Food Poisoning Lawyer & Attorney : Marler Clark : Food Poison Journal

The FDA announced yesterday that yet another company is recalling black pepper products as a result of Salmonella contamination.  This recall is related to the Mincing Overseas Spice Company recall that occurred on the heels of a major salmonella outbreak linked to Salami products manufactured and sold by Daniele Inc. 

The FDA announcement reads as follows:  As a result of a recall of Black Pepper by Mincing Overseas Spice Company and distributed by Dutch Valley Food Distributors due to the possibility of contamination with Salmonella, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems, a product recall is being issued. 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.

Dutch Valley Food Distributors, Inc. has issued a voluntary recall for the following products with a Bulk Foods Inc. label:

5 Pound boxes of Seasoning Salt, item 808530, with a Mfg. date of 1/4/10 and 2/2/2010
5 Pound boxes of Perfect Pepper Seasoning, item 808399, with a Mfg. date of 1/4/2010
5 Pound boxes of Perfect Pepper Dip Mix, item 278115, with a Mfg. date of 12/7/2009
5 Pound boxes of Vegetable Dip Mix, item 278112, with a Mfg. date of 1/4/2010 and 2/2/2010
5 Pound boxes of Southwest Dip Mix, item 278109, with a Mfg. date of 2/2/2010

50 Pound boxes of Medium Black Pepper, item 808464 with a lot number of 3309 (B, F, G, K, P and T) and 3258 (B, D, G, L, P, Q, R, T and X)
20 Pound boxes of Coarse Black Pepper, item 808465 with a lot number of 3309 (B, F, G, K, P and T) and 3258 (B, D, G, L, P, Q, R, T and X)
25 Pound boxes of Fine Black Pepper, item 808466 with a lot number of 3309 (B, F, G, K, P and T) and 3258 (B, D, G, L, P, Q, R, T and X)
50 Pound boxes of Fine Black Pepper, item 808467 with a lot number of 3309 (B, F, G, K, P and T) and 3258 (B, D, G, L, P, Q, R, T and X)
25 Pound boxes of Whole Black Peppercorns, item 808468 with a lot number of 3309 (B, F, G, K, P and T) and 3358 (B, D, G, L, P, Q, R, T and X)
20 Pound boxes of Medium Black Pepper, item 808469 with a lot number of 3309 (B, F, G, K, P and T) and 3358 (B, D, G, L, P, Q, R, T and X)
5 Pound pails of Whole Black Peppercorns, item 808470 with a lot number of 3309 (B, F, G, K, P and T) and 3358 (B, D, G, L, P, Q, R, T and X)

All items packaged and sold within the parameters mentioned are subject to this recall, including items sold on our website, www.dutchvalleyfoods.com1. The items were distributed nationwide. Retailers are advised to remove all these products from store shelves based on lot number or manufacture dates. Consumers who have purchased these products are asked to destroy them. Consumers with questions regarding the products listed may call Dutch Valley Foods at 1-800-733-4191 and speak with customer service. For more information on FDA’s ongoing investigation, visit the FDA’s website at www.fda.gov2.

 

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What do you think, should the Food and Drug Administration (FDA) hire Stephen Colbert to do all of its consumer alerts for recalled products? 

Based on his informational (and comedic) handling of the latest product to be recalled in the ever-expanding Salmonella HVP outbreak, Pringles Cheeseburger and Taco Night flavored chips, Mr. Colbert has my vote.  As an aside, when did Cheeseburger and Taco Night become a flavor that people craved in chip form?  And who decides what "Taco Night" should taste like?  "Well Bob, it's coming along nicely but I still think it needs a little more Night to really give it that authentic Taco Night flavor."

The Colbert Report	Mon - Thurs 11:30pm / 10:30c
Consumer Alert - Pringles
www.colbertnation.com
Colbert Report Full Episodes Political Humor Skate Expectations

Honestly, would you rather go to the FDA's website here and attempt to locate the information yourself, or watch Stephen Colbert?

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As lawsuits commence, the Dupage County Health Department continues to receive reports of illness linked to the Lombard, Illinois Subway restaurant that is at the epicenter of a major shigella outbreak.  Spokesperson David Hass recently stated that lab tests have confirmed 21 illnesses in the outbreak.  At least seven people have been hospitalized. 

We have been contacted by 12 families now seeking representation due to illness amongst family members.  Of those, several have been confirmed by stool tests as outbreak cases, but many have not.  The reality of any foodpoisoning outbreak, no matter the bacteria and no matter the food vehicle, is that many more people than simply the confirmed cases were sickened. 

In fact, some estimates indicate that the number of people sickened in foodpoisoning outbreaks is actually 20 or even 30 times the number of "confirmed cases."  These additional "cases" of illness may not have had a stool sample tested; they may not have had medical attention at all; or they may have received antibiotics prior to submitting the stool test.  Whatever the case, they are no less outbreak cases than the "confirmed cases." 

How many people are actually ill in the Lombard, Subway outbreak?  The math is a little scary.  21 X 30 equals . . . a lot of sick people.

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The Dupage County Health Department announced on March 4, 2010 that it "is investigating the cause of a cluster of gastrointestinal illnesses primarily among customers of a Subway restaurant located at 1009 E. Roosevelt Road in Lombard. Restaurant ownership and corporate representatives have been cooperating with health officials, and the Lombard restaurant has been closed pending further results of the investigation.

We have been contacted by ten families that are likely victims of the outbreak.  We will file suit tomorrow on behalf of a young boy who ate a shigella-contaminated sandwich at the restaurant in late February and suffered a severe gastrointestinal illness as a result.  Fortunately the is recovering, but he has a ways to go. 

Many of the people we have spoken with have done what most ordinary Americans would do when suffering from a severe case of foodpoisoning, a primary symptom of which is, of course, diarrhea:  they went to the drugstore, or more likely had a friend or family member go for them, and purchased either Imodium or Lomotil in an attempt to get the diarrhea to stop. 

We are JD's not MD's, but many physicians will strongly discourage the use of these over-the-counter drugs while ill with a case of foodpoisoning, or virtually any kind of infectious diarrhea.  In fact, also in its March 4 press release, the Dupage County Health Department stated:

Persons who exhibit any of the symptoms of shigellosis are advised to contact their physician to arrange for appropriate testing and treatment, as indicated. Before using antidiarrheal agents such as loperamide (Imodium®) or diphenoxylate with atropine (Lomotil®), contact your physician, since antidiarrheal agents can prolong illness in persons with shigellosis, and should be avoided.

The reason is that drugs that are designed to prevent diarrhea actually inhibit the passage of disease-causing bacteria in stool.  This is one of the body's many natural defense responses to things (e.g. bacteria, viruses, parasites, etc.) that it recognizes as foreign.  It is thus a necessary, though uncomfortable, process.  The best advice, as the Dupage County Health Department notes, is to talk to your doctor. 

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Shigella is indeed a very frequent cause of foodborne illness.  It is estimated, in fact, that more than 17,000 people become infected by Shigella every year in the USA.  The routes of transmission are typically food and person-to-person contact, which is why Shigella is a frequent cause of outbreaks at daycare centers. 

What is 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 (American Public Health Association [APHA], 2000), making Shigella one of the most communicable and severe forms of the bacterial-induced diarrheas (Gomez et al., 2002). Shigella thrives in the human intestine and.

Past Shigella Outbreaks and Litigation:

• Lombard, Illinois Subway Outbreak (2010): Last week, a shigella outbreak was discovered at a Lombard, Illinois Shigella.  On Friday, it was announced that four more cases of shigellosis were confirmed Friday, bringing the total number of confirmed cases caused by the outbreak at the restaurant to 12, health department spokesman Dave Hass said. Of those 12 cases, seven have required hospitalization. Six of those who were hospitalized have been released, Hass said.
• San Diego Filiberto's Outbreak (2006):  On September 1, 2006, the San Diego County Health and Human Services Agency (SDHHS) and the San Diego County Department of Environmental Health announced that they were working together to investigate an apparent Shigella outbreak among customers who had eaten at the University Avenue Filiberto’s. The restaurant was closed on August 31, and according to a news release issued by SDHHS , at least ten people had become ill with apparent Shigella infections after eating at Filiberto’s in late August, three of whom were hospitalized.
• Airline Food Outbreak linked to Gate Gourmet (2004):  In September, 2004, health agencies from several U.S. states, as well as international health agencies, began reporting persons ill with Shigella sonnei infections. An epidemiological investigation conducted by the Hawaii Department of Health, in collaboration with other health agencies, revealed that a cluster of persons ill with a genetically identical strain of Shigella had traveled by air from Honolulu, Hawaii during August 22 through 24, 2004. The investigation established that food from airline caterer Gate Gourmet, Inc.’s Honolulu, Hawaii location was a common link between airlines and the cluster of persons ill with Shigella.  Gate Gourmet, Inc.’s Honolulu facility came under fire after an inspection by the Food and Drug Administration for numerous federal food safety violations in April, 2005. Investigators found pests and vermin, food stored at temperatures over fifty degrees higher than what is considered safe, and a ‘pink slimy substance’ in the washing machine.
• Colorado Doubletree Hotel (2003):  The Colorado Department of Public Health and Environment (CDPHE) received reports of a Shigella outbreak on September 9, 2003. Interviews confirmed that multiple people had been ill during or following their stay at the Doubletree Hotel in Westminster, Colorado. CDPHE notified the Foodborne and Diarrheal Diseases Branch of the federal Centers for Disease Control and Prevention (CDC) of a cluster of diarrheal illness among guests of the hotel. On September 12, CDC staff left Atlanta for Denver, to assist the CDPHE and Tri-County Health Department in their investigation of the outbreak.  Two separate large groups of hotel guests were identified; one group consisted of a wedding party; the second group consisted of a World War II veterans reunion, with attendees from a number of different states. Members of both groups, as well as a random sample of hotel guests, were contacted and interviewed; in all, 132 people.Ten individuals were diagnosed with culture-confirmed cases of Shigella sonnei infections.  On September 18, following positive stool tests from three food handlers, additional interviews of 25 kitchen staff were conducted. A kitchen chef cultured positive; he had worked September 4-6, had illness onset of September 8, and continued to work September 9-13.
• Royal Fork Shigella Outbreak (2001):   An employee at a Mt. Vernon, Washington restaurant was determined to be the source of a Shigella outbreak. The Skagit County Health Department confirmed nine illnesses linked to food served at Royal Fork.
• Senior Felix Outbreak (2000):  In January, 2000, a multi-state outbreak of shigellosis was traced to 5 Layer Fiesta Dip (“bean dip”) manufactured by Senor Felix Gourmet Mexican Foods. Over 335 people Washington, California, Oregon, Idaho, New Mexico, Arizona, and Alaska had confirmed or suspected cases of Shigella traced to the dip.

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The DuPage County Illinois Health Department has reported that four more cases of shigellosis were confirmed Friday, bringing the total number of confirmed cases caused by the outbreak at the Subway restaurant in Lombard to 12. Of those 12 cases, seven have required hospitalization. Six of those who were hospitalized have been released. The restaurant at 1009 E. Roosevelt Road in Lombard remains closed as investigators try to determine the cause of the outbreak.

In mid-October of 1999, an unusually high number of hepatitis A cases were reported among individuals residing in Northeast Seattle and Snohomish County, Washington. Public health officials conducted an epidemiologic survey that included questions about whether case-patients had eaten at fast food restaurants and grocery stores prevalent in the North Seattle area. By November 5, 1999, 18 of 21 persons confirmed positive with hepatitis A in King County after October 15, 1999 were found to have eaten at one of two Subway Sandwich outlets during the two to six week period prior to the onset of symptoms. During this same time period, the SHD determined that at least six persons with hepatitis A had eaten at one of the two implicated Subway outlets.

An environmental investigation resulted in the finding that neither of the implicated Subway outlets had a written hand washing policy, and that employees were not required to document their knowledge of proper hand washing technique. Having confirmed that the Subway outlets were, in fact, the outbreak’s common source, health department officials issued a press release that stated, in part, that: “An ongoing investigation by Public Health suggests that many [hepatitis A] infections are associated with consuming food from one of two Subway Salads and Sandwiches outlets during the month of September. . . .”

It is estimated that over 40 persons became ill as a result of eating contaminated food sold at the two Subway outlets implicated in the September 1999 hepatitis A outbreak. One child developed acute liver failure and required a transplant; many others were hospitalized with severe symptoms.

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When an outbreak happens at a restaurant, as opposed to an outbreak from a food item sold in grocery stores, the cause is frequently that one of the restaurant's employees was ill and contaminated food.  Often, other employees in the restaurant become sick as well, which can cause the problem of illness amongst customers to increase exponentially.  This is surely the case in the 2003 Salmonella javiana outbreak linked to Chili's restaurant in Vernon Hills, Illinois.  See Analysis of the Chili's Chicago-area Salmonella outbreak. 

The Shigella outbreak at Subway in Lombard, Illinois may also have been because of ill employees.  The Dupage County Health Department has not released any findings yet because its efforts have been aimed primarily at stopping the outbreak, and making sure that the restaurant is in shape to operate again.  Currently, there are at least 12 confirmed illnesses in the outbreak, with seven hospitalizations. 

The legal requirements in the State of Illinois related to ill employees are quite clear.  Section 750.500(a) of the Illinois administrative code states:

No person, while affected with a disease in a communicable form that can be transmitted by foods or who is a carrier of organisms that cause such a disease or while afflicted with a boil, or infected wound, or an acute respiratory infection, shall work in a food service establishment in any capacity in which there is a likelihood of such person contaminating food or food-contact surfaces with pathogenic organisms or transmitting disease to other persons.

Whether sick employees were a cause of the Lombard Subway Shigella outbreak remains to be determined for sure.  But its always a good guess in a restaurant outbreak situation. Other interesting legal requirements for Illinois restaurants appear at the Dupage County Health Department site.  Certain requirements sure to be the subject of much discovery in lawsuits surrounding the outbreak are:  The personal cleanliness of restaurant personnel, employee training, and manager training and certification. 

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The FDA has updated its expanding recall list of various products containing Hydrolyzed Vegetable Protein. The list now includes:

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, HK Anderson, Hawaiian, National Pretzel Company, President's Choice, Safeway, Sunflower Markets

Soup Mix Products - Castella, Homemade Gourmet

Stuffing Products - McCormick

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It was reported by the Bismark Tribune this weekend that the North Dakota Department of Health will not file charges against Aggie Jennings, an unlicensed caterer whose food was linked to more than 180 Salmonella Montevideo infections.

The illnesses occurred over the course of three separate events that Ms. Jennings catered.  Three days prior to the last event, the health department issued a cease order for Ms. Jennings's operation due to lack of a license.  Despite the order, Ms. Jennings went ahead and catered the final event, a large wedding reception, leading to additional infections.

Strangely, the health department that oversees enforcement of regulations for catering operations decided that Ms. Jennings will not be charged with operating an unlicensed catering business, a Class B Misdemeanor.  According to Lisa Clute, executive officer for the First District Health Unit of Minot, there is a two-year period in which charges can be filed, but the board that voted against it felt "there was no need to do that at this point."  Ms. Clute said occasionally there are cases of unlicensed caterers, and in her 15 years as executive officer for First District, no charges have ever been filed.

Let me see if I understand this correctly.  An unlicensed caterer ran a catering business that injured more than 180 innocent folks, including 10 who were hospitalized with severe Salmonella infections.  Further, that caterer was ORDERED by the health department to cease operations, yet she deliberately disregarded the order leading to additional illness.  This, of course, begs the question: if those actions do not warrant a charge, what does?  It seems to me that where there are no consequences for operating an unlicensed business, a person in Ms. Jennings's position would simply not spend the money and effort to obtain a license in the first place.

Would a catering license have prevented the Salmonella outbreak?  Who knows.  But a licensed catering business would have been inspected regularly and required to follow basic food preparation regulations.  Those requirements would certainly have at least reduced the likelihood of a source outbreak such as this one.

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Foodpoisoning is a major national health concern, with associated costs topping $152 billion annually.  Currently, several major national outbreaks and recalls are occurring, resulting in likely many hundreds, if not thousands of cases of foodborne illness.  Since July, over 245 confirmed cases of foodpoisoning (specifically salmonella) are linked to salami coated with black pepper; and Basic Food Flavors, Inc., a Las Vegas company is at the epicenter of a massive recall of hydrolyzed vegetable protein (HVP) used in many foods distributed nationally. 

Another outbreak that is thankfully, hopefully over is from infection by Shigella sonnei at a Chicago-area Subway restaurant.  The restaurant was closed by health authorities.  Actually, the restaurant in question is located in Lombard, Dupage County, Illinois, but for any national readers, calling it Chicagoland probably gives you a better idea of where the restaurant is.  So far, there are reports of at least 8 confirmed cases in the outbreak with four hospitalizations. 

But the current Shigella sonnei outbreak linked to the Illinois Subway restaurant is only one of several major outbreaks to hit the general Chicago area in recent years.  In July 2007, over 700 people became ill in an outbreak linked to food sold by Pars Cove restaurant at the Taste of Chicago Festival. 

And In June 2003, a large Salmonella outbreak occurred in Vernon Hills, Illinois, a Chicago suburb.  The outbreak occurred at a Chili's restaurant, and the conditions found at the restaurant were memorably appalling.  Here is a short summary of the outbreak:

The Lake County Health Department concluded its investigation into the outbreak on July 18 2003, by which time over 300 individuals had been sickened as a result of consuming contaminated food. Of those, 141 customers and 28 employees had tested positive for the Salmonella bacteria, while 105 other infected individuals met the LCHD’s definition of a probable case. LCHD issued a preliminary report that concluded the outbreak was caused by infected employees who contaminated food with Salmonella as a result of poor sanitary practices and improper food-handling. It was by this time also determined that the Salmonella associated with the outbreak was Salmonella serotype javiana, a relatively rare and virulent strain often associated with foodborne transmission.

Once the LCHD believed the outbreak was controlled, the department sent a letter by certified mail informing the restaurant’s management of a hearing scheduled for July 31 to discuss their failure to cease operations during periods where no hot water, or no water at all, was available, failure to adequately monitor their employees’ health, and the steps management had implemented to prevent future outbreaks.

Following the hearing, Executive Director Dale Galassie stated that Chili’s had violated local ordinances by remaining open and serving customers while without available water. Although LCHD decided not to pursue punitive measures against Chili’s and its management, the department sent a letter to Chili’s corporate parent requesting reimbursement of outbreak-related investigation costs, including testing and training of staff, in the total amount of $32,500. A health department official stated, “[t]hese were extraordinary circumstances. There were excessive costs in dealing with [the outbreak] and therefore we are requesting reimbursement. The good news is that it prevented a secondary outbreak as a result of cooperation of the Chili’s corporation, local media, and ourselves, but it doesn’t excuse poor local management decisions made that caused it.” After a relatively lengthy, silent delay, it was announced on December 2, 2003, that Chili’s agreed to reimburse the LCHD for the costs associated with the outbreak.

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Hydrolyzed vegetable protein, or HVP, is produced by boiling cereals or legumes, such as soy, corn, or wheat, in hydrochloric acid and then neutralizing the solution with sodium hydroxide. The acid hydrolyzes, or breaks down, the protein in vegetables into their component amino acids. The resulting dark colored liquid contains, among other amino acids, glutamic acid, which consumers are more familiar with in the form of its sodium salt, monosodium glutamate, or MSG. It is used as a flavor enhancer in many processed foods. (Wikipedia)  HVP is a flavor enhancer used in a wide variety of processed food products, such as soups, sauces, chilis, stews, hot dogs, gravies, seasoned snack foods, dips, and dressings. It is often blended with other spices to make seasonings that are used in or on foods.

The U.S. Food and Drug Administration is actively investigating findings of Salmonella Tennessee in hydrolyzed vegetable protein (HVP) manufactured by Basic Food Flavors, Inc., in Las Vegas, NV. The FDA conducted an investigation at the facility after a customer of Basic Food Flavors reported finding Salmonella Tennessee in one production lot of HVP to the new FDA Reportable Food Registry.

56 Products Recalled to Date:

Dip Products

Follow Your Heart
Great Value
Johnny's Fine Foods
Oak Lake Farms
T. Marzetti

Dressing and Dressing Mix Products

Follow Your Heart
Trader Joe's

Pre-Packaged Meal Products

Follow Your Heart

Snack and Snack Mix Products

Hawaiian
Soup Mix Products
Castella
Homemade Gourmet

Download All Recalled Hydrolyzed Vegetable Protein Containing Products

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We have been following the large outbreak and recall linked to Daniele Inc. salami products since the middle of January.  The outbreak began in July 2009, but was not discovered until January 2010.  Two strains of Salmonella--Montevideo and Senftenberg--are known to have been involved.  The recall began on January 23, 2010, with Daniele's recall of 1,263,754 pounds of salami products, eventually expanded to include almost 1.3 million pounds of salami products.  Now, nearly a month and a half after the outbreak and recall was announced, and after a total of 245 confirmed illnesses have been reported nationally, the FDA is announcing that Mincing Overseas Spice Company of Dayton, NJ, has recalled its black pepper product.  After a little further research, it appears that Mincing Overseas actually began recalling its products back on February 25, 2010.

Earlier today, I indicated that the Mincing recall did not occur until today, but it appears that that statement was incorrect.  See Mincing's February 26, 2010 statement.  Only the FDA's announcement of the recall occurred today.  But if that's the case, isn't it a little concerning that the FDA, one of the two federal agencies whose job is, in part at least, protecting the public's health didn't announce Mincing's recall until today, two weeks after the the company initially announced the recall?  Maybe I'm missing the FDA's earlier recall notice . . .

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The Chicago Tribune reported last night on a developing Shigella outbreak linked to a Lombard, Illinois Subway restaurant:

A Subway restaurant in Lombard has been closed by the DuPage County Health Department after several customers contracted gastrointestinal illnesses, officials said Thursday.

Health Department officials said in a statement that eight cases of shigellosis, an infectious disease caused by a bacterium called shigella, have been confirmed. Four people were hospitalized, according to the statement.

The Health Department said the restaurant at 1009 E. Roosevelt Road has been closed pending additional results of an investigation. Owners of the restaurant and representatives of Subway's corporate offices were cooperating with health officials, according to the statement.

Health officials said most people infected with the bacterium develop a gastrointestinal illness, including diarrhea, vomiting, fever and stomach cramps one to two days after being exposed to it.

Illness can pass from one infected person to the next and can also be acquired from eating contaminated food.

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It is agonizing to think about what the family of Anthony Arriaga went through as they witnessed the four-year-old choke to death on a hot dog in January.  The following is from an interview with KING 5 TV station in Seattle:

"When I turned around and looked at my child, he was just waving his hands on the table, pounding," said Marta Rodgriguez, Anthony's mother.

Anthony started to turn blue. His uncle and two responding police officers first on the scene tried the Heimlich maneuver but they could not dislodge the hot dog.

"I immediately thought to myself I was not going to give up, I was not going to let him die, I was not going to let him go," said Vicente Arriaga, Anthony's father.

Anthony did not make it. His parents, who do not speak English, say they never heard that hot dogs were a choking hazard for young kids.

As it turns out, choking is the most common cause of death in kids from 1 to 5 years of age, and choking on hot dogs causes 17 percent of those deaths.  As a result of the problem, the American Academy of Pediatrics is pushing for better labeling on the risks of choking, if not outright redesign of the popular hot dog.  In a recent article by Liz Szabo of the USA Today: 

The academy would like to see foods such as hot dogs "redesigned" so their size, shape and texture make them less likely to lodge in a youngster's throat. More than 10,000 children under 14 go to the emergency room each year after choking on food, and up to 77 die, says the new policy statement, published online today in Pediatrics. About 17% of food-related asphyxiations are caused by hot dogs.

"If you were to take the best engineers in the world and try to design the perfect plug for a child's airway, it would be a hot dog," says statement author Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio. "I'm a pediatric emergency doctor, and to try to get them out once they're wedged in, it's almost impossible."

The Consumer Product Safety Commission requires labels on toys with small parts alerting people not to give them to kids under 3. Yet there are no required warnings on food, though more than half of non-fatal choking episodes involve food, Smith says.

"No parents can watch all of their kids 100% of the time," Smith says. "The best way to protect kids is to design these risks out of existence."

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Yesterday, the CDC updated the case count in the Salmonella outbreak linked to recalled salami from Daniele Inc., red pepper from Wholesome Spice, and likely black pepper as well.  A total of 245 people are now counted by the CDC as cases in this outbreak, coming from 44 states and the District of Columbia.  But this is not the whole story.  The 245 figure does not include any Salmonella senftenberg illnesses, another strain of salmonella that we have long known has been causing illnesses in this outbreak. 

As for the Salmonella montevideo illnesses in this outbreak, as stated, there are 245 of them.  The distribution nationally is as follows:  AK (2), AL (2), AZ (7), CA (30), CO (5), CT (5), DC (1), DE (3), FL (3), GA (3), IA (1), ID (4), IL (19), IN (4), KS (5), LA (1), MA (14), MD (1), ME (1), MI (4), MN (6), MO (2), MS (1), NC (11), ND (1), NE (3), NH (2), NJ (9), NM (2), NY (18), OH (9), OK (1), OR (9), PA (7), RI (2), SC (1), SD (3), TN (5), TX (7), UT (9), VA (1), WA (17), WI (1), WV (1), and WY (2).

But what about Senftenberg?  The CDC says:

Salmonella Senftenberg, a different serotype of Salmonella, has been found in food samples from retail and a patient household during this outbreak investigation. PulseNet identified 6 persons who had illness caused by Salmonella Senftenberg with matching PFGE patterns between July 1, 2009 and today. Public health officials have interviewed 5 of the 6 ill persons with this strain of Salmonella Senftenberg and determined that two purchased a recalled salami product during the week before their illness began. These six cases are not included in the overall case count reported above.

One of the positive salami samples was from Lee Hanks, our client from Missouri whose salami twas truly a ticking time bomb, testing positive for both strains of Salmonella .  Lee tested positive for Salmonella Montevideo, so he is most likely included in the CDC's case count, but why are these 6 Senftenberg illnesses not included in the CDC's official case count?  Two of the 6 had purchased recalled Daniele salami in the week before their illnesses, but what about the other four?  Does the CDC suspect that the contaminated pepper is in other products, and that these Senftenberg illnesses may in fact be associated with the same contaminated pepper, just from another food product? 

Notably, the two potential suppliers of black pepper to Daniele (at least the two that are publicly known) have not recalled black pepper, despite an announcement by the Rhode Island Department of Health that a sample of the black pepper had tested positive for the outbreak strain of Salmonella Montevideo.  But, two days ago, Heartland Foods, Inc. an Indiana company, did recall black pepper.  Still many unanswered questions in this outbreak.

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Late yesterday, Tim's Cascade Snacks of Algona, Washington recalled its 'HAWAIIAN® Kettle Style Potato Chips - SWEET MAUI ONION’ AND 'HAWAIIAN - SWEET MAUI ONION RINGS' because they have the potential to be contaminated with Salmonella.  The recalled chips were distributed nationwide and in Canada through retail stores, distributors, direct delivery and internet sales. These products were sold as individual bags and as components of packs, including variety packs. No other 'Hawaiian' products are involved in this recall.

The 'HAWAIIAN® Kettle Style Potato Chips - SWEET MAUI ONION' AND 'HAWAIIAN - SWEET MAUI ONION RINGS' are being recalled because they contain HVP (hydrolyzed vegetable protein) manufactured, distributed and recalled by Basic Food Flavors, Inc., Las Vegas, NV.

So far, other companies that have recalled products due to salmonella contaminated HVP from Basic Food include Johnny's Fine Foods (au jus powder), T. Marzetti Co has recalled a variety of dips, and Kroger has recalled onion dip and soup mixes. 

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Today, Randolph Packing Co. Inc., an Asheboro, N.C. establishment, recalled approximately 96,000 pounds of beef products due to potential E. coli O157:H7 contamination.  It is not known yet, publicly at least, whether the recall is due to recognition of an outbreak of illnesses or to positive beef samples detected in USDA or company tests.  Whatever the case, the Randolph Packing beef E. coli recall brings the total amount of beef recalled in the last four months to 5,768,000 pounds. 

The running tally thus far:

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.

On February 4, West MissourI Beef, LLC, a Rockville, Missouri beef company, recalled 14,000 pounds of boneless beef products due to potential E. coli O157:H7 contamination.

On January 11, 2010, Adams Farm Slaughterhouse, LLC., an Athol, Mass., stablishment, recalled approximately 2,574 pounds of beef products due to potential E. coli O157:H7 contamination. The recall occurred in the wake of an epidemiological investigation into the E. coli illness of at least one Massachusetts resident.

On Christmas Eve 2009, National Steak and Poultry recalled at least 124 tons of mechanically tenderized beef products. The National Steak and Poultry outbreak caused at least 21 E. coli O157:H7 illness in 16 states, including nine hospitalizations and one case of HUS.

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

So Randolph Packing, where's the beef?  What retail establishments have the potentially contaminated products?

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To date, at least three different companies have recalled a variety of food products due to fears that the products contain salmonella-contaminated hydrolyzed vegetable protein (HVP).  Johnny's Fine Foods Inc. of Tacoma, WA, has recalled its powdered french dip au jus mix; Kroger has recalled two onion dip and soup mixes; and T Marzetti Company, a dip-maker, has recalled a variety of dips. 

All of the recalled products were produced using hydrolyzed vegetable protein, which is, according to Wikipedia, 

is produced by boiling cereals or legumes, such as soy, corn, or wheat, in hydrochloric acid and then neutralizing the solution with sodium hydroxide. The acid hydrolyzes, or breaks down, the protein in vegetables into their component amino acids. The resulting dark coloured liquid contains, among other amino acids, glutamic acid, which consumers are more familiar with in the form of its sodium salt, monosodium glutamate, or MSG. It is used as a flavor enhancer in many processed foods

Somehow it escaped this blogger's attention, but the company that apparently produced the contaminated HVP has also issued a recall.  Basic Food Flavors, a Nevada company that has produced HVPs since the 1980s, has posted a "recall list" on its website at www.basicfoodflavors.com/resources.html.  The list is extremely long and complex; hopefully word is getting to the apparently many customers who may have contaminated product.  

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Yesterday, Heartland Foods, Inc., an Indianapolis, Indiana company recalled "all sizes/containers of COARSE GROUND BLACK PEPPER shipped from their facility at 6815 E. 34th Street, Indianapolis IN. Potential distribution took place on or after October 19th, 2009 to February 17th, 2010." 

This recall comes on the heels of a major national outbreak linked to pepper-coated salami that has sickened at least 238 people in 44 states and the District of Columbia.  The outbreak has been making people sick since July, and has long been thought to be linked to contaminated pepper, both red and black.  In fact, Wholesome Spice Company, a Brooklyn, NY spice wholesaler, has also recently recalled red pepper.  The recall has spawned two lawsuits so far.  Also, yesterday's recall by Heartland Foods immediately followed the filing of a wrongful death lawsuit arising from a 2009 Salmonella outbreak linked to white pepper produced by UF Union International Foods, a California company. 

Heartland's recall prompts a few questions.  Is Heartland a customer of Wholesome Spice, or is it linked in another way to the Daniele/Wholesome outbreak and recall--e.g. were Heartland and Wholesome supplied by the same pepper exporter?  Wholesome has recalled only red pepper, but black pepper was originally fingered as the contaminated vehicle in the Daniele outbreak; so does Wholesome need to recall its black pepper too? 

Further, and more importantly from a public health standpoint, where is Heartland's contaminated black pepper?  Notably, it distributes to only retailers and food producers, meaning that its potentially contaminated products are used as ingredients in further processed foods.  Which ones, and where are they? 

And this just in, T. Marzetti Company has recalled its veggetable and chip-dip products due to potential salmonella contamination.  What was the contaminated ingredient in the dip?  Was it pepper?  Was it something else like hydrolized vegetable protein, which is the suspect vehicle in the recent recall of Johnny's french dip au jus recall? 

More answers to come, but with all the spice recalls and lawsuits lately, it would not be surprising to ultimately see some relationship between them.  See Spices:  emerging threat or clear and present danger. 

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Heartland Foods, Inc. of Indianapolis is voluntarily recalling all sizes/containers of COARSE GROUND BLACK PEPPER shipped from their facility at 6815 E. 34th Street, Indianapolis IN. Potential distribution took place on or after October 19th, 2009 to February 17th, 2010. These products have the potential to be contaminated with Salmonella, an organism which can cause serious and sometimes fatal infections in young children, the elderly, and other with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea, 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 product involved includes the following sizes: 1 lb Quart (jar), 4 lb Gallon, 8 lb Bucket (new pail). Each container is identified with an individual label showing the Heartland Foods company logo, the description: Coarse Ground Black Pepper, and the specific Net Weight of the container (i.e., 1 lb, 4 lb, 8 lb). Product distribution of Coarse Ground Black Pepper has been suspended while the FDA continues its investigation.

 

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Over the last several years, there have been multiple outbreaks linked to, and recalls of, various kinds of spices. From white pepper, to red pepper, to black pepper and beyond, spices are a potentially ideal vehicle for the transmission of foodborne disease. More and more people are becoming ill from contaminated spices, and more and more recalls are occurring. So is this problem merely an emerging threat? Or is it a problem that food producers must confront here and now, finding ways to better ensure the safety of the consumers they profit from.

Spice outbreaks in recent history:

1. Veggie Booty

In May 2007, the Centers for Disease Control and Prevention (CDC) began a multi-state investigation in response to an increase in laboratory reports, first posted on PulseNet on April 2, 2007, of Salmonella Wandsworth. Salmonella Wandsworth is a very rare serotype that was never before implicated in a U.S. outbreak. As of September 6, 2007, there were 69 reported cases of Salmonella Wandsworth in 23 states and 14 cases of Salmonella Typhimurium in six states who became ill after consuming Veggie Booty, a puffed vegetable snack food with a raw, dried vegetable coating. A total of 61 bags of Veggie Booty were ultimately tested in twelve states. Salmonella was isolated from thirteen of them. Eleven of the thirteen bags were positive for the outbreak strain of Salmonella Wandsworth, and one bag was positive for Salmonella Typhimurium and Enterobacter sakazakii. One bag also tested positive for Salmonella Kentucky, and Salmonella Haifa and Saintpaul were isolated from other bags.

2. Union International

The Union International Food outbreak sickened more than 79 people in Western states between December 2008 and April 2009; the majority of the illnesses were in California. Public health officials traced the outbreak to white pepper manufactured by Union International and sold under the brand names Uncle Chen and Lian How. Ultimately the company recalled more than 50 products, including spices, oils, and sauces, due to potential contamination with Salmonella.

3. Wholesome Spice Company and Overseas Spice

This outbreak and recall is, of course, still going on.  According to the CDC just days ago, 238 individuals infected with the outbreak strain of Salmonella Montevideo, which displays either of two closely related pulsed-field gel electrophoresis (PFGE) patterns, have been reported from 44 states and District of Columbia since July 1, 2009.  Epidemiological investigation showed that these 238 sick people all ate Daniele Inc salami products contaminated by salmonella.  Daniele used salmonella-contaminated pepper in the production of the various kinds of recalled salami. 

4. Today’s recall of Johnny’s brand French dip au jus powder?

Will the Johnny’s recall, announced today out of Tacoma, Washington, be another recall or outbreak to add to this list? The ingredient list for the recalled prodcut states that it contains: 'MSG, Wheat, Soy & Milk; Hydrolyzed vegetable protein (corn, soy, wheat), yeast extract, salt, rice flour, monosodium glutamate, partially hydrogenated vegetable oil (soy & cottonseed), caramel color, whey solids, non-fat milk solids, mono & diglycerides."  Only time will tell, hopefully, what happened at Johnny's to prompt today's recall.  Spices?  Certainly possible.

The historical trend:

These kinds of events naturally prompt the question why are we suddenly seeing outbreaks and recalls linked to pepper and other spices. Is this truly a new phenomenon; a new species of failure by food importers and producers? 
 

Continue Reading...

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The USDA's Food Safety and Inspection Service just published the list of retail locations that may have beef and veal products subject to Huntington Meat's 4.9 million pound E. coli recall.  There are far too many retail locations that may have the recalled meat to list here.  See Retail List to see whether stores in your neighborhood may have recalled meat.  My local grocery store is not, but I've been to many that are.  No illnesses have yet been reported due to the potentially contaminated meat.

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The Food and Drug Administration, along with the Centers for Disease Control and Prevention and the U.S. Department of Agriculture’s Food Safety and Inspection Service, continues to work closely with the Rhode Island Department of Health and other states in the investigation of an outbreak of Salmonella Montevideo infections associated with certain Italian-style sausage products including salami/salame.

The CDC reports that 238 people have been infected with a matching strain of Salmonella Montevideo in at least 44 states and the District of Columbia. The CDC and public health officials in multiple states conducted an epidemiologic study by comparing foods eaten by 41 ill and 41 well persons. Analysis of this study identified salami/salame as a possible source of illness: http://www.cdc.gov/salmonella/montevideo/index.html.

Daniele International Inc. has recalled a variety of ready-to-eat Italian-style meats. The recalled products, including salami and Hot Sopressata Calabrese, are regulated by the USDA-FSIS. A complete listing of all recalled products and a list of the stores that sold these products can be found at: http://www.fsis.usda.gov/News_&_Events/Recall_006_2010_Products/index.asp.

The FDA is actively investigating the supply chains of both black and red pepper used in the manufacturing of the recalled meat products. The Agency has collected and is analyzing 153 composite pepper samples, which represent more than 4,000 individual samples. To date, samples from two lots of crushed red pepper collected from Daniele International Inc. have tested positive for Salmonella. The FDA is working to determine if the type of Salmonella found in the samples matches the outbreak strain.

Based on FDA’s and the state of Rhode Island’s confirmed test results, the supplier of crushed red pepper, Wholesome Spice, Brooklyn, N.Y., is recalling 25-pound boxes of crushed red pepper sold from April 6, 2009, to Jan. 20, 2010: http://www.fda.gov/Safety/Recalls/ucm202113.htm. The FDA continues to investigate and work with Wholesome Spice to determine the source of the crushed red pepper contamination.

Wholesome Spice sells spices directly to commercial customers, who may have incorporated them into their own products. FDA is currently working with Wholesome Spice to identify the customers who received the recalled product and determine if further recalls are necessary.

The FDA continues to work with CDC, USDA-FSIS, the Rhode Island Department of Health, and other states to investigate the outbreak and will provide updates if new information becomes available.

Salmonella 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 (infected aneurysms), endocarditis and arthritis. Individuals having consumed any Italian sausage products and who may be experiencing these symptoms should contact a health professional immediately. For details on Salmonella sources, symptoms, and treatment, please refer to the Salmonella page on FoodSafety.gov: http://www.foodsafety.gov/poisoning/causes/bacteriaviruses/salmonella.html.

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This evening, Wholesome Spice and Seasoning Company, a Brooklyn, NY, spice wholesaler, recalled "all lots of 25 lb boxes of Crushed Red Pepper sold between 4/6/09 and 1/20/10."  See FDA Recall Notice.  The reason for the recall is, of course, that the recalled red pepper is contaminated with Salmonella, thus explaining (partially, fully?) a national Salmonella outbreak that has sickened, to date, at least 238 people from 44 states and the District of Columbia.

Of course, the recall notice hedges a little bit, stating in bold that "It cannot be determined at this time if this product has been related to any illnesses to date."  Whether this is an acceptable qualification of Wholesome's recall remains to be seen.  After all, health authorities and the companies involved have long suspected that pepper was the source of contamination in the outbreak, and we know that at least 238 people are sick nationally with salmonella and an exposure to Wholesome's now recalled product.  Logic would suggest that there really isn't much reason to hedge. 

But, as has been the case throughout the evolution of this outbreak, there are still important questions to be answered.  Are other products implicated?  Not just other Daniele products, but food products from other companies to whom Wholesome may have sold the contaminated pepper.  Wholesome needs to reveal exactly where the contaminated pepper is now, and who bought it, so that public health authorities, not just the companies involved, can determine whether there is any ongoing threat to public health.   

Another question borne of legitimate concerns about the sheer size of this outbreak.  Did the manufacturing environment at Daniele become contaminated too, so that other products than only those containing red pepper may also be contaminated?  

Finally, how many people are really ill as a result of consuming the contaminated products?  There are many reasons why an infected person may not test positive for the outbreak bacteria.  The person may not have received medical attention; he may have seen his doctor and not had a stool test done; a stool test may have been done but returned falsely negative; or the doctor may have prescribed antibiotics before testing the stool sample, thereby basically eliminating the efficacy of the procedure.  In any case, it is a virtual certainty that, in any outbreak situation, more people than just the ones counted in the CDC's official list have actually been sickened. 

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The Huffington Post today announced its list of the ten worst product recalls of all time.  The food recalls include melamine-tainted milk, worm-infested chocolates, and of course the September 2006 E. coli O157:H7 (and other serotypes) outbreak linked to Dole baby spinach.  The spinach outbreak was among the most devastating outbreaks ever to occur in this country. 

2006 Spinach Outbreak:  a short summary:

Official word of the spinach outbreak broke with the FDA’s announcement, on September 14, 2006, that a number of E. coli O157:H7 illnesses across the country “may be associated with the consumption of produce.” “Preliminary epidemiological evidence suggests,” the statement continued, “that bagged fresh spinach may be a possible cause of this outbreak.” By the date of the announcement, fifty cases had been reported to the CDC, including eight cases of hemolytic uremic syndrome (HUS) and one death. States reporting illness included Connecticut, Idaho, Indiana, Michigan, New Mexico, Oregon, Utah, and Wisconsin.

The much-publicized outbreak grew substantially over the next several days. By September 15, the FDA had confirmed 94 cases of illness, including fourteen cases of HUS and, sadly, one death. Recognizing the lethality of the developing outbreak, the FDA’s September 15 release warned people should “not eat fresh spinach or fresh spinach containing products.” 

Continue Reading...

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There has been no further word on the massive Salmonella outbreak that sparked a major recall by Daniele Inc. of salami products distributed nationally.  The latest CDC update on the outbreak was on February 18, at which point the CDC had identified 233 illnesses in 44 states linked to the outbreak.  But as of the date of the CDC's last update, there remained many unanswered questions in the outbreak investigation.

To recap, Daniele Inc has recalled a total of almost 1.4 million pounds of salami products, some produced as recently as mid February.  See list of recalled products.  It is widely thought that both red and black pepper used during production of the recalled salami products was the original source of contamination.  Daniele Inc's pepper suppliers are two companies called Overseas Mincing Spice Company and Wholesome Spice Company.  Daniele has terminated its relationship with Wholesome Spice Company and now reports that it is using irradiated pepper exclusively in its products. 

But it has been nearly a week since we have received any word on the status of the outbreak, despite epidemiological evidence that contaminated products may in fact still be in consumer households.  So, are people still getting sick?  Are we dealing with an ongoing threat to public health?  Has all potentially contaminated product been recalled?  And what is the latest on the status of the investigation into the pepper, both red and black, that has been identified as the original source of contamination?  Notably, neither pepper company, Overseas Spices or Wholesome Spice Company, has recalled any of its products.  What is the significance of this?  There are only three possibilities:  (1) the true source of contaminaton was at Daniele alone, (2) the pepper companies did not sell the contaminated pepper to any other companies, and they are confident that the Daniele recall is broad enough to include all potentially contaminated pepper, or (3) the companies simply have not acted to protect public health.  We would like to think, in this day and age and in this country, that the third possibility is, in fact, not possible, but events over the past several years are cause for concern.  Recall that we are only one year removed from the now infamous PCA salmonella outbreak, in which Stewart Parnell knowingly sent salmonella-contaminated product on to other companies for inclusion in peanut-based products.

 

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Late yesterday, a Bellingham, Washington company called Jackie's Jersey Milk recalled raw milk product due to possible contamination by E. coli O157:H7.  The contamination was detected during routine sampling and testing of the company's products by the Washington State Department of Agriculture. 

Products subject to the recall include all Jackie's Jersey Raw Jersey Cow Milk with a "use by" date through March 4, 2010.  The half-gallon containers are sold in retail grocery stores in Whatcom, Skagit, Snohomish and King counties, so anybody with any raw milk in their refrigerators from South King County to the Canadian border would be well advised to find out exactly where their raw milk came from before consuming it themselves, or more importantly giving it to any small children. 

 

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Washington and Oregon have been the site of two recent cheese recalls due to contamination by listeria monocytogenes.  The first was announced earlier this month by the Estrella Family Creamery of Montesano, Washington.   And the second was announced yesterday by Queserita Bendita, a Yakima area cheese producer.  Interestingly, not all of the recalled cheeses were made from unpasteurized milk, meaning that the production environment was contaminated. 

There are no recognized illnesses linked to the earlier recall, but at least five people are known to have been sickened, and hospitalized, as a result of consuming the recalled Queserita Bendita cheeses.  At least two of these people were pregnant women, and both gave birth prematurely due to fetal distress.  

Regarding listeria and pregnancy, the FDA issues strong cautions about the consumption of soft-cheeses made from unpasteurized, or raw, milk products:

Most of the time, pregnant women who are infected with listeriosis don't feel sick. However, they can pass the infection to their unborn babies without even knowing it. That's why prevention of listeriosis is very important. In any case, if you experience any of the above symptoms, see your doctor or health-care provider immediately.

During the first trimester of pregnancy, listeriosis may cause miscarriage. As the pregnancy progresses to third trimester, the mother is more at risk. Listeriosis can also lead to premature labor, the delivery of a low-birth-weight infant, or infant death. Fetuses who suffer a late infection may develop a wide range of health problems, including mental retardation, paralysis, seizures, blindness, or impairments of the brain, heart, or kidney. In newborns, L. monocytogenes can cause blood infections and meningitis.

The FDA also highlights the risks of consumption to pregnant hispanic women, who are particularly susceptible due to culturally-based greater consumption of soft-cheeses:

Studies show that pregnant Hispanic women may have a higher incidence of listeriosis than pregnant non-Hispanic women. This is most likely because they might make and eat homemade soft cheese and other traditional foods made from unpasteurized milk. "Queso fresco"- a traditional homemade cheese, prepared from unpasteurized milk and widely consumed by Hispanics - has led to miscarriages, death of newborns, and premature delivery caused by L. monocytogenes.

To prevent the risk of listeriosis, Hispanic pregnant women should not eat homemade soft cheeses and other traditional foods made from unpasteurized milk. Like all other pregnant women, they should follow the food safety precautions outlined below.

Notably, however, the cheeses included in the Queseria Bendita's recall are not made with unpasteurized ingredients.  The company actually uses pasteurized products, which means that the listeria bacteria was present at the processing facility.  The bacteria may have been in the facility due to fecal contamination of food products by an infected food worker, or by introduction of the bacteria to the environment on a contaminated ingredient.   

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In the midst of ongoing salmonella and listeria outbreaks involving red pepper/black pepper/salami and Queseria Bendita cheese, we will file a lawsuit tomorrow in Oakland on behalf of the family of an elderly woman who died in April 2009 after ingesting white pepper contaminated by Salmonella rissen bacteria.  The defendants are the companies that manufactured and distributed the contaminated product.  It is apparent from the FDA's investigation records, and from letters the FDA sent to Union International, the spice company that manufactured the contaminated product, that the production environment had many critical food handling and production problems that contributed to the outbreak.  

During the FDA's inspection of Union International, fourteen swabs taken from different locations at the production facility tested positive for Salmonella.  Regarding the concerning findings, the FDA advised the company in a November 24, 2009 letter sent to Daniel Chen, Vice President & Manager, that:

Each of these positive subsamples was further serotyped and determined to be S. rissen, the same serotype with an indistinguishable Pulsed-Field Gel Electrophoresis (PFGE) pattern as isolated from the samples of finished product. Finding Salmonella very near to where food is exposed indicates a high risk of product contamination. Based on our analytical and inspectional findings, your firm's pepper and other spice products are adulterated within the meaning of Section 402(a)(4) of the Act, [21 U.S.C. § 342(a)(4)],

Further, serious violations of the Current Good Manufacturing Practice (CGMP) regulation for foods, Title 21, Code of Federal Regulations (CFR), Part 110 (21 CPR 110), including possible routes of cross-contamination, were identified by our investigators

This letter may not list all the violations at your facility. You are responsible for ensuring that your establishment operates in compliance with the Act and the CGMP regulation (21 CFR Part 110). Failure to implement lasting corrective action of these violations and prevent their recurrence may result in regulatory action being initiated by FDA without further notice. The Act authorizes injunctions against manufacturers and distributors of illegal products, and the seizure of such products, under sections 302 and 304 [21 U.S.C. §§ 332 and 334]. In addition, section 303(a)(1) of the Act [21 U.S.C. § 333(a)(I)] provides that there is criminal liability for all violations of the prohibited acts described in section 301 of the Act [21 U.S.C. § 331].

The company immediately acted to correct the violations, but not before a lot of people were sickened in a major outbreak in the western United States.  Suit will be filed tomorrow on behalf of a woman who died as a result of Union International's and supplier's mistakes.

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The FDA announced yesterday a recall by Queseria Bendita of certain cheese products due to fears that the products are contaminated by Listeria monocytogenes.  The potentially lethal bacteria has been found at the Queseria Bendita facility and in samples of unopened, recalled product.

Queseria Bendita is a small cheesemaking operation in Yakima, WA. They've been operating since 2000 and make primarily Queso Fresco, Requeson and sometimes Queso Panela, which they distribute to Hispanic specialty markets in Everett, Seattle and Tacoma, Washington and Hillsboro, Oregon.  The company has recalled all these types of cheeses bearing a date code up to and including April 30, 2010.

Listeria monocytogenes is a type of bacteria that is found in water and soil. Vegetables can become contaminated from the soil, and animals can also be carriers. Listeria has been found in uncooked meats, uncooked vegetables, unpasteurized milk, foods made from unpasteurized milk, and processed foods. Listeria is killed by pasteurization and cooking. There is a chance that contamination may occur in ready-to-eat foods such as hot dogs and deli meats because contamination may occur after cooking and before packaging.

Lynne Terry, from The Oregonian, reported as follows on the Queseria Bendita outbreak based on her discussions with Oregon State Epidemiologist Bill Keene:

One mother lives in Clackamas County and the other is in Washington County. Keene said both babies were delivered slightly prematurely because of fetal distress.

People with compromised immune systems are especially susceptible to the organism. It poses a particular risk to pregnant women, who can have miscarriages or seriously sick babies. The infants don’t always make it.

Although queso fresco has been associated with listeria because it's often made with raw milk in poor conditions, this dairy uses pasteurized milk, Keene said.

Still, inspectors from Washington state found listeria at Queseria Bendita’s small facility in Yakima. Positive samples were also found in unopened packages of its queso fresco, Keene said.

The cheese was sold to a limited number of stores in Oregon, mainly in the Portland and Hermiston areas.

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In order to aid consumers, the Food Safety and Inspection Service of the U.S. Department of Agriculture has consolidated into this one list all the of ready-to-eat Italian deli meats and sausages currently subject to recall by Daniele International Inc.

On January 23, 2010 and in an update on February 4, 2010, Daniele International Inc., an establishment with operations in Pascoag and Mapleville, R.I., recalled 1,263,754 pounds of the following 20 products:

3-ounce packages of "DANIELE NATURALE SALAME COATED WITH COARSE BLACK PEPPER."
 

Approximately 6-pound packages of "DANIELE SALAME GRANDE COATED WITH PORK FAT & PEPPER."

10-ounce packages of "DANIELE NATURALE SALAME COATED WITH COARSE BLACK PEPPER."
Catch weight packages of "DANIELE PEPPER SALAME."

9-ounce packages of "BLACK BEAR OF THE BLACK FOREST BABY GENOA PEPPER SALAME."

20-ounce packages of "DANIELE DELI SELECTION, GENOA SALAME, SMOKED SALAME, PEPPERED SALAME, RUSTIC SALAME."

340- and 454-gram packages of "DANIELE SURTIDO FINO ITALIANO, SALAMI GENOA CON PIMIENTA, LOMO CAPOCOLLO, SALAMI CALABRESE."

16-ounce packages of "DANIELE ITALIAN BRAND GOURMET PACK, HOT CALABRESE, PEPPER SALAME, HOT CAPOCOLLO."

8-ounce packages of "DIETZ & WATSON ARTISAN COLLECTION PARTY PLATTER PACK, HOT CALABRESE, PEPPER SALAME, HOT CAPOCOLLO."

8-ounce packages of "DANIELE ITALIAN BRAND GOURMET PACK, HOT CALABRESE, PEPPER SALAME, HOT CAPOCOLLO."

16-ounce packages of "DANIELE GOURMET COMBO PACK, PEPPER SALAME, CAPOCOLLO, CALABRESE."

500-gram packages of "DANIELE ITALIAN BRAND GOURMET PACK EMBALLAGE ASSORTI GOURMET ITALIEN, HOT CALABRESE, PEPPER SALAME, CALABRESE PIQUANT, SALAMI AU POIVRE, HOT CAPOCOLLO, CAPOCOLLO PIQUANT."

8-ounce packages of "BOAR'S HEAD BRAND ALL NATURAL SALAME COATED WITH COARSE BLACK PEPPER."

Catch weight packages of "DIETZ & WATSON ARTISAN COLLECTION, BABY GENOA PEPPER SALAME, MADE WITH 100% PORK COATED WITH BLACK PEPPER AND PORK FAT."

20-ounce variety packages of "DANIELE DELI SELECTION, GENOA SALAME, SWEET SOPRESSATA, PEPPERED GENOA, MILANO SALAME."

21-ounce variety packages of "DANIELE GOURMET ITALIAN DELI SELECTION, SWEET SOPRESSATA SALAMI, PEPPERED GENOA SALAMI, HOT SOPRESSATA SALAMI, MILANO SALAMI, SALAMI SOPRESSATA DOUX, SALAMI GENOA POIVRÉ, SALAMI SOPRESSATA PIQUANT, SALAMI MILANO."

7-ounce packages of "DANIELE SALAME BITES PEPPER SALAME."

14-ounce packages of "DANIELE GOURMET ITALIAN DELI SELECTION ASSORTMENT DE FINES CHARCUTERIE ITALIENNE, SWEET SOPRESSATA SALAMI, MILANO SALAMI, SALAMI SOPRESSATA DOUX, SALAMI MILANO."

Catch weight packages of "DANIELE NATURALE SALAME COATED WITH COARSE BLACK PEPPER."

32-ounce variety packages of "DANIELE DELI SELECTION, GENOA SALAME, SWEET SOPRESSATA, PEPPERED GENOA, MILANO SALAME."

Each package bears a label with establishment number "EST. 9992" or "EST. 54" inside the USDA mark of inspection. The establishment is recalling all the products listed above which are currently in commerce. These products were distributed to retail establishments nationwide, as well as internationally.

On January 31, 2010, Daniele International Inc. expanded the recall to include 17,235 pounds of the following three products:

Packages of "DANIELE HOT SOPRESSATA CALABRESE," produced on 11/7/09, 12/16/09 and 12/18/09.

Packages of "DANIELE SOPRESSATA CALABRESE," produced on 12/16/09 and 12/18/09.

Packages of "BOAR'S HEAD BRAND HOT SOPRESSATA CALABRESE," produced on 11/28/09, 12/9/09 and 12/14/09.

Each package bears a label with establishment number "EST. 54" inside the USDA mark of inspection and weighs approximately 3 to 3.5 pounds. These products were distributed to retail establishments nationwide.

On February 16, 2010, Daniele International Inc. expanded the recall to include 115,000 pounds of the following seven products:

8-ounce packages of "DANIELE HOT SALAME PANINO WITH FRESH MOZZARELLA."

8-ounce packages of "BOAR'S HEAD SALAME PANINO, SALAME ROLLED IN MOZZARELLA CHEESE."

8-ounce packages of "DANIELE ITALIAN STYLE SALAME PANINO, HOT SALAME ROLLED IN MOZZARELLA CHEESE."

Random weight packages of "DANIELE ITALIAN STYLE SALAME PANINO, HOT SALAME ROLLED IN MOZZARELLA CHEESE."

8-ounce packages of "DIETZ & WATSON ARTISAN COLLECTION HOT SALAME PANINO, HOT SALAME ROLLED IN MOZZARELLA CHEESE."

8-ounce packages of "DANIELE SALAME PANINO WITH FRESH MOZZARELLA AND BASIL."

1-pound 8-ounce variety packages of "DANIELE CAPOCOLLO PANINO WITH FRESH MOZZARELLA AND BASIL; PRESIDENT'S PROSCIUTTO PANINO WITH FRESH MOZZARELLA AND BASIL; HOT SALAME PANINO WITH FRESH MOZZARELLA," with UPC Code 736436709582.

NOTE: The products contained in this variety three-pack may be sold individually as well.
Each package bears a label with establishment number "EST. 459" inside the USDA mark of inspection. The above products are sold individually packed, except as noted above. The products subject to recall have sell-by dates ranging from February 3, 2010, through May 26, 2010, and were distributed to retail establishments nationwide.
 

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In the last two days, information has continued to trickle in from several sources (primarily, and refreshingly, the company itself) about the ongoing salmonella outbreak linked to recalled salami and black pepper . . . and now red pepper.  Yesterday evening, Daniele also disclosed that the supplier of the contaminated red and black pepper was the same entity, Wholesome Spice and Seasonings, who has long been associated with this outbreak.  Daniele has since terminated its relationship with Wholesome Spice, and is now buying only irradiated pepper for use in its salami products. 

Continuing disclosure of these bits of information is crucial to not only the epidemiological investigation into the outbreak, but also as a measure of preventing further illnesses from occurring--particularly since Daniele's most recent recall expansion included products produced as recently as February 15, 2010.

But one by-product of more information, sometimes, is more questions.  First, can we assume that Wholesome Spice Company, known to have supplied Daniele with black pepper, was also the supplier of the red pepper that tested positive for Salmonella?  Or did Mincing Overseas Spice Company supply Daniele with red pepper too? 

Why it matters:  in an outbreak with so many twists, turns, and new developments, nothing is too far-fetched to require a little investigation.  And if Mincing Overseas Spice Company did supply red pepper (maybe Mincing and Wholesome received red pepper from the same grower/supplier), there may be a need to recall salami products made with red pepper from Mincing too.

Second, and most importantly considering the still-evolving nature of this outbreak, is there a need to be concerned about environmental contamination--i.e. bacterial contamination of the equipment, premises, or workers--at Daniele, Inc?  There has been so much product recalled, and so many potential sources of contamination identified, that it would not be beyond reasonable possibility that the problem is now (if not since the beginning) that there is a persistent source of contamination at Daniele Inc itself. 

Nor would it be the first time that such a scenario--i.e. environmental contamination in a pepper outbreak--has occurred.  In March and April 2009, Union International Food Company recalled a variety of pepper products implicated in a large Salmonella serotype rissen outbreak that sickened many people in the western United States.  Investigation in the Union International outbreak revealed widespread contamination at the Union Internation facility.  And incidentally, we are filing a lawsuit this week on behalf of an elderly California woman who died as a result of her salmonella infection in the Union International outbreak. 

Environmental contamination is, indeed, an important possibility to consider in the ongoing outbreak linked to Daniele Inc's salami product, and not just from a retrospective point of view.  As noted above, Daniele's recent recall expansion included products produced as recently as February 15, making it certainly possible that the company has concerns that the salmonella is still in its facility.  And if the salmonella is still there, and its there not just on red or black pepper, but also on the equipment, premises, or in infected food workers, there is also the possibility that more products than just ones containing black or red pepper are contaminated.  Again, a conservative approach to this recall and outbreak by the companies involved is only going to cause more illnesses. 

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In a statement released today, Daniele Inc. indicates that the black and red pepper that was included in its recalled salami products came from the same supplier,  The statement reads, in part, as follows:

On February 16, 2010, Daniele expanded this recall because of concerns about red pepper used at one
of its plants. The company voluntarily recalled 115,000 pounds of its Hot Salame Panino product
produced between November 5, 2009 and February 15, 2010. The red pepper used on this product came
from the same supplier that provided Daniele with black pepper that also tested positive for salmonella.
Daniele has terminated its relationship with the supplier and is now using only irradiated pepper.

This is useful information in the context of what is clearly a continuing investigation into an ongoing public health event.  Daniele indicates in the statement that yesterday's expansion of its recall included products produced between November 5, 2009 and February 15, 2010.  With a last production date, based on information known now, just a couple of days ago, this timely information hopefully will be crucial in preventing some illnesses. 

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Yesterday evening, the USDA's Food Safety and Inspection Service (FSIS) announced that Daniele Inc is expanding its January 23 2010 recall of salami products to include another 115,000 pounds of potentially contaminated salami.  See list of recalled products.  The expansion is yet another twist in an outbreak that has continued to evolve, and with sometimes only limited information passed to the public by investigating health officials and the companies involved. 

But the recent expansion is more significant for the many questions that it creates.  It is based upon the presence of salmonella in salami packages that did not contain any black pepper, which has long been thought to have been the source of contamination in the outbreak.  Now, health authorities believe that crushed red pepper included in some of the Daniele Inc product may have been contaminated as well.

Here is a quick list of questions that need to be answered:

1.  Who is the supplier of red pepper? 

Why it matters:  if tests have indicated the presence of salmonella on the crushed red pepper that Daniele Inc used, the same contaminated pepper may have been distributed to other food producers or retailers, so more foods may be, or might become, contaminated.  Pepper has a long shelf life, so if this product is, indeed, elsewhere in the consumer chain of distribution, it represents an ongoing threat to human health.

2.  How many strains of Salmonella are implicated in this outbreak, and what are they?

The FSIS press release about the recall expansion tells us that crushed red pepper may now be contaminated, but says nothing about the strain of salmonella that was isolated.  We know Montevideo, and we know Senftenberg, It would seem unlikely, unless the supplier of the black and red pepper was the same, that both would be contaminated with the same strains of Salmonella.  Maybe the red pepper was contaminated with one, and the black with the other; or maybe the black with both known strains, and the red with a totally new strain.  Whatever the case, the public should have the benefit of this knowledge. 

3.  Have all potentially contaminated products been recalled?

Surely, the companies involved would say yes, but yesterday's announcement is, after all, effectively the third announced recall by Daniele, each one including more and different products.  So, has Daniele Inc taken a conservative approach to recall?  Or has it acted as broadly in scope as the ongoing risk to public health would seem to dictate. 

But at least Daniele has acted.  One thing causing great concern, here at least, is that there has been no recall of pepper, either the black or the red, despite tests that have confirmed the presence of salmonella in pepper from two, and maybe even three different companies.  Maybe Daniele was Overseas Spice and Wholesome Spice's only customer, and those companies have accurately determined that there is no ongoing risk because Daniele's recalls encompass all the potentially contaminated product.  We can only speculate at this point, but that doesn't sound like a sustainable business model. 

4.  Is the model currently in place for telling the public crucial information about outbreaks and recalls really the most efficient method we can think of?

The flow of information to the public about this major outbreak has been slow.  Recall that the CDC announced this outbreak in January by stating that the implicated product was "a widely distributed contaminated food product."  At the time of the CDC's announcement, it was certainly known by US Government that Daniele Inc's salami was the "widely distributed contaminated food product."  But instead of the CDC just saying that, it fell to Bill Marler, a private citizen way out in the northwest corner of the country, to announce what the product really was.

On her blog, Obamafoodorama.com, Eddie Gehman Kohan asked "How is it possible that a blogger notifies the public of a new Class I (you could die) recall of 1,240,000 pounds of meat before USDA does?":  She continued, "It's a grim situation when a private citizen is more on the ball than the federal agency that's supposed to be managing national food safety concerns (CDC's own e mail heads-up about the outbreak included no information, except that a product sold nationally was contaminated with Salmonella Montevideo)."

So back to the original question, is a system that is so reliant on the private sector--instead of first responders like the government, CDC, FDA, FSIS--to pass information about food outbreaks really an efficient model?  There are 230 recognized illnesses in this outbreak, many of which fell ill long before the pieces to the puzzle had fallen into place, but certainly some of whom fell ill after government and certain industry members knew the most essential details.  Clearly, this is not efficient from a public health standpoint, and some would certainly argue that it's not very efficient from a business standpoint either.  After all, the losses generated by the publicity surrounding these outbreaks in the form of reduced sales and lawsuits certainly compound the longer the outbreak remains in the public spotlight.  And one sure way of accomplishing that is to deliver information piecemeal and untimely.

 Many questions yet to be answered as this outbreak continues to unfold. 

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Daniele International Inc., an establishment with operations in Pascoag and Mapleville, R.I., is expanding its January 23 recall to include approximately 115,000 pounds of salami/salame products that may be contaminated with Salmonella, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The recall is being expanded as a result of a confirmed finding of Salmonella in an unopened salami product tested by FSIS, and by ingredient testing performed by the company. The product was sampled during the course of an ongoing investigation of a multi-state outbreak of Salmonella serotype Montevideo illnesses. These products were not subject to recall previously because they are not sausage products that contain black pepper on the external surface, or packaged with such products. Based on preliminary testing results, the company believes that crushed red pepper may be a possible source of Salmonella contamination.

Further testing is ongoing at a state health partner laboratory, and may determine if the product contained the Salmonella Montevideo strain associated with the multi-state outbreak. The Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), FSIS, state health and agriculture departments, and Daniele International are cooperating in this investigation. The CDC has posted information about the multi-state outbreak on its website (http://www.cdc.gov/salmonella) but the investigation is ongoing and the root cause of the contamination has not yet been determined.

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We have known for some time now that Daniele Inc.'s recalled salami products, and pepper sold by Overseas Spice Company and Wholesome Spice, were contaminated with more than one strain of Salmonella.  We have also known for some time that the strains involved, or at least two of them, are Montevideo and Senftenberg.  But who knew that some of the recalled, contaminated Salami products were contaminated with BOTH strains of Salmonella? 

Lee Hanks, our client from Missouri who filed the second suit nationally linked to this outbreak, found out the hard way.  Two of the salamis in a variety pack (hot calabrese and hot capocollo) that he purchased from a Missouri Costco store tested positive for both strains of the bacteria.  One wonders what discovery will show regarding the extent of contamination of the recalled salami products, and the black pepper used to make it. 

 

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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. 

The expansion of the Huntington Meat recall is remarkable for both its size and the fact that it occurred based on evidence gathered during an ongoing criminal investigation being conducted by the Office of the Inspector General (OIG) with assistance from FSIS. This evidence shows that the products subject to this recall expansion were produced in a manner that did not follow the establishment's Hazard Analysis and Critical Control Points (HACCP) plan. A HACCP plan describes the process controls an establishment must take to prevent food safety hazards and create a safe and wholesome product. The investigation has uncovered evidence to show that the food safety records of the establishment cannot be relied upon to document compliance with the requirements.

This recall expansion continues the disturbing trend of major meat recalls over the last several months.  On February 4, West MissourI Beef, LLC, a Rockville, Missouri beef company, recalled 14,000 pounds of boneless beef products due to potential E. coli O157:H7 contamination. 

On January 11, 2010, Adams Farm Slaughterhouse, LLC., an Athol, Mass., stablishment, recalled approximately 2,574 pounds of beef products due to potential E. coli O157:H7 contamination. The recall occurred in the wake of an epidemiological investigation into the E. coli illness of at least one Massachusetts resident.

On Christmas Eve 2009, National Steak and Poultry recalled at least 124 tons of mechanically tenderized beef products. The National Steak and Poultry outbreak caused at least 21 E. coli O157:H7 illness in 16 states, including nine hospitalizations and one case of HUS.

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

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Six students were hospitalized after falling ill at a YMCA Youth and Government conference in North Carolina.  In all, Wake emergency medical workers evaluated 150 students and adults who reported nausea, vomiting, diarrhea, stomach cramps and headaches after a catered dinner Friday night at the Raleigh Convention Center.  Catering company Centerplate spokesman Bob Pascal said a health department inspection cleared the company for another dinner planned for Saturday night. The source of the outbreak is being investigated.

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Nature’s Variety Recalls Raw Frozen Chicken Diets Nationwide

Nature’s Variety has initiated a voluntary recall of their Chicken Formula Raw Frozen Diet for dogs and cats with a "Best If Used By" date of 11/10/10 because these products may be contaminated with Salmonella. The only products affected are limited to chicken medallions, patties, and chubs with a "Best If Used By" date of 11/10/10. No other Nature’s Variety products are affected.

The affected products are limited to the Nature’s Variety Chicken Formula Raw Frozen Diet packaged in the following forms:

3 lb chicken medallions (UPC# 7 69949 60130 2) with a "Best If Used By" date of 11/10/10
6 lb chicken patties (UPC# 7 69949 60120 3) with a "Best If Used By" date of 11/10/10
2 lb chicken chubs (UPC# 7 69949 60121 0) with a "Best If Used By" date of 11/10/10

The “Best If Used By” date is located on the back of the package above the safe handling instructions. The affected product was distributed through retail stores and internet sales in the United States, and in limited distribution in Canada.

Raw pet food is popular among owners who say it promotes health, longevity and cuts down on vet bills. But raw meat, especially chicken, carries a risk of salmonella.

Nature’s Variety became aware of a potential problem after receiving a consumer complaint. Subsequent testing indicated that the lot code related to the consumer complaint tested negative for Salmonella. However, additional subsequent testing found the "Best If Used By" date of 11/10/10 to be contaminated with Salmonella.

Salmonella can affect both humans and animals. Even though no illnesses have been reported, consumers should follow the Safe Handling Guidelines published on the Nature’s Variety package when disposing of the affected product. People handling raw frozen pet foods may become infected with Salmonella, especially if they have not followed the safe handling guidelines set forth by the company.  Healthy people infected with Salmonella may experience some or all of the following symptoms:

nausea, vomiting, diarrhea or bloody diarrhea, abdominal cramping, or fever. Although rare, Salmonella can result in more serious ailments including arterial infections, endocarditis (inflammation of the lining of the heart), arthritis, muscle pain, eye irritation, or urinary tract symptoms. Consumers exhibiting these signs after having contact with the affected product should contact their health care provider.

Pets with Salmonella infections may become lethargic and have diarrhea or bloody diarrhea, fever, or vomiting. Some pets may experience only a decreased appetite, fever, or abdominal pain. Infected, but otherwise healthy pets can be carriers and infect other animals or humans. If your pet has consumed any of the affected products and is experiencing any of these symptoms, please contact your veterinarian.

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Huntington Meat Packing Inc., a Montebello, Calif., establishment, is expanding its recall of January 18 to include approximately 4.9 million additional pounds of beef and veal products that were not produced in accordance with the company's food safety plan. The products are adulterated because the company made the products under insanitary conditions failing to take the steps it had determined were necessary to produce safe products, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today. FSIS has received no reports of illnesses associated with consumption of these products. Individuals concerned about an illness should contact a physician.

The recall was expanded based on evidence collected in an ongoing criminal investigation being conducted by the Office of the Inspector General (OIG) with assistance from FSIS. This evidence shows that the products subject to this recall expansion were produced in a manner that did not follow the establishment's Hazard Analysis and Critical Control Points (HACCP) plan. A HACCP plan describes the process controls an establishment must take to prevent food safety hazards and create a safe and wholesome product. The investigation has uncovered evidence to show that the food safety records of the establishment cannot be relied upon to document compliance with the requirements. Therefore, FSIS must consider the products to be adulterated and has acted to remove the products from commerce.

The following beef and veal products, produced by the plant from January 22, 2009, to January 4, 2010, are subject to recall:

10 lb. boxes of "IMPERIAL MEAT CO. GROUND BEEF PATTY"
10 lb. boxes of "El Rancho MEAT & PROVISION ALL BEEF PATTIES"
20 lb. boxes of "IMPERIAL MEAT CO. GROUND BEEF PATTY"
50 lb. boxes of "HUNTINGTON MEATS GROUND BEEF"
50 lb. boxes of " HUNTINGTON MEAT PKG. INC. BEEF GROUND FOR FURTHER PROCESSING"
50 lb. boxes of "BEEF BURRITO FILLING MIX"
50 lb. boxes of "HUNTINGTON MEAT PKG. INC. DICED BEEF"
50 lb. boxes of "HUNTINGTON MEAT PKG. INC. SLICED BEEF"
10 lb. boxes of "Huntington Meat VEAL PATTY"
10 lb. boxes of "Imperial Meat VEAL PATTY"
10 lb. boxes of "El Rancho VEAL PATTY"
20 lb. boxes of "Huntington Meat VEAL PATTY"
20 lb. boxes of "Imperial Meat VEAL PATTY"
20 lb. boxes of "El Rancho VEAL PATTY"

Each box bears the establishment number "EST. 17967" inside the USDA mark of inspection on a label. The products were produced between January 22, 2009, and January 4, 2010, and were shipped to distribution centers, restaurants, and hotels within the State of California.

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Today Marler Clark filed a lawsuit on behalf of Raymond Cirimele, another victim of the Salmonella outbreak linked to salami manufactured by Daniele, Inc., and black pepper sold by Wholesome Spice Company and Overseas Spice Company.  Another suit was filed on behalf of a Missouri man named Lee Hanks last week.

Raymond Cirimele regularly purchased the now-recalled salami product at a Costco in Cook County. He fell ill in November 2009 with symptoms of Salmonella infection, and visited his primary care physician. He was ill for almost a month, and visited his doctor several times about his illness. When a test revealed that he had been infected by the outbreak strain of Salmonella montevideo, Mr. Cirimele was placed on antibiotics. He is still recovering from his illness.

As of 9:00 pm EST on February 10, 2010, a total of 225 individuals infected with the outbreak strain of Salmonella Montevideo, which displays either of two closely related PFGE patterns, have been reported from 44 states and District of Columbia since July 1, 2009. The number of ill persons identified in each state with this strain is as follows: AK (1), AL (2), AZ (6), CA (30), CO (4), CT (5), DC (1), DE (2), FL (3), GA (3), IA (1), ID (2), IL (15), IN (3), KS (3), LA (1), MA (13), MD (1), ME (1), MI (4), MN (5), MO (2), MS (1), NC (10), ND (1), NE (1), NH (2), NJ (8), NM (2), NY (18), OH (9), OK (1), OR (9), PA (6), RI (2), SC (1), SD (3), TN (5), TX (7), UT (9), VA (1), WA (17), WI (1), WV (1), and WY (2). Because the main Salmonella Montevideo outbreak PFGE pattern is commonly occurring in the United States, public health investigators may determine that some of the illnesses are not part of this outbreak.

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CDC is collaborating with public health officials in many states, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS), the U.S. Food and Drug Administration (FDA), and the State of Rhode Island to investigate a multistate outbreak of Salmonella serotype Montevideo infections. Investigators are using DNA analysis of Salmonella bacteria obtained through diagnostic testing to identify cases of illness that may be part of this outbreak.

As of 9:00 pm EST on February 10, 2010, a total of 225 individuals infected with the outbreak strain of Salmonella Montevideo, which displays either of two closely related PFGE patterns, have been reported from 44 states and District of Columbia since July 1, 2009. The number of ill persons identified in each state with this strain is as follows: AK (1), AL (2), AZ (6), CA (30), CO (4), CT (5), DC (1), DE (2), FL (3), GA (3), IA (1), ID (2), IL (15), IN (3), KS (3), LA (1), MA (13), MD (1), ME (1), MI (4), MN (5), MO (2), MS (1), NC (10), ND (1), NE (1), NH (2), NJ (8), NM (2), NY (18), OH (9), OK (1), OR (9), PA (6), RI (2), SC (1), SD (3), TN (5), TX (7), UT (9), VA (1), WA (17), WI (1), WV (1), and WY (2). Because the main Salmonella Montevideo outbreak PFGE pattern is commonly occurring in the United States, public health investigators may determine that some of the illnesses are not part of this outbreak.

Salmonella Senftenberg, a different serotype of Salmonella, has been found in food samples from retail and a patient household during this outbreak investigation. PulseNet identified 5 persons who had illness caused by Salmonella Senftenberg with matching PFGE patterns between July 1, 2009 and today. Public health officials have interviewed 4 of the 5 ill persons with this strain of Salmonella Senftenberg and determined that one consumed a recalled salami product during the week before their illness began. These five cases are not included in the overall case count reported above.

Among the persons with reported dates available, illnesses began between July 4, 2009 and January 24, 2010. Infected individuals range in age from < 1 year old to 93 years old and the median age is 39 years. Fifty-three percent of patients are male. Among the 166 patients with available information, 43 (26%) were hospitalized. No deaths have been reported.

During January 16-21, 2010, CDC and public health officials in multiple states conducted an epidemiologic study by comparing foods eaten by 41 ill and 41 well persons. Preliminary analysis of this study has suggested salami as a possible source of illness. Ill persons (58%) were significantly more likely than well persons (16%) to report eating salami. Additionally, 16 ill persons have been identified who purchased the same type of sliced salami variety pack at different grocery store locations before becoming ill; Two additional ill persons have been identified who purchased a similar type of sliced salami deli tray before becoming ill. These data suggest this product is the source of some of these illnesses. This sliced salami variety pack was recently recalled by Daniele International Inc. CDC and public health officials in multiple states continue to interview ill persons to ask them about the foods they ate during the week before they became ill as well as to collect shopper card information.

On January 23, 2010, FSIS issued a news release that Daniele International Inc. is recalling approximately 1,240,000 pounds of ready-to-eat varieties of Italian sausage products (including salame/salami) in commerce and potentially available to customers in retail locations because they may be contaminated with Salmonella. On February 4, 2010, FSIS updated its January 23, 2010 news release to include two additional salame/salami products, adding approximately 23,754 pounds to the initial recall. These products can have an extended shelf life of up to one year. The manufacturer has voluntarily halted production of salami products.

This initial recall followed isolation of Salmonella in a private laboratory from a retail sample of a salami product produced by Daniele International; this product was different than the sliced salami variety pack purchased at different grocery store locations by the 16 ill persons. FSIS reviewed and affirmed these private laboratory results. The Salmonella strain initially found by the private laboratory was different from the strains causing the outbreak. However, the Washington State Department of Health subsequently tested the bacterial culture provided by the private laboratory (the salami was not provided) and identified two different Salmonella serotypes, the strain found by the private lab and Salmonella Montevideo indistinguishable from the outbreak strain and Salmonella Senftenberg. In addition, the Iowa Department of Public Health and public health officials in Plymouth County, Iowa investigated a patient with Salmonella Montevideo infection indistinguishable from the outbreak strain and discovered an open sliced salami variety pack frozen at the patient's home. The patient had eaten this product before becoming ill. This sliced salami variety pack was the same as that purchased by 16 other ill persons. Using DNA analysis, the University of Iowa Hygienic Laboratory (Iowa's public health laboratory) confirmed that the Salmonella isolated from this leftover salami was indistinguishable from the outbreak strain of Salmonella Montevideo.

On January 31, 2010, FSIS issued a second news release that Daniele International Inc. has expanded its recall to include more ready-to-eat (RTE) varieties of Italian sausage products. Specific products include:

* Packages of “DANIELE HOT SOPRESSATA CALABRESE,” produced on 11/7/09, 12/16/09 and 12/18/09.
* Packages of “DANIELE SOPRESSATA CALABRESE,” produced on 12/16/09 and 12/18/09.
* Packages of “BOAR’S HEAD BRAND HOT SOPRESSATA CALABRESE,” produced on 11/28/09, 12/9/09 and 12/14/09.

The recall was being expanded as a result of a confirmed finding of Salmonella in an unopened salami product reported by the Illinois Department of Public Health. The product was sampled during the course of an ongoing investigation of a multistate outbreak of Salmonella serotype Montevideo illnesses. The product tested was not included in the previous recall (FSIS Recall 006-2010) issued January 23, 2010, but is similar to products bought by customers who later became sick and were identified as part of the Montevideo investigation. The company believes that black pepper is a possible source of Salmonella contamination.

On February 4, 2010, FSIS announced that Daniele International Inc. added two more products to its list of recalled products. Specific products include:

* 3-ounce packages of “DANIELE NATURALE SALAME COATED WITH COARSE BLACK PEPPER.”
* Approximately 6-pound packages of “DANIELE SALAME GRANDE COATED WITH PORK FAT & PEPPER.”

Further testing is ongoing at a state health partner laboratory, and might determine if the product tested in Illinois contained the Salmonella Montevideo strain associated with the multistate outbreak.
Daniele International Inc. has recalled ready-to-eat varieties of Italian sausage products, including salami, which are regulated by the USDA. Some of the products contain black pepper, which is regulated by the FDA.

Recent test results provided by the Rhode Island Department of Health revealed that an opened container of black pepper used in the manufacturing of at least some of the recalled products was positive for Salmonella Montevideo and that the DNA fingerprint matched the outbreak strain: http://www.ri.gov/press/view/10647 *.

The FDA is investigating the supply chain of the black pepper used in the manufacturing of the recalled meat products. The Agency has collected and is currently analyzing black pepper samples. To date, all the samples collected and analyzed by the FDA have tested negative for Salmonella, however, sample collection and analysis continues.

CDC and its public health partners are continuing the epidemiologic investigation to verify that the outbreak is controlled. CDC, USDA-FSIS, and FDA continue to work closely to identify the specific products or ingredients that became contaminated and how the contamination occurred and to identify any other food vehicles that may be involved.

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The CDC now counts 217 confirmed cases in the Salmonella montevideo outbreak linked to contaminated salami and pepper. 

As of 9:00 pm EST on February 8, 2010, a total of 217 individuals infected with a matching strain of Salmonella Montevideo have been reported from 44 states and District of Columbia since July 1, 2009. The number of ill persons identified in each state with this strain is as follows: AK (1), AL (2), AZ (5), CA (30), CO (4), CT (5), DC (1), DE (2), FL (3), GA (3), IA (1), ID (2), IL (14), IN (3), KS (3), LA (1), MA (12), MD (1), ME (1), MI (4), MN (5), MO (1), MS (1), NC (9), ND (1), NE (1), NH (1), NJ (8), NM (2), NY (18), OH (9), OK (1), OR (9), PA (6), RI (2), SC (1), SD (3), TN (5), TX (7), UT (9), VA (1), WA (15), WI (1), WV (1), and WY (2).

This outbreak was originally announced back on January 23, which is also the day that Daniele Inc recalled 1,240,000 pounds of salami products potentially contaminated by Salmonella.  Daniele later expanded the recall by over 17,000 pounds.  The products were distributed nationally and sold at many retail grocery outlets. 

Outbreak summary:  the 217--a number that will likely continue to grow--confirmed illnesses that the CDC has linked to the outbreak have occurred in 44 different states.  The Daniele Inc recalled salami product was contaminated with multiple strains of Salmonella, including montevideo.  There has been no official announcement of the other strains of salmonella involved in the outbreak.  We also know that the actual outbreak vehicle was the black pepper that was used to coat the recalled salami products.  Daniele purchased the contaminated pepper from two companies, Wholesome Spice and Overseas Spice Company.  Samples from unopened containers of pepper from both companies have tested positive for Salmonella. 

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The FDA has announced the recall of Haifa Smoked Fish brand vacuum packaged Whole Schmaltz Herring with the lot number 20, because the product was found to be uneviscerated.  The risk to consumers is that, due to the errors in production, the fish may be contaminated with clostridium botulinum.

The lot being recalled is a product of Norway, individually vacuum-packed in clear plastic pouches with lot # 20 indicated on the label and distributed through various food retailers in the NY and NJ area. 

The Whole Schmaltz Herring was sampled by a New York State Agriculture and Markets Food Inspector during a routine inspection. Subsequent analysis of the product by New York State Food Laboratory personnel confirmed that Whole Schmaltz Herring was not properly eviscerated prior to processing. 

The sale of uneviscerated fish is prohibited under New York State Agriculture and Markets regulations because of Clostridium Botulinum spores are more likely to be concentrated in the viscera than any other portion of the fish. Uneviscerated fish has been linked to outbreaks of botulism poisoning. 

Botulism is a serious and potentially fatal form of food poisoning, causes the following symptoms: general weakness, dizziness, double-vision and trouble with speaking or swallowing. Difficulty in breathing, weakness of other muscles, abdominal distension and constipation may also be common symptoms. People experiencing these problems should seek immediate medical attention. 

Haifa Smoked Fish, Inc's troubled past

On November 13, 2009, The U.S. Department of Justice, on behalf of the U.S. Food and Drug Administration, filed a complaint for permanent injunction against seafood processor Haifa Smoked Fish Inc. of Jamaica, N.Y., and two of its top officers for violations of the Federal Food, Drug and Cosmetic Act.

The injunction was sought to prevent the company from further manufacture, distribution, and sale of its products. “This company has consistently failed to make corrections to improve the insanitary conditions under which it processes smoked fish products, despite frequent warnings to do so,” said Michael Chappell, the FDA’s acting associate commissioner for regulatory affairs. “The FDA will not tolerate food companies that fail to provide adequate safeguards to protect the public.”

The company processes and distributes brined, cold-smoked, and hot-smoked fish and fishery products. The violations documented by the FDA pose a public health hazard because, without adequate controls, products made by Haifa Smoked Fish could become contaminated with (L. mono) or other pathogens and could cause serious illnesses.

“The public must be able to trust that the food in their grocery stores is safe for them to eat,” said Benton J. Campbell, the United States Attorney for the Eastern District of New York. “We will continue to work with the FDA to ensure that companies that produce food under dangerous or insanitary conditions take corrective action to clean up their act.”

Since 2001, the FDA and the New York State Department of Agriculture and Markets (NYSDAM) have inspected the Haifa Smoked Fish facility on numerous occasions. The inspections revealed insanitary conditions that could lead to the contamination of the finished product with L. monoor other pathogenic microorganisms. The act refers to unsanitary conditions as insanitary.

FDA analyses of samples taken during the inspections revealed that food products and environmental surfaces, including food-contact surfaces, were contaminated with L. mono. The company also continually failed to comply with FDA’s Hazard Analysis and Critical Control Point (HACCP) regulations. HAACP regulations require that seafood processors identify all food safety hazards likely to occur for each kind of seafood product, and develop and implement adequate plans to prevent and control those hazards.

The FDA issued warning letters to Haifa Smoked Fish in 2001 and 2004. In response, company officers promised to correct the violations. Subsequent inspections, however, revealed that the company did not make the corrections.
 

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We are currently investigating the illnesses of 15 people potentially sickened by Salmonella-contaminated Salami.  There is the possibility, as well, that other products are contaminated by Salmonella montevideo or other strains of salmonella, yet we know virtually nothing about the whereabouts of the pepper.  We were contacted yesterday by a young woman from Washington sickened in late January 2010 . . . after the Daniele Inc recall of 1.2 million pounds of potentially contaminated salami.  She bought the salami at Costco, but didn't consume it until after word of the outbreak and recall had been announced.  She just didn't know that the outbreak was occuring.

Had more effort been put forth to make people aware of the outbreak and dangers associated with consuming the implicated product, this woman's illness may not have happened, and she would not now be in danger of losing her job because of missed work days due to illness.  This outbreak is associated with a product--actually two products, pepper and salami--with very long shelf lives.  In such a situation, where there is more than a slim possibility that contaminated product will stay in people's homes well past public announcement of an outbreak or recall, better effort and more resources need to be devoted to informing the public of the risks they face. 

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It is Sunday, February 7, 2010; fifteen full days since Daniele Inc announced a recall of its salami products; and almost as long since the companies and investigating health authorities involved have either suspected or known that the ultimate source of illness in this large, and possibly growing outbreak, is black pepper.  But we, the food consuming public, continue to know nothing about the whereabouts of the contaminated pepper.  Why the silence?

To recap:  The CDC now counts 213 confirmed cases of Salmonella montevideo illnesses stretching from July 2009 to the present.  The cases are scattered across the country; 42 states in total; and California, Washington, Illinois, and Massachussets are the hardest hit states, with 30, 15, 13, and 12 cases respectively. Daniele Inc has recalled 1.28 million pounds of potentially contaminated product.  The Rhode Island health department announced on February 3 that it had detected the outbreak strain of Salmonella montevideo in pepper samples from two of Daniele Inc's pepper suppliers, Overseas Spice Company and Wholesome Spice.  Neither company, nor any government agency involved in the investigation (including FSIS, CDC, and USDA) has announced whether other food companies have received any of the contaminated pepper, or even whether the contaminated pepper is sitting on store shelves.  Nor has there been a recall of the contaminated pepper. 

From a public health standpoint, the proper flow of information would dictate that the public be made aware of where the contaminated pepper is; alternatively, if the companies involved and the governmental agencies investigating the outbreak have information to suggest that there really is no ongoing risk to the public, we should know that too. 

Most of the ire about the slow flow of information in this outbreak exists because of the potential that the outbreak is broader than simply contaminated salami.  We know that it wasn't the meat that was contaminated; it was contaminated pepper that ultimately caused the meat to become contaminated.  The pepper came from two companies who obviously had the same supplier of pepper.  Those pepper companies, Wholesome and Overseas, likely have more than one customer, thus creating the risk that more than Daniele is in possession of, or has used, the contaminated pepper.  And critically, there has been the suggestion, at least, that some people who are counted as outbreak cases (i.e. confirmed with the outbreak strain of Salmonella montevideo) did not even have any reported consumption of Daniele Inc salami in the days prior to their illnesses.  If true, this means that there must be more products that are making people sick, and may still be on store shelves. 

Some of the ire, though, exists because this is not an isolated instance of the slow flow of information in food outbreaks.  Recall that the E. coli O157:H7 outbreak linked to beef products from National Steak and Poultry was announced on Christmas Eve--probably the worst time possible to announce an outbreak and recall because most consumers simply aren't paying attention to recalls at that point in time.  Another example is the West Missouri Beef recall of 14,000 pounds of potentially contaminated boneless beef products.  Apparently, the meat was distributed to Chicago-area wholesalers, yet neither FSIS nor the company itself has disclosed the retail locations that received the potentially contaminated products. 

So the silence of the peppers continues.  If there is an ongoing risk to the public, we should have the benefit of knowing that so that we can make an informed choice about what products to buy.  If there is no ongoing risk to the public, we should have the benefit of knowing that information too. 

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The CDC has again revised its numbers in the Salmonella montevideo outbreak linked to Daniele Inc. salami and black pepper sold by Oversees Spices Company and Wholesome Spice.  There are currently 213 cases nationwide, stretching from July 2009 to the present.  California Washington, Illinois, and Massachussetts remain the hardest hit states, with 30, 15, 13, and 12 cases respectively. 

This outbreak has been thought provoking to say the least.  It highlights the need for better communication amongst public health agencies, and faster dissemination of crucial information to the public.  See The slow flow of information about food outbreaks.  It is also remarkable for its length, causing illnesses over at least a seven month period, and it remains to be seen whether the outbreak is even over.  Rhode Island has detected Salmonella in the black pepper sold to Daniele Inc by Oversees and Wholesome, and we still have no word on whether the contaminated black pepper is in consumers homes, on store shelves, or in other food products around the country. 

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The massive Salmonella Saintpaul outbreak from February through April 2009 was featured in a story by WHAS 11 News in Louisville, Kentucky.  Drew Falkenstein spoke with Channel 11's Adam Walser about the outbreak:

 

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From February through May of 2009, the CDC counted 235 confirmed victims of a Salmonella Saintpaul outbreak linked to alfalfa sprouts.  Here is the distribution of confirmed cases in the outbreak:

Nebraska was the hardest hit state by far, with 111 confirmed illnesses, many of whom consumed alfalfa sprouts on sandwiches from Jimmy John's restaurants.  South Dakota had the second most illnesses with 38. 

Investigating health authorities ultimately determined that sprout seeds distributed by a major seed distribution company called Caudill Seed (Louisville , KY) had been contaminated with Salmonella. 

The outbreak occurred in two phases.  The first phase, causing illness primarily in the midwest, occurred in February and March 2009, and the contaminated sprouts were grown by CW Sprouts, an Omaha Nebraska company.  The chlorine treatment methods used by CW Sprouts were inadequate to eliminate the bacteria from the contaminated seeds that Caudill Seed had distributed to CW. 

The second phase of the outbreak occurred shortly after the first, causing Salmonella infection by genetically indistinguishable bacteria from the CW Sprouts phase of the outbreak.  But CW Sprouts did not distribute to many of the states affected by the second phase.  The sprouts implicated in the second phase had been grown by multiple sprout growers from seeds produced and sold by Caudill Seed.  In fact, the seeds in both phases of this large outbreak came from the same lot (032) of Caudill's seeds.

Marler Clark represents nine people in this outbreak, mostly from the State of Nebraska.  Three lawsuits have been filed. 

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The CDC's February 2 update on the Salmonella outbreak linked to salami and black pepper indicates that Washington, with 15 victims, is among the hardest hit states in the outbreak.  Only California and New York, with 30 and 16 victims respectively, have more sick residents.  Here is a distribution map of illnesses linked to the outbreak:

The latest update on the outbreak:

Rhode Island Department of Health has confirmed that the black pepper used to manufacture Daniele Inc's salami products has tested postiive for Salmonella Montevideo, thus confirming that the pepper was the ultimate source of contamination in the outbreak.  Rhode Island has also indicated that black pepper from two of Daniele Inc's spice suppliers (Wholesome Spices and Oversees Spice Company) has tested positive for the outbreak strain of salmonella.  This means that Wholesome and Oversees must have purchased their black pepper from the same supplier. 

This outbreak may not be over.  Unfortunately, the FDA and CDC have been largely silent on the nature of the ongoing risk to the public.  And Wholesome and Oversees have not yet heeded calls to tell the public whether they sold contaminated product to other companies, so we do not yet know whether other food producers have been using the contaminated product.  In fact, it seems very likely that they did.  There is some indication that certain outbreak victims had no exposure to salami whatsoever in the timeframe of their illnesses, yet they match the outbreak strain of Salmonella.  The implication is that there is, in fact, another food that is, or was, making people sick.

 

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A second victim of the nationwide outbreak of Salmonella linked to pepper in salami meats has come forward to file a lawsuit against Daniele International Inc., which produced the recalled salami, and against Wholesome Spice, which supplied the tainted pepper. The CDC reports that currently 207 are confirmed ill in 42 states, with the actual total likely much higher.

“The CDC is the first to say that only about 3% of Salmonella illnesses are ever culture-confirmed, so the real number of victims of this outbreak is in the thousands,” said the attorney for the victims, William Marler. “Most people with Salmonella never know they have it, and try to ‘tough it out’ as a stomach flu, but Salmonella can get ugly, and it is important to visit a health care professional if you have consumed the recalled product or are experiencing symptoms of Salmonella infection.”

Harold Hanks purchased Salami products made by Daniele at a Walmart in Osage Beach, Missouri. He fell ill within a day of consuming the products, with nausea and diarrhea that continued to worsen. After medications prescribed by his physician failed to give him any relief, Mr. Hanks went to the emergency room at his local hospital, where he was treated for severe dehydration and bacterial infection. Stool samples taken during his hospital visit returned positive for the Salmonella montevideo outbreak strain. He continues to recover from his illness. His lawsuit was filed by Marler Clark and by Kansas attorney Roger Nail of Goza and Honnold.

“Salmonella infections have changed — and taken — lives,” continued Marler. “Our clients from the terrible outbreak of Salmonella in Peanut Butter have just learned that their lawsuits will be settled and bills paid from a twelve million dollar insurance policy. I’m glad we were able to help these people — even after the Peanut Corporation of America declared bankruptcy — but the best insurance policy any company can have is exemplary food safety practices.”

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Today, the Rhode Island Department of health announced that the pepper that Daniele Inc used to produce its salami--now the subject of a major recall and outbreak--was contaminated, not the meat itself   Pepper has been suspected as the source of this outbreak since at least January 23, 2010, if not before.  A little frighteningly, Rhode Island also says that pepper from both of Daniele Inc's suppliers has tested positive for the outbreak strain (suggesting a common grower or shipper) of salmonella, and that a number of outbreak victims may not have eaten salami at all.  What's the implication?  That more than just Daniele Inc. has received contaminated  black pepper.  Is it in your home now?

The problem that this scenario brings to light is that the public is clearly not getting the information that it should . . . and in a timely fashion.  As I posted earlier today, the suppliers of pepper to Daniele (Oversees Spice Company and Wholesome Spice) should publicly disclose the list of customers who bought, or may have bought, the contaminated pepper.  After all, the fact that some of the people sickened with the outbreak strain of salmonella in this outbreak, and who did not have an exposure to salami, suggests that other food producers may in fact have received the contaminated pepper as well, and they may be producing and selling food that is contaminated.  Maybe the FDA doesn't have enough information to establish just who that or those food producers are, but Oversees and Wholesome could certainly protect a lot of people by disclosing their customer list. 

This problem--i.e. the stagnant flow of information in food outbreaks--is not all on food suppliers either.  Timely information published in a manner that effectively passes the information to the consuming public is not a strong point of our government either.  Bill Marler authored a highly insightful blog post several days ago about this problem.  Asking "why the silence of the steaks and the perjury of the peppers," he stated as follows:

why do the US Government and US Business not believe in Capitalism? The one thing that makes capitalism – free markets – work is knowledge and transparency. If you know who poisoned you, you can stop buying food from them. However, here – especially here – the government and industry do everything they can to not tell us the facts. In both instances they put the information out on a holiday or a Friday night, so no one but a loser blogger would be paying attention. More importantly is the fact that they withhold information about the ultimate source of the contamination? Why not say whom the supplier of steaks and trim is? Why not let the public know who produced the peppers and where they are from?

As for steaks, the event that got Bill talking was the recall of 124 tons of tenderized beef products manufactured by National Steak and Poultry and sold to a variety of major restaurant chains throughout the country.  The recall was announced by USDA's Food Safety and Inspection Service on . . . Christmas Eve.  Other than a few lawyers and the CDC, who is paying attention to FSIS recall notices on Christmas Eve?  Or the following day?  Or really any day for the rest of the year?  And for that matter, on New Year's day too?  Virtually nobody, particularly not a very significant percentage of the food consuming public. 

This kind of information should not come on Christmas Eve, Friday night, or any other time of the year clearly designed to lessen the flow of information to the public, thereby protecting the interests only of the business that manufactured or sold the contaminated product.  Eddie Gehman Kohan said it much better on her blog, Obamafoodorama.com, posing the question "How is it possible that a blogger notifies the public of a new Class I (you could die) recall of 1,240,000 pounds of meat before USDA does?":

It's a grim situation when a private citizen is more on the ball than the federal agency that's supposed to be managing national food safety concerns (CDC's own e mail heads-up about the outbreak included no information, except that a product sold nationally was contaminated with Salmonella Montevideo).

If the answer to these valid questions is that notifying the public will encourage lawsuits, or make them easier to prove, the failure to do so is only going to allow outbreaks to happen.  And that's when the lawyers come in. 

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The Rhode Island Department of Health announced today that recent test results strongly suggest black pepper is the source of the Salmonella outbreak associated with Daniele Inc. salami.  According to the CDC, the outbreak has sickened at least 207 people in 42 states.

Daniele purchased black pepper from two different distributors (Mincing Oversees Spice Company and Wholesome Spices) who buy imported black pepper. Samples of pepper from both distributors have tested positive for Salmonella. All other tests of employees and the facilities are negative at this time. These findings are consistent with Daniele Inc.’s history of no Salmonella findings by in-house testing and USDA periodic testing. No additional food items have been added to the recall list.

As part of the outbreak investigation, it was determined that both distributors who supplied black pepper to Daniele imported pepper from common sources.

“These recent findings show that black pepper used during the manufacturing process at Daniele was the likely source of this outbreak,” said Director of Health David R. Gifford, MD, MPH. “This outbreak only underscores the importance of closely monitoring food that is imported from other countries as they may not have the same food safety standards as we do.”

Adding even more concern to an already devastating outbreak, a spokesperson for the Rhode Island Department of Health indicates that some of the outbreak victims don't have a known exposure to salami.  What does this mean?  Bad news for the american consumer.  If there are lots of people out there who have been sickened by a strain of Salmonella that genetically matches the strain on Daniele Inc salami, there is a high likelihood that plain old pepper, or pepper on foods other than salami, is making people ill too. 

What needs to happen now is that both suppliers of black pepper to Daniele Inc.--Mincing Oversees Spice Co. and Wholesome Spice--need to tell the government and everybody else who they distributed potentially contaminated pepper to.  Pepper is a product with a long shelf life, and is ubiquitous in every home.  This makes it a particularly risky food when there is a possibility that it is contaminated. 

Oversees Spice and Wholesome:  do what's right.  If your products and sales are traceable, as they should be, then tell the public where the potentially contaminated product went.  You may be facing multiple lawsuits now, but there will be many more to come if this outbreak continues to grow. 

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West Missouri Beef, LLC has voluntarily recalled 14,000 pounds of boneless beef products due to potential contamination by E. coli O157:H7.  USDA's Food Safety and Inspection Service (FSIS) announced the Class I recall in a press release last night.  It is the third Class I recall this year, and the fifth since November, adding up to 1,636,000 pounds of beef products that have been recalled due to potential E. coli O157:H7 contamination in the last 3+ months.

What is a Class I recall?

A Class I recall, according to FDA definitions, should occur when "there is a reasonable probability that the use of or exposure to a violative product will cause serious adverse health consequences or death."  Class II and III recalls are appropriate only when there is a significantly lesser, or remote, risk of adverse health consequences, or when the health consequences are minor.  Due to its lethal capacity, E. coli O157:H7 is a bacteria that always requires a Class I recall.

What is E. coli O157:H7?

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). Newborns have a sterile alimentary tract which within two days becomes colonized with E. coli.

More than 700 serotypes of E. coli have been identified. The different E. coli serotypes are distinguished by their “O” and “H” antigens on their bodies and flagella, 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. This section deals specifically with Stx-producing E. coli, including specifically E. coli O157:H7.

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).
 

Continue Reading...

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The unfortunate trend for E. coli and beef in late 2009 and 2010 continues.  This evening, West MissourI Beef, LLC, a Rockville, Missouri beef company, recalled 14,000 pounds of boneless beef products due to potential E. coli O157:H7 contamination.  Today's recall brings the tally for recalled beef due to E. coli contamination to 1,636,000 pounds of beef products in the last three months. 

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., stablishment, recalled approximately 2,574 pounds of beef products due to potential E. coli O157:H7 contamination. The recall occurred in the wake of an epidemiological investigation into the E. coli illness of at least one Massachusetts resident.

In November 2009, ground beef from a New York ground beef company called Fairbank Farms was recalled due to E. coli O157:H7 contamination. That outbreak caused resulted in 26 E. coli O157:H7 illnesses, nineteen hospitalizations, and five who developed hemolytic uremic syndrome (HUS).

And on Christmas Eve 2009, National Steak and Poultry recalled at least 124 tons of mechanically tenderized beef products. The National Steak and Poultry outbreak caused at least 21 E. coli O157:H7 illness in 16 states, including nine hospitalizations and one case of HUS.

Together, the recalls and outbreaks linked to beef from Adams Farm, National Steak and Poultry, Fairbank Farms, and now West Missouri Beef have caused at least 48 illnesses nationally. At least 1,636,000 pounds of beef have been recalled in total in the five recalls. .
 

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West Missouri Beef, LLC, a Rockville, Missouri establishment, is recalling approximately 14,000 pounds of fresh boneless 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. 

The following products are subject to recall:

One combo bin containing approximately 2,000 pounds of fresh boneless beef identified as “75 1-M,” produced on October 26, 2009.  

One combo bin containing approximately 2,000 pounds of fresh boneless beef identified as “90 3-D,” produced on November 25, 2009.  

One combo bin containing approximately 2,000 pounds of fresh boneless beef identified as “90 5-D,” produced on November 27, 2009. Combo bins containing approximately 2,000 pounds of fresh boneless beef identified as “90 2-P,” “90 2-R” or “90 2-V,” produced on December 8, 2009. 

One combo bin containing approximately 2,000 pounds of fresh boneless beef identified as “90 3-E,” produced on January 13, 2010. Each container is marked with the establishment number “EST. 5821” inside the USDA mark of inspection.  

The fresh boneless beef products were distributed to wholesalers in the Chicago, Ill., area. 

The problem was discovered by FSIS during a verification review performed at the establishment.

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Considered a local institution in Cicero, New York since its opening in 1974, the Nature's Fare Restaurant announced today that it is closing for good.  According to the Post-Standard, the restaurant, which cooked and prepared between 100 and 200 fresh, raw turkeys each day, was recently notified that it had been linked to the Salmonella infections of at least two Plainview county residents.  And this is not the first time.  Approximately 20 people in 2008, and another 7 people in 2009, had Salmonella infections that were linked to food prepared and served at the restaurant.

Interestingly, the owner says he will contact people in the restaurant business to see if they want to buy the site and operate it under a model that does not involve working with fresh, raw poultry.

 Symptoms of Salmonella include diarrhea, abdominal cramps, fever, nausea, and vomiting. In mild cases, diarrhea may be non-bloody, occur several times per day, and not be very voluminous; in severe cases it may be frequent, bloody and mucoid, and of high volume.

Fever generally occurs in the 100°F to 102°F (38°C to 39°C) range. Vomiting is less common than diarrhea. Headaches, myalgias (muscle pain), and arthralgias (joint pain) are often reported as well. Whereas the diarrhea typically lasts 24 to 72 hours, patients often report fatigue and other nonspecific symptoms lasting 7 days or longer.

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In response to my AM's blog post about the true scope of the Salmonella salami/pepper outbreak, a reader states as follows:

Can't you read between the lines Drew. The contaminated pepper was sent to
food plants all over the country, to supermarkets, restaurants etc. Its
everywhere. The only safe products now may be from Daniele Inc..The RI dept
of health and FDA have both confirmed positive salmonella in unopened
pepper. The truth is too big for you to get your mind around. This is a
big huge mess and now could be a bigger cover up. Someone should inform
people of the truth...

Good point.  Where else is the contaminated pepper?  What do our national public health agencies know about the pepper product (other than that it's from Vietnam), and when do we get the benefit of having them disclose what they know?  Is there any ongoing risk to consumer health?  Is the pepper in our homes?

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The CDC reported yesterday that there are 203 confirmed "cases" (i.e. victims who's stool sample has tested positive for the outbreak strain of bacteria) in the recent Salmonella outbreak linked to recalled salami (Daniele, Inc.) and the ingredient pepper (Wholesome Spice).  The outbreak is truly nationwide, having sickened people in at least 42 states and the District of Columbia.  But as in any outbreak situation, particularly one involving a relatively common product distributed over a wide geographic region over a seven month time frame, there are many more people ill across the country than the CDC's official count would suggest.

A leading study on the subject suggests 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. See Paul Mead et al.  http://www.cdc.gov/ncidod/EID/vol5no5/mead.htm.

There are several reasons why. First, it is highly unlikely that, considering the widespread distribution and availability of the potentially contaminated products, only the salami and pepper consumed by official "cases" was contaminated with Salmonella. More likely is that many more of the individual packages of salami were contaminated.  After all, Daniele Inc. has now recalled 1,257,000 pounds of Salami.  The 203 confirmed victims in this outbreak have certainly not purchased, much less consumed, that much salami.  

Second, as noted by Mead et al., underreporting of foodborne disease is common. See Mead Article at 607. “Surveillance of foodborne illness is complicated by several factors. The first is underreporting. Although foodborne illnesses can be severe or even fatal, milder cases are often not detected through routine surveillance.” It is frequently the case that only the more severe illnesses come to the attention of health department officials. The less severe illnesses in any given outbreak often require less medical treatment, and the possibility that the causative agent—e.g. Salmonella bacteria—will be identified decreases as well.

 Many cases of foodborne illness are not reported because the ill person does not seek medical care, the health-care provider does not obtain a specimen for diagnosis, the laboratory does not perform the necessary diagnostic test, or the illness or laboratory findings are not communicated to public health officials.

 See Mead Article at 609.

 Additionally, the likelihood that secondary transmission of Salmonella-bacteria occurred must be considered. As stated in the Mead Article, “many pathogens transmitted through food are also spread through water or from person to person, thus obscuring the role of foodborne transmission.” See Mead Article at 607. In other words, it is common in outbreak situations for people who became infected by contaminated food to thereafter sicken co-workers or family members by unwitting transmission of a small amount of bacteria.

Finally, in this particular outbreak, it must also be considered that the CDC's official "case" count is only for Salmonella Montevideo, which is the only strain that the CDC has officially linked to the recalled, contaminated product.  But the CDC has itself stated that testing by at least one State Health Department has detected the presence of other strains of Salmonella in or on the recalled product. It is difficult to accurately estimate the number of people who have suffered illness, confirmed by stool test or not, due to infection by a strain of Salmonella that has not even been made public. 

These circumstances constellate to make it highly likely that the salami outbreak is much larger than just 203 sick people. As Mead states:

 To calculate the total number of illnesses caused by each pathogen, it is necessary to account for underreporting, i.e., the difference between the number of reported cases and the number of cases that actually occur in the community. For Salmonella, a pathogen that typically causes nonbloody diarrhea, the degree of underreporting has been estimated at ~38 fold . . . [W]e used a factor of 38 for pathogens that cause primarily nonbloody diarrhea (e.g. Salmonella, Campylobacter).

See Mead Article at 607.  

203 multiplied by 38 is a big number  =  7,714.

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CDC reports that a total of 203 individuals infected with a matching strain of Salmonella Montevideo have been reported from 42 states and District of Columbia since July 1, 2009. The number of ill persons identified in each state with this strain is as follows: AK (1), AL (2), AZ (5), CA (30), CO (4), CT (4), DC (1), DE (2), FL (3), GA (3), IA (1), ID (2), IL (11), IN (3), KS (3), LA (1), MA (12), MD (1), ME (1), MI (3), MN (4), MO (1), NC (9), ND (1), NE (1), NH (1), NJ (8), NM (2), NY (16), OH (9), OK (1), OR (9), PA (5), RI (2), SC (1), SD (3), TN (4), TX (7), UT (7), VA (1), WA (15), WV (1), and WY (2).

Among the persons with reported dates available, illnesses began between July 4, 2009 and January 11, 2010. Infected individuals range in age from < 1 year old to 93 years old and the median age is 37 years. Fifty-three percent of patients are male. Among the 151 patients with available information, 40 (26%) were hospitalized. No deaths have been reported.

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Tomorrow morning, we will file a second lawsuit in the Salmonella outbreak linked to recalled salami (Daniele, Inc.) and pepper (Wholesome Spice).  The lawsuit will be filed on behalf of Lee Hanks, a resident of Lake Ozark, Missouri. 

Lee purchased the contaminated salami on January 17, 2010, at a WalMart store in Osage Beach, Missouri.  The Salmonella contaminated salami was one part of a variety package of Daniele Inc salami products.  At least one of the salami varieties contained pepper manufactured by defendant Wholesome Spice.

Lee Hanks consumed pieces of the contaminated salami the next day and fell ill late the same evening.  Symptoms began with cramps and nausea. Lee woke up in the early morning hours of January 19, 2010, feeling extremely nauseated, with alternating chills and fevers, and suffering from explosive bouts of diarrhea.

Lee's illness worsened over the next 48 hours, causing him to call his primary care physician the afternoon of Thursday, January 21, 2010. His physician prescribed anti-diarrheal and anti-nausea medications. Lee immediately began to take the medications that his doctor had prescribed, but he only became more ill, weak, and disoriented. Finally, on Saturday, January 23, 2010, Lee had become so ill that his wife demanded that he go to the emergency department at Lake Regional Hospital in Osage Beach, Missouri.

At the emergency department, Lee received several liters of fluid to correct his severe dehydration. He also received a potassium supplement, as his severe gastrointestinal losses had caused him to develop hypokalemia. Lee's attending physician ultimately diagnosed him with a severe bacterial infection and prescribed the antibiotic ciprofloxacin. And before being discharged, Lee submitted a stool sample for testing. 

Lee Hanks continued to be extremely ill and weak over the course of the next several days. The frequent bouts of diarrhea finally began to slow on or about Monday afternoon, but Lee continues to suffer from gastrointestinal discomfort as a result of his Salmonella infection.

In discussions with health officials from Miller County and the State of Missouri, Lee earned that the stool sample he submitted while at the emergency department tested positive for Salmonella Montevideo, which is the strain involved in the national outbreak linked to Defendants’ salami and pepper products.

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According to the Atlanta Journal Constitution and AP, over 100 victims of last year's nationwide salmonella outbreak will split $12 million as part of a bankruptcy settlement with the insurer of the company linked to the illnesses.

The attorney for the bankruptcy trustee, Atlanta attorney Alan Maxwell said Monday the money comes from an insurance policy that Lynchburg, Va.-based Peanut Corp. of America had with Hartford Financial Services Group Inc. The settlement could be doled out to more than 100 victims or their survivors who filed a claim.

Lawsuits against Kellogg Co. and King Nut Co. are still pending.

The outbreak was traced to the company's plants in Georgia and Texas. It sickened about 700 people and was linked to at least nine deaths. Peanut Corp. has since filed for bankruptcy and authorities have allegedly launched a criminal investigation.

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The recall is being expanded as a result of a confirmed finding of Salmonella in an unopened salami product reported by the Illinois Department of Public Health.

Daniele International Inc., an establishment with operations in Pascoag and Mapleville, R.I., is expanding its January 23 recall of 1,240,000 pounds of salami/salame to include approximately 17,235 pounds of ready-to-eat (RTE) varieties of Italian sausage products, including salami/salame, that may be contaminated with Salmonella, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The recall is being expanded as a result of a confirmed finding of Salmonella in an unopened salami product reported by the Illinois Department of Public Health. The product was sampled during the course of an ongoing investigation of a multi-state outbreak of Salmonella serotype Montevideo illnesses. The product tested was not included in the previous recall issued January 23, but is similar to products bought by customers who later became sick in the Montevideo investigation. Product subject to the expanded recall may have been cross-contaminated with black pepper before it was packed. The company believes that black pepper is a possible source of Salmonella contamination.

The Rhode Island Department of Health has confirmed that Salmonella has been found in samples of ground black pepper taken from an open container at Daniele International, Inc. The Salmonella recovered from Daniele's black pepper from Wholesome Spice matches the outbreak strain of Salmonella Montevideo.

As of last Friday, the CDC reports that a total of 202 individuals infected with a matching strain of Salmonella Montevideo have been reported from 42 states and District of Columbia since July 1, 2009. The number of ill persons identified in each state with this strain is as follows: AK (1), AL (2), AZ (5), CA (30), CO (4), CT (4), DC (1), DE (2), FL (3), GA (3), IA (1), ID (2), IL (11), IN (3), KS (3), LA (1), MA (12), MD (1), ME (1), MI (3), MN (4), MO (1), NC (9), ND (1), NE (1), NH (1), NJ (7), NM (2), NY (16), OH (9), OK (1), OR (9), PA (5), RI (2), SC (1), SD (3), TN (4), TX (7), UT (7), VA (1), WA (15), WV (1), and WY (2).

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The Food and Drug Administration, along with the Centers for Disease Control and Prevention and the U.S. Department of Agriculture, is working closely with the Rhode Island Department of Health and other states in the investigation of an outbreak of Salmonella Montevideo infection associated with certain salami products.

The CDC reports that 202 people have been infected with a matching strain of Salmonella Montevideo in at least 42 states and the District of Columbia. Recently, the CDC and public health officials in multiple states conducted an epidemiologic study by comparing foods eaten by 41 ill and 41 well persons. Preliminary analysis of this study has suggested pepper-coated salami as a possible source of illness: http://www.cdc.gov/salmonella/montevideo/index.html.

On Jan. 23, 2010, Daniele International Inc. recalled ready-to-eat varieties of Italian sausage products, including salami, which is regulated by the USDA: http://www.fsis.usda.gov/News_&_Events/Recall_006_2010_Release/index.asp. The recalled meat products have an extended shelf life up to one year. Consumers are advised to check the USDA list of the recalled products to make sure they do not have any of them in their homes. If so, discard them immediately in a safe manner.

Recent test results provided by the Rhode Island Department of Health revealed that an opened container of black pepper used at the salami manufacturing facility of at least some of the recalled products were positive for Salmonella Montevideo and that the DNA fingerprint matched the outbreak strain: http://www.ri.gov/press/view/10647.

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. The agency has collected and is currently analyzing black pepper samples. To date, all the samples collected and analyzed by the FDA have tested negative for Salmonella; however, sample collection and analysis continues.

If FDA identifies risks associated with the black pepper, or any other product, we will take appropriate action to protect the public health.

Salmonella 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 ( infected aneurysms), endocarditis and arthritis. Individuals having consumed any Italian sausage products and who may be experiencing these symptoms should contact a health professional immediately. For details on salmonella sources, symptoms, and treatment, please refer to the Salmonella page on FoodSafety.gov.: http://www.foodsafety.gov/poisoning/causes/bacteriaviruses/salmonella.html.

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The CDC reports that a total of 202 individuals infected with a matching strain of Salmonella Montevideo have been reported from 42 states and District of Columbia since July 1, 2009. The number of ill persons identified in each state with this strain is as follows: AK (1), AL (2), AZ (5), CA (30), CO (4), CT (4), DC (1), DE (2), FL (3), GA (3), IA (1), ID (2), IL (11), IN (3), KS (3), LA (1), MA (12), MD (1), ME (1), MI (3), MN (4), MO (1), NC (9), ND (1), NE (1), NH (1), NJ (7), NM (2), NY (16), OH (9), OK (1), OR (9), PA (5), RI (2), SC (1), SD (3), TN (4), TX (7), UT (7), VA (1), WA (15), WV (1), and WY (2). Because this is a commonly occurring strain, public health investigators may determine that some of the illnesses are not part of this outbreak.

Among the persons with reported dates available, illnesses began between July 4, 2009 and January 11, 2010. Infected individuals range in age from < 1 year old to 93 years old and the median age is 37 years. Fifty-three percent of patients are male. Among the 148 patients with available information, 38 (26%) were hospitalized. No deaths have been reported.

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A reader's comments about the journal post this morning titled "Unanswered questions remain in the Salmonella salami/pepper outbreak:"

As a former owner of a spice company that did extensive work with food processors, I agree that the public has a right to know the information pertaining to this outbreak. However, using and/or selling untreated pepper is much akin to playing Russian Rullette with 5 bullets in the chamber. The price you pay to have pepper treated to lower micro's and eliminate things like e-coli, salmonella, and mold is nominal compared to the potential damage allowing untreated product to go out the door. I place the blame on three equally guilty parties; the importer who bought and shipped this product without testing or probably not requiring testing at the shipping point, Wholesome spice for selling product that they did not take due care to make sure micro's were within acceptable specification from ASTA (American Spice Trade Assoc), and Daniele's for accepting inferior product probably due to price considerations and not requiring COA's (Certificate of Analysis) that would show testing for and reduction of salmonella

This is products liability 101 with a good dose of concern for public health.  Well said.

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The Tremeloes got it wrong.  Silence is far from golden when it comes to matters of public health.  We now know that the salami Salmonella outbreak linked to Daniele Inc.'s pepper-coated salami occurred because of contaminated pepper, and that the pepper came from a company called (oh the irony) Wholesome Spice, a New York distributor.  But there remain too many questions with regard to this outbreak, not to mention other significant public health matters (see "the silence of the steaks and the perjury of the peppers"), to say that consumer health is being adequately monitored and protected. 

Wholesome Spice is merely a distributor, meaning that the company did not grow, harvest, or package the contaminated pepper.  We do not yet know where the contamination occurred, but odds are that it happened prior to receipt of the product by Wholesome Spice.  The implications are clear.  Wholesome Spice may have only received a portion of the contaminated product.  This is certainly something that the CDC and FDA have considered and are likely looking into.  The significance of this fact to public health?  Contaminated pepper may be in the homes of American consumers in other forms, and on other products.

It is possible, also, that there is no further threat to consumer health in America.  Wholesome Spice may be the only American company to receive the contaminated pepper, and Daniele Inc may be the only company to have purchased and sold the contaminated pepper to consumers.  But that doesn't sound very logical.  Is Wholesome Spice the exclusive seller of pepper to Daniele Inc., or vice versa?  Isn't it more logical to assume that the contaminated pepper has reached American consumers in other forms? 

The flow of information to the public in this particular outbreak and recall has not exactly been unimpeded, timely, or free.  Recall the CDC's statement to the public late on the friday evening that the outbreak and recall was announced:  "A widely distributed contaminated food product might cause illnesses across the United States."  In fact, the CDC commented in the same statement on the outbreak that other products may be implicated.

So we know the distributor of the pepper, but we don't know what country it came from or the identity of the company who grew, harvested, or packaged it.  We don't know whether other American food companies received the contaminated pepper, not to mention other companies worldwide, whose residents are just as susceptiblle to illness and death from Salmonella as we are.  We don't know whether other products are contaminated, and there has been no further word from the CDC on the issue, despite the obvious wide-spread contamination and the early suspicion about whether other products were implicated.  Nor do we even have any official statement on what other strains of Salmonella the CDC, or other State health departments, have found in the contaminated Daniele salami products.  Recall the CDC's statement on this issue:

This recall followed isolation of Salmonella in a private laboratory from a retail sample of a salami product produced by Daniele International. FSIS reviewed and affirmed these private laboratory results.  This Salmonella strain is different from the strains causing the outbreak. In addition, this product was different than the sliced salami variety pack purchased at different grocery store locations by the 11 ill persons.

We have the right to know these things.

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The Washington State Department of Health issued a press release today on its continuing investigation into the Salmonella Montevideo outbreak associated with salami manufactured by Daniele International.  The salami has since been recalled and a list of retailers that may have received the implicated product can be found HERE.

Thus far,  the infections of fifteen Washingtonians have been linked to the nationwide outbreak strain, with all of the cases curiously occurring on the West side of the Cascades.  The sick individuals are located in the following counties:  Clark (3 cases), King (3), Snohomish (3), Jefferson (1), Thurston (1), Pierce (1), and Whatcom (1) counties.  By my count, that's only thirteen people, so perhaps a revised press release will identify the counties of residence for the missing two.

Only one of Washington’s cases was hospitalized. All 15 were sick between July and December 2009 and have since recovered. Public health officials advise people not to eat the recalled products, and to follow the instructions issued by the manufacturer.

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Today Daniele, Inc. announced that tests have confirmed the presence of salmonella in the black pepper that the company used to coat the salami product that has been implicated in a massive national salmonella outbreak. The outbreak, which has sickened at least 189 people in 40 states, involves multiple strains of Salmonella bacteria. Today’s announcement confirms what Daniele, Inc. seems to have suspected since announcing the recall back on January 23, 2010.

But the announcement also leaves some major questions unanswered, like who was the supplier of the contaminated pepper?  FSIS, FDA, and CDC have not acted promptly enough in informing the public about the circumstances of this outbreak and recall, so Daniele, Inc. should take the initiative in the name of public health and tell the public who supplied it with contaminated pepper. At this point, for all we know, the pepper could be in the homes of many people across the country.

Also, outbreaks linked to pepper are by no means a new phenomenon. In August 2008 the Canadian Food Inspection Agency (CFIA) and Pak National Foods Limited warned the public not to consume the National Black Pepper Powder because the product may have been contaminated with Salmonella. The product had been distributed in Alberta and British Columbia. The importer, Pak National Foods Limited, Richmond, British Columbia, voluntarily recalled the affected product from the marketplace.

In March 2009, a Northern California company recalled two product lines: "Uncle Chen" white and black peppers and "Lian How" dry spices, after health officials identified Lian How-brand white pepper as the culprit in a recent Salmonella outbreak. At least 42 people had fallen sick in the four-month outbreak. Three other states besides Washington have were also involved in the outbreak: California, Nevada and Oregon.

And in August 2009 Adams Extract and Spice announced a voluntary recall of products because they had the potential to be contaminated with Salmonella. The products contained a specific lot of ground red pepper supplied by Van de Vries Spice Corporation. This lot of ground red pepper initially tested negative for Salmonella. Subsequently, Adams Extract and Spice was informed that another sample drawn from the same lot was confirmed positive for Salmonella.
 

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CDC is collaborating with public health officials in many states, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS), and the U.S. Food and Drug Administration (FDA) to investigate a multistate outbreak of Salmonella serotype Montevideo infections. Investigators are using DNA analysis of Salmonella bacteria obtained through diagnostic testing to identify cases of illness that may be part of this outbreak.

As of 9:00 pm EST on January 25, 2010, a total of 189 individuals infected with a matching strain of Salmonella Montevideo have been reported from 40 states since July 1, 2009. The number of ill persons identified in each state with this strain is as follows: AL (2), AZ (5), CA (30), CO (3), CT (4), DE (2), FL (2), GA (3), IA (1), ID (2), IL (11), IN (3), KS (3), LA (1), MA (12), MD (1), ME (1), MI (1), MN (4), MO (1), NC (9), ND (1), NE (1), NH (1), NJ (7), NY (15), OH (9), OK (1), OR (8), PA (3), RI (2), SC (1), SD (3), TN (4), TX (7), UT (7), VA (1), WA (14), WV (1), and WY (2). Because this is a commonly occurring strain, public health investigators may determine that some of the illnesses are not part of this outbreak.

Among the persons with reported dates available, illnesses began between July 4, 2009 and January 7, 2010. Infected individuals range in age from < 1 year old to 88 years old and the median age is 36 years. Fifty-three percent of patients are male. Among the 134 patients with available information, 37 (28%) were hospitalized. No deaths have been reported.

The outbreak can be visually described with a chart showing the number of persons who became ill each day. This chart is called an epidemic curve or epi curve. Illnesses that occurred after January 8, 2010 might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 3 weeks. Please see the Salmonella Outbreak Investigations: Timeline for Reporting Cases for more details.

Investigation of the Outbreak

A widely distributed contaminated food product might cause illnesses across the United States. The identity of the contaminated product often is not readily apparent. In outbreaks like this one, identification of the contaminated product requires conducting detailed standardized interviews with persons who were ill. It may also require conducting interviews with non-ill members of the public ("controls") to get information about foods recently eaten and other exposures to compare with information from the ill persons. The investigation is often supplemented by laboratory testing of suspected products. In addition, investigators sometimes use purchase information provided by ill persons to trace suspect products back to the point of production. This process is labor-intensive and typically takes weeks. It is not always successful.

During January 16-21, 2010, CDC and public health officials in multiple states conducted an epidemiologic study by comparing foods eaten by 41 ill and 41 well persons. Preliminary analysis of this study has suggested salami as a possible source of illness. Ill persons (58%) were significantly more likely than well persons (16%) to report eating salami. Additionally, 13 ill persons have been identified who purchased the same type of sliced salami variety pack at different grocery store locations before becoming ill. These data suggest this product may be the source of some of these illnesses. This sliced salami variety pack was recently recalled by Daniele International Inc. On January 23, 2010, FSIS issued a notice that Daniele International Inc. is recalling approximately 1,240,000 pounds of ready-to-eat varieties of Italian sausage products (including salame/salami) in commerce and potentially available to customers in retail locations because they may be contaminated with Salmonella. (www.fsis.usda.gov/News_&_Events/Recall_006_2010_Release/index.asp). These products can have an extended shelf life of up to one year. The manufacturer has voluntarily halted production of salami products.

This recall followed isolation of Salmonella in a private laboratory from a retail sample of a salami product produced by Daniele International; this product was different than the sliced salami variety pack purchased at different grocery store locations by the 13 ill persons. FSIS reviewed and affirmed these private laboratory results. The Salmonella strain initially found by the private laboratory was different from the strains causing the outbreak. However, the Washington State Department of Health subsequently tested the bacterial culture provided by the private laboratory (the salami was not provided) and identified two different Salmonella serotypes, the strain found by the private lab and Salmonella Montevideo indistinguishable from the outbreak strain. In addition, the Iowa Department of Public Health and public health officials in Plymouth County, Iowa investigated a patient with Salmonella Montevideo infection indistinguishable from the outbreak strain and discovered an open sliced salami variety pack frozen at the patient's home. The patient had eaten this product before becoming ill. This sliced salami variety pack was the same as that purchased by 13 other ill persons. Using DNA analysis, the University of Iowa Hygienic Laboratory (Iowa's public health laboratory) confirmed that the Salmonella isolated from this leftover salami was indistinguishable from the outbreak strain of Salmonella Montevideo.

CDC and its public health partners are continuing the epidemiologic investigation to verify that the outbreak is controlled; to identify the specific products or ingredients that became contaminated and how the contamination occurred; and to identify any other food vehicles that may be involved. It is possible that more than one food product may be causing illnesses. The investigation is ongoing.

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The Centers for Disease Control and Prevention is an arm of the Department of Health and Human Services.  The CDC is one of the foremost investigative bodies in the world when it comes to tracking foodborne illness and foodpoisoning.  The agency's role in the investigation of foodborne illness outbreaks--e.g. the Salmonella outbreak linked to pepper covered salami products manufactured by Daniele, Inc.--is critical to the safety of our food supply and the lives of every person in the country.   

The CDC's role in national foodborne illness outbreaks:

Interestingly, though, the CDC is often not the agency that "discovers" otubreaks of foodborne disease like the salami Salmonella outbreak.  On its website, the CDC details its typical role in the investigation of many foodborne illness outbreaks:

Most foodborne outbreaks are identified and investigated by local and state health departments. CDC provides consultation on some of those, as well as assistance on request for outbreaks that are particularly large, unusual, or severe.

In recent years, large multi-state foodborne outbreaks have become more common, because better surveillance identifies outbreaks that would previously have been missed and because an increasingly centralized food supply means that a food contaminated in production can be rapidly shipped to many states causing a widespread outbreak.

Continue Reading...

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Winter 2010 is shaping up to be a rough one for West Coast residents, who are often insulated from the weather woes of the rest of the country.  Southern California has been hammered by constant rain causing mudslides, evacuations, and any number of other weather-induced perils.  Meanwhile, Salmonella bacteria have been finding their way into the homes of many California residents for months now.  The vehicle, of course, is salami produced by Daniele, Inc., a Rhode Island company, and at least 30 California residents (and that's only the confirmed cases) have been sickened.  Washington residents have not fared much better.  At least 14 people from the State have been sickened in the outbreak. 

Here is the CDC's map showing the distribution of recognized cases nationally:

Link to the CDC's interactive map. 

As of 9:00 pm EST on January 24, 2010, a total of 187 individuals infected with a matching strain of Salmonella Montevideo have been reported from 39 states since July 1, 2009. The number of ill persons identified in each state with this strain is as follows: AL (2), AZ (5), CA (30), CO (3), CT (4), DE (2), FL (2), GA (3), IA (1), IL (11), IN (3), KS (3), LA (1), MA (12), MD (1), ME (1), MI (1), MN (4), MO (1), NC (9), ND (1), NE (1), NH (1), NJ (7), NY (15), OH (9), OK (1), OR (8), PA (3), RI (2), SC (1), SD (3), TN (4), TX (7), UT (7), VA (1), WA (14), WV (1), and WY (2).

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Investigation Announcement: Multistate Outbreak of Human Salmonella Montevideo Infections
Persons Infected with the Outbreak Strain of Salmonella Montevideo, United States, by State, as of January 25, 2010:

Atotal of 187 individuals infected with a matching strain of Salmonella Montevideo have been reported from 39 states since July 1, 2009. The number of ill persons identified in each state with this strain is as follows: AL (2), AZ (5), CA (30), CO (3), CT (4), DE (2), FL (2), GA (3), IA (1), IL (11), IN (3), KS (3), LA (1), MA (12), MD (1), ME (1), MI (1), MN (4), MO (1), NC (9), ND (1), NE (1), NH (1), NJ (7), NY (15), OH (9), OK (1), OR (8), PA (3), RI (2), SC (1), SD (3), TN (4), TX (7), UT (7), VA (1), WA (14), WV (1), and WY (2). Because this is a commonly occurring strain, public health investigators may determine that some of the illnesses are not part of this outbreak.

Among the persons with reported dates available, illnesses began between July 2, 2009 and January 7, 2010. Infected individuals range in age from <1 year old to 88 years old and the median age is 36 years. Fifty-two percent of patients are male. Among the 133 patients with available information, 37 (28%) were hospitalized. No deaths have been reported.

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With the food safety spotlight currently, and squarely, on sausage (Daniele, Inc. salami linked to 184 illnesses in 38 states; at least 38 hospitalized; see FSIS press release), it might be worth the consumer's while to spend a few minutes reviewing some sausage safety basics.  Here are some common questions and answers about sausage:

1.  Besides the manufacturer, who is responsible for ensuring the safety of sausage sold in the United States?

Answer:  Sausage is a meat product regulated by the USDA's Food Safety and Inspection Service.  FSIS inspects all sausages in interstate commerce and all sausages that are exported to other countries. But sausages made at a retail establishment may be under the jurisdiction of that State's health or agriculture department.

2.  Is sausage a risky food to consume?

Answer:  It depends on who you ask, but the composition and preparation of sausage might be a factor that predisposes this product to bacterial contamination.  Sausage is obviously made from a variety of meat types and cuts, and just like ground beef, there are, as a result, many critical points in the sausage-making process where adequate controls are required in order to reduce or eliminate the likelihood that the product will become contaminated.  One such control that may often be overlooked is the safety of the spices (e.g. pepper) used to enhance flavor.  NOTE:  one working theory about the Salmonella Montevideo outbreak linked to Daniele, Inc salami is that the pepper in or on the sausage was contaminated.  All the more reason for manufacturers to know, and investigate, the food safety practices of their suppliers.

3.  What must be on the label of uncooked sausages (i.e. not "ready to eat")?

Answer:  Labels for sausages that are not ready to eat must contain safe handling instructions, among other things.  Sausages that are NOT ready to eat must bear certain features such as, safe handling instructions. In cases where the sausage is partially cooked or otherwise appears cooked but requires cooking by the consumer for safety, FSIS requires additional labeling features such as a prominent statement on the principal display panel, for example, "Uncooked, Ready to cook, Cook before eating, Cook and serve" or "Needs to be fully cooked." In addition, the product should display cooking directions that are sufficient for the intended user. The manufacturer would have to validate that the cooking directions are sufficient to destroy any pathogens that could be present.

If a sausage is perishable, the label must say "Keep Refrigerated." Some federally inspected shelf-stable sausages are not ready to eat. If so, they will be labeled as above but will not have "Keep Refrigerated" on the label.

Continue Reading...

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Recall Release CLASS I RECALL
FSIS-RC-006-2010 HEALTH RISK: HIGH

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.

According to the CDC, as of January 22, 2010, a total of 184 individuals infected with a matching strain of Salmonella Montevideo have been reported from 38 states since July 1, 2009. The number of ill persons identified in each state with this strain is as follows: AL (2), AZ (5), CA (30), CO (2), CT (4), DE (2), FL (2), GA (3), IA (1), IL (11), IN (3), KS (3), LA (1), MA (12), MD (1), ME (1), MI (1), MN (4), NC (9), ND (1), NE (1), NH (1), NJ (7), NY (15), OH (9), OK (1), OR (8), PA (3), RI (2), SC (1), SD (3), TN (3), TX (7), UT (7), VA (1), WA (14), WV (1), and WY (2). Because this is a commonly occurring strain, public health investigators may determine that some of the illnesses are not part of this outbreak

FSIS became aware of the problem during the course of an ongoing investigation of a multi-state outbreak of Salmonella serotype Montevideo illnesses. The Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), FSIS, state health and agriculture departments, and Daniele International are cooperating in this investigation. The CDC has posted information about the multi-state outbreak on its website (http://www.cdc.gov/salmonella) but the investigation is ongoing, and has not yet definitively identified a food vehicle(s).

During the course of that investigation, a sample of product found in commerce was tested on behalf of a participating state department of health and found to contain Salmonella, which FSIS has a zero tolerance for in RTE products. The product tested was similar to products bought by customers who later became sick in the Montevideo investigation, but currently there is not a direct link. The Salmonella strain in the tested product does not appear to be the Montevideo strain of interest and further testing of the sample is ongoing at a state health partner laboratory. FSIS is continuing to work with the CDC, affected state public health partners, and the company on the investigation and will update the public on the progress of this investigation as information becomes available.

In addition, the company presented information to FSIS and took the additional action to voluntarily recall all products in commerce associated with black pepper, which the company believes is a possible source of contamination.

The products subject to recall include:

- 10-ounce packages of "DANIELE NATURALE SALAME COATED WITH COARSE BLACK PEPPER."
- Catch weight packages of "DANIELE PEPPER SALAME."
- 9-ounce packages of "BLACK BEAR OF THE BLACK FOREST BABY GENOA PEPPER SALAME."
- 20-ounce packages of "DANIELE DELI SELECTION, GENOA SALAME, SMOKED SALAME, PEPPERED SALAME, RUSTIC SALAME."
- 340- and 454-gram packages of "DANIELE SURTIDO FINO ITALIANO, SALAMI GENOA CON PIMIENTA, LOMO CAPOCOLLO, SALAMI CALABRESE."
- 16-ounce packages of "DANIELE ITALIAN BRAND GOURMET PACK, HOT CALABRESE, PEPPER SALAME, HOT CAPOCOLLO."
- 8-ounce packages of "DIETZ & WATSON ARTISAN COLLECTION PARTY PLATTER PACK, HOT CALABRESE, PEPPER SALAME, HOT CAPOCOLLO."
- 8-ounce packages of "DANIELE ITALIAN BRAND GOURMET PACK, HOT CALABRESE, PEPPER SALAME, HOT CAPOCOLLO."
- 16-ounce packages of "DANIELE GOURMET COMBO PACK, PEPPER SALAME, CAPOCOLLO, CALABRESE."
- 500-gram packages of "DANIELE ITALIAN BRAND GOURMET PACK EMBALLAGE ASSORTI GOURMET ITALIEN, HOT CALABRESE, PEPPER SALAME, CALABRESE PIQUANT, SALAMI AU POIVRE, HOT CAPOCOLLO, CAPOCOLLO PIQUANT."
- 8-ounce packages of "BOAR'S HEAD BRAND ALL NATURAL SALAME COATED WITH COARSE BLACK PEPPER."
- Catch weight packages of "DIETZ & WATSON ARTISAN COLLECTION, BABY GENOA PEPPER SALAME, MADE WITH 100% PORK COATED WITH BLACK PEPPER AND PORK FAT."
- 20-ounce variety packages of "DANIELE DELI SELECTION, GENOA SALAME, SWEET SOPRESSATA, PEPPERED GENOA, MILANO SALAME."
- 21-ounce variety packages of "DANIELE GOURMET ITALIAN DELI SELECTION, SWEET SOPRESSATA SALAMI, PEPPERED GENOA SALAMI, HOT SOPRESSATA SALAMI, MILANO SALAMI, SALAMI SOPRESSATA DOUX, SALAMI GENOA POIVRÉ, SALAMI SOPRESSATA PIQUANT, SALAMI MILANO."
- 7-ounce packages of "DANIELE SALAME BITES PEPPER SALAME."
- 14-ounce packages of "DANIELE GOURMET ITALIAN DELI SELECTION ASSORTMENT DE FINES CHARCUTERIE ITALIENNE, SWEET SOPRESSATA SALAMI, MILANO SALAMI, SALAMI SOPRESSATA DOUX, SALAMI MILANO."
- Catch weight packages of "DANIELE NATURALE SALAME COATED WITH COARSE BLACK PEPPER."
- 32-ounce variety packages of "DANIELE DELI SELECTION, GENOA SALAME, SWEET SOPRESSATA, PEPPERED GENOA, MILANO SALAME."

Each package bears a label with establishment number "EST. 9992" or "EST. 54" inside the USDA mark of inspection. The establishment is recalling all the products listed above which are currently in commerce. These products were distributed to retail establishments nationwide, as well as internationally.

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Daniele, Inc. announced it is initiating a voluntary recall of its Pepper-Coated Salame products because of possible concerns about salmonella. Preliminary results indicate that eleven ill individuals had consumed salame products from "Daniele Italian Brand Gourmet Pack." State and federal health officials have been unable to confirm a direct link between the illnesses and any Daniele product.

However, the CDC announced that is collaborating with public health officials in many states, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS), and the U.S. Food and Drug Administration (FDA) to investigate a multistate outbreak of Salmonella serotype Montevideo infections. Investigators are using DNA analysis of Salmonella bacteria obtained through diagnostic testing to identify cases of illness that may be part of this outbreak.

As of January 22, 2010, a total of 184 individuals infected with a matching strain of Salmonella Montevideo have been reported from 38 states since July 1, 2009. The number of ill persons identified in each state with this strain is as follows: AL (2), AZ (5), CA (30), CO (2), CT (4), DE (2), FL (2), GA (3), IA (1), IL (11), IN (3), KS (3), LA (1), MA (12), MD (1), ME (1), MI (1), MN (4), NC (9), ND (1), NE (1), NH (1), NJ (7), NY (15), OH (9), OK (1), OR (8), PA (3), RI (2), SC (1), SD (3), TN (3), TX (7), UT (7), VA (1), WA (14), WV (1), and WY (2). Because this is a commonly occurring strain, public health investigators may determine that some of the illnesses are not part of this outbreak.

Among the persons with reported dates available, illnesses began between July 2, 2009 and January 1, 2010. Infected individuals range in age from <1 year old to 88 years old and the median age is 37 years. Fifty-two percent of patients are male. Among the 125 patients with available information, 35 (28%) were hospitalized. No deaths have been reported.

The term Salmonella refers to a group or family of bacteria that has been known to cause illness in humans for over 100 years. Salmonella bacteria are usually transmitted to humans by eating foods contaminated with animal feces or foods that have been handled by infected food workers.

Thoroughly cooking contaminated foods kills Salmonella. People infected with Salmonella have diarrhea, fever, and abdominal cramps occurring 12-72 hours after exposure. Illness usually lasts 4-7 days. Most people recover without treatment but serious illness can occur requiring hospitalization and even resulting in death.

The family of Salmonella bacteria is distinguishable by antigenic response. Scientists have identified more than 2500 serotypes of Salmonella. Salmonella serotype typhimurium is the most common serotype in the United States. Salmonella serotype Montevideo is one of the ten most common serotypes, with 19,928 case patients reported to the CDC in the thirty-year period, 1968 to 1998. Outbreaks of Salmonella Montevideo are not uncommon. Outbreaks have occurred in food served by an unlicensed caterer in Virginia (2009), pistachio nuts (2009), barbequed pork (2007 and in fast food roast beef sandwiches (2006).

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From a company press release:

Daniele, Inc. announced today it is initiating a voluntary recall of its Pepper-Coated Salame products because of possible concerns about salmonella. Preliminary results indicate that eleven ill individuals had consumed salame products from "Daniele Italian Brand Gourmet Pack." State and federal health officials have been unable to confirm a direct link between the illnesses and any Daniele product.

As recently as yesterday, Daniele's Rhode Island facilities were inspected by the state's Department of Health and the company was found to be meeting all regulatory and food safety standards. According to the Rhode Island Department of Health, Daniele Inc. has been working diligently with the department and U.S. Department of Agriculture to help identify the source of the contamination.

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CDC is collaborating with public health officials in many states, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS), and the U.S. Food and Drug Administration (FDA) to investigate a multistate outbreak of Salmonella serotype Montevideo infections. Investigators are using DNA analysis of Salmonella bacteria obtained through diagnostic testing to identify cases of illness that may be part of this outbreak.

As of 12:00 pm EST on January 22, 2010, a total of 184 individuals infected with a matching strain of Salmonella Montevideo have been reported from 38 states since July 1, 2009. The number of ill persons identified in each state with this strain is as follows: AL (2), AZ (5), CA (30), CO (2), CT (4), DE (2), FL (2), GA (3), IA (1), IL (11), IN (3), KS (3), LA (1), MA (12), MD (1), ME (1), MI (1), MN (4), NC (9), ND (1), NE (1), NH (1), NJ (7), NY (15), OH (9), OK (1), OR (8), PA (3), RI (2), SC (1), SD (3), TN (3), TX (7), UT (7), VA (1), WA (14), WV (1), and WY (2). Because this is a commonly occurring strain, public health investigators may determine that some of the illnesses are not part of this outbreak.

Among the persons with reported dates available, illnesses began between July 2, 2009 and January 1, 2010. Infected individuals range in age from <1 year old to 88 years old and the median age is 37 years. Fifty-two percent of patients are male. Among the 125 patients with available information, 35 (28%) were hospitalized. No deaths have been reported.

The outbreak can be visually described with a chart showing the number of persons who became ill each day. This chart is called an epidemic curve or epi curve. Illnesses that occurred after January 4, 2010 might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 3 weeks. Please see the Salmonella Outbreak Investigations: Timeline for Reporting Cases for more details.

A widely distributed contaminated food product might cause illnesses across the United States. The identity of the contaminated product often is not readily apparent. In outbreaks like this one, identification of the contaminated product requires conducting detailed standardized interviews with persons who were ill. It may also require conducting interviews with non-ill members of the public ("controls") to get information about foods recently eaten and other exposures to compare with information from the ill persons. The investigation is often supplemented by laboratory testing of suspected products. In addition, investigators sometimes use purchase information provided by ill persons to trace suspect products back to the point of production. This process is labor intensive and typically takes weeks. It is not always successful. As soon as a source of the outbreak is identified, if there is evidence of ongoing risk, public health officials advise the public to avoid the implicated product and recalls are conducted when appropriate. CDC and its public health partners are vigorously working to identify the specific contaminated product or products that are causing illnesses and will update the public on the progress of this investigation as information becomes available.

Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12–72 hours after infection. Infection is usually diagnosed by culture of a stool sample. The illness usually lasts from 4 to 7 days. Although most people recover without treatment, severe infections may occur. Infants, elderly persons, and those with weakened immune systems are more likely than others to develop severe illness. When severe infection occurs, Salmonella may spread from the intestines to the bloodstream and then to other body sites and can cause death unless the person is treated promptly with antibiotics.

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SALT LAKE CITY, UT (January 21, 2010) The first E. coli lawsuit against National Steak and Poultry, an Oklahoma meat manufacturing facility, was filed today in the Third Judicial District Court in Salt Lake City. The civil suit was filed by Marler Clark and by Utah attorneys Jared Faerber and Dustin Lance on behalf of a child sickened in the E. coli O157:H7 outbreak linked to NSP beef products. The lawsuit also names as yet unidentified “John Doe” companies that may have been involved in distributing the tainted meat products.

The recall linked to National Steak and Poultry was announced on Christmas Eve 2009. It included 248,000 pounds of beef products potentially contaminated with E. coli O157:H7, a toxic pathogen. NSP announced the recall after the USDA and CDC became aware of a cluster of E. coli O157:H7 illnesses linked to the product in six states. Ultimately, the E. coli O157:H7 outbreak was expanded to twenty-one people in 16 states. The victims live in California, Colorado, Florida, Hawaii, Iowa, Indiana, Kansas, Michigan, Michigan, Nevada, Ohio, Oklahoma, South Dakota, Tennessee, Utah, and Washington State. According to the CDC, most of the people sickened in the outbreak fell ill between mid October and late November; nine were hospitalized; and one person developed hemolytic uremic syndrome (HUS), a life-threatening complication, as a result of their E. coli infection. Most of the meat was distributed to restaurants.

According to the lawsuit, 14-year-old Utah resident “CD” was infected with E. coli O157:H7 in October 2009. Within days of consuming contaminated meat, he began to experience severe E. coli symptoms including agonizing abdominal cramps and diarrhea that soon turned bloody. When his symptoms worsened, his parents rushed him to the ER at Columbia Lakeview Hospital in Bountiful, Utah where he was diagnosed with gastrointestinal bleeding; his parents were ultimately directed to take him to Primary Children’s Medical Center due to his deteriorating condition. CD remained hospitalized at Primary Children’s Medical Center in Ogden, Utah from November 2 through 4, 2009. He was diagnosed with infectious colitis, and a stool specimen that he submitted during his hospitalization soon tested positive for E. coli O157:H7. CD’s parents learned from officials from the Centers for Disease Control and Prevention that the strain of E. coli O157:H7 that had infected their son matched the outbreak strain linked to the defendant National Steak Processor’s beef products.

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Virtually every time an E. coli O157:H7 outbreak occurs, the most severely injured people develop a condition called hemolytic uremic syndrome (HUS).  The cluster being investigated by health officials in Belgium, Wisconsin is no exception.  At least one of the cases, believed to be a child, developed HUS and spent multiple weeks hospitalized at Children's Hospital of Wisconsin.

What is 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. D+HUS 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.

How did these otherwise harmless E. coli become such killers?

It seems likely that DNA from a Shiga toxin producing bacterium known as Shigella dysenteriae type 1 was transferred by a bacteriophage (bacteria infected with a virus) to harmless E. coli bacteria, thereby providing them with the genes to produce one of the most potent toxins known to man. So potent, 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 Stx producing E. coli that can cause D+ HUS.

From Diarrhea to Dialysis

The chain of events leading to HUS begins with ingestion of Stx producing E. coli (e.g., E. coli O157: H7) in contaminated food, beverages or through person to person transmission. 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 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 Stx 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 Stx 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.

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The E. coli O157:H7 outbreak in Belgium, Wisconsin has sickened at least 6 kids (one who developed HUS) seems to have several well-defined epidemiological circumstances that may help the State of Wisconsin Health Department identify a source.  The victims seem to all be kids, the kids all come from the same relatively small part of the town, and the kids apparently do not interact socially.  

Whatever the ultimate significance of these circumstances, another highly interesting epidemiological point in the outbreak is the apparent presence of Cryptosporidium and Clostridium difficile infection among the outbreak cases. 

Clostridium difficile

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. In rare cases, C. difficile-associated disease can be fatal. Although C. difficile bacteria can be present in human intestinal tracts and cause no clinical symptoms (a condition called colonization), some individuals with C. difficile colonization are at increased risk of becoming ill. The most common risk factor for C. difficile-associated disease is exposure to antibiotics, especially those with broad-spectrum activity. Although less common, exposure to agents that suppress the immune system may also increase the risk of illness. Advanced age, severe underlying illness, gastrointestinal surgery, use of nasogastric tubes, and gastrointestinal medications (such as gastrointestinal stimulants or antacids) have also been associated with an increased risk of colonization. Most cases are acquired in hospitals or nursing homes, but an increased incidence of community–acquired C. difficile has been reported as well. Recent studies indicate that C. difficile can also be found in food products, thus raising a significant question: Can C. difficile cause foodborne illness?

Sources and Transmission

C. difficile is shed in feces. Any material, device, or surface that becomes contaminated with feces—such as toilets or bathing tubs—may serve as a reservoir for C. difficile spores. The ability of C. difficile to form spores is thought to be a key feature that enables the bacteria to persist in patients and the physical environment for long periods of time, thereby facilitating its transmission.

Continue Reading...

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Sheboyganpress.com reports that the six children living in a well-defined, relatively small corner of Belgium, Wisconsin who were infected with E. coli O157:H7 had related infections with other dangerous bugs, including Cryptosporidium and Clostridium difficile. 

Cryptosporidium parvum (also known as "Crypto") is a parasite that is too small to be seen with the naked eye. It is found in water and food sources contaminated with the feces of infected humans, cattle, and other mammals. The infectious form of the parasite, known as an "oocyst," is highly resistant to the levels of chlorine normally found in drinking water and swimming pools.

Symptoms of Cryptosporidium

Cryptosporidiosis, the infection caused by ingestion of the Cryptosporidium parasite, causes painful abdominal cramping and profuse, watery diarrhea. In addition to diarrhea, symptoms of infection are fatigue, fever, nausea, vomiting, and loss of appetite.

Symptoms of Cryptosporidiosis appear an average of seven days after oocysts are swallowed, and normally last for two weeks or less in healthy adults. People with compromised immune systems (those with diabetes, receiving cancer treatments, who have received organ transplants, or are infected with HIV/AIDS), the elderly, pregnant women, and small children are more likely to become infected, and will suffer more severe illnesses than healthy adults. In some cases, Cryptosporidiosis can be life-threatening, especially when those infected become dehydrated.

Detection and Treatment of Cryptosporidium

Continue Reading...

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Fox 6 News in Milwaukee reported today that the state of Wisconsin, with the aid of local health authorities, is investigating 6 E. coli O157:H7 illnesses in Belgium, Wisconsin.  Wisconsin has been hit hard by E. coli before.  Why is it that some states--Minnesota, Utah, and a list of 3 or 4 others--seem to be involved in many major E. coli O157:H7 outbreaks?

Forty-nine Wisconsin residents were sickened in the infamous spinach E. coli O157:H7 (and other serotypes) outbreak in August/September 2006.  (Actually, it was a call from the mother, in the second week of September, of TWO kids infected in the outbreak that helped us figure out exactly what was happening), as were multiple Minnesota residents.  In the Cargill E. coli O157:H7 outbreak in 2007, many Minnesota residents were sickened including Stephanie Smith.  And in the JBS E. coli O157:H7 outbreak in summer 2009, at least six Wisconsin residents were infected, including Joshua Rosploch, who developed HUS.  This is just a short list, but these several states (most prominently Wisconsin and Minnesota) truly have been at the epicenter of surveillance and detection of multiple major national outbreaks. 

Why?  Unlucky distribution of the implicated products?  Wisconsin and Minnesota residents eat more beef and bad produce? 

Many would say that the real reason doesn't have anything to do with plain old nebulous bad luck.  Instead, it happens because these states have surveillance, microbiological, and sanitation personnel who are among the most talented anywhere.  It is not mere coincidence that these states figure prominently in many outbreaks of foodborne disease.  

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Today, 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, of course, to potential contamination by E. coli O157:H7.  In addition to ground beef produced early this month (Jan 2010), the recall includes ground beef products produced as far back as February 19 to May 15, 2008, due to the concern that some of these products may still be frozen in consumers' homes.  For anybody keeping a running tally, with the addition of today's large recall, beef companies have recalled 1,640,000 pounds of beef products since November.  Its a little scary to think where this number may end up come December 2010. 

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FSIS reported today that Huntington Meat Packing Inc., a Montebello, Calif. establishment, is recalling approximately 864,000 pounds of beef products that may be contaminated with E. coli O157:H7.  Although the recall is Class I--i.e. associated with a very high risk to consumer health--there are no illnesses currently known to be associated with the potentially contaminated meat.  The recalled ground beef was produced between January 5, 2010, and January 15, 2010, and was shipped to distribution centers, restaurants, and hotels within the State of California.

The following products, consisting of all ground beef products produced by the plant from January 5, 2010 to January 15, 2010, are subject to recall:

40 lb. boxes of “Huntington Meats Ground Beef”
40 lb. boxes of “ HUNTINGTON MEAT PKG. INC. BEEF GROUND FOR FURTHER PROCESSING”
40 lb. boxes of “BEEF BURRITO FILLING MIX”
10 lb. boxes of “IMPERIAL MEAT CO. GROUND BEEF PATTY”
20 lb. boxes of “IMPERIAL MEAT CO. GROUND BEEF PATTY”
10 lb. boxes of “El Rancho MEAT & PROVISION ALL BEEF PATTIES”

Each box bears the establishment number "EST. 17967" inside the USDA mark of inspection on a label.

Interestingly, though, these are not the only products subject to the large recall.  FSIS investigation at Huntington Meat Packing, Inc., must have turned up some serious violations because the company is also recalling meat produced in 2008.  FSIS determined that the 2008 meat was adulterated because the ground beef products produced from February 19, 2008 to May 15, 2008 may have been contaminated with E. coli O157:H7.

As a result, the following products produced from February 19, 2008 to May 15, 2008, are subject to recall:

40 lb. boxes of “Huntington Meats Ground Beef”
40 lb. boxes of “ HUNTINGTON MEAT PKG. INC. BEEF GROUND FOR FURTHER PROCESSING”
40 lb. boxes of “BEEF BURRITO FILLING MIX”
10 lb. boxes of “IMPERIAL MEAT CO. GROUND BEEF PATTY”
20 lb. boxes of “IMPERIAL MEAT CO. GROUND BEEF PATTY”
10 lb. boxes of “El Rancho MEAT & PROVISION ALL BEEF PATTIES”

Each box bears the establishment number "EST. 17967" inside the USDA mark of inspection on a label.

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ST. PAUL, Minn. –The Minnesota Department of Agriculture (MDA) is alerting consumers to an expansion of the January 8, 2010, product recall issued by Parkers Farm, Inc., of Coon Rapids, Minnesota. The company has expanded its voluntary product recall to include all products produced under its label, as well as a number of products marketed under other labels and produced at its Coon Rapids facility. The company took this action after further investigation by MDA determined that all products produced at the company’s Coon Rapids facility may have been contaminated with Listeria monocytogenes bacteria.

A complete list of recalled product can be found at the MDA website at www.mda.state.mn.us.

According to Parkers Farm, the products subject to recall were distributed in retail stores nationwide including Hy-Vee, Cub, Rainbow, Lunds/Byerly’s, Target, Whole Foods, Jewel, Dominicks, Marsh, Price Chopper, Shop Rite, Nash Finch, Sams Club, Costco, Safeway, Kroger, Wal-Mart, and Aldi stores. Parkers Farm asks consumers who have purchased these products to return them to their place of purchase for a full refund.

To this point, no illnesses have been linked with this recall. However, consumption of food contaminated with Listeria monocytogenes can cause listeriosis, an uncommon but potentially serious disease marked by fever, severe headache, neck stiffness and nausea. Healthy people rarely contract listeriosis, but it can sometimes cause fatal infections in infants, the elderly and those with weakened immune systems. Listeriosis can also lead to miscarriages and stillbirths in pregnant women. Any consumers who believe they may have become ill after eating the products should contact their health care provider.

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From a company press release:

SOLON, Ohio, Jan. 13 /PRNewswire/ -- Nestle USA's Baking Division announced today it will begin using heat-treated flour in the manufacture of its Nestle Toll House refrigerated cookie dough. "Consistent with our quality standards for Nestle Toll House refrigerated cookie dough, this change will only further enhance the safety of our products," said Paul Bakus, General Manager, Nestle USA Baking Group.

In June 2009, Nestle USA voluntarily recalled refrigerated cookie dough after the Food and Drug Administration (FDA) and Centers for Disease Control notified us they were conducting an investigation into reported E. coli O157:H7 illnesses that may have been related to consumption of raw cookie dough. The product was relaunched in August of 2009 following a thorough investigation at the Danville, Virginia manufacturing facility and implementation of a "best-in-class" testing protocol. The quality assurance protocol includes testing ingredients before they enter our facility, rigorous environmental sampling throughout the facility, and testing of finished product before it is shipped to customers.

On January 11, 2010 we informed the FDA that two samples of Nestle Toll House refrigerated cookie dough manufactured at our Danville, Virginia facility did not pass this rigorous protocol, and had tested positive for E. coli O157:H7. Consistent with our quality assurance protocol, the finished product involved never left our factory or entered the supply chain, and none was shipped to customers. Product currently on store shelves displaying the "New Batch" sticker is not affected, and no product is being recalled.

The process of converting to heat-treated flour will begin today, January 13 and will result in a temporary suspension of production. Production with the new ingredient will begin the week of January 25, and the product will begin to appear on grocery store shelves in early March. Consumers may notice some shortages on store shelves as we implement this change at the factory.

We have informed the FDA of our plans and will continue to cooperate with them. In addition to converting to heat-treated flour, we also plan to continue our rigorous protocol of testing ingredients and finished product. While we are pleased our quality assurance protocols are working, we are taking these steps to further ensure the quality of our products.

As an important reminder, Nestle strongly advises that cookie dough should not be eaten raw, and to bake our products before consuming. Maintaining high food quality standards and ensuring the safety of our products and consumers continues to be our highest priority.

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Listen up, folks.  It's time to check your refrigerator and cupboards for food that may be contaminated with listeria monocytogenes, a very serious and potentially fatal foodborne pathogen. 

This morning, Food Safety News is reporting that Parkers Farm, Inc., a Coon Rapids, Minnesota-based food manufacturer is recalling a variety of products after product sampling conducted by food safety officials in Minnesota and Wisconsin returned positive for listeria monocytogenes.  The U.S. Food and Drug Administration (FDA) is now investigating to determine what caused the problem.

The implicated Parkers Farm products include:

• 34 OZ. PEANUT BUTTER - SELL BY DATES BETWEEN 8-11-2010 AND 9-30-2010
• 16 OZ. PEANUT BUTTER - SELL BY DATES BETWEEN 11-14-2010 AND 12-31-2010
• CHEESE CUPS (8oz.-12 oz.-16oz) - SELL BY DATES BETWEEN 11-14-2010 AND 12-31-2010
• SALSA - SELL BY DATES BETWEEN 3-14-2010 AND 4-30-2010
• PIMENTO/JALAPENO NACHO AND CONQUESO - SELL BY DATES BETWEEN 8-11-2010 AND 9-30-2010
• CREAM CHEESE SPREADS - SELL BY DATES BETWEEN 5-13-2010 AND 6-30-2010

Sell by dates are located on the side of the container below the lid.

These products are distributed and sold to a number of large, national grocery chains, including Hy-Vee, Cub, Rainbow, Lunds & Byerly's, Target, Whole Foods, Jewel, Dominick's, Marsh, Price Chopper, Shop Rite, Nash Finch, Sam's Club, Costco, and Safeway.

Thus far, no illnesses have been associated with this recall.  Consumers should return the recalled products to their retailers for a full refund.  Questions may be directed to Parkers Farm at (800)-869-6685.

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Over a year after the outbreak of Salmonella in peanut butter that sickened hundreds and caused the deaths of at least nine, criminal prosecution of the responsible parties has yet to begin. Marler Clark, who represents more than 45 of the Peanut Corporation of America (PCA) victims, is assisting them in an effort to hold PCA president Stewart Parnell accountable for his actions. Some of the victims spoke this week about Parnell and PCA.

“As someone who testified in front of the House subcommittee last February, I saw the emails that Parnell had sent out,” said Lou Tousignant, whose father, Clifford Tousignant, died from eating the tainted product. “I saw that he knowingly shipped contaminated product to high-risk areas (nursing homes and schools). If there can be a precedent of criminal charges for those that knowingly commit an act that can cause harm to society, maybe someone like Parnell would think twice before shipping contaminated products that sickened hundreds and killed 9 people, including my father.”

Bill Marler, managing partner of Marler Clark and attorney for the victims, agreed. “In 17 years of litigating every major foodborne illness outbreak in the US, I have not seen a clearer situation that demanded criminal prosecution,” he said. “If not this case, when?”

“We think his actions were akin to a personal invasion of our home to assault Karen,” said Larry Andrew, whose wife was severely sickened by Salmonella in PCA peanut butter. “He killed people! If a similar methodology were to be undertaken by a cell of terrorists, the country would be outraged and the federal government would immediately arrest and prosecute the perpetrators.”

Earlene Carter, whose mother, Minnie Borden, succumbed to her Salmonella infection, added that Mr. Parnell “…should face the consumers under criminal law - not civil - to answer for the crimes he committed. After depriving families of their loved ones (who are gone to soon), he should not be shielded. This should never happen again.”

 

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 Today's announcement by USDA-FSIS of another beef recall due to E. coli O157:H7 contamination bodes poorly for this new year.  Adams Farm Slaughterhouse, LLC., an Athol, Mass., establishment, is recalling approximately 2,574 pounds of beef products that may be contaminated with E. coli O157:H7.  The recall occurs in the wake of an epidemiological investigation into the E. coli illness of at least one Massachusetts resident.  The recall also marks the third beef recall in the last three months due to E. coli O157:H7 contamination.

In November 2009, ground beef from a New York ground beef company called Fairbank Farms was recalled due to E. coli O157:H7 contamination. That outbreak caused resulted in 26 E. coli O157:H7 illnesses, nineteen hospitalizations, and five who developed hemolytic uremic syndrome (HUS).   

And on Christmas Eve 2009, National Steak and Poultry recalled at least 124 tons of mechanically tenderized beef products.  The National Steak and Poultry outbreak caused at least 21 E. coli O157:H7 illness in 16 states, including nine hospitalizations and one case of HUS.   

Together, the recalls and outbreaks linked to beef from Adams Farm, National Steak and Poultry, and Fairbank Farms, has caused at least 48 illnesses in nationally.  At least 776,000 pounds of beef have been recalled in total in the three outbreaks.  

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 Adams Farm Slaughterhouse, LLC., an Athol, Mass., establishment, is recalling approximately 2,574 pounds of 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.  A sample of the recalled ground beef tested positive for E. coli O157:H7 in the wake of an epidemiological investigation initiated by Massachusetts into the illness of one resident.  Are there more illnesses?  

This is the second ground time in the last several months that Massachusetts citizens have been caught in the midst of a ground beef recall.  In November, ground beef from a New York ground beef company called Fairbank Farms was recalled due to E. coli O157:H7 contamination.  That outbreak caused at least 8 people in the Commonwealth of Massachusetts to become infected with E. coli O157:H7.    

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Recall Release CLASS I RECALL
FSIS-RC-002-2010 HEALTH RISK: HIGH

WASHINGTON, January 11, 2010 - Adams Farm Slaughterhouse, LLC., an Athol, Mass., establishment, is recalling approximately 2,574 pounds of 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.

This recall was initiated after the Massachusetts Department of Public Health (MDPH) confirmed a positive ground beef sample for E. coli O157:H7, which it collected during an epidemiological investigation. Working in conjunction with the Massachusetts Department of Public Health (MDPH), FSIS determined that there is an association between the ground beef products and an illness in the state of Massachusetts. FSIS is continuing to work with the MDPH on the investigation. Anyone with signs or symptoms of foodborne illness should consult a physician.

The following products are subject to recall:

1,025-pounds of "Beef Cuts and Ground" packed for Mazzarese.
697-pounds of "Beef Cuts and Ground" packed for Side Hill Farm.
852-pounds of "Beef Cuts and Ground" packed for Sweet Water Farm.

Each package bears a label with the establishment number "EST. 5497" inside the USDA mark of inspection as well as the packaging date of "11/11/2009." The beef products were distributed to private owners on three separate farms in the state of Massachusetts.

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CDC is collaborating with public health officials in several states and the United States Department of Agriculture’s Food Safety and Inspection Service (FSIS) to investigate a multistate outbreak of human infections due to Escherichia coli O157:H7 (E. coli 0157:H7).

As of 5:00 PM EDT, Monday, January 4, 2010, 21 persons infected with the outbreak strain of E. coli O157:H7 had been reported from 16 states. The number of ill persons who were identified resides in each state as follows: CA (1), CO (1), FL (1), HI (1), IA (1), IN (1), KS (1), MI (1), MN (3), NV (1), OH (2), OK (1), SD (2), TN (1), UT (2), and WA (1).

Known illness onset dates range from October 3, 2009 through December 14, 2009. Most patients became ill between mid-October and late November. Patients range in age from 14 to 87 years and the median age of patients is 34 years, which means half are younger than 34 years. Forty-three percent of patients are females. There have been 9 reported hospitalizations, 1 case of hemolytic uremic syndrome (HUS), and no deaths.

The outbreak can be visually described with a chart showing the number of persons who became ill each day. This chart is called an epidemic curve or epi curve. Illnesses that occurred after December 22, 2009 might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 3 weeks. Please see the Timeline for Reporting of E. coli Cases for more details.

In early December 2009, CDC's PulseNet staff identified a multistate cluster of 14 E. coli O157:H7 isolates with a particular DNA fingerprint or pulsed-field gel electrophoresis (PFGE) pattern reported from 13 states. CDC's OutbreakNet team began working with state and local partners to gather epidemiologic information about persons in the cluster to determine if any of the ill individuals had been exposed to the same food source(s). Health officials in several states who were investigating reports of E. coli O157:H7 illnesses in this cluster found that most ill persons had consumed beef, many in restaurants. CDC is continuing to collaborate with state and local health departments in an attempt to gather additional epidemiologic information and share this information with FSIS. At this time, at least some of the illnesses appear to be associated with products subject to a recent FSIS recall.

On December 24, 2009, FSIS issued a notice about a recall of 248,000 pounds of beef products from National Steak and Poultry that may be contaminated with E. coli O157:H7. The recall was issued after FSIS determined there was an association between non-intact steaks (blade tenderized prior to further processing) and illnesses in Colorado, Iowa, Kansas, Michigan, South Dakota and Washington.

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According to the CDC (well, actually the Washington Post last week), we know that 21 persons were infected with E. coli O157:H7 in 16 states caused by National Steak and Poultry "mechanically tenderized" steaks.

Also, according to the CDC (well, actually efoodalert), the ill persons reside in California (1), Colorado (1), Florida (1), Hawaii (1), Iowa (1), Indiana (1), Kansas (1), Michigan (1), Minnesota (3), Nevada (1), Ohio (2), Oklahoma (1), South Dakota (2), Tennessee (1), Utah (2), and Washington (1).

Also, according to the CDC, (well, actually efoodalert, again), known illness onset dates ranged from October 3, 2009 through December 14, 2009, and most patients became ill between mid-October and late November. Nine were hospitalized and one developed Hemolytic Uremic Syndrome (HUS).

What this means is that on Christmas Eve when the FSIS announced that National Steak and Poultry was recalling approximately 248,000 pounds of beef products that "MAY" be contaminated with E. coli O157:H7, the outbreak had been ongoing for nearly three months, and had been likely over for at least two weeks.

By the way, thank you Lyndsey Layton from the Washington Post and Phyllis Entis from efoodalert for doing the CDC's job of informing the public of a nation-wide E. coli outbreak. As of a few moments ago, the CDC still has not updated its website.

We now know which states the ill people reside (BTW, thanks to Food Safety News for reporting that the Washington resident actually ate the steak and became ill in Nebraska), however, we still do not know where the people who became ill consumed the "mechanically tenderized" steaks.

Here is perhaps a very large clue - According to the FSIS (well actually Nation's Restaurant News and the Tulsa World Herald), when the FSIS and National Steak and Poultry recalled over 25 different products, the products were apparantly sent to Olive Garden, Applebees, Moe’s Southwest Grill, Carino’s Italian and 54th Street Grill & Bar. However, were there others? Thus far the FSIS and National Steak an Poultry websites remain silent.

By the way, thank you Alan Liddle of Nation’s Restaurant News and Kim Archer of the Tulsa World Herald for doing the FSIS's job of informing the public of where some, most or all (you pick) of the meat products went.

It is wonderful to see the private sector picking up the work over the holidays of both the CDC and FSIS in alerting the public to a Class I Recall.

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According to Alan Liddle of Nation’s Restaurant News “at least five restaurant chains are now included in a list of those affected by the late December recall of [250,000 pounds] of beef including,” Olive Garden, Applebees, Moe’s Southwest Grill, Carino’s Italian and 54th Street Grill & Bar.

"The Owasso, Oklahoma-based National Steak and Poultry said in a statement to Nation's Restaurant News that it had contacted all of its customers by December 24."

The U.S. Centers for Disease Control and Prevention have reported 21 confirmed cases of E. coli illness in 16 states, including nine that required hospitalization with one that developed Hemolytic Uremic Syndrome (HUS).

According to the CDC, the onset dates of the E. coli O157:H7 illness cases reported so far have ranged from Oct. 3 to Dec. 14. The states impacted are California, Colorado, Florida, Hawaii, Iowa, Indiana, Kansas, Michigan, Minnesota Nevada, Ohio, Oklahoma, South Dakota, Tennessee, Utah and Washington.

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As of Monday, January 4, 2010, 21 persons infected with the outbreak strain of E. coli O157:H7 had been reported from 16 states. The number of ill persons who were identified resides in each state as follows: California (1), Colorado (1), Florida (1), Hawaii (1), Iowa (1), Indiana (1), Kansas (1), Michigan (1), Minnesota (3), Nevada (1), Ohio (2), Oklahoma (1), South Dakota (2), Tennessee (1), Utah (2), and Washington (1).  Known illness onset dates range from October 3, 2009 through December 14, 2009. Most patients became ill between mid-October and late November. Patients range in age from 14 to 87 years and the median age of patients is 34 years, which means half are younger than 34 years. Forty-three percent of patients are females. There have been 9 reported hospitalizations, 1 case of hemolytic uremic syndrome (HUS), and no deaths.

"Tip-o-pen" to efoodalert.

According to the FSIS, National Steak and Poultry, an Owasso, Okla., establishment, is recalling approximately 248,000 pounds of 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.

The products subject to recall include:

4-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SC68408.”
6-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SP680608.”
8-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SC68808”
9-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SC68908.”
“NATIONAL STEAK AND POULTRY BONELESS BEEF TIPS,” with an identifying case code of “69108.”
“NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK” with an identifying case code of “XXSP68008.”
“NATIONAL STEAK AND POULTRY SAVORY SIRLOIN TIPS” with an identifying case code of “XX69008.”
5-ounce “NATIONAL STEAK AND POULTRY BACON WRAPPED BEEF FILLET,” with an identifying case code of “23508.”
“NATIONAL STEAK AND POULTRY USDA SELECT BEEF SHOULDER MARINATED TENDER MEDALLIONS” with an identifying case code of “23289.”
“NATIONAL STEAK AND POULTRY 75% BONELESS BEEF TRIMMINGS,” with an identifying case code of “33575.”
“NATIONAL STEAK AND POULTRY BEEF TRIMMINGS,” with an identifying case code of “36545.”
“NATIONAL STEAK AND POULTRY BEEF SIRLOIN PHILLY STEAK,” with an identifying case code of “88008.”
4-ounce “EGN BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680425.”
7-ounce “EGN BONELESS BEEF SIRLOIN TRI TIP STEAK,” with an identifying case code of “69725.”
9-ounce “EGN BONELESS BEEF SIRLOIN TRI TIP STEAK,” with an identifying case code of “680925.”
7-ounce “KRM BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680715.”
9-ounce “KRM BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680915.”
12-ounce “KRM BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680215.”
8-ounce “CARINO’S BONELESS BEEF OUTSIDE SKIRT STEAK,” with an identifying case code of “130874.”
“CARINO’S BONELESS BEEF OUTSIDE SKIRT STEAK PIECES,” with an identifying case code of “13074.”
“MOE’S BEEF STEAK,” with an identifying case code of “78027.”

Each package bears a label with the establishment number “EST. 6010T” inside the USDA mark of inspection, respective case codes cited above, and packaging dates of “10/12/2009,” “10/13/2009,” “10/14/2009,” or “10/21/2009.” These products were shipped to restaurants nationwide.

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According to State Health Department officials in six States, as of Monday there were reports of 1 illness each in Washington, Michigan, Iowa, Kansas and Colorado and 2 in South Dakota linked to the National State and Poultry E. coli O157:H7 beef recall linked to “mechanically-tenderized” steaks. The 1 ill person in Washington ate the steak in Nebraska.

However, according to the Michigan Department of Health and the CDC, and reported by the Tulsa World Herald this morning, there are a total of 19 ill nationwide, and, according also to a CDC spokesperson this morning, the number of States reporting illnesses is 16, not 6 as previously reported.

Those 10 States are yet unnamed as are the restaurants, or other retail outlets, that actually served the steaks that sickened the 19 people. 

However, yesterday National Steak and Poultry stated that the recall of nearly 250,000 pounds of meat did not include products shipped to retailers but was limited to products sold to Moe's, Carino's Italian Grill and KRM restaurants in Colorado, Iowa, Kansas, Michigan, South Dakota and Washington State, National Steak and Poultry said. KRM Restaurant Group is the parent company of 54th Street Grill & Bar, which operates 15 locations in Missouri, Kansas and Illinois.

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Thankfully Kim Archer of the Tulsa World Herald is adding to the slow roll of information on this outbreak and recall – “Owasso beef linked to E. coli.” Here is some clarified and newer information:

Nineteen sickened, so says the CDC:

The E. coli outbreak — considered a Class 1 recall because the health risk is high — has sickened at least 19 people, said Arleen Porcell-Pharr, a spokeswoman for the federal Centers for Disease Control and Prevention in Atlanta. She could not provide further information about the severity of the illnesses.  Hmm, yesterday I had confirmation from state health departments of 1 illness each in Iowa, Kansas and Colorado and 2 in South Dakota. The 1 ill in Washington ate in Nebraska. Michigan now has responded and they confirm only 1.  So, where does the CDC get 19?

Only three restaurant chains received the steak:

The recall did not include products shipped to retailers but is limited to products sold to Moe's, Carino's Italian Grill and KRM restaurants in Colorado, Iowa, Kansas, Michigan, South Dakota and Washington State (not sure that is accurate given sick person from Washington ate in Nebraska), National Steak and Poultry said. KRM Restaurant Group is the parent company of 54th Street Grill & Bar, which operates 15 locations in Missouri, Kansas and Illinois.

National Steak and Poultry product tested positive for E. coli O157:H7, so says FSIS:

The USDA verified those dates, adding that source material for the company's chopped steak product produced Oct. 12 that had tested positive for E. coli O157:H7 had mingled with products produced on the other dates.  Hmm, when was that test done?  Who had the information?  Was the product shipped before test results came back?

Federal officials began investigation December 11:

Federal officials began investigating the E. coli outbreak Dec. 11, according to the USDA's Food Safety and Inspection Service. The Owasso plant's beef recall was issued Christmas Eve.  What prompted investigation by Federal officials (USDA, FSIS, CDC)?  When did state Department's of Health become involved?

As I said yesterday:

Bill Marler, a Seattle-based food safety advocate and attorney, said that "when it involves E. coli O157:H7, just issuing a recall isn't remotely enough action to protect consumers." "The recall was issued on a holiday, with illnesses across the country and only a vague reference to meat being shipped to restaurants nationwide," he said. Federal agencies and the company "must know which restaurants it went to, and the public deserves to know, too."  Kim's story is helpful, but still more questions than answers.

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According to recent press reports, a statement from National Steak and Poultry and discussions with various state health officials, Colorado has confirmed that at least one person in that state was sickened there in November but wasn't hospitalized. Iowa and Kansas each confirmed one illness. A Washington State resident, a woman in her 60s, was infected while visiting Nebraska. She was hospitalized, but since released and is at home now. There were two cases of illnesses at, as yet unnamed, restaurants in South Dakota. One in Minnehaha County, the other in Brookings County. The State Epidemiologist says two people in South Dakota ordered steaks from restaurants and got sick with E. coli. It happened in November and both have both recovered. We are now waiting only on Michigan and the CDC.

According to National Steak and Poultry and the FSIS, the products now being recalled include various sizes of the company's "Boneless Beef Sirloin Steak," "Boneless Beef Tips," "Savory Sirloin Tips," "Bacon Wrapped Beef Fillet," "Beef Shoulder Marinated Tender Medallions," "75 percent Boneless Beef Trimmings," "Beef Trimmings,” "Beef Sirloin Philly Steak," "EGN Boneless Beef Sirloin Steak," "EGN Boneless Beef Sirloin Tri Tip Steak," "KRM Boneless Beef Sirloin Steak," "Carino's Boneless Beef Outside Skirt Steak," "Carino's Boneless Beef Outside Skirt Steak Pieces" and "Moe's Beef Steak."

National Steak and Poultry has confirmed that the recall is limited to beef products sold primarily to the Moe's, Carino's Italian Grill, and KRM restaurants (KRM Restaurant Group operates Jeremiah Johnson's and nine locations of the 54th Street Grill) in the six states.

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Authorities Have Not Revealed Which Restaurants Received The Tainted Steaks

On Christmas eve the Food Safety and Inspection Service (FSIS) issued a notice that National Steak and Poultry (NSP) was recalling 248,000 pounds of beef steaks contaminated with the highly virulent pathogen E. coli O157:H7. The steaks were mechanically tenderized “non-intact steaks”, and were shipped to restaurants nationwide. Although the Centers for Disease Control (CDC) working with state health and agriculture departments linked the steaks to NSP while investigating illnesses in restaurants six states—Colorado, Iowa, Kansas, Michigan, South Dakota, and Washington—a list detailing the distribution of the steaks has not been released by FSIS, CDC or NSP.

“When it involves E. coli O157:H7, just issuing a recall isn’t remotely enough action to protect consumers,” said Bill Marler, a Seattle-based, food safety advocate and attorney. “The recall was issued on a holiday, with illnesses across the country and only a vague reference to meat being shipped to restaurants nationwide. The FSIS, CDC and NSP must know which restaurants it went to and the public deserves to know too.”

Food Safety News reported this morning that Agriculture Secretary Tom Vilsack was warned in June 2009 of the risk of “non-intact steaks (blade tenderized prior to further processing),” or mechanically tenderized meat, by a coalition of food safety advocates. Secretary Vilsack was specifically warned that outbreaks associated with mechanically tenderized meat products have been on the rise. Beef products, like steaks and roasts, that are tenderized by piercing the surface with small needles or blades, create a risk that any pathogens on the surface of the meat would be transferred to the interior of the product, where they might not be eliminated when the product was cooked.

“Information on the distribution of these steaks have been withheld to protect whom?” continued Marler. “We need to know, who is looking out for the consumer? How will someone know if the restaurant they patronized received the meat or even knows about the recall? How will the management of the restaurants know that it should return the product and not serve it. This information is available, and getting it out quickly is absolutely critical to public health.”

ABOUT MARLER CLARK: Marler Clark has represented victims of every major food borne illness outbreak since 1993. The firm’s attorneys have litigated high-profile food poisoning cases against such companies as ConAgra, Dole, Cargill, Wendy’s, Chili’s, Chi-Chi’s, and Jack in the Box, securing over $500,000,000 for their clients.

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In 1999, the USDA-FSIS asked the National Advisory Comittee for Microbiological for Foods whether tenderized beef presented increased risks of contamination by E. coli O157:H7.  The answer, of course, was that it does, and that risks to consumer health increased correspondingly.  See Recommendations. 

This is not surprising, of course, nor is it particularly newsworthy in and of itself given the recent outbreak linked to tenderized beef from National Steak and Poultry.  In other words, we already knew that.  What i am interested in at this point is what questions we need to ask of National Steak and Poultry in upcoming litigation over the outbreak.  Essentially, what did National Steak and Poultry, and the industry at large, know about the risks of tenderized beef, and what did they do in order to reduce these risks and make a safer product. 

FSIS recommended several such steps, which certainly do not exhaust the list of things that manufacturers of tenderized beef need to do, but are good first steps at least:

First, the FSIS asked each plant operater that mechanically tenderizes beef to specifically consider in their annual reassessment of their HACCP (hazard analysis and critical control points) plan the significance of E. coli outbreaks linked to tenderized beef as a hazard that is reasonably likely to occur. 

Second, FSIS asked that each of these processors implement purchase specifications requiring the incoming product to be treated to reduce or eliminate E. coli to an undetectable level or apply an approved antimicrobial treatment to the meat.  See yesterday's post on this subject.

Third, though not really a recommendaiton, FSIS was "considering" a requirement that raw, mechanically tenderized beef be labeled to show that it had undergone mechanical tenderization.  (A brilliant idea, and one that all state legislatures should consider independently of any FSIS commandment on the subject; consumers should, at the very least, know whether the meat they are about to consume has undergone a tenderization process that may require a different cooking approach to make the product safe to eat)

Further, in light of the FSIS research and recommendations, the Dairy and Food Protection Branch (Division of Environmental Health, Department of Environmental and Natural Resources) issued the following additional recommendations:

1.  All beef not labeled as intact and without buyer specifications to show that it is intact must be assumed to be a non-intact beef product based on the standard meat processing industry practices of pinning, tenderizing or injecting these products. This also includes comminuted beef steak (chopped, flaked, ground, minced, restructured or reformulated).

2. Cook non-intact beef products to a temperature of 155°F as measured by a properly calibrated food thermometer as required by the FDA Food Code.

3. If you currently tenderize beef steaks or other beef products in your restaurant kitchen, please stop this practice.

4. Educate your staff about the identified risks of mechanically tenderized (non-intact) beef products.

5. When possible, notify consumers about the risk of getting E. coli from mechanically tenderized (nonintact) beef steaks and roasts

I wholeheartedly agree, particularly with any recommendation aimed at achieving elimination of bacterial contamination by the slaughterhouses, as well as with any recommendation that aims to educate the consumer about the risks he or she faces by consuming tenderized beef.  National Steak and Poultry, which of these steps were you actively taking at the time of the outbreak?

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Bill Marler, food safety advocate and attorney, whose Seattle law firm, Marler Clark, has been contacted by victims of the E. coli outbreak traced to the National Steak and Poultry steak recall that has sickened people in Colorado, Iowa, Kansas, Michigan, South Dakota and Washington, called today on National Steak and Poultry to pay the medical bills and lost wages of all individuals.

“We know that several people became ill with E. coli infections after eating National Steak and Poultry steak,” Marler said. “The cost of treating victims of E. coli infections can run in the tens of thousands of dollars, or in a severe case, in the hundreds of thousands of dollars or more,” Marler continued. “These families need National Steak and Poultry to do more than promise to cooperate in the investigation into this outbreak. They need to know that National Steak and Poultry intends to fulfill its corporate responsibility by looking out for its customers.”

Marler noted that in other outbreak-situations companies such as Chi-Chi’s, Dole, Jack in the Box, Con Agra, Odwalla and Sheetz advanced medical costs for outbreak victims whose illnesses were traced to their food products.

Since the Jack in the Box E. coli outbreak in 1993, Bill Marler has represented thousands of E. coli 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.

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Injury issues aside (see John Mcdonalds HUS story), the problem with tenderized beef is that it internalizes bacteria from the surface of intact cuts of beef, thereby reducing the likelihood that cooking will serve as an effective kill step.  The recent (ongoing???) outbreak of E. coli O157:H7 linked to National Steak and Poultry products occurred because the cuts of beef were mechanically tenderized.  In fact, somewhat frighteningly, a majority of the steaks and roasts destined for consumption at hotels, restaurants, and other institutional settings are mechanically tenderized.  Clearly, unless consumers stop eating tenderized beef or a reliable pre-cooking kill step is established and actually used, the onus for the task of manufacturing safe beef products remains squarely on the manufacturers' shoulders.

"Manufacturer" is a broad term, and I intend to confine it to no one entity in the process of manufacturing beef products.  It includes slaughterhouses and retail meat producers alike (e.g. National Steak and Poultry).  Because our inboxes and voicemail systems are already filling up with inquiries about the outbreak, we will have the opportunity to discover everything that National Steak and Poultry, and the entities who sold it the contaminated products, knew about the risks associated with tenderized beef.  And more importantly, we will have the opportunity to discover what those entities did to minimize or eliminate the risk that consumers of their products would become infected by E. coli O157:H7.

For starters, we will be interested to know what studies these entities participated in to research both the prevelance of E. coli and other bacteria on the surface and in the interior of tenderized beef; what the results of those studies were; and how these entities used or acted upon the results of their work.  If the answer is, as it very well may be, "No, we did not fund or participate in any such studies," i'm not sure that's going to mean much in front of a jury who is going to hear that such studies have, in fact, been done. 

One such study by The Center for Red Meat Safety at Colorado State University, which sought to determine the efficacy of anti-microbial treatments at various stages of the manufacturing process, found that the obvious was true:  bacteria is very hard to effectively remove or kill once it has been introduced into the interior of the beef; but that surface interventions can effectively reduce the contamination load on the surface of the product.  See the whole study here.   The timing of the chosen treatment (in the study, researchers used both water and lactic acid) is also important, as the study quite logically found that the treatments were more effective when done prior to tenderization. 

The main point of this study, or at least the point that i think we should all take from this and other similar studies, is that there is no failsafe method, in use presently, of eliminating bacteria from the surface or interior of beef products once those products become contaminated.  Thus, manufacturers must attack the problem of bacterial contamination on meat products where interventions can be more effectively applied:  during the slaughtering process.  If we prevent meat from becoming contaminated in the first place, the need to eliminate contamination from the surface or interior of the meat will cease to exist.  

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Certain circumstances surrounding the National Steak and Poultry E. coli O157:H7 outbreak have me worried.  The pathogen is incredibly dangerous; the vehicle (non-ground beef products) is often not cooked to a high enough temperature to kill E. coli; many of the beef products recalled are frozen, thus extending the shelf-life, putting more people at risk over a longer time frame, and frustrating public health detection efforts; and perhaps most concerning, the list of products is really long: 

4-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SC68408.”

6-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SP680608.”

8-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SC68808”

9-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SC68908.”

“NATIONAL STEAK AND POULTRY BONELESS BEEF TIPS,” with an identifying case code of “69108.”

“NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK” with an identifying case code of “XXSP68008.”

“NATIONAL STEAK AND POULTRY SAVORY SIRLOIN TIPS” with an identifying case code of “XX69008.”

5-ounce “NATIONAL STEAK AND POULTRY BACON WRAPPED BEEF FILLET,” with an identifying case code of “23508.”

“NATIONAL STEAK AND POULTRY USDA SELECT BEEF SHOULDER MARINATED TENDER MEDALLIONS” with an identifying case code of “23289.”

“NATIONAL STEAK AND POULTRY 75% BONELESS BEEF TRIMMINGS,” with an identifying case code of “33575.”

"NATIONAL STEAK AND POULTRY BEEF TRIMMINGS,” with an identifying case code of “36545.”

“NATIONAL STEAK AND POULTRY BEEF SIRLOIN PHILLY STEAK,” with an identifying case code of “88008.”

4-ounce “EGN BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680425.”

7-ounce “EGN BONELESS BEEF SIRLOIN TRI TIP STEAK,” with an identifying case code of “69725.”

9-ounce “EGN BONELESS BEEF SIRLOIN TRI TIP STEAK,” with an identifying case code of “680925.”

7-ounce “KRM BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680715.”

9-ounce “KRM BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680915.”

12-ounce “KRM BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680215.”

8-ounce “CARINO’S BONELESS BEEF OUTSIDE SKIRT STEAK,” with an identifying case code of “130874.”

“CARINO’S BONELESS BEEF OUTSIDE SKIRT STEAK PIECES,” with an identifying case code of “13074.”

“MOE’S BEEF STEAK,” with an identifying case code of “78027.”

I suppose that only time, and the CDC, will tell how many people since September have been sickened, or died, in this outbreak.  We already know that there are victims in six states, including Washington, Michigan, South Dakota, Iowa, Colorado, and Kansas.  Maybe the final destructive tally will not be as large as the circumstances of this outbreak suggest that they could be.  But it certainly seems like a perfect storm, of sorts, to me.

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E. coli O157:H7 strikes again, this time stealing some of Santa's thunder and delivering a pile of bad news (for the meat industry, the consumer, everybody) on Christmas Eve.  The outbreak linked to National Steak and Poultry, an Oklahoma-based purveyor of pre-portioned beef products, has sickened people in Colorado, Iowa, Kansas, Michigan, South Dakota, and Washington.  I havent' yet seen reference to how many are thought to have been sickened in the outbreak, but a listing of six states stretching from the eastern time zone all the way to the west coast portends some bad news on that front.

There is never "down time" at Marler Clark.  We are constantly busy, sometimes almost too busy, representing people who have been sickened in E. coli and other outbreaks.  But this outbreak adds more than a few "to dos" to our lists at Marler Clark.  The epidemiological evidence so far establishes that people were falling ill in this outbreak as far back as September 09; it also suggests that we're dealing with a possibly frozen product--i.e. one that does not necessarily have a short shelf life (all the more reason for National Steak and Poultry to heed Bill Marler's call to release its customer list so that people don't continue to get sick). 

I can think of more than a few people who have called me since September who were ill themselves, or were distraught over the illness of a family member.  We investigate even the illnesses of those who are not part of a recognized outbreak, but even the lawyers at Marler Clark are sometimes limited by the known epidemiological evidence.  Now, however, after announcement of the National Steak and Poultry outbreak, we've got a heck of a lot more to go on.  I know what I'll be doing this afternoon, tomorrow, and into next week:  sorting through the files of probably one hundred E. coli victims who have called since September, looking for possible exposures to national steak and poultry products.   

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On Christmas Eve, the Food Safety and Inspection Service (FSIS) released an advisory that there was “a recall of approximately 248,000 pounds of steaks that may be contaminated with E. coli O157:H7.” This is a CLASS I RECALL - which means - “This type of recall involves a health hazard where a reasonable probability exists that eating the food would cause serious, adverse health consequences or death.” The recalled products are packages of steaks bearing a label with the establishment number “EST. 6010T” inside the USDA mark of inspection and packaging dates of “10/12/2009,” “10/13/2009,” “10/14/2009,” or “10/21/2009.”

National Steak and Poultry and the FSIS have only made available a list of recalled products, but so far have refused to reveal where those products were shipped, even in light of illnesses linked to the meat in “Colorado, Iowa, Kansas, Michigan, South Dakota and Washington.”

“The FSIS has indicated that E. coli illnesses are being investigated by the CDC in connection with the recall,” said food safety advocate and attorney William Marler. “Yet consumers have no information as to what states the tainted steaks were shipped or what retail outlets or restaurants received it. National Steak and Poultry has this information at its fingertips, FSIS should have access to it as well, and it is unconscionable that they have not made it available to the public,” continued Marler.

“This recall is the tenth so far in 2009. The FSIS policy of identifying retailers that received recalled products continues to appear to be getting a hit-or-miss application. At times, retailers and restaurants are identified on the same day as a recall, and on others, not at all. We know where we shop or where we had a steak. If we or restaurants are told where the contaminated steaks that has been recalled were sold, someone could go right to the freezer to see if there is any of the product,” added Marler.

After years of large recalls, focused efforts by meat regulators brought down E. coli contamination recalls to a low of 182,000 pounds in 2006. Recalls shot up again in 2007, and in the ensuing years (2007-2009), nearly 45 million pounds of beef have been recalled due to contamination with E. coli O157:H7.

The CDC estimates that every year at least 75,000 Americans are sickened and 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.

The products subject to recall include:

Continue Reading...

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E. coli Steaks

National Steak and Poultry, an Owasso, Okla., establishment, is recalling approximately 248,000 pounds of 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.

FSIS became aware of the problem during the course of an investigation of a cluster of E. coli O157:H7 illnesses. Working with the Centers for Disease Control and Prevention (CDC) and state health and agriculture departments, FSIS determined that there is an association between non-intact steaks (blade tenderized prior to further processing) and illnesses in Colorado, Iowa, Kansas, Michigan, South Dakota and Washington. FSIS is continuing to work with the CDC and affected state public health partners on the investigation. Anyone with signs or symptoms of foodborne illness should consult a physician.

The products subject to recall include:

* 4-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SC68408.”
* 6-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SP680608.”
* 8-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SC68808”
* 9-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SC68908.”
* “NATIONAL STEAK AND POULTRY BONELESS BEEF TIPS,” with an identifying case code of “69108.”
* “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK” with an identifying case code of “XXSP68008.”
* “NATIONAL STEAK AND POULTRY SAVORY SIRLOIN TIPS” with an identifying case code of “XX69008.”
* 5-ounce “NATIONAL STEAK AND POULTRY BACON WRAPPED BEEF FILLET,” with an identifying case code of “23508.”
* “NATIONAL STEAK AND POULTRY USDA SELECT BEEF SHOULDER MARINATED TENDER MEDALLIONS” with an identifying case code of “23289.”
* “NATIONAL STEAK AND POULTRY 75% BONELESS BEEF TRIMMINGS,” with an identifying case code of “33575.”
* “NATIONAL STEAK AND POULTRY BEEF TRIMMINGS,” with an identifying case code of “36545.”
* “NATIONAL STEAK AND POULTRY BEEF SIRLOIN PHILLY STEAK,” with an identifying case code of “88008.”
* 4-ounce “EGN BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680425.”
* 7-ounce “EGN BONELESS BEEF SIRLOIN TRI TIP STEAK,” with an identifying case code of “69725.”
* 9-ounce “EGN BONELESS BEEF SIRLOIN TRI TIP STEAK,” with an identifying case code of “680925.”
* 7-ounce “KRM BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680715.”
* 9-ounce “KRM BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680915.”
* 12-ounce “KRM BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680215.”
* 8-ounce “CARINO’S BONELESS BEEF OUTSIDE SKIRT STEAK,” with an identifying case code of “130874.”
* “CARINO’S BONELESS BEEF OUTSIDE SKIRT STEAK PIECES,” with an identifying case code of “13074.”
* “MOE’S BEEF STEAK,” with an identifying case code of “78027.”

Each package bears a label with the establishment number “EST. 6010T” inside the USDA mark of inspection, respective case codes cited above, and packaging dates of “10/12/2009,” “10/13/2009,” “10/14/2009,” or “10/21/2009.” These products were shipped to restaurants nationwide.

Listeria Hams

Associated Grocers of Maine, importing firm, a Gardiner, Maine, establishment, is recalling approximately 312 pounds of ham products that may be contaminated with Listeria monocytogenes, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The following products are subject to recall:

16-ounce packages of “SUPER TRIM, Shurfine, IMPORTED, COOKED HAM, WATER ADDED, 98% FAT FREE.”

Each package bears the establishment number “141” inside the Canadian seal of inspection and a Sell by date of “10JA24.” The ham products were produced on November 25, 2009, and distributed to retail establishments in Maine and New Hampshire.

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According to John Horton of Cleveland The Plain Dealer:

Veal delivered to two Cleveland meat markets has been recalled because of possible E. coli contamination.  Zagreb Quality Meats on St. Clair Avenue and Sebastian Meats at the West Side Market received potentially tainted veal sometime during the past week, according to Mahan Packing. The Trumbull County company also delivered some of the 772 pounds of recalled veal to Rulli Brothers of Austintown, according to a news release issued Tuesday afternoon via the Ohio Department of Agriculture.  The company issued the voluntary recall given a positive E. coli test in a veal sample taken from Mahan's facility last week. The product that tested positive never left the building, but there's a possibility nine other carcasses may be contaminated.

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An editorial from today's Bismark Tribune hits the nail squarely on the head--the job of public health departments is to protect and oversee the public's health.  That's why it is somewhat frustrating that many months after 150 people became ill from Salmonella infections after consuming or being exposed to contaminated food prepared by an unlicensed caterer in North Dakota, no official action has been taken against the business.

For a quick recap: "the unlicensed caterer continued to prepare and serve food after being issued a cease-and-desist order by the First District Health Unit following the outbreak one weekend in Washburn and before the second bout of food poisoning the following weekend."

"The board of directors of the First District Health Unit met in July, when all of the facts may not have been in, and decided to take not action at that time. That board isn't scheduled to meet again until sometime in February. While the Tribune can appreciate that the board of directors have a schedule they might want to adhere to, the caterer, victims and public deserve a certain timely attention. Public health issues are just that: "public" health issues."

"For those that might believe this is much to do about nothing, consider the cost for hospital visits and testing paid for by the victims and their health insurance companies. One out-of-state family said they spent about $4,000 in airline fares and hotel rooms dealing with their part of the crisis, and that doesn't include the cost of hospitalization of the husband and wife, both in their 70s."

"And then there's the physical price of being sick."

"The public needs to know that the Health Unit and other public health officials are focused on public safety. Good intentions and professional distance are fine things, but there's something to be said for taking care of business. The board of directors of the Health Unit should have met again months ago but now should meet as soon as possible and resolve all parts of this issue."

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AP reports that the family of a New Mexico boy who got sick after eating sirloin from JBS Swift Beef Co. is working to settle a lawsuit seeking unspecified damages against the Greeley, Colo.-based company.

JBS Swift recalled about 380,000 pounds of beef this summer due to connections with outbreaks of E. coli.

Alex Roerick and his mother, Hollie, of Albuquerque filed a lawsuit in July saying Alex developed kidney failure after eating meat from the company.

In documents filed in U.S. District Court in Denver on Monday, lawyers for the Roericks and the company asked that the claims be dismissed, with no money changing hands, so the parties could pursue a settlement.

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CDC is collaborating with public health officials in many states to investigate a multistate outbreak of human Salmonella serotype Typhimurium infections due to contact with water frogs including African Dwarf Frogs. Water frogs commonly live in aquariums or fish tanks. Amphibians such as frogs and reptiles such as turtles, are recognized as a source of human Salmonella infections. In the course of routine assessment, a number of cases with the same strain have been identified over many months.

As of 12pm EST on December 7, 2009, 48 individuals infected with the outbreak strain of Salmonella Typhimurium have been reported from 25 states. The number of ill persons identified in each state is as follows: Arizona (1), California (2), Colorado (2), Florida (1), Georgia (1), Idaho (1), Illinois (5), Kentucky (1), Louisiana (1), Massachusetts (2), Maryland (2), Michigan (3), Minnesota (1), Missouri (2), Mississippi (1), New Jersey (2), New Mexico (1), New York (1), Ohio (2), Pennsylvania (3), Tennessee (2), Texas (3), Utah (6), Virginia (1), and Washington (1).

Among the persons with reported dates available, illnesses began between June 24, 2009 and November 14, 2009. Infected individuals range in age from <1 year old to 54 years old. Seventy-seven percent (77%) of patients are younger than 10 years old and the median age is 4 years. Fifty-five percent (55%) of patients are female. No deaths have been reported.

Investigation of the Outbreak

In an epidemiologic study, ill persons answered questions about contact with animals and foods consumed during the days before becoming ill and investigators compared their responses to those of persons of similar age and gender previously reported to State Health Departments with other illnesses. Preliminary analysis of this study suggests contact with frogs, including water frogs such as African Dwarf Frogs, is a likely source of the infections. In addition, environmental samples taken from aquariums containing aquatic frogs in three homes of ill persons have yielded isolates of Salmonella Typhimurium matching the outbreak strain.

Advice to Consumers

Always wash hands thoroughly with soap and water after touching any amphibian (e.g., frog) or reptile (e.g, turtle), their housing, or anything (for example, food) that comes in contact with them or their housing. Adults should assist young children with hand washing.

Watch for symptoms of Salmonella infection, such as diarrhea, fever, and abdominal cramps. Call your health care provider if you or a family member have any of these symptoms.

Persons who should avoid contact with amphibians and reptiles and their habitats (e.g., aquarium, fish tank, or terrarium)

Persons at increased risk for serious infection from salmonellosis are children < 5 years old, elderly persons, and persons with weakened immune systems.

These persons should avoid contact with amphibians (e.g., frogs) and reptiles (e.g., turtles) and anything that comes in contact with them (e.g., aquarium, habitat, and water).

Keep amphibians and reptiles out of homes with children < 5 years old or people with weakened immune systems.

Placement and maintenance of habitats

Amphibians (e.g., frogs) and reptiles (e.g., turtles) should not be kept in child-care centers.
Habitats containing amphibians or reptiles should not be kept in a child’s bedroom, especially children aged < 5 years.

Do not allow amphibians or reptiles to roam freely through the house, especially in food preparation areas.

Keep amphibians and reptiles out of kitchens and other areas where food and drink is prepared or served to prevent contamination.

Habitats and their contents should be carefully cleaned outside of the home. Use disposable gloves when cleaning and do not dispose of water in sinks used for food preparation or for obtaining drinking water.

Do not bathe animals or their habitats in your kitchen sink. If bathtubs are used for these purposes, they should be thoroughly cleaned afterward. Use bleach to disinfect a tub or other place where reptile or amphibian habitats are cleaned.

Children aged <5 years should not clean habitats.

Always wash hands thoroughly with soap and water after cleaning habitats.

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Denise Reynolds RD of EmaxHealth does a great job of giving an overview of Cargill’s comedy of errors:

Beef Packers, Inc., owned by Cargill, announced late last week that it is recalling over 20,000 pounds of ground beef contaminated with a drug-resistant strain of salmonella. It is the second time this year the company has recalled meat distributed for consumer sale.

Safeway Grocery store announced that the recall affects ground beef sold at its stores in Arizona and New Mexico and has been pulled from store shelves. The meat involved was produced on September 23rd, 2009 and includes fresh ground beef, beef patties, meatballs, and stuffed peppers with a sell-by date between September 28th and October 11th, 20009. The labels include the establishment number EST.31913 marked on the case code labels.

The Arizona Department of Health Services has linked two illnesses to the ground beef.

In August 2009, the California-based Beef Packers recalled almost 826,000 pounds of ground beef contaminated with the same strain of salmonella that prompted the current recall. At least 39 people were sickened.

The strain of bacteria involved is called Salmonella Newport. Infections can be life-threatening, especially to young children, the elderly, and people with weak immune systems, particularly because it is resistant to many of the most commonly prescribed antibiotics. Symptoms include diarrhea, fever, abdominal cramps and vomiting that can last up to seven days.

Beef packers had previously been a major supplier of beef products to the National School Lunch Program. Since July 2009, the company appears to have discontinued the relationship, as it has been suspended three times – twice for failing to produce ground beef free of microorganisms.

Salmonella hasn’t been Cargill’s only food safety concern. Recently a dance instructor from Cold Spring, Minnesota, filed a $100 million lawsuit against the company that alleges that they are responsible for a contamination of ground beef from E. coli O157:H7, another deadly bacterial organism that causes food-borne illness.

Stephanie Smith consumed the tainted meat two years ago at a fall family cookout. The Minnesota Department of Health and the US Department of Agriculture traced her contaminated meat to the company’s plant in Butler, Wisconsin and sold under the “Sam’s Club” brand. Ms. Smith suffered severe consequences as a result of the illness, was hospitalized for more than six months, and today undergoes rehabilitation in the hopes of relearning to walk.

The company recalled 845,000 pounds of ground beef after learning of the contamination in October 2007.

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Safeway in cooperation with Beef Packers, Inc.’s (Cargill) recall of 22,000 pounds of fresh ground beef that may be linked to an outbreak of Salmonella, Safeway Inc. is recalling fresh ground beef products with "Sell By” dates of September 28 through October 11, 2009. The recall affects all stores in Arizona and one store in New Mexico in the city of Gallup.  The beef recall was triggered by a report by the Arizona Department of Health Services to FSIS that illnesses from Salmonella Newport may be associated with ground beef products. The state agency and the ADHS determined that the association between the fresh ground beef products and two cases of salmonella illnesses reported in Arizona.

While the recalled product is no longer in stores, Safeway is asking its customers to check all ground beef in their freezers. The recall includes fresh ground beef products sold during the dates listed above at the full-service counter in brown butcher paper and at the self-service area wrapped on black Styrofoam trays. These products include fresh ground beef, fresh ground beef patties, fresh meat balls, fresh meat loaf and fresh bell peppers stuffed with beef and pork.

Consumption of food contaminated with Salmonella Newport can cause salmonellosis. Salmonella Newport infections can be life-threatening, especially to those with weak immune systems, infants, the elderly, and persons undergoing chemotherapy. This particular strain of Salmonella Newport is resistant to many commonly prescribed drugs, which can increase the risk of hospitalization or possible treatment failure in infected individuals. The most common symptoms of salmonellosis are diarrhea, abdominal cramps, and fever within eight to 72 hours. Additional symptoms may include chills, headache, nausea and vomiting that can last up to seven days.

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Stephanie Smith, the twenty-two year old Minnesota dance instructor left paralyzed by a burger tainted with E. coli filed suit today against Cargill, who produced the contaminated meat. Ms. Smith, whose “The Burger that Shattered Her Life” profile in the New York Times was emailed all over the country, covered by hundreds of media outlets and galvanized legislators to change food laws, attempted mediation with the company, but was unable to come to a fair agreement with them. The lawsuit was filed on behalf of Stephanie’s guardian, William R. Sieben, in the United States District Court for the District of Minnesota by Bill Marler of the Seattle foodborne illness law firm Marler Clark, and by Jardine, Logan and O’Brien of St. Paul.

“I have handled foodborne illness cases since the Jack in the Box outbreak nearly seventeen years ago, and I have never seen someone sickened this severely and survive,” said Ms. Smith’s attorney, Bill Marler. “This young woman has been on a horrifying and unimaginable journey just to regain basic motor and communication skills. She has lost the ability to walk, to dance, to have a family, to work or care for herself. She is tied to a wheelchair and a pharmacy of medications to address all the medical issues she struggles with. She will likely need multiple kidney transplants. I don’t think it’s possible to adequately convey in a sentence or two the massive challenges Stephanie has faced and continues to face.”

After eating a hamburger produced by Cargill in September 2007, Stephanie became ill and was diagnosed with an E. coli infection. She rapidly deteriorated and was determined to have hemolytic uremic syndrome (HUS), a complication of E. coli that causes kidney failure. In Stephanie’s case, she also began having seizures, which lead to a coma, where she remained for three months, on a ventilator and dialysis. When doctors were able to bring her out of the coma, the full extent of the injury to her brain, organs, and abilities began to be apparent.  Stephanie has spent 2 years in rehabilitation, both inpatient and at home. She is still in a wheelchair, where she will likely remain. She will require constant care and medical attention for the rest of her life. Her medical bills—already more than two million dollars—will continue to add up to tens of millions of dollars.

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 The Washington State Departments of Health and Agriculture today released information linking recent E. coli illnesses in Washington State to raw milk produced by the Dungeness Valley Creamery in Sequim, WA.  See www.marlerblog.com.  I will point out up front that the Dungeness Valley Creamery, which appears to be where the milk was produced, is a dairy properly licensed in Washington to sell raw milk.  I would ban the sale of raw milk from any dairy in the country, personally, whether licensed or not, but that is not the point of this post.  Every time a raw milk outbreak happens, which is relatively frequently, it causes me to think how many options there really are for people who are looking to purchase the product . . . even in states that otherwise ban it.  

I talked recently in an article on foodsafetynews.com about the deceptive, transparent efforts of many unlicensed dairies to sell raw milk under the guise of cow-share agreements.  Read the article here.  First of all, these arrangements are patently illegal in most states, including Washington, and even states where the Legislature has not specifically condemned them.  Read Washington State Dept of Agriculture's views on cow-share agreements for a perfect example.  And second, it's really a little scary to think that, because these dairies are selling raw milk without having to meet state licensure requirements, some of them produce their product under some terrible conditions. 

Continue Reading...

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Washington State Department of Agriculture News Release: Dec. 2, 2009

Three recent E. coli infections in Washington have been linked to drinking raw, unpasteurized milk. As a result, the Washington state departments of Health and Agriculture are reminding consumers of the potential health hazards of these products.

The patients all report drinking raw milk produced by the Dungeness Valley Creamery in Sequim. No E. coli has been found in samples from the dairy's current batch of milk, but during an investigation at the dairy, WSDA found the same bacteria that caused one of the illnesses.

While most strains of the bacteria Escherichia coli (abbreviated as E. coli) are harmless, others, including E. coli O157, produce a toxin. Toxin-producing E. coli infections may cause severe diarrhea, stomach cramps and bloody stool. Symptoms generally appear three to four days after exposure, but can take as long as nine days to appear. Anyone experiencing these symptoms should contact a health care provider.

Each year, the E. coli strain found in this investigation causes about 100,000 illnesses, 3,000 hospitalizations and 90 deaths in the United States.  The infection sometimes causes hemolytic uremic syndrome, a serious disease in which red blood cells are destroyed and the kidneys fail.  Infants, children, pregnant women, the elderly and those with compromised immune systems are especially at risk.

Raw milk is riskier than pasteurized milk because it hasn't been heated to kill harmful bacteria. Pasteurization kills the bacteria in raw milk that can cause illness. Besides E. coli, raw milk can also contain other potentially serious or life-threatening bacteria that have caused illness outbreaks in the past. These include Salmonella, Campylobacter and Listeria.

Retail raw milk is legal to sell and buy in Washington, but there are serious potential health risks. Consumers should read the warning label on the retail raw milk container carefully and ask their retailer to verify the milk was produced and processed by a WSDA-licensed operation.

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Last week several confidential settlements were reached on behalf of people sickened (or surviving family members of those who died) from E. coli O157:H7.  The illnesses stemmed from an E. coli outbreak linked to Kroger stores in Ohio and Michigan and a restaurant in Southern Georgia.  All were linked to a recall of beef by Omaha based, Nebraska Beef Ltd.

Several months ago the CDC reported that State departments of health and agriculture in several states, collaborating local health jurisdictions, CDC, and the United States Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) are investigating a multi-state outbreak of Escherichia coli O157:H7 infections. As of July 17, 2008, 49 confirmed cases have been linked both epidemiologically and by molecular fingerprinting to this outbreak. The number of cases in each state is as follows: Georgia (4), Indiana (1), Kentucky (1), Michigan (20), New York (1), Ohio (21), and Utah (1). Their illnesses began between May 27 and July 1, 2008. Twenty-seven persons have been hospitalized. One patient developed a type of kidney failure called hemolytic-uremic syndrome (HUS). No deaths have been reported. Twenty-eight (57%) patients are female. The ages of patients range from 4 to 78 years; 47% are between 10 and 24 years old (only 21% of the U.S. population is in this age group).

State health and agriculture departments tested ground beef purchased at Kroger® retail stores and recovered from several patient residences in Michigan and Ohio and ground beef recovered from a restaurant in Georgia where several patients reported eating before their illnesses. Molecular fingerprinting testing conducted by the Michigan, Ohio, and Georgia Departments of Health and Agriculture Laboratories, in collaboration with PulseNet, the national molecular subtyping network for foodborne disease surveillance, on E. coli O157 isolates isolated from these ground beef samples have confirmed them to be the outbreak strain.

CDC's OutbreakNet Team conducted a multi-state case-control study in collaboration with health authorities in Ohio and Michigan to epidemiologically examine exposures that might be related to illness. The data indicate a significant association between illness and eating ground beef purchased at one of several Kroger® Company stores in Michigan and Ohio. CDC has provided these results to the USDA-FSIS and public health agencies in Michigan and Ohio.

On June 25, 2008, a recall was announced for ground beef sold at Kroger® Co. Stores in Michigan and Ohio. On July 3, the Kroger® Co. expanded the June 25th recall to include ground beef products from Kroger® establishments outside of Michigan and Ohio. On June 30, 2008, a recall of 531,707 pounds of ground beef components from Nebraska Beef Ltd. was announced. On July 3, 2008, Nebraska Beef Ltd. expanded the June 30 recall to include all beef manufacturing trimmings and other products intended for use in raw ground beef produced between May 16 and June 26, 2008, totaling approximately 5.3 million pounds. More information about these recalls can be found at the United States Department of Agriculture, Food Safety and Inspection Service’s (USDA/FSIS) web site at http://www.fsis.usda.gov/Fsis_Recalls/.

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State health departments, CDC, and the United States Department of Agriculture's Food Safety and Inspection Service (USDA-FSIS) are investigating a multi-state outbreak of Escherichia coli O157:H7 infections. On October 31, 2009, FSIS issued a notice about a recall of approximately 545,699 pounds of ground beef products from Fairbank Farms that may be contaminated with E. coli O157:H7. Health officials in several states who were investigating a cluster of E. coli O157:H7 illnesses, with isolates that match by “DNA fingerprinting” analyses, found that most ill persons had consumed ground beef, with several purchasing the same or similar product from a common retail chain. A number of the illnesses appear to be associated with products subject to these recalls. Two samples from opened packages of ground beef recovered from a patient's homes were tested by the Massachusetts and Connecticut Departments of Health and yielded an E. coli O157:H7 isolates that matched the patient isolates by DNA analysis.

The cluster includes 26 persons from 8 states infected with matching strains of E. coli O157:H7. The number of ill persons identified in each state is as follows: California (1), Connecticut (6), Massachusetts (8), Maryland (1), Maine (4), New Hampshire (4), New York (1), and Vermont (1). Of these, the genetic associations of 24 human isolates and both of the product isolates have been confirmed by an advanced secondary DNA test; secondary tests are pending on others. Depending on the results of continuing laboratory testing and ongoing case finding, the number of persons determined to be in this cluster may increase or decrease.

The first reported illness began on September 17, 2009, and the last began on November 6, 2009. Nineteen patients are reported to have been hospitalized and 5 developed a type of kidney failure called hemolytic uremic syndrome (HUS). Two deaths have been reported. Fifty percent of patients are male and 38% are less than 18 years old (range 1 to 88 years).

Most of the beef packages in the recall bear the establishment number "Est. 492" inside the USDA mark of inspection and have identifying package dates of "091409", "091509" or "091609". Consumers are urged to check their refrigerators and freezers for beef products produced by this firm and purchased on or after September 15, 2009 and discard or return the recalled beef products to the place of purchase for a refund. Customers with questions about the source of a package of beef should contact the place where they purchased it (e.g., grocery store, club store, or meat market).

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People who purchased a meal at a fund raiser in Conway Nov. 13 are urged to dispose of any leftover food from the fund raiser as an investigation has begun into a possible foodborne outbreak involving the event, the S.C. Department of Health and Environmental Control announced today.

“The meals were prepared at a local hunting club and sold at the Cedar Grove Baptist Church in Conway to raise money to benefit the family of an ill child,” said Covia L. Stanley, M.D., director of DHEC’s Region 6 public health office, which serves Horry, Georgetown and Williamsburg counties. “So far, we have received reports of five people hospitalized with gastro-intestinal illness symptoms after purchasing and consuming food from the fund raiser.”

Dr. Stanley said meals sold at the fund raiser included barbeque pork, baked sweet potatoes, cole slaw and rolls.

“Members of the hunting club and the church are cooperating fully with DHEC staff as this investigation continues,” he said. “Anyone who ate the food from this fund raiser and becomes ill with symptoms including nausea, vomiting, diarrhea and abdominal cramping should take care to wash their hands thoroughly, avoid preparing food for others and contact their healthcare provider right away.”

Dr. Stanley said anyone with leftovers from that fund raiser should not eat or feed the leftovers to animals. Samples of the leftover food are being sent to the DHEC laboratories in Columbia for analysis.

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Outbreak Widens as Four Maine Residents May be Infected

As news broke that more Maine residents may be infected with E. coli from Fairbank Farms ground beef, an Augusta woman severely sickened in the E. coli outbreak has filed suit against the company. The lawsuit was filed in the Maine District Court by the plaintiff’s attorneys, Bill Marler of foodborne illness law firm Marler Clark, and Peter Felmley of the Portland firm Drummond, Woodsum, & MacMahon.

On October 31, Ashville, NY-based Fairbank Reconstruction Corporation, doing business as Fairbank Farms Inc., recalled 545,699 pounds of ground beef tainted with toxic E. coli O157:H7. The recall included meat that the company had processed between September 14 and September 16. 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.

The Associated Press reported on November 17 that four Maine residents may now be infected, causing the state to remind consumers to check their freezers for meat that may be part of the recall.

Margaret Long purchased meat produced by Fairbank Farms at Shaw’s Market in Augusta, Maine. She consumed the product on September 23, and by September 26, had symptoms consistent with E. coli infection. Her illness worsened, and she was hospitalized from September 29 through October 4. While she was there, her cultures tested positive for the same strain of E. coli O157:H7 found in the recalled meat.

“Anyone who has battled a severe E. coli infection will continue to have ongoing health problems,” said Marler. “Not only does this woman have to deal with lost work time and hospital bills, but she continues to struggle with health issues. And it all started with a meal – a meal made with meat that should never have reached the marketplace.”

This is the second E. coli lawsuit filed by Marler Clark in the Fairbank Farms outbreak. The first lawsuit was filed November 3 on behalf of a Massachusetts family sickened in the outbreak.

ABOUT MARLER CLARK: Marler Clark has represented victims of every major food borne illness outbreak since 1993. The firm’s attorneys have litigated high-profile food poisoning cases against such companies as ConAgra, Wendy’s, Chili’s, Chi-Chi’s, and Jack in the Box, securing over $500,000,000 for their clients. Marler Clark currently represents thousands of victims of outbreaks traced to ground beef, tomatoes, peppers, lettuce, peanut butter, and spinach, as well as other foods.

Consumer Resource: Downloadable Family Health Guide on E. coli.

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A Maine woman severely sickened in the recent E. coli outbreak tied to ground beef from Fairbank Farms has filed suit against the company. The lawsuit was filed in the Maine District Court by the plaintiff’s attorneys, Bill Marler of foodborne illness law firm Marler Clark, and Peter Felmley of the Portland firm Drummond, Woodsum, & MacMahon.

On October 31, Ashville, NY-based Fairbank Reconstruction Corporation, doing business as Fairbank Farms, Inc, recalled 545,699 pounds of ground beef tainted with toxic E. coli O157:H7. The recall included meat that the company had processed between September 14 and September 16. 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 at least 25 E. coli illnesses in 10 states, most of them in New England.

Margaret Long purchased meat produced by Fairbank Farms at Shaw’s Market in Augusta, Maine. She consumed the product on September 23, and by September 26, had symptoms consistent with E. coli infection. Her illness worsened, and she was hospitalized from September 29 through October 4. While she was there, her cultures tested positive for the same strain of E. coli O157:H7 found in the recalled meat.

“Anyone who has battled a severe E. coli infection will continue to have ongoing health problems,” said Marler. “Not only does this woman have to deal with lost work time and hospital bills, but she continues to struggle with health issues. And it all started with a meal – a meal made with meat that should never have reached the marketplace.”

This is the second E. coli lawsuit filed by Marler Clark in the Fairbank Farms outbreak. The first lawsuit was filed November 3 on behalf of a Massachusetts family sickened in the outbreak.

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Two customers of a Lake Stevens restaurant who were sickened in an E. coli outbreak last year have filed lawsuits against the business.  E. coli infected at least 23 customers at the Ixtapa Family Mexican Restaurant in October 2008, the Snohomish Health District said.

The law firm representing the customers, Marler Clark, said the plaintiffs, Sally Ring and Jean Jubie, suffered "severe illnesses requiring substantial medical treatment."

Four people were hospitalized for a brief time in the outbreak that closed the restaurant for a time.

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The family of an 11-year-old Rhode Island girl has filed a lawsuit against a Massachusetts meat company that supplied meat to a youth camp where she became ill.  The lawsuit filed today in the Plymouth Superior Court claims that Lynn Santos of Lincoln, R.I., fell severely ill with an E. coli infection and was hospitalized for four days last month after eating contaminated beef supplied by South Shore Meats Inc.

It is the second lawsuit filed against the Brockton-based company after more than 30 people got sick at a Massachusetts youth camp.  Last month the company voluntarily recalled ground beef and other products after tests showed E. coli in leftover beef samples.

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The CDC again amended its case-count in the Fairbank Farms ground beef E. coli O157:H7 outbreak.  Secondary DNA tests (surely MLVA) have helped the CDC whittle the number of cases down from 28 in 12 states on November 2, to 26 in 11 states on November 3, to 25 in 10 states today.  These changing case-counts got me thinking about an important aspect of every outbreak of foodborne disease:  that the number of "confirmed cases" is rarely, if ever, an accurate count of the number of actual victims in any outbreak situation. 

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 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. 

 

Continue Reading...

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Several state health departments, CDC, and the United States Department of Agriculture's Food Safety and Inspection Service (USDA-FSIS) are investigating a multi-state outbreak of Escherichia coli O157:H7 infections. On October 31, 2009, FSIS issued a notice about a recall of approximately 545,699 pounds of ground beef products from Fairbank Farms that may be contaminated with E. coli O157:H7. Health officials in several states who were investigating a cluster of E. coli O157:H7 illnesses, with isolates that match by “DNA fingerprinting” analyses, found that most ill persons had consumed ground beef, with several purchasing the same or similar product from a common retail chain. At least some of the illnesses appear to be associated with products subject to these recalls. A sample from an opened package of ground beef recovered from a patient's home was tested by the Massachusetts Department of Health and yielded an E. coli O157:H7 isolate that matched the patient isolates by DNA analysis.

The cluster includes 25 persons from 10 states infected with matching strains of E. coli O157:H7. The number of ill persons identified in each state is as follows: California (1), Connecticut (4), Massachusetts (8), Maryland (1), Maine (2), New Hampshire (4), New Jersey (1), New York (1), Pennsylvania (2), and Vermont (1). Of these, the genetic associations of 22 human isolates and the product isolate have been confirmed by an advanced secondary DNA test; secondary tests are pending on others. Depending on the results of continuing laboratory testing and ongoing case finding, the number of persons determined to be in this cluster may increase or decrease.

The first reported illness began on August 18, 2009, and the last began on October 10, 2009; however all but 2 patients reported becoming ill between September 17 and October 10, 2009. Sixteen patients have been reported to be hospitalized and 3 developed a type of kidney failure called hemolytic uremic syndrome (HUS). Two deaths have been reported. Sixty-four percent of patients are male and 44% are less than 18 years old (range 1 to 84 years).

Most of the beef packages in the recall bear the establishment number "Est. 492" inside the USDA mark of inspection and have identifying package dates of "091409", "091509" or "091609". Consumers are urged to check their refrigerators and freezers for beef products produced by this firm and purchased on or after September 15, 2009 and discard or return the recalled beef products to the place of purchase for a refund. Customers with questions about the source of a package of beef should contact the place where they purchased it (e.g., grocery store, club store, or meat market).

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 The CDC did not provide any updated statistics today about the number of people sickened in the ongoing E. coli O157:H7 outbreaks linked to ground beef (still 26 illness in 11 states, with 2 deaths and 3 HUS), but the Food Safety and Inspection Service (FSIS) did update the list of retail stores who may have received contaminated ground beef.  The list is long and comprehensive and, to me at least, suggests that the number of people who may be involved in at least the Fairbank Farms outbreak may continue to grow.  See the FSIS update here.

 Here is the short version:  

Shaws in Connecticut, Maine, Massachussetts, Rhode Island, New Hampshire and Vermont

Price Chopper in Connecticut, Pennsylvania, Rhode Island, and Vermont

Acme in Delaware, Maryland, New Jersey, and Pennsylvania

Giant in Pennsylvania

Pathmark in Delaware, New Jersey, New York, and Pennsylvania

Food Lion in North Carolina, South Carolina, Virginia and West Virginia

Trader Joe in Connecticut, Delaware, Maryland, Massachussetts, New Jersey, New York, and North Carolina

BJ in New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Virginia

Martins in Maryland, Pennsylvania, Virginia, and West Virginia

Great American in New York

IGA in Maine, New York, and Vermont

Surefresh in Delaware, Maryland, and Pennsylvania

Grand Union in Connecticut and New York

A&P in New Jersey and New York

Waldbaum in New York

C&S in Vermont

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 The CDC reports today that there are currently only 26 illnesses in 11 states that are linked to the Fairbank Farms E. coli O157:H7 ground beef outbreak and recall.  This represents a reduction in the number of cases attributed to the outbreak by two.  

Here is the outbreak rundown:

On October 31, 2009, FSIS issued a notice about a recall of over 500,000 pounds of beef products from Fairbank Farms that may be contaminated with E. coli O157:H7. Health officials in several states who were investigating a cluster of E. coli O157:H7 illnesses, with isolates that match by “DNA fingerprinting” analyses, found that most ill persons had consumed ground beef, with several purchasing the same or similar product from a common retail chain. At least some of the illnesses appear to be associated with products subject to these recalls. A sample from an opened package of ground beef recovered from a patient's home was tested by the Massachusetts Department of Health and yielded an E. coli O157:H7 isolate that matched the patient isolates by DNA analysis.

The cluster includes 26 persons from 11 states infected with matching strains of E. coli O157:H7. The number of ill persons identified in each state is as follows: California (1), Connecticut (4), Massachusetts (8), Maryland (1), Maine (2), Minnesota (1), New Hampshire (4), New Jersey (1), New York (1), Pennsylvania (2), and Vermont (1). Of these, the genetic association of 13 human isolates and the product isolate have been confirmed by an advanced secondary DNA test; secondary tests are pending on others. Depending on the results of continuing laboratory testing and ongoing case finding, the number of persons determined to be in this cluster may increase or decrease.

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The latest CDC summary on the ongoing E. coli O157:H7 outbreak linked to Fairbank Farms ground beef says that there are 28 confirmed cases in 12 states.  The USDA-FSIS's latest outbreak summary, which is where you would expect to find information on the retailers who have received recalled product, seems a little slow on the uptake.  As we posted yesterday, the FSIS statement is limited to Price Chopper and Shaws' stores in just 8 states.  So what about the other 4 states with sick people in them?  Isn't there some missing information here?

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Recently, certain sectors have argued that the incidence of E. coli O157:H7, and other shiga-toxin producing strains of E. coli, in ground beef has dropped precipitously, and that our food safety system is, as a result, working very well.  At Marler Clark, over the last several years—in fact, beginning with the infamous Dole baby spinach outbreak in September 2006—fully 90% of the people we 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, 95% of these folks were sickened by contaminated ground beef.  In fact, with the recent, virtually simultaneous recalls of about 546,000 pounds of ground beef by South Shore Meats and Fairbank Farms, 45,000,000 pounds of ground beef have been recalled in the last two years.  These statistics sure don’t jibe well with any optimism about our food safety system, as a whole, or ground beef more specifically. 

As recently as the beginning of 2007, the beef industry touted 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 at Marler Clark, that the meat industry had indeed cleaned up its act—that big beef finally would put Bill Marler's 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 two million pounds of product, if not more. 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 are illustrative. Progress? Optimism? I don’t see it.

Ultimately, these numbers may serve the opposing perspective 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.

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 Tuesday morning, we will be filing lawsuits on behalf of the families of two children sickened in the ongoing, likely developing, outbreaks of E. coli O157:H7 linked to ground beef.  The lawsuits will be filed in Plymouth County Superior Court for the Commonwealth of Massachussetts against Brockton, Mass.-based Crocetti-Oakdale Packing, Inc., doing business as South Shore Meats Inc., and Ashville, NY-based Fairbank Farms, Inc. Both companies recalled meat last week after their products were identified as the source of a national E. coli outbreak.

The medical complications associated with E. coli O157:H7 infection are many.  Most infections are characterized by 7-10 days of diarrhea, frequently bloody, severe abdominal cramps, and a host of other painful symptoms.  Infection by this dangerous pathogen frequently results in hospitalization, and kills with frightening efficiency and regularity.  Those who are acutely susceptible to severe infection whether by age or immuno-compromisation frequently have dangerously severe medical courses.  

Far and away the most frightening medical complication associated with infection by E. coli O157:H7, however, is hemolytic uremic syndrome, or HUS.  The chain of events leading to HUS begins with ingestion of Stx producing E. coli (e.g., E. coli 0157: H7) in contaminated food, beverages or through person to person transmission. 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 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 Stx 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 Stx 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.

 

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Earlier today, the CDC posted the following update on the E. coli O157:H7 ground beef outbreak and recall on its website:

Several state health departments, CDC, and the United States Department of Agriculture's Food Safety and Inspection Service (USDA-FSIS) are investigating a multi-state outbreak of Escherichia coli O157:H7 infections. On October 31, 2009, FSIS issued a notice about a recall of 545,699 pounds of beef products from Fairbank Farms that may be contaminated with E. coli O157:H7. Health officials in several states who were investigating a cluster of E. coli O157:H7 illnesses, with isolates that match by “DNA fingerprinting” analyses, found that most ill persons had consumed ground beef, with several purchasing the same or similar product from a common retail chain. At least some of the illnesses appear to be associated with products subject to these recalls. A sample from an opened package of ground beef recovered from a patient's home was tested by the Massachusetts Department of Health and yielded an E. coli O157:H7 isolate that matched the patient isolates by DNA analysis.

The cluster includes twenty-eight persons from 12 states infected with matching strains of E. coli O157:H7. Of these, the genetic association of 7 human isolates and the product isolate have been confirmed by an advanced secondary DNA test ; secondary tests are pending on others. The number of ill persons identified in each state is as follows: California (1), Connecticut (4), Massachusetts (8), Maryland (1), Maine (2), Minnesota (1), New Hampshire (4), New Jersey (1), New York (1), Pennsylvania (2), South Dakota (2), and Vermont (1).

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FSIS today released the identities of retail stores that may have received E. coli O157:H7-contaminated ground beef involved in the current recall by Fairbank Farm.  All Shaw's stores in Connecticut, Maine, New Hampshire, Rhode Island, Massachussets, and Vermont may have received contaminated meat; and all Price Chopper stores in Connecticut, Pennsylvania, New York and Vermont may have received contaminated meat.  The CDC now reports that 2 deaths and 26 illnesses may be linked to the Fairbank Farm recall, with the majority of illnesses coming from New England residents.  Fairbank Farm has recalled approximately 546,000 pounds of fresh ground beef. 

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Trader Joe's, Price Chopper, Lancaster, Wild Harvest, Shaw's, BJ's, Ford Brothers, and Giant stores have been linked to the recent recall of E. coli O157:H7-tainted hamburger produced by Fairbank Farms.  Trader Joe's, Price Chopper, Shaw's and BJ's have been linked to prior E. coli O157:H7 outbreaks:

Trader Joe’s

June 9, 2007 - United Food Group, LLC, a Vernon, Calif., establishment, is voluntarily expanding its June 3 and 6 recalls to include a total of approximately 5.7 million pounds of both fresh and frozen ground beef products produced between April 6 and April 20 because they may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture’s Food Safety and Inspection Service announced.

Price Chopper

June 26, 2009 - Price Chopper supermarket is recalling some of its ground beef and beef loin bottom sirloin steak products because of possible E. coli contamination. The recall, announced today, applies to purchases made between May 7th and May 16th; stores that may have sold the beef include those in Albany, Schenectady and Rensselaer counties, as well as neighboring Vermont and Massachusetts counties.

Price Chopper

In August, 2005, an eight-year-old Albany, New York girl became ill with an E. coli O157:H7 infection after eating a hamburger purchased from Price Chopper. The ground beef used in the hamburger had been supplied to Price Chopper by Topps Meats.

Price Chopper

September 2007 - Price Chopper Supermarkets has pulled Topps brand products after an E. coli scare, the company announced yesterday. The New York State Department of Agriculture tested Topps ground beef patties and found E. coli in 3- and 5-pound boxes of quarter-pound hamburger patties with a sell-by date of June 22, 2008. According to Price Chopper, the tests are preliminary. The USDA is reviewing the state’s findings and neither agency has confirmed E. coli. In a statement, Price Chopper said, to be safe, it recalled the beef patties and all other Topps products. The recall affects stores throughout the state, including three stores in the Mid-Hudson: Middletown, Vails Gate and Newburgh.

Shaw’s

June 16, 1998 - A woman who says she ate undercooked beef from a Shaw's Supermarket in Warwick came down with a mild E. coli infection last month, state health officials said yesterday. The case is the first in Rhode Island to be linked to tainted meat at the supermarket chain, which last Friday recalled beef sold at its 124 New England stores. The recall followed the discovery of E. coli, an intestinal bacteria, in samples from two outlets in Keene and Lebanon, N.H. The woman's case is significant because it could help federal investigators narrow the search for the supplier of the contaminated meat.

Shaw's

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.

BJ’s

In 2002, several children became ill with E. coli O157:H7 infections which were traced to the consumption of ground beef sold at BJ’s Wholesale Club stores in New York and New Jersey. Remaining ground beef was recalled, but the children were so severely injured after suffering from Hemolytic Uremic Syndrome (HUS) that their families sought to recover damages from BJ’s through the legal system.

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Firm Recalls 546,000 pounds tied to E. coli Illnesses – Over 41,000,000 pounds recalled in last two years.

The first lawsuit stemming from the E. coli outbreak in Massachusetts and likely Rhode Island, will be filed Monday in the Trial Court of the Commonwealth of Massachusetts, Superior Court, against Crocetti-Oakdale Packing, doing business as South Shore Meats, Inc., which had recalled 1.039 pounds of E. coli tainted beef linked to illnesses.

The E. coli lawsuit was filed on behalf of a Marshfield, Massachusetts family, whose grandmother and children were infected with the pathogenic E. coli strain O157:H7 after eating ground beef purchased from the Star Market in Marshfield. The plaintiffs are represented by Marler Clark, a Seattle law firm dedicated to representing victims of foodborne illness.

In addition, on Saturday (10/31/09), Ashville NY firm Fairbank Farms recalled 546,000 pounds of beef products due to E. coli contamination. According to the USDA release, the meat has been linked to illnesses in Maine, Massachusetts, and Connecticut, and distributed via retail outlets including Trader Joe's, Price Chopper, Lancaster, Wild Harvest, Shaw's, BJ's, Ford Brothers, and Giant. Ground beef packaged under the Fairbank Farms name was also distributed to stores in Maryland, Massachusetts, North Carolina, New Jersey, New York, Pennsylvania, and Virginia.

It appears that this recall is an expansion of the Crocetti-Oakdale Packing, doing business as South Shore Meats, Inc., recall of 1.039 pounds of E. coli tainted beef linked to illnesses in Massachusetts and likely Rhode Island. “This expansion is a massive recall, and the danger cannot be overstated,” said foodborne illness expert and attorney Bill Marler, who represents several families in the outbreak. “The last recall of this size—Nebraska Beef in August of 2008—sickened dozens. It means that tainted meat is in homes across the country, and we have to do our best to get the word out to consumers so that they don’t suffer the illnesses that these families have.”

A cluster of at least 20 E. coli illnesses were reported by middle schoolers and chaperones who visited Camp Bournedale in Plymouth, MA in mid-October. “At this time it is unclear if these illnesses are linked to either recall, however, the timing is quite suspicious,” added Marler.

With the recent recall of 1,039 pounds of hamburger contaminated with E. coli O157:H7, and the additional 546,000 pounds of hamburger recalled, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today. Hamburger recalls since 2007 have now reached 41,958,504 pounds. And, this is not counting another recall from 2008. Then, Hallmark/Westland Meat Packing Co., a Chino, California establishment, voluntarily recalled approximately 143,383,823 pounds of raw and frozen beef products that FSIS had determined to be unfit for human food because the cattle did not receive complete and proper inspection.

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In part from Fairbank Farms and USDA Press Release:

Fairbank Farms (USDA Establishment 492), a New York manufacturer of ground beef, has issued a voluntary recall for a specified line of fresh ground beef products sold in eight states. Approximately 545,699 pounds of fresh ground beef product produced between September 14 through September 16, 2009, may possibly be linked to E. coli O157:H7.

An important point of fact, the recalled products are very specifically defined and are past their expiration date by 23 to 32 days. This means they are no longer being sold as fresh product in supermarkets. The products were sold in the following states: Connecticut, Maryland, Massachusetts, New Jersey, New York, North Carolina, Pennsylvania and Virginia.

To identify recalled products, consumers should check the package label and look for the product name, package weight and sell-by date. All labels will show an establishment number of EST 492 inside the USDA mark of inspection. Recalled products include:

ACME, BJ’s Wholesale Club/Burris, Ford Brothers, Giant Food Stores, Price Chopper, Shaw’s Supermarkets, Inc., Trader Joe’s, "Other products:" - See Lables

Cases of 10-lb. Fairbank Farms fresh ground beef chubs (for store grind). These products had a sell date of 10/3/09, 10/4/09 or 10/5/09, but will likely not bear those sell-by dates on their package labels. These products were distributed to retail establishments in Maryland, Massachusetts, North Carolina, New Jersey, New York, Pennsylvania, and Virginia for further processing. Consumers with concerns should contact their point of purchase.

It appears that this recall is an expansion of the Crocetti-Oakdale Packing, doing business as South Shore Meats, Inc., recall of 1.039 pounds of E. coli tainted beef linked to illnesses in Massachusetts and likely Rhode Island. “This expansion is a massive recall, and the danger cannot be overstated,” said foodborne illness expert and attorney Bill Marler, who represents several families in the outbreak. “The last recall of this size—Nebraska Beef in August of 2008—sickened dozens. It means that tainted meat is in homes across the country, and we have to do our best to get the word out to consumers so that they don’t suffer the illnesses that these families have.”

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Recall Release CLASS I RECALL
FSIS-RC-057-2009 HEALTH RISK: HIGH

Crocetti's Oakdale Packing Co., doing business as, South Shore Meats, Inc., a Brockton, Mass., establishment, is voluntarily recalling approximately 1,039 pounds of fresh ground beef patties derived from bench trim as well as mechanically tenderized beef cuts that may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today.

This recall was initiated after the Massachusetts Department of Public Health (DPH) confirmed a positive sample for E. coli O157:H7 which it collected during an epidemiological investigation. FSIS is continuing to work with the Massachusetts DPH, the Rhode Island Department of Health and the Centers for Disease Control and Prevention on the investigation. CDC had determined that the product sampled is associated with the illnesses being investigated. Anyone with signs or symptoms of foodborne illness should consult a physician.

The products subject to recall include:

* 10-pound boxes containing 40, 4-ounce packages of "Beef Sirloin Patties, Manufactured by South Shore Meats."
* 7.5-pound boxes containing 12, 10-ounce packages of "Beef Teres Major Steaks Seasoned."
* Boxes of 24, 5-ounce packages of "BEEF BUTT STEAKS, (Filet Style)."
* 9-pound boxes containing 12, 12-ounce packages of "BEEF BUTT STEAKS, Center Cut, (sirloin style)."
* 9-pound boxes containing 12, 12-ounce packages of "BEEF BUTT STEAK, Center Cut, (filet style)."
* 6.75-pound boxes containing 12, 9-ounce packages of "BEEF BUTT STEAK, Center Cut, (sirloin style)."
* Boxes of 16, 10-ounce packages of "Beef Top Butt Steaks Sirloin Style."
* Boxes of 20, 8-ounce packages of "Beef Butt Steaks Club Style."
* Boxes of 26, 6-ounce packages of "Beef Top Butt Steaks Sirloin Style."
* Boxes of 12, 10-ounce packages of "BEEF BUTT STEAKS, (Filet Style)."
* 6-pound boxes containing 16, 6-ounce packages of "Beef Filet Of Sirloin, Executive Cut."
* Boxes of 12, 8-ounce packages of "BEEF BUTT STEAKS, (Filet Style)."

Each box bears the establishment number "EST. 6336" inside the USDA mark of inspection and may also bear a date code of "281." The beef products were produced on October 8, 2009, and were distributed to wholesale distributors and institutions in Massachusetts. If available, the retail distribution list(s) will be posted on FSIS' Web site at http://www.fsis.usda.gov/FSIS_Recalls/ Open_Federal_Cases/index.asp

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SACRAMENTO - Dr. Mark Horton, director of the California Department of Public Health (CDPH), today warned consumers not to eat Jigong Chayote Candy imported from China after tests found unacceptable levels of lead.  Recent analysis of this candy by CDPH determined that Jigong Chayote Candy contained as much as 0.68 parts per million (ppm) of lead. Candies with lead levels in excess of 0.10 ppm are considered contaminated.  The Jigong Chayote Candy container has a copper/gold colored lid, with a picture of a warrior, Chinese symbols, and orange fruit. The word Jigong is printed in green on a black background. Jigong Chayote Candy is imported and distributed by King Wai Trading Company, based in Union City, in the Bay Area. King Wai Trading has voluntarily recalled the candy.  Pregnant women and children who may have consumed this candy should consult a physician or health care provider to determine if medical testing is needed. Consumers who find Jigong Chayote Candy for sale are encouraged to call the CDPH Complaint Hotline at (800) 495-3232.

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On October 19, the Rhode Island Department of Health (HEALTH) was notified several sixth grade students from Lincoln Middle School had diarrheal illness. The students had attended a field trip at a camp in Massachusetts from October 13 through October 16.

As of today (October 21), there have been 15 cases of diarrheal illness. There have been two students who tested positive for E. coli O157:H7. Two students are hospitalized.

“We want to assure parents and students that we are not seeing this diarrheal illness spread person to person,” said Chief of HEALTH’s Center for Infectious Diseases Robert S. Crausman, MD, MMS. “However, any student or chaperone who was on the field trip and has diarrhea should call their doctor for medical evaluation and treatment. HEALTH is working closely with our colleagues at the Massachusetts Department of Public Health in the investigation of this incident.”

Students or chaperones who were on the field trip who do not have diarrhea do not need to take any special precautions. Massachusetts Department of Public Health and the USDA are investigating foods at the camp as the likely source of this illness. The Center for Disease Control and Prevention (CDC) will be assisting with this investigation.

“Our first concern is the health and safety of our students and staff,” said Lincoln School Superintendent Georgia Fortunado. “We are working collaboratively with the Department of Health on this response.”

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The United States Department of Agriculture's (USDA) Food Safety and Inspection Service (FSIS) has just announced a Class I recall for 925 pounds of San Diego Meat Company ground beef products that may be contaminated with E. coli O157:H7.

The products subject to recall include:

• 15-pound cases of "SAN DIEGO MEAT, GROUND BEEF PATTIES
  
• 10-pound bags of "SAN DIEGO MEAT, BULK GROUND BEEF

Each case and bag bears establishment number "EST. 4116" inside the USDA marks of inspection and "Safe Handling Instructions" on the back. The front of each package advises "KEEP REFRIGERATED."

The above products were produced October 7, 2009 through October 9, 2009 and October 12, 2009 and were distributed to restaurants and two caterers in the San Diego County area.

FSIS routinely conducts recall effectiveness checks to verify recalling firms notify their customers (including restaurants) of the recall and that steps are taken to make certain that the product is no longer available to consumers.

The problem was discovered through FSIS microbiological sampling. FSIS has received no reports of illnesses associated with consumption of these products. Individuals concerned about an illness should contact a physician.

E. coli O157:H7 is a potentially deadly bacterium that can cause bloody diarrhea, dehydration, and in the most severe cases, kidney failure. The very young, seniors and persons with weak immune systems are the most susceptible to foodborne illness.

Media and consumers with questions regarding the recall should contact company Establishment Owner, Bob Watkins at 619-233-8871 619-233-8871.

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LEAFY GREENS: 363 outbreaks involving 13,568 reported cases of illness

EGGS: 352 outbreaks involving 11,163 reported cases of illness

TUNA: 268 outbreaks involving 2341 reported cases of illness

OYSTERS: 132 outbreaks involving 3409 reported cases of illness

POTATOES: 108 outbreaks involving 3659 reported cases of illness

CHEESE: 83 outbreaks involving 2761 reported cases of illness

ICE CREAM: 74 outbreaks involving 2594 reported cases of illness

TOMATOES: 31 outbreaks involving 3292 reported cases of illness

SPROUTS: 31 outbreaks involving 2022 reported cases of illness

BERRIES: 25 outbreaks involving 3397 reported cases of illness

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According to news reports, the U.S. bankruptcy judge said today he will sign an order establishing a $12 million fund to pay claims from people sickened by Salmonella poisoning connected to Lynchburg-based Peanut Corporation of America.

The action by judge William E. Anderson sets the framework for settling about 175 claims for illnesses traced to PCA’s plant in Blakely, Georgia.  The fund will be administered by Roy Creasy, bankruptcy trustee for Western Virginia. The money will be provided by two Hartford Insurance divisions.

According to William Marler, attorney for 125 of the filed claimants, "the $12 million will be a start in compensating the victims and their families.  Please remember, at least nine people died and over 700 were sickened."

Notice of the claims process will be published in USA Today.  "People still have time to file claims with the Court.  The $12 million can only be used to compensate the personal injury victims.  If $12 million is not sufficient to satisfy all claims, Kellogg and King Nut, the two largest re-manufacturers, will need to pay the balance," added Marler.

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According to an article in today's Kansas City Star, Johnson County health officials in Lenexa, Kansas are looking to salsa served at Mi Ranchito restaurant as the likely case of a sudden and alarming outbreak of illness at the restaurant.  The salsa was evidently tainted with a pesticide called methomyl.  Its use is highly restricted due to its high toxicity in humans.

About 20 people fell suddenly ill in late August while dining at the restaurant. More than a dozen people were taken to the hospital. Some customers complained of severe nausea and vomiting, which can be symptoms of poisoning by the pesticide.

Rulber Dela Torre, one of the founders of the Mi Ranchito restaurants, said this morning that state health officials have not told him that poisoning caused the sickness. Health officials declined to comment today.

“We don’t store poisons in our restaurants,” Dela Torre said. “If this did happen, it was a deliberate act by somebody who wants to hurt my business.”

Employees at the restaurants make about 20 gallons of fresh salsa every morning and more some afternoons, he said. The salsa goes into a walk-in cooler and is taken out as needed and put in pans in a refrigerator, he said.

State officials cleared the restaurant to open last week after it passed a safety inspection and its employees passed a safety test.

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It is a crime to sell raw milk in the state of Wisconsin, and one farmer may be going jail for doing just that.  According to an article in Walworth County Today,  the Walworth County District Attorney's Office is evaluating whether to file charges against the owners of an Elkhorn farm shut down after more than two dozen people fell ill with Campylobacter infections after consuming the farm's raw milk.

Assistant District Attorney Zeke Wiedenfeld on Monday met with three representatives from the Wisconsin Department of Agriculture, Trade and Consumer Protection.

"It's a crime to sell raw milk," Wiedenfeld said after the meeting. "Whether or not it gets charged is a determination that we have to make. I'll be speaking to them (officials) about making a charging decision and what is the proper outcome for a case like this."  Wiedenfeld said it will be a matter of weeks before he makes a charging decision.

As has become a common workaround for similar laws banning the sale of raw milk in other states, some of the buyers claim they did not buy raw milk because they actually have an ownership in the cow under a cow-share scheme.  They claim the arrangement should make it legal for them to have raw milk because Wisconsin law allow farmers and their families to consume their own raw milk as long as they don't sell it.

But Wiedenfeld says that theory is a no go. According to him, selling raw milk is illegal in Wisconsin, even under a cow-share program.

DATCP spokeswoman Donna Gilson said some consumers are misinformed about the law and think they have found a loophole that would allow them to obtain raw milk. But to get raw milk from a farm, Wisconsin statutes require individuals to be bona fide owners with a "real financial stake on the farm," she said.

For just a sampling of the dangers associated with consuming raw milk, check out this study published in Foodborne Pathogens and Disease: Food Safety Hazards Associated with Consumption of Raw Milk.

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Bruce Cadwallader of the Columbus Dispatch wrote the following story:

A former New Albany resident who sued the Kroger Co. for selling tainted beef has settled her lawsuit.
Attorneys for Amanda J. Adam, 27, notified Franklin County Common Pleas Court officials on Sept.15 that she had reached a settlement with Kroger and Nebraska Beef of Omaha, Neb. A trial had been scheduled for Sept. 22.  Adam, formerly of Pharlap Drive, had one of 39 confirmed cases of E. coli infection in Ohio and Michigan during the summer of 2008. She was the first person to file suit in Ohio, saying she became ill from hamburger purchased at a Dublin Kroger store that June.

The outbreak caused the voluntary recall of more than 34 million pounds of beef.  Adam has not discussed the case publicly and now is prohibited from doing so.

"The amount of the settlement is confidential, which is typical in cases like this involving insurers and private companies," William Marler, Adam's Seattle-based attorney, said last week.

Three other lawsuits linked to the 2008 outbreak also have been settled, court records show.  A fifth is pending in U.S. District Court in Columbus.

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Although this story comes from across the Atlantic in England, a lesson can still be learned and applied here.

According to the Guardian UK, Heston Blumenthal, the world-renowned chef of the Fat Duck restaurant in Bray, Berskshire, has offered a personal apology  to the more than 500 people who took ill after dining at the restaurant in January and February, 2009. 

Earlier this month the Health Protection Agency reported that an outbreak of the norovirus was to blame and highlighted oysters as the probable cause.

Blumenthal did not comment on the findings of a 45-page report, which also claimed it had found evidence of poor practice at the restaurant.

Today Blumenthal said: "I am relieved to be able to finally offer my fullest apologies to all those who were affected by the outbreak at the Fat Duck. It was extremely frustrating to not be allowed to personally apologise to my guests until now.

"It was devastating to me and my whole team, as it was to many of our guests and I wish to invite them all to return to the Fat Duck at their convenience."

It may seem insignificant to hear an at-fault party say the simple word "sorry," but often that is precisely what clients injured in a foodborne illness outbreak tell me they want--and need--to hear.  Why is it so difficult for defendants faced with clear evidence of causing injury to others to say that simple word?  Elton John and Bernie Taupin were right, "Sorry Seems To Be The Hardest Word."

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After a frightful two-year stretch in 2005 and 2006 that included two Dole spinach/lettuce outbreaks due to E. coli O157:H7 contamination, the resurgence of ground beef as a leading vector in E. coli cases must have caused lettuce to feel a little left out.  The last month, with the announcement of a major national outbreak linked to shredded lettuce and yesterday's announcement of a three-state outbreak also likely linked to lettuce, feels a bit like the wakening of a very mean jolly green giant. 

Here's a brief look at E. coli O157:H7 outbreaks linked to lettuce and other leafy greens over the past decade (or a little longer): 

- in October 2003, thirteen residents of a California retirement home were sickened, and two people died, after eating E. coli-contaminated, pre-washed spinach;

- in September 2003, nearly forty patrons of a California restaurant chain fell ill after eating salads prepared with bagged, pre-washed lettuce; and

- in July 2002, over fifty young women fell ill with E. coli O157:H7 at a dance camp after eating “pre-washed” lettuce, leaving several hospitalized and one with life-long kidney damage.

Here are a few more examples:

- Aug. 1993  E. coli O157:H7 outbreak linked to a salad bar; 53 reported cases in Washington State

- July 1995  Lettuce (leafy green; red; romaine) E. coli O157:H7; 70 reported cases in Montana

- Sept. 1995  Lettuce (romaine) E. coli O157:H7; 20 reported cases in Idaho

- Sept. 1995  Lettuce (iceberg) E. coli O157:H7; 30 reported cases in Maine

- Oct. 1995  Lettuce (iceberg; unconfirmed) E. coli O157:H7; 11 reported cases in Ohio

- May-June 1996  Lettuce (mesclun; red leaf) E. coli O157:H7; 61 reported cases in Connecticut, Illinois, and New York

- May 1998  Salad E. coli O157:H7; two reported cases in California

- Feb.-Mar. 1999  Lettuce (iceberg) E. coli O157:H7; 72 reported cases in Nebraska

- Apr. 2004  Spinach E. coli O157:H7; 16 reported cases in California

- Sep. 2005  Lettuce (romaine) E. coli O157:H7; 32 reported cases in Minnesota, Wisconsin, and Oregon

But we all know that the list does not end there. E. coli O21:H19 nearly killed two women at a Wendy's in Utah.  Also Taco Bell and Taco John's in late 2006.

2008 saw E. coli outbreaks linked to lettuce in Michigan and the State of Washington - Spinach too in Oregon.

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CDC and Three States Investigating E. coli O157:H7 Outbreak

The FDA is aware of an outbreak involving E. coli O157:H7 in Utah, Colorado, and New York State. Health officials are conducting investigations with assistance from the CDC. A food vehicle has yet to be identified.

According to the NY State Dept. of Health, no food or restaurant has been implicated at this time. Produce (including lettuce) is being looked at as a possible source.

FoodTrack is awaiting response from the CDC on this outbreak following a request for additional information.

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A fresh produce may once again be responsible for a new outbreak of the dreaded E. coli O157:H7 bacteria in Utah, Colorado, and New York, the new Food Safety News is reporting today.

According to FNS, there is an ongoing investigation is being led by public health agencies in Utah and Colorado; Colorado reportedly has the most cases.

A spokesman for the U.S. Food & Drug Administration (FDA) said the cause of the outbreak has not yet been officially sourced, but those close to the investigation say lettuce from a California supplier is the likely culprit.

The Centers for Disease Control & Prevention (CDC) in Atlanta is assisting in the investigation. "I can confirm we have one case of E. coli," said a spokesman for the New York Department of Health. New York is letting the western states take the lead.

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The USA Today reported today that "Federal agencies that supply food for 31 million schoolchildren [Food and Nutrition Service] fail to ensure that tainted products are pulled quickly from cafeterias."  The audit, which was conducted by Congress's Government Accountability Office, concluded that "The delays raise the risk of children being sickened by contaminated food," according to the USA Today. 

The GAO audit focused on the recent Salmonella outbreak linked to peanuts and peanut products recalled by the Peanut Corporation of America, finding that the Food and Nutrition Service was six days delinquent in telling schools to pull products that were affected  by the recall. 

True, outbreaks tend to evolve, and information about potentially implicated products does too,  but the GAO's findings highlight a generally deficient approach taken by the FNS in disseminating information to schools about contaminated products.  USA Today states as follows:

The [GAO] audit focuses on the Food and Nutrition Service, an arm of the Department of Agriculture that provides states and school systems with federally purchased commodities for school lunch and breakfast programs.  The agency lacks systems to ensure that it is notified when the Food and Drug Administration (FDA) begins a food-safety investigation that may lead to a recall [].

Then, instead of determining in advance whether a suspect product was sent to schools--and advising those schools not to serve the food while the investigation is underway--the service sometimes doesn't begin that process until a recall announcement is made.

In response to the GAO audit, Rep. George Miller, Democrat from CA, stated "Further actions must be taken to strengthen the communications, planning and procedures needed to prevent recalled or contaminated foods from entering (school) cafeterias.  Agriculture Secretary Tom Vilsack says in a written response that the safety of school meals is of "utmost importance."  According to the USA Today, Sec. Vilsack also stated that the Department of Agriculture is in the process of developing a system where the Department of Ag would receive advance notice when the FDA is investigating potentially contaminated food products.

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MADISON -- DNA test results and other evidence have now established that an outbreak of illness involving at least 35 people, the majority children and teens, was linked to drinking unpasteurized milk. Wisconsin food safety officials are cautioning consumers not to drink raw milk and farmers not to sell it to the public.

"Laws requiring pasteurization of milk have been on the books for more than half a century, and there are good public health reasons for that," said Steve Ingham, head of the Food Safety Division in the Department of Agriculture, Trade and Consumer Protection.

"We have very compelling evidence linking these illnesses to drinking raw milk. This is the third major outbreak in Wisconsin since 2001 that has been tied to raw milk consumption. That's not to mention a number of smaller ones in which the link was strongly suspected, but patients were unwilling to identify farms that provided the milk. So far we've been fortunate that the infections have not been life-threatening, but raw milk is an inherently risky food and it can lead to other, more dangerous illnesses, including E. coli 0157:H7 infection."

An epidemiologic investigation conducted by DATCP and the Wisconsin Department of Health Services has found 35 confirmed cases of Campylobacter jejuni infection, including 21 patients under age 18. One person was hospitalized. All the patients had consumed unpasteurized milk. Thirty of the patients identified Zinniker Family Farm, Elkhorn, as the source of the raw milk. The farm sells raw milk through a "cow-share" program. Twenty-seven of the confirmed cases were in Walworth and Waukesha counties; the rest were in Racine and Kenosha counties.

Additional testing showed that the Campylobacter jejuni isolated from 25 of the patients -- all linked to Zinniker Family Farm -- had the same DNA fingerprint. Manure samples obtained directly from milking cows on that farm also tested positive for Campylobacter jejuni with the same DNA fingerprint. Manure on the cows' udders or in the milking barn environment can contaminate milk. Pasteurization kills Campylobacter jejuni and other disease-causing bacteria in milk.

Campylobacter jejuni are bacteria that cause symptoms including diarrhea, abdominal cramping, fever, nausea and vomiting. Rarely, an infection may lead to paralysis, which may require hospitalization and artificial respiration. This generally occurs after the initial symptoms have disappeared. Campylobacter can be transmitted by consuming food contaminated by animal feces or handled by someone with the infection who has not adequately washed his/her hands after using the bathroom.

Milk samples from the farm taken after the initial outbreak did not test positive, which is not unusual, Ingham said. Cattle shed the bacteria intermittently, so the bacteria may not have been present when the samples were taken. Changes in sanitation procedures could also explain the absence of bacteria in later milk samples, he said.

Because Zinniker Family Farm sells milk to a defined customer list, there is little risk to the general public in this case. However, the outbreak should discourage consumers from joining "cow-share," membership, or other similar arrangements to buy raw milk, and should discourage dairy producers from adopting such an arrangement for their farms, Ingham said.

"Selling raw milk to consumers is illegal in Wisconsin. Some farmers believe that such arrangements exempt them from the law. They are mistaken. The law says that owners may consume raw milk from their farms, but those owners have to be true owners with a real financial stake in the farm. And the law clearly says that unpasteurized milk can be sold only to a licensed dairy plant or to other licensed businesses that sell to dairy plants," he said.

Other outbreaks in Wisconsin that have been tied to raw milk include:

* In December 2001, at least 30 laboratory-confirmed cases of Campylobacter jejuni were identified in northwestern Wisconsin, all tied to a cow-share program.
* In June 2006, 19 laboratory-confirmed and 39 probable cases of Campylobacter jejuni infection were traced to cheese curds made from unpasteurized milk in an unlicensed facility by an unlicensed cheese maker in Ashland. The cases occurred in many Wisconsin counties and six other states.

Nationwide, the Centers for Disease Control and Prevention report that 45 outbreaks tied to unpasteurized milk or cheese consumption occurred from 1998 to 2005. These outbreaks occurred in 22 states, two were multi-state outbreaks, and they resulted in 1,000 illnesses, 104 hospitalizations and two deaths.

In an article published in the Wisconsin Medical Journal in August 2000, the Wisconsin Division of Public Health reported that from 1992 to 1999, consumption of raw milk and raw milk products was one of the top three risks for E. coli 0157:H7 infection in Wisconsin. E. coli 0157:H7 infections can be fatal.

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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.

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Lynne Terry of The Oregonian reported this afternoon that Oregon health authorities have announced a suspected link between 124 Salmonella Typhimurium illnesses nationally and lettuce.  The illnesses began appearing in mid-July and trailed off about a month later.  Seven Oregon residents fell ill between Aug. 4 to 16, including three in the Portland metro area.

One of the Oregon residents who became ill suffered a particularly severe illness and was hospitalized for several weeks.  Doctors removed a portion of her gastrointestinal tract, which had become necrotic and non-functional as a result of her severe infection with Salmonella Typhimurium.  We represent this unfortunate woman, and are working hard to discover for her what the ultimate source of her illness was.

This would certainly not be the first time that contaminated lettuce or other leafy greens caused an outbreak of severe illnesses.  In addition to the infamous Dole spinach E. coli outbreak in 2006, here are a few others:

Continue Reading...

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Non-O157 shiga toxin-producing Escherichia coli (STEC) are the causative agents of zoonotic emerging infectious diseases, often of bovine origin. Below is a general review of non-O157 STEC prevalence studies in humans, cattle, and beef products.

Humans

Non-O157 STEC infections are under-recognized and under-reported due to inadequate epidemiological and laboratory surveillance. In the United States, E. coli O157:H7 became nationally notifiable in 1994, whereas non-O157 STEC infections were not reportable until 2000, following adoption of a position statement (2000 ID#1) by the Council for State and Territorial Epidemiologists (CSTE). At that time, the CSTE recognized that the threat to public health from STEC infections extended beyond just the E. coli O157:H7 serogroup.

In recent years, improved diagnostic assays for non-O157 STEC have contributed to an increased appreciation of the severity of disease caused by these strains including hemolytic uremic syndrome (HUS). Notably, the number of non-O157 STEC cases reported to CDC’s FoodNet has risen steadily each year; from 2000-2006, there was an overall 4-fold increase in incidence (0.12 cases per 100,000 to 0.42 cases per 100,000 population) at FoodNet sites. The most common serogroups reported to cause foodborne illness in the United States are O26, O111, O103, O121, O45, and O145 (Brooks et al, 2005).

Johnson et al (2006) evaluated the emerging clinical importance of non-O157 STEC and concluded that these strains may account for up to 20 to 50% of all STEC infections in the United States. Clearly, the prevalence of non-O157 STEC infections is placing an enormous burden on society and the health care system in the United States.

Cattle as Reservoirs

Beef and dairy cattle are known reservoirs of E. coli O157:H7 and non-O157 STEC strains (Hussein, 2007; Hussein and Sakuma, 2005). In reviews of STEC occurrence in cattle worldwide, the prevalence of non-O157 STECs ranged from 4.6 to 55.9% in feedlot cattle, 4.7 to 44.8% in grazing cattle, and 0.4 to 74% in dairy cattle feces. The prevalence in beef cattle going to slaughter ranged from 2.1 to 70.1%. While most dairy cattle-associated foodborne disease outbreaks are linked to milk products, dairy cattle still represent a potential source of contamination of beef products when they are sent to slaughter at the end of their useful production life (termed “cull” or “spent” dairy cows); this “dairy beef” is often ground and sold as hamburger.

The high prevalence of non-O157 STEC in some cattle populations, combined with the lack of effective on-farm control strategies to reduce carriage, represents a significant risk of contamination of the food supply and the environment.

Beef Products

Numerous non-O157 STEC serotypes known to cause human illness are from bovine origin, thus putting the beef supply at-risk. Both E. coli O157:H7 and non-O157 STEC may colonize the gastrointestinal tract of cattle, and potentially contaminate beef carcasses during processing. Although not as well studied, the risk factors for contamination of beef products from cattle colonized with non-O157 STECs are probably the same or very similar to E. coli O157:H7. For example, cattle hides contaminated with E. coli O157:H7 during slaughter and processing are a known risk factor for subsequent E. coli O157:H7 contamination of beef products. One study showed that the prevalence of non-O157 STEC (56.6%) on hides is nearly as high as that found for E. coli O157:H7 (60.6%) (Barkocy-Gallagher et al, 2003).

Hussein and Bollinger (2005) evaluated published reports from over three decades and found that non-O157 STEC were more prevalent in beef products compared with E. coli O157. In their study, the prevalence of non-O157 STEC ranged from 1.7 to 58% in packing plants, from 3 to 62.5% in supermarkets, and an average of 3% in fast food restaurants. In a recent survey of retail ground beef products in the United States, 23 (1.9%) of 1,216 samples were contaminated with non-O157 STEC (Samadpour et al, 2009). In another study, researchers found a 10 to 30% prevalence of non-O157 STEC in imported and domestic boneless beef trim used for ground beef (Bosilevac et al, 2007).

Non-E. coli O157:H7 Outbreaks

Worldwide, non-O157 STEC outbreaks emerged in the 1980’s, and the first reported outbreaks in the United States occurred in the 1990’s (Hussein 2007; Brooks et al, 2005). The number of reported outbreaks due to non-O157 STECs remains relatively low in the United States, but experts agree that documented outbreaks probably represent the “tip of the iceberg.” From 1983-2002, seven non-O157 STEC outbreaks were reported in the United States (Brooks et al, 2005). During the following five-year period from 2003-2007, CDC documented an additional five non-O157 STEC outbreaks (CDC Outbreak Surveillance Data, http://www.cdc.gov/foodborneoutbreaks/outbreak_data.htm).

Products Implicated in Previous Outbreaks

There is a paucity of information on the vehicles of transmission for human non-O157 STEC infections, but contaminated raw dairy products, produce, and water have been implicated in the United States (Brooks et al, 2005). A review of non-O157 STEC in Connecticut showed that exposures, including ground beef, were similar in both non-O157 STEC and E. coli O157:H7 cases, suggesting that the routes of transmission are similar (CDC 2007). Considering the relatively high prevalence of both E. coli O157:H7 and non-O157 STEC in cattle populations and their products, it is not surprising that ground beef and other beef products could be a common food vehicle.

Non-O157 STEC outbreaks attributed to ground beef and its sausage products have been documented outside the United States including Argentina, Australia, Germany, and Italy. These beef-related outbreaks involved 8 STEC serogroups (O1, O2, O15, O25, O75, O86, O111, and O160). HUS cases were reported in five of the six outbreaks, mostly striking children and the elderly.

More rigorous investigation into the cause of non-O157 STEC outbreaks is needed to better understand the role of beef products and other foods in the contamination of the human food supply with these strains. Bettelheim (2007) described non-O157 STECs as “under-rated pathogens.” Indeed, the surveillance trends suggest that if left unchecked, it is only a matter of time before the United States experiences large non-O157-related outbreaks. Amending FMIA regulations to include pathogenic non-O157 STEC strains under the definition of “adulterated” is an urgently needed step in the prevention and control of these potentially deadly pathogens.

References

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Click above to download Summons and Complaint.

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By Doug Powell - Kansas State University.

That’s the title of a book chapter that’s just been published and attempts to answer the question: what does it take for farmers, processors and retailers to pay attention to food safety risks – in the absence of an outbreak?

Last week, trade magazine The Packer did a story about Earthbound Farms, the producer of E. coli O157:H7 tainted-spinach in 2006, which quoted president Charles Sweat as saying,

“Now that we are three years beyond that, it’s almost always hard to go back and put our mind where it was in 2005 and 2006 because we know so much more today than we knew then.”

What Ben Chapman, Casey Jacob and I asked in the book chapter is, why didn’t companies like EarthBound know a lot more about microbial food safety before over 200 became ill and four died in 2006?

In October, 1996, a 16-month-old Denver girl drank Smoothie juice manufactured by Odwalla Inc. of Half Moon Bay, California. She died several weeks later; 64 others became ill in several western U.S. states and British Columbia after drinking the same juices, which contained unpasteurized apple cider -- and E. coli O157:H7. Investigators believed that some of the apples used to make the cider might have been insufficiently washed after falling to the ground and coming into contact with deer feces (Powell and Leiss, 1997).

Almost 10 years later, on Sept. 14, 2006, the U.S. Food and Drug Administration announced that an outbreak of E. coli O157: H7 had killed a 77-year-old woman and sickened 49 others (United States Food and Drug Administration, 2006). The FDA learned from the Centers for Disease Control and Wisconsin health officials that the outbreak may have been linked to the consumption of produce and identified bagged fresh spinach as a possible cause (Bridges, 2006a).

In the decade between these two watershed outbreaks, almost 500 outbreaks of foodborne illness involving fresh produce were documented, publicized and led to some changes within the industry, yet what author Malcolm Gladwell would call a tipping point -- "a point at which a slow gradual change becomes irreversible and then proceeds with gathering pace" (http://en.wikipedia.org/wiki/Tipping_Point) -- in public awareness about produce-associated risks did not happen until the spinach E. coli O157:H7 outbreak in the fall of 2006. At what point did sufficient evidence exist to compel the fresh produce industry to embrace the kind of change the sector has heralded since 2007? And at what point will future evidence be deemed sufficient to initiate change within an industry?

We conclude:

Ultimately, investigators showed that the E. coli O157:H7 was found on a transitional organic spinach field and was the same serotype as that found in a neighboring grass-fed cow-calf operation. These findings, coupled with the public outcry linked to the outbreak and the media coverage, sparked a myriad of changes and initiatives by the industry, government and others. What may never be answered is, why this outbreak at this time? A decade of evidence existed highlighting problems with fresh produce, warning letters were written, yet little was seemingly accomplished. The real challenge for food safety professionals, is to garner support for safe food practices in the absence of an outbreak, to create a culture that values microbiologically safe food, from farm-to-fork, at all times, and not just in the glare of the media spotlight.

Powell, D.A., Jacob, C.J., and Chapman, B. 2009. Produce in public: Spinach, safety and public policy in Microbial Safety of Fresh Produce: Challenges, Perspectives, and Strategies ed. by X. Fan, B.A. Niemira, C.J. Doona, F.E. Feeherry and R.B. Gravani. Blackwell Publishing.

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The 2006 outbreak of E. coli tied to spinach sickened more than 205 people nationwide, many gravely. More than 31 developed Hemolytic Uremic Syndrome (HUS) and five lost their lives. One of the most critically ill was Jane Majeska of Fond du Lac, Wisconsin, an 85-year old woman whose fight to stay alive in the months after she consumed the Dole E. coli O157:H7-tainted spinach cost almost a $500,000 dollars. William Marler of the Seattle-based foodborne illness law firm Marler Clark, along with the Fond du Lac firm of Sager, Colwin Samuelsen, will file a lawsuit today in the Fond du Lac branch of the Wisconsin Circuit Court against Dole, Natural Selection Foods, Mission Organics and Pic-n-Save.

“This amazing woman fought through serious medical traumas and has continued to fight to win back her health,” said Marler. “Jane Majeska is alive today because she was incredibly healthy and active before she ate contaminated food, because she had tremendous medical care, and because she fought every hour of every day to get better,” continued Marler. “No one should have to go through that, but if they do, they certainly shouldn’t have to sue to be compensated for it. But sometimes, that’s what it takes.”

Jane Majeska ate Dole spinach in late August 2006. Within days, she was experiencing nausea, vomiting, and diarrhea that became bloody. She was admitted to the hospital as her kidneys failed and she was diagnosed with HUS. Her months in the hospital were marked by increasingly invasive procedures to address her cascading illnesses. In addition to renal failure, she experienced stroke, cognitive impairment, a collapsed lung, a pulmonary embolism, and the inability to eat or breathe on her own. She was given dialysis, blood transfusions, plasmapheresis, and survived on a feeding tube and ventilator. Even as she began to improve, she required aggressive physical, occupational, and speech therapy, as well as rehabilitation nursing.

Although E. coli outbreaks are often associated with meat, produce-borne outbreaks have become more frequent in recent years. The Center for Science in the Public Interest noted that fully 25 percent of E. coli outbreaks from 1990-1998 were traced to produce. Data from the Centers for Disease Control show that over the last 12 years, twenty-two E. coli outbreaks have been traced specifically to leafy greens.

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When food-borne illnesses result in critical life-threatening conditions, typically the victims do not get to tell the stories. Their pain and suffering are usually shared only by their closest friends and families, but the public usually turns away not wanting to hear about internal organs being removed or the loss of liver function or brain damage.

The Washington Post Tuesday ventured the world where the swift loss of health is almost too frightening to believe.   Staff Writer Lyndsey Layton told the story of Linda Rivera, who made what might turn out to be a fatal mistake.   Last May, according to the Post, Rivera “nonchalantly ate several spoonfuls of the Nestle cookie dough her family had consumed for years.”

She is among the most seriously injured of the 80 people in 31 states that state and federal health officials say were sickened by the Nestle cookie dough because it carried the deadly bacteria E. coli O157:H7. Rivera is among the ten Nestle victims who developed Hemolytic Uremic Syndrome (HUS), a potentially life-threatening disease.

“Linda Rivera,” the Post reported, “has just been trying to stay alive. Her cascading problems started about seven days after she ate the dough when her kidneys shut down and she went into septic shock.

“The doctors had to remove part of her colon, which had become contaminated. Soon, her gallbladder was inflamed and hard to be excised. Shortly after, her liver stopped functioning. It unclear exactly what is causing her loss of speech, although the toxin produced by the E. coli O157:H7 bacteria can attack the brain.”

"People just don't really understand how horrible food-borne illness is," said William Marler, a prominent Seattle-based food-safety lawyer who is representing the Rivera family and 23 other victims in the cookie dough outbreak. "They think food-borne illness is a tummy ache and diarrhea."

As Congress nears the end of its summer recess, food safety advocates are hoping the Post’s story on Linda Rivera helps keep the need for reform on the Congressional radar screen. Before the break, the House passed the Food Safety Enhancement Act of 2009.  

The new law imposes fees and gives the Food and Drug Administration (FDA) stepped up powers of inspection and for issuing recalls. It focuses on tracing back foods and specific ingredients to the source while imposing uniform standards on both imports and domestically produced goods.

“Victims and their families telling their stories at almost a dozen Congressional hearings during the past three years is the main reason food safety legislation has gotten this far,” Marler said. “I’m hopeful that the fight Linda is making for her very life will help move the Senate to join the House in passing a food safety bill the President will sign."

Read the entire story by clicking on the headline below:

“This Woman Might Die From Eating Cookie Dough - Severe Case Gives Context to Issue of Food Safety” 

Above: Richard cares for wife Linda Rivera.

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Linda Rivera's E. coli O157 infection seems to have struck a nerve.  Virtually every major news outlet, and many local ones, across the country has reported on her devastating illness.  Foxnews.com reported this morning that "A 57-year-old woman clinging to life in a Las Vegas hospital serves as a warning as to how dangerous and potentially deadly foodborne illnesses can be."  The LA Times yesterday recounted the following sobering statistics, of which Linda Rivera is now a part:  "One in four Americans get food-borne illnesses each year," and continued that "lawmakers are scrambling to respond."  And, in its raw expose on Ms. Rivera's illness, the Washington Post's byline reads "Severe case gives context to issue of food safety." 

It is certainly no wonder why Linda's illness has become a major topic of discussion in national newsrooms and editors' offices.  My only concern is that history will, again and again and again, repeat itself despite Linda's awful circumstances.  It's not like lawmakers haven't "scrambled" before, and its certainly not the case that we haven't had context for the issue of food safety for years, even decades.  After all, it's been sixteen years since the infamous E. coli O157:H7 outbreak at Jack in the Box, in which Brianne Kiner, Bill Marler's client, was horribly injured.  And there are a number of other high-profile, devastating outbreaks--including spinach in 2006, and peanuts/peanut butter in 2007 and 2008, to mention just a few--that gave plenty of context to food safety, and should have had lawmakers not only "scrambling," but actually pushing through food safety legislation that has a real impact. 

Unfortunately, Linda Rivera's story is not rare by any means.  It is just heart-wrenchingly sad.  But not rare.  It feels like we have been saying this for years about other folks, some no longer living and many with futures irrevocably changed by the spectre of living with transplanted kidneys.  Hopefully more good comes of the incredible suffering endured by the Nestle cookie dough victims than came of any past outbreaks. 

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A company called Melon Acres, which is located in Oaktown, Ind., recently recalled cantaloupes that it had shipped to three states in the Midwest due to Salmonella contamination.  The bad, or potentially bad, melons made their way on August 13-14 to the Aldi's store in Greenwood Indiana, and Meijer stores in Lansing and Newport Michigan and Tipp City Ohio.  The company's recall notice indicates that nobody has yet become sickened by the contaminated melons.  The recall was prompted by FDA testing, which generated a positive result for Salmonella in the affected lots.

The affected melons were identified as 41 MG 10, bin numbers 4753-4980; the release didn't say how many bins were included in the recall. One melon in a sample of 20 tested positive for salmonella, according to the company's release.

Now recalls and outbreaks happen all the time--and this certainly is not the first go 'round for cantaloups--but I certainly hope that there is some explanation (it is probably too beurocratic to be comprehensible) for the FDA's failure to report the positive result for 10 days, as well as Melon Acres' failure to recall the melons until six days after receiving the report from the FDA.  

If people do end up getting sick as a result of ingesting Salmonella bacteria from these melons, we will be interested to find out the real answers to these seeming failures.  Unacceptable answers, at least from a civil-liability standpoint, will be that Melon Acres did not know precisely who received the contaminated melons; or that the test result was merely a presumptive positive rather than being confirmed by further testing days later.  

I understand that outbreaks are going to happen; and everybody agrees, i think, that everybody in the chain needs to do a better job of policing stores, testing for pathogens and preventing contamination from occuring in the first place.  But all efforts will undeniably be in vein if the regulators, and more importantly the companies being regulated, do not act quickly when their products are, in fact, contaminated.  That is the proverbial deal-breaker.  The entities with the last clear chance absolutely must be willing and able to act, preferring consumer safety over profit margins.  

 

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BBC has been following an E. coli O157:H7 outbreak among attendees of a dance camp held in Cresselly, Wales.  At least thirteen people who attended the dance camp have reported symptoms consistent with E. coli infection since the camp's conclusion on August 9.  

While the investigation is ongoing and a source has

not yet been identified, the current outbreak resembles a 2002 E. coli outbreak among attendees at a dance camp held at Eastern Washington University (EWU) in Cheney, Washington.  That outbreak was ultimately traced to contaminated romaine lettuce sold by Spokane Produce, and included cases from a cafeteria dinner on a Spokane campus, lunch the following day from the same cafeteria, a restaurant salad in Spokane County, romaine lettuce purchased at several Spokane-area grocery stores, two restaurant salads in Walla Walla County, and romaine served at a restaurant in a Midwestern State.

We trust that educational institutions serve safe food, but the reality is that the E. coli outbreak associated with lettuce served at EWU was not an anomaly.  In 2003, an E. coli outbreak associated with prepackaged lettuce included victims from school districts in San Diego County.  Last year, another lettuce-associated E. coli outbreak sickened students at Michigan State University and the University of Michigan.  The lettuce was supplied to the schools by Aunt Mid's Produce Company of Detroit, Michigan.

It will be interesting to learn what Welsh public health authorities determine to be the source of the current dance camp-related E. coli outbreak.  Whether the source is lettuce or some other food, it is a good reminder for educational institutions to review their food safety policies and take a close look at their suppliers.  As they say, an ounce of prevention is worth a pound of cure.

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According to the Quad-City Times, the Rock Island County Health Department has reported its 18th case of hepatitis A stemming from an outbreak that began about a month ago.

"This individual is a household contact to one of the cases reported the week of July 13," said Theresa Foes, a spokeswoman for the health department. The person in question did not get immunized against the disease, she added. More than 5,300 people were immunized at clinics the department offered last month.

There have now been at least 32 cases of hepatitis A confirmed in western Illinois and eastern Iowa in connection with the outbreak. All of them involve or are somehow related to people who visited a McDonald's restaurant, 400 W. 1st St., Milan, Ill., earlier this summer.

Three lawsuits have been filed in Rock Island County Circuit Court in connection with the outbreak of the disease.

Hepatitis A is the least serious of all the hepatitis diseases that affect the liver. It has an incubation period of 14 to 28 days, but it can affect people for up to 50 days. Officials think hepatitis A cases will continue to turn up in this area into early September.

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The presence of antibiotic resistant Salmonella at the slaughterhouse may be one thing, but its presence in retail meat (i.e. its final stop before consumption) is yet another.  So how much retail meat (ground turkey, chicken, beef, and pork) is actually contaminated at the point of purchase?  And with what? 

An article in the New England Journal of Medicine reported on a study that answers these specific questions.  And the results of the study provide only more grist for the mill regarding the current debate over the non-adulterant status of antibiotic resistant Salmonella and other pathogens.  Click on image below to view entire article.

The scientists who performed the study selected 200 samples of ground meat (ground turkey, chicken, beef, and pork) being offered for sale at three grocery stores in the greater Washington, DC area:  98 from one store, 54 from the second, and 48 from the third.  Testing revealed an alarming level of contamination . . . in my opinion.  Salmonella isolates were recovered from 41 of the 200 samples, with 4 samples testing postive for more than one strain of Salmonella.  In total, 13 different strains accounted for the 45 Salmonella isolates.  Adding to the level of concern, and hopefully the debate over the USDA/FSIS definition of "adulterant," was that 38 of 45 isolates (that's 84%) displayed resistance to at least one antibiotic, and 24 of 45 isolates (53%) displayed resistance to at least three antibiotics. 

Constructive dialogue on this important issue can only help delineate the arguments, both for and against expanding the USDA/FSIS's current definition of adulterant to include more bugs that kill people.  I guess you could say i'm biased because the people who have been injured or killed, or their families, are the folks we work for.  But even putting that aside, doesn't it make just plain good sense that something as harmful, and apparently as prevalent, as antibiotic resistant Salmonella and other dangerous pathogens should be considered "adulterants" on the foods we consume?  What are the counter arguments?   I know they can't be that this is just an issue of passing concern.  As one commenter on one of my recent blog posts puts it:   

It is unlikely we can reverse this process or reduce their existance by not using antibiotic resistant bacterial. Once these new organism is formed they only multiply and spread. You can see what happened with HA-MRSA since 1980s.

So what are the counter arguments?

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The health staff writers over at the LA Times have written a great article, Eating With the Enemy, on the growing prevalence of widespread foodborne illnesses stemming from products as seemingly disparate as ground beef, romaine lettuce, cilantro, Anaheim peppers, granola nut clusters, alfalfa sprouts and of course, peanuts.  The article serves as a preface to a fantastic and informative in-depth piece, The Science of Salmonella, covering many details of the ubiquitous Salmonella bacteria.  This is the same bacteria responsible for the laundry list of food items just mentioned, and includes the current antibiotic-resistant Salmonella Newport outbreak associated with Fresno, California’s Beef Packers, Inc (aka Cargill). ground beef products.

As the writers aptly point out, “Food-borne illnesses have always been with us, but outbreaks of food poisoning are no longer confined to a select few who ate improperly cooked antelope or who chose unwisely at the company picnic. The sheer complexity of modern food production gives the bacteria responsible for food-borne illnesses almost infinitely greater range.”  This point was well illustrated just this past winter when Salmonella contaminated peanuts manufactured by the now-defunct Peanut Corporation of America managed to sicken over 700 people (although the actual number is probably closer to 25,000), and resulted in the recall of over 4,000 products at a economic cost estimated to be hovering somewhere around $1.5 billion.  And it all resulted from a 90 person company accounting for only 2.5% of the US's entire annual peanut crop.

To that end, the federal government has finally taken some forward steps beginning with the House’s recent passage of HR 2749, a bill that would, among other things, overhaul US food safety laws by increasing the Food and Drug Administration's authority to inspect food manufacturers and requiring it to craft a better way of tracing food-borne illnesses and giving it greater recall powers.  For a more in-depth analysis of this dense piece of legislation, check out Marler Blog here.  Farmers and food processors would be required to do their part as well under the new laws.  The Senate is expected to consider a similar measure after its August recess.

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A Brooklyn, New York, company called Peregrina Cheese Corporation announced a recall today of all products manufactured in its Brooklyn since March 17, 2009.  The company announced the recall today due to fears that the recalled products may be contaminated with Listeria monocytogenes, which is a devastating foodborne pathogen that is particularly dangerous to young children, the elderly, and others with weakened immune systems.  It is also of particular health concern to pregnant women; listeria can cause miscarriages and stillbirths 

The recall action, which is hopefully the final action taken in a string of recalls of affected products, involves the following products produced since March 17, 2009:

1. Peregrina Cheese brand QUESO FRESCO Fresh Cheese, 14 Oz. (397 g) foil-wrapped package, Plant # 36-8431, UPC 8 17424 00024 6, all lot codes on the market produced since March 17, 2009.
2. Chipilo brand MEXICAN CHEESE QUESO FRESCO – Fresh Cheese, NET WT. 15 oz. (425g), Plant #36-8431, UPC 8 17424 00028 4, all lot codes on the market produced since March 17, 2009.
3. Peregrina Cheese brand QUESO HEBRA Queso Oaxaca, NET WT. 15 Oz. (425g), Plant #36-8431, UPC 8 17424 00026 0, all lot codes on the market produced since March 17, 2009.
4. Peregrina Cheese brand QUESO COTIJA MOLIDO, NET WT. 15 OZ. plastic bags, Plant # 36-1388, UPC 8 17424 00027 7, all lot codes on the market produced since March 17, 2009.
5. Peregrina Cheese brand Flan, NET WT 8 oz., Plant # 36-8431, UPC 8 17424 00026 0, all lot codes on the market produced since March 17, 2009.
6. Peregrina Cheese brand GELATIN, NET WT. 10 OZ., Plant # 36-8431, UPC 8 17424 00031 4, all lot codes on the market produced since March 17, 2009.
7. Peregrina Cheese brand CREMA MEXICANA Mexican Cream, Weight 16 Oz., Plant # 55-8991, UPC 8 17424 00030 7, all lot codes on the market produced since March 17, 2009.
 

The products were distributed to retail stores in New York and Pennsylvania.  No illnesses have been reported to date.

 

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California based NewStar Fresh Foods today recalled green onions due to possible Salmonella contamination.  772 cartons of iced jumbo green onions are subject to the recall, sold under the brand names Omo and Fu Choy, and distributed from three locations:  R.A.M. Produce Distributors of Detroit, Michigan; Franzella Distributing of San Francisco, CA; and United Food Service of East Point, GA.

No illnesses have been reported. The product is packaged in a 48-count iced carton, item numbers 02487403 and 02487452, product lot numbers 40550707 and 40510707, with production dates of July 20th and July 21st 2009.

All affected product within the foodservice channel has been accounted for and destroyed, at least 58 cartons were shipped to, and possibly sold from, small grocery outlets in the Detroit and San Francisco areas.  Consumers in California may have purchased the product from Larry’s Produce in Fairfield, La Loma Produce, Good Life Grocery and El Grande, all San Francisco, and Valley Produce & Meat Market, San Pablo. Consumers in Michigan may have purchased the product from Confers Supermarket in New Lothrop, Ryan’s Food in Detroit, Brothers Supermarket and Al Jazeera Market in Dearborn and Sahara Market in Warren.

The jumbo green onions are past their shelf-life, but the recall was announced as a cautionary measure in the event that consumers might have purchased from the listed retail outlets and still have the product in their home refrigerators.

 

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The recall of over 826,000 pounds of ground beef, produced by Beef Packers Inc (aka Cargill), due to Salmonella contamination has resounded loudly in the food biz . . . but unfortunately not because a recall linked to ground beef is such a rarity.  It most certainly is not.  This recall has been big news, in large part, because the contaminant is antibiotic resistant Salmonella Newport, which only increases the public health nightmare associated with an already dangerous foodborne pathogen.  

In trying to understand why E. coli O157:H7 is an adulterant according to the USDA-FSIS, but other very common (and very lethal) pathogens are not, one can't help but be impressed by the rather common-sense argument that these bugs just aren't good for people; and as a result, they should be considered nothing if not an adulterant on any food product.  

Continue Reading...

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According to Garance Burke, super AP reporter, USDA records show  that Beef Packers, Inc., that recalled tons of hamburger meat due to salmonella fears was slapped with humane handling violations in a government review of meatpacking plants last year.

At least 28 people in three Western states have reported salmonella-related illnesses since Fresno-based Beef Packers Inc. (Cargill) recalled nearly 826,000 pounds of ground beef last Thursday.

U.S. Department of Agriculture auditors visited there in March 2008. Inspection records show some cattle there were being electrically stunned and rendered unconscious so they could be pulled through an area inside the slaughterhouse.

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Web updates on outbreaks from the Centers for Disease Control and Prevention (CDC) are like those old “paint by numbers” sets.   Sometimes it takes several passes, but eventually the picture is filled out pretty well.

In its fifth and final update on the multi-state outbreak of E. coli O157:H7 infections linked to eating raw refrigerated pre-packaged cookie dough CDC all but wraps a bow around Nestle Toll House products.

“In an epidemiologic study, ill persons answered questions about foods consumed during the days before becoming ill and investigators compared their responses to those of persons of similar age and gender previously reported to State Health Departments with other illnesses,” the CDC update says. “Preliminary results of this investigation indicate a strong association with eating raw prepackaged cookie dough. Most patients reported eating refrigerated prepackaged Nestle Toll House cookie dough products raw.“On June 29, 2009, the U.S. Food and Drug Administration (FDA) announced that a culture of a sample of prepackaged Nestle Toll House refrigerated cookie dough currently under recall yielded E. coli O157:H7,” CDC continues.  “The contaminated sample was collected at the firm on June 25, 2009. Further laboratory testing showed that the strain in the sample was not the outbreak strain. E. coli O157:H7 has not been previously associated with eating raw cookie dough…”

As of ten days ago, health departments in 31 states working with CDC and FDA, has counted 80 confirmed cases of E. coli O157:H7 with the particular DNA match associated with the Nestle outbreak.

Most persons became ill during May and June. Ill persons range in age from 2 to 65 years; however, 66 percent are less than 19 years old; 69 percent  are female. Thirty-five persons have been hospitalized, ten developed hemolytic uremic syndrome (HUS).  

Multiple lawsuits have already been filed against Nestle. Marler Clark, which represents victims of food-borne illnesses throughout the United States , represents 24 sickened by E. coli O157:H7 including six with HUS with all the illnesses linked to the Nestle outbreak. The Seattle-based firm has filed with courts in Colorado, California and Washington State.

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According to a CDC update on the multistate outbreak of E. coli O157:H7 linked to Nestle cookie dough, the agency is working with public health officials in several states and collaborating with the FDA and FSIS to investigate the outbreak.

Preliminary results of the investigation “indicate a strong association with eating raw prepackaged cookie dough,” though the agency is still trying to figure out the exact cause of the contamination. In late June, the FDA announced that it found a strain of E. coli O157:H7 in a sample of the recalled cookie dough, but the culture did not match the outbreak strain.

At last count, 80 persons from 31 states have been sickened. Of those cases, 70 have been confirmed by advanced DNA testing as having the outbreak strain, 35 have been hospitalized, and 10 developed hemolytic uremic syndrome. In response to the outbreak, Nestle recalled 3.6 million packages of cookie dough.

The Danville Nestle cookie dough plant linked to the outbreak received clearance to restart manufacturing cookie dough July 9 and shipped out its first shipment of cookie dough since the outbreak last week.

The agency continues to recommend that consumers not eat any variety of the recalled dough. Of Nestle cookie dough packages have a “new batch” label then they were not a part of the outbreak. The agency also reminds consumers that they should not eat raw products that are meant to be cooked or baked before consumption.

Here is the CDC’s updated map:

The number of ill persons identified in each state is as follows: Arizona (2), California (5), Colorado (6), Connecticut (1), Delaware (1), Georgia (2), Iowa (2), Idaho (1), Illinois (7), Kentucky (2), Massachusetts (4), Maryland (2), Maine (3), Minnesota (8), Missouri (1), Montana (1), North Carolina (2), New Hampshire (2), New Jersey (1), Nevada (2), New York (1), Ohio (3), Oklahoma (1), Oregon (1), Pennsylvania (2), South Carolina (1), Texas (3), Utah (4), Virginia (2), Washington (6), and Wisconsin (1).

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William D. Marler - Op-ed

When we hear that there has been a recall of hamburger tainted with Salmonella Newport, how many of us would know which company slaughtered the cow and ground the meat? Would we know that the meat came from Beef Packers Inc. (a.k.a. Cargill), or would we only know the store we bought the meat from? My guess it would be the store only. So, why do we not yet know completely where the contaminated meat was sold? Here is what we do know.

On August 6, 2009 Fresno-based Beef Packers Inc. (a.k.a. Cargill) recalled nearly 826,000 pounds (over 400 tons) of ground beef produced from June 5-23. Health officials in three Western states said last Friday at least 40 people have reported illnesses tied to the recalled ground beef. Colorado health officials said 21 people there have been sickened. California officials said five people have reported sick (we know one has been hospitalized). Wyoming health officials reported that two people have fallen ill. Officials are investigating other reported illnesses in Arizona, Idaho, Illinois, Nebraska, New Mexico, Nevada, South Dakota and Texas that may be linked to the same strain of Salmonella.

The U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) says the beef was sent to retail distribution centers in Arizona, California, Colorado and Utah, but has been silent on what stores sold the tainted beef. California Department of Health, however, has announced that some of the meat was sold at Safeway Inc. and Sam's Club.

So, why the silence from FSIS and Beef Packers Inc. (a.k.a. Cargill)? Here is some history - on August 18, 2008 after years of hand wringing, the FSIS finally put public health before “proprietary” business interests when it made the following rule: 9 C.F.R. § 390.10 Availability of Lists of Retail Consignees during Meat or Poultry Product Recalls:

The Administrator of the Food Safety and Inspection Service will make publicly available the names and locations of retail consignees of recalled meat or poultry products that the Agency compiles in connection with a recall where there is a reasonable probability that the use of the product could cause serious adverse health consequences or death.

The Bottom Line: The FSIS is now supposed to make available to the public names and locations of retail consignees (grocery stores, etc.) of meat and poultry products recalled by a federally-inspected meat or poultry establishment if the recalled product has been distributed to the retail level. The rule will only apply to Class I recalls (like this one). The information is supposed to be posted on the FSIS website, generally within three (3) to ten (10) working days, following the announcement of the recall.

So, why can California give the public a list in days but FSIS can not? More to the point, why can not Beef Packers Inc. (a.k.a. Cargill) give the same information? 

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Whether its just extremely competent public health officials, or that this particular state just got more of the bad meat than everybody else, Colorado is currently at the epicenter of a national outbreak of antibiotic resistant Salmonella Newport linked to ground beef.  To date, at least 21 Coloradans have been sickened in the outbreak, with the following breakdown of counties:  Arapahoe (3), Broomfield (3), Denver (3), Douglas (1), Elbert (1), Garfield (1), Jefferson (5), Mesa (1), Pueblo (1) and Weld (2).  The Boulder Food Examiner reports that there may be 3 cases in Boulder County as well.  The contaminated meat was distributed to Safeway and Sam's Club stores in Colorado, and has use or freeze by dates ranging from the end of June to July 11, 2009.  See http://www.fsis.usda.gov/News_&_Events/Recall_041_2009_Release/index.asp for more detail on which products are subject to the recall.   

 

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 In 1999, several states reported clusters of Salmonella Newport, an antibiotic resistant strain of the bug, with an indistinguishable PFGE pattern and the same anti-microbial resistance pattern.  The states reported to PulseNet, the national database for foodborne disease surveillance, which prompted an investigation into the cause of the outbreak.

In the investigation, health officials found that 7 out of 8 people in the clusters had eaten ground beef within several days before the onset of illness.  Ultimately, the investation identified a single producer that had distributed the contaminated meat to grocery stores, and an unopened package of ground beef ultimately tested positive for the outbreak strain of Salmonella Newport.  Investigators also found that, from 1997-1999, 1% of all Salmonella in meat processing facilities was Salmonella Newport.  

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Health officials in three Western states said Friday at least 40 people have reported illnesses tied to recalled ground beef that may be tainted with salmonella. On Thursday, Fresno-based Beef Packers Inc. (a.k.a. Cargill) recalled nearly 826,000 pounds (over 400 tons) of ground beef produced from June 5-23.

The U.S. Department of Agriculture's Food Safety and Inspection Service says the beef was sent to retail distribution centers in Arizona, California, Colorado and Utah, with some sold at Safeway Inc. and Sam's Club. Friday, the department confirmed that California, Colorado and Wyoming have reported illness linked to the recalled beef. Colorado health officials said 21 people there have been sickened, and all are recovering. California officials said five people have reported feeling sick. Wyoming health officials reported that two people have fallen ill.

Officials are investigating other reported illnesses in Arizona, Idaho, Illinois, Nebraska, New Mexico, Nevada, South Dakota and Texas that may be linked to the same strain of salmonella, the USDA said. Because the beef was repackaged under different retail names, USDA recommends consumers check with the store where they purchased the beef to determine whether what they bought has been recalled.

Salmonella is a bacterium that causes one of the most common enteric (intestinal) infections in the United States – Salmonellosis. In some states (e.g. Georgia, Maryland), salmonellosis is the most commonly reported cause of enteric disease, and overall it is the second most common bacterial foodborne illness reported (usually slightly less frequent than Campylobacter infection).

The reported incidence of Salmonella illnesses is about 14 cases per each 100,000 persons (MMWR Weekly, 2006), amounting to approximately 30,000 confirmed cases of salmonellosis yearly in the U.S. (CDC, 2005, October 13). In 2005, just over 36,000 cases were reported from public health laboratories across the nation, representing a 12 percent decrease compared with the previous decade, but a 1.5 percent increase over 2004 (CDC, 2007).

As only about 3 percent of Salmonella cases are officially reported nationwide, and many milder cases are never diagnosed, the true incidence is undoubtedly much higher (Mead, 1999). The CDC estimates that 1.4 million cases occur annually (CDC, 2005, October 13). Approximately 600 deaths are caused by Salmonella infections in the U.S. every year, accounting for 31 percent of all food-related deaths (CDC, 2005, October 13; MMWR Weekly, 2001).

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This post is about a brutal illness caused by Salmonella.  It happened to one of our clients several years ago.  Don't stop reading 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.”

Continue Reading...

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 Safeway today announced a nine state recall of ground beef (825,769 pounds) due to fears that the meat may be contaminated with Salmonella Newport.  The recalled product was produced by Beef Packers Inc. (aka "Cargill").  This is just another outbreak/recall in what has turned into a year dominated by Salmonella woes.

Here are just a few recall/outbreaks that have occurred, thus far, in 2009:

http://www.foodpoisonjournal.com/2009/08/articles/food-poisoning-information/colorado-health-officials-identify-walmart-as-one-retailer-of-recalled-cilantro/

http://www.foodpoisonjournal.com/2009/07/articles/foodborne-illness-outbreaks/salmonella-lawsuit-filed-on-behalf-of-memphis-father-and-son-sickened-by-food-from-local-

bbq/http://www.foodpoisonjournal.com/2009/07/articles/food-poisoning-watch/georgia-peppers-recalled-in-ohio-new-york-and-massachusetts/

http://www.foodpoisonjournal.com/2009/07/articles/food-poisoning-information/north-dakota-salmonella-outrbeak-traced-to-unlicensed-caterer/ 

Of course, nobody can forget the now infamous Salmonella outbreak linked to products produced by the Peanut Corporation of America:

http://www.marlerblog.com/2009/02/articles/legal-cases/fdas-peanut-product-recall-list-hits-2750-and-fda-prepares-a-simplified-distribution-chart/

We've even seen Salmonella problems linked to turtles this year:

http://www.foodpoisonjournal.com/2009/06/articles/food-poisoning-information/baltimore-police-seize-turtles-linked-to-salmonella-risk/

But we've probably seen more Salmonella problems this year with alfalfa and other sprouts than anything else.  Remember, a very large outbreak, at least 235 confirmed victims ( and likely lots more unconfirmed victims), occurred in February, March, April, and May 2009.  This outbreak was ultimately linked to sprout seeds sold by Caudill Seed and Manufacturing, Co., out of Louisville Kentucky.  All the problems with sprouts caused me to wonder, Sprouts, Honestly:  Does it Get Any Risker?

What will the last 5 months of the year bring?

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Today the USDA Food Safety and Inspection Service (FSIS) announced a recall of ground beef products due to possible Salmonella contamination. According to the press release, “Beef Packers, Inc. [BPI]…is recalling approximately 825,769 pounds of ground beef products that may be linked to an outbreak of salmonellosis.” The link between confirmed Salmonella infections and consumption of BPI ground beef products was first discovered by the Colorado Department of Public Health, and a subsequent traceback investigation conducted by FSIS.

This recall was, for me, surprising news—and also inexplicable given the USDA’s long-held position that Salmonella is not an adulterant per se in raw meat, and the meat industry’s prior success in getting a court to invalidate Salmonella performance standards that the USDA had tried to implement as part of its Pathogen Reduction, HACCP regulations adopted in 1996. So when I read about this recall, my first thought was to wonder why BPI agreed to the recall. (Remember: FSIS lacks the statutory authority to compel a recall.) And my second thought was: I wonder if the meat industry is going to sue the USDA to try and prevent the Agency from seeking a second recall in the future based on possible Salmonella contamination.

I obviously cannot answer either of these questions. But I can provide some useful background information about why this particular recall is so surprising, and so inexplicable. (And, by the way, by inexplicable I mean that it is nearly impossible to explain how FSIS could take this action in light of 25 years worth of policy and court decisions that would appear to suggest that the Agency has no authority to do what it did. The recall is certainly NOT inexplicable from a public health and safety perspective, which is certainly ironic given the fact that the FSIS has the term “safety” in its name, and doing something in favor of safety should not be inexplicable.)

And so now onto some history:

Continue Reading...

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More than two million pounds of ground beef has been recalled since spring and unlike past years the major cause is not the deadly E. coli 0157:H7.

Instead it is two drug resistant strains of Salmonella that are said to be responsible for almost 1.3 million of the total of 2.1 million pounds of ground beef recalled so far in 2009. 

The latest recall is related to a multi-state Salmonella outbreak in the West that has made a couple dozen people sick and because antibiotics are not working treatment is taking longer,  say health officials.

Salmonella Typhimurium DT104 was linked to the 466,236 pounds of ground beef recalled July 22^nd by the Denver-based King Sooper’s grocery store chain. A spokesman for the Food Safety & Inspection Service said it was the first time ground beef was recalled for salmonella contamination.

Late yesterday—just two weeks later—it happened again as Beef Packers Inc. of Fresno, CA recalled 825,769 pounds of ground beef implicated in the multi-state outbreak of Salmonella Newport.

Both the DT104 and Newport strains are proving resistant to treatment with antibiotics, meaning more difficult recoveries for those poisoned by Salmonella.

There have been eight ground beef recalls for E. coli 0157:H7 contamination this year, adding up to a total of 568,635 pounds.  

Largest of the E coli actions so far in 2009 was the June 24-28 recalls by JBM Swift Co. of 421,280 pounds from its Greeley, CO Beef Plant. Earlier on June 2^nd, SP Provisions of Portland, OR recalled 39,973 pounds of ground beef, and on May 21^st Valley Meats in Illinois recalled 95,898 pounds.

There was also a May 29^th recall of 241,000 pounds of beef by Holten Meat, Inc. of Sauget, IL that did not involve either E. coli or Salmonella. “Foreign objects” had gotten into the shipment and it was rounded up in a low health risk incident. 

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Beef Packers, Inc., a Fresno, Calif., establishment, is recalling approximately 825,769 pounds of ground beef products that may be linked to an outbreak of salmonellosis, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today.

As a result of an ongoing investigation into an outbreak of Salmonella Newport associated with ground beef products, the Colorado Department of Public Health and Environment (CDPHE) notified FSIS of the situation. Epidemiological and traceback investigations conducted by FSIS and CDPHE determined that there is an association between the fresh ground beef products and illnesses reported in Colorado. The illnesses were also linked through the epidemiological investigation by their uncommon pulsed-field gel electrophoresis (PFGE) pattern found in PulseNet, a national network of public health and food regulatory agency laboratories coordinated by the Centers for Disease Control and Prevention.

The products subject to recall include:

60 pound cases of "GRD Beef Sirl Fine 90/10." Each case bears the identifying case code W69012 with Use/Freeze by dates of 06/23/09, 06/26/09, 06/28/09, 06/29/09, 06/30/09, 07/03/09, 07/05/09, 07/06/09, 07/07/09, 07/10/09 and 07/11/09.

60 pound cases of "Grnd Bf Fine Sir 90/10 10/60 H". Each case bears the identifying case code W69064 with Use/Freeze by dates of 06/26/09, 07/03/09, 07/06/09, 07/07/09 and 07/14/09.

60 pound cases of "Grnd Beef 90/10 Fine 60." Each case bears the identifying case code W69063 with Use/Freeze by dates of 06/23/09, 06/26/09, 06/30/09, 07/03/09, 07/07/09, 07/10/09 and 07/11/09.

80 pound cases of "Grnd Beef Fine 91/09 10#/80." Each case bears the identifying case code W69108 with Use/Freeze by dates of 06/30/09, 07/06/09, 07/08/09 and 07/13/09 .

60 pound cases of "Grnd Beef Fine 93/07 10/60." Each case bears the identifying case code W69363 with Use/Freeze by dates of 06/23/09, 06/26/09, 06/28/09, 06/29/09, 06/30/09, 07/03/09, 07/07/09, 07/10/09 and 07/11/09.

60 pound cases of "Grnd Beef Fine 93/07 10#/60 H." Each case bears the identifying case code W69360 with Use/Freeze by date of 06/26/09, 07/03/09, 07/06/09, 07/10/09 and 07/14/09.

40 pound cases of "GRD BEEF FINE 96/04-10#/40." Each case bears the identifying case code W69602 with Use/Freeze by dates of 06/23/09, 06/30/09, 07/03/09, 07/07/09, 07/10/09 and 07/11/09.

The ground beef products were produced on various dates ranging from June 5, 2009 through June 23, 2009 and bear the establishment number "EST. 31913" printed on the case code labels. The ground beef products were distributed to retail distribution centers in Arizona, California, Colorado and Utah. Because these products were repackaged into consumer-size packages and sold under different retail brand names, consumers should check with their local retailer to determine whether they may have purchased any of the products subject to recall.

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 United Food Group announced several days ago that a number of its products contained instant non-fat dried milk subject to the already massive recall of food products made with instnat non-fat dried milk from Plainview Milk Products Cooperative.  In June of this year, Plainview Milk Products recalled dried milk produced at its Plainview, MN facility during most of 2007, all of 2008, and most of 2009 (up until the time that the problems were discovered and the recall announced).  The recall was announced due to possible Salmonella contamination of the milk.

Plainview's dried milk apparently is an ingredient in an enormous quantity of products distributed throughout the United States.  This has forced an impressive list of food manufacturers to recall products that include Plainview's dried milk as an ingredient.  The current, complete list of recalled products can be found at http://www.accessdata.fda.gov/scripts/Milk/.  

During an investigation of the Plainview facility, FDA found that some of the equipment was contaminated with Salmonella. At this time, the Centers for Disease Control and Prevention has not linked any human illnesses to potentially contaminated products from the Plainview facility.

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The Colorado Department of Public Health and Environment (CDPHE) issued an updated Salmonella outbreak alert on Juy 31. In it, CDPHE announced that 21 cases of antibiotic-resistant Salmonella Newport have been reported in Colorado. Most ill individuals sick with Salmonella Newport reported experiencing symptoms of Salmonella infection beginning in late June or early July, and while CDPHE did not announce that a second ground beef recall had been issued, the agency did warn consumers about the possibility that ground beef they have in their freezers could be contaminated with antibiotic-resistant strains of Salmonella.

This most recent drug-resistant Salmonella outbreak follows on the heels of a July 22, 2009 USDA announcement that King Soopers was recalling ground beef for Salmonella contamination. The recalled meat was also contaminated with antibiotic-resistant Salmonella (DT104), and was source of a Salmonella outbreak among residents of several states. According to news reports, most of the illnesses reportedly associated with the earlier Salmonella DT104 outbreak were also among Colorado residents. 

In its July 31 press release, CDPHE stated:

This is the second large Salmonella outbreak that the department has investigated in July. Both outbreaks have been linked to ground beef. Further investigation with the USDA in to the source of the meat in this outbreak is ongoing.

Alicia Cronquist, the foodborne disease epidemiologist at the state health department, said, “We can’t be certain that ground beef is the source of these infections, but we are concerned enough that it might be and want consumers to be aware.”

Antibiotic-resistant Salmonella contamination in ground beef has increasingly been implicated as the source of human illness. On its drug-resistant Salmonella page, the World Health Organization states:

The emergence of Salmonella strains that are resistant to commonly used antimicrobials should be particularly noted by clinicians, microbiologists and those responsible for the control of communicable diseases, as well as the food producers including the food industry. Control of drug-resistant Salmonella is most efficiently achieved through the reduction of antimicrobial use. Prudent usage in food animals should be combined with good husbandry, good abattoir practice and good hygiene at all stages in the food production chain, from processing plants to kitchens and food service establishments. These combined efforts should reduce the numbers of the relevant strains in food animals and lower the risk of contamination by resistant Salmonella at all stages in the food production chain.

While activities addressing the occurrence of antimicrobial resistance in foodborne microorganisms are ongoing, the magnitude of the problem is largely unknown in many countries. International collaborative efforts, including efforts in support of surveillance and risk assessment, need to be increased.

H.R. 1549 - Preservation of Antibiotics for Medical Treatment Act of 2009 proposes the restriction of antibiotic use in feed animals to therapeutic purposes only to prevent the emergence of additional antibiotic-resistant strains of Salmonella and other foodborne pathogens in our food supply. The passage of this bill could be a huge step toward preventing future outbreaks like the two that have struck in Colorado this summer. 

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Unfortunately, those who dined at the Milan, Illinois McDonalds restaurant located at 400 West 1st Street during the month of July, and maybe even June, and are still not yet sick are not yet out of the woods.  Hepatitis A has an incubation period--i.e. the time that elapses between ingestion of the virus and onset of illness--is longer than most foodborne pathogens at 15 to 50 days.  It appears that infected workers at the restaurant may have worked until as late as July 13 or 14.  This means that, assuming July 14 is the last possible date of exposure, illness may not begin for a person infected on that date until the end of August, or the very beginning of September. 

At the risk of adding further stress to the lives of those now worried sick that they might become ill, the efficacy of immuneglobulin shots (i.e. the 5,366 innoculations that the Rock Island County Health Department has given) is not absolute.  It is effective in most cases (approximately 80-90%), but only if administered within two weeks of exposure.  Thus, anybody infected in June who received an injection in late July is probably not protected.  And obviously, those who dined at the restaurant at any point during the exposure period, and who did not receive an injection, are unprotected against the onset of illness as well.

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An outbreak of Salmonella in Memphis Tennessee linked to a local bar-be-que restaurant has resulted in legal action.  A lawsuit was filed today in the Circuit Court for Shelby County, Tennessee against A&R Bar-be-que, LLC. The lawsuit was filed by Seattle foodborne illness law firm Marler Clark and by John Day of the Tennessee firm Day & Blair on behalf of a Memphis father and son.

As many as 20 llnesses reported to the Shelby County Health Department by customers of the A&R Bar-be-que restaurant at 3701 Hickory Hill Road prompted the Health Department to launch an investigation, which started on July 14. The restaurant closed voluntarily on July 25 and remains closed while the investigation continues.

On July 9, 2009, Eric Phillips Sr. purchased food at the Hickory Hill A&R Bar-be-que restaurant. He and his son consumed the food on July 9 and 10. On Friday, July 10, the 15-year-old began to feel ill and quite nauseous. His condition worsened over the weekend, and he was taken to the doctor on Tuesday. The family doctor gave instructions to keep the young man hydrated and he was sent home with the expectation that he would improve. However, his symptoms increased in severity and he experienced vomiting, nausea, and diarrhea over the next few days. On the following Monday, July 20, he was admitted to Le Bonheur Children’s Hospital,and diagnosed with Salmonella.

Meanwhile, Eric Phillips Sr. was experiencing similar symptoms over the same period of time. He was eventually admitted to Methodist Germantown Hospital in Memphis.Both father and son suffered acute kidney failure as a result of their Salmonella infections, requiring extensive medical treatment, including dialysis. They both remain in the hospital.

“The impact on this father and son—and family—will be life-long,” said the family’s attorney, Andy Weisbecker. “No one can change that, but what we can do is to make sure that they have a way to pay for the care they will need.”

Salmonella is a bacterium that causes one of the most common intestinal illnesses in the US: Salmonellosis. It can be present in uncooked or undercooked meat, poultry, eggs, or unpasteurized dairy products, as well as other foods contaminated during harvest, production, or packaging. Symptoms can begin 6 to 72 hours from consumption, and include diarrhea, abdominal cramps, fever, nausea, and/or vomiting.

 

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Last January 18^th, a group from the St. Paul Missionary Baptist Church of Itta Bena dined at Greenwood Pizza Hut in northern Mississippi.

Afterwards 19 people were taken to the hospital with symptoms of vomiting and nausea. The Mississippi Health Department investigated but could not find the source of the illnesses. An April report delivered the inconclusive news.

Now a local attorney has stepped forward representing 15 of the Baptists in a $1.1 million lawsuit filed in Leflore County Circuit Coiurt against Kansas-based NPC International Inc., which owns the Greenwood franchise.

A Pizza Hut spokesman has stepped forward to flatly deny the franchise is responsible for the illnesses, citing reports from both the state health department and the U.S. Food & Drug Administration (FDA).

NPC International is the nation’s largest Pizza Hut franchisee with hundreds of restaurants under its control.

Originally the lawsuit involved two plaintiffs, but has grown to include 13 more now. They claim “the restaurant failed to exercise reasonable care in preparing and storing food and did not properly train employees.”   The 15 claim to have eaten chicken at the Pizza Hut and that the chicken sickened them.

The 19 were taken to the hospital within an hour of eating and were treated and released, the AP reported.

The state health department found raw chicken being kept at “inappropriate temperatures,” but bacteria that might be present would not typically make people sick so quickly. 

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