Food Safety Talk 100: No buns in the bathroom

Food Safety Talk, a bi-weekly podcast for food safety nerds, by food safety nerds. The podcast is hosted by Ben Chapman and barfblog contributor Don Schaffner, Extension Specialist in Food Science and Professor at Rutgers University.  Every two weeks or so, Ben and Don get together virtually and talk for about an hour.1459283728049

They talk about what’s on their minds or in the news regarding food safety, and popular culture. They strive to be relevant, funny and informative — sometimes they succeed. You can download the audio recordings right from the website, or subscribe using iTunes.1461946810971

Episode 100 can be found here and on iTunes.

Here is a bulleted list of link to the topics mentioned on the show:

Are ready-to-eat salads ready to eat?

We investigated a nationwide outbreak of Salmonella Coeln in Norway, including 26 cases identified between 20 October 2013 and 4 January 2014. We performed a matched case-control study, environmental investigation and detailed traceback of food purchases to identify the source of the outbreak.

lettuce.skull.noroIn the case-control study, cases were found to be more likely than controls to have consumed a ready-to-eat salad mix (matched odds ratio 20, 95% confidence interval 2·7–∞). By traceback of purchases one brand of ready-to-eat salad was indicated, but all environmental samples were negative for Salmonella.

This outbreak underlines that pre-washed and bagged salads carry a risk of infection despite thorough cleaning procedures by the importer. To further reduce the risk of infection by consumption of ready-to-eat salads product quality should be ensured by importers.

Outbreaks linked to salads reinforce the importance of implementation of appropriate food safety management systems, including good practices in lettuce production.

Are ready-to-eat salads ready to eat? An outbreak of Salmonella Coeln linked to imported, mixed, pre-washed and bagged salad, Norway, November 2013

F. Vestrheima1a2 c1, H. Langea1a3, K. Nygårda1, K. Borgena1, A. L. Westera1, M. L. Kvarmea4 and L. Volda1

Epidemiology and Infection, Volume 144, Issue 8, June 2016, pages 1756-1760, DOI: http://dx.doi.org/10.1017/S0950268815002769

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=10299069&utm_source=Issue_Alert&utm_medium=RSS&utm_campaign=HYG

4 dead, 33 ill from Listeria in lettuce: Of course Dole knew

Beginning August 2, 1998, over 80 Americans fell ill, 15 were killed, and at least six women miscarried due to listerosis. On Dec. 19, 1998, the outbreak strain was found in an open package of hot dogs partially consumed by a victim. The manufacturer of the hot dogs, Sara Lee subsidiary Bil Mar Foods, Inc., quickly issued a recall of what would become 35 million pounds of hot dogs and other packaged meats produced at the company’s only plant in Michigan. By Christmas, testing of unopened packages of hot dogs from Bil Mar detected the same genetically unique L. monocytegenes bacteria, and production at the plant was halted.

four.monkeysA decade later, the deaths of two Toronto nursing home residents in the summer of 2008 were attributed to listeriosis infections. These illnesses eventually prompted an August 17, 2008 advisory to consumers by the Canadian Food Inspection Agency (CFIA) and Maple Leaf Foods, Inc. to avoid serving or consuming certain brands of deli meat as the products could be contaminated with L. monocytogenes. When genetic testing determined a match between contaminated meat products and listeriosis patients, all products manufactured at a Toronto Maple Leaf Foods plant were recalled and the facility closed. An investigation by the company determined that organic material trapped deep inside the plant’s meat slicing equipment harbored L. monocytogenes, despite routine sanitization that met specifications of the equipment manufacturer. In total, 57 cases of listeriosis as well as 22 deaths were definitively connected to the consumption of the plant’s contaminated deli meats.

As far back as 2013, Blue Bell ice cream was finding Listeria in places like floors, catwalks and cleaning tubs. Blue Bell had positive listeria findings from at least 11 swabs of plant surfaces between March 2013 and November 2014. Each time, it vigorously cleaned the area, and moved on without testing the equipment that touches the ice cream. At the same time, Blue Bell had problems with the layout of its plants, with condensation dripping all over the place. After federal officials linked an illness outbreak to Blue Bell in 2015, they tested the company’s food processing equipment and found LM. Three people died and 10 were sickened.

In all three Listeria outbreaks, the companies had data that showed an increase in Listeria-positive samples.

But rather than pay attention, they ignored the safety.

Those who study engineering failures –the BP oil well in the Gulf, the space shuttle Challenger, Bhopal – say the same thing: human behavior can mess things up.

listeria4In most cases, an attitude prevails that is, “things didn’t go bad yesterday, so the chances are, things won’t go bad today.”

And those in charge begin to ignore the safety systems.

Or hope the problem will just go away.

Kellogg’s was taking Salmonella-contaminated peanut paste based on paperwork in 2009? Pay attention, Nestle did.

In 2009, the operator of a yakiniku barbecue restaurant chain linked to four deaths and 70 illnesses from E. coli O111 in raw beef in Japan admitted it had not tested raw meat served at its outlets for bacteria, as required by the health ministry.

“We’d never had a positive result [from a bacteria test], not once. So we assumed our meat would always be bacteria-free.”

Chipotle Mexican Grill was aware of a norovirus outbreak among people who had eaten in one of its restaurants in Simi Valley, Calif., but did not tell public health officials there until after it had closed and cleaned the restaurant. More than 200 people were sickened.

So it’s no surprise that officials at Dole’s Springfield, Ohio plant, which bags lettuce and other supposedly healthy meals, knew about Listeria in its facility for 18 months before shutting down and issuing a recall.

Four people have died and 33 sickened in Canada and the U.S. from Listeria in the Dole products.

Kudos to Bill Marler and his Food Safety News, as well as Food Poisoning Bulletin, for filing the Freedom of Information request on U.S. Food and Drug Administration inspections at the Dole plant and putting together a preliminary picture of who knew what when.

Inspection reports (483) obtained by Food Safety News revealed the timeline of positive Listeria results and inaction. Dole Fresh Vegetables Inc. finally suspended production at its salad plant in Springfield, OH, on Jan. 21 this year after a random test by state officials showed a bagged salad contained Listeria monocytogenes.

Dole restarted production at the plant in Springfield, OH, on April 21. Company officials won’t say what was done to clean the plant or how they plan to prevent future contamination there.

powell_soli_AUG2Inspectors from FDA checked the production plant three times in January and twice in February after genetic fingerprinting showed the undeniable link between the sick people and salads from the facility. They collected swab samples, unfinished product samples, testing records and other documents and information.

According to the FDA’s inspection reports, in July 2014 Dole did swab tests of surfaces in the Springfield plant. The tests returned positive results for Listeria, but the facility kept producing salads, shipping them to dozens of states and at least five Canadian provinces.

At least five more times in 2014 and three times in late 2015 Dole’s internal tests showed Listeria contamination, but Dole kept the salad lines kept rolling until January this year.

The FDA inspection report states that Dole’s vice president for quality assurance and food safety, as well as the company’s quality assurance manager, were aware internal tests on Jan. 5 and 7 this year showed Listeria on equipment and other surfaces in the plant. But Dole continued to produce and ship salads.

The plant kept operating until Jan. 21. The following day Dole posted a recall notice with the FDA and the Canadian Food Inspection Agency (CFIA) for salads produced at the Springfield facility. Dole branded salads and house brands for Walmart, Kroger, Loblaws and Aldi were included in the recall.

Marler, a prominent food safety lawyer who represents one of the victims in a lawsuit against Dole told Stephanie Strom of the N.Y. Times, “If the government inspectors hadn’t showed up, who knows when or if they were going to tell anyone.”

“They’d been having positive tests for listeria for some time,” said William Goldfield, a spokesman for Dole. “We understand these recent news reports may raise questions among our consumers and customers. They should be assured, however, that we have worked in conjunction with the F.D.A. to address those observations and ensure that Dole products are safe.”

Lauren Sucher, a spokeswoman at the F.D.A., said that companies must notify the agency when they find a food has a “reasonable probability” of causing serious adverse health consequences.

But, Ms. Sucher said, not all strains of listeria cause disease. “When listeria is found in the manufacturing environment, rather than on the food itself, it is not uncommon for a company to immediately take corrective action rather than test further to see if the strain of listeria poses a threat,” she wrote in an email.

Food companies that find listeria during periodic testing are not required to run further tests to determine whether the pathogen is of a toxic variety.

In Dole’s case, it was swabbing various locations in its plant in Springfield, Ohio, not necessarily testing the finished products, according to the F.D.A. inspection. Rather, Canadian public health officials investigating an outbreak of listeriosis dating to summer 2015, tested bagged Dole salads and found four varieties that were contaminated.

Listeria in Italy: An on-going outbreak

In the first seven weeks of 2016, six cases of invasive listeriosis were recorded in Ancona province, Italy. Five strains of Listeria monocytogenes serotype 1/2a were isolated and typed by enterobacterial repetitive intergenic consensus (ERIC)-PCR and PFGE, indicating clonality. In addition, seven serotype 1/2a L. monocytogenes strains from cases of invasive listeriosis recorded in the same area in 2015 were also typed and showed relatedness. Here we provide details of the ongoing outbreak.

listeria4From 4 January to 15 February 2016, six L. monocytogenes strains (3 from blood, 3 from cerebrospinal fluid (CSF)) were isolated from six patients diagnosed with invasive listeriosis at the Clinical Microbiology Laboratory of Ancona Regional Hospital (eastern Italy) of Area Vasta 2 (AV2) which encompasses Ancona, Fabriano, Senigallia, and Jesi.

Patients had been admitted to four different departments: emergency room (ER) (n=2), oncology (n=2), infectious diseases (n=1), and intensive care unit (ICU) (n=1). Four of the six patients were women and the most common risk factors/underlying conditions were: age (n=5; >71 years), cancer (n=2), and diabetes (n=1). Clinical manifestations included septicaemia (n=3), meningitis (n=2) and meningoencephalitis (n=1).

In addition to the cases detected in 2016, eight L. monocytogenes strains (5 from blood and 3 from CSF) had been isolated in AV2 (from 7 cases) and nearby Ascoli Piceno (from 1 case) in 2015 (Figure 1); clinical samples came from six hospital departments: ER (n=1), general medicine (n=3), nephrology (n=1), vascular surgery (n=1), infectious diseases (n=1), and ICU (n=1). Five patients were men and the mean patient age was 73.6 years (range: 55–84; median: 75); a 77 year-old man died.

The 2015 and 2016 isolates were identified as L. monocytogenes by Gram staining and the Vitek MS system (bioMérieux Italia SpA, Firenze, Italy). Susceptibility to ampicillin, meropenem, erythromycin, and sulphamethoxazole-trimethoprim was tested by the E-Test (Liofilchem, Teramo, Italy) according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines [1]. All strains were susceptible to all the antibiotics tested.

The incidence of listeriosis has been rising since the early 2000s in several European countries, mainly in immunocompromised patients older than 65 years [7-9]. In particular, a statistically significant increase was reported in Austria, Denmark, Hungary, Italy, France, Spain, and Sweden from 2005 to 2009 [10]. In the past 30 years, outbreaks of listeriosis have been mostly linked to serotype 1/2a and 4b clones [8]. A shift to serotype 1/2a has been observed in Europe and North America in the last decade [8]. In Italy, surveillance of invasive listeriosis has found an increase in serotype 1/2a isolates over the same period, mainly in the central and northern regions (about 80% of cases) [10-14].

Listeriosis is an infection of great concern to public health due its clinical severity and high case fatality rate, despite its low incidence compared with other foodborne diseases such as salmonellosis or campylobacteriosis. The present data suggest an ongoing outbreak of listeriosis due to serotype 1/2a L. monocytogenes in AV2 that most probably started in 2015, since the strain was already present in the area in 2015. As in other European countries, most cases were associated with an underlying condition and involved elderly people [8,9].

Local authorities are working with the Italian national public health institute (the Istituto Superiore di Sanità, Rome) and the regional Istituto Zooprofilattico Umbria and Marche to identify the sources of food contamination. A recent press release [15] points out that there are findings which suggest contamination of a pork product as a possible vehicle of infection for at least one human case. At present, however, no clear link can be established between the contaminated pork product and the infections. Investigation into the source of infection in AV2 is still in progress.

 

Ongoing outbreak of invasive listeriosis due to serotype 1/2a Listeria monocytogenes, Ancona Province, Italy, January 2015 To February 2016

28 April 2016

Eurosurveillance, Volume 21, Issue 17

E Marini, G Magi, C Vincenzi, E Manso, B Facinelli

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=22460

Damn that Listeria is tricky

Listeria monocytogenes is an important foodborne pathogen commonly isolated from food processing environments and food products.

listeria4This organism can multiply at refrigeration temperatures, form biofilms on different materials and under various conditions, resist a range of environmental stresses, and contaminate food products by cross-contamination. L. monocytogenes is recognized as the causative agent of listeriosis, a serious disease that affects mainly individuals from high-risk groups, such as pregnant women, newborns, the elderly, and immunocompromised individuals.

Listeriosis can be considered a disease that has emerged along with changing eating habits and large-scale industrial food processing. This disease causes losses of billions of dollars every year with recalls of contaminated foods and patient medical treatment expenses. In addition to the immune status of the host and the infecting dose, the virulence potential of each strain is crucial for the development of disease symptoms. While many isolates are naturally virulent, other isolates are avirulent and unable to cause disease; this may vary according to the presence of molecular determinants associated with virulence.

In the last decade, the characterization of genetic profiles through the use of molecular methods has helped track and demonstrate the genetic diversity among L. monocytogenes isolates obtained from various sources. The purposes of this review were to summarize the main methods used for isolation, identification, and typing of L. monocytogenes and also describe its most relevant virulence characteristics.

The continuous challenge of characterizing the foodborne pathogen Listeria monocytogenes

Foodborne Pathogens and Disease. April 2016, ahead of print. doi:10.1089/fpd.2015.2115.

Camargo Anderson Carlos, Woodward Joshua John, and Nero Luís Augusto

http://online.liebertpub.com/doi/abs/10.1089/fpd.2015.2115

Artisan? UK cheesemaker banned from ever making cheese again after health inspectors found deadly salmonella, E. coli and listeria in her mozzarella

An artisan cheesemaker has been banned from ever making cheese again after salmonella, E.coli and listeria was found in her mozzarella.

frances.woodHealth inspectors discovered Frances Wood’s dairy in West Cranmore, Somerset, in a filthy state with ‘high-risk’ moldy cheese laid on dirty racks with taps rusting away.

A judge branded the 70-year-old’s cheese-making operation ‘shoddy’ and ‘amateurish’ after hearing that her products contained salmonella, E.coli and the listeria bug – which kills one-third of people infected.

Wood would often travel to London’s Camden Market to sell her artisan mozzarella which she also sold to local pizza restaurants.

She ran Alham Wood Cheeses at Higher Alham Farm, where she kept buffalo and made mozzarella cheese from their milk.

The buffalo have been on the farm since 1997, with a 200-strong herd kept there.

Mendip District Council inspected her dairy several times and saw no change in the disgusting conditions.

And when they viewed her stall at Camden Market, they found the same unhygienic products.

The local authority said they tried to work with Wood to improve her cheese-making, but took legal action when it became clear she had not made any improvements to hygiene conditions at her dairy.

She was served with formal notices at the end of November 2014 and was then prosecuted for two offences under food safety and hygiene regulations.

Alham_Farm_cheeses_2Wood pleaded guilty to the charges and was fined a total of £787 and made to pay £6,000 in prosecution costs.

But a district judge also took the rare step of imposing a Hygiene Prohibition Notice, which bans Wood from ‘participating in the management of any cheese production or processing business in the future’.

He called Wood’s business ‘a shoddy operation’ which was ‘rather amateurish’.

Foodborne outbreak at Pittsburgh’s Carnegie Mellon University

Carnegie Mellon University says 15 students have diarrhea, nausea and vomiting and 13 of those cases have been directly linked to a cafe on campus.

La Prima ExpressoThirteen of the students who are ill ate soup or sandwiches from La Prima Expresso on the Pittsburgh school’s campus on Monday or Tuesday. The owner of the business hasn’t commented, but school officials say certain menu items have been removed from the cafe as a precaution.

The school’s University Health Services is working with the Allegheny County Health Department to determine what’s causing the illnesses.

The school plans to post student alerts as more information develops.

Apricot kernels pose risk of cyanide poisoning

Eating more than one large or three small raw apricot kernels in a serving can exceed safe levels. Toddlers consuming even one small apricot kernel risk being over the safe level.

apricot_kernels_160427A naturally-occurring compound called amygdalin is present in apricot kernels and converts to cyanide after eating. Cyanide poisoning can cause nausea, fever, headaches, insomnia, thirst, lethargy, nervousness, joint and muscle various aches and pains, and falling blood pressure. In extreme cases it is fatal.

Studies indicate 0.5 to 3.5 milligrams (mg) cyanide per kilogram of body weight can be lethal. The European Food Safety Authority’s Scientific Panel on Contaminants in the Food Chain set a safe level for a one-off exposure (known as the Acute Reference Dose, or “ARfD”) of 20 micrograms per kilogram of body weight. This is 25 times below the lowest reported lethal dose.

Based on these limits and the amounts of amygdalin typically present in raw apricot kernels, EFSA’s experts estimate that adults could consume one large or three small apricot kernels (370mg), without exceeding the ARfD. For toddlers the amount would be 60mg which is about half of one small kernel.

Apricot fruit is not affected

Normal consumption of apricot fruit does not pose a health risk to consumers. The kernel is the seed from inside the apricot stone. It is obtained by cracking open and removing the hard stone shell and, therefore, has no contact with the fruit.

Most raw apricot kernels sold in the EU are believed to be imported from outside the EU and marketed to consumers via the internet. Sellers promote them as a cancer-fighting food and some actively promote intakes of 10 and 60 kernels per day for the general population and cancer patients, respectively.

Evaluating the claimed benefits of raw apricot kernels for cancer treatment or any other use is outside EFSA’s food safety remit and was, therefore, not part of this scientific opinion.

EFSA consulted its partners in EU Member States to discuss this scientific opinion and previous assessments by national authorities (see report below). This risk assessment will inform risk managers in the European Commission and Member States who regulate EU food safety. They will decide if measures are needed to protect public health from consumption of raw apricot kernels.

Increased action required to protect those with food allergies

Our daughter has been diagnosed with a moderate shellfish allergy, which is a shame with all the great shellfish in and around Brisbane, but more importantly it means we carry an epi pen and know how to use it.

food-allergies-imageIt’s made me more empathetic to those with severe allergies.

An independent review of the UK’s food system has concluded more action needs to be taken in order to better protect people with food allergies. That’s according to a report from a leading UK team of food safety experts, including Professor Chris Elliott from Queen’s University Belfast, a co-author of a paper published in The Royal Society of Chemistry’s journal Analyst, outlining a strategy to close the gaps in current processes for detecting and measuring allergens – substances in foods that can trigger an allergic reaction. The publication comes during the UK’s Allergy Awareness Week (25th April – 1 May).

Food allergy is a rapidly growing problem in the developed world, affecting up to 10 per cent of children and 2-3 per cent of adults. Allergic reactions can range from a mild runny nose, skin irritation or stomach upset to severe anaphylaxis, which can be fatal.

Food allergies have significant impact on quality of life and usually require lifelong avoidance of the offending foods. There are also burdens on health care, the food industry and regulators.

Professor Elliott and Professor Duncan Burns, Emeritus Professor at Queen’s Institute for Global Food Security, are among a team of experts led by Michael Walker from the Government Chemist Programme at LGC, which has outlined a ‘grand vision’ to address the key challenges in allergen measurement and analysis. They make a series of recommendations primarily addressed to the European Commission’s Health and Food Safety Directorate, DG Santé, aimed at securing a food chain which is reliable, resistant to fraud and ultimately safe for consumers.

Professor Elliott is a world-renowned expert on food fraud and traceability and led the independent review of the UK’s food system following the 2013 horsemeat scandal. He said: “The food supply chain is highly vulnerable to fraud involving food allergens, risking consumer health and reputational damage to the food industry. Cross-contamination during production, processing and transport is also a problem. While efforts have been made to improve food labelling and introduce the concept of threshold quantities for allergens, these depend on being able to accurately detect and quantify allergens in the first instance. Gaps in the current system mean that it is difficult to achieve this.

“This paper sets out a strategy to address those gaps and calls on the EC to take action in three particular areas. Firstly, the use of bioinformatics studies for modelling how best to predict what allergens present in foods, and specifically what quantities of these allergens, will adversely affect the health of someone with food allergies. Secondly, the development of reference methods which will provide a ‘gold standard’ for the detection and measurement of allergens in food. And thirdly, the production of reference materials which can support threshold decisions -samples of foods with known, controlled amounts of allergens present, to allow for checks on the accuracy of allergen testing methods.”

Significant international effort and an inter-disciplinary approach will be required to achieve these aims and protect those at risk of food allergies. Lead author of the report, Michael Walker from LCG said: “If we fail to realise the promise of future risk management of food allergens through lack of the ability to measure food allergens properly, the analytical community will have failed a significant societal challenge. Our recommendations are complex with associated resource demand but rarely has such an exciting interdisciplinary scientific endeavour arisen as a solution to a key socially relevant problem.”

The open access paper in Analyst is available at  http://pubs.rsc.org/en/content/articlehtml/2016/an/c5an01457c?page=search.

‘Tropical’ parasite emerges in Canadian Artic

An outbreak of an intestinal parasite common in the tropics, known as Cryptosporidium, has been identified for the first time in the Arctic. The discovery was made in Nunavik, Quebec, by a team from the Research Institute of the McGill University Health Centre (RI-MUHC), in collaboration with the Nunavik Department of Public Health, Institut National de Santé Publique du Québec and Health Canada. The discovery, which was documented in the journalPLoS Neglected Tropical Diseases, could have long-term implications for the health of children in Nunavik and Nunavut’s communities. 

crypto.hominis“We were very surprised to discover this strain of Cryptosporidium in the Artic, which is more typically seen in low-income countries than elsewhere in North-America,” says the study’s senior author, Dr. Cédric Yansouni, who is Associate Director of the J.D. MacLean Centre for Tropical Diseases at the MUHC and Professor of the Division of Infectious Diseases in the Department of Medical Microbiology at McGill University. 

Cryptosporidium is a microscopic parasite that lives in the intestine of mammals, including humans, and is transmitted by the fecal-oral route from ingestion of contaminated food or water or contact with infected individuals.

The researchers examined an outbreak of Cryptosporidium that occurred between April 2013 and April 2014 across 10 villages in Nunavik. In close collaboration with the clinical teams on site, the researchers were able to identify that the strain was Cryptosporidium hominis, which is spread from human to human and usually found in tropical countries.

“We are being particularly vigilant because it is known in low-income countries that repeated Cryptosporidium infections can cause growth delays and difficulty at school in children.  In the Nunavik outbreak, children under the age of five were the group most affected by the infection,” explains Dr. Yansouni.

There is a treatment for Cryptosporidiosis in the United States and in other countries where the disease is found, but at present the treatment is only available in Canada under a special access program.

“What we observe in the Arctic, as in any other remote region, reminds us about the limitations of the healthcare system in terms of access to diagnosis facilities,” says Dr. Yansouni, who suspects that there are many unreported cases of infection. 

The study Cryptosporidium hominis Is a Newly Recognized Pathogen in the Arctic Region of Nunavik, Canada: Molecular Characterization of an Outbreak was co-written by Karine Thivierge (first author), Asma Iqbal, Brent Dixon, Réjean Dion, Benoît Levesque, Philippe Cantin, Lyne Cédilotte, Momar Ndao, Jean-François Proulx and Cedric P. Yansouni (main author).