Where’s the leafy greens lobby? Feds to seek listeria, leafy green connections after Dole outbreak

Mike Hornick of The Packer writes that health officials will begin routinely asking listeria outbreak victims if they consumed leafy greens, according to the Centers for Disease Control and Prevention.

lettuce.skull.noroThe addition of leafy greens to the standard federal questionnaire on listeria comes in response to last winter’s outbreak linked to a Dole Fresh Vegetables salad plant in Springfield, Ohio. That outbreak sickened 33 in the U.S. and Canada and was tied to at least one death. Dole stopped production in January and reopened the plant in April.

It was the first reported listeria outbreak in the U.S. associated with leafy greens, and the eighth with fresh produce. All occurred since 2008, according to an Aug. 26 report by the CDC.

“It is unclear whether the appearance of these outbreaks might be attributed to improved outbreak detection, changes in consumer behavior, or changes in production and distribution,” the report says. “Fresh produce processors are advised to review food safety plans and consider incorporating measures to avoid the growth and persistence of listeria.”

In the Ohio centered outbreak, the older questionnaire failed to identify a common source for seven infections reported by Nov. 30.

Then in December and January, eight new or previously interviewed patients or their representatives took part in open-ended interviews or provided shopper card records.

That revealed the connection. All reported consuming leafy greens in the month before the onset of illness.

Among these, seven reported romaine and six reported spinach, higher than national food consumption estimates of 47% and 24%, respectively. Six patients recalled consuming packaged salad, according to the report.

Dole Fresh Vegetables denied responsibility in two foodborne illness lawsuits that followed the outbreak.

CDC version: 4 dead, 33 sickened from Listeria linked to Dole packaged greens

The U.S. Centers for Disease Control came out with a summary of its investigation of Listeria in Dole packaged leafy greens produced at its Columbus, Ohio plant.

lettuce.tomato.skullIn September 2015, PulseNet, the national molecular subtyping network for foodborne disease surveillance, identified a cluster of Listeria monocytogenes (Listeria) clinical isolates indistinguishable by two-enzyme pulsed-field gel electrophoresis (PFGE) pattern combination and highly related by whole-genome multilocus sequence typing (wgMLST). A case was defined as isolation of Listeria with the outbreak PFGE pattern and highly related by wgMLST with an isolation date on or after July 5, 2015, the isolate date of the earliest case in this cluster.

A standardized Listeria Initiative questionnaire (1) was used to gather information about foods consumed in the 4 weeks before illness from seven persons identified by November 30, 2015, with isolation dates occurring July 5, 2015–October 30, 2015. This tool did not include leafy green vegetables and failed to identify a common source for the infections. During December 2015 and January 2016, eight new or previously interviewed patients or their surrogates participated in open-ended interviews or provided shopper card records, and all reported consuming leafy greens in the month before illness onset. Among these, seven (88%) reported romaine and six (75%) reported spinach, higher than national food consumption estimates of 47% (p = 0.022) and 24% (p = 0.003), respectively (2). Six patients (75%) recalled consuming packaged salad, and three patients (38%) who recalled brands reported packaged salad brands processed by Company A (that’d be Dole).

The Ohio Department of Agriculture obtained packaged salad processed at Company A’s Ohio facility from a store during routine sampling. On January 14, 2016, PulseNet analyzed sequence data from Listeria isolated from the packaged salad, and the isolate was highly related to the clinical isolates by wgMLST (median allele differences <10). This molecular finding, combined with the epidemiologic information, led the Food and Drug Administration to initiate an inspection of Company A’s Ohio facility on January 16, 2016. Two food samples collected during the inspection yielded Listeria, and wgMLST analysis indicated that they were highly related (median allele differences <10) to clinical and retail product isolates.

On January 21, 2016, Company A voluntarily halted production at its Ohio facility and conducted a market withdrawal of all packaged salad products from that facility because of possible Listeria contamination.* The market withdrawal included 22 varieties of packaged salads sold under various brand names. Company A issued a voluntary recall of these products on January 27, 2016, which further identified the list of affected products and brand names.

After the market withdrawal and recall, CDC fielded >450 inquiries about listeriosis from concerned consumers and clinicians, and the CDC outbreak website received >787,000 page views, more views than after any other foodborne illness outbreak to date.

lettuceAs of March 28, 2016, there were 19 persons meeting the case definition from nine states (Connecticut, Indiana, Massachusetts, Michigan, Missouri, New Jersey, New York, Ohio, and Pennsylvania) with isolation dates through January 31, 2016. All were hospitalized; one died. One illness in a pregnant woman resulted in a preterm live birth. One otherwise healthy child developed meningitis.

The Public Health Agency of Canada investigated 14 cases of listeriosis associated with this outbreak, with onset dates from May 7, 2015 to February 23, 2016 (3). Six Canadian clinical isolates were compared with U.S. clinical isolates and were highly related by wgMLST. Three cases reported consuming packaged salad processed at the Ohio facility. In January 2016, the Canadian Food Inspection Agency (CFIA) collected 55 packaged salads from stores in Canada representing 12 different products processed at the Ohio facility. CFIA isolated the outbreak strain and issued a food recall warning on January 22, 2016, for all products processed at the Ohio facility and distributed in Canada.

The wgMLST analysis identified this listeriosis cluster and provided evidence of the link between contaminated food products and human illness. This allowed timely recall of potentially contaminated food, which might have prevented additional cases of serious illness.

This is the first reported outbreak of listeriosis associated with leafy greens and the eighth reported outbreak of listeriosis associated with fresh produce in the United States; all occurred since 2008 (4).** It is unclear whether the appearance of these outbreaks might be attributed to improved outbreak detection, changes in consumer behavior, or changes in production and distribution. Fresh produce processors are advised to review food safety plans and consider incorporating measures to avoid the growth and persistence of Listeria.†† The Listeria Initiative questionnaire has been revised to include additional questions about fresh produce to better identify produce vehicles of Listeria.

Outbreak of listeriosis associated with consumption of packaged salad – United States and Canada, 2015-2016

Weekly / August 26, 2016 / 65(33);879–881

JL Self, A Conrad, S Stroika, A Jackson, L Burnworth, J Beal, A Wellman, KA Jackson, S Bidol, T Gerhardt, M Hamel, K Franklin, C Kopko, P Kirsch, ME Wise, C Basler

http://www.cdc.gov/mmwr/volumes/65/wr/mm6533a6.htm?s_cid=mm6533a6_e

Washing is never enough but are they linked? Summer means Cyclospora in Canada, Mexico and Texas

Finally, some decent risk-based advice from a government agency.

Washing will not remove Cyclospora from fresh produce.

pesto.basil_.cyclosporaWashing removes very little of anything from fresh produce.

Canada’s Public Health Agency is investigating 51 cases of people infected with the single-celled parasite Cyclospora cayetanensis between mid-May and late-July. Forty-four of the 51 cases reported so far have been in Ontario.

The infection can cause watery diarrhea, fatigue, stomach pain

Though uncommon in food and drinking water in Canada and the U.S., the parasite often persists on fruit and vegetables even after they have been washed. Public Health Canada recommends that people cook vegetables and fruit imported from Peru, Cuba, India, Nepal, Mexico, Guatemala, Southeast Asia and Dominican Republic.

Last week, health officials in Texas also reported a major outbreak of the disease, and are continuing an investigation into fresh produce as a possible source. After a series of outbreaks linked to imported produce from Puebla Mexico in 2015, the U.S. Food and Drug Administration banned imports from the region during summer months.

Previous outbreaks of Cyclospora have been linked to pre-packaged salad mix, basil, cilantro, raspberries, blackberries, and snap-peas.

At the same time, 148 British tourists have been confirmed with Cyclospora after visiting 24 luxury hotel complexes most of which are in the Riviera Maya resort near Cancun in Mexico.

Public Health England  are now warning UK tourists to be wary of travelling to Mexico and the Foreign Office have updated their website to include a warning from health authorities about travelling to the region.

14 sick with Cyclospora in (North) Texas

Frank Heinz of NBC DFW 5 cited health officials as saying more than a dozen cases of cyclosporiasis have been confirmed in North Texas’ four major counties and that the source is likely contaminated food.

pesto.basil.cyclosporaThe Texas Department of State Health Services said Wednesday the parasite was found in Dallas, Tarrant, Collin and Denton counties and that the origin may be linked to a fresh produce item.
County officials told NBC 5 there have been four cases recorded in Dallas County, three in Collin County, four in Denton County and seven in Tarrant County. The Denton County cases and at least four of the Tarrant County cases had recently traveled out of the country — calling into question the point of origin.

Across the state, there are currently 66 confirmed cases of cyclosporiasis — though the sources of infection haven’t been confirmed. For most people, the symptoms are serious. “But for those who are very young and those who are older, or those who have a suppressed immune system, this illness can cause major problems,” said Dr. Khang Tran, chief medical officer at The Medical Center of Plano. 

In recent years, 2012-2015, cyclospora outbreaks were associated with fresh cilantro imported from Puebla, Mexico. Since the summer of 2015, the Food and Drug Administration has instituted ban on imports from that region between from April through August.
In 2015, the DSHS said there were 316 cases of cyclosporiasis in Texas.

Cyclosporiasis Case Counts and Incidence Rates in Texas, 2001-2014

Year | Case Count | Incidence Rates

2014* | 200 | 0.7
2013* | 351 | 1.3
2012* | 44 | 0.2
2011* | 14 | 0.1
2010 | 9 | 0.0
2009 | 10 | 0.0
2008 | 6 | 0.0
2007 | 2 | 0.0
2006 | 1 | 0.0
2005 | 1 | 0.0
2004 | 4 | 0.0
2003 | 1 | 0.0
2002 | 1 | 0.0
2001 | 0 | 0.0

IR=incidence rate per 100,000 *incidence rates are bases on projected census data obtained from the DSHS Center for Health Statistics. 

Nosestretcher alert: Australian food safety type talks shit

Food poisoning and gastroenteritis affect 4.1 million Australians a year.

y a t il un pilote dans l'avion ? airplane flying high 1980 réal : Jim Abrahams David et Jerry Zucker Leslie Nielsen Collection Christophel Collection Christophel

If you do find yourself stricken with something nasty, it might be tempting to put a big, black mark against the last restaurant you ate in. But, according to Dr Vincent Ho, clinical gastroenterologist and lecturer in medicine at the University of Western Sydney, eating out isn’t always to blame. “It’s more common to get food poisoning with home meals, and that’s because people eat at home more often than they go out,” he tells Time Out. “Generally speaking, in Australia, and other developed countries where we have good sanitation, the vast majority of the time when we go out, there isn’t any food poisoning or gastroenteritis.”

Another so-called expert talking shit.

For instance there was an outbreak caused by contaminated lettuce in NSW recently. They were able to trace that back by looking at the people affected, asking about what they were eating and looking for common elements.”

Some would call it epidemiology.

Poultry products and meat are the most common sources of food poisoning, but most cases of gastroenteritis can be traced back to inadequate hand washing.

Nosestretcher alert.

Can’t image a more factually incorrect and condescending statement.

Fresh produce is the leading source of foodborne illness in Western countries and has been for over a decade.

But it’s still 1978 here in Australia.

jon.stewart.handwashing.2002In Australia and other developed countries, “we’ve taken special preparations to reduce the incidences of food-borne infections.” We have health inspections, food safety laws and signs everywhere that say “all staff must wash hands” when we’re eating out.

Seriously, you think those signs work?

How did you get to be a professor of anything?

At home, we have to rely on ourselves, and it turns out, many people are not that reliable. It only takes 10 seconds of washing your hands with soap and water to seriously reduce your chance of passing around a stomach bug, and yet, most people aren’t doing it properly.

That’s the reason you’re more likely to pick up an illness at home, or in a closed-off environment like a cruise ship, day care or nursing home, where you’re exposed to lots of people’s germs, than you are from a restaurant. At a restaurant, “although there are always occasions where food isn’t prepared optimally” there are structures in place to ensure caution. At home, you’re on your own.

Dr. Ho, I’ll gladly go to your home and watch you prepare a meal.

Most people don’t invite me to dinner because they know who I am.

But I’ll give you a tip-sensitive digital thermometer.

What about going public? Why produce organizations adopt food safety protocols

We examine theoretically and empirically the factors associated with commodity organizations’ voluntary adoption of stricter food safety guidelines. Our theoretical analysis finds that larger organizations are less likely to require members to invest in food safety procedures due to higher implementation costs.

lettuce.skull.noroRecalls induce organizations to adopt stricter food safety standards only when expected future gains from improved product reputation outweigh the short run costs of implementing those standards. The same logic holds for organizations representing growers of a product with higher demand, e.g., a larger share of fruit and vegetable sales. Organizations whose members have a larger share of the market for their product are more likely to adopt stricter food safety guidelines when that investment induces members to increase output, a necessary condition for which is that members’ current food safety procedures are more protective than the industry average.

Our econometric analysis finds that organizations with more members are less likely to adopt food safety guidelines for their members, as our theoretical analysis predicts. Organizations whose members account for a larger share of the market for their product and organizations for commodities representing larger shares of fruit and vegetable sales are more likely to implement food safety guidelines, consistent with considerations of long term profitability increases due to improved reputation for safety outweighing concerns about increases in cost of production. Organizations that have experienced negative shocks to reputation as measured by the number of Class I FDA recalls are also more likely to adopt food safety guidelines, again consistent with considerations of long term profitability due to improved reputation for safety outweighing concerns about increases in cost of production.

Foodborne illness outbreaks, collective reputation, and voluntary adoption of industrywide food safety protocols by fruit and vegetable growers

AgEcon Search

Aaron Adalja and Erik Lichtenberg

http://ageconsearch.umn.edu/bitstream/235865/2/AAEA_P9730_Adalja_Lichtenberg_final.pdf

 

2 dead, 151 sick: UK says stop using imported rocket (lettuce), but not blaming anyone

Continuing in the fairytale theme that purveyors of food have the best interest of consumers at heart, as do taxpayer funded regulators, Public Health England have told a small number of wholesalers to stop using imported rocket leaves in their salad mixes, as investigations into a major E. coli outbreak continue.

lettuce.skull.e.coli.O145The outbreak had so far claimed two lives, PHE said today, with a total of 151 cases identified, 62 of which required hospital care.

Director of Public Health England, Dr Isabel Oliver, said  “PHE is using various approaches including whole genome sequencing (WGS) technologies to test samples from those affected. WGS technologies are at the forefront of improving the diagnosis of infectious diseases and this testing has indicated that the strain involved is likely to be an imported strain, possibly from the Mediterranean area.

“PHE is also working closely with the Food Standards Agency to trace, sample and test salad products grown in the UK and other parts of Europe.

“All food sample results to date have been negative for E.coli O157, but it’s important to be aware that where food has been contaminated with E.coli O157, it is not always possible to identify the bacteria on food testing.

“As an additional precautionary measure, we have advised a small number of wholesalers to cease adding some imported rocket leaves to their mixed salad products pending further investigations

The UK Food Standards Agency said in the most bureaucratic way possible – with 2 dead and 151 sick – it is continuing to work closely with PHE and local authorities to investigate an outbreak of E.coli O157. The outbreak has been linked to eating mixed salad leaves, including rocket leaves, however a specific food source has not been confirmed at this stage.

As a precaution, the FSA is reminding people of the importance of good hand and food hygiene practices. All vegetables, including salads, intended to be eaten raw should be thoroughly washed unless they are specifically labelled ‘ready to eat’. Investigations are ongoing.

Fail. Nothing about on-farm food safety.

 

109 sick from E. coli in leafy greens UK: Best advice bureautypes have is wash your hands

This just gets continuinglyly hopeless. More sick people – that’s good to disclose, know it’s uncomfortable for Brits and most Europeans – but telling consumers to wash their hands is stupid.

lettuce.skull.e.coli.O145Why wouldn’t Public Health England (PHE) or the farm groups involved say, this is what we do to reduce risk, and talk about on-farm food safety efforts?

Instead, they tell consumers to wash their hands.

To date, 109 cases (figure correct as at 4 July 2016) of this strain of E. coli have been identified (102 in England, 6 in Wales and 1 in Scotland) with the South West of England particularly affected.

PHE has been working to establish the cause of the outbreak and has now identified that several of the affected individuals ate mixed salad leaves including rocket leaves prior to becoming unwell. Currently, the source of the outbreak is not confirmed and remains under investigation. PHE is now reminding people to maintain good hygiene and food preparation practices in response to the current outbreak.

Dr Isabel Oliver, director of PHE’s field epidemiology service, said, We continue to stress the importance of good hand and food hygiene practices at all times. We urge people to remove any loose soil before storing vegetables and thoroughly wash all vegetables (including salads) that will be eaten raw unless they have been pre-prepared and are specifically labelled ‘ready to eat’. These measures may reduce the risk of infection from any E.coli contaminated vegetables, fruit and salad but will not eliminate any risk of infection completely. 

84 sick with E. coli O157: Leafy greens cone of silence – English-style

As if the English weren’t taunted enough, an outbreak of E. coli O157 phage type (PT) 34 linked with leafy salad has prompted regulators to remind consumers “about the importance of good hygiene and food preparation practice” and wash their f*cking hands (that pic, right, is what accompanied s300_Handwashing__NHS_MOORFIELDS_308-10056_960x640the PR; I can’t make this shit up).

This has nothing to do with E. coli O157 on leafy greens, and is a further continuation of Scotland’s it’s-a-f*cking pink chicken educational campaign.

Public Health England says it is investigating an outbreak of E. coli O157 which may be associated with eating leafy salad. To date 84 cases (figure correct as at 1 July 2016) of this strain of E. coli have been identified (77 in England, 5 in Wales, 1 in the Channel Islands and 1 in Scotland) with the majority of cases confirmed in the South West of England.

Dr. Isabel Oliver, director of PHE’s field epidemiology service, said: PHE has put in place heightened surveillance for this strain of E. coli and is and carefully monitoring the reporting of cases across the entire country. To assist with this investigation, we have convened a national outbreak control team to identify the source of infection and to ensure all necessary control measures are put in place.

lettuce.skull.e.coli.O145And collaborate with the U.K. Food Standards Agency, whose idea of science-based verification is to cook meat until it is piping hot, and declared in 2011 that E. coli O157:H7 found on or in leeks or potatoes, was the consumers’ responsibility.

Almost two months after revealing 250 people were sickened and one died with E. coli O157:H7 phage-type 8 over the previous eight months in 2011, linked to people handling loose raw leeks and potatoes in their homes, FSA decided to launch a campaign reminding people to wash raw vegetables to help minimize the risk of food poisoning.

No information on how those 250 became sick and no information on farming and packing practices that may have led to such a massive contamination that so many people got sick, no information on anything: just advice to wash things thoroughly so that contamination can be spread throughout the kitchen.

This outbreak once again combines two of the central themes of conflict and public trust in all things food, which the English are seemingly terrible at: when to go public, and blaming consumers.

And now, John Oliver, again (NSFV).

An avirulent Salmonella to better understand outbreaks on produce

Recurrent outbreaks of bacterial gastroenteritis linked to the consumption of fresh fruits and vegetables highlight the paucity of understanding of the ecology of Salmonella enterica under crop production and postharvest conditions.

tomatoThese gaps in knowledge are due, at least in part, to the lack of suitable surrogate organisms for studies for which biosafety level 2 is problematic. Therefore, we constructed and validated an avirulent strain of Salmonella enterica serovar Typhimurium.

The strain lacks major Salmonella pathogenicity islands SPI-1, SPI-2, SPI-3, SPI-4, and SPI-5 as well as the virulence plasmid pSLT. Deletions and the absence of genomic rearrangements were confirmed by genomic sequencing, and the surrogate behaved like the parental wild-type strain on selective media. A loss-of-function (phoN) selective marker allowed the differentiation of this strain from wild-type strains on a medium containing a chromogenic substrate for alkaline phosphatase. Lack of virulence was confirmed by oral infection of female BALB/c mice. The strain persisted in tomatoes, cantaloupes, leafy greens, and soil with the same kinetics as the parental wild-type and selected outbreak strains, and it reached similar final population levels. The responses of this strain to heat treatment and disinfectants were similar to those of the wild type, supporting its potential as a surrogate for future studies on the ecology and survival of Salmonella in production and processing environments.

Importance 

There is significant interest in understanding the ecology of human pathogens in environments outside of their animal hosts, including the crop production environment. However, manipulative field experiments with virulent human pathogens are unlikely to receive regulatory approval due to the obvious risks. Therefore, we constructed an avirulent strain of S. enterica serovar Typhimurium and characterized it extensively.

Development of an avirulent Salmonella surrogate for modeling pathogen behavior in pre- and postharvest environments

Marcos H. de Moraes a, Travis K. Chapin b, Amber Ginn c, Anita C. Wright c, Kenneth Parker a, Carol Hoffman d, David W. Pascual d, Michelle D. Danyluk b and Max Teplitski a

A Soil and Water Science Department, Genetics Institute, University of Florida Institute of Food and Agricultural Sciences (UF/IFAS), Gainesville, Florida, USA

B Department of Food Science and Human Nutrition, Citrus Research and Education Center, UF/IFAS, Lake Alfred, Florida, USA

C Department of Food Science and Human Nutrition, UF/IFAS, Gainesville, Florida, USA

D Department of Infectious Diseases and Pathology, University of Florida, Gainesville, Florida, USA

Applied and Environmental Microbiology, Volume 82, Number 14, July 2016, Pages 4100-4111, doi:10.1128/AEM.00898-16

http://aem.asm.org/content/82/14/4100.abstract?etoc