Going public (not): E. coli outbreak at Chicago restaurant sickened over 100 in June

In June, 2016, people started getting sick after dining at Carbon Live Fire Mexican Grill at 300 W. 26th St., Chicago.

carbon-live-mexican-grillBy July 1, at least 25 people were sick with Shiga-toxin producing E. coli, and the restaurant closed.

Five months later, and cilantro has been fingered as the source.

By the end of the outbreak, 68 people were sickened, 22 of whom were hospitalized. All have since been treated and released.

According to a report from the department of health, cilantro was identified as “food vehicle” that likely caused the outbreak. 

All prepared food was disposed, food handling practices were reviewed, and all staff who handle food were tested at least twice for the bacteria,” according to a release from Healthy Chicago, an initiative of the Chicago Department of Health, said at the time the outbreak was reported. 

Carbón withdrew from the Taste of Chicago so that it could turn “its full attention to addressing the issues at its Bridgeport location,” health officials said.

The owners also closed their second location at 810 N. Marshfield “out of an abundance of caution.” That location reopened July 9, health officials said. 

Two lawsuits stemming from the outbreak were filed against the restaurant, one seeking more than $90,000 in damages.

That’s the PR version.

The team at Marler’s Seattle law firm had previously filed a Freedom of Information Act request and found more than 100 people were sickened and that 16 of 40 food-handling employees of Carbón Live Fire Mexican Grill tested positive for E. coli soon after the restaurant’s two locations voluntarily closed for cleaning July 1.

Lab tests confirmed 69 people were sickened during the outbreak, with another 37 probable cases. Of the sick people, 22 had symptoms so severe that they required hospitalization. Illness onset dates ranged from June 3 to July 23.

Cilantro is the suspected source of the E. coli based on percentages of sick people who ate menu items made with the fresh produce item. Inspectors collected 12 food items, including cilantro, but none of the food returned positive results for E. coli bacteria. The cilantro was sourced from Illinois and Mexico, according to traceback information provided to the health department.

“Lettuce was associated with illness in both multivariable models but was consumed by only 44 percent of cases,” according to the health department report.

“In comparison, cilantro was consumed by 87 percent of cases, and either cilantro or salsa fresca (which included cilantro) were consumed by 95 percent of cases.”

The report references “several critical violations” observed during a July 1 inspection, such as improper temperatures for several food items including red and green salsas, tequila lime sauce, raw fish, guacamole and cheese. Inspectors also noted improper hand hygiene practices among food handlers.

Reinfection of cattle with E. coli

Enterohaemorrhagic Escherichia coli (EHEC), like E. coli O157:H7 are frequently detected in bovine faecal samples at slaughter. Cattle do not show clinical symptoms upon infection, but for humans the consequences after consuming contaminated beef can be severe.

epa01322503 View of some of the more than 7,000 cattle that arrived to Liniers Market in Buenos Aires, Argentina, on 22 April 2008, to be slaughtered. Argentinean government and the biggest agriculture organizations had been discussing, this morning, the situation of milk sector that is one of the most conflictive topics on the negotiations with cow meat, grains and regional economies. EPA/CEZARO DE LUCA

The immune response against EHEC in cattle cannot always clear the infection as persistent colonization and shedding in infected animals over a period of months often occurs. In previous infection trials, we observed a primary immune response after infection which was unable to protect cattle from re-infection. These results may reflect a suppression of certain immune pathways, making cattle more prone to persistent colonization after re-infection.

To test this, RNA-Seq was used for transcriptome analysis of recto-anal junction tissue and ileal Peyer’s patches in nine Holstein-Friesian calves in response to a primary and secondary Escherichia coli O157:H7 infection with the Shiga toxin (Stx) negative NCTC12900 strain. Non-infected calves served as controls.

In tissue of the recto-anal junction, only 15 genes were found to be significantly affected by a first infection compared to 1159 genes in the ileal Peyer’s patches. Whereas, re-infection significantly changed the expression of 10 and 17 genes in the recto-anal junction tissue and the Peyer’s patches, respectively. A significant downregulation of 69 immunostimulatory genes and a significant upregulation of seven immune suppressing genes was observed.

Although the recto-anal junction is a major site of colonization, this area does not seem to be modulated upon infection to the same extent as ileal Peyer’s patches as the changes in gene expression were remarkably higher in the ileal Peyer’s patches than in the recto-anal junction during a primary but not a secondary infection. We can conclude that the main effect on the transcriptome was immunosuppression by E. coli O157:H7 (Stx) due to an upregulation of immune suppressive effects (7/12 genes) or a downregulation of immunostimulatory effects (69/94 genes) in the ileal Peyer’s patches. These data might indicate that a primary infection promotes a re-infection with EHEC by suppressing the immune function.

Potential immunosuppressive effects of Escherichia coli O157:H7 experimental infection on the bovine host

BMC Genomics; 2016; 17:1049; DOI: 10.1186/s12864-016-3374-y; Published: 21 December 2016

E. Kieckens, J. Rybarczyk, R. W. Li, D. Vanrompay, and E. Cox

http://bmcgenomics.biomedcentral.com/articles/10.1186/s12864-016-3374-y

Tragic Thanksgiving outbreak linked to Clostridium perfringens 

It’s deja vu all over again. In November 2015 over 40 fell ill with Clostridium perfringens in my home state of North Carolina following a Thanksgiving community meal.

The caterer failed to keep the hot foods hot according to the investigation report in MMWR:

Turkeys were cooked approximately 10 hours before lunch, placed in warming pans, and plated in individual servings. Food was then delivered by automobile, which required multiple trips. After cooking and during transport, food sat either in warming pans or at ambient temperature for up to 8 hours. No temperature monitoring was conducted after cooking.

Today, according to the LA Times, perfringens has been linked to another Thanksgiving outbreak. This one was fatal.thanksgiving-dinner-1_0

Health officials say common foodborne bacteria caused an illness that left three people dead and sickened 22 others who attended a Thanksgiving dinner at an events hall in Antioch, Calif.

Officials identified the three people who died as 43-year-old Christopher Cappetti, 59-year-old Chooi Keng Cheah, and 69-year-old Jane Evans. All were residents of assisted living facilities in Antioch.

From a Contra Costa County press release:

A laboratory at the U.S. Centers for Disease Control & Prevention (CDC) confirmed the presence of the bacteria in stool samples taken from people sickened by food served at the Nov. 24 holiday celebration, held by a community church at Antioch’s American Legion auditorium.

“Our investigation was not able to determine exactly what people ate that made them sick. But after extensive interviews we found most of the ill people ate turkey and mashed potatoes and they all ate around the same time. Some dishes served at the event, including cooked turkey, were brought to the site after they were prepared in private homes,” said Dr. Marilyn Underwood, CCHS Environmental Health director.

 

High school students make semen frosting; serve to cooking teacher

This one is just gross.

According to the Omaha World-Herald three students added a secret ingredient into their turnover project this week.

The boys, ages 14 and 15, each masturbated into containers, then mixed their bodily fluids with frosting, according to a law enforcement official familiar with the case.shakes-desserts-turnover-apple-1024x557

The boys face misdemeanor disturbing the peace charges. Their cases will be handled in juvenile court.

The law enforcement official, who spoke on the condition of anonymity, gave the following account:

The class’ assignment was to make turnovers and frost them.

At some point, the boys excused themselves and went to a bathroom.

They eventually mixed their bodily fluids with frosting and spread them on the turnover.

Doing a quality-control check, the teacher, a female, tasted one of the turnovers and noticed something amiss.

A fellow student eventually approached the teacher and told her that he had overheard the boys talking about their plot.

The high sugar content of the frosting should reduce the chance of foodborne pathogens.

The high sugar content will not make it less gross.

Huckster: Shed no tears for Odwalla exec making another go of it (and making millions)

This is why avant-garde jazz saxophonists shouldn’t be responsible for food safety

And that’s nothing against avant-garde jazz saxophonists, although I hate jazz.

greg-steltenpohlBut what I really hate is when people make dumb decisions that lead to another’s death, all marketed with the halo of natural, and yet still heralded as some titan of business.

In late Oct. 1996, an outbreak of Escherichia coli O157:H7 was traced to juice containing unpasteurized apple cider manufactured by Odwalla in the northwest U.S. Sixty-four people were sickened and a 16-month-old died from E. coli O157:H7. During subsequent grand jury testimony, it was revealed that while Odwalla had written contracts with suppliers to only provide apples picked from trees rather than drops – those that had fallen to the ground and would be more likely to be contaminated with feces, in this case, deer feces — the company never verified if suppliers were actually doing what they said they were doing. Earlier in 1996, Odwalla had sought to supply the U.S. Army with juice. An Aug. 6, 1996 letter from the Army to Odwalla stated, “we determined that your plant sanitation program does not adequately assure product wholesomeness for military consumers. This lack of assurance prevents approval of your establishment as a source of supply for the Armed Forces at this time.”

Once a huckster, always a huckster.

Stephanie Strom of the N.Y. Times reports for the past 20 years, Greg Steltenpohl, an avant-garde jazz saxophonist turned beverage entrepreneur, has worked to rekindle the magic behind his greatest hit — and make peace with a nightmare that led to an abrupt fall.

Food safety issue: Mr. Steltenpohl started the juice company Odwalla in 1980, selling drinks out of his band’s Volkswagen van in and around San Francisco. Within a few years, the company was a multimillion-dollar business, flying high as one of the first breakout healthy drinks now commonplace in grocery aisles.

Then, in 1996, a child died and dozens were sickened because of contaminated apple juice produced by Odwalla, changing everything. About 90 percent of the company’s revenue evaporated almost overnight in the wake of the outbreak. With the company on the brink of bankruptcy, Mr. Steltenpohl and his partners were forced to sell a controlling interest in Odwalla to private equity firms, the equivalent — to him — of selling out to the devil. Not long after, the company was sold to Coca-Cola.

odwalla-cider-e-coliDude, you sold out long before that, pushing production and foregoing safety to make bucks.

Quite a fairytale he spins.

“Odwalla took him to the top of the world and then to the bottom,” said Berne Evans, his business partner today. “I don’t think he’s ever gotten over it.”

But now Mr. Steltenpohl, a gentle and avuncular 62, is once again near the center of beverage industry buzz as the head of Califia Farms, a nut milk business that is fast expanding into bottled coffees and other drinks. This time, he is taking advantage of a new trend sweeping the industry, as young beverage companies — empowered by changes in distribution and consumer tastes — are rising and competing successfully with titans like Coca-Cola and PepsiCo.

Only a few years after its founding, in 2012, Califia is on track to ring up $100 million in sales and is adding products at a fast clip. The company is considered one of the hottest young brands in the beverage world, leading to whispers about whether one of the big competitors will soon swoop in with a buyout offer that Mr. Steltenpohl and his partners can’t refuse.

Not this time, he insists. “I’ve had to sell out once,” Mr. Steltenpohl said. “That was enough.”

The story has lots of financial stuff, and how people who know shit about food safety market and sell shit to people who don’t know better, and the people who know shit make billions.

With Trump as President, the time is ripe for a comeback, I guess.

Duane Stanford, the editor of Beverage Digest, said a young beverage company today can buy its flavors from a flavor house, branding expertise from a branding expert and manufacturing from a producer on contract.

“You have this situation where these companies can become viable, robust, cash-generating businesses without the help of a big company,” he said. “They’re even getting creative at building independent distribution networks.”

Odwalla came together out of a necessity to eat. After graduating from Stanford with a degree in environmental sciences, Mr. Steltenpohl joined with some friends to start a band called the Stance. He also got hooked on the taste of fresh-squeezed orange juice, which his father made for him.

“We were a band of musicians who weren’t really that accomplished — or popular,” Mr. Steltenpohl said of himself and the band members, who became his partners in Odwalla. “We were broke and starving, and we figured if we started a juice business, we could live off the juice and maybe make a little extra.”

He read a book, “100 Businesses You Can Start For $100,” and the partners invested in a juicer and started making juice. They didn’t even try to break into groceries and convenience stores, instead stocking refrigerators in video stores and laundromats with Odwalla fresh juice each day. “Everyone who was a musician back then was basically living out of a VW bus,” Mr. Steltenpohl said. “We quit living in ours and began selling juice out of the back.”

For most of its early years, the Santa Cruz Community Credit Union financed the company. But as consumers cottoned on to its intensely flavored, wacky mixes of unpasteurized juice, it needed something more.

In October, 1996, a 16-month-old Denver girl drank Smoothie juice manufactured by Odwalla Inc. of Half Moon Bay, California. She died several weeks later; 64 others became ill in several western U.S. states and British Columbia after drinking the same juices, which contained unpasteurized apple cider — and E. coli O157:H7. Investigators believed that some of the apples used to make the cider might have been ins

The brand’s claims about the healthiness came back to haunt it as reporters dug into its failure to heed warnings about food-safety lapses.

Those failures are legendary in the food safety world, and a similar failure for Steltenpohl to say, “(Coke) never saw the enormous potential of the Odwalla brand and instead saw it as just another product in the juice portfolio.”

It’s also a failure for the N.Y Times to not report how those Odwalla failures went straight to the top..

Odwalla’s brand is nothing more than a cautionary food safety fairytale.

I have many.

Maybe Cafia will become one.

Hucksters.

The story notes that Steltenpohl is also trying to avoid past mistakes. The plant is equipped with cutting-edge food-safety monitors that share alerts about problems as they happen with the entire senior management team. Josh Butt, who previously oversaw food safety systems at Danone, the big French dairy company, presides over the plant’s operations.

Cutting-edge is a phrase that appeals to investors but means shit to any food safety type.

Cutting corners is this guy’s calling card.

And making a buck.

This is what I wrote at the time:

Sometime in late September 1996, 16-month-old Anna Gimmestad of Denver has a glass of Smoothie juice manufactured by  Odwalla Inc. After her parents noticed bloody diarrhea, Anna was admitted to Children’s Hospital on Oct. 16.  On 8 November 1996 she died after going into cardiac and respiratory arrest.  Anna had severe kidney problems, related to hemolytic uremic syndrome and her heart had stopped several times in previous days.

The juice Anna — and 65 others who got sick — drank was contaminated with E. coli O157:H7, linked to fresh, unpasteurized apple cider used as a base in the juices manufactured by Odwalla.  Because they were unpasteurized, Odwalla’s drinks were shipped in cold storage and had only a two-week shelf life.  Odwalla was founded 16 years ago on the premise that fresh, natural fruit juices nourish the spirit.  And the bank balance: in fiscal 1996, Odwalla sales jumped 65 per cent to $60 million (U.S.).  Company chairman Greg Steltenpohl told reporters that the company did not routinely test for E. coli because it was advised by industry experts that the acid level in the apple juice was sufficient to kill the bug.

Who these industry experts are remains a mystery.  Odwalla insists the experts were the U.S. Food and Drug Administration.  The FDA isn’t sure who was warned and when.   In addition to all the academic research and media coverage concerning verotoxigenic E. coli cited above, Odwalla claimed ignorance.

In terms of crisis management — and outbreaks of foodborne illness are increasingly contributing to the case study literature on crisis management — Odwalla responded appropriately.  Company officials responded in a timely and compassionate fashion, initiating a complete recall and co-operating with authorities after a link was first made on Oct. 30 between their juice and illness.  They issued timely and comprehensive press statements, and even opened a web site containing background information on both the company and E. coli O157:H7.  Upon learning of Anna’s death, Steltenpohl issued a statement which said, “On behalf of myself and the people at Odwalla, I want to say how deeply saddened and sorry we are to learn of the loss of this child.  Our hearts go out to the family and our primary concern at this moment is to see that we are doing everything we can to help them.”

For Odwalla, or any food firm to say it had no knowledge that E. coli O157 could survive in an acid environment is unacceptable.  When one of us called this $60-million-a-year-company with the great public relations, to ask why they didn’t know that E. coli O157 was a risk in cider, it took over a day to return the call.   That’s a long time in crisis-management time.  More galling was that the company spokeswoman said she had received my message, but that her phone mysteriously couldn’t call Canada that day.

Great public relations; lousy management.  What this outbreak, along with cyclospora in fresh fruit in the spring of 1996 and dozens of others, demonstrates is that, vigilance, from farm to fork, is a mandatory requirement in a global food system.  Risk assessment, management and communication must be interlinked to accommodate new scientific and public information.  And that includes those funky and natural fruit juices.

Risk-based: Foodborne illness strategy in Australia

Foodborne illness is a global public health burden. Over the past decade in Australia, despite advances in microbiological detection and control methods, there has been an increase in the incidence of foodborne illness. Therefore improvements in the regulation and implementation of food safety policy are crucial for protecting public health.

aust-food-safetyIn 2000, Australia established a national food safety regulatory system, which included the adoption of a mandatory set of food safety standards. These were in line with international standards and moved away from a “command and control” regulatory approach to an “outcomes-based” approach using risk assessment. The aim was to achieve national consistency and reduce foodborne illness without unnecessarily burdening businesses.

Evidence demonstrates that a risk based approach provides better protection for consumers; however, sixteen years after the adoption of the new approach, the rates of food borne illness are still increasing. Currently, food businesses are responsible for producing safe food and regulatory bodies are responsible for ensuring legislative controls are met. Therefore there is co-regulatory responsibility and liability and implementation strategies need to reflect this. This analysis explores the challenges facing food regulation in Australia and explores the rationale and evidence in support of this new regulatory approach.

Australian food safety policy changes from a “command and control” to an “outcomes-based” approach: Reflection on the effectiveness of its implementation

Int. J. Environ. Res. Public Health 2016, 13(12), 1218; doi:10.3390/ijerph13121218

James Smith, Kirstin Ross and Harriet Whiley

http://www.mdpi.com/1660-4601/13/12/1218/htm

Just in time for the holidays: H-E-B recalls raw shelled pistachios for Salmonella

San Antonio, TX – H-E-B announced today that it has issued a recall for both bulk and packaged raw shelled pistachios. The product is being removed because there is potential it could be contaminated with Salmonella.

pistachiosThe issue was discovered through FDA routine sampling.

There have been no reports of illness to date and all product has been removed from stores.

Darwin parents urged to vacuum up gecko and frog poo amid spike in Salmonella cases

Darwin is in northern Australia.

It’s close to the equator.

geckoIt’s hot.

ABC News reports Top End parents are being urged to vacuum up tiny brown and white droppings of gecko poo amid an above-average rise in salmonella cases affecting young children.

Darwin annually records above national average rates of salmonella, especially among children under five during the humid months around Christmas.

This wet season is no different, however the past month has seen an unexpected rise in cases.

“We’re getting about 50 per cent more than we’d expect at the moment,” Dr Peter Markey, head of disease surveillance at the NT Centre for Disease Control, said.

There are many different strands of salmonella, with the disease’s spread generally linked to contaminated food, warm conditions, polluted water, unclean surfaces and the spread of faecal matter.

Symptoms include fever, diarrhoea, vomiting and dehydration, with children and the elderly especially badly affected.

Dr Markey said Top End-specific research conducted by the centre in recent years had identified many well-known risk factors.

“We’ve isolated salmonella from geckos, lizards, snakes. Dogs and cats and turtles are important carriers too. Goldfish even, because aquarium water can be contaminated.”

Dr Markey said young children handling pets and then not washing their hands would often lead to them getting sick, however some might be getting sick from actually eating tiny animal faeces.

Gecko poo is generally elongated and brown, sometimes with a tip of white, and is often mistaken for mouse or rat droppings.

“Toddlers of course live on the ground and crawl around and put anything in their mouths,” Dr Markey said.

“We showed that regular vacuuming can help.

“It’s important to get that gecko poo or the frog poo off the ground or balcony.”

 

Chlorine works, focus on public health: NZ campy-in-water inquiry wraps up with 16 draft recommendations

I served on one of those water inquires, back in Canada after the 2000 outbreak of E. coli O157:H7 that killed seven and sickened 2,300 residents in Walkerton, Ontario, Canada, a town of about 5,000.

Walkerton Water Tower

Walkerton Water Tower

It was decent work, but what surprised me most was the actions taken by various social actors in the aftermath of the outbreak: protect themselves, public health be damned.

The number of higher-ups who wanted to meet with me to express why they did what they did, in a private chat, had absolutely no influence on my conclusions, and was sorta repulsive.

Maybe I was naïve.

Still am (I’m the full professor from Kansas State University who got fired for bad attendance with  — nothing, except my family, and that makes a good Hollywood tale).

In August, 2016, about 5,530 or 39 per cent of Havelock North, New Zealand’s population reported gastroenteritis from Camplylobacter in the water supply, 1,072 of those confirmed cases.

Nicki Harper of the New Zealand Herald reports a government inquiry into contamination of a Hawke’s Bay water supply has made 16 draft recommendations.

The inquiry into the Hastings District Council’s request to re-activate a Brookvale Road bore to augment Havelock North’s peak summer water supply retired today with a set of draft recommendations.

Before wrapping up proceedings, inquiry panel chair Lyn Stevens QC thanked the Hawke’s Bay Regional Council (HBRC) and Hastings District Council (HDC) for the efforts they made that resulted in the regional council dropping its prosecution of the Hastings council.

This agreement came after the first day of hearings on Monday, when pressure was applied by the panel to re-consider the charges.

After extensive questioning on Monday, the regional council agreed to withdraw the charges relating to breaches of the Hastings District Council’s resource consent conditions for taking water from Brookvale bores 1 and 2 – opting to instead consider issuing infringement notices.

Mr Stevens said, “The panel has noted a level of defensiveness in some of the evidence filed to date.

“I’m not being critical of any organisation or witness but wish to emphasise the overriding interest with this inquiry is the public interest, while we look to fulfil the terms of reference to determine the possible causes of contamination.”

A set of 16 draft recommendations were issued and Mr Stevens said the joint working group would be an important conduit to implement them.

The aim was to have the bore re-opened at the end of January before Havelock North water use reached peak demand in February.

Among the recommendations was a directive that the working group – comprising representation from HDC, HBRC, the DHB and drinking water assessors – meet regularly and share information of any potential drinking water safety risk.

For at least 12 months from December 12, the bore would receive cartridge filtration, UV and chlorine treatment, and a regime of regular montioring be implemented.

It was also recommended that the HDC draft an Emergency Response Plan before Bore 3 was brought on line.

Rapid testing for big 6 shiga toxin E. coli in slaughterhouses

Six major Shiga toxin producing Escherichia coli (STEC) serogroups: O26, O103, O145, O111, O121, and O45 have been declared as adulterants in federally inspected raw beef in the USA effective June 4th, 2012 in addition to the routinely tested STEC O157: H7. This study tests a real-time multiplex PCR assay and pooling of the samples to optimize the detection and quantification (prevalence and contamination) of six major non-O157 STEC, regardless of possessing Shiga toxins.

imagesTo demonstrate the practicality, one large-scale slaughter plant (Plant LS) and one small-scale slaughter plant (Plant SS) located in the Mid-Western USA were sampled, in 2011, before the establishment of 2013 USDA laboratory protocols. Carcasses were sampled at consecutive intervention stations and beef trimmings were collected at the end of the fabrication process. Plant SS had marginally more contaminated samples than Plant LS (p-value 0.08). The post-hide removal wash, steam pasteurization, and lactic acid (≤5%) spray used in Plant LS seemed to reduce the six serogroups effectively, compared to the hot-water wash and 7-day chilling at Plant SS.

Compared to the culture isolation methods, quantification of the non-O157 STEC using real-time PCR may be an efficient way to monitor the efficacy of slaughter line interventions.

Evaluating the efficacy of beef slaughter line interventions by quantifying the six major non-O157 Shiga toxin producing Escherichia coli serogroups using real-time multiplex PCR

Food Microbiology, Volume 63, May 2017, Pages 228-238, DOI: http://dx.doi.org/10.1016/j.fm.2016.11.023

KST Kanankege, KS Anklam, CM Fick, MJ Kulow, CW Kaspar, BH Ingham, A Milkowski, D Döpfer

http://www.sciencedirect.com/science/article/pii/S0740002016305639