Ben Chapman

About Ben Chapman

Dr. Ben Chapman is an associate professor and food safety extension specialist at North Carolina State University. As a teenager, a Saturday afternoon viewing of the classic cable movie, Outbreak, sparked his interest in pathogens and public health. With the goal of less foodborne illness, his group designs, implements, and evaluates food safety strategies, messages, and media from farm-to-fork. Through reality-based research, Chapman investigates behaviors and creates interventions aimed at amateur and professional food handlers, managers, and organizational decision-makers; the gate keepers of safe food. Ben co-hosts a biweekly podcast called Food Safety Talk and tries to further engage folks online through Instagram, Twitter, Facebook, YouTube and, maybe not surprisingly, Pinterest. Follow on Twitter @benjaminchapman.

Finding vomit on an airplane

Illness happens on planes, and when it does it’s miserable.

In 2009 I dealt with campylobacteriosis over a day of travel from Manhattan (Kansas) to Raleigh. In 2013, then four-year-old Jack yacked on a flight which led to a fascinating approach by Delta Airlines involving plastic bags to contain the risk and coffee pods to manage the smell. The flight crew let us off the plane first (although we were in the second-to-last row) as we potentially inoculated the plane and passengers with norovirus.

Maybe the best plane-related outbreak was one reported in Clinical Infectious Diseases a couple of years ago. I’d describe my poop and barf-related imagination as pretty good but I couldn’t have dreamt up the scenario that unfolded on a plane leaving Boston bound for Los Angeles in October 2008.111007015237-sick-throwing-up-airplane-motion-story-top

Members of [the] tour group experienced diarrhea and vomiting throughout an airplane flight from Boston, Massachusetts, to Los Angeles, California, resulting in an emergency diversion 3 h after takeoff.

The problematic flight departed Boston on Oct 8, 2008, heading for Los Angeles and carrying among its passengers 35 members of a leaf-peeping tour group. (Four more members of the group had planned other routes home, while two had been hospitalized in the previous 2 days.)

The outbreak included a passenger with “multiple episodes of diarrhea, with at least 1 occurring in the aisle of the first-class section. The soiled aisle was not cleaned until after completion of the flight.”

As the international discussion of Ebola transmission continues, USA Today writes about bodily fluids on airplanes.

[Linda] Cannon, a teacher from Palatine, Ill., was on a United Airlines flight from Chicago to Las Vegas when she felt something wet on her seat. “I pulled out my hand, which was covered in vomit,” she recalls.

The crewmember cleaned the seat while Cannon changed into some clean clothes. But it didn’t help: Bits of upchuck still coated her seat.

“I sat for 3½ hours with the remnants of vomit on my jeans and underwear,” says Cannon. ” I spent the entire flight with nausea and the woman in the next seat telling me it still smelled.”

The passengers who came into contact with blood, urine and vomit wonder who to blame for the lack of hygiene on a plane, and what they’re doing about it.

The answer is a bit complicated. Of course, airlines are responsible for the cleanliness of their aircraft, and it’s a job they say they take seriously.

At American Airlines, for example, planes are tidied up between flights, which can include cleaning the lavatories, seats and replacing any obviously soiled blankets or pillows.

Overnight, the planes are serviced more thoroughly. The restrooms are serviced, seats and tray tables are wiped down, carpets are vacuumed and blankets and pillows are replaced.

Every month, each aircraft is given a “deep” cleaning, where seat covers are washed and the entire cabin is sanitized using government-approved cleaning agents. 

While there have many been plane-linked outbreaks, a quick overnight servicing with a wipe-down could explain reoccurring noro events.

Food Safety Talk 65: All My Ports are Engaged

Food Safety Talk, a bi-weekly podcast for food safety nerds, by food safety nerds. The podcast is hosted by Ben Chapman and barfblog contributor Don Schaffner, Extension Specialist in Food Science and Professor at Rutgers University. Every two weeks or so, Ben and Don get together virtually and talk for about an hour.  They talk about what’s on their minds or in the news regarding food safety, and popular culture. They strive to be relevant, funny and informative — sometimes they succeed. You can download the audio recordings right from the website, or subscribe using iTunes.

Man who thinks he's European perplexed by maths.

Man who thinks he’s European perplexed by maths.

 

In this episode, Ben is absent, but Don is not alone. Mike Batz, Assistant Director of Food Safety Programs, Emerging Pathogen Institute at the University of Florida, is a guest on the show. He appeared not once, but twice on the podcast before.

Don and Mike start by talking a little about their travels, then, they quickly move to a discussion on the Chobani Yogurt recall. The news article leaves Mike unsure whether Mucor circinelloides was pathogenic to both animals and humans. A brief digression about podcast listening speed reveals that Batz listens at 1.5 speed while Don is more civilized. Returning to yogurt, they discuss the originalmBio article. Don concludes the study did not provide enough evidence to show M. circinelloides is truely pathogenic to humans.

Don asks Mike about a psychology experiment done by Facebook where they manipulated users feeds. Mike was disappointed by Facebook’s methodology since the study never requested an informed consent from the users. They then rambled about again about their various and sundry international travels. Mike resided close to the Rijks Museum (that’s in Amsterdam) for a while and Schaffner shared his experience in Finland (including reindeer tartare) and New Zealand (and beef tartare).

Next, they talked about a document from the FAO marketed as providing a list of the top 10 foodborne parasites ). To continue, they discussed seasonal food safety tips. While Mike confessed to not always follow his own food safety recommendations, Don revealed he is reluctant to eat a cut cantaloupe by a stranger.

Soon after, the discussion shifted to antibiotics in meat. Both agreed that the issue is quite complicated and there is not a straight forward answer.

They concluded the show with a discussion on cross contamination including cutting boardsartisanal cheese and the 5 second rule. Don recommended plastic cutting board for meat and wood cutting board for any other food types.

Shigellosis or sunstroke?

This one time, when I was working at a greenhouse as a summer student, I called in sick and told the boss I had sunstroke (from working outside the previous day).

And then I went to a free lunch-time Red Hot Chili Peppers concert on Yonge St (that’s in Toronto, which is in Canada). I’ve matured since then.Red Hot Chili Peppers backstage before a gig in Boston, MA in August 1990. © B.C. Kagan

According to the UK Mirror  a per 250 Brits who visited a resort in Egypt were told by management that they were suffering from sunstroke – but it was actually shigellosis.

The Mirror revealed last month how First Choice customers caught the bug, thought to be shigella, at Coral Sea Waterworld, Sharm el Sheikh.

Victim Tracy Roscoe, 51, said she got a letter two days before she and her family were due to leave after spending most of the trip laid up.

“It stinks,” said Mrs Roscoe. “They tried to blame the sun when they knew it was a bug doing the rounds in the hotel.”

The letter – “Sunstroke And How To Stay Healthy” – referred to heat above 40C and how over-exposure and low fluids can cause sunstroke.

But many sick guests complained of poor food hygiene by staff.

Nick Harris of lawyers Simpson Millar – handling claims from 250 of them – said: “It’s outrageous if there was an attempt to intimate to customers that the massive sickness outbreak was caused by sunstroke, which is what the letter seems to imply.”

Tracing leafy green storage and display temperatures in schools

Ellen Thomas, PhD candidate in the Department of Food, Bioprocessing and Nutrition Sciences at North Carolina State University writes,

In 2006, an E. coli O157:H7 outbreak associated with bagged spinach resulted in 205 illnesses and three deaths. Investigators cited many factors, including feral swine, that resulted in contamination of spinach in the field. It is also suspected that temperature abuse of the spinach (meaning that the spinach wasn’t kept cold enough) during transportation and storage also allowed the E. coli to reproduce, boosting the population of bacteria on the spinach  Numerous additional studies have shown that temperature abuse of cut leafy greens can result in growth of pathogens such as E. coli O157:H7.

product_butterlettuceOne of the great parts about working in the field of food safety and extension is that you often get a chance to help protect public health by answering questions about current policies for different groups. Two years ago, the North Carolina Department of Public Instruction (DPI) voiced concerns that their current systems for serving salads as part of school lunch programs might not be holding produce at cold enough temperatures, as recommended by the FDA Food Code (5°C or below). DPI approached our group to request help in addressing this issue.

The North Carolina school Hazard Analysis and Critical Control Points HACCP program defines two methods for the storage and serving of salads. The first system is “time in lieu of temperature” (TILT), which sets a time limit on how long food can be held on the serving line; any food remaining after that time must be discarded. The second system is the three-day rule, in which a salad may be displayed for up to three days and must be discarded by the end of day three.

In 2012, I visited 24 schools across North Carolina in order to determine the temperatures at which salads were actually being stored and served. I did this by placing a data logger in a “test salad” that was held with other salads and held in the same conditions (it was labeled to prevent accidental sale). The data logger recorded temperature every five minutes for the entire time that the salad was put on the serving line. This allowed me to determine how long temperatures might have exceeded 5°C.

I found that the majority of the serving systems were out of compliance- most salads were reaching temperatures above 5°C for long periods of time. After observing this trend, we made the recommendation to DPI that schools should adopt the TILT system to replace the three day rule in order to reduce the risk of foodborne illness through temperature abuse – and they did.

“Tracing Temperature Patterns of Cut Leafy Greens during Service in North Carolina School Food Service” was published in the September issue of Journal of Food Protection.

Abstract:

Contaminated fresh produce has been increasingly identified as a cause of foodborne illnesses. Because of concerns about pathogen growth on these food items at retail, the 2009 U.S. Food and Drug Administration Food Code established that cut leafy greens (lettuce, spinach, spring mix, cabbage, arugula, and kale) must have time and temperature controls for safety and hence should be kept at refrigerated temperatures (5°C or lower). The purpose of this study was to determine the temperature profiles of cut leafy greens in single-serving clamshell containers provided as part of the North Carolina School Lunch Program and to compare the two policies that North Carolina has in place to control the temperature of these products (the 3-day rule and time in lieu of temperature). Temperatures were recorded with data loggers in 24 schools during a 3-day period. In all cases, substantial temperature variability was found for these products, including temperatures above 5°C for at least 1 h on each of the 3 days. In some cases, temperatures reached above 5°C for more than 3 h throughout the serving time. The results demonstrate the importance of developing a protocol for continuous temperature monitoring of leafy greens served in school lunch programs.

Packed lunch Twitter chats with @iftmedia on Sept. 8 and 11, #SafeLunch

Labor Day has come and gone, summer vacation is over and the start of the school year is here. To celebrate, I’m participating in a Twitter chat, hosted by The Institute of Food Technologists (IFT) @iftmedia, about packed lunch safety. We’ve chosen two different dates and times to hold the chat, so feel free to jump in on the one that is most convenient.packed lunch

Monday, September 8, from 6:00pm-7:00pm ET

Thursday, September 11, from 1:00pm-2:00pm ET

Participate (or just follow the discussion) using the hashtag #SafeLunch. Topics for discussion include:

Lunch box/bag food safety dangers

Different kinds of lunch bags–which keep food the safest?

How to pack leftovers

How to keep cold foods cold, hot foods hot

Participants will receive an IFT lunch bag

Blessed are the cheese makers (except those that have an import alert)

Following the don’t-age-on-wood-boards-uh-just-kidding incident earlier this year, the U.S. FDA are again raising the hackles of cheese purveyors. This time over an import alert.

According to Janet Fletcher of the L.A. Times Daily Dish, an FDA-issued alert on certain manufacturers of raw milk cheeses due to presumed insanitary conditions is keeping some top-selling cheeses off of baguettes.

In early August, these cheeses and many more landed on an FDA Import Alert because the agency found bacterial counts that exceeded its tolerance level. Cheeses on Import Alert can’t be sold in the U.S. until the producer documents corrective action and five samples test clean, a process that can take months.hqdefault

Of course, French creameries haven’t changed their recipes for any of these classic cheeses. But their wheels are flunking now because the FDA has drastically cut allowances for a typically harmless bacterium by a factor of 10.

The limits for nontoxigenic E. coli were cut from 100 MPN (most probable number) per gram to 10 MPN. These are bacteria that live in every human gut; they are typically harmless and we coexist happily. But the FDA considers them a marker for sanitation: If a cheese shows even modest levels of nontoxigenic E. coli, the facility that produced it must be insufficiently clean.

Dennis D’Amico, an assistant professor at the University of Connecticut whose specialty is dairy microbiology, says this premise is flawed.

“There was no health risk in all the years we operated at 100 MPN,” says David Gremmels of Oregon’s Rogue Creamery, which produces several raw-milk blues. “We look at this as an arbitrary change.”

Gremmels and others say they felt blindsided by the revised FDA guidelines, learning about them only when European cheeses began being held. The agency hasn’t offered any scientific support for the altered E. coli allowance, prompting unease about its decision making.

The stepped-up testing creates headaches for companies like Gourmet Imports, a Los Angeles cheese importer and distributor.

“In the past year, we’ve had delays on things you never would have imagined would be held before,” reports general manager Alex Brown. Even Parmigiano-Reggiano, a well-aged, low-moisture cheese unlikely to have microbial issues, was recently held for testing.

“It’s the safest cheese on the planet,” Brown says.

An import alert allows FDA to ask for more data (micro or inspection from an exporting country) and according to the Alert page, This import alert represents the Agency’s current guidance to FDA field personnel regarding the manufacturer(s) and/or products(s) at issue. It does not create or confer any rights for or on any person, and does not operate to bind FDA or the public.

After a bit of digging I found a 2009 FDA Staff Compliance Policy Guide Sec. 527.300 Dairy Products – Microbial Contaminants and Alkaline Phosphatase Activity (CPG 7106.08) that states:

The presence of Escherichia coli in a cheese and cheese product made from raw milk at a level greater than 100 MPN/g (Most Probable Number per gram) indicates insanitary conditions relating to contact with fecal matter, including poor employee hygiene practices, improperly sanitized utensils and equipment, or contaminated raw materials. The presence of Escherichia coli at levels greater than 10 MPN/g in a dairy product, other than a cheese or cheese product made from raw milk, also indicates insanitary conditions. The presence of Escherichia coli at levels greater than 10 MPN/g in a dairy product made from pasteurized milk indicates that contamination occurred after pasteurization.

Any government agency needs to clearly and effectively communicate risk-based decisions, (especially changes) and provide the evidence to back a particular decision.

UNC Public health school serves raw milk cheese at welcome reception

Although North Carolina is largely seen as a basketball-first state, college football is definitely king during the fall months. Despite a current top-25 ranking for Carolina, and a less-than-stellar start of the season for N.C. State (a last minute one-point win over Georgia Southern) the two schools are gearing up for the all-important rivalry game in November. The rivalry often spills over into other areas; including public health and food safety.

Liz Rogawski, a student at UNC Chapel Hill’s Gillings School of Public Health writes in a letter to The Daily Tarheel,

raw-milk-cheese-940x626Students, faculty, and staff in the School of Public Health today were welcomed to the fall semester with a large selection of local delicacies as part of the welcome-back social. The spread included raw milk cheese — cheese that is made from unpasteurized milk. The irony of serving raw milk cheese in a school of public health is hard to miss. Pasteurization, which kills harmful bacteria, is one of public health’s finest achievements in disease prevention.

Raw milk is “150 times more likely to cause foodborne illness and results in 13 times more hospitalizations than illnesses involving pasteurized dairy products,” according to the Food and Drug Administration website (this is from a CDC-authored paper -ben).

The serving of raw milk cheese puts our students and staff at unnecessary risk of diseases that have been prevented by pasteurization since the mid-19th century. Luckily, we have plenty of epidemiologists around to investigate any disease outbreaks if needed.

The CDC-authored paper that Rogawski cites reports that between 1993-2006, “of the 65 outbreaks involving cheese, 27 (42%) involved cheese made from nonpasteurized milk. Of the 56 outbreaks involving fluid milk, an even higher percentage (82%) involved nonpasteurized milk.”

The raw data shows more outbreaks related to pasteurized-milk cheeses compared to unpasteurized-milk the relative risk tells a different story.

The authors go on to say:

Because consumption of nonpasteurized dairy products is uncommon in the United States, the high incidence of outbreaks and outbreak-associated illness involving nonpasteurized dairy products is remarkable and greatly disproportionate to the incidence involving dairy products that were marketed, labeled, or otherwise presented as pasteurized.

A 2013  joint FDA/Health Canada risk assessment detailed the relative risks.

While there are foodborne illness risk differences between soft and hard unpasteuized cheeses due to the influence of water activity, raw milk cheeses, regardless of aging carry increased risk (see this 2013 outbreak and others as well as D’Amico and colleagues, 60-day aging requirement does not ensure safety of surface-mold-ripened soft cheeses manufactured from raw or pasteurized milk when Listeria monocytogenes is introduced as a post processing contaminant).

Communicating the risk to the eaters is important, I’m all about informed choice.

Dominican Republic resort visitor awarded five-figure settlement following salmonellosis

In 2004 I visited the Dominican Republic, a popular Caribbean destination for Canadians attempting to escape the winter cold, wet and grey.  Dani and I took advantage of her spring break and Millennium Scholarship (probably not what they were meant for) and spent a week sitting on the beach, eating buffets and playing scrabble. It was pretty fun. My food paranoia was focused on ice cubes, foods held at the wrong temperature and fresh fruits and vegetables. I don’t think I ate anything that wasn’t fried and stuck to beer all week. Dani wasn’t nearly as ridiculous as I was (she rarely is) and she tried lots of stuff.
The week was a success; not only did we get some Vitamin D, neither of us had any foodborne illness symptoms.100B8930
According to Express and Star, Tracey Middleton was not as lucky as we were. In 2011 she visited the Casa Marina Reef Resort in the Dominican Republic with her husband, Keirnan and was felled with salmonellosis.
But on her return home, she was admitted to Staffordshire Hospital for four days after becoming severely dehydrated due to sickness and diarrhoea and she was diagnosed with salmonella, which has left her with on-going symptoms.
 
The couple instructed lawyers to investigate the cause of Tracy’s illness and they have secured a five-figure settlement for Tracy to cover the pain and suffering caused by her illness on the Thomas Cook holiday.
Mrs Middleton, aged 50, said: “Kieran and I were shocked at the conditions at the hotel, as we expected them to be of a high standard as it was supposed to be a luxury resort. We noticed that on occasions that food was being left uncovered for prolonged periods of time and some food was reheated and served with fresh food. We sometimes found the restaurant cutlery to be dirty and we noticed on occasions that some of the food served was undercooked. On occasions we also saw birds in the restaurant area.
 
“This nightmare has put me off travelling to the Dominican Republic again. I feel as though I’m more cautious about what I eat and what I do now. The illness and health problems have had a significant impact on my life.
 
Nearly three years on from the holiday, she still experiences painful stomach cramps and muscle pains on her sides. Her stomach swells from time to time especially after she has eaten and she now has to avoid foods such as bread, pasta and wine.
 
A Thomas Cook spokeswoman said: “Thomas Cook is sorry that Mrs Middleton fell ill while on holiday in the Dominican Republic in October 2011. We have extended our apologies to the party, while reaching an agreement with their legal representatives.
 
“We would like to assure customers that incidents of this type are rare, as Thomas Cook closely audits all the properties to which it operates to ensure that only the very highest hygiene standards are maintained.
 
Audits and inspections are never enough. Evaluating the tools that the resort provides to staff, or how they evaluate their suppliers is just the beginning – evaluating whether the behaviors to adhere to standards is more important.

Cyclospora redux: Cilantro linked to 21 illnesses in Texas

We eat a lot of cilantro in my house; whether in fresh salsa, guacamole or as an ingredient in tacos it’s a favorite.

I’m rethinking my love of the herb as it’s entering the raw sprouts realm.

After notable recalls in 2009, 2011 and a 2013 Cyclospora outbreak where the U.S. Food and Drug Administration and Centers for Disease Control and Prevention concluded that fresh cilantro grown in Puebla, Mexico was the source, cilantro is at it again.cilantro.slugs_.powell.10-300x225

According to NBCDFW a current outbreak of Cyclospora has been linked yet again to the fresh herb.

The Texas Department of State Health Services said Thursday the its investigation has linked the cases in four restaurants clusters to fresh cilantro from Puebla, Mexico.

Texas DSHS says a total of 21 people got sick and all of them reported eating food containing cilantro within two weeks of becoming ill.

The FDA and DSHS traced the cilantro from all four restaurants to Puebla, Mexico. While investigators could not find cilantro contaminated with cyclospora they say there’s a strong enough “epidemiological link” between the illnesses and the cilantro to draw the conclusion.

In October 2013, the Centers for Disease Control and Prevention also linked a cyclospora outbreak to cilantro from Puebla, Mexico.

The Texas DSHS reported a total of 166 confirmed cyclospora cases in the state, but only 126 cases were considered part of the outbreak.

Dallas County reported the majority of this year’s cases with 38, 19 cases were confirmed in Tarrant County and 12 in Collin County.