Food Poisoning Lawyer & Attorney : Marler Clark : Food Poison Journal

Sprouts are a food item that have been associated with outbreaks of foodborne disease on multiple occasions in the past decade, including a major Salmonella saintpaul outbreak between February and April of 2009.  In the 2009 outbreak, the CDC counted 235 confirmed outbreak victims, and likely thousands more people across the country were sickened. 

Today,the FDA issued a press release on a Louisiana sprout company that is doing its sprout-growing brethren across the country a major disservice by staying in business.  Hopefully, the FDA's actions will shut the company down permanently.  The press release states as follows:  

The Department of Justice, in an action initiated by the U.S. Food and Drug Administration, is seeking a permanent injunction against A Chau Sprouting Co., a sprout grower in Gretna, La., company owner and manager Quang “Mike” Trinh, and Hue Nguyen, the company production manager.

The complaint, filed on March 16, 2010, in the U.S. District Court for the Eastern District of Louisiana, charges the defendants with violating the Federal Food, Drug, and Cosmetic Act by preparing, packing, and holding sprouts under insanitary conditions, where they may have become contaminated with filth.

“The agency has repeatedly warned the company over several years that corrective actions need to be taken in this facility,” said Michael Chappell, acting associate commissioner for regulatory affairs at the FDA. “While no illnesses have been reported to date, this action is necessary to ensure that it remains that way.”

The ready-to-eat sprouts are distributed to wholesale suppliers, who in turn distribute them to customers located in Gulf Coast states, including Louisiana, Mississippi, Alabama, Florida, and Texas.

Five FDA inspections over the past nine years, including an inspection conducted between August 2009 and September 2009, revealed that the defendants failed to implement basic food sanitation principles and practices for their sprout growing operation, according to the complaint.

The complaint alleges violations that include equipment and facilities that were unclean or unable to be sufficiently cleaned, insanitary employee practices, and a poorly maintained facility.

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The massive Salmonella Saintpaul outbreak from February through April 2009 was featured in a story by WHAS 11 News in Louisville, Kentucky.  Drew Falkenstein spoke with Channel 11's Adam Walser about the outbreak:

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From February through May of 2009, the CDC counted 235 confirmed victims of a Salmonella Saintpaul outbreak linked to alfalfa sprouts.  Here is the distribution of confirmed cases in the outbreak:

Nebraska was the hardest hit state by far, with 111 confirmed illnesses, many of whom consumed alfalfa sprouts on sandwiches from Jimmy John's restaurants.  South Dakota had the second most illnesses with 38. 

Investigating health authorities ultimately determined that sprout seeds distributed by a major seed distribution company called Caudill Seed (Louisville , KY) had been contaminated with Salmonella. 

The outbreak occurred in two phases.  The first phase, causing illness primarily in the midwest, occurred in February and March 2009, and the contaminated sprouts were grown by CW Sprouts, an Omaha Nebraska company.  The chlorine treatment methods used by CW Sprouts were inadequate to eliminate the bacteria from the contaminated seeds that Caudill Seed had distributed to CW. 

The second phase of the outbreak occurred shortly after the first, causing Salmonella infection by genetically indistinguishable bacteria from the CW Sprouts phase of the outbreak.  But CW Sprouts did not distribute to many of the states affected by the second phase.  The sprouts implicated in the second phase had been grown by multiple sprout growers from seeds produced and sold by Caudill Seed.  In fact, the seeds in both phases of this large outbreak came from the same lot (032) of Caudill's seeds.

Marler Clark represents nine people in this outbreak, mostly from the State of Nebraska.  Three lawsuits have been filed. 

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The Meat Trade News Daily misses only a couple major food safety issues (i.e. outbreaks) in yesterdays summary of ten major food stories in 2009.  In the blog post, titled "USA - Food Safety a Bloody Disgrace," MTND includes: 

1.  Stephanie Smith's E. coli O157:H7 and HUS illness from eating a contaminated Cargill ground beef patty.  Stephanie has sued Cargill for $100,000,000.

2.  Linda Rivera's E. coli O157:H7 and HUS illness from eating contaminated Nestle cookie dough.

3.  Peanut Corporation of America's Salmonella Typhimurium outbreak, remarkable for a lot of things, not least of which the depth of its seemingly utter disdain for the wellbeing of consumers.

4.  The Salmonella Newport (an antibiotic resistant strain) outbreak linked to Cargill ground beef.

5.  President Obama's failure to nominate somebody, despite having served for almost a year--a year marked by, well, see above and below--for the position of Undersecretary of Food Safety at the USDA.

6.  The Milan, Illinois McDonald's Hepatitis A outbreak, lacking only an ounce of intent in its comarability to the actions of PCA and Stewart Parnell.

7.  The Organic Pastures E. coli O157:H7 outbreak linked to raw milk.

8.  The E. coli O157:H7 outbreak linked to JBS beef.

9.  A Chinese court's acceptance of the first lawsuit to arise from the 2008 melamine scandal linked to tainted milk, which killed 6 babies and sickened about 300,000.

10.  The "food fight" sparked by the Center for Science in the Public Interest's report on the ten riskiest foods regulated by the FDA.

A good list.  I would add many more if there was room in a list of ten, but two are certainly worthy of emphasis:

1.  The E. coli O157:H7 outbreak, announced in a Christmas Eve press release, linked to tenderized beef products produced by National Steak and Poultry.

2.  The large Salmonella Saintpaul outbreak from January through April linked to contaminated sprouts.  Ultimately, at least 228 people were sickened in the outbreak from 13 states.

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The FDA announced recently another recall of sprouts.  Here is the release:

Kowalke Family Sprouts of Los Angeles CA is recalling all Kowalke Family Sprouts Brand Alfalfa Products with sell-by dates from June 18 through June 30 because they may be contaminated with Salmonella, which can cause serious illness. Mike’s Produce, Inc. dba Kowalke Family Sprouts is voluntarily recalling the alfalfa products after receiving notification that a surveillance sample taken at a retail location with a June 21 sell-by date tested positive for Salmonella.

No illnesses have been reported from these products. Kowalke Family Sprouts has informed the Food and Drug Administration of its actions and is fully cooperating with the Agency.

The alfalfa sprouts tested negative for the presence of Salmonella prior to being shipped to retailers. Nonetheless, the firm is recalling all sprouts from this seed lot out of abundance of caution in response to being notified of alfalfa sprout seeds that may have been contaminated with Salmonella.

Kowalke Family Sprouts meets all FDA disinfection, processing, and pathogen testing guidelines. In addition, the FDA tested for the presence of Salmonella on sprout growing equipment, food contact surfaces, walls, floors, and drains at the Kowalke Family Sprouts facility. All tests results were negative. The FDA found no Salmonella at the Kowalke Family Sprouts facility.

Kowalke alfalfa products are sold in 4 oz, 8 oz, 1 pound and 5 pound clear plastic, clam shell packages. Two other Kowalke products also contain alfalfa sprouts - the Dinner Salad in a 6 oz package and the Onion/Alfalfa Mix in a 4 oz package.

These products were sold to produce distributors in Los Angeles and to retail stores in Southern California, Nevada, and Arizona. It is possible the sprouts may have been transported to other states.
 

I will note that the Kowalke seems to have done the right thing in initiating a voluntary recall after receiving a positive test result for Salmonella on product back in June.  We hope that the recall had its intended effect.  Too many have become ill from sprouts lately.

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We are in the midst of another sprouts recall.    Sprouts from Kowalke Organics from Culver City, California are being pulled from shelves over potential contamination with Salmonella.    According to the LA Times:  "Mike Matthews, Kowalke’s owner, told the Associated Press that only one package -- with the sell-by date of June 21 -- tested positive for salmonella, so far."   There is not yet confirmation of illness associated with this latest recall.  Still, Mr. Matthews comment brings up again how misleading statements like this can be.

A perfect example is last summer's E. coli O157:H7 outbreak traced to lettuce.  Health officials gathered overwhelming  epidemiological evidence to implicate the product.   The producer, though, kept crowing to the press about how none of the lettuce tested from its plant tested positive.  Of course, health officials were forced to point out that the product tested was CURRENT PRODUCT, i.e. the product in the plant at the time the outbreak was recognized.   Thank goodness there wasn't STILL contaminated product on hand.  The product actually implicated in the outbreak was long gone, and could not be tested.

In outbreaks involving perishable items, such as produce, finding product produced and packaged at a time that coincides with product implicated in an outbreak is very unusual.  Think about this very plausible, but hypothetical, time line.   Produce goes out, lets say lettuce, processed on July 1.   It hits the shelves on July 5.   On July 7 its purchased, and then consumed two days later on July 9.  The incubation period for E. coli O157:H7 generally runs 2 days to a week.   So let's say the consumer has onset of symptoms on July 12.  By July 14, the consumer is sick enough to go to the doctor.  If we are lucky, a stool culture is ordered the first day of medical care.  Results return 48 hours later, and now it is July 16.   A good health department is notified of the illness, and interviews the consumer for a food history immediately.  It's now July 17.  Before health officials are testing product, there usually need to be multiple illnesses that suggest a product as a culprit.  Even assuming the best time line, it is probably nearly three weeks from processing to the opportunity to test product.  By then, product processed on July 1 has been consumed or discarded.

So, the next time you hear a produce supplier tell you that "none of our product has tested positive," bear this in mind.  Such proclamations are essentially worthless at best, and more likely misleading.

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For any of you out there audacious enough to still consume raw sprouts (click here for a recent discussion of the problem), today's announcement from the California Department of Public Health (CDPH) provides yet another example of why eating raw sprouts is simply not worth the risk.  CDPH announced this afternoon that consumers should not eat certain Kowalke Organics alfalfa sprouts due to possible Salmonella contamination.

Mike's Produce, Inc., doing business as Kowalke Family Sprouts of Culver City, is voluntarily recalling the following products with sell-by dates from June 18 to 30:

* Kowalke Organics Alfalfa Sprouts - 4 oz., 8 oz., 1 pound and 5 pound packages
* Kowalke Organics Dinner Salad - 6 oz. package
* Kowalke Organics Onion Mix - 4 oz. package

Kowalke Family Sprouts has initiated this voluntary recall after receiving notification that a surveillance sample tested positive for Salmonella. These products were distributed primarily to grocery stores in Southern California including Gelson's and Whole Foods.

No illnesses have been reported from these products to date.  "Consumers, especially young children, the elderly and people with weakened immune systems are susceptible to serious infection when exposed to Salmonella," Horton said.

"Today's warning is part of our ongoing efforts to ensure the safety of foods sold in California."
Salmonella is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems.

Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. Consumers who have eaten this product and are experiencing the above symptoms should consult their health care provider.

CDPH continues to advise consumers about the risk of consuming raw sprouts. Sprouts have been linked to previous foodborne outbreaks. Conditions required for sprout growing are ideal for rapid bacterial growth. Additionally, green leaf sprouts, such as alfalfa sprouts, are usually eaten raw with no additional treatment, such as cooking to eliminate bacteria that can cause disease.

Consumers who wish to reduce their risk of foodborne illness may want to consider avoiding sprouts.

Consumers who purchased these products should immediately discard them or return them to the point of purchase for a refund. Consumers with questions may contact Kowalke Family Sprouts at (310) 636-1924.

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Once again, the Perishable Pundit has managed to give, and get, some excellent commentary on sprouts and other food safety issues.  I particularly enjoyed the statement by Devon Zagory, Ph.D, an industry leader in produce safety science, discussing the proper role of FDA regulations.  If I may be so bold, and speak for Dr. Zagory, I believe he would fully acknowledge the importance of FDA regs on any number of produce, medicinal, or other food products.  But he appears to also share the sentiment that FDA regs are a floor, not a ceiling.  He states, in reference to sprouts and his new job with Salad Cosmo:

"In the mean time we are already instituting a program that includes adherence to FDA test-and-hold procedures [step one] and goes well beyond FDA guidelines [step two] in terms of seed testing, water testing, environmental sampling, hazard analysis, development of detailed SOPs and validation of food safety programs and processes. Of course we are investigating seed sources to try to find seed produced following GAPs. It is a challenge that we relish. I don’t eat sprouts unless I know where and how they were produced. I eat sprouts from Salad Cosmo."

(emphasis and commentary supplied)

We see way too many companies in litigation trumpeting their adherence to FDA regs, or standards, and drawing the connection between that and proof of reasonable conduct.  The two are not equal.  There are hundreds, probably even thousands, of files in our file cabinets at Marler Clark containing the records of people injured in outbreaks where the manufacturer was "adhering to FDA standards."  Think about it.  Would you ever advise somebody--your children, co-workers, anybody--to "do the bare minimum and all will be well?"  Why should that defense work in front of a jury then?

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A new study finds that only 60 percent of Americans search their homes for recalled foods when a recall happens.  Reuters carried an interesting article on the study recently, and it got me thinking . . . about the current sprouts situation, as usual.  I have talked to a number of different publications recently about the sprouts outbreak generally, and more specifically about the actions (or some would say omissions) of Caudill Seed in responding appropriately to the outbreak.  As i've talked about for many days now, Caudill Seed has chosen to conduct a "market withdrawal" rather than announce a "recall." 

Why?  You got me.  Actually, that's not true.  I know perfectly well that Caudill is simply avoiding the stigma, and ultimately the financial responsibility, of announcing a recall of its product--an unfortunate decision for the many Americans who continue to eat sprouts, and who probably believe that the FDA, and more importantly the businesses involved in this recent outbreak, have done everything they can to protect the people they profit from.  (By the way, at last count by the CDC, there were 235 confirmed illnesses in this outbreak)  But a class I recall requires "serious risk of injury or death."  Oh, I forgot, we don't have that here.  Are these 235 people that the CDC says were sick in this outbreak really just monopoly figurines or something?

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Good Lord, where do I start?  Well, to begin with, thank you to Mr. Orwig (picture left), Caudill Seed, and Jim Prevor, aka "the Perishable Pundit" (the latter thank you being entirely without my tongue in my cheek--I really do enjoy Jim's weekly emails) for a wealth of extremely valuable information.  What I'm referring to here is an interview that the Pundit had with Lyle Orwig, spokesman for Caudill Seed, who is now embroiled, despite any remonstrances to the contrary, in a public health nightmare--i.e. national Salmonella outbreak--linked to its alfalfa sprout seeds.  Read the interview here. 

There are lots of things to talk about, legal and otherwise, after reading the interview.  Much of it will have to wait for official discovery and trial, but I do want to highlight just a couple of things:

Pundit:  FDA says the preliminary epidemiology ties the alfalfa salmonella outbreak to Caudill seeds. What can you tell us?

Orwig:  The seeds have been implicated but there is no proof. While the seeds are said to be epidemiologically linked, FDA hasn’t been able to conclusively tie the source of the salmonella in the sprouts back to where it actually occurred. FDA would need an exact fingerprint serotype match, but it has no confirmed test.

From the seed company perspective, we encourage all sprouters to follow FDA food safety guidance. Back in ’99, they did all that work to establish best practices. If the seeds are treated with recommended soaking chemical and the sprouters do that and test and hold, we wouldn’t be talking about this problem now. Not everyone tests and holds.
 

The voice of reason (that's debatable):  I don't mean to tell anybody how to do their job.  That is for bosses, and I'm not there yet.  Mr. Orwig is a public relations guy who works for a prominent PR firm called Charleston Orwig.  Here is my one bit of advice for Mr. Orwig:  you do not do your business or, more importantly, your client's business any good by trying to obscure the issue.  I don't know, maybe it's a legitimate PR tactic to deny and then hedge, but the reality is that Caudill has been linked to a massive salmonella outbreak.  How do I know?  What do 228 people across the country who are sick with Salmonella Saintpaul have in common?  You guessed it.  I don't need a genetically matched sample from the grounds or product at Caudill Seed to convince a jury of that. 

Pundit:

Are food safety measures conducted at the seed level? Does the seed company hold some responsibility here? On your website, it says all of the alfalfa sprouting seed provided by Caudill has been tested for germination, purity and absence of salmonella and E coli. How does that work?

Orwig:

We sell a raw agricultural product. What that means is that the alfalfa seed is either put into the ground to grow, or the sprouter will use it to produce edible product. It can be the same seed. Part of the seed industry law, in and of itself, is that when we sell, there’s a seed tag that shows what the germination is of that bag of seed, as well as the purity and process it has gone through. This is part of the federal law we follow that has to go on every bag we send out. When we buy seed, it’s sorted, tested and bagged and when it’s bagged and the tag goes on it, we’ve followed our legal duty. Then it’s the sprouter’s responsibility.
 

The voice of reason (highly debatable):  Mr. Orwig gives yet another example of the attitude that, in my view, is responsible for many, many of the foodborne illnesses that occur in this country every year.  Essentially what he's saying is, "our responsibility for food safety begins when the seeds come through our doors, and our responsibility ends when the seeds leave."  Is bullshit too strong a word here?  I don't care about FDA guidance, if any, on this issue.  Caudill, you and every other food manufacturer in the country has a continuing obligation to protect the people you profit from--i.e. consumers--before you receive your product and after you sell it.  This means, at a minimum, knowing the companies you do business with, and knowing all intended uses.  It also means TAKING ADEQUATE STEPS TO PROTECT THE CONSUMERS WHEN YOU KNOW, OR HAVE REASON TO KNOW, THAT A PROBLEM EXISTS.  See my post yesterday about recalls and market withdrawals.  I guess the good thing in this kind of attitude is that it will keep us in business.  I don't know how this helps consumers of your products though.

Pundit: To what degree, if any, do you have control over the growers and the conditions under which product will be grown? Are you using any preventive measures to insure good agricultural practices are being followed? Do you test specific fields and conduct regular audits?

Orwig:  We do inspections, but I can’t tell you how often. We don’t do audits.

Just a guy from Seattle:  Ummmm . . . see my last comment above.

Pundit:  Have you conducted inspections of the farms connected to this seed lot in Italy?

Orwig:  We have not yet visited the production area in Italy associated with this problem; that was planned for this month, but will not happen now because of the time commitment to this issue.
 

My creativity is spent:  That's convenient.  In addition, dare I say . . . see my last two comments???

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I'm doing my best to find any reference to a recall of the seeds implicated by the FDA and CDC in the recent Salmonella Saintpaul outbreak, which is now responsible for at least 228 illnesses in 13 states.  I can't find any action by Caudill Seed taken to actually recall the product.  I'm not talking about a market withdrawal, or any other less-than-serious effort to obscure the reality of this very significant public health nightmare.  I'm talking about a recall . . . something that is supposed to voluntarily happen when a company (Caudill Seed) sells a product (alfalfa sprout seeds) that pose a significant public health risk (228 illnesses and counting). 

Maybe the answer from Caudill Seed would be "well, we issued a market withdrawal."  Here's how the FDA defines "market withdrawal:"  "occurs when a product has a minor violation that would not be subject to FDA legal action. The firm removes the product from the market or corrects the violation. For example, a product removed from the market due to tampering, without evidence of manufacturing or distribution problems, would be a market withdrawal."

By comparison, the FDA defines a Class I Recalls as follows:  "a situation in which there is a reasonable probability that the use of or exposure to a violative product will cause serious adverse health consequences or death."

This is not a market withdrawal situation.  There are 228 confirmed illnesses in 13 states.    These are human beings who have been exposed to something that can kill them.  

Moreover, I've done some research to find out that alfalfa sprout seeds have an extremely long "shelf-life"--we're talking years--the significance of which fact needs very little explanation here.  If Caudill Seed doesn't act quickly and, this time, with resolute action that is not done for purely PR purposes, but to actually PREVENT THE FURTHER SPREAD OF DISEASE, we may be having this same discussion for months.  A Class I Recall was, and remains, warranted. 

It is actions like this--which amount to little more than veneers of concern by foodmanufacturers--that keep Marler Clark in business.   

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Here is a copy of the Morbidity and Mortality Weekly Report from the CDC addressing the recent sprout outbreak.  We have been reporting on this for weeks now (maybe months), since cases were first report in Nebraska in February.  Please take a look at this report; it provides a good summary of the anatomy of an outbreak, especially when sprouts are the vehicle. 

Moreover, consider now that the CDC is reporting at least 228 illnesses from 13 states (including NE, IA, SD, MI, KA, PA, MN, OH, IL, WV, FL, NC, and UT).  These outbreaks are evolving things, and more illnesses may ultimately be determined to have been confirmed in this outbreak by the time all is said and done.  But even if a hundred additional illnesses are added, that's nothing compared to the true scope and impact of this outbreak.  I've been posting for weeks that the number of likely ill people in this outbreak already exceeds a thousand, maybe many thousands.  But that's only part of the story.

There are many other victims in these outbreaks.  In fact, this is exactly what Bill Marler is speaking to the House of Lords in England about this week:  How One Peanut Company Caused 1.5 Billion Dollars in Losses.  My guess is that there are many more victims in this current sprout outbreak, in the form of both people and business losses, than the 228 people who are currently recognized as victims in the CDC report.  How many millions, hundreds of millions, billions (a little too bold??? maybe, maybe not) will the outbreak now linked to Caudill Seed cause?  Only time, and a little hard-driving discovery about what Caudill Seed knew and when they knew it, will tell.

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Our work at Marler Clark requires lots of travel . . . sometimes even overseas.  Looks like it might be time to up my intake of spaghetti carbonnara and red wine so that I'm ready to roll when it comes time to take a closer look at the Italian company selling the sprout seeds that are now responsible for a major Salmonella outbreak in the US associated with alfalfa sprouts.  Of course, there are a number of reasons why we might do this . . . not least of which is to find out exactly what, or who, Caudill Seed was relying on for the safety of the product that it was selling.

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There is plenty of information out there on (1) what sprout and seed companies should be doing to reduce or eliminate the risk that they sell contaminated food to customers, and (2) what sprout sellers should be doing now, in the context of the Salmonella Saintpaul outbreak linked to sprouts/sprout seeds.  With absolutely no effort at sarcasm, that is truly all well and good.  But what about YOU?  What should you do when you have eaten a contaminated product?

My guess is that the sprout sellers of the world aren't reading this blog.  If they are, and they're doing it for ideas on how to improve the safety of their product, that's a little scary.  So this post is dedicated to the victims.  First, from a medical standpoint, doctors and moms across the country stress the importance of staying hydrated.  Second, it is important to have a doctor monitor your progress, or lack thereof.  Symptoms like a high fever, reduced urine production, nose bleeds, etc., may not seem too alarming in a vacuum, but they can signify the onset of devastating conditions, among them hemolytic uremic syndrome and sepsis.  Finally, it is always a good idea to encourage your doctor to run a stool test.  Now your doctor may or may not think that this is warranted in your individual circumstances, but it is extremely important in certain medical situations, and it is critical in helping to stop the spread of disease if you're involved in an outbreak.  The truth of the matter is that any investigating health authorities in an outbreak will not have the benefit of knowing your involvement (and your individual circumstances may be quite important in the outbreak investigation) unless you have a stool sample that tests positive for the outbreak bacteria or virus.  Important steps, all.

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Steve Meyerowitz is, apparently, the Sproutman.  Although I disagree with his analysis of the numbers--i.e. Sprouts have caused a hell of a lot more foodborne illnesses than 2,000 in the last 40 years--it's good to see an industry man who recognizes the risks associated with his product, and who cares enough about consumer health to advocate that his fellow sprout devotees do all they can, by way of researching and developing new pasteurization methods, to reduce risks. 

Nonetheless, I am not a convert, and I never will be.  I feel too much for those sickened and hospitalized in the recent outbreaks and recalls linked to sprouts.  Let us not forget that there are over 120 people in Nebraska, Iowa, South Dakota, and Kansas (not to mention the sprouts/listeria recall or the Calco, Inc sprouts advisory), and a bunch in Michigan, who (1) probably didn't know the risks associated with sprouts and (2) wouldn't have thought it could happen to them anyway. 

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By the end of this year, I hope to have more devoted readers than there are sprout outbreaks and recalls.  As I sit here today, it's pretty much neck and neck, and I'll be honest, my competition is relentless.  See my earlier post (TODAY!!!) on the ongoing Salmonella outbreak in Michigan .  And this just in:  The California Department of Health warns consumers not to eat Los Angeles Calco, Inc. brand alfalfa sprout products "because the products may be contaminated with Salmonella."  

What a shocker.  Salmonella and sprouts; sprouts and Salmonella.  Though there are not yet any illnesses known to be linked to Calco, Inc's products, we must wait for the public health folks in California, who are no strangers to outbreaks associated with raw produce, to connect all the dots.  We'll see what tomorrow brings.   

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We have filed two lawsuits on behalf of two victims of the Salmonella Saintpaul outbreak linked to sprouts manufactured by CW Sprouts, a Nebraska Company.  For information about the outbreak, click here.  Keep in mind, studies have shown that the actual number of victims in any given outbreak is many times more than the number of culture-confirmed "cases"--i.e. by stool or blood test.  Some people don't seek medical attention, but are no less infected by the bacterium or virus; and some, like one of our clients in Colorado, are sick enough to have their intestines spilled out onto the operating table but their stool tests are negative.  Bottom line, you are no less a victim of an outbreak merely because your stool sample is not positive for Salmonella, E. coli O157:H7, hepatitis A, or any other bacterium or virus associated with foodpoisoning, assuming you have an epidemiological relationship to the outbreak.  Bottom line in the CW Sprouts outbreak, there may be hundreds sick across the midwest due to Salmonella-contaminated sprouts.

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It never ceases to amaze many clients of ours at Marler Clark how foods that seem so healthy can pose so much risk of foodborne disease.  Lettuce and E. coli O157:H7???  Many victims were shocked, not to mention badly injured, when baby spinach was the cause of yet another outbreak of E. coli O157:H7 and other pathogens associated with leafy greens during the 2006 spinach outbreak. 

Sprouts are another case in point.  We've all had them, and most of us have never been sick from them, but there are hundreds of victims across the mid-west who cannot say the same thing.  Here is an interesting article on how sprouts are grown and harvested, and why they are such a risky food to eat, especially for young children, the elderly, or the immune compromised. 

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In a recent CanWest News story, Joe Schwarcz asks "what are you more worried about eating, beef from a hamburger joint or a sandwich made with alfalfa sprouts at your local health food emporium?"

Scientifically, this is a "no contest." I know what you're thinking. Eat beef and risk mad cow disease. Or, eat beef and risk E. coli 0157:H7. After all, didn't 120 or so people die in England from mad cow disease? And what about the four children who died from eating tainted hamburgers in the famous "Jack In The Box" episode in 1993? Yes, both of these are awful numbers. But the chance of any individual being affected is extremely low. In England, two million infected cows ended up in the food stream and that resulted in about 10 deaths a year. In Canada we are talking about one cow that never ended up in the food system. As far as the Jack In The Box episode goes, the meat wasn't properly cooked. That's it. Cooking hamburger to an internal temperature of about 70 degrees Celsius eliminates the risk of bacterial contamination.

Now let's turn to those sprouts that adorn many a salad and sandwich in places that feature so-called health foods. The largest recorded case of E. coli 0157:H7 infection in history had nothing to do with meat. It had to do with radish sprouts. In 1996 in Japan 6,000 people became sick and 17 died from eating raw radish sprouts. Can you imagine the publicity this would have garnered if meat had been involved? And it doesn't only happen in Japan. In the US since 1995, 15 outbreaks of Salmonella infection and two of E. coli 0157:H7 have been associated with sprouts.

Why does this happen? Because conditions favourable for seed sprouting are ideal for increasing bacterial counts on seeds. Bacteria just love the moist, warm, nutrient-filled sprouts. How do bacteria contaminate the seeds in the first place? On the farm untreated agricultural water may be used, manure used as fertilizer may be improperly composted and there may be runoff from animal production facilities. That's why federal guidelines stipulate that potable water should be used, that synthetic fertilizers are preferable for sprout seed growth and that seeds should be disinfected by dipping them into a calcium hypochlorite solution for 15 minutes. It is also recommended that people at high risk for infections, such as young children or the elderly not consume raw sprouts.

As for the rest of us, there is no worry if recommended procedures are followed. Indeed certain sprouts, especially broccoli sprouts are highly recommended. These contain sulphoraphane, a substance that may help reduce the risk of macular degeneration, hypertension and prostate cancer. No worry about contamination here because the company that produces these takes extreme care to follow government guidelines and tests every batch for salmonella and E. coli before shipping to stores. But as far as the run of the mill raw sprouts that burst out of those vegetarian sandwiches E well who knows their history? Statistically there is a greater chance they will make you sick than the hamburger everyone worries about.

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