motivated to create a safe product, because, among other reasons, their procedure will be less encumberd by inspection.  On the other hand, I worry that there might be an incentive to downplay the potential risks involved with a product in order to streamline a process.   We are a long way from having a law on the books, but it will be interesting to see how it plays out.

The Scope of the Recent Salmonella Sprouts Outbreak

Press accounts, as well as those from the CDC, addressing the number of sick people in the ongoing Salmonella sprouts outbreak are a little misleading if you don't know what is actually being said.  The reality of these outbreaks (whether E. coli O157, Salmonella, or anything else) is that the number of people who are actually ill, as opposed to the number who have a stool sample that tests positive, is much bigger than the reports would indicate. 

In fact, one of the leading studies on the subject suggests (and this is obviously not a bright line rule) that the number of actual victims in a given outbreak, as opposed to merely those with positive stool samples, is as much as 38 times the number of stool sample confirmed individuals.  I hope that makes sense.  Paul Mead et al, explain it much more clearly in their article, which I will post in a few minutes (technical difficulties). 

 

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E.coli Found in Indiana Creek

Yesterday, there was a report of  E. coli contamination in the Merrimack River in Massachusetts.   Today a report of a positive test from the Greenwood Creek in Greenwood, Indiana.   The creek is apparently a popular swimming spot in the summer.   General tests for E. coli do not indicate whether or not E. coli O157:H7 is present.   The dangerous bacteria is, however, one of the many strains of E. coli

Waterborne E. coli presents a risk to human health, particularly where drinking water is involved.  Last summer hundreds were sickened in Oklahoma in an outbreak of E. coli O111, another pathogenic strain in the E. coli family.  Health officials have tied that outbreak to well water served in a restaurant.

Interview an E. coli Lawyer (not a vampire)

Brandy Baltzell is a freshman at Millersville University.  She is going to major in biochemistry, and will soon, I think, be doing great work with E. coli O157:H7 and other nasty little foodborne pathogens.  I was happy to play what role I could in the recent research paper that she wrote, discussing the characteristics of E. coli O157:H7, including how it spreads and what it does to the body.  See Brandy's paper here.

Guide for Sprout Growers to avoid Salmonella and E. coli Lawsuits

ATTENTION SPROUT GROWERS:  If you haven't seen it already, read the FDA's industry guidance on "Reducing Microbial Food Safety Hazards on Sprouted Seeds."  If you have seen it, then see it again.  But don't stop there:  make your employees see it, and then meet with your staff to determine the best ways to implement anything contained in the FDA guide that you haven't already.  AND DON'T STOP THERE:  then contribute a little money or time to research and development so that the 33 outbreaks sprouts have caused since 1990 stays at 33 outbreaks, and the FDA stops telling people not to buy or consume your product.  That can't be good for business. 

Nevada Hospitalization linked to Salmonella in Spices

According to this Mercury News story, a 77 year old woman from Dayton, Nevada was among those sickened with Salmonella.   An outbreak of illness has led to the recall of white and black pepper distributed by Union International Food Co.and CJ United Corp.  There have been nine such illnesses reported in Nevada.  Thankfully, the Dayton resident is reportedly the only Nevada member of the outbreak to be hospitalized.

E. coli in the Merrimack River?

 

The Daily News in North Andover, Massachusetts is reporting on water quality issues in the Merrimack River.  According to the story, the Merrrimack River Watershed Council states that E. coli has been found in the river.

Apparently, it was not an isolated incident.  According to the story, the river was unsafe for swimming on 6% of wet weather days during the study, based on the applicable state standards.  Worse, "state standards for safe E. coli levels are lax when viewed against standards set by other water quality governing agencies. If [one] were to measure the Merrimack River's E. coli levels against safety standards set by the 40-year-old Charles River Watershed Association, for instance, the river would be deemed unsafe for swimming and boating far more often."

E. coli is a general term for a family of common fecal bacteria.  Within that family is E. coli O157:H7, a pathogenic bacteria that can cause serious illness in humans, including hemolytic uremic syndrome, or HUS.

 

Peanut Industry Welcoming Regulation?

An article from the Press-Enterprise in Riverside, California explains that members of the peanut industry are recognizing that new legislation is necessary in light of two massive Salmonella outbreaks in the past three years.

A lobbyist for the Western Peanut Growers Association says the industry wants to be part of fixing the problem.  This is great, but should it be something new?  The article also quotes a professor estimating the total cost of the outbreak at roughly a bilion dollars.  Hmm, where have we heard that before?

No doubt that having an industry be involved in creating the legislation that regulates it makes great sense.   It just makes more sense to be ahead of the curve, as opposed to reacting (slowly) to tragedy.

Sproutman Gets it Right . . . Somewhat Right Anyway

Steve Meyerowitz is, apparently, the Sproutman.  Although I disagree with his analysis of the numbers--i.e. Sprouts have caused a hell of a lot more foodborne illnesses than 2,000 in the last 40 years--it's good to see an industry man who recognizes the risks associated with his product, and who cares enough about consumer health to advocate that his fellow sprout devotees do all they can, by way of researching and developing new pasteurization methods, to reduce risks. 

Nonetheless, I am not a convert, and I never will be.  I feel too much for those sickened and hospitalized in the recent outbreaks and recalls linked to sprouts.  Let us not forget that there are over 120 people in Nebraska, Iowa, South Dakota, and Kansas (not to mention the sprouts/listeria recall or the Calco, Inc sprouts advisory), and a bunch in Michigan, who (1) probably didn't know the risks associated with sprouts and (2) wouldn't have thought it could happen to them anyway. 

Ranking the Riskiest Foods

An administrator with the FSIS (Food Safety and Inspection) branch of the USDA is calling for a ranking of the "riskiest" foods, in order to better structure regulation of our entire food system.  Cetainly an idea that makes some sense.   This is especially true in light of the fact that the resources to regulate our food system seem always to lag behind our goals in that regard.  Prioritizing the risks could lead to a more effecient allocation of those resources.

Its not a scientific survey, but recent outbreaks seem to suggest two candidates for the list:  (1) alfalfa sprouts, currently implicated in a Salmonella outbreak.;  and also being recalled in Rhode Island over listeria fears;  and (2) unpastuerized dairy products, currently implicated in a campylobacter outbreak in Colorado. 

Salmonella and Sprouts--I'm not making this up

By the end of this year, I hope to have more devoted readers than there are sprout outbreaks and recalls.  As I sit here today, it's pretty much neck and neck, and I'll be honest, my competition is relentless.  See my earlier post (TODAY!!!) on the ongoing Salmonella outbreak in Michigan .  And this just in:  The California Department of Health warns consumers not to eat Los Angeles Calco, Inc. brand alfalfa sprout products "because the products may be contaminated with Salmonella."  

What a shocker.  Salmonella and sprouts; sprouts and Salmonella.  Though there are not yet any illnesses known to be linked to Calco, Inc's products, we must wait for the public health folks in California, who are no strangers to outbreaks associated with raw produce, to connect all the dots.  We'll see what tomorrow brings.   

Who Pushed The Pause Button on Foodborne Illness Prevention?

The CDC has just released a 10-state study, Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through Food --- 10 States, 2008, the conclusions of which I have suspected for some time (and our busy law practice at Marler Clark has confirmed)--illness related to foodborne pathogens is NOT decreasing.

As the study's authors state, "progress toward the national health objectives has plateaued, suggesting that fundamental problems with bacterial and parasitic contamination are not being resolved...The lack of recent progress toward the national health objective targets and the occurrence of large multistate outbreaks point to gaps in the current food safety system and the need to continue to develop and evaluate food safety practices as food moves from the farm to the table. "

In the past two years alone we've had two huge peanut-related Salmonella outbreaks, and now another is emerging related to pistachio nuts.  When are food companies that sell these products to the trusting (but decreasingly so) public going to step up to the plate?  Perhaps when they too start falling ill from consuming their own products.

Worries About Cuts to Food Safety Programs

The Arizona Republic is reporting that produce industry members in Arizona are concerned that the budget for a program for leafy green food safety may be reduced or elminated.  No doubt times are tough, and budgets everywhere are stressed.   How many times does the lesson have to be learned though, that it's this "ounce of prevention" that is saving money in the long run?

E. coli O157:H7 at Petting Zoos and Animal Exhibits

The vast majority of our E. coli O157:H7 cases are foodborne.   Our clients have been sickened by, among other things, ground beef, tri-tip, spinach, lettuce, and apple juice. 

Another vector for the transmission for E. coli O157:H7 is human/animal contact at petting zoos and other animal exhibits.   A survey of the literature, including CDC's  Morbidity & Mortality Weekly Report  (MMWR)  reveals at least 23 outbreaks of zoonotic disease, including illnesses from E. coli 015:H7, associated with animal exhibitions in the United Kingdom and the United States before the dual outbreaks in 2004 in   North Carolina and Florida. These prior outbreaks included an E. coli 0157:H7 outbreak associated with a county fair in Medina, Ohio, in August, 2000; two E. coli 0157:H7 outbreaks in Pennsylvania in 2000 and 2001 associated with farm animals; 92 E. coli 0157:H7 cases associated with the Wyandot County Fair in Ohio in September 2001; and the largest E. coli 0157:H7 outbreak in Oregon history at the  Lane County Fair in September 2002.

Fortunately, the CDC and the National Association of State Public Health Veterinarians have developed recommendations aimed at reducting the risk of E. coli O157:H7 transmission in these settings.

How Viruses Turn "Harmless" E. coli Pathogenic

This article on www.physorg.com explains in fairly understandable terms the manner in which viruses are involved in turning a strain of E. coli pathogenic.   Most strains of E. coli are not pathogenic to humans.   Some, including E. coli O157:H7, can cause serious human illness.   Shiga-toxins produced by E. coli O157 can cause hemolytic uremic syndrome (HUS) especially in the young and the elderly. 

Sprouts and Foodborne Illness: The how and the why

It never ceases to amaze many clients of ours at Marler Clark how foods that seem so healthy can pose so much risk of foodborne disease.  Lettuce and E. coli O157:H7???  Many victims were shocked, not to mention badly injured, when baby spinach was the cause of yet another outbreak of E. coli O157:H7 and other pathogens associated with leafy greens during the 2006 spinach outbreak. 

Sprouts are another case in point.  We've all had them, and most of us have never been sick from them, but there are hundreds of victims across the mid-west who cannot say the same thing.  Here is an interesting article on how sprouts are grown and harvested, and why they are such a risky food to eat, especially for young children, the elderly, or the immune compromised. 

Who's Job is it Anyway?

Interesting survey, given the lethal risks that the food-consuming public faces. Kidney failure due to HUS, reactive arthritis, post-infectious IBS (pdf), sometimes even death . . . all outcomes that we at Marler Clark have seen way too many times in recent years due to foodpoisoning—something that is all-too-often passed off as a couple of days of diarrhea. 

But really, let’s give credit, or place blame as the case may be, where it is due. The consumer is not, and should not be, the last line of defense. The viruses and bacteria that cause foodborne illness are simply too dangerous, the risks too great, to count on recall information reaching busy moms and dads in time to help them do what the food manufacturers are failing to do themselves: keep our food safe.

Salmonella in Unpastuerized Orange Juice, 2005

I can't proclaim to be a regular reader of the University of Chicago Journal "Clinical Infectious Diseases."   An article in its April issue, however, was pointed out to me.   That article concerned the investigation of the 2006 Dole Spinach  E. coli O157:H7 outbreak as it related to cases in Wisconsin.

In that same issue is an article on a 2005 outbreak of Salmonella Saint Paul traced to unpasteurized orange juice.  You can view the article here.    The article refers to 152 cases of Salmonella poisoning  in 23 states.  Unpasteurized juices have been linked to serious illness outbreaks in the past.   In 1996 an outbreak of E. coli O157:H7 was linked to apple juice.  More recently unpastuerized carrot juice was linked to deadly botulism poisoning. 

As far as I know, unpastuerized orange juice doesn't have the following of "raw milk."  That's probably a good thing. 

Report on 2006 Spinach E. coli O157:H7 Outbreak in Wisconsin, the Counted and the Not-Counted

This month's issue of Clinical Infectious Diseases has an excellent article recounting the State of Wisconsin's investigation into the 2006 E. coli O157:H7 outbreak linked to Dole spinach.   You can see the article here.    For reasons that are still not entirely clear, Wisconsin was something of a "ground zero" for the outbreak with 49 of the 204 cases reported nationwide.  Strong work by health officials in Wisconsin (and elsewhere) helped recognize the outbreak and put a stop to it.

Despite this excellent effort in cataloging the illnesses in order to end the outbreak and draw conclusions, the count is still incomplete.  I have spent the day working on the case of a retirement aged woman from Wisconsin who developed HUS after consuming Dole Spinach from the same lot associated with the outbreak.   She spent 7 weeks in the hospital.    She only survived through the receipt of donated blood, mechanical ventilation and dialysis.   Yet because she was not tested for E. coli O157:H7 until well into her hospitalization she is not one of the 49. 

E. coli O157:H7 Season is Nearly Upon Us - Will it be 2005 and 2006 or 2007 and 2008?

The presence of E. coli O157:H7 in hamburger was defined as an adulterant under the Federal Meat Inspection Act in 1994. However, recalls of E. coli O157:H7 contaminated meat and related illnesses continued over the next decade to grow, as did my law firm. Oddly too, and with near regularity, E. coli O157:H7 recalls and illnesses seemed to begin in the Spring and peak in late Summer and Fall from 1993 through 2002.

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 O157:H7 – related illnesses drop 48% between 2000 and 2006.

The reality is that from 1993 through 2002, children sickened with E. coli O157:H7 tainted hamburger made up the bulk of my law practice. However, as E. coli O157:H7 hamburger recalls fell from 2003 through the end of 2006, I wondered if the law firm would survive. Springs just simply were not the same.

But then came Spring 2007. E. coli O157:H7, which begins its life in the hindgut of a cow, mounted a surge on its home court. And, it came back with a vengeance. Since the Spring of 2007, forty-four million pounds of beef have been recalled in 25 incidents due to E. coli O157:H7. And, I am now back in the meat business, and look to Spring not just for the beginning of hay fever season.

Now, Spring 2009 is upon us. In preparing for it, I had some research done on the “seasonality” of E. coli O157:H7 in both humans and cattle and then say what was available in the literature as to the reasons behind it. Perhaps it does not fully explain what I experienced from 1993 though 2008, but it is a start. It is all about being prepared.

Seasonality in humans:

• A review of E. coli O157:H7 diarrhea in the US by Slutsker et al (1997) found that E. coli O157:H7 was isolated most frequently from patients during the summer months.
• Results from an epidemiological review of E. coli O157:H7 outbreaks in the US (1982-2002) showed that outbreaks involving ground beef peaked in summer months (Rangel et al, 2005)
• In a review of non-O157 STEC infections in the US from 1983-2002 revealed that these infections also were most frequent during the summer (Brooks et al, 2005)
• In Scotland, HUS and E. coli O157:H7 infections peaked in patients under 15 years of age in July/August, followed by a plateau from June to September (Douglas et al, 1997). Interestingly, the prevalence in Scottish beef cattle at slaughter was found to be highest during the winter, but the concentration of E. coli O157:H7 (number of bacteria shed in cattle feces) was highest during the warmer months (Ogden et al, 2004).

Seasonality in ruminants:

• Numerous studies in cattle indicate that fecal shedding of E. coli O157:H7 is typically low in the winter, increases in the spring, peaks during the summer and tapers off in the fall (Edrington et al, 2006; Hancock et al, 2001; Hussein et al, 2005, etc.)
• Barkocy-Gallagher et al (2003) found that the prevalence of E. coli O157:H7 in cattle feces peaked in the summer, and prevalence on hides (a known risk factor for beef contamination) was highest from spring through fall.
• A survey of ground beef samples in the US showed that they were 3x more likely to be contaminated with E. coli O157:H7 from June – September (Chapman, et al 2001)
• A survey in the UK found that the majority of retail meats that tested positive for E. coli O157:H7 were collected between May and September.

Hypotheses on why there are seasonal differences in prevalence in both humans and cattle

Human factors:

• Differences in handling and cooking food, or differences in consumption patterns during the summer, especially ground beef (outdoor BBQs, picnics, summer camps)
• Higher prevalence of E. coli O157:H7 in cattle feces and hides entering the slaughterhouse
• More outbreaks linked to swimming pools, recreational water, and agriculture fairs during the summer

Animal factors:

• Speculation that temperature may affect shedding or survival in feces (warmer months promoting survival and/or growth of E. coli O157:H7).
• Studies by Edrington et al (2006 and 2008) suggested that day length and effects on hormones such as melatonin secretion from the gastrointestinal tracts may be the underlying mechanism for seasonality in cattle. The authors hypothesized that the seasonal variation is a result of physiological responses within the host animal to changing day-length. Hormones have been shown to play a role in the regulation of bacterial populations and host immunity.

REFERENCES

1. Barkocy-Gallagher, G. A., T. M. Arthur, M. Rivera-Betancourt, X. Nou, S. D. Shackelford, T. L. Wheeler, and M. Koohmaraie. 2003. Seasonal prevalence of Shiga toxin-producing Escherichia coli, including O157:H7 and non-O157 serotypes, and Salmonella in commercial beef processing plants. J Food Prot 66:1978-86.
2. Besser, R. E., P. M. Griffin, and L. Slutsker. 1999. Escherichia coli O157:H7 gastroenteritis and the hemolytic uremic syndrome, an emerging infectious disease. Annu Rev Med 50:355-67.
3. Brooks, J. T., E. G. Sowers, J. G. Wells, K. D. Greene, P. M. Griffin, R. M. Hoekstra, and N. A. Strockbine. 2005. Non-O157 Shiga toxin-producing Escherichia coli infections in the United States, 1983-2002. J Infect Dis 192:1422-9.
4. Chapman, P. A., C. A. Siddons, A. T. Gerdan Malo, and M. A. Harkin. 1997. A 1-year study of Escherichia coli O157 in cattle, sheep, pigs and poultry. Epidemiol Infect 119:245-50.
5. Douglas, A. S., and A. Kurien. 1997. Seasonality and other epidemiological features of haemolytic uraemic syndrome and E. coli O157 isolates in Scotland. Scott Med J 42:166-71.
6. Dunn, J. R., J. E. Keen, and R. A. Thompson. 2004. Prevalence of Shiga-toxigenic Escherichia coli O157:H7 in adult dairy cattle. J Am Vet Med Assoc 224:1151-8.
7. Edrington, T. S., T. R. Callaway, S. E. Ives, M. J. Engler, M. L. Looper, R. C. Anderson, and D. J. Nisbet. 2006. Seasonal shedding of Escherichia coli O157:H7 in ruminants: a new hypothesis. Foodborne Pathog Dis 3:413-21.
8. Edrington T.S., T. R. Callaway, D. M. Hallford, L. Chen, R. C. Anderson, and D. J. Nisbet. 2008. Effects of exogenous melatonin and tryptophan on fecal shedding of E. coli O157:H7 in cattle. Microb Ecol. 55:553-60.
9. Fernandez, D., E. M. Rodriguez, G. H. Arroyo, N. L. Padola, and A. E. Parma. 2009. Seasonal variation of Shiga toxin-encoding genes (stx) and detection of E. coli O157 in dairy cattle from Argentina. J Appl Microbiol 106:1260-7.
10. Hancock, D., T. Besser, J. Lejeune, M. Davis, and D. Rice. 2001. The control of VTEC in the animal reservoir. Int J Food Microbiol 66:71-8.
11. Hancock, D. D., T. E. Besser, M. L. Kinsel, P. I. Tarr, D. H. Rice, and M. G. Paros. 1994. The prevalence of Escherichia coli O157.H7 in dairy and beef cattle in Washington State. Epidemiol Infect 113:199-207.
12. Hancock, D. D., T. E. Besser, D. H. Rice, D. E. Herriott, and P. I. Tarr. 1997. A longitudinal study of Escherichia coli O157 in fourteen cattle herds. Epidemiol Infect 118:193-5.
13. Hussein, H. S., and L. M. Bollinger. 2005. Prevalence of Shiga toxin-producing Escherichia coli in beef cattle. J Food Prot 68:2224-41.
14. Khaitsa, M. L., M. L. Bauer, G. P. Lardy, D. K. Doetkott, R. B. Kegode, and P. S. Gibbs. 2006. Fecal shedding of Escherichia coli O157:H7 in North Dakota feedlot cattle in the fall and spring. J Food Prot 69:1154-8.
15. LeJeune, J. T., T. E. Besser, D. H. Rice, J. L. Berg, R. P. Stilborn, and D. D. Hancock. 2004. Longitudinal study of fecal shedding of Escherichia coli O157:H7 in feedlot cattle: predominance and persistence of specific clonal types despite massive cattle population turnover. Appl Environ Microbiol 70:377-84.
16. MacDonald, K. L., M. J. O'Leary, M. L. Cohen, P. Norris, J. G. Wells, E. Noll, J. M. Kobayashi, and P. A. Blake. 1988. Escherichia coli O157:H7, an emerging gastrointestinal pathogen. Results of a one-year, prospective, population-based study. JAMA 259:3567-70.
17. Ogden, I. D., M. MacRae, and N. J. Strachan. 2004. Is the prevalence and shedding concentrations of E. coli O157 in beef cattle in Scotland seasonal? FEMS Microbiol Lett 233:297-300.
18. Ostroff, S. M., J. M. Kobayashi, and J. H. Lewis. 1989. Infections with Escherichia coli O157:H7 in Washington State. The first year of statewide disease surveillance. JAMA 262:355-9.
19. Pearl, D. L., M. Louie, L. Chui, K. Dore, K. M. Grimsrud, D. Leedell, S. W. Martin, P. Michel, L. W. Svenson, and S. A. McEwen. 2006. The use of outbreak information in the interpretation of clustering of reported cases of Escherichia coli O157 in space and time in Alberta, Canada, 2000-2002. Epidemiol Infect 134:699-711.
20. Rangel, J. M., P. H. Sparling, C. Crowe, P. M. Griffin, and D. L. Swerdlow. 2005. Epidemiology of Escherichia coli O157:H7 outbreaks, United States, 1982-2002. Emerg Infect Dis 11:603-9.
21. Rasmussen, M. A., and T. A. Casey. 2001. Environmental and food safety aspects of Escherichia coli O157:H7 infections in cattle. Crit Rev Microbiol 27:57-73.
22. Slutsker, L., A. A. Ries, K. D. Greene, J. G. Wells, L. Hutwagner, and P. M. Griffin. 1997. Escherichia coli O157:H7 diarrhea in the United States: clinical and epidemiologic features. Ann Intern Med 126:505-13.
23. Van Donkersgoed, J., T. Graham, and V. Gannon. 1999. The prevalence of verotoxins, Escherichia coli O157:H7, and Salmonella in the feces and rumen of cattle at processing. Can Vet J 40:332-8.

USDA Okays First E Coli 0157:H7 Vaccine In United States

A Brave New World is upon us. A vaccine for E. coli 0157:H7 is now available for use in cattle in the United States.

At least two other companies, including one with product already available in Canada, are also seeking approval from the U.S. Department of Agriculture to sell their vaccines.

The company that is first in the U.S. market with the vaccine is the Willmar, Minn.-based Epitopix. Its vaccine works by denying the E. coli the proteins it needs to absorb iron from the guts of cattle and thereby killing the bacteria.

Epitopix was given a conditional license to market the vaccine in the United States, but it must continue with both potency and efficacy studies required for a full license.

Bioniche Life Sciences Inc., which gained approval to market its vaccine in Canada last October, is also seeking USDA approval. Its vaccines goes for about $7 (US) per head. GeneThera Inc., based in Colorado, is also going through the process for U.S. approval.

In an industry where pennies often are pinched to cut per head costs of production, it remains to be seen how widely the cattle industry will adopt the new vaccines.

Go here, for more.

 

Top Ten Food Safety Challenges for 2009 - Bill Marler Style

As we're all getting ready to ring in the New Year, our thoughts usually turn to the resolutions for change we'd like to see in 2009.  And since this is a blog about food safety, what better way to do that than by highlighting Bill Marler's Top 10 excellent food safety challenges for us to meet head on in 2009.  Let's make this next year safer and less outbreak-ridden than the past one!

Now, on to the Top 10 list...

1. Globalization: More international recalls and outbreaks due to expanding globalalization of the food supply and the challenges of oversight/infrastructure in developing countries. International challenges probably deserve a list of their own, but in the mean time, this wide umbrella includes the possibility of bioterrorism and/or “economic/chemical terrorism” (intentional adulterations with a profit motive, like melamine).

2. Local Food: Outbreaks linked to local food and/or farmer's markets. Community Supported Agriculture (CSA) groups and food co-ops need to demonstrate knowledge and practice of food safety, and be inspected. In addition to produce and meats/fish, prepared items are currently unsupervised.

3. Non-O157 STEC (Shiga Toxic producing E. coli) illnesses and outbreaks (both beef and produce): E. coli O157:H7 is listed as an adulterant, is tested for, and is still a terrible problem. E. coli strains that are non-O157 (but are equally as deadly) have not been evaluated or listed, and are not regularly tested for.

4. Animal to Human contamination: More contamination events involving the whole food chain (from animal feed to animals to humans). Whether it’s dioxin in Irish hogs or melamine in Chinese egg-laying hens, it’s clear that what goes into animals eventually goes into us. As the market for animals-as-food grows, so does the price to feed those animals and then the impetus to cut corners.

5. Having to do more with less: Public funding for food safety research, surveillance, and education is down, but the work load (and its importance) continues to grow.

6. 21st Century communication: In addition to improving communication between each other, food safety agencies need to improve communication with consumers. Outbreaks will move through the population with increasing speed, and agencies need to streamline their processes (and embrace social media like twitter and Facebook) in order to keep up.

7. Balancing food protection and environmental health: How to balance on-farm food safety practices with the protection of water quality, the prevention of soil erosion & dust, and the protection of wildlife and their habitats.

8. Zoonotic diseases: The rise of grain prices and starvation in other parts of the world will have many consequences, including the possibility that as people hunt wild animals for food, they may become exposed to new diseases, triggering a zoonotic virus jumping into humans. (A zoonotic virus is one that originates in animals and crosses to humans, like avian influenza.)

9. Consumers and food safety: How do consumers sort through the cacophony of information on food? What’s “safe”? What does “organic” mean anymore? How is it that “USDA inspected and passed” doesn’t guarantee pathogen-free meat? Who does the consumer believe/trust? Included in this category are the raw milk controversy, food irradiation, and even the new labeling laws like COOL (Country Of Origin Label). Will we get closer to farm to fork tracking of all fruits and vegetables this year?

10. Pet food ills: Pet food testing is increasing, so the level of contamination will become more apparent, and we should expect more recalls. Supervision of the pet food industry as a whole needs improvement, with clarity in ingredients and calorie counts.

Melamine-Tainted Foods Still On US Shelves!

Winter has certainly come to the Northwest!  Here in Seattle we have over a foot of snow and the temperature has yet to crack freezing level in the past week and a half.  Wherever you are, now is the time of year to bundle up, take a walk, and sip on a nice cup of steaming hot cocoa.

But if you purchased that cocoa from Big Lots or Shopko under the brand name "G & J," put that cup down.   

Three "G & J" brand cocoa products packaged for Christmas sale at Big Lots and Shopko are being recalled after testing positive for melamine.  It seems this melamine problem will just not go away, as evidenced by the numerous recalls and stories from around the world, including contaminated baby formula in China that led to 294,000 children sickened, hundreds hospitalized, and at least six infants who lost their lives. 

As Phyllis Entis points out in her excellent three-part article, Getting Rid of Melamine, this problem is now not just China's or the US's.  More must be done to stop this type of flagrant disregard for food safety laws that puts all of us at risk.  How about starting with some of the suggestions made by Bill Marler in his open letter to the new Undersecretary for Food Safety at FSIS?

But I digress.  Getting back to the current recall, the products are:

  • Hot Cocoa Stuffer (bar code number 061361201444), sold in small green and blue packages along with a candy cane and marshmallows.
  • His and Hers Hot Cocoa Set (bar code number 489702201296), sold with two ceramic mugs in a brown box.
  • Cocoa (bar code number 061361201260), sold in two flavors -- French vanilla, sold in a small green bag, and double chocolate, sold in a small pink bag. Both have a whisk attached.

For more details, see the Wisconsin Department of Agriculture, Trade, and Consumer Protection.

Musical Tribute to Food Safety

Carl Winters and the other great folks at UC Davis's Food Science and Technology Department have put together an educational, and hilarious, musical tribute to food safety.  So head on over to their website and before you know it you'll be dancing to soon-to-be-classics like, We Are the Microbes or Who Left the Food Out!

 

Musical Tribute to Food Safety

Carl Winters and the other great folks at UC Davis's Food Science and Technology Department have put together an educational, and hilarious, musical tribute to food safety.  So head on over to their website and before you know it you'll be dancing to soon-to-be-classics like, We Are the Microbes or Who Left the Food Out!

 

The Future Of Foodborne Pathogen Testing Is Now

I have seen the future of foodborne pathogen monitoring technology!  According to a new article published by the US Department of Agriculture's Quality and Safety Assessment Research Unit, Salmonella detection (with other possible pathogens to follow) may be possible at a level not previously seen in food pathogen testing systems.

By using nanotechnology,  microscopic biological sensors can detect Salmonella bacteria in laboratory testing.  The sensors could be adapted to detect other foodborne pathogens as well.

The sensor is part of an evolving science known as nanotechnology—the study and manipulation of materials on a molecular or even atomic level, measured in billionths of a meter, which is about 10 to100 times thinner than a human hair.

There are examples of biosensors in nature. Insects detect tiny amounts of sex pheromones in the environment and use them as a beacon to find mates. And fish use natural biosensors to detect barely perceptible vibrations in the surrounding water.

ARS engineer Bosoon Park at the Quality and Safety Assessment Research Unit in Athens, Ga., and cooperators at the University of Georgia used nanotechnology to develop the biosensor. The detection method may have great potential for food safety and security, according to Park.

The biosensors that Park and his university colleagues developed include fluorescent organic dye particles attached to Salmonella antibodies. The antibodies hook onto Salmonella bacteria and the dye lights up like a beacon, making the bacteria easier to see.

People who eat Salmonella-infected food products can get salmonellosis, a disease characterized by nausea, vomiting, severe diarrhea, and sometimes death.

For his research, Park recently received the prestigious first place Innovation Nano Research Award at the Sixth International Nanotech Symposium and Exhibition, in Ilsan, Korea.

Perhaps this technology can help reduce the alarming number of people who fall ill from Salmonella outbreaks each year .

FDA Warning - Botulism in Ungutted, Salt-Cured Alewives (Gaspereaux) Fish

I'm not sure how many of you out there are avid consumers of ungutted, salt-cured Alewives fish (mmm, sounds delicious, doesn't it?), but for those of you who are you need to heed the FDA's just-announced consumer warning

Retailers and food service operators are being instructed not to offer for sale ungutted, salt-cured alewives (also called gaspereaux fish) from Michel & Charles LeBlanc Fisheries Ltd., CAP-PELÈ, New Brunswick, Canada, because the fish may contain the Clostridium botulinum (C. botulinum) toxin. Consumers should not consume the product.

C. botulinum toxin can cause botulism, a serious and sometimes life-threatening condition. The toxin cannot be removed by cooking or freezing.

The fish were imported into the United States and sent to these Florida distributors:

  • Quirch Foods Inc.
  • Den-Mar Exports LLC
  • Dolphin Fisheries Inc.
  • Labrador & Son Food Products Inc.

The fish were packed in 30-pound, white plastic pails with green plastic lids. The brand name "Michel & Charles LeBlanc Fisheries Ltd.," appears on the side of the pails, as does the phrase "Product of Canada." One hundred seventy-three (173) 30 lb. pails of fish were distributed. The fish may have been repacked or sold loose by retailers in Florida.

The FDA considers any ungutted fish over five inches in length that is salt-cured, dried, or smoked, such as the ungutted, salt-cured alewives/gaspereaux fish, to be adulterated because it could contain the C. botulinum toxin. The Florida Department of Agriculture and Consumer Services discovered the ungutted alewives/gaspereaux fish from Michel & Charles LeBlanc Fisheries Ltd. being sold in stores and alerted the FDA. The FDA prohibits the sale of this adulterated product in the United States.

To date, there have been no reported illnesses associated with this product. However, consumers who have purchased ungutted, salt-cured alewives/gaspereaux fish in Florida should contact the place of purchase to determine if the fish they bought originated from Michel & Charles LeBlanc Fisheries Ltd. If the fish were from this company or if the source of the fish cannot be determined, consumers should immediately discard the fish and any foods made with these fish. 

Symptoms of botulism poisoning can begin from six hours to 10 days after eating food that contains the toxin. Symptoms may include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth and muscle weakness that affects first the shoulders and then moves progressively down the rest of the body. Botulism poisoning can also cause paralysis of the breathing muscles which can result in death unless assistance with breathing (mechanical ventilation) is provided.

Individuals who show these symptoms and who may have recently eaten alewives/gaspereaux fish should seek immediate medical attention.

For information about other botulism related issues, check out http://www.botulismblog.com/.

Food Safety Still Has A Long Way To Go

It looks like Congress is about to throw Detroit a bone by infusing some taxpayer money into the cash-starved Big Three.  But the area Congress should really be focusing its attention is on the US's preparedness (or lack thereof) for health emegencies.

Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) released a report yesterday that concludes the US's ability to protects itself from disease outbreaks, natural disasters, and bioterrorism is now at risk from budget cuts and the worsening economic crisis.

With regard to food safety specifically, the report noted that America’s food safety system has not been fundamentally modernized in more than 100 years.  Further, twenty states and the District of Columbia do not meet or exceed the national average rate for being able to identify the pathogens, like E. coli O157:H7 and Salmonella, that are responsible for foodborne disease outbreaks in their respective states.

Conclusion?  SHOW FOOD SAFETY THE MONEY!

The full report is available here.

Outbreak Alert! 2008: Foodborne Illness Trends

The Center for Science in the Public Interest (CSPI) has released a report entitled Outbreak Alert! 2008 that has some fascinating, and disquieting, information regarding current trends in foodborne outbreak incidents.

After compiling data for outbreaks of illnesses linked to specific foods occurring between 1990 and 2006, the results are:

• Seafood: 1,140 outbreaks involving 11,809 cases of illness
• Produce: 768 outbreaks involving 35,060 cases of illness
• Poultry: 620 outbreaks involving 18,906 cases of illness
• Beef: 518 outbreaks involving 14,191 cases of illness
• Eggs: 351 outbreaks involving 11,143 cases of illness

The authors also have made some excellent recommendations for CDC and Congress based on their findings, including:

1.  The Centers for Disease Control and Prevention (CDC) should continue to improve outbreak reporting and surveillance. The CDC has improved its reporting and surveillance system, but gaps still remain. For example, nearly half of all states do not follow national standards for tracking disease outbreaks. Those gaps are particularly troubling given the numerous recent large outbreaks. Improvements in state oversight and coordination and increased funding at state level would allow CDC to act more quickly and could reduce the sizes of foodborne illness outbreaks.

2.  Congress should pass legislation to modernize food safety laws and increase funding, starting with FDA’s food safety program. While creating a unified, independent foodsafety agency would be the best solution in the long run, the crisis in confidence in FDA’s ability to manage food safety problems creates an urgency for making improvements at that agency. Outbreaks occur, in part, because of inadequate regulatory authority, inadequate monitoring, and inadequate funding. Congress should separate food safety from drug approvals, by creating a new Food Safety Administration at the Department of Health and Human Services. A new Administrator would oversee the modernization of the food safety program, with an enhanced mission in the areas of
prevention, inspection and enforcement and would help restore consumer confidence.

For the full report, click here

Food Poisoning On The Brain...Literally

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.

Muskrat feces: Salmonella fighter?

You can file this entry under the "DO NOT TRY AT HOME" category.  According to a new report out of South Korea, scientists have found that the excrement of muskrats - the semi-aquatic rodents prized for their musk - contains an antibiotic that can treat food poisoning.

Ki Keun Kim and colleagues at Pusan National University, South Korea, have found that muskrat excrement contains a potent antibiotic that can kill the Salmonella bacteria, a common cause of food poisoning, and also the Vibrio bacteria that cause seafood-linked food poisoning.

The antibiotic was also found to be effective against Staphylococcus aureus, a common cause of opportunistic infections, reports New Scientist.

Also, the experiments revealed that the compound kills termites as well, thus providing an environmentally friendly method of insect control.

It is possible to collect the antibiotic by drying the feces, and then using an organic solvent to extract the compound.

However, the patent did no reveal anything about the chemistry of the compound, or if could be safely administered to humans.

Turkey + Holidays = Foodborne Illness

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

Best Efforts Of Nation's Vet's Cannot Keep Avoidance Databank From Closing

Bryan Salvage at Meat & Poultry, the business journal for meat and poultry processors, today reports on the demise of the Food Animal Residue Avoidance Databank.

It was used by veterinarians, livestock producers and state and federal regulatory and extension specialists to ensure that drug, environmental and pesticide contaminants do not end up in meat, milk, and eggs. (Do you mean like MELAMINE?)

The Avoidance Databank began shutting down on Oct. 1st after it failed to get an infusion of cash and long-term funding from Congress. It needed about $2.5 million per year.

The American Veterinary Medical Association worked with Congress, through lobbying and grassroots efforts, to have language authorizing the Avoidance Databank at $2.5 million inserted in this year's Farm Bill. The USDA, however, never incorporated the funding in its budget, and Congress has provided neither emergency funding nor appropriations, Meat & Poultry reported.

"It's disheartening -- even tragic -- that a program that costs so little yet does so much to keep our food supply safe is not being funded," said Dr. Mark Lutschaunig, the Vet's government relations director. "We're talking about a cost of less than a penny per American to help keep meat, eggs and dairy products free of drugs and pesticides."

Even a supportive website could not offset the indifference or opposition by both the U.S. Food and Drug Administration (FDA) and USDA's Food Safety & Inspection Service.

 

Food Micro 2008 Conference Going On This Week

Britain's best known food safety expert, Professor Hugh Pennington, will be speaking to almost 850 delegates from 50 countries - including many leading scientists - attending Food Micro 2008 which is exploring a huge range of microbiological issues surrounding the safety and quality of food.

The Emeritus Professor of Bacteriology at the University of Aberdeen will ask whether lessons have been learned from the 1996 Lanarkshire E. coli outbreak when 21 elderly people died after eating contaminated meat from a Wishaw butcher.

Professor Pennington chaired the public inquiry into the case which was the world's worst recorded outbreak of E. coli food poisoning.

He is currently chairing the public inquiry into the 2005 E. coli O157 outbreak in Wales which claimed the life of a five-year-old and left 150, mainly schoolchildren, ill. Again contaminated meat supplied by a butcher was to blame.

Professor Hugh Pennington's talk entitled Groundhog Day Again! takes place on Thursday, September 4.

For more on conference, go here.  We will look for anything interesting that comes out of it, and pass it alone.

 

FDA Final Rule Favors Radiation Of Fresh Lettuce & Spinach

Someone we learned much from about government taught us that, for better or for worse, there are certain periods of time when things happen in near silence.   At the end of every year, from Thanksgiving through New Year's, many decisions without much notice or attention.  This occurs in every statehouse, courthouse, and city hall across the land.

The final days of every Presidency is also such a time.   For all that is written about "lame ducks," the power of the Presidency is every much as complete in its last moment as its first.  In other words, the outgoing administration is not less powerful just because Congress and the media are distracted by the campaign.

The issue of timing came to our mind as soon as we heard of the U.S. Food and Drug Administration (FDA)'s long awaited decision to allow ionizing radiation for the treatment of fresh iceberg lettuce and fresh spinach.

Radiation would be used "for control of food-borne pathogens" and "extension of shelf life."

A petition for voluntary use of ionizing radiation of many foods was presented to FDA in the final days of the Clinton Administration by the Grocery Manufacturers Association. With no action on it after six years, the association amended their petition to focus on fresh lettuce and spinach.

Both lettuce and spinach were subjects of E. coli 0157:H7 outbreaks at the time the petition was amended, illustrating the need for a "kill step" for pathogens.

The trouble with making big policy decisions at these moments when nobody is looking is that nobody is vested in the outcome.

"I do not know anyone clamoring for it." said Scott Horsfall of California's Leafy Green Marketing Agreement.   "There has to be consumer acceptance. We do not know how big a hurdle that might be. The science needs to be looked at and the cost, too."

While industry has its doubts and reservations, consumer groups are downright hostile to radiation of food with one activist calling it an "expensive gimmick."

Gimmick or not, its an FDA final rule.  One that "does not individually or cumulatively have a significant effect on the human environment."  In early 2009, we will find out just want its effect on the political environment will be when the new President and new Congress begin going through their "in" baskets.

San Francisco Chronicle has good story here

 

 

 

 

Attorney Denis W. Stearns Questions USDA Policies

Guest Blog by Denis W. Stearns:

On October 3, 2002 I submitted a petition to the USDA in which I asked the agency to explicitly clarify whether a USDA policy that appeared to allow the deadly pathogen E. coli O157:H7 on so-called “intact meat” applied to meat sold to retail outlets like grocery stores and restaurants. Even now it is a near-universal practice for retail outlets to use this meat—commonly called “boxed beef” because the cuts of meat are individually shrink-wrapped and then boxed—to make ground beef. Sometimes the meat is directly used to make ground beef, and sometimes only trimmings are used—that is, the pieces left over after roasts and steak are cut and trimmed. Either way, there has never been any doubt that tens of thousands of grocery stores and restaurants use tons of intact meat every day to make ground beef. To my mind it makes absolutely no sense that the USDA would allow meat companies to sell intact meat contaminated with E. coli O157:H7. Why allow a loophole so large that it essentially moots USDA policy on this deadly pathogen?

Interestingly, the USDA responded to my petition with a letter from Philip Derfler, Deputy Administrator of the Food Safety and Inspection Service. In the letter, Mr. Derfler acknowledged that USDA policy was unclear, and stated that my petition would be treated as a public comment and referred to the Regulations and Directives Development Staff. That was six years ago, and USDA policy is less clear today than it was back then, and just as indefensible.

We are now in the midst of yet another outbreak of heartbreaking illnesses and likely deaths caused by contaminated meat that the beef industry claims the USDA authorizes it to sell. This claim is hardly new either. In 2004, the American Meat Institute and other meat industry trade groups fought all the way to the United States Supreme Court trying to overturn a Wisconsin Court of Appeals decision. The decision held that USDA policy on intact meat did not immunize meat companies from lawsuits based on allegations that E. coli-contaminated meat was unreasonably dangerous as a matter of state law. In other words, the meat industry was fighting for the right to sell E. coli-contaminated meat, claiming that USDA policy said that it could. It lost, but that did not prompt the USDA to change or clarify its policy.

Putting legal arguments aside, common sense alone clearly demonstrates why an exception for intact meat makes no sense. While the meat industry can cleverly argue that its intact meat is not intended for ground beef, and that cooking always makes it safe, neither statement is true. As the recent Nebraska Beef outbreaks make tragically clear, most intact meat does not reach consumers still intact. Furthermore, if each shrink-wrapped cut of meat had “DO NOT USE FOR GROUND BEEF; E. COLI O157:H7 PRESENT” printed in bold letters on it, there is not a grocery store in the country that would buy it. Indeed, commenting on the current outbreak, a representative of Whole Foods explained that it was using intact meat to make its own ground beef “in an attempt to assure quality and safety.” I guess the joke was on them then.

The current USDA policy on E. coli and intact meat is indefensible because it protects the interests of the meat industry instead of the public health. A policy that is based on the demonstrably false assumption that intact meat is not being used to make ground beef at a retail level is a policy that has no basis in fact or reason. It also entirely ignores the incredible risk of cross-contamination, which is what caused the 2000 outbreak at a Milwaukee-area Sizzler restaurant that killed one child and sickened scores of others. The Sizzler outbreak also recently resulted in a $7.1 million verdict against the same meat company that fought to the Supreme Court (with industry trade groups) for the right to sell the deadly stuff. Meanwhile, all these years later, the USDA says it is continuing to consider its options. Well, I have a suggestion: How about putting the interests of the public first for a change and sticking to a real zero-tolerance policy for this deadly pathogen?

Adnan Sami Victim of Food-borne Illness: Making Recovery

We always try and note when famous people become victims of food-borne illnesses.

Bollywood News and Gossip is reporting that singer, composer, pianist Adnan Sami is recovering from severe food poisoning after being rushed to a hospital.

According to Bollywood:

Bubbly singer-cum-composer-cum-pianist Adnan Sami was recently rushed to the hospital as he suffered from severe food poisoning.

His ill health forced him to miss out the music launch of Vikram Bhatt’s flick 1920, for which he is the composer.

 

 

Bipartisan Group of Senators Led By Harkin Floats Food Safety Reform Bill

Congress is taking its usual summer recess and there is precious little real legislative time left before they leave town for good to campaign to get their jobs back.   Nevertheless, it is not unusual to have the concepts and support for legislation to come together now and become spring-loaded for advancing through the new Congress that will convene in January.

That might be what we are looking at in a food safety bill introduced last week by powerful farm state Senator Tom Harkin, D-Iowa.  The bill is cosponsored by Dick Durbin (D-IL), Judd Gregg (R-NH), Richard Burr (R-NC), Chris Dodd (D-CT) and Lamar Alexander (R-TN).  The bipartisan group put out a joint press release.

“This country doesn’t need any more spectacles like the slow unfolding of FDA’s investigation of the recent Salmonella outbreak. The present system is not just a public health concern, but an issue for producers feeling the economic impact of food safety scares,” said Harkin. “This food safety bill gives FDA the authority it needs to prevent and respond to food safety problems, from requiring recalls, to setting food safety standards for fresh produce, to enhancing trace-back and surveillance of food-borne illness. It’s a win-win for producers and consumers.”
“When Americans go to the grocery store, the last thing on their mind should be the safety of the foods they are bringing home to serve their families,” Gregg stated. “The recent salmonella outbreak highlights the current vulnerability of our food supply and the need to modernize our food safety laws. We cannot afford to wait until the next food-borne illness outbreak or an intentional attack on our food supply occurs for Congress to act on this bipartisan legislation to ensure the safety of our food and restore confidence in the quality of these products for American families.”


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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

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.

MRSA Found In Pigs & Farmworkers By University of Iowa

Andrew Schneider, Senior Correspondent for the Seattle Post-Intelligencer, ruined many a breakfast this morning---that’s if any of his Emerald City readers still eat bacon with their eggs.

You see Schneider put in his newspaper today what had already been on his Seattle P-I's "Secret Ingredients" blog:  that Tara Smith, an assistant professor at the University of Iowa Department of Epidemiology, and her graduate researchers found MRSA in more than 70 percent of the pigs they tested on farms in Iowa and Illinois.

MRSA -- methicillin-resistant Staphylococcus aureus –is a potentially fatal bacteria.
Schneider reports:

In what is apparently the first testing of swine for MRSA in the U.S., Smith and her team swabbed the noses of 209 pigs on 10 farms. They also found the bacteria among livestock workers employed by those hog operations.

On Friday, at the annual meeting of the American Society for Microbiology in Boston, Abby Harper, one of Smith's graduate assistants, presented the results of the study on farmworkers. She said she and Michael Male tested 20 workers at the Iowa swine farms and found that
45 percent carried the same MRSA bacteria as the pigs.

As they say in Seattle, "Its in the P-I" here.


About Food Poisoning

The CDC estimates that 76 million foodborne illness, or food poisoning, cases occur in the United States every year, which means that one in four Americans contracts a foodborne illness annually after eating foods contaminated with such pathogens as E. coli O157:H7, Salmonella, Hepatitis A, Campylobacter, Shigella, Norovirus, and Listeria. Approximately 325,000 people are hospitalized with a diagnosis of food poisoning, and 5,000 die. The estimated costs in terms of medical expenses and lost wages or productivity are between $6.5 and $34.9 billion (Buzby and Roberts, 1997; Mead, et al., 1999).

While most foodborne illness cases go unreported to health departments, nearly 13.8 million food poisoning cases are caused by known agents – 30% by bacteria, 67% by viruses, and 3% parasites (Mead, et al., 1999).

A recent report (2005) released by the CDC in collaboration with the FDA and USDA showed important declines in foodborne infections due to common bacterial pathogens in 2004. From 1996-2004, the incidence of E. coli O157:H7 infections decreased 42 percent. Campylobacter infections decreased 31 percent, Cryptosporidium dropped 40 percent, and Yersinia decreased 45 percent. Salmonella infections dropped 8 percent, but only one of the five most common strains declined significantly. The incidence of Shigella, which is found in a wide variety of foods, did not change significantly from 1996 through 2004. Vibrio infections increased 47 percent.

Foodborneillness.com describes seven of the most commonly recognized bacteria and viruses that cause food poisoning. In addition to a general description of each pathogen, we have provided information on the symptoms and risks of each kind of foodborne illness, as well as how they are detected as the cause of infection, and measures you can take to prevent contracting each type of bacterial or viral food poisoning.

The cost of foodborne illness

Mark Thibault recently commented on foodborne illness on his "Hypercycle" blog.  Part of his post was about the cost of foodborne illness:
Gastrointestinal illnesses, also known as upset stomach, are fairly common. The main pathogens are Salmonella, E-coli, Listeria, Campylobacter (all bacteria), Rotavirus and Norovirus. Diarrhea is second only to the common cold as a cause of lost working time, with about 25 days lost from work or school each year for every 100 Americans. 4 out of 5 children under 5 will develop Rotavirus. The overall cost has been estimated at $6.9 billion for bacterial infections (Department of Agriculture) and $1 billion for Rotavirus alone. Although no estimate have been publicly released, the economic impact of Norovirus can be estimated between $4 and $8 billion, as the CDC believes that over 50% of all food-borne diseases are due to this virus.
This chart helps illustrate his point:

Foodborne Illness Cost

Prevent foodborne illnesses

The Cariboo Press reports that according to Health Canada, seniors are more vulnerable to foodborne illness.

As we age, our immune system tends to deteriorate. The immune system is one of the most important mechanisms for fighting disease and preserving health, so a decrease in the level of disease- fighting cells is a significant factor in the number of infections that may occur.

In addition, undergoing major surgery also affects the body's ability to fight off infections. To counteract the effects of aging on the immune system, long-term regular exercise is important.

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Pregnancy and food no-nos

Julie Greene of the Herald Mail reports that there's a long list of dos and don'ts for pregnant women. Consumer Reports recently recommending a new don't - tuna of any kind.

Fish is an important source of protein that is low in saturated fat and high in nutrients such as omega 3 fatty acids. But some fish should be avoided by pregnant women due to their high mercury content, and other fish, with lower mercury levels, should be eaten in limited quantities.

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Eating Out This Weekend? You Need to Read This

Steve Burger of 14 WFIE reports that there are about 950 retail food establishments in Vanderburgh County, with more being added almost weekly.

All that's standing between you and the potential food borne illnesses possible at any of those restaurants, convenience stores and supermarket delis are three inspectors and one supervisor in the Food Section of the Vanderburgh County Health Department's Environmental Division.

The workload for each of those inspectors is approximately one third higher than federal recommendations.

Some viruses that can cause food borne illness are so contagious that as few as ten particles can spread the disease.

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Foodborne illness peaks in summer - Why?

She Knows reports that year after year, we hear and read the same advice: Handle food carefully in the summer because foodborne illness -- also known as "food poisoning" -- is more prevalent in warmer weather. Do foodborne illnesses increase during the summer months? If so, why?

Watch out for bacteria!

Yes, foodborne illnesses do increase during the summer, and the answer appears to be twofold. First, there are the natural causes. Bacteria are present throughout the environment in soil, air, water and in the bodies of people and animals. These microorganisms grow faster in the warm summer months. Most foodborne bacteria grow fastest at temperatures from 90 to 110 degrees Farenheit. Bacteria also need moisture to flourish, and summer weather is often hot and humid.

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Health 101: Cookouts aren't entirely carefree

Courtney Klemm of the Herald & Review (Decatur, IL) reports that as family and friends gather around in anticipation of juicy burgers and bratwursts, it may seem there is not a care in the world, but grilling has its health risks, nutrition experts say.

"One of the biggest concerns that people may not practice is making sure everything is cooked to the proper temperature," said Jananne Finck, University of Illinois Extension educator in nutrition and wellness. "Also, use the two-hour rule: Perishable foo ds should not be out for longer than two hours in room temperature. When food is sitting in the outdoors temperature, the two-hour rule decreases to just one hour."

According to the U.S. Department of Agriculture, outdoor-grilled hamburgers represent more than 30 percent of all hamburgers consumed at home. Outdoor grilling may be riskier, however, because patties that sit outdoors before grilling warm quickly, provid ing an opportunity for bacteria growth, and cooked hamburgers may become cross-contaminated if they are put on a plate that held raw patties.

Researchers at Kansas State University have also found that ground beef browns at different rates, so browning alone, which was long considered the means of determining ground beef to be cooked, is no longer an accurate indicator of doneness.

Beware! The foods that kill!

eDiets reports that you may have had food poisoning (you've become ill after eating a food contaminated with a bacteria, virus or toxin) and not have known it; that's because symptoms are similar to stomach flu. The FDA estimates that 60 million to 80 million people get sick annually from eating contaminated food, but that could be underestimated.

What's known is that more than 5,000 Americans yearly die from foodborne illness. The very young, the very old and those with weak immune systems are most vulnerable. Without warning you could be the next victim, but you can lower your risk by taking precautions. As usual, the educated consumer is the safest. Some foods need extra caution; all foods need proper preparation.

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Summer food safety: You know the grill

Doug Worgul of the Kansas City Star (MO) reports that grills just want to have fun this time of year, but you have to be careful when you cook with them.

Grilling is not without risks, says Fadi Aramouni, a Kansas State University Research and Extension food scientist. "Common food safety mistakes, especially underestimating cooking times or overlooking the need to check cooked temperatures, increase the risk of food-borne illness," he says in a monthly bulletin from K-State Research and Extension.

Researchers at Kansas State University have found that ground beef browns at different rates, so that browning alone -- long considered the primary means of determining ground beef to be cooked -- is no longer an accurate indicator of doneness.

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Simple Ways To Prevent Food Poisoning At Cookouts

Dr. Mallika Marshall for CBS4 Boston reports that for many of us, Memorial Day marks the traditional start of the summer picnic and cookout season.Unfortunately, thousands of Americans become sick from food poisoning every year.

"When you're at BBQ's or family events the kids are running around, it's very easy to get distracted and the other thing is the temperature being warmer in the summer, folks are not conscious of that and they are leaving food out and it's spoiling faster," said Michele DeBiasse, a registered dietician.

But the good news is that there are some easy ways to prevent foodborne illness.

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Dodging grocery aisle health risks

Sylvia Carter of Newsday recently wrote about Marion Nestle's book What to Eat: An Aisle-by-Aisle Guide to Savvy Food Choices and Good Eating. Nestle, the Paulette Goddard professor of Nutrition, Food Studies and Public Health at New York Univers ity and former chair of that department, has a PhD in molecular biology and a master's in public health in nutrition, but to research her book, she used common sense as well as science and shopping the aisles.

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Coming clean on washing vegetables: U of G food scientist, graduate student, have found an effective way to clean your produce

Thana Dharmarajah of The Guelph Mercury reports that scrubbing lettuce won't get rid of the pathogens hiding in the edges of the leaves or the pores of the vegetable, according to a University of Guelph food microbiologist.

Leafy vegetables such as spinach and cabbage, which tend to be eaten raw, have a higher risk of contamination, said Keith Warriner.

The vegetables can be exposed to contamination in the field through irrigation if the water source is contaminated with sewage, he said.

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Beware: 13 foods that kill

Debra Holtzman, JD, MA, for eDiets.com reports that according to the Centers for Disease Control (CDC), about 76 million Americans will suffer from food-borne illness, and at least 5,000 will die this year. Children, the elderly and those with compromised immune systems are at the greatest risk.

Symptoms of food-borne illnesses include diarrhea, abdominal cramping, fever, blood or even pus in the stool, headache, vomiting and severe exhaustion.

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Revised labelling required for poultry products

Ahmed ElAmin of Food Production Daily reports that by next month food companies will be required to have more explicit instructions that uncooked, breaded or boneless poultry products need to be cooked.

The new requirement was sparked by a recent food recall due to consumer confusion over whether such products needed to be cooked. The product led to a number of people falling sick from Salmonella enteritidis.

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Combination of hot-water surface pasteurization of whole fruit and low-dose gamma irradiation of fresh-cut cantaloupe

Journal of Food Protection, Volume 69, Number 4, April 2006, pp. 912-919(8)

Fan, Xuetong et al

Abstract:

Improvements in methods for disinfecting fresh-cut cantaloupe could reduce spoilage losses and reduce the risk of food-borne illness from human pathogen contamination. The objective of this study was to investigate the feasibility of using hot-water treatment in combination with low-dose irradiation to reduce native microbial populations while maintaining the quality of fresh-cut cantaloupe. Whole cantaloupes were washed in tap water at 20 or 76 degrees C for 3 min. Fresh-cut cantaloupe cubes, prepared from the washed fruit, were then packaged in clamshell containers, and half the samples were exposed to 0.5 kGy of gamma radiation. Native microflora populations and sensory qualities were evaluated during the subsequent 7 days of storage at 4 degrees C. The hot-water surface pasteurization reduced the microflora population by 3.3 log on the surface of whole fruits, resulting in a lower microbial load on the fresh-cut cubes compared with cubes cut from fruit treated with cold water. Irradiation of cubes prepared from untreated fruit to an absorbed dose of 0.5 kGy achieved a low microbial load similar to that of cubes prepared from hot-water-treated fruit. The combination of the two treatments was able to further reduce the microflora population. During storage, the headspace atmosphere of the packages was not significantly influenced by any of the treatments. Color, titratable acidity, pH, ascorbic acid, firmness, and drip loss were not consistently affected by treatment with irradiation, hot water, or the combination of the two. Cubes prepared from hot-water-treated whole fruit had slightly lower soluble solids content. The combination of hot-water pasteurization of whole cantaloupe and low-dose irradiation of packaged fresh-cut melon can reduce the population of native microflora while maintaining the quality of this product.

USDA's Meat and Poultry Hotline offers food safety recommendation for spring religious holidays

Per a FSIS Media Release, USDA's Meat and Poultry Hotline receives many calls during the spring season related to the preparation of traditional religious holiday celebrations.

To ensure food safety when using eggs, USDA's Meat and Poultry Hotline suggests that consumers do the following:

Buy eggs before the "Sell-By" or "EXP" (expiration) date on the carton.

Always buy eggs from a refrigerated case. Choose eggs with clean, uncracked shells.

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Foodborne Illness

CDC Center for Disease Control logoThe CDC estimates that 76 million foodborne illness, or food poisoning, cases occur in the United States every year, which means that one in four Americans contracts a foodborne illness annually after eating foods contaminated with such pathogens as E. coli O157:H7, Salmonella, Hepatitis A, Campylobacter, Shigella, Norovirus, and Listeria. Approximately 325,000 people are hospitalized with a diagnosis of food poisoning, and 5,000 die. The estimated costs in terms of medical expenses and lost wages or productivity are between $6.5 and $34.9 billion (Buzby and Roberts, 1997; Mead, et al., 1999).

While most foodborne illness cases go unreported to health departments, nearly 13.8 million food poisoning cases are caused by known agents -- 30% by bacteria, 67% by viruses, and 3% parasites (Mead, et al., 1999).

A recent report (2005) released by the CDC in collaboration with the FDA and USDA showed important declines in foodborne infections due to common bacterial pathogens in 2004. From 1996-2004, the incidence of E. coli O157:H7 infections decreased 42 percent. Campylobacter infections decreased 31 percent, Cryptosporidium dropped 40 percent, and Yersinia decreased 45 percent. Salmonella infections dropped 8 percent, but only one of the five most common strains declined significantly. The incidence of Shigella, which is found in a wide variety of foods, did not change significantly from 1996 through 2004. Vibrio infections increased 47 percent.

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