Food Poisoning Information

Incubation Period

Although incubation periods—the time between ingestion of a foodborne pathogen and the onset of symptoms—are only ranges, and wide ones at that, they can still be used to identify a suspect food poisoning claim.  For example, the claimant who insists that an E. coli O157:H7 illness was sparked by the hamburger eaten an hour before the onset of illness does not have a viable case. The incubation period of E. coli O157:H7 is one to ten days, typically two to five days.

Incubation Periods of Common Foodborne Pathogens

PATHOGEN INCUBATION PERIOD
Staphylococcus aureus 1 to 8 hours, typically 2 to 4 hours.
Campylobacter 2 to 7 days, typically 3 to 5 days.
E. coli O157:H7 1 to 10 days, typically 2 to 5 days.
Salmonella 6 to 72 hours, typically 18-36 hours.
Shigella 12 hours to 7 days, typically 1-3 days.
Hepatitis A 15 to 50 days, typically 25-30 days.
Listeria 3 to 70 days, typically 21 days.
Norovirus 24 to 72 hours, typically 36 hours.

So, if you suffer from a foodborne illness, it is not usually the last meal you ate.  Also, a stool culture for the above – except Listeria and Hepatitis A – which need blood tests – is the best way to definitively determine what “bug” has made you ill.

If you test positive in either stool or blood for one of the above bacteria or viruses, the doctor, lab or hospital is required to alert the local and state health departments, and they are obligated to interview you about the possible source of your illness.

The Wyoming Department of Health (WDH) and the Casper-Natrona County Health Department continue to investigate a growing Natrona County hepatitis A outbreak that began in October.

Since October, 14 cases have been confirmed among Natrona County residents, which is a significant increase over the usual total for Wyoming. Previously, the long-term average statewide was two cases annually with the last reported local Hepatitis A infection in 2012.

“While some of the Natrona County cases did not have a clear hepatitis A exposure risk, recent cases have been concentrated among current injection drug users,” said Clay Van Houten, Infectious Disease Epidemiology Program manager with WDH.

Infection with hepatitis A typically results in symptoms in older children and adults. Symptoms usually occur abruptly and include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored stools, joint pain and jaundice.

There can be a significant delay between when someone who is exposed to the virus and when they show symptoms. “People recently exposed to hepatitis A who have not been vaccinated should receive a vaccine as soon as possible,” Van Houten said.

Specific risk factors for hepatitis A include:

  • Persons with direct contact with a person who has hepatitis A
  • Men who have sex with men
  • Users of injection and non-injection drugs
  • Travelers to countries with high rates of hepatitis A infectionHepatitis A can cause infection in the liver. The virus is primarily spread person-to-person through oral contact with contaminated items such as swallowing food or drink tainted with a tiny amount infected feces.

Van Houten said the best way to prevent hepatitis A is through vaccination. Handwashing, especially after using the bathroom, changing diapers, and before preparing or eating food, plays an important role in preventing the spread of the virus.

Vaccination to prevent hepatitis A is routinely recommended. Children aged at least 12 months and less than 24 months should receive two doses of the vaccine separated by at least 6 months and no less than 18 months. The vaccine series is also recommended for people aged 2 years or older who have not already received it. The Casper-Natrona County Health Department offers the hepatitis A series vaccine; some people may qualify for free or discounted vaccine. For more information or to schedule a clinic appointment, please call 307-235-9340.

Hepatitis A:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Hepatitis A outbreaks. The Hepatitis A lawyers of Marler Clark have represented thousands of victims of Hepatitis A and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Hepatitis A lawyers have litigated Hepatitis A cases stemming from outbreaks traced to a variety of sources, such as green onions, lettuce and restaurant food.  The law firm has brought Hepatitis A lawsuits against such companies as Costco, Subway, McDonald’s, Red Robin, Chipotle, Quiznos and Carl’s Jr.  We proudly represented the family of Donald Rockwell, who died after consuming hepatitis A tainted food and Richard Miller, who required a liver transplant after eating food at a Chi-Chi’s restaurant.

If you or a family member became ill with a Hepatitis A infection after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Hepatitis A attorneys for a free case evaluation.

National Frozen Foods Corporation (NFFC) is voluntarily recalling a limited quantity of Not-Ready-To Eat Individually Quick Frozen (IQF) green beans and IQF mixed vegetables because they have the potential to be contaminated with Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, listeria infection can cause miscarriages and stillbirths among pregnant women.

Following cooking preparation instructions on the labels of master cases or packages will effectively reduce the risk of exposure to this bacterium

This press release includes recalled products distributed to foodservice accounts in bulk and packaged containers in AK, AR, AZ, CA, CO, FL, ID, IL, KS, MI, MS, MT, ND, NE, NM, NV, OR, TN, TX, VA, and WA. The products being recalled listed below were distributed between August 18, 2017 and January 12, 2018.

The recalled items can be identified by the date codes printed on the back of the 32oz. sized bag or the side of the master case. Only the following codes are affected by this recall:

Brand Listed on Packaging Commodity Net Weight NFFC Item #
Customer #
Lot Information / Code Printed On Packaging
Bountiful Harvest Foundations Cut Green Beans 30 LB. 22486-11918
2229881
17100903A02
Bountiful Harvest Originals Cut Green Beans 30 LB. 22486-11908
2229871
17100903A02
Monarch Capri Blend 20 LB. 58108-00602
670229
38511-7H11G3N
Monarch Capri Blend 20 LB. 58108-00602
670229
38511-7H11H3N
NW Treasure Cut Green Beans 30 LB. 62406-90007
3828405
17102603A02
Simplot Classic Meadow Blend 32 oz. 71179-67166 965AUG081705H
Sysco Classic Cut Green Beans 32 oz. 74865-04977
1435197
17102703A03
Sysco Imperial Whole Green Beans 32 oz. 74865-24917
2101855
17102703A03
(No Brand Name) Cut Green Beans 30 LB. 15001-01070 38627-7H28A3N
(No Brand Name) Cut Green Beans 30 LB. 15001-01070 38627-7H28B3N
(No Brand Name) Cut Green Beans 30 LB. 15001-01070 38627-7H28C3N
(No Brand Name) Cut Green Beans 30 LB. 15001-01070 38627-7H28D3N
(No Brand Name) Cut Green Beans 30 LB. 15001-01070 38627-7H28E3N
Valamont* Cut Green Beans 32 oz. 72608-12082 38474-7H08F3N
Valamont Cut Green Beans 20 LB. 72608-12150 38510-7H11F3N
The World’s Harvest* Cut Green Beans 32 oz. WRH99-FV021 38475-7H08F3N
The World’s Harvest* Cut Green Beans 32oz. WRH99-FV021 38475-7H08G3N

* The 32 oz. inner clear poly bag has only lot code printed.

The recall was initiated based on a 3rd party test result of the IQF Green Beans only by a downstream customer that revealed that the finished products may potentially be contaminated with the bacteria. There has been no report of human illness to date.

The top five germs that cause illnesses from food eaten in the United States are:

1.  Norovirus

Norovirus is the leading cause of gastroenteritis, or what we commonly think of as stomach flu symptoms. It causes 23 million cases of gastroenteritis per year, or over half of all gastroenteritis cases in the U.S., and is the second most common virus after the common cold.

Norovirus is usually transmitted from the feces to the mouth, either by drinking contaminated food or water or by passing from person to person. Because noroviruses are easily transmitted, are resistant to common disinfectants, and are hard to contain using normal sanitary measures, they can cause extended outbreaks.

Symptoms of Norovirus

The norovirus incubation period tends to be 24 to 48 hours, after which symptoms begin to appear. An infection normally lasts only 24 to 60 hours. However, in some cases, dehydration, malnutrition, and even death can occur. These complications are more likely among children, older people, and patients in hospitals and nursing homes with weakened immune systems. Common symptoms include:

  • Nausea
  • Diarrhea
  • Vomiting
  • Abdominal pain
  • Headache
  • Low-grade fever

Norovirus Diagnosis

Norovirus usually takes its course and goes away on its own after one to three days. It is hard to diagnose using samples in a lab, and so is usually diagnosed based on the combination of common symptoms, including mild fever, vomiting, and short duration of illness.

Norovirus Treatment

There is no specific treatment for norovirus. However, it is essential to replenish fluids and minerals, as these are depleted with diarrhea.

How to Prevent Norovirus Infection

The good news is that norovirus does not multiply on food, since it is a virus and not a bacterium. There is no way to tell whether foods – like shellfish, which are often eaten raw – are contaminated with norovirus. The only way to assure you don’t get norovirus from foods like shellfish is to cook them thoroughly. Here are other norovirus prevention methods:

  • Wash hands properly, especially after being at events with catered meals, nursing homes, schools, or on cruise ships
  • Wash raw vegetables thoroughly before serving them
  • While traveling, only drink boiled drinks or carbonated bottled beverages
  • Avoid letting anyone known to have norovirus in kitchen space

2.  Salmonella

Salmonella is the second most common intestinal infection in the United States. More than 7,000 cases of Salmonella were confirmed in 2009; however, the majority of cases go unreported. The Centers for Disease Control and Prevention estimates that over 1 million people in the U.S. contract Salmonella each year, and that an average of 20,000 hospitalizations and almost 400 deaths occur from Salmonella poisoning, according to a 2011 report.

Salmonella infection usually occurs when a person eats food contaminated with the feces of animals or humans carrying the bacteria.  Salmonella outbreaks are commonly associated with eggs, meat and poultry, but these bacteria can also contaminate other foods such as fruits and vegetables. Foods that are most likely to contain Salmonella include raw or undercooked eggs, raw milk, contaminated water, and raw or undercooked meats.

Salmonella is generally divided into two categories. Non-typhoidal Salmonella is the most common form, and is carried by both humans and animals. Most serotypes of Salmonella, such as Salmonella Javiana and Salmonella Enteritidis cause non-typhoidal Salmonella.  Typhoidal Salmonella, which causes typhoid fever, is rare, and is caused by Salmonella Typhi, which is carried only by humans.

Symptoms of Salmonella Infection

Symptoms of Salmonella infection, or Salmonellosis, range widely, and are sometimes absent altogether. The most common symptoms include diarrhea, abdominal cramps, and fever.

Typical Symptoms of Salmonella infection: Appear 6 to 72 hours after eating contaminated food and last for 3 to 7 days without treatment.

  • Diarrhea
  • Abdominal Cramps
  • Fever of 100 F to 102 F

Additional symptoms

  • Bloody diarrhea
  • Vomiting
  • Headache
  • Body Aches

Typhoid Fever Symptoms: Symptoms of typhoid fever appear between 8 and 14 days after eating contaminated food and last anywhere from 3 to 60 days. They include a fever of 104 F, weakness, lethargy, abdominal pain, coughing, nosebleeds, delirium, and enlarged organs. Typhoid fever is a serious illness that can result in death.

Complication of Salmonella

Complications of Salmonella poisoning are more likely to occur among young children and people age 65 or older. Possible complications include:

Reactive ArthritisReactive arthritis is thought to occur in 2 to 15 percent of Salmonella patients. Symptoms include inflammation of the joints, eyes, or reproductive or urinary organs. On average, symptoms appear 18 days after infection

Reactive Arthritis: Campylobacter infection may also lead to reactive arthritis. Symptoms include inflammation of the joints, eyes, or reproductive or urinary organs. On average, symptoms appear 18 days after infection

Focal Infection: A focal infection occurs when Salmonella bacteria takes root in body tissue and causes illnesses such as arthritis or endocartitis. It is caused by typhoidal Salmonella only.

Salmonella Treatment

Salmonella infections generally last 3 to 7 days, and often do not require treatment. People with severe dehydration may need rehydration through an IV.

Antibiotics are recommended for those at risk of invasive disease, including infants under three months old. Typhoid fever is treated with a 14-day course of antibiotics.

Unfortunately, treatment of Salmonella has become more difficult as it has become more resistant to antibiotics. Finding the right antibiotic for a case of Salmonella is crucial to treating this bacterial infection.

Prevention of Salmonella Infection

These safety measures can help prevent Salmonella poisoning:

  • Wash your hands before preparing food and after handling raw meats
  • Cook meat and eggs thoroughly until they reach an internal temperature of 160 F (71 C)
  • Do not eat foods containing raw eggs or milk, such as undercooked French toast
  • Avoid cooking raw meat in the microwave, as it may not reach a high enough internal temperature to kill Salmonella bacteria and may be unevenly cooked
  • Avoid bringing uncooked meat into contact with food that will not be cooked (i.e. salad)
  • Wash hands with soap after handling reptiles or animal feces
  • Always wash your hands after going to the bathroom

3.  Clostridium Perfringens

Clostridium perfringens are bacteria that produce toxins harmful to humans. Clostridium perfringens and its toxins are found everywhere in the environment, but human infection is most likely to come from eating food with Clostridium perfringens in it. Food poisoning from Clostridium perfringens fairly common, but is typically not too severe, and is often mistaken for the 24-hour flu.

Source of Clostridium Perfringens

The majority of outbreaks are associated with undercooked meats, often in large quantities of food prepared for a large group of people and left to sit out for long periods of time. Because of this, it is sometimes referred to as the “food service germ.” Meat products such as stews, casseroles, and gravy are the most common sources of illness from C. perfringens. Most outbreaks come from food whose temperature is poorly controlled. If food is kept between 70 and 140 F, it is likely to grow Clostridium perfringens bacteria.

Symptoms of Clostridium Perfringens Infection

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

Illness from Clostridium Perfringens generally lasts around 24 hours, and is rarely fatal.

Complication from Clostridium Perfringens

The Type C strain of Clostridium perfringens can cause a more serious condition called Pig-bel Syndrome. This syndrome can cause death of intestinal cells and can often be fatal.

Preventing a Clostridium Perfringens Infection

To prevent infection by Clostridium perfringens, follow these tips:

  • Cook foods containing meat thoroughly
  • If keeping foods out, make sure they maintain a temperature of 140 F (60 C)
  • When storing food in the refrigerator, divide it into pieces with a thickness of three inches or less so that it cools faster
  • Reheat foods to at least 165 F (74 C)

4.  Campylobacter

Campylobacter jejuni is the most common cause of bacterial foodborne illness in the United States. Over 6,000 cases of Campylobacter infection were reported in 2009 alone, but many cases are not reported to public health authorities. A 2011 report from the CDC estimates that Campylobacter causes approximately 845,000 illnesses in the United States each year.

Campylobacter is found most often in food, particularly in chicken. Food is contaminated when it comes into contact with animal feces.  Any raw poultry may contain Campylobacter, including organic and “free range” products. In fact, studies have found Campylobacter contamination on up to 88 percent of chicken carcasses. Despite the commonness of Campylobacter, however, infections are usually isolated events, and widespread outbreaks are rare.

Campylobacter Symptoms

Symptoms of food poisoning from Campylobacter usually occur 2 to 5 days after a person eats contaminated food, but may take up to 10 days to appear. The most common symptom of a Campylobacter infection is diarrhea, which is often bloody.  Typical symptoms include:

  • Diarrhea: Diarrhea ranges from mild to severe and is often bloody
  • Fever
  • Nausea
  • Vomiting
  • Abdominal pain
  • Headache
  • Muscle pain

Two age groups are most commonly affected by Campylobacter: children under 5 years of age and young adults aged 15-29.

Complications of Campylobacter Infection

Although complications from Campylobacter food poisoning are unlikely, they do occur in some cases. The following is a list of possible long-term consequences of Campylobacter infection.

Guillan-Barré Syndrome (GBS): Although rare, Guillan-Barré Syndrome is the most common cause of acute generalized paralysis in the western world.  GBS occurs when the antibodies the body builds up against Campylobacter attack one’s nerve cells. Symptoms of GBS appear several weeks after diarrheal illness. Approximately one in every 1000 reported Campylobacter cases results in GBS.

Reactive Arthritis: Campylobacter infection may also lead to reactive arthritis. Symptoms include inflammation of the joints, eyes, or reproductive or urinary organs. On average, symptoms appear 18 days after infection.

Other complications: Campylobacter may also cause appendicitis or infect specific parts of the body, including the abdominal cavity, the heart, the central nervous system, the gall bladder, the urinary tract, or the blood stream.

Diagnosis of Campylobacter Infection

To assess whether someone has a Campylobacter infection, doctors take a stool sample and send it to a laboratory for testing.  However, if the stool sample is taken after an individual has begun antibiotic treatment, the test results may be falsely negative.

Campylobacter Treatment

Campylobacter infections usually resolve after about a week, although treatment with antibiotics can shorten the course of the illness. Patients with Campylobacter poisoning should drink lots of fluids to stay hydrated as long as the diarrhea lasts. Antidiarrheal medication may also help lessen symptoms.

The amount of foodborne bacteria resistant to antibiotics is on the rise, so certain antibiotics may prove ineffective at treating a given type of Campylobacter. Finding an effective antibiotic is key to treating this bacterial infection.

How to Prevent Campylobacter Infection

Campylobacter jejuni grows easily if contaminated foods are left out at room temperature. The bacterium is sensitive to heat and other sterilization methods, including pasteurization, cooking meat fully, and water chlorination. Follow these easy safety procedures to avoid Campylobacter infection.

  • Make sure the thickest part of any poultry product you are cooking reaches 165 F (74 C)
  • Choose the coolest part of the car to transport meat and poultry home from the store
  • Defrost meat and poultry in the refrigerator or microwave, making sure juices do not drip
  • Do not cook stuffing inside the bird
  • Never leave food out at room temperature for over two hours
  • Use pasteurized milk and eggs
  • Wash fruits and vegetables carefully
  • Wash hands thoroughly after…
  • Contact with pets or farm animals
  • Preparing food, especially poultry
  • Changing diapers
  • Children return from school or daycare

Note: Helicobacter pylori, a bacterium that causes peptic ulcers and gastritis, is often misconstrued as a Campylobacter. While it was originally thought that Helicobacter pylori was indeed a Campylobacter due to its similar structure, it is now known to be a different bacteria.

5.  Staphylococcus aureus

Staphylococcus aureus (S. aureus), often referred to as “staph,” is a bacterium commonly carried on the skin or in the nose of healthy people. S. aureus typically causes a skin infection, but can cause infections in the bloodstream and major organs. Methicillin-resistant S. aureus (MRSA) occurs when the bacteria become resistant to the antibiotic, methicillin and other more common antibiotics such as oxacillin, penicillin and amoxicillin, making it more difficult to treat. The rate of invasive MRSA (infections in typically sterile sites like the bloodstream) is estimated to be 32 per 100,000 persons in the United States; the mortality (death) rate is thought to be about 6 per 100,000 persons. The risk of invasive MRSA infections is highest among older individuals, Blacks/African Americans, and men.

MRSA infections were initially limited to hospitals and nursing homes, especially among patients with weakened immune systems. Since the 1980s, community-acquired cases and outbreaks also have been reported. Community acquired cases are those not related to past year hospitalization or medical procedures like dialysis, surgery, or catheterization. These infections typically occur among otherwise healthy individuals and are more likely to be limited to skin infections. An increase in the virulence of MRSA bacteria in the past decade, however, has been responsible for more severe and sometimes fatal community acquired infections. More recently, MRSA has been identified in food animals and a few outbreaks have been ‘food-initiated’ or foodborne. In one such outbreak, those affected developed typical foodborne illness symptoms, such as vomiting and stomach cramps,

Sources and Transmission

The major site where people carry S. aureus is in the nasal passages. Approximately 25% to 30% of the population is colonized (when bacteria are present, but not causing an infection) with S. aureus, but only about 1% of the population is colonized with MRSA. The main mode of transmission of staph and MRSA is through hands, which may become contaminated by contact with colonized or infected individuals or through contact with colonized or infected body sites of other persons. Contact with devices, items, or environmental surfaces contaminated with body fluids containing staph or MRSA may also cause infection. Other factors contributing to transmission include close skin-to-skin contact, crowded conditions, and poor hygiene.

Studies in recent years have demonstrated that food-producing animals also carry MRSA. Studies conducted in the U.S. as well as several other countries, including Austria, Canada, China, Belgium, Denmark, France, Italy, South Korea, Taiwan, and The Netherlands, have isolated MRSA mainly from pigs. Other animals testing positive for MRSA have included chickens, cattle, and dairy cows. In addition, the testing of raw meat samples from slaughter houses and retail markets has revealed MRSA in several countries. This is likely due to the high use of antibiotics in food animal production. Estimates of the amounts of growth-promoting antibiotics used in U.S. animal production range from 3.1 million to approximately 25 million pounds annually. In some instances, animal strains are similar or identical to human strains. In fact, the presence of MRSA in food-producing animals has also led to the transmission of MRSA to farmers, their families, and veterinarians, resulting in human colonization.

Of even greater concern is the identification of MRSA in retail meats and food products, including pork, beef, and dairy products. This has occurred in the U. S. as well as in Austria, China, The Netherlands, Portugal, and South Korea. However, few foodborne or food-initiated outbreaks have been reported. One ‘food-initiated’ outbreak in The Netherlands involved the transmission of MRSA from a colonized but healthy hospital dietary worker to a patient through food. The contaminated food (which tested positive for MRSA) was ingested by the patient who was severely immunocompromised, and the patient contracted a fatal infection. Transmission from that patient to other hospital workers and subsequently to other patients resulted in a major outbreak. In another food-related case, a community-acquired foodborne illness outbreak occurred in Tennessee. In that outbreak, a family developed typical foodborne illness symptoms after eating food prepared by a commercial foodhandler who was colonized with MRSA (see details below)

Symptoms

Community-acquired MRSA infections most often present as a skin or soft tissue infection such as a boil or abscess. Individuals frequently recall a “spider bite”. The involved site is red, swollen, and painful and may have pus or other drainage. MRSA infections also can cause more serious infections, such as necrotizing fasciitis, a rapidly progressive, life-threatening infection that involves skin, soft tissue, and deep fascia; bloodstream infections; or pneumonia, leading to symptoms of shortness of breath, fever, and chills. As seen in at least one outbreak, individuals with foodborne illness caused by MRSA may experience nausea, vomiting and stomach cramps.

According to the Centers for Disease Control and Prevention (CDC), individuals with MRSA infections that meet all of the following criteria likely have community-acquired MRSA infections:

  • Diagnosis was made in the outpatient setting or by a culture positive for MRSA within 48 hours after admission to the hospital.
  • No medical history of MRSA infection or colonization.
  • No medical history in the past year of:
    a. Hospitalization
    b. Admission to a nursing home, skilled nursing facility, or hospice
    c. Dialysis
    d. Surgery

Detection and Treatment

In general, a culture is obtained from the infection site (skin, blood, or urine) and sent to the microbiology laboratory. In the case of a skin Infection, a culture is taken from a small biopsy of skin or drainage from the infected site. A sputum culture should be taken in the event of pneumonia. If S. aureus is isolated, the organism should be tested to determine which antibiotics will be effective for treating the infection.

Staph skin infections, such as boils or abscesses, may be treated by incision and drainage, depending on severity. Antibiotic treatment, if indicated, should be guided by laboratory testing of the bacteria to determine antibiotic susceptibility.

Prevention

Frequent handwashing is the most important way to prevent spread of staph in the community. If an individual has a skin infection, it should be kept covered. Keep wounds that are draining or have pus covered with clean, dry bandages until healed. Bandages and tape can be discarded with the regular trash.

Family members and others in close contact should wash their hands frequently with soap and water or use an alcohol-based hand sanitizer, especially after changing the bandage or touching the infected wound. Do not share personal items, such as towels, washcloths, razors, clothing or uniforms, that may have had contact with the infected wound or bandage. Wash sheets, towels, and clothes that become soiled with water and laundry detergent. Use a dryer to dry clothes completely.

Since little is known about the transmission of MRSA through food, other than through foodhandlers, there are no specific recommendations about the prevention of foodborne illness with regard to MRSA. In general, individuals should wash their hands with soap and water before preparing food, especially commercial foodhandlers; wash produce; wash cutting boards often; wash hands, utensils, and cutting boards after they have been in contact with raw meat or poultry and before they touch another food; and refrigerate food within 2 hours of serving. Use a food thermometer to cook meat and poultry to proper temperatures and keep hot foods hot; cold foods should be kept at 40°F or below.

The Utah Department of Health reported that two restaurants are linked to an ongoing hepatitis A outbreak in Utah County and other parts of the state since August.  This on top of a 7-11 earlier this month.

Anyone who ate, drank or used the restroom at Sonic Drive-In or Olive Garden in Spanish Fork on certain days in December may have been exposed to hepatitis A, health officials warn. An infected employee was working at those locations at the time, the department said. It warns that symptoms don’t show up immediately and it is important to get a vaccine as soon as possible.

Those at risk visited Sonic on North Main Street on Dec. 23 or 24, or Olive Garden on North Canyon Creek Parkway anytime from Dec. 21-30, the Utah County Health Department said in a prepared statement Tuesday evening.

The department is making vaccinations available to those who may have been exposed to the disease.

The health department encouraged businesses that serve food to vaccinate employees.

Since January 1, 2017, Utah public health has identified 152 confirmed cases of hepatitis A virus (HAV) infection; many among persons who are homeless and/or using illicit drugs. Several cases have been linked by investigation and/or viral sequencing to a national outbreak of hepatitis A involving cases in California and Arizona. Hospitalization rates of less than 40% have been described in previous hepatitis A outbreaks; however, other jurisdictions associated with this outbreak are reporting case hospitalization rates approaching 70%. The high rate of hospitalization may be a result of cases having underlying illnesses (e.g., alcoholism), or a higher rate of hepatitis comorbidities (e.g., hepatitis B or C). In response to the outbreak, public health officials have been working to identify cases and contacts, provide education, and ensure opportunities for vaccination of close contacts to cases and vulnerable populations.

Hepatitis A is usually spread through having oral contact with items contaminated with hepatitis A, for example, through ingesting food or drinks contaminated by infected feces. Some people do not develop symptoms, even if infected. If symptoms occur, they usually appear anywhere from 2-6 weeks after exposure. Symptoms usually develop over a period of several days, and may include jaundice (the yellowing of the skin or whites of the eyes), abdominal pain, nausea or diarrhea. Hepatitis A vaccination is the best way to prevent hepatitis A infection.

In January 1993, the Washington State Department of Health launched an investigation into an uncommonly high incidence of hemolytic uremic syndrome (HUS) among Seattle-area children. It traced the source of their illnesses back to E. coli O157:H7 bacteria that had contaminated hamburger patties sold at area Jack in the Box restaurants. In the following weeks, Idaho, California and Nevada reported numerous cases of E. coli infection among residents that had eaten at Jack in the Box restaurants. The scope of the outbreak widened.

Ultimately, 73 different Jack in the Box locations were linked to the E. coli outbreak. The bacteria sickened over 700 people in four states (602 of them from Washington) and led to 171 hospitalizations and 4 deaths. The investigation into the outbreak eventually identified five slaughterhouses in the United States and one in Canada as possible sources of the bacteria, but the exact source of the contaminated meat, produced by the Von Corporation of California, was never pinpointed. Further investigation revealed that Foodmaker, Inc., parent company of Jack in the Box, had been warned by local health departments and its own employees that its hamburgers were being undercooked, but had decided that cooking them to the required 155 degrees made them too tough.

Brianne Kiner, nine years old at the time, suffered one of the worst of the illnesses resulting from this culinary choice.  Brianne was admitted to Seattle’s Children’s hospital days after eating a hamburger from a Redmond, WA Jack in the Box.  She developed HUS, which caused her to become puffy and jaundiced.  She began to bleed from every orifice in her body and required months if dialysis.

Brianne would eventually slip into a coma, during which doctors removed her large intestine and hooked her heart, lungs, and kidneys up to machines to keep them functioning. Though expected to die, Brianne eventually emerged from the coma, and began the slow process of recovery, to the extent she would be able to recover. Many effects of her infection were permanent, including diabetes, asthma, brain damage and future kidney problems that will eventually lead to the need for a transplant.

William Marler represented Brianne in a claim against Jack in the Box and Foodmaker, and obtained a $15.6 million settlement on her behalf, in addition to successfully resolving cases on behalf of dozens of other victims of the outbreak.

An accomplished attorney and national expert in food safety, William (Bill) Marler has become the most prominent foodborne illness lawyer in America and a major force in food policy in the U.S. and around the world.  Marler Clark, The Food Safety Law Firm, has represented thousands of individuals in claims against food companies whose contaminated products have caused life altering injury and even death.

Bill began litigating foodborne illness cases in 1993, when he represented Brianne Kiner, the most seriously injured survivor of the historic Jack in the Box E. coli O157:H7 outbreak, in her landmark $15.6 million settlement with the company.  The 2011 book, Poisoned: The True Story of the Deadly E. coli Outbreak that Changed the Way Americans Eat, by best-selling author Jeff Benedict, chronicles the Jack in the Box outbreak and the rise of Bill Marler as a food safety attorney.

For the last 20 years, Bill has represented victims of nearly every large foodborne illness outbreak in the United States, filing lawsuits against such companies as Cargill, Chili’s, Chi-Chi’s, Chipotle, ConAgra, Dole, Excel, Golden Corral, KFC, McDonald’s, Odwalla, Peanut Corporation of America, Sheetz, Sizzler, Supervalu, Taco Bell and Wendy’s. Through his work, he has secured over $600,000,000 for victims of E. coli, Salmonella, Listeria, Botulism and other foodborne illnesses.

Among the most notable cases he has litigated, Bill counts those of nineteen-year-old dancer Stephanie Smith, who was sickened by an E. coli-contaminated hamburger that left her brain damaged and paralyzed, and Linda Rivera, a fifty-seven-year-old mother of six from Nevada, who was hospitalized for over 2 years after she was stricken with what her doctor described as “the most severe multi-organ [bowel, kidney, brain, lung, gall bladder, and pancreas] case of E. coli mediated HUS I have seen in my extensive experience.”

New York Times reporter Michael Moss won a Pulitzer Prize for his coverage of Smith’s case, which was settled by Cargill in 2010 for an amount “to care for her throughout her life.” Linda’s story hit the front page of the Washington Post and became Senate Majority Leader Harry Reid’s touchstone for successfully moving forward the Food Safety Modernization Act in 2010.

Bill Marler’s advocacy for a safer food supply includes petitioning the United States Department of Agriculture to better regulate pathogenic E. coli, working with nonprofit food safety and foodborne illness victims’ organizations, and helping spur the passage of the 2010-2011 FDA Food Safety Modernization Act.  His work has led to invitations to address local, national, and international gatherings on food safety, including testimony before the U.S. House of Representatives Committee on Energy and Commerce.

At little or no cost to event organizers, Bill travels widely and frequently to speak to food industry groups, fair associations, and public health groups about the litigation of claims resulting from outbreaks of pathogenic bacteria and viruses and the issues surrounding it.  He gives frequent donations to industry groups for the promotion of improved food safety, and has established numerous collegiate science scholarships across the nation.

He is a frequent writer on topics related to foodborne illness.  Bill’s articles include “Separating the Chaff from the Wheat: How to Determine the Strength of a Foodborne Illness Claim”, “Food Claims and Litigation”, “How to Keep Your Focus on Food Safety”, and “How to Document a Food Poisoning Case” (co-authored with David Babcock). He is the publisher of the online news site, Food Safety News and his award-winning blog, www.marlerblog.com is avidly read by the food safety and legal communities. He is a frequent media guest on food safety issues and has been profiled in numerous publications, including the ABC News, New York Times, The New Yorker, and The Wall Street Journal.

In 2010 Bill was awarded the NSF Food Safety Leadership Award for Education and in 2008 earned the Outstanding Lawyer Award by the King County Bar Association.  He also received the Public Justice Award from the Washington State Trial Lawyers Association.

Bill graduated from the Seattle University School of Law in 1987, and in 1998 was the Law School’s “Lawyer in Residence.”  In 2011, he was given Seattle University’s Professional Achievement Award.

1987 –  J.D. Seattle University School of Law

1982 –  B.A.s Political Science, Economics, English, Washington State University

2013 – Seattle University Distinguished Law Graduate Award

2011- Seattle University Professional Achievement Award

2011 to Present – ABA Journal “Blawg 100” Best Legal Blogs

2010 – NSF Food Safety Leadership Award: Innovation in Education

2009 to Present –  Best Lawyers in America

2002 to Present –  Bar Register of Preeminent Attorneys

2008 –  Public Justice Award, Washington State Trial Lawyer’s Association

2008 – Outstanding Lawyer Award, Seattle/King County Bar Association

1998 to Present – “Super Lawyer”, Washington State Attorneys

1998 – 2004 Governor Appointee, Washington State University Board of Regents Chairman

1997 –  Distinguished Achievement Award, WSU College of Liberal Arts

Poisoned: The True Story of the Deadly E. Coli Outbreak That Changed the Way Americans Eat, By Jeff Benedict

2017 – Seattle Litigator Bill Marler Follows the Food Chain Bloomberg News Cases and Controversies Podcast, Steven Sellers, December 18

2017 – Meet The Attorney Behind The Biggest Food Safety Cases, KNKX, Gabriel Spitzer & Kevin Kniestedt, September 30

2017 – This Food Poisoning Expert Revealed The 6 Things He Refuses To Eat HealthyWay, R.J.Wilson, May 18

2016 –  How one Attorney Is Trying to Make Food Safer Civil Beat News, Rui Kaneya, August 22

2016 – This genius lawyer is our best hope against deadly food poisoningMother Jones, Kiera Butler, May 20

2016 – 7 Things We Learned About Food Safety Oversight From A Foodborne Illness Expert Consumerist, Ashlee Kieler, February 2

2015 – Profile in Obsession: Bill Marler, Naomi Tomky, March 24

2015 – The New Yorker – A Bug in the System The New Yorker, Wil S. Hylton, February 2

2014 – Q&A: Food Safety Lawyer Bill Marler on What Not to Eat The National Law Journal, Jenna Greene, November 3

2012 – Bill Marler, Attorney, Blogger, and Food Safety Advocate, Talks Turkey (Or Spinach, Rather) Miami New Times, Ily Goyanes, November 2

2012 – Bill Marler Interview, Part Two: His Most Difficult Cases and Lobbying Congress Miami New Times, Ily Goyanes, November 14

2012 – Profiles in Public Health Law: Interview with William “Bill” Marler CDC Public Health Law News, July

2012 – Food Safety Lawyer Bill Marler On Sprouts, Raw Milk, and Why “Local” Isn’t Always Safer Blisstree.com, Hanna Brooks Olsen, March 5

2011 – Listeria outbreak draws Seattle lawyer to battle Associated Press, Shannon Dininny, October 9

2011 – Food-Borne Illness Attorney: Top Foods to Avoid ABC News, Neal Karlinsky, September 29

2011 – How to Keep Food Free of Salmonella: Lawsuits The Atlantic, Barry Estabrook, August 31

2011 – More Stomach-Churning Facts about the E. Coli Outbreak New York Times, Mark Bittman, June 8

2011 – Bill Marler: A Personal Injury Attorney and More The Xemplar, Nicole Black, June 1

2011 – Good Food Hero: Bill Marler, Food Safety Attorney Good Food World, Gail Nickel-Kailing, May 23

2011 –  Poisoned: The True Story of the Deadly E. coli Outbreak that Changed the Way Americans Eat Inspire Books, Jeff Benedict, May 15

2011 – New Book Chronicles Islander Marler’s Work Bainbridge Island Review, Connie Mears, May 13

2010 – Food Safety Lawyer Puts His Money Where Your Mouth Is AOL News, Andrew Schneider, September 29

2009 – Bill Marler: Taking on E.coli, BigAg, Raw Milk, Conspiracy Theorists, and the USDA Simple, Good, and Tasty, Shai Danielson, December 16

2009 – Food Safety Lawyer’s Wish: Put Me Out of Business Seattle Times, Maureen O’Hagan, November 23

2009 – WSU Discourse on Food Safety, Courtesy Seattle Lawyer Kitsap Sun, Tristan Baurick,  August 29

2009 – Calling for Real Food Safety Reform: Bill Marler for FSIS Civil Eats, David Murphy, June 24

2009 – When Food Sickens, He Heads for Courthouse Minneapolis Star-Tribune, Matt McKinney, June 24

2009 –  Bill Marler, The Food-Safety Litigator Culinate, Miriam Wolf, April

2009 – Food Fight:Bill Marler’s Beef (PDF) Washington Law & Politics, David Volk, May

2009 – Candidate for Top FSIS Job talks E. coli Testing, Irradiation, Education The Meating Place, Ann Bagel Storck, February 6

2009 – Five Minutes with Bill Marler, Well Known Lawyer, Food Safety Activist CattleNetwork, Chuck Jolley, February 5

2009 – Outspoken Food Safety Attorney Wants In The Washington Post, Ed O’Keefe, January 27

2008 –  E. Coli Lawyer Is Busier Than Ever Associated Press, February 4

2007 –  Legally Speaking: The Food Poisoning Lawyer The Southeast Texas Record, John G. Browning, November 20

2007 –  The Nation’s Leading Food-borne Illness Attorney Tells All Washington State Magazine, Hannelore Sudermann, August

2007 – Food Fight Portland Oregonian, Alex Pulaski, March

2006 –  How a Tiny Law Firm Made Hay Out of Tainted Spinach The Wall Street Journal, Heather Won Tesoriero and Peter Lattman, September 27

2001 –  THE INSIDE STORY: How 11 Schoolkids Got $4.75 Million in E. coli Lawsuit MeatingPlace.com, Bryan Salvage, March 7

2001 –  Hammer Time: Preparation Pays When Disputes Escalate to Lawsuits Meat & Poultry Magazine, David Hendee

2001 –  For Seattle Attorney, A Bacterium Brings Riches—and Enemies The Wall Street Journal, Rachel Zimmerman

2001 –  The Bug That Ate The Burger Los Angeles Times, Emily Green, June

1999 –  Courting Publicity, Attorney Makes Safe Food His Business Seattle Post, Maggie Leung, September 7

BACKGROUND

In 2016, a multijurisdictional team investigated an outbreak of Shiga toxin–producing Escherichia coli (STEC) serogroup O121 and O26 infections linked to contaminated flour from a large domestic producer.

METHODS

A case was defined as infection with an outbreak strain in which illness onset was between December 21, 2015, and September 5, 2016. To identify exposures associated with the outbreak, outbreak cases were compared with non-STEC enteric illness cases, matched according to age group, sex, and state of residence. Products suspected to be related to the outbreak were collected for STEC testing, and a common point of contamination was sought. Whole-genome sequencing was performed on isolates from clinical and food samples.

RESULTS

A total of 56 cases were identified in 24 states. Univariable exact conditional logistic-regression models of 22 matched sets showed that infection was significantly associated with the use of one brand of flour (odds ratio, 21.04; 95% confidence interval [CI], 4.69 to 94.37) and with tasting unbaked homemade dough or batter (odds ratio, 36.02; 95% CI, 4.63 to 280.17). Laboratory testing isolated the outbreak strains from flour samples, and whole-genome sequencing revealed that the isolates from clinical and food samples were closely related to one another genetically. Trace-back investigation identified a common flour-production facility.

CONCLUSIONS

This investigation implicated raw flour as the source of an outbreak of STEC infections. Although it is a low-moisture food, raw flour can be a vehicle for foodborne pathogens.

Samuel J. Crowe, Ph.D., M.P.H., Lyndsay Bottichio, M.P.H., Lauren N. Shade, B.S., Brooke M. Whitney, Ph.D., Nereida Corral, M.P.H., Beth Melius, M.N., M.P.H., Katherine D. Arends, M.P.H., Danielle Donovan, M.S., Jolianne Stone, M.P.H., Krisandra Allen, M.P.H., Jessica Rosner, M.P.H., Jennifer Beal, M.P.H., Laura Whitlock, M.P.H., Anna Blackstock, Ph.D., June Wetherington, M.S., Lisa A. Newberry, Ph.D., Morgan N. Schroeder, M.P.H., Darlene Wagner, Ph.D., Eija Trees, D.V.M., Ph.D., Stelios Viazis, Ph.D., Matthew E. Wise, M.P.H., Ph.D., and Karen P. Neil, M.D., M.S.P.H. N Engl J Med 2017; 377:2036-2043November 23, 2017DOI: 10.1056/NEJMoa1615910

Weight Watchers Smart Ones Chocolate Chip Cookie Dough Sundae frozen desserts are being recalled due to possible contamination. The issue was identified when Aspen Hills, the supplier of the cookie dough pieces, reported positive test results for Listeria monocytogenes. Weight Watchers immediately began an investigation and took action as a precautionary measure.

There have been no consumer complaints or reports of illness related to this issue to date. The recall is for approximately 100,000 cases of Weight Watchers Smart Ones Chocolate Chip Cookie Dough Sundae frozen desserts. No other sizes, varieties or code dates of Weight Watchers Smart Ones products are included in this recall.

The hepatitis A lawyers of Marler Clark have many years of experience working with clients on Hepatitis A outbreak lawsuits.

Hepatitis A is one of five human hepatitis viruses (hepatitis A, B, C, D, and E) that primarily infect the liver and cause illness. It is a communicable (or contagious) disease that spreads from person-to-person through fecal-oral contact, often from an infected food handler contaminating food. The cases the Marler Clark hepatitis A lawyers have been involved in have generally resulted from contaminated food or water.

An estimated 80,000 hepatitis A cases and an estimated 100 deaths due to acute liver failure brought on by hepatitis A occur each year in the U.S. The rate of infection has dramatically decreased since the hepatitis A vaccine was licensed and became available in 1995. Despite the decrease in hepatitis A cases nationally, Marler Clark has represented clients young and old who have become ill with hepatitis A after eating contaminated food or who were exposed to the virus and had to receive an injection to prevent illness.

The Marler Clark hepatitis A lawyers have unmatched experience representing victims of Hepatitis A. Our Hepatitis A lawyers have represented victims of notable hepatitis A outbreaks such as the 2003 Chi Chi’s hepatitis A outbreak, the 2005 California lettuce hepatitis A outbreak, and the 2010 Quad-Cities McDonald’s hepatitis A outbreak. Contact us today to learn more about our services.

Hepatitis A Outbreak Lawsuits

Hepatitis A:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Hepatitis A outbreaks. The Hepatitis A lawyers of Marler Clark have represented thousands of victims of Hepatitis A and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Hepatitis A lawyers have litigated Hepatitis A cases stemming from outbreaks traced to a variety of sources, such as green onions, lettuce and restaurant food.  The law firm has brought Hepatitis A lawsuits against such companies as Costco, Subway, McDonald’s, Red Robin, Chipotle, Quiznos and Carl’s Jr.  We proudly represented the family of Donald Rockwell, who died after consuming hepatitis A tainted food and Richard Miller, who required a liver transplant after eating food at a Chi-Chi’s restaurant.

If you or a family member became ill with a Hepatitis A infection after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Hepatitis A attorneys for a free case evaluation.

In total, four customers and one employee contracted the disease. The Health Department is pushing patrons who visited bartaco between Oct. 13 and 23 to receive preventative treatment while they still can. The Port Chester school district also sent an email Thursday alerting people about the Health Department’s recommendation.

The Westchester County Department of Health is recommending that individuals who ate or drank at bartaco, a restaurant in Port Chester, between October 12th and October 23rd receive preventive treatment against Hepatitis A, a viral illness that affects the liver. The health department learned today that an employee with the illness worked at the restaurant while infectious.

Preventive treatment is only effective if given within two weeks of exposure. Therefore, those who dined on October 12th need to receive preventive treatment by tomorrow, October 26th. Those who dined on October 13th through October 23rd need to receive preventive treatment within two weeks of their exposure.

The health department will offer free preventive treatment at the County Center in White Plains for people who ate or drank at bartaco in Port Chester during this time period. Anyone with a prior history of Hepatitis A vaccination or Hepatitis A infection does not need to be treated. The health department will offer preventive treatment on the following dates and times:

• Thursday, October 26 from 4:00 – 7:45 p.m.
• Friday, October 27 from 12:00 – 4:45 p.m.
• Saturday, October 28 from 8:30 a.m. – 4:30 p.m.

Anyone under 18 years of age must be accompanied by a parent/guardian to provide consent.

Advance registration for the county preventive clinic is highly recommended. To register, go to www.health.ny.gov/gotoclinic/60. If you do not have internet access or need more information, call 211 from 8 a.m. to 10 p.m. Restaurant patrons with exposure can also be treated by their own health care provider.

The Westchester County Department of Health is also informing people who ate or drank at bartaco in Port Chester between August 22nd and October 11th those they may also have been exposed to Hepatitis A. While these individuals are outside the window to receive preventive treatment, they should contact their health care provider immediately if they experience symptoms so that anyone they may have exposed can receive preventive treatment. Upon learning of the first cases, the Health Department immediately launched an investigation into the source of the infection.

“Hepatitis A is generally a mild illness whose symptoms include fatigue, fever, poor appetite, abdominal pain, diarrhea, dark urine, light colored stool and jaundice, which is the yellowing of the skin and whites of the eyes” said Dr. Sherlita Amler, Commissioner of Health. “There are no special medications used to treat a person once symptoms appear, but Hepatitis A transmission to others can be prevented through proper handwashing.”

Not everyone infected with Hepatitis A will have all of its symptoms. Symptoms commonly appear within 28 days of exposure, with a range of 15 to 50 days. Preventive treatment is only effective within two weeks of exposure to the virus, but symptoms typically do not appear until a person has had the virus for a few weeks. The illness is rarely fatal and most people recover in a few weeks without any complications.

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Hepatitis A outbreaks. The Hepatitis A lawyers of Marler Clark have represented thousands of victims of Hepatitis A and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Hepatitis A lawyers have litigated Hepatitis A cases stemming from outbreaks traced to a variety of sources, such as green onions, lettuce and restaurant food.  The law firm has brought Hepatitis A lawsuits against such companies as Costco, Subway, McDonald’s, Red Robin, Chipotle, Quiznos and Carl’s Jr.  We proudly represented the family of Donald Rockwell, who died after consuming hepatitis A tainted food and Richard Miller, who required a liver transplant after eating food at a Chi-Chi’s restaurant.

If you or a family member became ill with a Hepatitis A infection after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Hepatitis A attorneys for a free case evaluation.