100 lawyers sickened at banquet in Philly

“What do you call 100 lawyers at the bottom of the ocean?

“An excellent start.

“l used to resent jokes like that.

“Now l see them as simple truths.”

danny.devito.war.rosesDanny DeVito in the truly fabulous divorce movie, War of the Roses.

Sam Wood of Philly.com writes that nearly 100 lawyers and law students were sickened last month after attending a banquet celebrating the Lunar New Year in Chinatown.

But even though the restaurant has a history of food-safety problems stretching back several years, the city Health Department says it cannot publicly discuss details of its investigation, citing a 1955 state law.

That law hasn’t silenced the outbreak’s victims.

It’s that social media thing, and restaurants better get used to it – fast.

About 250 people attended the feast Feb. 27 at Joy Tsin Lau, the venerable dim sum restaurant at 10th and Race Streets. Dozens of the diners reported that they felt the first symptoms two mornings later.

Chi Mabel Chan, who has owned Joy Tsin Lau for more than 30 years, denied that the diners had suffered food poisoning from the banquet.

“It was not a problem with my restaurant,” she said, theorizing that chilly weather or festivities at a karaoke bar after the dinner might be to blame.

001679_12“Maybe they got cold or drank too much,” she said of the victims.

Wow.

Good luck with that in court. Against lawyers.

The eight-course dinner – well-documented on social media – was a fund-raiser for a group of Temple University law students, the Asian Pacific American Law Student Association.

“This was the worst case of food poisoning I’ve ever witnessed,” Antima Chakraborty, a Philadelphia assistant district attorney, wrote on Yelp, a restaurant review site. “Many individuals had to go to the ER.”

City inspection reports show that Joy Tsin Lau has long had a problem maintaining food-safety standards.

Just 17 days before the banquet, a Health Department sanitarian was at Joy Tsin Lau to check back on an earlier problem. In a report dated Feb. 10, Kyria Weng wrote “that current management practices have allowed unacceptable public health or food-safety conditions.”

An Inquirer analysis of city inspection reports found that the average eat-in restaurant in Philadelphia last year had 2.3 risk factors for foodborne illness, the more serious of the two main categories defined by the Food and Drug Administration.

Weng cited Joy Tsin Lau for five such risk factors. Several of those – dumplings held at a bacteria-friendly 57 degrees, and a lack of soap and paper towels in the employee restroom – were noted as repeat violations. Weng also found nine lesser violations, called “lack of good retail practices.”

But that was an improvement over Weng’s Dec. 22 visit, when she cited the restaurant for seven risk factors for foodborne illness (including a chicken held at unsafe temperatures) and 13 lesser violations.

Back in 2010, the city Health Department filed suit against Joy Tsin Lau after deeming it a “public nuisance” and issued a cease-and-desist order for “failure to ensure that public-health standards for a safe and sanitary operation . . . are being maintained.”

City legal officials did not respond to questions asking if the city ever acted on the order or if the restaurant ever was forced to close.

David S. Haase, a Center City lawyer, said he began to feel nauseated about 30 hours after the banquet. Contrary to Chan’s theory, he said he was warmly dressed and did not go to the karaoke bar.

A combination of nonstop puking and explosive diarrhea kept him bedridden for four days.

“It was freaking terrible,” Haase said. “I’d crawl back into bed and curl up into a ball, moaning like a child with the cramps.”

Organizers, in a post-banquet e-mail to attendees, said multiple guests had sought medical attention.

Thursday, nearly four weeks after the banquet, Health Department spokesman Jeff Moran would say only that a “food source” had been identified for the outbreak.

“We are not permitted, by law, to publicly release the findings of outbreak investigations,” Moran said.

Bullshit.

He cited the Pennsylvania Disease Prevention and Control Law of 1955, which prohibits health authorities from disclosing reports or records of diseases. Though the law primarily addresses patients with venereal diseases and tuberculosis, its confidentiality clause keeps secret the details of all health investigations.

Most states have similar laws, according to Scott Burris, the codirector at Temple University’s Center for Health Law, Policy, and Practice.

“It’s pretty typical,” Burris said. “Pennsylvania is not an outlier.”

Investigators need some secrecy to collect sensitive information, he said, but the laws may go too far when it comes to alerting the public of potential threats.

“That’s a price we pay,” Burris said of secrecy laws. “It’s probably worth working on our privacy laws to see if we can find an approach that lowers that price.”

But there is no law silencing the sickened.

“If you enjoy being on your back for the 48 hours post-dinner writhing in pain, burning up, and exploding out of all orifices, then this is the restaurant for you,” wrote Jack Jiang, a University of Pennsylvania researcher who attended the banquet with his girlfriend.

In an e-mail to a reporter, Jiang said he had been bedridden for three days and suffered lingering effects through the end of the week.

Haase, who missed his daughter’s championship track meet due to the illness, said he had contacted a Health Department coordinator, who told him the outbreak was likely brought on by norovirus.

Norovirus, the most common cause of foodborne illness, sickens about 20 million people a year in the United States, according to the Centers for Disease Control and Prevention. The pathogen is often spread by contact with an infected person or by ingesting food or water contaminated by fecal matter. Acute gastroenteritis strikes usually between 24 and 48 hours after exposure to norovirus.

Caroline Johnson, director of the city’s division of disease control, said she couldn’t talk specifics, but in general said the goal of investigations “is to find out what happened, correct that problem, and move on.”

As for the secrecy, she said, “We don’t want to drive underground the facts we want to uncover.”

Her agency told Haase about the norovirus because “we feel that by telling them, they won’t need to have the wrong antibiotic prescribed to them or have unnecessary testing. It’s the right medical thing to do. I wouldn’t withhold information from them because it might have medical significance to their situation.”

Norovirus would have a much quicker onset than two days.

Going public: Inspectors fail to reveal Salmonella outbreak at popular Calif. deli

A popular LA-area restaurant may have left nearly two dozen people with salmonella poisoning over a four-month period — and health officials failed to warn the public of the danger, an NBC4 I-Team investigation has uncovered.

brent's.deli.reubenBrent’s Deli in Westlake Village, a popular family-owned restaurant dubbed by Zagat as “the Cadillac of delis,” was the suspected source of the poisonings, according to Ventura County records obtained by the I-Team. Some victims reported eating Brent’s famous corned beef sandwiches, some ate pastrami, and others believe it was salads or soups that sickened them.

“It felt like someone reached in and was tearing out my stomach,” said J.D. Leadam of Simi Valley, 25, who said he became ill two days after eating a roast beef sandwich at Brent’s in Westlake in August. He said the nausea, body aches and diarrhea were so bad that his doctor thought he might have contracted Ebola.

Days later, tests confirmed it was salmonella.

State and Ventura County health officials began learning about salmonella cases from Brent’s customers months before Leadam ate at the restaurant, but both agencies failed to inform the public about the growing outbreak.

“I wouldn’t have eaten there if the county had warned the public,” Leadam told NBC4. “I really don’t think the health department was looking out for the public.”

Records from the state health department show the first Brent’s customer became sick with salmonella symptoms in late April, with more cases reported in May, June, July and August. In total, 21 cases of salmonella were associated with the 2014 outbreak, including two Brent’s employees, according to state records.

“We generally don’t notify the public when we’re in the midst of an investigation,” said William Stratton, director of Ventura County Environmental Health, which investigated the Brent’s outbreak.

But county health departments in Los Angeles and San Francisco have alerted the public to food poisoning outbreaks within days of learning of the first cases, so that customers who experience symptoms can get proper medical care.

Bill  Marler said, “They clearly had an obligation to tell the public, from a moral and a public health perspective. This outbreak was an accident waiting to happen,” referring to Brent’s inspection history.

Since 2007, county officials have repeatedly cited Brent’s in Westlake for major health code violations — such as keeping food at unsafe temperatures and employees not properly washing their hands, both of which can spread bacteria to food.

The I-Team also found other Brent’s Westlake customers reported contracting Salmonella in 2007, 2010 and 2013 — well before the 2014 outbreak.

Ventura County health officials say in hindsight, they could have made a public statement warning the public about the outbreak.

“Is issuing a news release or notifying the public one of those things we could have done? Perhaps it is,” Stratton said. “That’s something we’re going to be evaluating.”

NBC4 spoke by phone with one of the owners of Brent’s in Westlake, Marc Hernandez, who says his restaurant is now safe to eat at.

Stadium food safety expose linked to firing

When I turned 16 my dad and I (below, exactly as shown) took a trip around the U.S. and caught a bunch of baseball games at MLB parks. Seven cities, seven games in eight days. In each of the stadiums my dad and I ate a standard hot dog (to compare and rate) as well as a sample of the local food specialty (poutine in Montreal, cheesesteaks in Philly, etc.).

I wasn’t the healthiest teenager.n564500217_1828077_9385

Food is a big part of the stadium experience for many.

In November 2014, ESPN’s Outside the Lines ran a story about Jon Costa, an Aramark employee at Kaufmann Stadium who reported frustration with his bosses over not being able to address food safety problems. Today, ESPN reported that Costa had been fired.

Jon Costa shared with “Outside the Lines” a copy of a letter he said his former employer, Aramark, sent him on March 17 saying Costa was being fired “for cause.” The letter outlines a number of reasons, the first of which is that he violated the company’s media policy by taking his concerns public.

The company defended its food safety record: “In Kansas City, we have served over 17 million fans since 2007 at hundreds of games and events and have a strong record of performance. We have continued to work closely with the Kansas City Health Department who has inspected Truman Sports Complex more than 100 times over our operating tenure. None of our Kansas City sports operations have ever been shut down by the Health Department and there have been no cases of food-related illness tied to our operations.”

In its letter of termination, Aramark also said Costa “failed to take prompt action to address food safety issues, notwithstanding documented support from his managers and direction from them to do so” and to discipline employees who were violating food safety practices.

But Costa said he had tried to solve problems by addressing them on site and bringing them to the attention of managers who never supported his efforts. He said he did not supervise anyone and had neither the authority nor training to discipline fellow employees.

The letter detailing his firing also says that Costa hampered Aramark’s relationship with the local health department and that he did not follow protocol in dealing with the department. Costa, who used to work for the City of Kansas City, Missouri, Health Department, denied those allegations. When “Outside the Lines” interviewed health department division manager Naser Jouhari in November, he said he knew Costa as a former employee and Aramark representative and that, “It’s all been pleasant. We never had any major concerns.”

Dutch meat trader at center of horse scandal faces five years in jail

The Dutch trader accused of contaminating beef with horse meat should be jailed for five years, the public prosecution department said on the opening day of his trial in Den Bosch.

willy-selten-horse-meat-trader-560x390Willy Selten is accused of mixing over 300,000 kilos of horse into products which were labelled as pure beef.  His company was at the center of the horse meat scandal which hit the European food sector two years ago. Selten is charged with selling horse to meat processing firms which had ordered beef and false accounting. In one case he supplied horse to a snack food maker in Oss even though beef had been ordered.

Selten admits making mistakes but denies that he deliberately committed fraud, using horse meat in order to earn more money. The public prosecution department claims Selten was a ‘master of deception’.

 

UK supermarkets block efforts to tackle Campylobacter

Government can’t do much to hold food producers accountable, but consumers can. That’s why microbial food safety should be marketed at retail, so consumers can vote with their dollars (or pounds).

campy.chickenThe UK Food Standards Agency has declared that supermarkets are blocking efforts to tackle Campylobacter, which is found in up to 79 per cent of raw birds on sale.

Levels are dangerously high in 19 per cent of chickens and the agency has demanded this figure should be below 10 per cent by year’s end.

It says however that Asda, Tesco, Sainsbury’s, Morrisons, Waitrose and the Co-op are failing to help. Only Marks & Spencer is giving updates on its plans and progress in tackling campylobacter.

Professor Paul Wiles of the FSA said the industry’s response had been ‘unacceptable’.

Chief executive Catherine Brown said supermarkets had ‘pushed back’ against providing information and claimed the stores were unhappy over the FSA’s publication of campylobacter league tables.

To date, only M&S has given the FSA details of its comprehensive plan to tackle campylobacter, which involves changes on farms and in slaughterhouses.

Problems public health investigators face: It’s a tough job (but we love ya for it)

In Ontario, Canada (that’s in Canada), enteric case investigators perform a number of functions when conducting telephone interviews including providing health education, collecting data for regulatory purposes ultimately to prevent further illness, enforcement, illness source attribution and outbreak detection. Information collected must be of high quality as it may be used to inform decisions about public health actions that could have significant consequences such as excluding a person from work, recalling a food item that is deemed to be a health hazard, and/or litigations. The purpose of this study was to describe, from the perspectives of expert investigators, barriers experienced and the techniques used to overcome these barriers during investigation of enteric disease cases (that’s Sider, right, exactly as shown).

doug.siderMethods

Twenty eight expert enteric investigators participated in one of four focus groups via teleconference. Expert investigators were identified based on their ability to 1) consistently obtain high quality data from cases 2) achieve a high rate of completion of case investigation questionnaires, 3) identify the most likely source of the disease-causing agent, and 4) identify any possible links between cases. Qualitative data analysis was used to identify themes pertaining to successful techniques used and barriers experienced in interviewing enteric cases.

Results

Numerous barriers and strategies were identified under the following categories: case investigation preparation and case communication, establishing rapport, source identification, education to prevent disease transmission, exclusion, and linking cases. Unique challenges experienced by interviewers were how to collect accurate exposure data and educate cases in the face of misconceptions about enteric illness, as well as how to address tensions created by their enforcement role. Various strategies were used by interviewers to build rapport and to enhance the quality of data collected.

Conclusions

To our knowledge, this is the first study to examine the perspectives of expert enteric disease case investigators on successful interview techniques and barriers experienced during enteric case investigation. A number of recommendations could improve the process of enteric case investigation in the Ontario context which include formal training and development of resource materials pertaining to interviewing, standardized interviewing tools, strategies to address cultural and language barriers, and the implementation of the single interviewer approach.

A focus group study of enteric disease case investigation: successful techniques utilized and barriers experienced from the perspective of expert disease investigators

BMC Public Health, Disease epidemiology- infectious, Volume 14, doi:10.1186/1471-2458-14-1302

Stanley Ing, Christina Lee, Dean Middleton, Rachel D Savage, Stephen Moore and Doug Sider

http://www.biomedcentral.com/1471-2458/14/1302

Regulatory myths

Ronald L. Doering, the first president of the Canadian Food Inspection Agency and currently counsel in the Ottawa offices of Gowlings, writes:

ron.doeringOne of the most persistent regulatory myths is the notion that politics can and should be kept out of science-based regulatory decision making. But as Covello and Merkhofer have clearly shown: “In practice, assumptions that have policy implications enter into risk assessment at virtually every stage of the process. The idea of a risk assessment that is free, or nearly free, of policy considerations is beyond the realm of possibility.” It is surprising how much our public discourse is still dominated by the quaint utopian view that science and policy can be strictly separated.

This enduring myth is the basis of the current kerfuffle regarding the government’s “war on science,” the allegation that decisions are based on ideology, not science, that politicizing science is a very bad thing and that all decisions must be “evidence-based.” Ironically, these same critics make a virtue out of being skeptical of mainstream science by opposing, for example, fluoridation, GM food, irradiation and vaccinations. But their basic misunderstanding is that they believe or pretend to believe that science and policy can be separated. Their whole concept of “evidence-based” is flawed. It is the legitimate and necessary role of politicians to take the science-based risk assessment and then carry out the policy based risk management function by weighing the social, political, economic, ethical and environmental factors in order to arrive at the appropriate regulatory decision. In our democratic system scientists cannot, should not, carry out what is the legitimate role of elected politicians and their senior advisers.

What should be the acceptable level of PCBs in farmed salmon? What should be the appropriate mix of rules to prevent the importation of BSE into Canada? What is the acceptable level of phthalates in plastic toys? What are the best regulations to prevent the importation of FMD into Canada? What is the right regulatory regime for the approval of genetically modified traits in seeds? What is the acceptable level of GM corn in wheat products? What should be the necessary rules for the storage of high level nuclear waste? What is the safe level of BPA in water bottles? How should the level of salt in processed food products be regulated? Should it continue to be illegal to sell raw milk? What should be the rules for raw milk cheese? This is just a small sample of the science-based public policy issues with which I was directly involved in recent years.

riskIn all of these cases it was the regulator’s task to protect the public health and safety of Canadians through a complex process of weighing the many factors involved without, may I say again, the aid of some quantitative cost benefit analysis; the factors were too complex to be monetized in a way that would be useful for decision making. In all these cases the science was relevant by not determinative. And yet in all these cases the parties argued that the basic question was one of science: if only we could get the science right, the public policy answer would follow. If only the world were that simple.

When I was president of Canada’s largest science-based regulator, I dealt regularly with scientists who were seemingly unaware how much their science advice was imbued with unstated policy considerations, and how much the uncertainty of their science required the consideration of other factors. Many academic and government scientists and their public sector unions still shamelessly march in the streets arguing that decisions must only be “evidence-based.” My nutrition and food science students seem genuinely unaware, uncomfortable even, with the idea that science-based health risk assessments are replete with policy considerations.

We need to engender a broad public debate about the role of science and scientists in policy making. For starters we need to debunk the myth that politics can and should be taken out of science-based regulation making.

UAE: Food safety violators to face stiff fine and jail

The Federal National Council (FNC) on Tuesday approved a draft law on food safety with minor amendments, with suggested jail terms of up to two years and fines ranging from Dh100,000 to Dh2 million for flouting food safety rules.

jail.monopolyThe bill will be sent back to the Cabinet for its approval and then for presidential assent for implementation. The bill was passed by the Cabinet in March last year.

The house called for the establishment of a federal authority for the research and development of techniques and policies pertaining to food safety in the country. The authority, the FNC suggested, could implement food safety regulations and services with the judicial power of imposing penalties on those found flouting food safety policies.

Under the proposed law, food imports into the country will only be done with the approval of the Ministry of Environment and Water.

Those found importing or distributing unhealthy and dangerous foodstuff will face a prison term of up to two years, and a fine ranging between Dh100,000 and Dh300,000, or both.

The proposed law also authorises the Ministry of Economy to impose fines of up to Dh100,000 for other offences regulated by the Cabinet.

The draft law also states a prison term of not less than a month and a fine of Dh500,000 for those found importing foodstuff containing any by-products of pork and alcohol without permission.

Why I don’t eat raw shellfish: Viruses in food

The UK Advisory Committee on the Microbiological Safety of Food (ACMSF) has published its extensive review of viruses in the food chain. The ACMSF set up a group to revisit the issue of foodborne viruses in light of developments in this area. The final report considered the most important viruses associated with foodborne infections – norovirus, hepatitis A, and hepatitis E.

heston_blumenthalThe report makes a number of recommendations for government departments, including the need for more research in certain areas, and for clear advice for consumers, for example on cooking shellfish and pork products and information on washing leafy green vegetables and soft fruit. The government will respond in due course when the recommendations have been considered in detail.

Professor Sarah O’Brien, Chair of the ACMSF, said: ‘Until recently it has been difficult to assess accurately the impact of foodborne viruses on public health. However, significant advances in our ability to detect viruses in food, coupled with up- to-date estimates of the burden of illness, highlighted in the ACMSF’s latest update, show us that viruses are very important, preventable causes of foodborne illness.’

Summary

In 1994, in response to the outcomes of a joint Advisory Committee of Microbiological Safety of Food (ACMSF) and Steering Group on the Microbiological Safety of Food (SGMSF) meeting, a Working Group was set up to investigate the science and epidemiology of Foodborne Viral Infections. The Working Group assessed the risk from viruses that were believed to be the primary cause of foodborne illness. This report provides an update to this information and provides a new focus on the viruses which are currently the major route of foodborne illness.

Since the publication of the 1998 report, with the exception of two minor risk assessments on hepatitis E and avian influenza, no formal review on viruses had been performed by the ACMSF. It was decided that as significant developments had been made not only in the detection of foodborne viruses, but also in the amount of information obtained from the Infectious Intestinal Disease (IID) Study in England (published in 2000), which indicated a significant disease burden from enteric viruses in the community, it was important that an Ad-Hoc Group was convened to revisit these issues and to provide an update to the 1998 risk assessment.

norovirus-2The FVI Group first met to begin their consideration in November 2010. Over 32 months, the Group met thirteen times to discuss all aspects of viruses in the food chain from farm to fork. As a starting point for the report, the Group reviewed the recommendations from the 1998 report and gave consideration as to whether these had been adequately addressed or were still relevant. At the same time the recommendations from the 2008 World Health Organisation (WHO) Viruses in Food: Scientific Advice to Support Risk Management Activities Matrix and CODEX Criteria, and the European Food Safety Authority (EFSA) Scientific Opinion on an update on the present knowledge on the occurrence and control of foodborne viruses were reviewed.

Using this information along with data on disease burden in the community and outbreak data (from IID and IID2) the Group agreed the scope of the report and what viruses would be its main focus. It was decided that that due to their potential impact and the paucity of data in this area, norovirus, hepatitis E and hepatitis A would be the main focus of the report, although many of the recommendations would also be applicable to other enteric viruses.

During its consideration, the Group reviewed available data on commodities contaminated at source, i.e. bivalve shellfish, pork products and fresh produce and reviewed data on risks associated with infected food handlers. Environmental contamination was reviewed with consideration given to testing methods such as polymerase chain reaction (PCR), person-to-person transmission and food handlers. The Group also considered the engagement with industry and other Government departments (OGDs) regarding environmental conditions of shellfish waters and its impact on norovirus.

A review of data on issues regarding food contact surface contamination, including survivability and persistence was considered along with options for control at all stages of the food chain e.g. thermal processing, storage etc. The thermal stability of hepatitis E was considered with data presented on the increasing occurrence of the disease particularly in older UK males and the recent case control study on the association with processed pork products.

In order to obtain sentinel data the group investigated the important issue of knowledge gathering and surveillance data regarding foodborne viruses. The current limitations of the data were discussed along with what type of data was needed to provide more useful/accurate information on foodborne virus outbreaks. This review included looking at outbreaks from an Environmental Health Officer (EHO) perspective and how they prioritise what they investigate and the data they collect.

Finally, the group reviewed the consumer perspective on risk. This included looking at how risk is presented and information distributed, as this was likely to impact on any future risk assessment.

Within the report the Group has endeavoured to prioritise the recommendations by separating these into those that will inform risk assessments and those that will impact on risk assessments. Full details are provided in the report; however, key recommendations include:

A better understanding of ‘’foodborne viral disease’ (Chapter 3) is required by investigating the correlation between infective dose and genome titre. Molecular diagnostics, typing and quantification should also be used to better understand the burden of virus contamination in foodstuffs. Work is also recommended to develop the methods used to assess norovirus and hepatitis E infectivity in food samples. This would better inform surveys and could potentially be applied to routine monitoring.

Improved ‘routine surveillance and investigation of foodborne viruses’ (Chapter 5) is required with Government agencies developing a single integrated outbreak reporting scheme. A joined up approach that would also involve the annual consolidation of records would reduce the chance of underreporting outbreaks. Further to this, reliable methods for norovirus whole genome sequencing should be developed to enable virus tracking and attribution.

More research on the ‘contamination of food’ (Chapter 6) through sewage contamination is recommended. In particular work should investigate the effectiveness of sewage treatment processes in reducing norovirus concentrations, including the use of depuration on shellfish species and disinfection treatments. Similarly, research is needed to identify the most effective means of decontaminating ‘fresh produce’ post-harvest (Chapter 7).

With the emerging risk of hepatitis E in pigs, the Group recommends work is undertaken to investigate the heat inactivation of hepatitis E in ‘pork products’ (Chapter 8). Research on the effect of curing and fermentation on hepatitis E in pork products is also recommended.

The full list of conclusions and recommendation are presented at the end of each subject area and are consolidated in Chapter 12 for ease of reference.

The assessments made and conclusions reached by the Group reflect evidence oral and written drawn from the scientific community, Government departments and Agencies, EFSA and the scientific literature. The Group’s full conclusions, identified data gaps and recommendations are brought together at the end of this report. The ACMSF accepts full responsibility for the final content of the report.

Prepared Indian foods recalled for botulism concerns in Scotland

A range of pre-prepared Indian foods from the Mrs Unis brand have been recalled by the Food Standards Agency following concerns over the Edinburgh-based company’s procedures to control Clostridium botulinum.

shaheen.unisThe brand, headed by veteran businesswoman Shaheen Unis, dubbed “Scotland’s curry queen”, was ordered to withdraw a range of ‘atmosphere packed’ products – including six different tyypes of pakora – from sale as a “precautionary measure”. The FSA said that there was “not enough evidence” to show that the products are safe to eat, warning that the process controls at the company’s factory at the Peffermill industrial estate, which provides foods for the retail, catering and wholesale market, were not effective in their ability to prevent the growth and toxin production of the bacterium.