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Come on Whataburger – Vaccinate your Employees for Hepatitis A

Health officials are once again alerting the public about possible hepatitis A exposure – this time at that Austin Texas Whataburger in Central Austin. A restaurant employee there at the 2800 Guadalupe St. location has been diagnosed with the hepatitis A virus.  The same officials urge patrons to seek medical advice and treatment.

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 food-service workers, especially those who 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 U.S. Centers for Disease Control and Prevention (CDC), since the inception of the vaccine, rates of infection have declined 92 percent.

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, more than 10,000 people were hospitalized due to hepatitis A infections, and 83 people died. In 2003, 650 people became sickened, four died, and nearly 10,000 people got IG (immunoglobulin) 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 CDC has not yet called for mandatory vaccination of food-service workers, it has repeatedly pointed out that the consumption of worker-contaminated food is a major cause of foodborne illness in the U.S.

Hepatitis A continues to be one of the most frequently reported, vaccine-preventable diseases in the U.S., despite 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 preventive shots have not been used is because of the high turnover rate of food-service employees. Eating out becomes a whole lot less of a gamble if all food-service workers faced the same requirement.

According to CDC, the costs associated with hepatitis A are substantial. Between 11 percent and 22 percent 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 younger than 18. In 1989, the estimated annual direct and indirect costs of hepatitis A in the U.S. were more than $200 million, equivalent to more than $300 million in 1997 dollars.  A new CDC report shows that, in 2010, slightly more than 10 percent of people between the ages of 19 and 49 got a hepatitis A shot.

Vaccinating an employee make sense.  It is moral to protect customers from an illness that can cause serious illness and death. Vaccines also protect the business from the multi-million-dollar fallout that can come if people become ill or if thousands are forced to stand in line to be vaccinated to prevent a more serious problem.

What is it with Peanut Butter and Salmonella?

In 2009 President Obama was quoted:

“At a bare minimum, we should be able to count on our government keeping our kids safe when they eat peanut butter,” the president said.

“That’s what Sasha eats for lunch,” Obama said, referring to his 7-year-old daughter. “Probably three times a week. I don’t want to worry about whether she’s going to get sick as a consequence of eating her lunch.”

The FDA announced on Tuesday that nSpired Natural Foods, Inc. was voluntarily recalling certain retail lots of Arrowhead Mills® Peanut Butters, MaraNatha® Almond Butters and Peanut Butters and specific private label nut butters packaged in glass and plastic jars sold at Trader Joe’s, Whole Foods and other retailers, because they have the potential to be contaminated with Salmonella.  The potential risk was brought to the Company’s attention by the U.S. Food and Drug Administration following routine testing. The Company has received reports of four illnesses that may be associated with these specific products.

So, what is it with Peanut Butter and Salmonella?  Here is a bit of history:

ConAgra Peter Pan & Great Value Peanut Butter Salmonella Outbreak – Nationwide (2006-2007) – The Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) announced that there had been 715 confirmed cases of Salmonella infection in 41 states from August 2006 through May 2007. Although the outbreak slowed, cases continued to be confirmed after this time period. The cases were linked to the consumption of Peter Pan and Great Value brand peanut butter manufactured in ConAgra’s Georgia peanut butter plant. Any Peter Pan or Great Value brand peanut butter beginning with product code 2111 was recalled in response to the outbreak investigation.

Peanut Corporation of America Peanut Butter Salmonella Outbreak – Nationwide (2008-2009) – At least 714 people in 46 states were confirmed ill with Salmonella Typhimurium infection after consuming peanut and peanut butter products produced by Peanut Corporation of America (PCA) in 2008 and 2009.  Nine people died.  The Minnesota health department first listed a product advisory on January 9, 2009, when the presence of Salmonella was detected in King Nut peanut butter.  The outbreak strain of Salmonella was then traced to the Peanut Corporation of America’s Blakely, GA processing facility.  Recalls began with commercially distributed peanut butter, but the list of recalled products quickly grew to include over 3600 products made with peanut butter and peanut paste produced by PCA in the Blakely, GA and Plainview, TX facilities since January 1, 2007. PCA declared Chapter 7 bankruptcy in February of 2009.  PCA principals are presently on trial in Georgia for felonies stemming from this outbreak.

Sunland and Trader Joe’s Peanut Butter Salmonella Outbreak – Multistate (2012) – In September, October and November of 2012, public health officials from at least 20 states, the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration announced that a Salmonella serotype Bredeney outbreak had been traced to the consumption of products made by Sunland, Inc. of New Mexico.  Forty-two people were sickened.  Trader Joe’s Valencia Creamy Salted Peanut Butter made with Sea Salt was the initial product suspected to be the source of the Salmonella outbreak, but further investigation led to the identification of additional nut butter products as potential sources of Salmonella infections.  Sunland issued a recall of peanut butter and nut butter products shortly after the Salmonella outbreak announcement.  Sunland eventually filed for bankruptcy protection.

Makes you think twice when you grab for that jar to make your kid’s peanut butter and jelly sandwich.

Sysco Fined $20M for Food Safety Violations

Vicky Nguyen of NBC San Francisco reports that Sysco Corporation, the world’s largest food distributor, has agreed to pay $19.4 million in penalties and restitution after an NBC Bay Area investigation uncovered the company’s secret food sheds regulators called illegal and unsafe.

Inspectors from the California Department of Public Health (CDPH) launched their investigation into Sysco Corporation last July, after whistleblowers came forward to NBC Bay Area to expose the company’s longstanding practice of storing meat, produce, dairy, and other fresh food in dirty, unrefrigerated, outdoor storage units.  CDPH inspectors combed though company records from July 2009 to August 2013 and found:

  • 25 unregistered drop sites across Sysco’s 7 distribution centers spanning from – Sacramento to San Diego
  • 23,287 cumulative days food was illegally stored
  • 156,740 food items stored in drop sites without temperature controls
  • 405,859 food items stored in illegal drop sites

Last summer, NBC Bay Area witnessed this potentially hazardous process first hand, as the Investigative Unit’s surveillance cameras captured raw food being transported from Sysco’s Fremont distribution center to unrefrigerated storage lockers in Concord and San Jose where it was placed on the floor next to insects and rattraps. The food sat for hours in temperatures as high as 80 degrees before it was picked up by sales associates and delivered to restaurants and hotels.

In a written statement, the Santa Clara District Attorney’s office wrote: “The July 2013 NBC report triggered a state-wide investigation by the California Department of Public Health and, ultimately, an enforcement proceeding brought by the California Food Drug and Medical Device Task.”

Following their investigation (pdf) Santa Cruz and Santa Clara counties ultimately filed suit.

As part of the settlement, Sysco agreed to pay more than $4 million in restitution, including a $1 million food contribution to food banks throughout California and $3.3 million to fund a 5 year state-wide-program aimed at helping health inspectors enforce food transportation laws.

13 Infected by Strain of E. coli O111 Never Before Seen in United States and Tied to Applebee’s Restaurants in Minnesota

Bill Marler—whose privately-funded study lead to O111 being recognized as an adulterant by USDA—applauds proactive approach by chain to protect customers

The Minnesota Department of Health (MDH) is investigating an outbreak of E. coli O111 that has, to date, infected 13 people, including four who required hospitalization. This genetic strain of E. coli O1111 has not been seen in the United States previously.

While seven of the people with E. coli O111 infections reported eating at Applebee’s restaurants in Minnesota between June 24 and 27, there are multiple cases with no apparent connection to the restaurant or otherwise. Even though Applebee’s hasn’t been identified as the definitive source of the outbreak, the restaurant chain is cooperating fully with the investigation and has even voluntarily removed the Oriental Chicken Salad and some of its related ingredients from menus at all its Minnesota locations.

“There’s a grey period during every outbreak when you know the illness is out there, but you don’t know what’s causing it. Sometimes the source is immediately apparent; other times—like in this case—it’s not as clear. I applaud Applebee’s for taking proactive steps to try and minimize any further infections,” said Bill Marler, a prominent food safety attorney and advocate.

Marler has been on the front lines of food safety for more than two decades. Some of his first related clients stemmed from the outbreak E. coli O157: H7 traced back to the fast food chain Jack in the Box in the early 1990s. It was only after that outbreak that the USDA’s Food Safety Inspection Service (FSIS) began to recognize E. coli O157:H7 as an adulterant that needed to be monitored in this nation’s meat supply.

“The monitoring of E. coli O157:H7 by the FSIS was, certainly, an important first step to making our food supply safer, but it really was just the tip of the iceberg,” said Marler, who also represented Minnesota-native Stephanie Smith whose dreams of being a dancer were shattered after she ate a hamburger tainted with O157: H7.

There are many different strains of E. coli, some of which pose no harm to human health. There are other strains though, like E. coli O111—the subject of this most recent outbreak being investigated by the MDH—that can be just as deadly as the dreaded O157:H7. E. coli O111 is one of the so-called “Big Six”, which are non-O157 serogroups of the Shiga-toxin producing E. coli bacterium.

Even though the Big Six, which includes O111, are responsible for 80% of all non-O157 E. coli infections, it wasn’t until 2012—almost 20 years after O157 began to be monitored—when the USDA’s FSIS decided to finally put together a plan to start testing the nation’s meat supply for non-O157 strains of E. coli.

So what made the FSIS change its position? In part, the answer lies in a study funded privately by Marler.

Over the course of his career, Marler had several run-ins with non-O157 strains of E. coli and saw the devastating affect they had on their victims. One of the worst outbreaks was in 2008 when Country Cottage Restaurant in Locust Grove, OK was proven to be the source of an E. coli O111 outbreak that sickened 344, hospitalizing 71. Of those, 26 developed hemolytic uremic syndrome, a serious kidney and blood complication resulting from E. coli infections.

“I had kind of had enough. We were seeing all these cases of non-O157 E. coli strains there were just as harmful, but nothing was being done. The USDA just continued to claim that these strains weren’t in the food supply. It was really frustrating,” said Marler.

In 2008, Marler began working with nationally respected food scientist Mansour Samadpour and, eventually, commissioned a private study—paying $500,000 out of his own pocket—to see how prevalent the Big Six were in the US meat supply, particularly ground beef. The final results revealed about 2% of the U.S. supply is tainted, which translates to millions of pounds of infected beef per year.

Eventually, this study lead to Marler being a part of a small team of food safety advocates who met privately with Dr. Elisabeth Hagan, the USDA’s Under Secretary for Food Safety. After 90 minutes, Marler felt confident that Hagan understood the threats the Big Six posed to public health.

“From a legal perspective, it has never mattered whether one of these pathogens is considered an adulterant, but it does, and should matter, to the average consumer,” said Marler. “I’ve seen what devastation the Big Six strains can cause and, unfortunately, because they have just started to be monitored, it will likely be years before outbreak, like this one, stop being a fairly common occurrence.”

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of E. coli outbreaks and hemolytic uremic syndrome (HUS). The E. coli lawyers of Marler Clark have represented thousands of victims of E. coli and other foodborne illness infections 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 E. coli lawyers have litigated E. coli and HUS cases stemming from outbreaks traced to ground beef, raw milk, lettuce, spinach, sprouts, and other food products. The law firm has brought E. coli lawsuits against such companies as Jack in the Box, Dole, ConAgra, Cargill, and Jimmy John’s. We have proudly represented such victims as Brianne Kiner, Stephanie Smith and Linda Rivera.


Hepatitis A Scare: Fort Collins Tortilla Marissa’s Restaurant

The Larimer County Department of Health and Environment is advising the public about a possible exposure to hepatitis A virus at the Tortilla Marissa’s restaurant located at 2635 S. College Avenue in Fort Collins.

A food worker employed at Tortilla Marissa has tested positive for hepatitis A, a disease that might be passed to others through food directly handled by the employee before any symptoms appeared.  The restaurant is cooperating fully in the investigation and has agreed to voluntarily close until approved by the Department to reopen.  The risk of transmission to others occurred primarily in June 2014, but there is a very low risk that transmission might extend back to May of this year.  As of today, any customers have reported no secondary cases, but the disease has a long incubation period (time from infection to illness) of 14-50 days,

Health Department Recommendations for those who have dined in the past 14 days:

Customers who consumed food or drinks (either dine-in or take-out) from the restaurant in the past 14 days could benefit from getting a Hepatitis A vaccination or Immune Globulin (IG) injection to reduce the risk of illness.

The Larimer County Health Department is recommending vaccine or IG shots for people who have eaten any food prepared at Tortilla Marissa’s if they can obtain preventive treatment within 14 days of their exposure.   Shots can be obtained from private health care providers or at two special clinics the Health Department will be holding on Sunday and Monday specifically for those potentially exposed to Hepatitis A through this restaurant.

The Health Department will be providing shots free-of-charge at the Larimer County Health Department, 1525 Blue Spruce Drive, Fort Collins, on Sunday, June 29th, from noon to 5 p.m. and on Monday, June 30, from 5pm – 8 pm.  These clinics are only for customers who have eaten food prepared at Tortilla Marissa’s since June 15 (for the Sunday clinic) or since June 16 (for the Monday clinic.)  Information about signing up for the two clinics will be posted on the Larimer County website (www.larimer.org) by Saturday afternoon, June 28.  Online pre-registration for the clinics is strongly encouraged; as it will significant reduce wait times to receive services.

Some pharmacies may be able to provide Hepatitis A vaccine, with a physician’s order, for those customers whose 14-day window will expire on June 27 or 28, if they cannot get into their provider’s office. People who have had at least one vaccination for hepatitis A or have had the illness in the past are protected from hepatitis A infection and do NOT need to receive any shots.

People who recently ate at Tortilla Marrisa’s who are not currently in the Larimer County area are urged to contact their state or local public health department or their health care provider to obtain necessary shots if they can do so within the 14-day window.

Health Department Recommendations for those of that dined earlier in June or in May:

Those who ate at the restaurant more than 14 days ago might have been exposed, but a shot would not offer protection from any potential exposure to food from this restaurant.  They should monitor their health and contact their health care provider if hepatitis symptoms develop.

Symptoms of hepatitis A may include fever, tiredness, loss of appetite, nausea, abdominal discomfort, dark urine, gray or white stools, and jaundice (yellowing of the eyes and/or skin).  Symptoms are more severe in adults than children.  For most people, symptoms usually appear about 4 weeks after ingesting the virus.

Anyone who develops symptoms should contact their health care provider and NOT prepare food for others. This is especially important for food workers, health care workers, and day care workers.

Preventing Transmission: Hepatitis A virus is shed in the stool and can be spread when an infected person does not properly wash his or her hands after using the bathroom, and then touches food or objects that others will put into their mouth.  Kissing, hugging, sneezing, or casual contact does NOT spread it.

Thorough hand washing can prevent the spread of hepatitis A virus.  As a prevention measure, people should always wash their hands thoroughly with soap and water after using the bathroom, after diapering, before preparing food, and before eating.

Hepatitis A Risk at Springfield Red Robin

KSPR’s Jeff Phillips reports that Springfield Health officials have now administered more than 2,300 doses of the hepatitis A vaccine. Clinics offered by Mercy Springfield and Cox Health Systems treated a total of 300 people Saturday. Each also ran clinics Sunday in the aftermath of an exposure at the Red Robin restaurant in Springfield this month.

On Monday, vaccinations will be available from noon to 4 at:

Mercy’s urgent care at the Smith Glynn Callaway building at 3231 S. National Avenue and Cox’s urgent care at the Turner Center at 1000 E. Primrose.

On Tuesday, the health department will administer vaccines from 7:30 a.m. to 10 a.m. at the department’s Westside Public Health Center.

On May 20, health department officials learned of a food service worker at the local Red Robin restaurant who had tested positive for Hepatitis A. Individuals potentially exposed to the Hepatitis A virus dined at the restaurant between May 8 and 16.

Hepatitis A Risk at Springfield Missouri Red Robin

The Springfield-Greene County Health Department is vaccinating customers of a Red Robin restaurant in Springfield, MO, who may have been exposed to Hepatitis A between May 8-16.

Health officials are worried that 5,000 people may have been exposed after a restaurant worker was diagnosed with the virus.

In order for the vaccine to work, it must be taken within 14 days of exposure, so the department is working fast to inform the public about its vaccination clinics being held May 22-26.

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.

Time for warning on sprouts?

With well over 40 outbreaks linked to sprouts over the last few decades, perhaps it is time for awarning.

sprouts warn.jpg

As far back as September 1998, the FDA issued a warning against sprouts urging:

children, pregnant women and the elderly should not eat alfalfa sprouts until growers find a way to reduce the risk of a potentially deadly bacteria that infects some sprouts, the Food and Drug Administration said this week. The FDA, which is investigating sprout industry practices, said children, the elderly and people with weakened immune systems should avoid eating sprouts. The agency’s statement, issued Monday, repeated similar but little-noticed advice the U.S. Centers for Disease Control gave to doctors and researchers a year ago.

Here is the CDC warning :

Sprouts Not Healthy Food for Everyone

Children, the elderly, and persons whose immune systems are not functioning well should not eat raw sprouts, because current treatments of seeds and sprouts cannot get rid of all bacteria present.

Persons who are at high risk for complications from foodborne illness should probably not eat raw sprouts, according to an article in the current issue of Emerging Infectious Diseases, CDC’s peer-reviewed journal, which tracks new and reemerging infectious diseases worldwide.

Although sprouts are often considered a “health food,” the warm, humid conditions needed for growing sprouts from seeds are also ideal for bacteria to flourish. Salmonella, E. coli, and other bacteria can grow to high levels without affecting the appearance of the sprouts.

Researchers have treated both seeds and sprouts with heat or washed them in solutions of chlorine, alcohol, and other chemicals. Some of these disinfectants reduced the levels of bacteria, but a potential hazard remained, especially for persons with weak immune systems. High temperatures that would kill the bacteria on the seeds would also keep them from sprouting. Until an effective way is found to prevent illness from sprouts, they should be eaten with caution, if at all.

Jimmy John’s Sickens Customers again with E. coli

KIRO reports that an outbreak of E. coli O21 cases have led state health officials to warn consumers not to eat raw clover sprouts from an Idaho producer. The sprouts under investigation are linked to seven confirmed and three probable cases of E. coli O121 illnesses in Washington and Idaho. Five of those patients were hospitalized; there have been no deaths.

Five cases were reported in Spokane County, two in King County, and three in Kootenai County, Idaho.

The state Health Department said all the cases were reported the first two weeks of May.

Results from initial investigations indicate a strong link to eating raw clover sprouts produced by Evergreen Fresh Sprouts, LLC of Idaho. Sprouts were eaten in sandwiches at several food establishments including Jimmy John’s Gourmet Sandwiches locations in King and Spokane counties, as well as two Pita Pit locations in Spokane County, and Daanen’s Deli as well as a Jimmy John’s location in Kootenai County. The restaurants where the cases reported eating raw clover sprouts have voluntarily suspended serving sprouts.

Sound familiar?

Multistate Jimmy John’s Restaurants Raw Clover Sprouts 2011

14 Sickened (possibly 19) – On February 15, 2012, the Centers for Disease Control announced an ongoing investigation into illnesses linked to the consumption of raw clover sprouts consumed at Jimmy John’s Restaurants in several states. The number of ill persons identified in each state is as follows: Iowa (5), Missouri (3), Kansas (2), Michigan (2), Arkansas (1), and Wisconsin (1). Among 11 ill persons with information available, 10 (91%) reported eating at a Jimmy John’s sandwich restaurant in the 7 days preceding illness. Ill persons reported eating at 9 different locations of Jimmy John’s restaurants in 4 states in the week before becoming ill. One Jimmy John’s restaurant location was identified where more than one ill person reported eating in the week before becoming ill. Among the 10 ill persons who reported eating at a Jimmy John’s restaurant location, 8 (80%) reported eating a sandwich containing sprouts, and 9 (90%) reported eating a sandwich containing lettuce. Currently, no other common grocery stores or restaurants are associated with illnesses. Preliminary traceback information has identified a common lot of clover seeds used to grow clover sprouts served at Jimmy John’s restaurant locations where ill persons ate. FDA and states conducted a traceback that identified two separate sprouting facilities; both used the same lot of seed to grow clover sprouts served at these Jimmy John’s restaurant locations. On February 10, 2012, the seed supplier initiated notification of sprouting facilities that received this lot of clover seed to stop using it. Investigations are ongoing to identify other locations that may have sold clover sprouts grown from this seed lot.

Sprouters Northwest, Jimmy John’s Restaurants Clover Sprouts 2010

7 Sickened – Sprouters Northwest of Kent, Washington, issued a product recall after the company’s clover sprouts had been implicated in an outbreak of Salmonella Newport in Oregon and Washington. At least some of the cases had consumed clover sprouts while at a Jimmy John’s restaurants. Jimmy John’s Restaurants are a restaurant chain that sells sandwiches. Concurrent with this outbreak, a separate Salmonella outbreak (Salmonella, serotype I 4,5,12,i- ; see Multistate Outbreak, Tiny Greens Organic Farm, Jimmy John’s Restaurants), involving alfalfa sprouts served at Jimmy John’s restaurants was under investigation. The recall of Northwest Sprouters products included: clover; clover & onion; spicy sprouts; and deli sprouts. The Sprouters Northwest products had been sold to grocery stores and wholesale operations in Washington, Oregon, Idaho, Alaska, British Columbia, Saskatchewan, and Alberta. The FDA inspection found serious sanitary violations.

Multistate Outbreak, Tiny Greens Organic Farm, Jimmy John’s Restaurants Alfalfa Sprouts 2010

140 Sickened – On December 17, the Illinois Department of Health announced that an investigation was underway into an outbreak of Salmonella, serotype I4,[5],12:i:-. Many of the Illinois cases had eaten alfalfa sprouts at various Jimmy John’s restaurants in the Illinois counties of: Adams, Champaign, Cook, DuPage, Kankakee, Macon, McHenry, McLean, Peoria, and Will counties. The sprouts were suspected to be the cause of the illnesses. On December 21, Jimmy John Liautaud, the owner of the franchised restaurant chain, requested that all franchisees remove sprouts from the menu as a “precautionary” measure. On December 23, the Centers for Disease Control revealed that outbreak cases had been detected in other states and that the outbreak was linked with eating alfalfa sprouts while at a nationwide sandwich chain. On December 26, preliminary results of the investigation indicated a link to eating Tiny Greens’ Alfalfa Sprouts at Jimmy John’s restaurant outlets. The FDA subsequently advised consumers and restaurants to avoid Tiny Greens Brand Alfalfa Sprouts and Spicy Sprouts produced by Tiny Greens Organic Farm of Urbana, Illinois. The Spicy Sprouts contained alfalfa, radish and clover sprouts. On January 14, 2011, it was revealed that the FDA had isolated Salmonella serotype I4,[5],12:i:- from a water runoff sample collected from Tiny Greens Organic Farm; the Salmonella isolated was indistinguishable from the outbreak strain. The several FDA inspections of the sprout growing facility revealed factors that likely led to contamination of the sprouts.

CW Sprouts, Inc., SunSprout Sprouts, “restaurant chain (Chain A),” a.k.a. Jimmy Johns 2009

256 Sickened – In February, Nebraska Department of Health and Human Services officials identified six isolates of Salmonella Saintpaul. Although this is a common strain of Salmonella, during 2008, only three cases had been detected in Nebraska and only four subtypes of this outbreak strain had been identified in 2008 in the entire USA. As additional reports were made, a case control study was conducted; alfalfa sprout consumption was found to be significantly related to illness. The initial tracebacks of the sprouts indicated that although the sprouts had been distributed by various companies, the sprouts from the first cases originated from the same sprouting facility in Omaha, Nebraska. Forty-two of the illnesses beginning on March 15 were attributed to sprout growing facilities in other states; these facilities had obtained seed from the same seed producer, Caudill Seed Company of Kentucky. The implicated seeds had been sold in many states. On April 26, the FDA and CDC recommended that consumers not eat raw alfalfa sprouts, including sprout blends containing alfalfa sprouts. In May, FDA alerted sprout growers and retailers that a seed supplier, Caudill Seed Company of Kentucky, was withdrawing all alfalfa seeds with a specific three-digit prefix.  Many of the illnesses occurred at “restaurant chain (Chain A).