Maybe something is lost in translation: 4-year-old’s death a misadventure

Kids dying from foodborne illness hits me like a punch in the gut. After following illnesses and outbreaks for 15 years I still take pause to think about my kids when I see a tragic story involving children.

Outbreaks rarely end with the classic smoking gun resolution (a genetically matched strain in the food/environment and stool). Epidemiology, in the absence of pathogen matches, is king and uncertainty is reduced with reliable data and statistics. Once a possible food/site match is made, investigators go out to the field and check the food handling out.broken-telephone

A conscientious investigator can talk about possible risk factors in a report – but the subsequent reporting and broken telephone game of sharing the information can bleed potential factors into must-have-happened fact.

A few years ago an environmental health officer shared her concerns about how the story gets changed between the field and the report interpretation. She had investigated a outbreak blamed on poor handwashing shared with me that her notes showed no soap at the time she was in the kitchen a week after the illnesses were reported – that was translated into poor handwashing by the staff at the time of the outbreak.

She felt that was an extrapolation wrought with assumptions.

Folks who used the example didn’t care.

Getting the risk factor story right really matters.

According to the Straits Times a four-year-old boy in Singapore tragically died from salmonellosis and court proceedings point to food handling practices a shopping center food court stall. Based on the coverage, I’m not sure it’s that simple. And I wouldn’t call it a misadventure.

Shayne Sujith Balasubraamaniam, together with his mother and two-year-old sister, came down with food poisoning on Jan 19 this year, a day after his mother had bought food, including tahu goreng and curry chicken, from a nasi padang stall at Kopitiam food court at Northpoint Shopping Centre.

All three were taken brought to Bukit Batok Polyclinic the next day. Shayne was assessed to be severely dehydrated and was prescribed medication.

He showed apparent signs of recovery, but deteriorated on Jan 22 when his mother found him unconscious at home. He died in hospital about two hours later from salmonella septicaemia.

On Thursday, State Coroner Marvin Bay said in his findings that the boy’s death underscores that careless food handling and inattention to proper hygienic practices can result in catastrophic consequences on young and vulnerable persons. He found the boy’s death to be one of misadventure.

The most significant lapse, the inquiry heard, was the practice of partial cooking and refreezing of chicken parts. The kitchen would receive 80 parts of chicken as a batch. After washing the batch, 60 chicken parts were refrozen for use the next day. They would be stored with plastic bags with other raw food at the freezer, a practice which would encourage cross-infection between the raw and partially cooked food. Swabs from the tongs used to handle food, and the blender found a high concentration of bacteria that exceeded safety limits.

While the post-outbreak investigation demonstrates serious issues with food handling at the business, I’m not sure what was presented is enough to link the salmonellosis. If the stored chicken was partially cooked it implies that it would be further cooked – which if temperatures exceeded 165F would result in a 5-log reduction of Salmonella. Maybe cross contamination between raw and sorta raw chicken is really a factor – especially if there weren’t other illnesses. Or maybe the washing step spread pathogens around the kitchen.

Raw sprouts with Salmonella strike again; UK wedding guests win compensation

Wedding guests have won tens of thousands of pounds worth of compensation after beansprouts served at a reception caused a deadly outbreak of food poisoning.

wedding.crashersRene Kwartz, 82, died in hospital three weeks after contracting salmonella at a Jewish celebration in Prestwich in August, 2010.

Now 25 other guests who were also struck down with the bug have settled civil cases against caterers Shefa Mehadrin and suppliers Duerden Brothers.

Among them were Colin Thornton, 57, and his wife Rozanne, 53.

Colin, who used to live in Prestwich and now lives in Clitheroe, Lancashire, said: “You expect to go to a wedding reception and have a nice meal, you don’t expect this to happen to anybody.

“I feel very sorry for the family that booked it. They must feel terrible but it wasn’t their fault.”

He added: “It is very annoying that we’ve had to fight for four and a half years for this.

“A person’s life has been lost.”

The outbreak was traced back to a batch of beansprouts served raw in a salmon teriyaki dish.

Expert guidance recommends they are cooked to kill any bacteria.

The bride’s mum Norma Harris was among the others infected, along with the groom and best man.

At the time she said: “We are devastated. My daughter doesn’t want to see her wedding photographs. We are in bits.”

The settlements, negotiated by Slater and Gordon, are understood to range from £1,000 to £5,000.

We document at least 55 sprout-associated outbreaks occurring worldwide affecting a total of 15,233 people since 1988. A comprehensive table of sprout-related outbreaks can be found at http://barfblog.com/wp-content/uploads/2014/08/Sprout-associated-outbreaks-8-1-14.xlsx.

Z Natural Foods recalls Lightly Roasted Organic Carob Powder due to possible Salmonella health risk

We all experiment in university. For me it was six months of vegetarianism, and I replaced chocolate with carob powder, as I was cooking everything from scratch.

salm.carobCarob tastes like dust.

Z Natural Foods of West Palm Beach, Florida is recalling 55 lbs of Lightly Roasted Organic Carob Powder because it has the potential to be contaminated with Salmonella.

The recalled Lightly Roasted Organic Carob Powder was available for sale directly through Z Natural Foods website at www.ZNaturalFoods.com. It was not available in retail stores.

The Lightly Roasted Organic Carob Powder was available in a 1 lb and 5 lb standup resealable foil pouches either bronze (1 lb) or silver in color (5 lb) and marked with Lot # ZNCARB39513 and a Best By Date of 12/5/2016 at the bottom of the label.

No illnesses have been reported to date and we are issuing this recall purely as a precautionary measure. The potential for contamination was noted after learning that another customer of our ingredient supplier received a positive test for Salmonella. While sampling conducted by the manufacturer did not indicate the presence of Salmonella, we are recalling this product out of an abundance of caution. No other Z Natural Foods products are affected.

And so it goes: at least 6 sick from Salmonella in frozen chicken thingies in Minn

State health and agriculture officials said today that six recent cases of salmonellosis in Minnesota have been linked to raw, frozen, breaded and pre-browned, stuffed chicken entrees. The implicated product is Antioch Farms brand A La Kiev raw stuffed chicken breast with a U.S. Department of Agriculture stamped cFunkyChickenHiode of P-1358. This product is sold at many different grocery store chains. Investigators from the Minnesota Department of Health (MDH) and the Minnesota Department of Agriculture (MDA) determined that six cases of Salmonella infection from August and September 2014 were due to the same strain of Salmonella Enteritidis. One person was hospitalized for their illness. “Our DNA fingerprinting found that the individuals were sickened by the same strain of Salmonella,” said Dr. Carlota Medus, epidemiologist for the Foodborne Diseases Unit at MDH. “The Minnesota Department of Agriculture collected samples of the same type of product from grocery stores and the outbreak strain of Salmonella was found in packages of this product.” There have been six outbreaks of salmonellosis in Minnesota linked to these types of products from 1998 through 2008. This is the first outbreak since improvements were made in 2008 to the labeling of these products. The current labels clearly state that the product is raw.  Salmonella is sometimes present in raw chicken, which is why it is important for consumers to follow safe food-handling practices. This includes cooking all raw poultry products to an internal temperature of at least 165 degrees Fahrenheit. “The problem arises when consumers don’t realize that they are handling and preparing a raw product,” according to Dr. Carrie Rigdon, an investigator for the MDA Dairy and Food Inspection Division. MDA and MDH officials advised that consumers with these products in their freezers, if they choose to use them, should cook them thoroughly. Other important food handling practices include hand washing before and after handling raw meat, keeping raw and cooked foods separate to avoid cross-contamination, and placing cooked meat on a clean plate or platter before serving. Consumers can find more information about safe food-handling practices on the MDH website at: www.health.state.mn.us/foodsafety. Symptoms of salmonellosis include diarrhea, abdominal pain and cramps and fever. Symptoms usually begin within 12 to 72 hours after exposure, but can begin up to a week after exposure. Salmonella infections usually resolve in 5 to 7 days, but approximately 20 percent of cases require hospitalization. In rare cases, Salmonella infection can lead to death, particularly in the elderly or those with weakened immune systems.

Direct video observation of adults and tweens cooking raw frozen chicken thingies 01.nov.09
 British Food Journal, Vol 111, Issue 9, p 915-929 
Sarah DeDonder, Casey J. Jacob, Brae V. Surgeoner, Benjamin Chapman, Randall Phebus, Douglas A. Powell
 http://www.emeraldinsight.com/Insight/viewContentItem.do;jsessionid=6146E6AFABCC349C376B7E55A3866D4A?contentType=Article&contentId=1811820
 Abstract:
 Purpose – The purpose of the present study was to observe the preparation practices of both adult and young consumers using frozen, uncooked, breaded chicken products, which were previously involved in outbreaks linked to consumer mishandling. The study also sought to observe behaviors of adolescents as home food preparers. Finally, the study aimed to compare food handler behaviors with those prescribed on product labels.
 Design/methodology/approach – The study sought, through video observation and self-report surveys, to determine if differences exist between consumers’ intent and actual behavior. chicken.thingies.raw.cook
Findings – A survey study of consumer reactions to safe food-handling labels on raw meat and poultry products suggested that instructions for safe handling found on labels had only limited influence on consumer practices. The labels studied by these researchers were found on the packaging of chicken products examined in the current study alongside step-by-step cooking instructions. Observational techniques, as mentioned above, provide a different perception of consumer behaviors. 
Originality/value – This paper finds areas that have not been studied in previous observational research and is an excellent addition to existing literature.

North Carolina firm recalls Serrano peppers

A 2008 Salmonella Saintpaul outbreak initially thought to be solely tomatoes was eventually linked to  a couple of types of peppers. According to a 2011 paper published by the investigation team  raw tomato-containing dishes (like salsa) were linked to three clusters of illnesses but jalapeño peppers at a shipper in Texas and agricultural water and Serrano peppers on a Mexican farm were all found to contain the outbreak strain.

Peppers hadn’t been implicated as a vehicle for illness in an outbreak until then. Since then buyers (like retailers and food service firms) have increased focus on all fresh produce – and have increased product testing. So have state health officials.220px-Serranochilis

According to a press release posted at the U.S. Food and Drug Administration’s website,

A random sample was taken by the Michigan Department of Agriculture on October 13, 2014 from a warehouse in Lansing, Michigan. Bailey Farms, Inc. received notice that the sample tested positive for Salmonella on October 20, 2014.

Bailey Farms, Inc. of Oxford, NC is voluntarily recalling 6,215 pounds of Fresh Serrano Chile Peppers, because it has the potential to be contaminated with Salmonella.
 
The Fresh Serrano Chile Peppers was distributed to Meijer, Inc. and customers may have purchased this product from October 14th to October 19th at Meijer stores in Michigan, Illinois, Indiana, Kentucky and Ohio.
 
In addition this product was distributed to Publix Super Markets Inc., Merchants Distributors, Inc., Walmart, Food Lion, Flavor 1st Growers and Packers, US Foods, Military Produce Group, LLC.,C&S Wholesalers, John Vena, Inc. and Harris Teeter. Consumers who suspect they may have purchased Fresh Serrano Chile Peppers from the above listed companies between the dates of October 2, 2014 to October 21, 2014 should check with the above listed companies to verify if the product was subject to recall.
 
This recall is the result of the possibility that the remainder of these lots could be contaminated with this bacteria. We are working with the North Carolina Department of Agriculture and Consumer Services to investigate the root cause of the potential contamination.
No illnesses have been reported/linked to this recall.

Salmonella in sprouts sparks Organic Traditions brand sprouted flax seed powder recalled due to Salmonella

Sprouts, especially the organic kind, you never fail – fail to initiate recalls.

organic.sprouts.recall.cdnAdvantage Health Matters is recalling Organic Traditions brand Sprouted Flax Seed Powder from the marketplace due to possible Salmonella contamination. Consumers should not consume the recalled products described below.

Recalled products

Brand Name Common Name Size Code(s) on Product UPC
Organic Traditions Sprouted Flax Seed Powder 227 g BIO13SGF291 8 54260 00626 1
Organic Traditions Sprouted Flax Seed Powder 454 g BIO13SGF291 8 54260 00553 0

This recall was triggered by the Canadian Food Inspection Agency (CFIA) test results. The CFIA is conducting a food safety investigation, which may lead to the recall of other products. If other high-risk products are recalled, the CFIA will notify the public through updated Food Recall Warnings.

The CFIA is verifying that industry is removing recalled product from the marketplace.

There have been no reported illnesses associated with the consumption of these products (not yet).

We document at least 55 sprout-associated outbreaks occurring worldwide affecting a total of 15,233 people since 1988. A comprehensive table of sprout-related outbreaks can be found at http://barfblog.com/wp-content/uploads/2014/08/Sprout-associated-outbreaks-8-1-14.xlsx.

(This is not satire) 363 sickened in multistate outbreak of human Salmonella infections linked to live poultry in backyard flocks (final update)

The U.S. Centers for Disease Control and Prevention reports:

  • This outbreak appears to be over. However, live poultry, including those kept in backyard flocks, remain an important cause of human Salmonella infections in the United States. More information about Salmonella from live poultry and the steps people can take to reduce their risk of infection is available.
  • OLYMPUS DIGITAL CAMERAA total of 363 persons infected with the outbreak strains of Salmonella Infantis, Salmonella Newport, or Salmonella Hadar were reported from 43 states and Puerto Rico.

o   33% of ill persons were hospitalized, and no deaths were reported.

  • Epidemiologic, laboratory, and traceback findings linked this outbreak of human Salmonella infections to contact with chicks, ducklings, and other live poultry from Mt. Healthy Hatcheries in Ohio.

o   73% of ill people reported contact with live poultry in the week before their illness began.

  • Findings of multiple traceback investigations of live baby poultry from homes of ill persons identified Mt. Healthy Hatcheries in Ohio as the source of chicks and ducklings.

o   This is the same mail-order hatchery that has been associated with multiple outbreaks of Salmonella infections linked to live poultry in past years, including in 2012 and 2013.

  • CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory conducted antibiotic resistance testing on Salmonella isolates collected from 11 ill persons infected with the outbreak strains of Salmonella Infantis or Newport. Of the 11 isolates tested:

o   Two (18%) were resistant to tetracycline.

o   Nine (82%) were susceptible to all antibiotics on the NARMS panel.

  • Mail-order hatcheries, agricultural feed stores, and others that sell or display chicks, ducklings, and other live poultry should provide health-related information to owners and potential purchasers of these birds prior to selling them. This should include information about the risk of acquiring a Salmonella infection from contact with live poultry.

chicken.south.parko   Read the advice to mail-order hatcheries and feed stores and others that sell or display live poultry.

  • Consumers who own live poultry should take steps to protect themselves:

o   Always wash your hands thoroughly with soap and water right after touching live poultry or anything in the area where these birds live and roam.

o   Do not let live poultry inside the house.

o   Learn about additional recommendations to protect yourself and your family from Salmonella infections. These recommendations are important and apply to all live poultry, regardless of the age of the birds or where they were purchased.

Blame it on the (chicken) juice — enhances surface attachment and biofilm formation of Campylobacter

We were having dinner with friends Sunday night, and they do a Chinese-style cooking that is light and yummy, but I noticed a lot of cross-contamination going on during the prep (can someone please come up with a better name than cross-contaminaion, and more succinct than, dangerous bugs move around a lot).

icarly.chicken.cell.handsThe patron said, that’s why you cook it, and I said, just cook it doesn’t cut it, and explained why.

We may never be invited for dinner again.

The next day (another school holiday) the two 5-years-olds were with me for a few hours, so after a couple of hours at the park, I decided we would make two cakes — one gluten/dairy free, one traditional.

I don’t like cake but it is a part of my spring ritual of getting rid of spices that have accumulated for six years and, like Ikea furniture, crap that looked good at the store but awful at home.

The girls became involved in an extended discussion of Salmonella, eggs and cross-contamination.

They enjoyed the cake.

Brown et al. published in Applied and Environmental Microbiology that the bacterial pathogen Campylobacter jejuni is primarily transmitted via the consumption of contaminated foodstuffs, especially poultry meat. In food processing environments, C. jejuni is required to survive a multitude of stresses and requires the use of specific survival mechanisms, such as biofilms. An initial step in biofilm formation is bacterial attachment to a surface.

Here, we investigated the effects of a chicken meat exudate (chicken juice) on C. jejuni surface attachment and biofilm formation. Supplementation of brucella broth with ≥5% chicken juice resulted in increased biofilm formation on glass, polystyrene, and stainless steel surfaces with four C. jejuni isolates and one C. coli isolate in both microaerobic and aerobic conditions. When incubated with chicken juice, C. jejuni was both able to grow and form biofilms in static cultures in aerobic conditions. Electron microscopy showed that C. jejuni cells were associated with chicken juice particulates attached to the abiotic surface rather than the surface itself.

sorenne.doug.usa.today.jun.11This suggests that chicken juice contributes to C. jejuni biofilm formation by covering and conditioning the abiotic surface and is a source of nutrients. Chicken juice was able to complement the reduction in biofilm formation of an aflagellated mutant of C. jejuni, indicating that chicken juice may support food chain transmission of isolates with lowered motility. We provide here a useful model for studying the interaction of C. jejuni biofilms in food chain-relevant conditions and also show a possible mechanism for C. jejuni cell attachment and biofilm initiation on abiotic surfaces within the food chain.

Helen L. Brown, Mark Reuter, Louise J. Salt, Kathryn L. Cross, Roy P. Betts, and Arnoud H. M. van Vliet

http://aem.asm.org/content/80/22/7053.abstract?etocjejuni

Eggs? 3 sick with Salmonella during festival of Pilar in Spain

Three people were stricken with Salmonella and hospitalized during the past holiday Pilar in Zaragoza.

Venida_de_la_Virgen_del_Pilar_(Ximenez_de_Maza)The latest data published by the Public Health Epidemiological Bulletin of Aragon recorded a total of 480 food poisoning during the 2014, slightly above the estimated public health figure for this period, which is 431 based on the data accumulated in the last five years in the community. Last week a total of 9 cases were detected in the community. Five of them were in the province of Zaragoza and the four others in Huesca.

Most outbreaks of food poisoning (TIA) and acute gastroenteritis (AGE) are caused by spoiled food. The tendency of these eating disorders has been rising in recent months in Aragon. In May, the figure exceeded 200 affected after a major outbreak group of 13 people. The figure rose again in June, when it came to 242 It is precisely in the summer when poisoning soar and egg products are often the main cause of salmonella.

Salmonellosis outbreak linked to North Carolina church conference

Earlier this year, the Food Safety Summit, an annual gathering of food safety nerds dealt with an outbreak of foodborne illness amongst attendees. Over 100 became ill with C. perfringens  after eating a buffet meal. Conferences provide a nice environment for an outbreak – everyone eats sorta the same stuff and when things go bad, a lot of people get sick. salmonella

WSOCTV reports that Gaston County (NC) health officials are investigating an outbreak of salmonellosis that has been linked to a conference held Oct 1-5 at Living Word Tabernacle Church in Bessemer City.

According to the Department of Health and Human Services, at least 50 attendees are reporting symptoms including diarrhea, abdominal pain and fever.

As of 2 p.m. Tuesday, seven cases of Salmonella were confirmed with a significant number of lab results pending and more samples being collected.

“Our public health staff is working closely with the church, the North Carolina Division of Public Health, and the community,” said Chris Dobbins, DHHS director. “Our priority is to identify those who have fallen ill, ensure they have received proper medical attention, and work together to identify a source so we can educate and prevent future outbreaks of this nature.”