Salmonella and campy happen in France too

In 2007, Amy and I spent a few weeks in France, and being the food safety nerd, I was struck by the indifference many of the people I met showed to foodborne illness.

DSC00006.JPGIt seemed to be a point-of-pride amongst the locals to not report foodborne illness.

I’m familiar with the French desire for food to be alive, sexy, and part of a life well-lived, but also saw a lot of people going to McDonald’s.

We stayed for a week at a friend’s cottage in a small town in the south, and we would visit the butcher, who cross-contaminated everything.

We had dinner at a neighbor’s place one night and he confessed, that butcher, “he made me so sick with his chicken.”

And when I got home, someone told me my don’t eat poop story made it onto Letterman, while Amy developed the look.

Researchers report that community incidence estimates are necessary to assess the burden and impact of infections on health and to set priorities for surveillance, research, prevention, and control strategies.

letterman2The current study was performed to estimate the community incidence of campylobacteriosis and nontyphoidal salmonellosis in France from the number of laboratory-confirmed cases reported to the national reference center (NRC). The probabilities of a case in the community visiting a doctor, having a stool sample requested, having a positive laboratory test, and having the case reported to the NRC were estimated using data of national surveillance systems, national hospitalization and health insurance databases, and specific surveys informing about these parameters. Credible intervals (CrI) were calculated using Monte Carlo simulation. In addition, we estimated the number of hospitalizations for both infections in France.

The annual community incidence rate in France is estimated at 842 cases per 100,000 (90%CrI 525–1690) for campylobacteriosis and 307 cases per 100,000 (90%CrI 173–611) for salmonellosis. The annual number of hospitalizations is estimated at 5182 for campylobacteriosis and 4305 for salmonellosis. The multiplication factors between cases ascertained by the surveillance system and cases in the community were 115 for campylobacteriosis and 20 for salmonellosis.

amy.the.look.2007They are consistent with estimates reported in other countries, indicating a high community incidence of campylobacteriosis and salmonellosis in France.

Community incidence of campylobacteriosis and nontyphoidal salmonellosis, France, 2008–2013

Foodborne Pathogens and Disease. 2015 ahead of print. doi:10.1089/fpd.2015.1964.

Van Cauteren Dieter, De Valk Henriette, Sommen Cecile, King Lisa A., Jourdan-Da Silva Nathalie, Weill François-Xavier, Le Hello Simon, Mégraud Francis, Vaillant Veronique, and Desenclos Jean C.


Public health infrastructure: Quarter of Listeria cases in Texas not tracked or recorded

Roughly one-fourth of Texas cases involving Listeria, which contaminated Blue Bell ice cream and forced a crippling national recall in April, are not submitted to public health officials as required by law and go untracked, a newspaper reported Sunday.

listeria4Texas is not alone: Many state health departments in the U.S. don’t receive samples in 10 to 40 percent of confirmed Listeria cases to enter into databases, which can leave regulators unable to trace an outbreak, leave deadly food on the market and help companies avoid responsibility, the Houston Chronicle reported.

The Blue Bell outbreak could have been identified sooner had Listeria reporting been better around the country, said Richard Danila, assistant state epidemiologist for the Minnesota State Health Department.

“The clinical laboratory is there for the diagnosis and treatment of the patient,” said Shari Shea, director of food safety for the Association of Public Health Laboratories. “There’s not always appreciation for the way it fits into the public health system.”

At least 19 states don’t have laws requiring laboratories to submit confirmed Listeria samples, or “isolates,” to state health officials. Of those that do, Texas hovers around the middle of the pack in states missing samples in confirmed cases, according to the Council to Improve Foodborne Outbreak Response.

But despite Texas requiring laboratories to submit samples, the state has never enforced the mandate. Texas Department of State Health Services spokeswoman Carrie Williams said the agency instead prefers to work with labs and health providers to educate them and bring them into compliance.

Penalties are almost never enforced in any state, said Craig Hedberg, epidemiologist at the University of Minnesota. He said part of the reason is that public health departments depend on relationships with laboratories.

Means little to me says widower: NZ men and company fined $200K over Listeria meat sold to hospital

New Zealand is an island, but to say they’ve never had a problem with Listeria in cold cuts is to ignore history.

listeria4So much like Canada in 2008, and the U.S. in 1998. Listeria kills.

After two cold-cut related deaths in New Zealand in 2012, a health spokesthingy said they “routinely hands out brochures” and it no longer provides chilled pre- cooked meats to patients.

Do people really have to die before changes are implemented? Isn’t that why dieticians are in hospitals? Does anyone with a medical background know anything about Listeria?

It’s not like it’s something new.

Pay attention.

The widower of a woman who died in the Listeria outbreak at Hawke’s Bay Hospital in 2012 said the fines imposed on a meat company, its director and a staff member meant little.

In Napier District Court on Wednesday Bay Cuisine was fined $130,000, company director Garth Wise was fined $32,500 and production manager Christopher Mackie was fined $30,000.

The charges related to their supplying Listeria-contaminated meat to Hawke’s Bay Hospital and others, and for intentionally deceiving regulators by omitting test results that revealed the contamination.

Sound familiar?

The health board discovered cold ready-to-eat meats supplied by the company were contaminated in July 2012, after several Listeria cases had been linked to the hospital kitchen.

Patricia Hutchinson, 68, and an 81-year-old woman died after contracting listeria. Two other people were infected.

Robin Hutchinson, who held his wife of 46 years as she passed away, said “the fines imposed mean little to me”.

listeria.sweden“Even now there has not been a single word or remorse. For those people to have contacted myself and the Napier victim’s husband would have cost a tax deductible phone call. My feelings are they must jointly have a conscience of steel,” he said.

Hutchinson remained angry at the health board for providing cold meats to immuno-compromised patients such as his wife when Health Ministry advice was that such people should avoid it.

A DHB spokeswoman said the pre-packaged meats provided by Bay Cuisine had been tested and had shown negative results for listeria.

The Health and Disability Commisisoner had investigated the matter and found no fault by the DHB, she said.

DHB chief executive Kevin Snee said the company should have faced more serious charges.

The fines imposed on Wednesday brought some closure to the effects of the 2012 outbreak, but “the district health board remains of the view that it would have preferred to see the company facing more severe charges that reflect the seriousness of those acts, and the toll those actions have taken on people’s lives”.

Outside court an MPI spokesman said the charges laid against the company were the most severe available under the Animal Products Act, and anything more serious, such as manslaughter, would need to be laid by police.

Hawke’s Bay detective sergeant Mike Foster said the matter had been fully investigated by police and advice from the Crown had been that there was insufficient evidence to lay a criminal charge.

Judge Bridget Mackintosh said the decision to deceive had been intentional and the offenders must have known the risk their offending posed to those people at greatest risk of contracting listeria.

A subsequent editorial in the the Dominion Post says Bay Cuisine has got off far too lightly, and doesn’t the whole episode also reflects very badly on the regulator, the Ministry of Primary Industries?

This is a lamentable business and it raises the most serious questions.

The company stands condemned for intentionally deceiving MPI by not telling it about test results that showed its cold meats were contaminated by Listeria.

But MPI is also to blame in this matter, although they seem to have escaped any punishment.

When its tests found that meat from the company was contaminated, it did not inform the DHB because it didn’t know the meat was going to the hospital.

ITALY-G8-G5-AGRICULTURE-FARMThe obvious question is: why didn’t it know? Why didn’t it ask the company where it was sending the meat?

Wasn’t that an obvious query for a public health regulator? Isn’t the public entitled to think that the regulator would show more curiosity about the possible destination consumers of infected meat?

Snee says the DHB would have liked to know the result of the MPI tests earlier, but he was “not interested in relitigating events” that occurred three years ago.

This is a most unfortunate remark.

Unless we learn from history we are doomed to repeat it. Do we know that MPI has learned from its slackness back in 2012?

One of the fortunate results of this whole sad case is that both the company and  the regulator’s shortcomings have been exposed.

The company has been fined; the regulator will suffer a deserved dent in its reputation.

But Robin Hutchinson says neither he nor the husband of the other victim has heard “a single word of remorse” from the company.

If that is so it is a disgrace.

The New Zealand Meat Processors Association responded it is confident the industry is doing enough to stop Listeria-contaminated food from entering the market.

Environmental and Scientific Research was sent 62 unopened Bay Cuisine cold-meat packages and all were found to contain Listeria.

Company employees lied and told the district health board that a batch of corned silver side tested negative for listeria, although it had actually tested “presumptive positive”.

Meat Processors Association chair Nick Harris said this is a very rare case and he can’t believe a company would deceive customers.

“This is absolute top of mind of all manufacturers. Listeria is a very difficult organism and our industry works very, very hard to ensure that these types of situations don’t occur,” Harris reports.

“There’s probably 1000 tonnes of product produced each week in New Zealand and, as we mentioned, it’s the first case ever.”

Aerosolization of pathogens? Petting zoo returns to Minn. fair after 2014 E. coli outbreak

Zerebko Zoo Tran, a traveling petting zoo, is returning to the 2015 Rice County Fair, a year after it was suspected to be the source of an E. coli outbreak.

courtlynn.petting.zooIn 2014, the Minnesota Department of Health identified 13 people from four different events who developed E. coli after visiting the Zerebko Zoo Tran traveling petting zoo.

 But Rice County Fair officials say fair goers shouldn’t be worried. Rice County Fair Executive Director John Dvorak said they were comfortable bringing Zerebko Zoo Tran back.

“The biggest factor is that they were extremely cooperative in working with the department of health, and others with the investigation,” Dvorak said.

Dvorak said the fair has also made changes to the facilities fair goers can use to clean up after visiting the zoo. In the past, the fair supplied hand-washing stations that used a chemical to sanitize hands. This year, the fair is bringing running-water hand washing stations with soap.

“E. coli is best cleaned away by friction, so by bringing the running water hand washing stations, that will help get rid of anything that could be spread,” Dvorak said.

Operational changes have been made in the fairground’s barns, like keeping an extra eye to keep walkways clear of waste and making layout changes within the barns so animals never have to step outside to go to a different part of the barn, he said.

Wally Zerebko, owner of Zerebko Zoo Tran, said after the incident in 2014, he contacted several experts and had all of his animals tested. He also had the company’s vet mention the problem at a conference, which led to them finding a vaccine they could give the animals.

Top 10 soundbites about Salmonella

Emily Willingham of Everyday Health writes that at least eight people have fallen ill with salmonella-related food poisoning in an outbreak that has triggered a recall of 1.8 million pounds of raw, stuffed chicken products, says the U.S. Department of Agriculture (USDA) in a July 12 announcement.

chicken.thingies.2The recall originally was announced July 2 but has been expanded to include additional products. The disease cases were identified in Minnesota and Wisconsin, but the recall is nationwide.

The culprit in this case is breaded, stuffed, raw chicken breasts produced by Barber Foods in the U.S. and No Name brand in Canada, identified after a cluster of salmonella illnesses cropped up in late June.

  1. Use thermometers. According to Doug Powell, PhD, a former food science professor at Kansas State University who maintains a blog tracking food safety, if consumers want to protect themselves, they should always use a meat thermometer when cooking meat. Noting that the USDA has required raw products to be labeled as raw and to list the proper cooking temperature for safety, he says that most consumers won’t use thermometers. “They just guess,” Dr. Powell says. “Most people just throw (the food) in the microwave to warm it up (and) don’t carry around thermometers like I do.” The target temperature for poultry is 165 F, which the USDA says should be checked at the center of the meat, at the thickest part.
  2. Avoid cross-contamination. “Another risk,” he says, “is how much they’re handling (the meat) before it’s cooked.” Powell says that he urges people “be the bug” and think about the surfaces that meat might touch during handling and keep things clean. “Think about where that bacteria is going to be,” he says. According to the CDC, prevention includes immediately washing with warm soap and water any kitchen work surfaces and utensils that come in contact with raw meats.
  3. Be aware of what could be exposed to salmonella. The bacteria live in the intestines of animals, so anything that could be exposed to intestinal contents can be at risk of salmonella contamination. Powell gives an example: “I’ve got an herb garden in my back yard,” he says, “and I know that birds (poop) on it and that they’re (pooping) salmonella.” Indeed, some outbreaks around the world have not involved meat at all but instead have been associated with plants, including peanuts, spices, and a fruit-based candy. Unpasteurized foods, including unpasteurized milk, are also a risk.raw.chicken.thingies.outbreak
  4. Pets can be a risk … and at risk. Because of the risk of contamination from exposure to fecal matter, pets like turtles, other reptiles, and baby chicks are particularly prone to being sources of salmonella infection. Says Powell about contact with chickens, which were the source of another recent U.S. outbreak: “You see a cute bird, I see a salmonella vector.” Dogs and cats can actually be infected, with sometimes-severe and long-lasting symptoms, and can pass infection to humans.
  5. Other outbreaks have also involved raw, stuffed chicken products. According to Powell’s blog, several other salmonella outbreaks have been traced to chicken products like those in the current recall. Powell thinks that products like these should be cooked for the consumer in the first place. “The consumer is not the critical control point,” he says.
  6. Even the very healthy are not immune to hospitalization. Oakland A’s pitcher Sonny Gray became gravely ill from a recent bout with salmonella and had to be hospitalized. According to reports, his fever reached 103 F, and he required considerable fluid replacement.
  7. Freezing does not kill salmonella. Powell says that freezing does not knock out the microbes, it just shuts them down temporarily. “Once you warm (the food) up,” he says, “they go to town.”
  8. Microwaves and salmonella may not mix. The heat in a microwave isn’t very well controlled, according to Powell. Within the food, microwaves “just give tremendously ridiculous differences in heat,” he says, which can mean uneven temperatures and places for the bacteria to persist.
  9. There’s a reason Minnesota is ground zero for salmonella outbreaks. “Minnesota is particularly good at picking them up,” says Powell, “because they have a well-funded public health system.” So while it might seem like Minnesota has a problem with outbreaks, including another current salmonella outbreak related to frozen raw tuna, the real reason the state appears in so many outbreak stories is because of its strong tracking systems.
  10. Handwashing is an important preventive measure. Wash hands before and after handling raw meat, pets, or outdoor plants, after swimming, and before eating. “Salmonella is natural and it is there,” says Powell. “Be aware.”

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;jsessionid=6146E6AFABCC349C376B7E55A3866D4A?contentType=Article&contentId=1811820

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.

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. 

Restaurants required to freeze raw fish before serving

Once again, the New York Times has show how really little it knows, declaring that fish mush be frozen before serving raw.

Ceviche_mixto_890They’ve been frozen at sea for decades, to control parasites.

And I don’t eat raw fish.

New regulations, published this week by the New York City Department of Health and Mental Hygiene, require that fish served raw, undercooked or marinated raw in dishes like ceviche must first be frozen, to guard against parasites. In March, the Board of Health approved the regulations, which now align with Food and Drug Administration recommendations and are set to take effect in August.

That means that by the end of summer all fish used in sushi, sashimi, tartare and other popular raw dishes will make a pit stop in the freezer before they end up on diners’ plates.

Though some customers might blanch at the idea that their coveted crudo and sashimi — sometimes costing hundreds of dollars — emerged from a deep freeze, the truth is that many chefs in the city’s top restaurants have long used frozen fish to prevent serving their raw fare with a side of pathogens.

“We purposely deep-freeze at negative 83 degrees, and we use one of those medical cryogenic freezers,” said Yuta Suzuki, vice president of Sushi Zen, a popular Times Square restaurant. “This way, it’s kind of like cooking, but instead of using heat we use freezing to remove parasites or bacteria on the outer surface.”

Even the New York City chapter of the New York State Restaurant Association, which had complained about the regulations at a health department hearing in January, has reversed course. Now that the regulations have been stripped of certain record-keeping requirements that the association considered onerous, establishments serving raw fish should be able to handle the change, James W. Versocki, a legal counselor for the group, said.

Do the crime, do the time: US Justice Dept. warning of more food safety prosecution for outbreaks

Following a deadly listeria outbreak in ice cream, the Justice Department is warning food companies that they could face criminal and civil penalties if they poison their customers.

blue.bell.justice“We have made a priority holding individuals and companies responsible when they fail to live up to their obligations that they have to protect the safety of the food that all of us eat,” Associate Attorney General Stuart Delery said in an interview with The Associated Press.

After years of relative inactivity, the administration has stepped up criminal enforcement on safety cases. In the most high-profile case, a federal court in Georgia last year found an executive for the Peanut Corporation of America guilty of conspiracy, obstruction of justice, wire fraud and other crimes after his company shipped out salmonella-tainted peanuts that sickened more than 700 and killed nine in 2008 and 2009.

Delery, the No. 3 official at the Justice Department, wouldn’t say whether the government plans to pursue charges against Texas-based Blue Bell Creameries, which recalled all its products and shut down production earlier this year after listeria in the company’s ice cream was linked to illnesses and three deaths. A Food and Drug Administration investigation found that Blue Bell knew that it had listeria in one of its plants for almost two years before the recall.

Other recent actions prompted by the Justice Department during the Obama administration:

— A 2013 guilty plea from Colorado brothers who grew and sold listeria-tainted cantaloupe that killed more than 30 people in 2011.

— A 2014 plea deal, resulting in prison time and millions of dollars in fines, between the government and an Iowa egg company and its executives. An outbreak of salmonella linked to the eggs sickened almost 2,000 people in 2010.

— A May 2015 settlement with ConAgra Foods for $11.2 million after the company shipped Peter Pan peanut butter tainted with salmonella from a plant in Georgia, sickening more than 600 people in 2006. That sum includes the highest criminal fine in a U.S. food safety case.

Bill Marler, a food safety lawyer who has represented victims in many of those cases, says Justice’s recent activity is especially notable because in many of the cases, company executives didn’t know they were shipping out tainted food, but they were hit with criminal charges anyway.

“It’s been very much of a sea change,” Marler said. “Once you start down this road you have to decide whether you are going to do it all the time or selectively.”

Crypto and giardia take $5 billion bite out of NYC

Two tiny organisms present a big problem for New York City’s water department: cryptosporidium and giardia.

crypto.waterThe city has spent $5 billion over the last five years combatting these organisms, which can cause fatal illnesses in the sick and elderly and gastrointestinal problems for those with healthy immune systems.

“In the city’s east-of-Hudson Croton watershed, where development has encroached on watershed land, federal regulators forced the city to filter the water; hence the $3 billion Croton filtration plant that recently opened,” City Limits reported.

The plant itself was a giant, politically fraught project.

Russian routlette: Risk and public health

The UK Food Standards Agency (FSA) wants to balance consumer choice with public protection with its ‘risky foods framework’ policy for local authorities. John Bassett, food safety consultant, argues that this approach has implications for enforcers, industry and above all consumers.

hamburger-safe and unsafe-thumb-450x138-175Although the FSA went public on their risky foods framework at the end of last year, they haven’t been shouting about it too loudly. Steve Wearne, the FSA’s director of policy, emphasised that consumer choice was at the heart of everything they do and outlined the approach at the recent CIEH Food Safety Conference. 

It is clear that the framework will support increased freedoms to sell and choose such ‘Russian roulette’ delicacies such as rare burgers and raw milk. Some consumers are passionate about their right to eat foods that many would consider unsafe, and cynics may say that the framework has been developed as a result of the inability of the FSA and local authorities to effectively communicate or regulate for those risks. A recent example of this is demonstrated by the court ruling allowing for Davy’s to sell rare burgers. 

But apart from the strong UK consumer voice, there is a drive globally for regulators to base management decisions on risk and remove prescriptive controls that seek to reduce risk down to an unachievable zero risk. Risk-based controls will allow businesses to manage risks more flexibly, on the basis of robust risk assessment, which should lead to innovations in food products and cost-savings, benefits that can flow to consumers both directly through better/cheaper products and indirectly through more targeted regulatory attention to the most significant risks. In particular, there are significant cost, nutritional and environmental benefits to be realised by the reduction of over-processing of many food products.

meatwad.raw.hamburgerWhile government and food businesses can develop or commission risk assessments, these products by definition will still pose a higher risk than the majority of foods. The remaining risk will have been deemed by the FSA to be ‘acceptable’, at least to the consumers who accept the higher risk that they pose. But will consumers be able to understand the risks that they are taking? One key communication channel will undoubtedly be packaging labelling. The FSA board is considering the extension of raw milk labelling requirements for Northern Ireland and England in their meeting in July, but they also recognise that ‘it is difficult to demonstrate quantifiable public health benefits associated with enhanced labelling and consumer research carried out … provided variable view’.

Warnings on menus where rare burgers are served are subject to the same uncertainties as raw milk labels. A key part of the risky foods framework and the FSA strategy in general is the engagement of consumers on the risks they personally find acceptable. A lot more work is required before the FSA and businesses can say with confidence that the risks they want to communicate are truly, effectively received and understood, and hence accepted by consumers.

Food safety indifference

When I repeat a breakout drill on the ice rink for 6-9-year-olds playing hockey – in Australia — I can see the parents rolling their eyes, yet the same parents marvel at the improvement when it comes to games. takes time. It takes effort. It takes fun.

I’ve been playing, coaching and sometimes administrating hockey for almost 50 years.

I’ve been playing, coaching and sometimes administrating microbial food safety things for 23 years (I’m old – two grandsons).

There’s not much difference.

Except one group is little kids trying to learn things, and the other is adults, paid money, who seem to want to make money.

And not learn.

Food safety indifference is the biggest challenge I’ve faced in my professoring or professional career: How to get people to care in the absence of an outbreak?

I’ve had the good fortune to work with industry types around the globe who recognized risk and were proactive – but it was really about trade, not fewer sick people.

indifferenceFrom Sara Lee in 1998 to Maple Leaf Foods in 2008 to Blue Bell today, companies act with shock and compassion when they find out they sickened people – in all these cases with Listeria — but a reflective glance is more critical.

They all had Listeria positives, but no one got sick yesterday, so the assumption is there’s a greater probability no one will get sick tomorrow.

Nice approach, until you get caught.

In Sept. 2014, 130 Canadians were sickened with E. coli O157 in pork.

Not the usual vehicle.

When a Canadian television station tried to do a follow-up in 2015, they were blocked by government and industry at every step.

Global News went through a years-long access-to-information process to obtain incident reports on E. coli found in Canadian food plants, most of it redacted.

How is it that 22 years after Jack-in-the-Box, North Americans seem to be adopting an attitude of indifference to food safety?

There’s lots of outbreaks, and communications research would suggest people are overloaded, so what’s a food safety type to do?

There is so much bad food safety advice that circulates in the PR-driven media, I’m not sure: How many years can anyone spend saying, you’re scientifically full of crap, stop it.

Food safety types need to persevere against the push for profit and stick with the message and the medium.

The best companies will do more than have manufactured soundbites about how food safety is their number 1 priority.

It doesn’t match up with reality, and food safety types, you’ll be needed sooner than you think.

Make food safety data public; market microbial food safety at retail; and repeat.

We won the game last week because the kids knew the drill, we’d practiced it, and we had fun.

Food safety should be the same.

Dr. Douglas Powell is a former professor of food safety at the University of Guelph in Canada and Kansas State University in the U.S., who shops, cooks and ferments from his home in Brisbane, Australia.

0478 222 221