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Bill Marler – E. coli Attorney and Lawyer

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.

He 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, he has represented victims of nearly every large foodborne illness outbreak in the United States.  He has filed lawsuits against such companies as Chili’s, Chi-Chi’s, Cargill, ConAgra, Dole, Excel, Golden Corral, KFC, McDonald’s, Odwalla, Peanut Corporation of America, Sheetz, Sizzler, Supervalu, Taco Bell and Wendy’s, securing over $600,000,000 for victims of E. coli, Salmonella, 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 frequent media guest on food safety issues and has been profiled in numerous publications.

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 has also received the Public Justice Award from the Washington State Trial Lawyers Association.

All about Clostridium Botulinum ( Botulism )

WHAT IS BOTULISM?

Botulism is a rare but potentially life-threatening bacterial illness. Clostridium Botulinum bacteria grows on food and produces toxins that, when ingested, cause paralysis. Botulism poisoning is extremely rare, but so dangerous that each case is considered a public health emergency. Studies have shown that there is a 35 to 65 percent chance of death for patients who are not treated immediately and effectively with botulism antitoxin.

Infant botulism is the most common form of botulism. See below for symptoms specific to infant botulism.

Most of the botulism cases reported each year come from foods that are not canned properly at home. Botulism from commercially canned food is rare, but commercial canned chili products were identified as the source of a botulism outbreak in 2007.

SYMPTOMS OF BOTULISM

Botulism neurotoxins prevent neurotransmitters from functioning properly. This means that they inhibit motor control. As botulism progresses, the patient experiences paralysis from top to bottom, starting with the eyes and face and moving to the throat, chest, and extremities. When paralysis reaches the chest, death from inability to breathe results unless the patient is ventilated. Symptoms of botulism generally appear 12 to 72 hours after eating contaminated food.  With treatment, illness lasts from 1 to 10 days.  Full recovery from botulism poisoning can take weeks to months.  Some people never fully recover.

In general, symptoms of botulism poisoning include the following:

Nausea
Vomiting
Fatigue
Dizziness
Double vision
Dry skin, mouth and throat
Drooping eyelids
Difficulty swallowing
Slurred speech
Muscle Weakness
Body Aches
Paralysis
Lack of fever

Infant botulism takes on a different form. Symptoms in an infant include lethargy, poor appetite, constipation, drooling, drooping eyelids, a weak cry, and paralysis.

LONG-TERM EFFECTS OF BOTULISM

The majority of botulism patients never fully recover their pre-illness health. After three months to a year of recovery, persisting side-effects are most likely permanent. These long-term effects most often include fatigue, weakness, dizziness, dry mouth, and difficulty performing strenuous tasks. Patients also report a generally less happy and peaceful psychological state than before their illness.

BOTULISM DIAGNOSIS

If a patient displays symptoms of botulism, a doctor will most likely take a blood, stool, or gastric secretion sample. The most common test for botulism is injecting the patient’s blood into a mouse to see whether the mouse displays signs of botulism, since other testing methods take up to a week.

Sometimes botulism can be difficult to diagnose, since symptoms can be mild, or confused with those of Guillan-Barre Syndrome.

TREATMENT OF BOTULISM

If found early, botulism can be treated with an antitoxin that blocks circulation of the toxin in the bloodstream. This prevents the patient’s case from worsening, but recovery still takes several weeks.

PREVENTION OF BOTULISM

Since botulism poisoning most commonly comes from foods improperly canned at home, the most important step in preventing botulism is to follow proper canning procedure. Ohio State University’s Extension Service provides a useful guide to sanitary canning techniques.

Further botulism prevention techniques include:

Not eating canned food if the container is bulging or if it smells bad, although not all strains on Clostridium Botulinum smell
Storing garlic or herb-infused oil in the refrigerator
Not storing baked potatoes at room temperature
To prevent infant botulism, do not give even a small amount of honey to an infant, as honey is one source of infant botulism.

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Botulism outbreaks. The Botulism lawyers of Marler Clark have represented thousands of victims of Botulism 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 Botulism lawyers have litigated Botulism cases stemming from outbreaks traced to carrot juice and chili.

Food Safety Lawyer Bill Marler to Speak at International Association for Food Protection 2014 Meeting in Indianapolis

The Seattle food safety attorney will discuss the infamous Jack in the Box E. coli case and how it changed the way we look at food safety

WHO: Bill Marler of Marler Clark, LLP is an accomplished personal injury and products liability attorney. He began litigating foodborne illness cases in 1993, when he represented Brianne Kiner, the most seriously injured survivor of the Jack in the Box E. coli O157:H7 outbreak.

Marler settled Brianne’s case for $15.6 million, creating a Washington state record for an individual personal injury action. He settled several other Jack in the Box E. coli outbreak cases for more than $1.5 million each.

At IAFP 2014, Marler will walk through the history of the Jack in the Box outbreak and how this terrible tragedy led to necessary changes in food safety – from supply to preparation.

WHAT: Opening Session Lecture – 20 Years Later, Where Were We, Where are We and Where are We Going? at The International Association for Food Protection (IAFP) Annual Meeting, which in 2014 is in Indianapolis, Indiana at the Indiana Convention Center.

WHEN: Sunday, April 3, 2014 from 6:00 PM

WHERE: 500 Ballroom (Indiana Convention Center)

The 1992–1993 Jack in the Box E. coli O157:H7 outbreak was one of the biggest outbreaks in the beef and restaurant industry. The story of Brianne Kiner, the most seriously injured survivor, and how Bill Marler came to represent her is recounted in the nonfiction novel Poisoned by Jeff Benedict.

“It is a privilege to speak at the IAFP and be given a chance to honor those who were sickened and those who died in the outbreak,” said Marler. At the Opening Session Lecture, Marler will also recognize the major breakthroughs over the past 20 years that have occurred in academics, government, and industry, in trying to make our food supply safer.

For media wishing to speak with Bill Marler, please contact Ginger Vaughan (ginger@quinnbrein.com) or Sam Jones (sam@quinnbrein.com) or call 206-842-8922. Also contact us if you would like to attend the conference as Marler’s guest.

Canada Offers Botulism Warnings

What is Infant Botulism?

Infant botulism is a very rare but serious form of illness that can affect children up to one year. It is caused by a bacterium called Clostridium botulinum. This bacteria forms “spores” that when swallowed may grow and produce a poison in the baby’s intestine.

C. botulinum can be found in both pasteurized and unpasteurized honey. Therefore, it is very important to never feed honey to a child under the age of one. As the spores are not easily destroyed by heat (for example by cooking or boiling), it should also not be added to infants’ food as a sweetener. C. botulinum can also be found in soil and dust.

What you should do?

–  Don’t give honey to infants younger than one year of age
–  Don’t add honey to their formula, food or water
–  Don’t put honey on their soother

Older children (more than one year old) can safely eat honey

Signs and Symptoms of Infant Botulism

Constipation is often the first sign of infant botulism that parents notice (although many other illnesses also can cause constipation). Contact your health care provider if your baby hasn’t had a bowel movement for several days.  Other symptoms can include:

–  weakness and/or lack of energy
–  too weak to cry or suck as usual
–  wobbly head because the neck is weak
–  lacks facial expression
–  weak arms and legs
–  has trouble breathing
–  unable to swallow

Botulism:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Botulism outbreaks. The Botulism lawyers of Marler Clark have represented thousands of victims of Botulism 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 Botulism lawyers have litigated Botulism cases stemming from outbreaks traced to carrot juice and chili.

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

Who audits the auditors? How rockmelons can turn deadly

96% and a stellar audit rating did not stop a US rockmelon farm from selling contaminated melons that killed 33 people. How much responsibility should the auditor bear?

In 2011, whole rockmelons contaminated with Listeria monocytogenes sickened 147 and killed 33 people in the US. The rockmelons were traced to Jensen Farms in south-eastern Colorado. The two brothers who owned the farm were indicted with six federal misdemeanor charges for “introducing adulterated food into interstate commerce”. They each faced up to six years in prison plus up to US$1.5 million in fines.

After seeing their farm forced into bankruptcy, Eric and Ryan Jensen have just been sentenced with each receiving five years’ probation, six months of home detention and $150,000 each in restitution fees to victims. Victim families have already received $3.8 million from the Jensens’ insurance policy.

Now consumers have every right to expect that the rockmelon they purchase from the supermarket will not kill them and will not make them sick. But where does responsibility lie for this contamination disaster?

Prior to this case there is no record of whole, unprocessed rockmelons causing sickness. Then there is the matter of auditing.

The Jensen brothers moved their rockmelons through the distributor Frontera Produce to retailers including Walmart and Kroger. Apparently Frontera “required” the farm to be audited by PrimusLabs, a California-based food-safety consultant that provides “internationally recognized audits” for food producers such as Jensen Farms.

Jensen Farms contracted with PrimusLabs for an audit of both its farmlands and its packing house. PrimusLabs then hired a subcontractor, Bio Food Safety, to conduct the actual audit. Just six days before the Listeria outbreak began, Bio Food Safety’s auditor, James Dilorio, gave Jensen Farms 96/100 and a “superior” rating.

There is no question that Jensen Farms was the source of the outbreak and several problem areas have been highlighted. The packing room floor had water puddles, the conveyor and washing system was difficult to clean, the melons were washed in town water without added chlorine sanitizer, the farm-warm melons were not pre-cooled before going into cold storage …

However, if you had just received 96/100 for your food safety audit would you be looking for problems?

The Jensen brothers had no intention of causing anyone any harm – they just wanted to run their farm and make a living for their families. There is no way the brothers could have been charged with murder as there was absolutely no “intention to cause harm”. If the brothers were charged with a felony they could quite justifiably plead “not guilty” and hold their audit results up as proof that they were endeavoring to do the right thing. The matter could stay before the courts for decades.

To avoid this, the brothers were charged with a misdemeanor. Unlike felony convictions, misdemeanor convictions do not require proof of fraudulent intent or even of knowing or willful conduct. All that is required is that the person held a position of responsibility such that they could have prevented the violation. There is no need to even prove that the person knew of the violation – just that they could have stopped it.

The Jensen brothers could have stopped the contamination disaster so they had absolutely no option except to plead guilty.

With the farm bankrupt and each receiving five years’ probation, six months of home detention and $150,000 in restitution fees to victims, the brothers will now be able to sue the auditors, distributor and even the retailers.

Food safety is a basic consumer right and the responsibility for this safety needs to continue through the full distribution chain.

Walmart and Kroger required audits that they knew full well would generate a glowing inspection, all the while ignoring what was there to be seen. They used their market power to squeeze the supply chain of any profit that could have been invested in food safety while covering their own backs by setting the specifications for the “fresh fruits”.

The relationship between retailers and auditor is simply a conspiracy to keep product flowing through the chain of distribution at the lowest cost and an attempt to shield retailers from responsibility for the products they sell.

If the Jensen brothers had not met “Primus Certified” standards and so been “Primus Certified” they could not have sold and distributed their rockmelons in interstate commerce through Frontera.

They would also not be pleading guilty to federal misdemeanors and 33 people would not have died.

It is very easy to say that food processors should check their auditors – but how do you do that? And what can you do when the choice of auditor is dictated by those to whom you are selling your goods?

Food safety is a basic right and it is crucial that when foodborne disease outbreaks occur they are investigated and steps are taken to ensure that the problem cannot happen again.

Reprinted with permission of http://www.foodprocessing.com.au/articles/65435-Who-audits-the-auditors-How-rockmelons-can-turn-deadly.

Michigan Salmonella Outbreak Linked to Pints and Quarts Pub and Grill or C.F. Prime Chophouse & Wine Bar

Public Health Muskegon County is nearing the conclusion of the investigation of an outbreak of Salmonella that has sickened at least 29 people (25 Muskegon County, 4 Ottawa County). Laboratory testing revealed that most cases were caused by Salmonella Enteritidis, a common type of Salmonella associated most often with eggs and poultry. Those sickened had in common a history of consuming meals containing chicken and/or lettuce at Pints and Quarts Pub and Grill or C.F. Prime Chophouse & Wine Bar, which share the same kitchen, in Roosevelt Park between Oct. 30 and Nov. 2, 2013.

“We conducted over 100 interviews with food service workers, restaurant patrons, and others,” explained Ken Kraus, Director of Public Health Muskegon County. “We spoke with those who were ill as well as those who did not get sick to gather as much information as possible about what may have happened during this 4-day period.”

In addition to conducting interviews and gathering food consumption histories, all food-borne illness outbreaks include reviewing food handling processes, exploring the possibility of food cross contamination as well as checking food supply sources.

Human E. coli O157:H7 Illnesses Reduced 50% to 85% with Cattle Vaccine

The University of Glasgow reported today:

Vaccinating cattle against the E. coli O157 bacterium could cut the number of human cases of the disease by 85%, according to scientists.

The bacteria, which cause severe gastrointestinal illness and even death in humans, are spread by consuming contaminated food and water, or by contact with livestock faeces in the environment. Cattle are the main reservoir for the bacterium.

The vaccines that are available for cattle are rarely used, but could be significant.

The research was lead by a team of researchers at the University of Glasgow in collaboration with the University of Edinburgh, the Royal Veterinary College, Scotland’s Rural College, Health Protection Scotland, and the Scottish E. coli O157/VTEC Reference Laboratory.

The study, published in the online journal PNAS, used veterinary, human and molecular data to examine the risks of E. coli O157 transmission from cattle to humans, and to estimate the impact of vaccinating cattle.

The risk of E. coli O157 infection is particularly significant when the cattle are ‘super-shedding’ – excreting extremely high numbers of bacteria in their faeces for a limited period of time. Vaccines against the bacteria exist that can reduce super-shedding.

As a consequence, the researchers predict that vaccinating cattle could reduce human cases by nearly 85 percent, far higher than the 50 percent predicted by studies simply looking at the efficacy of current vaccines in cattle.

These figures provide strong support for the adoption of vaccines by the livestock industry, and work is now underway to establish the economic basis for such a programme of vaccination. In addition, research is continuing in Scotland by the same collaborative grouping to develop even more effective vaccines that would further reduce the impact on human disease.

Lead author, Dr Louise Matthews, Senior Research Fellow in the Institute of Biodiversity, Animal Health and Comparative Medicine, said: “E. coli O157 is a serious gastrointestinal illness. The economic impact is also serious – for instance studies in the US suggest that healthcare, lost productivity and food product recalls due to E. coli O157 can cost hundreds of millions of dollars each year.

“Treating cattle in order to reduce the number of human cases certainly makes sense from a human health perspective and, while more work is needed to calculate the cost of a vaccination programme, the public health justification must be taken seriously.”

In Scotland, an average of 235 culture positive cases of E. coli O157 infection per year (i.e. people who had the organism in their stools) were notified to Health Protection Scotland from 2008 to 2012.

The vaccines that are available currently have poor take-up: one version in the US is not fully licensed because medicines for veterinary use must show that animal health is improved. This is problematic because E. coli O157 does not harm cattle and assessing the impact of treatment involves coordination between human and veterinary health practitioners.

Senior author Professor Stuart Reid of the Royal Veterinary College added: “We increasingly recognise the fact that we share a common environment with the animals we keep – and inevitably the pathogens they harbour. This study is an excellent example the interface between veterinary and human medicine and of the concept of ‘One Health’ in action – controlling infections in animals can have a major impact on public health.”

One year ago Kansas State reported:

A commercial vaccine for cattle can effectively reduce levels of E. coli by more than 50 percent, a Kansas State University study has found. The vaccine is also effective using two doses instead of the recommended three doses, which can help cut costs for the beef industry.

David Renter, associate professor of epidemiology, is the principal investigator on a project that researched the effectiveness of products used to prevent the shedding of E. coli O157:H7 in cattle. The research appears in a recent online version of the journal Vaccine and helps improve current preventative methods for addressing food safety concerns.

While E. coli O157:H7 does not affect cattle, it causes foodborne disease in humans. Vaccines and other products may be given to cattle to help prevent the spread of the bacteria.

“We wanted to test how well these products work to control E. coli O157:H7 in a commercial feedlot with a large population of cattle that were fed in the summer and may be expected to have a high level of E. coli O157:H7,” Renter said.

Other Kansas State University researchers involved include T.G. Nagaraja, university distinguished professor of microbiology; Nora Bello, assistant professor of statistics; Charley Cull, doctoral student in pathobiology, Oakland, Neb.; and Zachary Paddock, doctoral student in pathobiology, Manhattan, Kan. Abram Babcock, an August 2010 Kansas State University doctoral graduate, also was involved in the research.

Using a commercial feedlot setting, the researchers studied more than 17,000 cattle during an 85-day period. They studied two products: a vaccine and a low-dose direct-fed microbial.

“What’s unique about this study is the number of animals we used, the research setting and that we used commercial products in the way that any cattle producer could use them,” Renter said. “We didn’t want it to be any different than the way somebody would use the products in a commercial feedlot.”

The researchers found that the vaccine reduced the number of cattle that were shedding E. coli O157:H7 in feces by more than 50 percent. E. coli shedding was reduced by more than 75 percent among cattle that were high shedders of E. coli. While the vaccine label suggests that it is given in three doses, the researchers found that two doses of the vaccine significantly reduced E. coli.

“Showing that level of efficacy with two doses is really important because a shift to two doses from three could significantly cut costs for the beef industry,” Renter said. “In terms of logistics, it can be difficult for commercial feedlot production systems to vaccinate animals three times. Both of these benefits help when considering how the vaccine can be adopted and implemented in the industry.”

The researchers also discovered that the low-dose direct-fed microbial product did not work as well as the vaccine. Renter said while the study used a lower dose of the direct-fed microbial and could find no evidence that it reduced E. coli shredding, it is possible that the direct-fed microbial product is more effective at a higher dose.

“This vaccine is an option for reducing E. coli,” Renter said. “We have shown that this vaccine works and that it is a tool that could be adopted in the industry.”

Westside Market – Marler Clark Calls for Hepatitis A Vaccinations for All Foodservice Workers – Again

New Yorkers are again being urged to stand in line and get Hepatitis A vaccines or Immune Globulin (Ig) shots to prevent the infection and further spread of hepatitis A after being exposed to a hepatitis A infected foodservice worker – this time at the Westside Market.

Hardly a month passes without a warning from a health department somewhere that an infected food handler is the source of yet another potential hepatitis A outbreak. Absent vaccinations of food handlers, combined with an effective and rigorous hand washing policy, there will continue to be more hepatitis A outbreaks. It is time for health departments across the country to require vaccinations of foodservice workers, especially those that serve the very young and the elderly.

Hepatitis A is a communicable disease that spreads from person-to-person. It is spread almost exclusively through fecal-oral contact, generally from person-to-person, or via contaminated food or water. Hepatitis A is the only foodborne illness that is vaccine preventable.  According to the Centers for Disease Control and Prevention (CDC), since the inception of the vaccine, rates of infection have declined 92 percent.

The Centers for Disease Control (CDC) estimate that 83,000 cases of hepatitis A occur in the United States every year, and that many of these cases are related to food-borne transmission. In 1999, over 10,000 people were hospitalized due to hepatitis A infections and 83 people died. In 2003, 650 people became sickened, 4 died and nearly 10,000 people got Ig shots after eating at a Pennsylvania restaurant. Not only do customers get sick, but also businesses lose customers or some simply go out of business.

Although the CDC has not yet called for mandatory vaccination of foodservice workers, it has repeatedly pointed out that the consumption of worker-contaminated food is a major cause of food-borne illness in the United States.

Hepatitis A continues to be one of the most frequently reported, vaccine-preventable diseases in the United States, despite the FDA-approval of hepatitis A vaccine in 1995. Widespread vaccination of appropriate susceptible populations would substantially lower disease incidence and potentially eliminate indigenous transmission of hepatitis A infections. Vaccinations cost about $50. The major economic reason that these preventative shots have not been used is because of the high turnover rate of foodservice employees. Eating out becomes a whole lot less of a gamble, if all foodservice workers faced the same requirement.

According to the CDC, the costs associated with hepatitis A are substantial. Between 11% and 22% of persons who have hepatitis A are hospitalized. Adults who become ill lose an average of 27 days of work. Health departments incur substantial costs in providing post-exposure prophylaxis to an average of 11 contacts per case. Average costs (direct and indirect) of hepatitis A range from $1,817 to $2,459 per case for adults and from $433 to $1,492 per case for children less than 18 years of age. In 1989, the estimated annual direct and indirect costs of hepatitis A in the United States were more than $200 million, equivalent to more than $300 million in 1997 dollars.  A new CDC report shows in 2010 just over 10 percent of people between the ages of 19 and 49 years old got a Hepatitis A shot.

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 Subway, McDonald’s, Chipotle, Quiznos, Chi-Chi’s and Carl’s Jr.

NYC HEALTH DEPARTMENT WARNS PATRONS OF AN UPPER WEST SIDE MARKET AT 97TH AND BROADWAY OF POSSIBLE EXPOSURE TO HEPATITIS A FROM AUGUST 9th TO AUGUST 22nd

Customers who ate Chopped, Ready-to-Eat Fruit from the Westside Market (2589 Broadway btwn. 97th and 98th) Between Those Dates Should Get Hepatitis A Vaccine as a Precautionary Measure

No Current Reports of Hepatitis A in Customers

August 22, 2013 – In response to a case of hepatitis A in a food handler at Westside Market located at 2589 Broadway between 97th and 98th street, on the Upper West Side, the Health Department is urging patrons who ate chopped, ready-to-eat fruit either in-store, through catering or delivery between August 9th and August 22nd to get hepatitis A vaccination as a precautionary measure. Fruits involved include those packaged in plastic containers and sold in the refrigerated case immediately to the left as you enter the store and includes watermelon cut into halves and quarters; peeled whole pineapples; and shelled and cut coconut. Hepatitis A is spread by eating food (even though it might look clean) that has been contaminated with traces of fecal matter from an infected person. Symptoms include jaundice (yellowing of eyes and skin), fatigue, abdominal pain, nausea, and diarrhea. People typically develop symptoms of hepatitis A

infection about one month (range is 15 to 50 days) after they are exposed to the virus. However, if people are vaccinated within 14 days of exposure, it can prevent the disease from occurring.

Any person who ate chopped, ready-to-eat fruit from the Westside Market either in-store, through catering or delivery from August 9th to August 22nd is considered at risk and is recommended to receive a preventive vaccine. The Health Department has already worked with the store to ensure all of the remaining ready-to-eat fruit with expiration dates within the at-risk time period have been destroyed.

The Westside Market is cooperating fully with the Health Department, and estimates that it sells approximately 100 ready-to-eat fruit containers per day.

People can visit their regular doctor to receive this shot. The Health Department will offer free hepatitis A vaccinations starting tomorrow at MS 258: Community Action School located at 154 West 93rd Street New York, NY 10025 at the following times:

Friday, August 23: 2pm – 8pm Saturday, August 24: 10am – 2pm Sunday, August 25: 2pm – 6pm

Monday, August 26: 2pm – 8pm

*(Those with insurance, please bring your insurance card with you)

People who were exposed but have already received two doses of hepatitis A vaccine sometime in their life do not need another shot; all others should be vaccinated. Pregnant women are urged to consult with their doctor to discuss whether to receive vaccine or a different preventive treatment.

“We are asking these store patrons to get this vaccination as a precautionary measure,” said Health Commissioner Dr. Thomas Farley. “If people experience symptoms, they should see a doctor immediately. This incident serves as an important reminder to always wash your hands thoroughly to prevent the spread of disease.”

About Hepatitis

Hepatitis type A is a liver disease caused by a virus. It is spread from person to person by putting something in the mouth (even though it might look clean) that has been contaminated with traces of fecal matter from an infected person. There are no special medicines or antibiotics that can be used to treat a person once the symptoms appear. While some people who have chronic liver disease or a weakened immune system could experience more severe illness and require hospitalization, hepatitis A is rarely fatal (fewer than 1% of cases).

In order for the vaccine to be most effective, people who have been exposed to hepatitis A should be vaccinated within 14 days. The earlier the vaccine is given, the more effective it is in preventing the disease.

About the Investigation

The Health Department investigates all cases of hepatitis A in New York City. The Department was notified of this case on August 21, began the investigation, and inspected today. An average of 65 cases of hepatitis A occur in New York City each year, with 1-2 occurring in food handlers.

If you would like vaccination location and hours or incident updates sent directly to your phone, you may text HEPA to 877877.

Tracking Twitter may enhance monitoring of food safety at restaurants

A new system could tell you how likely it is for you to become ill if you visit a particular restaurant by ‘listening’ to the tweets from other restaurant patrons.

The University of Rochester researchers say their system, nEmesis, can help people make more informed decisions, and it also has the potential to complement traditional public health methods for monitoring food safety, such as restaurant inspections. For example, it could enable what they call “adaptive inspections,” inspections guided in part by the real-time information that nEmesis provides.

The system combines machine-learning and crowdsourcing techniques to analyze millions of tweets to find people reporting food poisoning symptoms following a restaurant visit. This volume of tweets would be impossible to analyze manually, the researchers note. Over a four-month period, the system collected 3.8 million tweets from more than 94,000 unique users in New York City, traced 23,000 restaurant visitors, and found 480 reports of likely food poisoning. They also found they correlate fairly well with public inspection data by the local health department, as the researchers describe in a paper to be presented at the Conference on Human Computation & Crowdsourcing in Palm Springs, Calif., in November.

The system ranks restaurants according to how likely it is for someone to become ill after visiting that restaurant.

“The Twitter reports are not an exact indicator – any individual case could well be due to factors unrelated to the restaurant meal – but in aggregate the numbers are revealing,” said Henry Kautz, chair of the computer science department at the University of Rochester and co-author of the paper. In other words, a “seemingly random collection of online rants becomes an actionable alert,” according to Kautz, which can help detect cases of foodborne illness in a timely manner.

nEmesis “listens” to relevant public tweets and detects restaurant visits by matching up where a person tweets from and the known locations of restaurants. People will often tweet from their phones or other mobile devices, which are GPS enabled. This means that tweets can be “geotagged”: the tweet not only provides information in the 140 characters allowed, but also about where the user was at the time.

If a user tweets from a location that is determined to be a restaurant (by using the locations of 24,904 restaurants that had been visited by the Department of Health and Mental Hygiene in New York City), the system will continue to track this person’s tweets for 72 hours, even when they’re not geotagged, or when they are tweeted from a different device. If a user then tweets about feeling ill, the system captures the information that this person is now ill and had visited a specific restaurant.

The correlation between the Twitter data and the public inspection data means that about one third of the inspection scores could be reliably predicted from the Twitter data. The remainder of the scores show some disagreement. “This disagreement is interesting as the public inspection data is not perfect either,” argued co-author Adam Sadilek, formerly a colleague of Kautz at Rochester and who is now at Google. “The adaptive inspections could reveal the real risk, which is currently hidden for both methods.”

This work builds on earlier work by Kautz and Sadilek that used Twitter to find out how likely a specific user was to have flu-like symptoms, and also to find the influence of different lifestyle factors on health. At the heart of all this work is the algorithm that Sadilek developed to distinguish between tweets that suggest a person tweeting is sick and those that don’t. This algorithm is based on machine-learning, or as Sadilek described it, “it’s like teaching a baby a new language,” only in this case it’s a computational algorithm that is being taught.

In their new system, nEmesis, they brought in an extra layer of complexity to improve the algorithm; they used crowdsourcing. For any one person, it would be exhausting and time-consuming to look through thousands of tweets to categorize them. The end results might not even be very accurate if their judgment is not quite right.

Instead the researchers turned to Amazon’s Mechanical Turk system to reach out to a crowd of readily available workers. These were paid small amounts of money to categorize some tweets that could then be used to train the algorithm. They ensured the pool of tweets they were going use was of high accuracy by having more than one worker look at each tweet and incentivizing the right answer by paying the workers when their answer agreed with that of the majority and deducting money when it didn’t. The algorithm was then able to learn from the training samples how to spot tweets that show people that are likely to have foodborne illnesses.

Of course, the system only considers people who tweet, who might not even be a representative sample of the whole population or of the population visiting a restaurant. But the Twitter data can be used together with knowledge gained from other sources to detect foodborne illness in a timely manner. It provides an extra layer – a passive level of monitoring – which is cost-effective. And the information that nEmesis offers can benefit both Twitter and non-Twitter users.

Rochester researchers Sean Brennan, graduate student, and Vincent Silenzio, associate professor of psychiatry, are also both part of the team that worked on nEmesis.