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Food Poison Journal

Food Poisoning Outbreaks and Litigation: Surveillance and Analysis

Listeria Recall: Mom’s Chicken Extra Thin Cutlets

TNUVA USA, a Fairfield, N.J., establishment is recalling approximately 8,316 pounds of Mom’s Chicken Extra Thin Cutlets product due to possible contamination with Listeria monocytogenes (Lm), the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The product was produced on August 18, 2013, and shipped to the company’s distributor in New Jersey. FSIS will post complete store locations as the list becomes available on its website at www.fsis.usda.gov. The following product is subject to recall:

28.8-oz. (1.8 lb.) bags containing “MOM’S CHICKEN EXTRA THIN CUTLETS, THIN-CUT BREADED CUTLET SHAPED CHICKEN BREAST PATTIES.”

Bags bear the Israeli establishment number “209” within the Israeli mark of inspection. The product’s expiration date is February 18, 2015, and bears the following UPC number on the packaging: 843426005866.

The problem was discovered when FSIS personnel conducted a routine sampling of product which tested positive for Lm. FSIS held the product and it did not enter commerce. Further investigation by FSIS determined that other products were produced on the same line without clean up between products. FSIS and the company are concerned that some product may be frozen and in consumers’ freezers. FSIS and the company have received no reports of illnesses associated with consumption of these products.

Consumption of food contaminated with Lm can cause listeriosis, a serious infection that primarily affects older adults, persons with weakened immune systems, and pregnant women and their newborns. Less commonly, persons outside these risk groups are affected.

Listeriosis can cause fever, muscle aches, headache, stiff neck, confusion, loss of balance and convulsions sometimes preceded by diarrhea or other gastrointestinal symptoms. An invasive infection spreads beyond the gastrointestinal tract. In pregnant women, the infection can cause miscarriages, stillbirths, premature delivery or life-threatening infection of the newborn. In addition, serious and sometimes fatal infections in older adults and persons with weakened immune systems. Listeriosis is treated with antibiotics. Persons in the higher-risk categories who experience flu-like symptoms within two months after eating contaminated food should seek medical care and tell the health care provider about eating the contaminated food.

Whole Genome Sequencing Prompts Nut Butter Salmonella Recall

The CDC reports as of August 20, 2014, a total of four persons infected with the outbreak strain of Salmonella Braenderup have been reported from four states since January 1, 2014.

The number of ill persons identified in each state is as follows: Connecticut (1), Iowa (1), Tennessee (1), and Texas (1).  One ill person has been hospitalized. No deaths have been reported.

Collaborative investigation efforts of state, local, and federal public health and regulatory agencies indicate that almond and peanut butter manufactured by nSpired Natural Foods, Inc. is the likely source of this outbreak.

The U.S. Food and Drug Administration (FDA) isolated the same strain of Salmonella Braenderup from environmental samples collected from an nSpired Natural Foods facility during routine inspections in January and July 2014.

Public health investigators are using the PulseNet system to identify cases of illness that may be part of this outbreak. PulseNet, the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC, receives DNA “fingerprints” of Salmonella bacteria obtained through diagnostic testing using pulsed-field gel electrophoresis, or PFGE. Whole genome sequencing, a highly discriminatory subtyping method, was also used to define the outbreak strain. Whole genome sequencing helped clarify which illnesses were related to the outbreak.

On August 19, 2014, nSpired Natural Foods, Inc. voluntarily recalled certain lots of almond and peanut butters because of potential contamination with Salmonella.  The recalled brands include Arrowhead Mills, MaraNatha, Trader Joe’s, Whole Foods, Safeway, and Kroger.  A complete listing of all of the recalled products is available on the FDA website.

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.