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Food Poison Journal

Food Poisoning Outbreaks and Litigation: Surveillance and Analysis

CDC: Salmonella Papayas from Mexico – “When in doubt, don’t eat it; just throw it out”

As of August 9, 2017, 141 people infected with the outbreak strains of Salmonella Kiambu (51) or Salmonella Thompson (90) have been reported from 19 states. Connecticut 5, Delaware 4, Iowa 2, Illinois 2, Kentucky 3, Louisiana 2, Maryland 8, Massachusetts 6, Michigan 1, Minnesota 4, North Carolina 3, New Jersey 27, New York 39, Ohio 1, Oklahoma 4, Pennsylvania 8, Texas 7, Virginia 14, Wisconsin 1, Total 141

Illnesses started on dates ranging from May 17, 2017 to July 27, 2017. Ill people range in age from less than 1 year to 95, with a median age of 39. Among 136 ill people with available information, 83 (61%) are female. Among 98 people with available information, 66 (67%) are of Hispanic ethnicity. Among 103 people with available information, 45 (44%) have been hospitalized. One death was reported from New York City.

Illnesses that occurred after July 14, 2017, might not be reported yet due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 4 weeks.

Based on information collected to date, CDC is now recommending that consumers not eat Maradol papayas from the Carica de Campeche farm in Mexico. If consumers aren’t sure if their Maradol papaya came from the Carica de Campeche farm, they should ask the place of purchase. When in doubt, don’t eat it; just throw it out. Restaurants and retailers should not serve or sell Maradol papayas from the Carica de Campeche farm.

As was reported in the last update on August 4, FDA tested other papayas imported from Mexico and isolated several types of Salmonella bacteria, including Salmonella Agona, Salmonella Kiambu, Salmonella Gaminara, Salmonella Thompson, and Salmonella Senftenberg. CDC is working to determine if there are any illnesses with these other types of Salmonella linked to this outbreak.

The FDA is advising consumers not to eat Maradol papayas from the Carica de Campeche farm in Mexico because they are linked to an outbreak of salmonellosis.

Three brands of Maradol papayas have been recalled: Caribeña brand, distributed by Grande Produce; certain Cavi brand papayas distributed by Agroson’s; and Valery brand papayas, distributed by Freshtex Produce, LLC. If anyone has these papayas in their home, they should dispose of them immediately.

The Cyclospora Parasite Sickens Hundreds in United States

According to Food Safety News, Federal health officials are asking health care providers across the country to be on the lookout for foodborne infections from the Cyclospora parasite because more than double the number of cases have already been confirmed this year and the peak season is not yet ended.

From May 1 through Aug. 2 this year in the United States there were 206 confirmed cases of cyclosporiasis, compared with 80 confirmed cases during that time period in 2016, according to an advisory posted Monday by the Centers for Disease Control and Prevention. Such advisories are relatively rare, with Monday’s being only the sixth from the CDC this year.

“At this time, no specific vehicle of interest has been identified, and investigations to identify a potential source of infection are ongoing. It is too early to say whether cases of Cyclospora infection in different states are related to each other and/or to the same food item(s),” according to the CDC advisory.

“Previous outbreaks in the United States have been linked to various types of imported fresh produce — e.g., basil, cilantro, mesclun lettuce, raspberries, and snow peas.”

The CDC advisory did not include a state-by-state breakdown of confirmed infections, but it did report that at least 18 people have required hospitalization. The 206 confirmed infections have been reported from 27 states, most of which have reported relatively few cases, CDC reported.

On Aug. 1 the Texas Department of State Health Services reported confirmed cases in the Lone Star state had more than doubled in the second half of July, increasing from 68 on July 17 to 160 as of Aug. 1.

The NYC Health Department reported on July 24 that it has been tracking an increase of Cyclospora parasite infections there. A total of 27 cases were reported between Jan. 1 – June 30, 2017, compared to 13 cases in 2016, and 21 cases in 2015 during the same time period,” the New York City department reported.

What is Cyclospora?

Cyclospora is a parasite composed of one cell, too small to be seen without a microscope. The organism was previously thought to be a blue-green alga or a large form of cryptosporidium. Cyclospora cayetanensis is the only species of this organism found in humans. The first known human cases of illness caused by cyclospora infection (that is, cyclosporiasis) were first discovered in 1977. An increase in the number of cases being reported began in the mid-1980s, in part due to the availability of better diagnostic techniques. Over 15,000 cases are estimated to occur in the United States each year. The first recorded Cyclospora outbreak in North America occurred in 1990 and was linked to contaminated water. Since then, several cyclosporiasis outbreaks have been reported in the U.S. and Canada, many associated with eating fresh fruits or vegetables. In some developing countries, cyclosporiasis is common among the population and travelers to those areas have become infected as well.  See, www.outbreakdatabase.com for past outbreaks related to Cyclospora cayetanensis.

Where does Cyclospora come from?

Cyclospora is spread when people ingest water or food contaminated with infected stool. For example, exposure to contaminated water among farm workers may have been the original source of the parasite in raspberry-associated outbreaks in North America.

Cyclospora needs time (one to several weeks) after being passed in a bowel movement to become infectious. Therefore, it is unlikely that Cyclospora is passed directly from one person to another. It is not known whether or not animals can be infected and pass infection to people.

What are the typical symptoms of Cyclospora infection?

Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea, bloating, increased gas, stomach cramps, and loss of appetite, nausea, low-grade fever, and fatigue. In some cases, vomiting, explosive diarrhea, muscle aches, and substantial weight loss can occur. Some people who are infected with Cyclospora do not have any symptoms. Symptoms generally appear about a week after infection. If not treated, the illness may last from a few days up to six weeks. Symptoms may also recur one or more times. In addition, people who have previously been infected with Cyclospora can become infected again.

What are the serious and long-term risks of Cyclospora infection?

Cyclospora has been associated with a variety of chronic complications such as Guillain-Barre syndrome, reactive arthritis or Reiter’s syndrome, biliary disease, and acalculous cholecystitis. Since Cyclospora infections tend to respond to the appropriate treatment, complications are more likely to occur in individuals who are not treated or not treated promptly. Extraintestinal infection also appears to occur more commonly in individuals with a compromised immune system.

How is Cyclospora infection detected?

Your health care provider may ask you to submit stool specimen for analysis. Because testing for Cyclospora infection can be difficult, you may be asked to submit several stool specimens over several days. Identification of this parasite in stool requires special laboratory tests that are not routinely done. Therefore, your health care provider should specifically request testing for Cyclospora if it is suspected. Your health care provider might have your stool checked for other organisms that can cause similar symptoms.

How is Cyclospora infection treated?

The recommended treatment for infection with cyclospora is a combination of two antibiotics, trimethoprim-sulfamethoxazole, also known as Bactrim, Septra, or Cotrim. People who have diarrhea should rest and drink plenty of fluids. No alternative drugs have been identified yet for people with Cyclospora infection who are unable to take sulfa drugs. Some experimental studies, however, have suggested that ciprofloxacin or nitazoxanide may be effective, although to a lesser degree than trimethoprim-sulfamethoxazole. See your health care provider to discuss alternative treatment options.

How can Cyclospora infection be prevented?

Avoiding water or food that may be contaminated is advisable when traveling. Drinking bottled or boiled water and avoiding fresh ready-to-eat produce should help to reduce the risk of infection in regions with high rates of infection. Improving sanitary conditions in developing regions with poor environmental and economic conditions is likely to help to reduce exposure.

Washing fresh fruits and vegetables at home may help to remove some of the organisms, but Cyclospora may remain on produce even after washing.

Mama C’s Donuts sickens 266 with Norovirus

A Norovirus outbreak that was traced back to Mama C’s Donuts sickened 266 people. That number continues to climb, according to the Toledo-Lucas County Health Department.

The department also believes the virus was foodborne instead of an environmental issue.

“I would suspect this is a foodborne illness. Again, Norovirus is a flu-like stomach bug, if you will. And that’s what we see, that’s what it’s pointing to again. Where did it actually come from? Was it food contact surface or was it an affected food service worker?” said health commissioner Eric Zgodinski. 

The Toledo-Lucas County Health Department said the outbreak is tied to Mama C’s Donuts located on Conant Street in Maumee. The restaurant remains closed during the investigation.

All those affected by the virus had eaten at the restaurant from August 4 to August 7.

The restaurant voluntarily closed for cleaning on August 8. 

Symptoms of Norovirus include diarrhea, vomiting, abdominal pain, headaches, body aches and a mild fever. 

The health department said people typically become sick 24 to 48 hours after exposure to the virus, with symptoms lasting one to two days.

However, people who had the virus can spread it up to two weeks after the symptoms go away. 

Norovirus is spread through contact with infected individuals or through contaminated food prepared by a person who is currently or was recently ill.

The health department said Norovirus is common this time of year, and those affected should refrain from handling and working with food for at least three days after their symptoms go away.

Positive E. coli Test Prompts Recall

Good Food Concepts, LLC., a Colorado Springs, Colo. establishment, is recalling approximately 1,290 pounds of raw intact and non-intact beef because the products may be contaminated with E. coli O26, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The raw intact and non-intact beef items were processed and packaged on Aug. 3 and Aug. 4, 2017. The following products are subject to recall: [View Labels (PDF Only)]

  • Various weights of individual packages of “CALLICRATE BEEF, Celebrate goodness, Celebrate life, Filet Mignon,” with lot code 170731CC.
  • Various weights of individual packages of “CALLICRATE BEEF, Celebrate goodness, Celebrate life, Brisket Flat,” with lot code 170731CC.
  • Various weights of individual packages of “CALLICRATE BEEF, Celebrate goodness, Celebrate life, Sirloin Tip,” with lot code 170731CC.
  • Various weights of individual packages of “CALLICRATE BEEF, Celebrate goodness, Celebrate life, Ribeye,” with lot code 170731CC.
  • Various weights of individual packages of “CALLICRATE BEEF, Celebrate goodness, Celebrate life, Stew Meat,” with lot code 170731CC.
  • Various weights of individual packages of “CALLICRATE BEEF, Celebrate goodness, Celebrate life, New York Strip,” with lot code 170731CC.
  • Various weights of individual packages of “CALLICRATE BEEF, Celebrate goodness, Celebrate life, Skirt Steak,” with lot code 170731CC.
  • Various weights of individual packages of “CALLICRATE BEEF, Celebrate goodness, Celebrate life, Top Sirloin,” with lot code 170731CC.
  • Cases of 14.60-lb of “RANCH FOODS DIRECT GROUND BEEF 80/20 BEEF,” with lot code 170804.
  • Cases of 6.40-lb of “RANCH FOODS DIRECT GROUND BEEF 80/20” BEEF, with lot code 170803.
  • Cases of 6.40-lb of “RANCH FOODS DIRECT PHILLY MEAT BEEF,” with lot code 170803.
  • Cases of 6.40-lb of “RANCH FOODS DIRECT TOP SIRLOIN STEAK 8oz BEEF,” with lot code 170803.
  • Cases of 40-lb of “RANCH FOODS DIRECT GROUND CHUCK BEEF,” with lot code 170804.
  • Cases of 6.40-lb of “RANCH FOODS DIRECT GROUND BEEF (73/27),” with lot code 170803.
  • Cases of 40-lb of “RANCH FOODS DIRECT FLAT IRON BEEF,” with lot code 170804.
  • Cases of “FAMILY BUNDLE, 4-GROUND BEEF 80% LEAN 20% FAT, 1-LONDON BROIL, 2-PKGS CUBE STEAKS, 6-FLATIRON STEAKS, $91.99” with lot code 170804.
  • Cases of “STEAK BUNDLE, 4-RIBEYE STEAKS, 4-NEW YORK STRIP STEAKS, 4-TOP SIRLOIN STEAKS, 4-FILET MIGNON $174.99” with lot code 170804.
  • Cases of “RIBEYE STEAK BUNDLE, 10-RIBEYE STEAKS, $117.99” with lot code 170803.
  • Cases of “COLORADO BUNDLE, 4-SKIRTS STEAKS, 4-CHUCK EYE STEAKS, 4-TOP SIRLOIN, 2-CHUCK ROAST, 15-GROUND BEEF 80% LEAN 20%FAT, $199.19” with lot code 170804.
  • Cases of 20-lb of “GROUND BEED, 90% LEAN, 10% FAT $125.99” with lot code 170804.
  • Packages of “ALL NATURAL CALLIGRATE BEEF, Celebrate goodness, Celebrate Life, GROUND BEEF.”

The products subject to recall bear establishment number “EST. 27316” inside the USDA mark of inspection. These items were shipped to retail locations, wholesale locations, and restaurants in Colorado Springs, Colorado.

The problem was discovered on Aug. 5, 2017 when plant management at Good Food Concepts, LLC notified FSIS in-plant inspection personnel that they tested a production lot of carcasses they received from the Callicrate Ranch on July 31, 2017. The carcass trimmings from the N60 analysis was positive for non-O157 STEC serogroup O26.