Jimmy Page played it: Song Remains the Same in Ireland for Hep A and Norovirus in berries

I’m conflicted about food safety advice regarding frozen berries.

I love the berries.

melon.berriesBut there have been thousands stricken with Hepatitis A from frozen berries.

At my last annual blood test, I asked the physician to check if I had a titer against Hep A because I couldn’t remember if I got my second shot before coming to Australia.

I had and I have.

A while ago, a food safety type said I was silly for boiling frozen berries.

Yes, it reduces the nutritional value.

But for the thousands who have become sick with Hep A from frozen berries in Europe, as well as dozens in Australia and North America, the advice seems prudent.

And was reiterated by the Food Safety Authority of Ireland yesterday.

Why is the FSAI reiterating its advice to boil imported frozen berries for one minute?
As a result of recent outbreaks of norovirus in Sweden and hepatitis A virus in Australia, both of which have been linked to the consumption of imported frozen berries, the FSAI is reiterating its advice to continue to boil imported frozen berries for one minute before consumption. This is particularly important when serving these foods to vulnerable people such as nursing home residents.
The outbreak in Sweden occurred in a nursing home in the beginning of May, causing 70 people to become ill with norovirus.  Three deaths are reported to have been potentially linked to this outbreak.  Contrary to national food safety advice in Sweden, the frozen imported raspberries were served uncooked in a dessert. Microbiological analysis confirmed the presence of norovirus in the frozen berries.

Could contaminated imported frozen berries be on sale in Ireland?
There is no indication that batches of berries implicated in the recent Swedish and Australian outbreaks have been imported into Ireland. These outbreaks, however, demonstrate an ongoing risk in the global imported frozen berry supply chain.

How do I know if frozen berries are imported?
If the label does not state the country of origin, you should assume that the berries are imported. The shop where you purchased the berries may be able to provide this information.

Will retailers be displaying notices about the requirement to boil imported frozen berries?

frozen-berriesRetailers selling imported frozen berries need to ensure that the berries they use are sourced from reputable suppliers operating effective food safety management systems and comprehensive traceability systems. As the food chain can be quite complex, it is necessary for food businesses at each stage of the food chain to seek assurances regarding the effectiveness of the food safety management systems in place from their suppliers. If such assurances are not available, the FSAI recommends that the retailer displays a notice advising customers that the frozen berries should be boiled for one minute before consumption.

How do I know that the berries used by food businesses (e.g. smoothie bars, cake manufacturers, etc.) are safe to eat?
Food businesses using imported frozen berries need to ensure that the berries they use are sourced from reputable suppliers operating effective food safety management systems and comprehensive traceability systems. As the food chain can be quite complex, it is necessary for food businesses at each stage of the food chain to seek assurances regarding the effectiveness of the food safety management systems in place from their suppliers. If such assurances are not available, the FSAI recommends that the berries should be boiled for one minute before being used in foods.

What if I have some berries in my freezer at home – are these safe to eat?
If the berries are imported you should boil them for one minute before consumption. Boiling for one minute will destroy viruses, if present.

Are fresh berries safe/ok to eat?
There is no evidence to suggest that fresh Irish or fresh imported berries are a risk. Fresh berries should be washed before consumption which is in keeping with the advice for all fresh fruit and vegetables.

Can I eat the berries I grow in my own garden?
Yes, this issue only relates to frozen imported berries and so this advice does not apply to berries grown in your own garden and frozen after picking.

Why are imported frozen berries more of a risk than other types of berries?
Across Europe, more outbreaks have been linked to imported frozen berries than to other types of berries.  Freezing preserves viruses such as norovirus and hepatitis A.

Are all frozen berries a risk?
This safety advice refers to imported frozen berries, such as raspberries, strawberries, redcurrants, blackberries, blackcurrants and blueberries. However, as a precaution, we are advising that all imported frozen berries should be boiled for one minute before consumption.

Are tinned berries also a risk?
No, tinned or canned berries have not been identified as a risk.

What if I have eaten frozen berries recently, without boiling them?
The time from consumption of contaminated food to the onset of illness with hepatitis A, ranges from 15-50 days, with the average being 28 days. In the case of norovirus, symptoms usually appear around 12 to 48 hours after consuming contaminated food.
If you think that you have consumed frozen berries and may be ill as a result, you should seek medical advice. This applies in all cases if you believe that any food you have eaten has made you ill.

Should I stop buying frozen berries?
No, there is no need to stop buying frozen berries. Frozen imported berries should be boiled before eating until further notice.

I have given my toddler/child puree made from frozen berries, should I be worried?
If you are concerned about your toddler/child, you should seek medical advice but you should not be concerned about giving them berries that have been boiled. Boiling for one minute will destroy viruses, if present.

What is hepatitis A and what are the symptoms?
Hepatitis A infection is an acute disease of the liver caused by the hepatitis A virus. There are five main hepatitis viruses, referred to as types A, B, C, D and E.
Illness usually starts about 28 days after exposure to the virus, but it can start anytime between 15 and 50 days after infection. The most common symptoms are fever, loss of appetite, nausea, fatigue and abdominal pain, followed within a few days by jaundice. The disease often fails to show the noticeable symptoms or is mild, particularly in children below five years. Jaundice occurs in 70-80% of people aged over 14 years and less than 10% of children younger than six years. Symptoms may last from one or two weeks to a number of months. Prolonged, relapsing hepatitis for up to one year occurs in 15% of cases.

What should I do if I think I have hepatitis A?
You should seek medical advice. More information on hepatitis A can be found on the Health Protection Surveillance Centre (HPSC) website

How is hepatitis A virus spread ?
Hepatitis A is a human virus that is primarily spread from person-to-person via the faecal-oral route. The virus is shed in the faeces of infected people. It may also be spread through food that has been contaminated by infected food handlers or by contaminated water. People who have the virus are most infectious in the week or two before onset of symptoms and may be infectious up to one week after onset.

What is norovirus and what are the symptoms?
Norovirus is one of the most common causes of gastroenteritis. Symptoms include – nausea (often sudden onset), vomiting (often projectile) and watery diarrhoea. Symptoms begin around 12 to 48 hours after becoming infected. The illness is usually brief, with symptoms lasting only about 1 or 2 days. Most people make a full recovery within 1-2 days, however some people (usually the very young or elderly) may become very dehydrated and require hospital treatment.d

What should I do if I think I have norovirus?
You should seek medical advice. More information on norovirus can be found on the Health Protection Surveillance Centre (HPSC) website

How is norovirus spread?
Noroviruses are very contagious and can spread easily from person-to-person. Both the faeces and vomit of an infected person contain the virus and are infectious. People infected with norovirus are contagious from the moment they begin feeling ill to 2/3 days after recovery. Some people may be contagious for as long as 2 weeks after recovery.
It is important for people to use good handwashing and other hygienic practices after they have recently recovered from norovirus illness. In addition, noroviruses are very resilient and can survive in the environment (e.g. on surfaces) for a number of weeks.

How might berries become contaminated with norovirus and hepatitis A virus?
Contamination could occur on the farm, through use of sewage-contaminated agricultural water or through contamination by infected workers. Cross-contamination could occur post-harvest along the supply chain, through contact with contaminated surfaces of machines, equipment and facilities during freezing, mixing and packaging processes.

When did the FSAI first recommend boiling of imported frozen berries?
The FSAI first issued this advice in 2013, during the investigation of an outbreak of hepatitis A virus in Ireland which was linked to imported frozen berries.  The outbreak turned out to be part of a multi-state outbreak, with over 1,000 cases reported in 12 EU countries.

What was the source of contamination of the frozen berries in the 2013 hepatitis A virus outbreak?
The multi-state investigation did not identify the source of the contamination. The investigation concluded that contamination could have occurred at the freezing processor or at the primary production stage.  It highlighted the importance of compliance with Good Hygiene Practice (GHP) and Good Agricultural Practice (GAP) and cautioned that contaminated product related to the outbreak could still be circulating in the food chain.

What was the evidence that linked imported frozen berries with the 2013 multi-state hepatitis A virus outbreak in Europe?
Contaminated batches of mixed frozen berries/berry-containing products were identified in Italy, France and Norway and were recalled from the market. This evidence together with epidemiological and environmental investigations from the affected countries identified frozen berries as the mostly likely vehicle of infection for this outbreak and suggested that it could be a single outbreak linked to a common, continuous source of contamination.
At the request of the European Commission, the European Food Safety Authority (EFSA) coordinated the tracing activities of affected Member States. This work involved collecting data on the source of each berry delivery from retail sale back to the farmer to see if a common source or sources of contamination could be identified. Bulgarian blackberries and Polish redcurrants were identified as the most common ingredient in the food consumed by affected people. However, this might be explained by the fact that Poland is the largest producer of redcurrants in Europe, and Bulgaria is a major exporter of frozen blackberries. While no single point source of contamination was identified, twelve food operators were identified with links to cases and batches in five of the countries affected.

Fancy food ain’t safe food: NY Swan Club edition

Several clues point to the highly contagious norovirus as the mystery culprit that may have sickened more than 100 weekend guests at the Swan Club, leading county health officials to shut it down temporarily, the Roslyn catering hall’s owner said.

SwanClub2The Swan Club, which has been around for decades, has served as the backdrop to many GOP dinners and fundraisers, and owner Bobby Sidana worries the outbreak has damaged his business’ reputation. He received 300 calls Wednesday, most of them customers who support him.

He said he contacted health officials Monday as soon as guests notified him about gastrointestinal problems. The health department has ordered his staff to undergo tests, including for norovirus, he said, and will be looking at the facilities of the club’s food purveyors.

“We said just come in and do a full inspection here,” Sidana said. “We don’t want to take a chance with safety.”

Michigan Carrabba’s outbreak confirmed as norovirus

Last week I was part of a panel with Aron Hall and Chip Manuel at the Food Safety Summit. For an hour and a half we talked burden, outbreaks, sanitizers, vomit and social media. The conclusion was there’s a bunch a noro in the U.S.; it sticks around for a long time in the environment; and, restaurants are a popular place for outbreaks. Like Carrabba’s Italian Grill in Delta Township, MI.635991863436297897-IMG-2401

The department announced the findings Wednesday afternoon, but it was not clear how many people were sickened in the outbreak. The agency said in a news release and on its Facebook page that more than 100 people became ill after eating at the restaurant over two days in May. But Greg Cabose, the agency’s community services supervisor, disputes the number of people stricken. He declined to give a total Wednesday, but earlier this week pegged the figure who became ill at closer to 30.

All of the people who were sickened ate at the restaurant on May 7 or May 8, the department said. Carrabba’s voluntarily shut down on May 10 after a visit from Health Department officials. The restaurant was cleared to reopen May 12 and there have been no sickness complaints since.

Yes Virginia, even scientists get Norovirus

The New Mexican reports more than 30 top scientists attending a symposium in Santa Fe earlier this month were sickened in an outbreak of Norovirus.

santa.barf_sprout_raw_milk(7)The conference at the Hilton Santa Fe Historic Plaza hotel drew 251 people, including participants from the University of California-Berkeley, Stanford, Harvard and the Massachusetts Institute of Technology, as well as various prestigious biomedical research centers here and abroad.

And unfortunately between 30 and 40 of them experienced sudden bouts of vomiting, diarrhea and stomach cramps, according to the state health department.

One person went to the hospital, another to urgent care, but no one was hospitalized and nobody had complications.

The cause is undetermined and might remain so, said David Selvage, bureau chief for the Infectious Disease Epidemiology Bureau.

Keystone Symposia on Molecular and Cellular Biology, which hosted the event, is a nonprofit that convenes peer-reviewed conferences across a range of life sciences. It’s a regular visitor to Santa Fe and plans other conferences in the city later this year and in 2017. The one that opened May 2 was titled “Epigenetic and Metabolic Regulation of Aging and Aging-Related Diseases.”

The Hilton notified the health department and took immediate precautions by ordering in food for the symposium from outside vendors, even though there was no determination that the source of the norovirus was the hotel kitchen.

“They really wanted to do the right thing and did,” Selvage said.

In fact, because there were no other complaints from other hotel guests, Selvage suspects the origin was something else — person-to-person transmission or a food item shared by many people at the symposium. “If it was a food handler, you would expect other groups attending events there to become ill and we didn’t see that,” he said.

The health department, he said, collected three specimens from people attending the conference and the state lab reported May 10 that all were positive for norovirus.

The state lab does not have a test for determining the presence of norovirus in food.

96 sickened with stomach flu at San Jose school

Not sure of the basis for this policy, but a San Jose elementary school was keeping children indoors all day Friday to stop the spread of stomach flu.

norovirus-resized-600.jpgIn a matter of weeks, 90 students and six employees at Horace Mann Elementary School have caught the virus.

It began April 29, when a student started vomiting in a classroom. Since then, more and more students have gotten sick.

The health department has ordered a complete wipe down of the facilities to stop the outbreak.

“They closed off the drinking fountain, they’ve closed off the bathroom, they’ve cleaned everything… even the posts at the school,” said parent Bethany Lewis.

Despite the sunny forecast and warm temperatures Friday, the school was on a rainy day schedule where all the kids are indoors all day, including lunch and recess.

The district calls it “social distancing,” where they limit the contact between students to try and stop the spread of germs.

On Friday, they got another six cases reported, pushing the total to 96.

22 New Rochelle, NY 8th-graders stricken by Norovirus during class trip to DC

22 eighth-grade students from Isaac E. Young Middle School in New Rochelle become violently ill during the last night of a class trip to Washington, D.C.

norovirus-2The suspicion is that students may have contracted the virus earlier that evening at restaurant or on a boat during a ferry ride. The first students began vomiting shortly after 9 p.m. with the virus continuing to spread throughout the night. School Principal Dr. Anthony Bongo said that based on a preliminary report it appears the students were infected with Norovirus

Bongo said that he worked with Dr. Weiss, the school district’s medical officer and the Westchester County Department of Health to coordinate information with GWU Hospital. “Parents of children on the trip have been kept informed by on-site staff every step of the way, and all students are safe,” said a school district spokesperson. 22 students were hospitalized. Most were released soon after but 10 remained at the hospital to be treated for dehydration. Six teachers and two chaperons worked hard throughout the night to care for the sick students, said Dr. Anthony Bongo.

40 sick: Tourism breakfast hosts Norovirus outbreak

The Door County, Wisc. tourism breakfast event held on Tuesday, May 3 resulted in 40 of the 117 attendees and employees at the Sandpiper Restaurant at Maxwelton Braes in Baileys Harbor stricken with Norovirus.

sandpiper3.20356Following the protocols required for a Norovirus outbreak, the restaurant has taken precautions to sanitize surfaces that may have come into contact with this virus, the Door County Public Health Department said in a news release. The establishment has since opened and continues to operate without further incident.

Fairytale #4: ‘No one has ever gotten sick here before’ 42 stricken with noro at wedding in Jersey

Press of Atlantic City reports the Cape May County and state health departments are investigating reports of an illness that affected dozens of people who attended a wedding at the Flanders Hotel last month.

fairy_puke_rainbow_by_lu_tih-d6mpm8qKevin Thomas, public health coordinator for the county, said Monday that 42 of 150 guests were confirmed to have fallen ill a day or two after the April 30 wedding.

“No one has ever gotten sick here before,” said Karen Bergman, catering director for the Flanders. “We’re very careful. We play by the rules. We take pride in what we do.”

Food poisoning and norovirus are the likeliest reasons for the outbreak, Thomas said, although it is possible no definitive cause will be identified.

“We find no fault with the Flanders,” said Lois Marcasciano, mother of the bride. “It was a flukey thing that people got sick. I would go back there again. I would have another wedding there.”

But will it make fewer people barf? Chipotle hires more food safety expertise

Reuters reports that David Acheson, a former official at the U.S. Food and Drug Administration and the U.S. Department of Agriculture, and David Theno, a food safety consultant and former Jack in the Box executive who is credited with fixing food safety at the fast-food chain following a deadly E. coli outbreak in the 1990s, have joined the payroll at Chipotle Mexican Grill.

chipotle.burrito.vomitThey join James Marsden, a former meat science professor at Kansas State University, and Mansour Samadpour, chief executive of IEH Laboratories & Consulting Group.

That’s a lot of egos in one sandbox.

Or as friend of the barfblog, Don Schaffner, a food science professor at Rutgers University, told Reuters,“If I had to put together a dream team to fix something, you could do a lot worse,” But, he added, “I’ve begun to wonder a little bit about too many cooks. Each of those guys is going to have a perspective on what to do to fix the problem.”

Spokesman Chris Arnold confirmed the consultants were retained last year but would not say when or detail their duties. He did say Marsden, as executive director of food safety, would have “primary responsibility for our food safety programs.”

Expanding its complement of food safety experts is part of Chipotle’s effort to rebound from a spate of disease outbreaks – including E. coli, salmonella and norovirus – last year that crushed sales, repulsed customers and slashed $6 billion off its market valuation.

“We have committed to establishing Chipotle as an industry leader in food safety, and we have assembled an extremely capable team to help us achieve that goal,” Arnold told Reuters.

chipotle_ad_2Chipotle declined to make members of the team available for interviews.

Michael Doyle, director of the Center for Food Safety at the University of Georgia, said he expected the group’s focus “would likely be more on food safety preventive controls and less on food testing.”

Chipotle’s initial response emphasized testing ingredients for pathogens with the goal of stopping any source of illness from getting into its restaurants.

Acheson criticized the Chipotle for relying too heavily on that one approach. “I’m not a believer that you can test your way to safety,” he told Reuters in early December.

At the time, he said the focus should be on improving food sourcing and handling practices, including how suppliers are approved, “how they are leveraged in terms of training, storing, handling, and preparing of food.”

Arnold said Chipotle continues to work with the IEH testing firm. Its more recent changes have focused on food preparation. For instance, Chipotle said on its latest earnings call that it had started blanching bell peppers in an effort to kill germs.

family.guy.diarrheaThe chain also has cut some small suppliers. Kenter Canyon Farms said it lost business providing oregano to Chipotle through a third-party distributor.

“When that whole scandal happened with the E. coli, when they revamped their food safety. They cut ties with a lot of growers,” said Mark Lopez, sales director for the farm.

Chipotle’s Arnold said the chain would continue to support smaller farms, and has committed to spending $10 million to help them meet its standards. But he said the company has noted that it may be difficult for “some of our smaller suppliers to meet our heightened food safety standards.”

Cutting cantaloupe and blaming consumers: Food safety starts on the farm

In 1998, the U.S. Department of Agriculture very publicly began to urge consumers to use an accurate food thermometer when cooking ground beef patties because research demonstrated that the color of meat is not a reliable indicator of safety.

cantaloupe.half_.sep_.12USDA Under Secretary for Food Safety at the time, Catherine Woteki, said, “Consumers need to know that the only way to be sure a ground beef patty is cooked to a high enough temperature to destroy any harmful bacteria that may be present is to use a thermometer.”

At the time, I said, no one uses a meat thermometer to check the doneness of hamburgers. The idea of picking up a hamburger patty with tongs and inserting the thermometer in sideways was too much effort (others insist the best way to use a tip sensitive digital thermometer is to insert into the middle of the patty at a 45 degree angle).

I was wrong.

Shortly thereafter, I started doing it and discovered, not only was using a meat thermometer fairly easy, it made me a better cook. No more burgers resembling hockey pucks, overcooked to ensure dangerous pathogens were gone. They tasted better.

By May 2000, USDA launched a national consumer campaign to promote the use of food thermometers in the home. The campaign featured an infantile mascot called Thermy who proclaimed, “It’s Safe to Bite When the Temperature is Right.”

Almost two decades later and I have the fervor of a born-again thermometerist, distributing them to friends, one meal at a time.

Sometime in the mid-2000s, in light of on-going outbreaks involving cantaloupe (rock melon) USDA started recommending that consumers wash the exterior to prevent dangerous microorganisms on the surface of the cantaloupe from coming into contact with the inner flesh.

I was not convinced.

And remain unconvinced (see video, below, from 2009).

cantaloupe.salmonella_0.featuredWhat is important that as soon as cantaloupe is chopped or cut in half, it needs to be kept cold (which is why it is disconcerting at markets and megalomarts in Australia and elsewhere to see melons sliced in half, wrapped in plastic and sitting at ambient temperature, which can be a tad warm in Brisbane).

A new study compared two cantaloupe cutting methods and concluded that it’s best to limit contact with pathogens on the farm.

Whole and cut cantaloupes have been implicated as vehicles in foodborne illness outbreaks of norovirus, salmonellosis, and listeriosis. Preparation methods that minimize pathogen transfer from external surfaces to the edible tissue are needed.

Two preparation methods were compared for the transfer of Listeria monocytogenes, Salmonella enterica serovar Typhimurium LT2, murine norovirus, and Tulane virus from inoculated cantaloupe rinds to edible tissueand preparation surfaces.

For the first method, cantaloupes were cut into eighths, and edible tissue was separated from the rind and cubed with the same knife used to open the cantaloupes. For the second method, cantaloupes were scored with a knife around the circumference sufficient to allow manual separation of the cantaloupes into halves. Edible tissue was scooped with a spoon and did not contact the preparation surface touched by the rind. Bacteria and virus were recovered from the rinds, preparation surfaces, and edible tissue and enumerated by culture methods and reverse transcription, quantitative PCR, respectively. Standard plate counts were determined throughout refrigerated storage of cantaloupe tissue.

Cut method 2 yielded approximately 1 log lower recovery of L. monocytogenes and Salmonella Typhimurium from edible tissue, depending on the medium in which the bacteria were inoculated. A slight reduction was observed in murine norovirus recovered from edible tissue by cut method 2. The Tulane virus was detected in approximately half of the sampled cantaloupe tissue and only at very low levels. Aerobic mesophilic colony counts were lower through day 6 of storage for buffered peptone water–inoculated cantaloupes prepared by cut method 2. No differences were observed in environmental contamination as a function of cutting method.

Although small reductions in contamination of edible tissue were observed for cut method 2, the extent of microbial transfer underscores the importance of preventing contamination of whole cantaloupes.

Transfer of pathogens from cantaloupe rind to preparation surfaces and edible tissue as a function of cutting method

Journal of Food Protection®, Number 5, May 2016, pp. 696-889, pp. 764-770(7)

Shearer, Adrienne E. H.; LeStrange, Kyle; Castañeda Saldaña, Rafael; Kniel, Kalmia E.