12 sick: E. coli leafy greens cone of silence, again

The Public Health Agency of Canada is collaborating with federal and provincial public health partners to investigate an outbreak of Escherichia coli O157:H7, commonly called E.coli, with a possible link to leafy greens. A specific product has not been identified yet, and the investigation is ongoing.

lettuce.skull.e.coli.O145At this time, the risk to Canadians is low. However, Canadians are reminded to follow safe food handling practices to avoid illness. (WTF are Canadians supposed to do with leafy greens?)

There have been 12 cases of E. coli with a matching genetic fingerprint reported in Alberta (9), Saskatchewan (1), Ontario (1), and Newfoundland and Labrador (1). The illness onset dates range from March 13 to March 31, 2015.

Based on the investigation findings to date, exposure to leafy greens has emerged as a possible source of illness. Leafy greens can include all varieties of lettuces and other green leaf vegetables such as kale, spinach, arugula, or chard. The Canadian Food Inspection Agency’s investigation into the food source is ongoing. If products are identified, the Agency will inform the public and ensure that they are promptly removed from the marketplace.

The following tips will help you reduce your risk of infection with E. coli or other food-borne illnesses:

Wash fresh fruits and vegetables before eating them, clean counters and cutting boards and wash your hands regularly.

Bullshit. Packaged leafy greens are not to be re-washed.

Australian taxpayers and growers are led up a garden path

(I and others applied for this, but knew it was an inside job. Here is the take from Australian Food News)

lettuce.skull.e.coli.O145The Fresh Produce Safety Centre (FPSC), which is an organisation established with government and industry support in 2013, has announced the winning tender bid for the conduct of a literature review of fresh produce safety research.

The announcement has produced some skepticism from commentators about the whole bureaucratic process involving the Fresh Produce Safety Centre’s role in improving the current Australian food safety regime for fresh produce.

The principal industry sector group supporting the establishment of the Fresh Produce Safety Centre has been the Produce Marketers Association Australia New Zealand (PMA A-NZ), which is the representative body of importers and international traders of fruit and vegetables.

The major supermarkets and food safety audit organisations already follow and monitor their own very strict food safety protocols at all points in the supply chain. Commentators are therefore asking why it ought be necessary for the FPSC to be ‘reinventing the wheel’.

Incidentally, the winning tender bid is a team consisting of TQA Australia Inc, RMCG, and the Institute of Environmental Science and Research in New Zealand, in concert with the Food Safety Centre at the University of Tasmania. The project has the support of the NSW Food Authority, Pip Fruit New Zealand, Golden State Foods and Snap Fresh Foods, and Fresh Select.

In 2009-2010, a process had been initiated by Food Standards Australia New Zealand (FSANZ) to incorporate food safety primary production and processing standards for horticultural produce into the Australia New Zealand Food Standards Code (Food Standards Code). However, the PMA and some of the major produce importers opposed the inclusion in the Food Standards Code of a set of food safety standards for their industry sector. Ultimately, the Federal Government relented and the FSANZ process for developing a new mandatory food safety standard was aborted.

The reasons given at the time for the abandonment of the proposals included: the fact that the majority of horticulture product grown in Australia is already grown under a food safety scheme, and that a better understanding of those products that were not grown under a food safety scheme was required before further regulation should be considered.

FSANZ proposed a collaboration between the horticulture industry and government – with suggested measures such as “targeted guidance, codes of practice, education materials and training” and better through-chain traceability measures.

The PMA took the initiative to establish the concept of a ‘fresh produce safety centre’ with government and industry backing.

Some commentators are now consider the whole process a ‘waste of time and industry resources, and taxpayer funds’, especially for growers, supermarkets and other operators in the horticultural supply chain within Australia.

Probably cilantro that sickened hundreds with cylospora in 2013; better detection needed

The 2013 multistate outbreaks contributed to the largest annual number of reported US cases of cyclosporiasis since 1997. In this paper we focus on investigations in Texas.

cilantroWe defined an outbreak-associated case as laboratory-confirmed cyclosporiasis in a person with illness onset between 1 June and 31 August 2013, with no history of international travel in the previous 14 days. Epidemiological, environmental, and traceback investigations were conducted.

Of the 631 cases reported in the multistate outbreaks, Texas reported the greatest number of cases, 270 (43%). More than 70 clusters were identified in Texas, four of which were further investigated. One restaurant-associated cluster of 25 case-patients was selected for a case-control study. Consumption of cilantro was most strongly associated with illness on meal date-matched analysis (matched odds ratio 19·8, 95% confidence interval 4·0–∞). All case-patients in the other three clusters investigated also ate cilantro. Traceback investigations converged on three suppliers in Puebla, Mexico.

Cilantro was the vehicle of infection in the four clusters investigated; the temporal association of these clusters with the large overall increase in cyclosporiasis cases in Texas suggests cilantro was the vehicle of infection for many other cases. However, the paucity of epidemiological and traceback information does not allow for a conclusive determination; moreover, molecular epidemiological tools for cyclosporiasis that could provide more definitive linkage between case clusters are needed.

2013 multistate outbreaks of Cyclospora cayetanensis infections associated with fresh produce: focus on the Texas investigations

Epidemiology and Infection [ahead of print]

Abanyie, R. R. Harvey, J. R. Harris, R. E. Weigand, L. Gual, M., Desvignes-Kendrick, K. Irvin, I Williams, R. L. Hall, B. Herwaldt, E. E. Gray, Y. Qvarnstrom, M. E. Wise, V. Cantu, P. T. Cantey, S. Bosch, A. J. Da Silva, A. Fields, H. Bishop, A. Wellman, J. Beal, N. Wilson, A. E. Fiore, R. Tauxe, S. Lance, L. Slutsker and M. Parise

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9644741&fileId=S0950268815000370

Listeriosis and Produce: What’s the Connection? (via The Abstract)

I’m collaborating with Matt Shipman, public information officer at NC State University and curator of The Abstract, on a set of food safety-related posts from other NCSU folks as we roll toward WHO’s World Health Day on April 7– which is focused this year on food safety. Here’s a post on Listeria’s history with produce by Danisha Garner, a graduate student in NC State’s Department of Food, Bioprocessing and Nutrition Sciences.

In the United States and other industrialized nations, consumption of fresh fruits and vegetables is considered a key component of a healthy diet.

There are many benefits to eating fresh produce such as receiving adequate vitamins and minerals, reducing the risk of heart disease, lowering blood pressure, and preventing some types of cancer. Even healthy foods, however, can be vehicles for foodborne pathogens. Indeed, fresh produce is now considered a major contributor to human foodborne disease, and an increasing number of produce-associated foodborne disease outbreaks have occurred in recent years.

An especially worrisome trend is the increase in outbreaks of listeriosis, involving the pathogen Listeria monocytogenes.

Danisha Garner. Photo courtesy of Danisha Garner.

What Is Listeriosis?

Although it is relatively uncommon, human listeriosis remains a major public health concern due to high hospitalization and death rates. In fact, it has the highest hospitalization rate of all foodborne pathogens in the U.S. and is the third largest contributor to deaths from foodborne illness. Symptoms of infection can be severe and include septicemiameningitis, stillbirths and abortions. At high risk are the elderly, pregnant women and their fetuses, and patients with cancer and other immunocompromising conditions.

L. monocytogenes can be found in decaying plant material, soil and water, and has been detected on many types of fresh produce. Its reservoirs in nature remain poorly characterized but likely include soil and vegetation. Major contributors to the ability of L. monocytogenes to contaminate foods include its capacity to persistently colonize the environment and equipment of both food processing plants and produce packing sheds, and to grow even at refrigeration temperatures. Hence, foods typically implicated in human listeriosis are those that are processed, cold-stored and ready-to-eat – i.e. consumed without further treatment.

History of Listeriosis Outbreaks

The first outbreak of human listeriosis to be epidemiologically investigated (and to confirm foodborne transmission of the pathogen) involved produce (coleslaw) and took place in the Maritime Provinces of Canada in 1981. However, most subsequent outbreaks involved dairy products (especially soft cheeses) and ready-to-eat meats. Fresh produce was generally considered at low risk for listeriosis.

This situation changed dramatically in 2011, when one of the largest listeriosis outbreaks on record was traced to contaminated whole cantaloupe and resulted in a total of 147 cases of illness and 33 deaths across 28 states. This was also the first time that whole cantaloupe was found to serve as food vehicle for listeriosis. Contamination of the cantaloupes occurred in the packing facility, likely due to inadequate cleaning and sanitation of equipment. The pathogen was not recovered from the field where the melons were grown or from fruit prior to packing.

Even though additional melon-associated outbreaks of listeriosis have not been noted since the 2011 outbreak, several other produce-associated outbreaks have been documented in the U.S. since 2010. Implicated produce included diced celery (2010), sprouts (2014) and commercially produced, prepackaged caramel apples (2014). In all investigated cases, the source of contamination was the packing/processing environment or equipment. These outbreaks highlight the importance of having good sanitation practices in the packing/processing facility to prevent or reduce contamination with Listeria and other pathogens.

Research and Prevention

At NC State, several efforts are being focused on characterizing Listeria-produce associations with the ultimate goal of identifying new tools and strategies to reduce the risk of contamination.

In the Department of Food, Bioprocessing and Nutrition Science, researchers in the lab of Sophia Kathariou are collaborating with Lisa Gorski and William G. Miller at USDA-ARS to investigate genes of L. monocytogenes that mediate the pathogen’s adherence and growth on both fresh produce and on surfaces likely to be encountered in packing sheds and processing plants.

In collaboration with Christian Melander (in NC State’s Department of Chemistry) the Kathariou lab is also investigating the potential of novel compounds to prevent or disperse biofilms formed by L. monocytogenes on environmental surfaces and equipment. Such research will be critically needed for development of novel tools and strategies to ensure the safety of fresh produce and reduce the risk for human listeriosis.

More information about Listeria monocytogenes and listeriosis outbreaks can be found at http://www.cdc.gov/listeria/

Safety don’t have much to do with it: Food safety audits are just what retailers wanted

I’m not Dr. Doug.

doug.coach.happy.feb.15Kids call me coach, others call me asshole, all fine by me.

Dr. Bob and Dr. Dan exist, and probably many others in the misguided belief they are enhancing the public understanding of science, when it’s just demeaning and arrogant.

Dr. Bob says during grower food safety events, “we often talk about why having a food safety program is important and how it is critical to have a program to protect your own business, protect your customers and, ultimately, public health. We talk about emerging science, the importance of foundational food safety programs such as sanitation practices and worker hygiene and how to identify and manage potential cross-contamination hazards on the farm and in the packinghouse.

“After going through this information and basically laying out the why, how, and what of food safety, often some brave soul in the audience will raise their hand and ask, So what score do I need to get in order to pass the audit? And that’s when the frustration sets in. How did passing an audit become a substitute for actually building a risk-based food safety program?”

Oh, Oh, Dr. Bob, I can answer that.

Because back in the late 1990s, as fresh fruit and vegetable outbreaks took on national prominence, retailers decided, we want third-party audits, rather than food safety programs promoted by grower groups.

I chaired a national committee in Canada about 2002 to look at the issue, came up with a solution that would be advantageous to growers and consumers, and was then overruled behind the scenes so the grower groups could keep their Canadian Food Inspection Agency funding (and the bureaucracy).

I walked away.

Thirteen years later and Dr. Bob is wondering how this happened?

Reported foodborne outbreaks due to fresh produce: US vs EU

Consumption of fruit and vegetables is associated with a healthy lifestyle. Various international organizations, such as the World Health Organization, encourage the daily intake of at least 400 g of fruit and vegetables per day (excluding potatoes and other starchy tubers) for the prevention of chronic diseases, such as heart disease, cancer, diabetes, and obesity.

lettuce.skull.noroA large portion of this produce is consumed raw, and the number of foodborne outbreaks associated with these products has increased correspondingly. In this context, unpasteurized fruit juices and raw sprouts are also considered high-risk foods. The 2011 Escherichia coli O104:H4 outbreak from sprouted seeds in Germany gives a clear indication of the emerging relevance of the consumption of these products within food safety issues.

Globalization and growing international trade can also increase the risk, especially if produce comes from countries with lower safety standards. Nevertheless, nutrition educators and healthcare professionals believe that the benefits of eating fresh fruits and vegetables outweigh the risk of contracting a foodborne illness by consuming fresh produce.

The number of reported outbreaks (defined as the occurrence of two or more cases of similar illness resulting from the ingestion of a common food) reported both in the United States and European Union represents only a fraction of the actual number of outbreaks that occur.

Large outbreaks, outbreaks associated with food service and institutions, and outbreaks that have a longer duration or cause serious disease are more likely to be investigated and reported. Conversely, the data may not reflect what occurs in

sporadic cases. Moreover, there are differences in the sensitivity of the national or state systems in identifying and investigating foodborne outbreaks.

melon.berriesA wide spectrum of pathogens and food vehicles has been documented in produce-associated outbreaks. The occurrence of food-related infections due to fresh produce calls for better control interventions and the need for improved prevention strategies worldwide, since food can be contaminated at any point in the food chain, and interventions must be applied where appropriate at every step. Hence, the future success of global efforts to prevent produce-related outbreaks depends on the understanding of the key contributing factors and the maintenance of best practices to reduce and eliminate contamination.

Reported foodborne outbreaks due to fresh produce in the United States and European Union: trends and causes

Foodborne Pathogens and Disease. January 2015, 12(1): 32-38

Callejón Raquel M., Rodríguez-Naranjo M. Isabel, Ubeda Cristina, Hornedo-Ortega Ruth, Garcia-Parrilla M. Carmen, and Troncoso Ana M.

http://online.liebertpub.com/doi/abs/10.1089/fpd.2014.1821#utm_source=ETOC&utm_medium=email&utm_campaign=fpd

Abstract

The consumption of fruit and vegetables continues to rise in the United States and European Union due to healthy lifestyle recommendations. Meanwhile, the rate of foodborne illness caused by the consumption of these products remains high in both regions, representing a significant public health and financial issue. This study addresses the occurrence of reported foodborne outbreaks associated with fresh fruits and vegetables consumption in the United States and European Union during the period 2004–2012, where data are available. Special attention is paid to those pathogens responsible for these outbreaks, the mechanisms of contamination, and the fresh produce vehicles involved. Norovirus is shown to be responsible for most of the produce-related outbreaks, followed by Salmonella. Norovirus is mainly linked with the consumption of salad in the United States and of berries in the European Union, as demonstrated by the Multiple Correspondence Analysis (MCA). Salmonella was the leading cause of multistate produce outbreaks in the United States and was the pathogen involved in the majority of sprouts-associated outbreaks. As is reflected in the MCA, the pattern of fresh produce outbreaks differed in the United States and European Union by the type of microorganism and the food vehicle involved.

produce.vehicle.us.jan.15

 

 

 

 

 

 

 

produce.vehicle.eu.jan.15

Scared by the apple recall? These 5 fruits and veggies are even bigger risks

I’m still somewhat bemused that anyone has no trouble contacting me – this time while goofing around in Hawaii – yet university admin types were baffled so much they fired me for bad attendance.

Excellence in education.

lettuce.skull.noroAmy Rushlow of Yahoo! Health reports that a bacterial outbreak in apples has killed seven people and hospitalized 31, according to the Centers for Disease Control (CDC).

The Food and Drug Administration (FDA) recently confirmed that strains of listeria bacteria were discovered at the Bidart Bros. apple-packing plant in California. A majority of the cases have been linked to prepackaged caramel apples. Last week, Bidart Bros. voluntarily recalled all Granny Smith and Gala apples following the results of the tests.

Apples are the second most popular fruit in America, according the Agricultural Marketing Resource Center. But apple contamination is actually rare because they have a hard surface, which prevents bacteria from entering the fruit, says Doug Powell, PhD, a former professor of food safety in the U.S. and Canada who publishes barfblog.com.

“Fresh fruits and vegetables are probably the biggest source of foodborne illness today in North America, and that’s because they’re fresh — we don’t cook them — so anything that comes into contact has the potential to contaminate,” Powell tells Yahoo Health.

Powell is especially careful with the following five fruits and vegetables, which have been linked to a significant number of foodborne illness outbreaks over the past years. (And no, apples didn’t make the list.)

1. Sprouts

This is the one food that Powell simply refuses to eat. “There are outbreaks all the time around the world.” You might recall the 2011 outbreak in Germany, which killed more than 50 people and sickened more than 4,000. In late 2014, more than 100 Americans became ill after eating sprouts tainted with E. coli.

Sprouts are particularly prone to bacteria because they germinate in a high-temperature, high-moisture environment — the same environment where germs thrive. “They’ve shown in many of these cases, it’s the seed that’s contaminated on the inside, so then when you get it germinated, you only need one cell and it’s going to grow,” he adds.

The CDC recommends that pregnant women, children, older adults, and people with weak immune systems avoid eating raw sprouts. Cooking sprouts destroys harmful bacteria.

cantaloupe.salmonella2. Cantaloupe

Unlike honeydew melons or watermelon, cantaloupes have porous rinds that allow bacteria to enter the fruit. In addition, the fields where cantaloupes are grown often flood, Powell explains, “So they’re sitting in water, and that water may have come downstream from a livestock operation.”

3. Leafy greens

Bacteria becomes trapped on the inner leaves as the head is forming, Powell explains. Plus, leafy greens are especially difficult to wash effectively. Over the past several years in the U.S., bags of romaine lettuce, prepackaged salad mix, spinach, and spring mix have all been linked to E. coli outbreaks.

4. Tomatoes

There are several ways for germs to enter the fruit of the tomato, including via groundwater or through the water tomatoes are plunged into to give them a little shine, Powell says. “The dunk tank water has to be within five degrees of the interior of the tomato or else a vacuum is formed and water rushes in, so whatever is in dunk tank water is now inside of the tomato.” An easy fix is for tomato companies to monitor the dunk tank water, but unfortunately there isn’t a simple way for consumers to know if their grower does this.

5. Garnishes, such as green onions, cilantro, and parsley

Green onions and other herbs and vegetables used as garnishes are at high risk for outbreaks because we don’t cook them, Powell explains. He recommends leaving them off the plate if they’re simply for decoration.

Don’t let all of this scare you away from eating fresh fruits and vegetables, Powell stresses. While there is no one measure that will keep you completely safe, a few small steps can add up. For one, Powell himself shops for produce at the largest store he can find. “They have the resources to demand that their supply has to go through some basic food safety standards that they’re going to apply internally,” he says. He also recommends giving fresh produce a rinse, which removes surface debris and some (but not all) bacteria.

And while Powell doesn’t suggest always cooking fruits and vegetables to kill bacteria, since there are nutritional benefits to eating them raw, it’s a step you can take if you’re especially concerned. The FDA website offers additional everyday food safety tips.

E. coli can get airborne: Buffer zone guidelines may be inadequate to protect produce from feedlot contamination

Escherichia coli O157:H7 can spread, likely airborne, more than one tenth mile downwind from a cattle feedlot onto nearby produce, according to a paper published ahead of print in Applied and Environmental Microbiology.

lettuce.skull.noroThe high percentages of leafy greens contaminated with E. coli suggest great risk for planting fresh produce 180 m [590 feet] or less from a feedlot,” the investigators write. That suggests that current buffer zone guidelines of 120 meters [400 feet] from a feedlot may be inadequate. This is the first comprehensive and long-term study of its kind, says first author Elaine D. Berry, of the U.S. Department of Agriculture, Agricultural Research Service, U.S. Meat Animal Research Center, in Clay Center, Nebraska.

In the study, the investigators sampled leafy greens growing in nine plots; three each at 60, 120, and 180 meters downwind from the cattle feedlot at the research center, over a two year period. The rate of contamination with the pathogenic E. coli O157:H7 declined with distance from an average of 3.5 percent of samples per plot at 60 meters to 1.8 percent at 180 meters.

The researchers sampled the produce six times between June and September of each year. They also sampled the feedlot surface manure in 10 feedlot pens for E. coli O157:H7, finding it in an average of 71.7 to 73.3 percent of samples in 2012 and 2011, respectively.  Moreover, the study’s long-term nature enabled sampling under a greater diversity of weather conditions.

A variety of conditions can affect the level of contamination, says Berry. For example, following a period of high cattle management activity when the feedlot was dry and dusty, including removal of around 300 head of cattle for shipping, the rate of total non-pathogenic E. coli-contaminated samples per plot at 180 meters shot up to 92.2 percent.

lettuceConversely, total E. coli-positive leafy green samples were notably lower on one August sample date than on any other date, a finding the investigators attribute to cleaning and removal of feedlot surface manure from the nearby pens a few weeks earlier.

The investigators also found E. coli in air samples at 180 meters from the feedlot, though the instruments were not sensitive enough to pick up E. coli O157:H7. However, the presence of E. coli in the air samples serves as a surrogate for E. coli O157:H7, demonstrating that the pathogen may also be transmitted in this manner, says Berry. The highest levels of contamination found on leafy greens, in August and September of 2012, followed several weeks of very little rainfall and several days of high temperatures, conditions that appear to abet airborne transport of bacteria from the feedlot, she says.

Limitations of the research include that it was conducted only in one state—Nebraska, which is not a produce growing state. Nonetheless, Berry says that the location was a reasonable model for some of the U.S.’s major produce growing regions, such as California’s Central Coast, as winds there can blow almost as hard as in Nebraska, and both places can have dry summers, which are conducive to airborne transport of bacteria.

The impetus for conducting the research was the rising incidence of foodborne disease outbreaks caused by contamination of fresh produce, says Berry.

If you try sometimes, you’ll get what you need: FDA says can’t have it both ways on food safety

Two of the things growers and shippers want to see in new federal food safety rules — flexibility and simplicity — are mutually exclusive according to officials from the Food and Drug Administration.

mick.taylorCoral Beach of The Packer writes the more flexible the rules, the more complicated they have to be. That was the message from FDA’s top food safety staff during a Nov. 21 session in Florida where they fielded questions on proposed rules required by the Food Safety and Modernization Act.

Mike Taylor (right, not exactly as shown), FDA deputy director of foods, and Samir Assar, director of produce safety at the FDA’s Center for Food Safety and Applied Nutrition, also said time has not been on the agency’s side in terms of developing the rules.

“It’s an incredibly rapid, very tight time frame were on,” Taylor said, adding that a court order requires the agency to publish the final rule for produce in October next year.

Taylor and other federal officials spent about 90 minutes reviewing the proposed rules and revisions before taking questions during the session, which was sponsored by the Florida Agriculture Department. It was the fifth such state session Taylor and the others have attended since Nov. 6.

(Terrible pretend playing in the video below; and this guy interviewed Nixon.)

 

Plastic or corrugated containers? Which is better for produce food safety

Two recent studies of bacteria on reusable plastic containers — both sponsored by corrugated carton groups — question the cleaning process used on RPCs before they enter the supply chain again.

reusable-plastic-containerRPC supplier IFCO and the Reusable Packaging Association has countered that no foodborne illness outbreak has been traced to RPCS.

Keith Warriner, professor of food safety at the University of Guelph in Ontario, Canada, said the study of RPCs — commissioned by the Canadian Corrugated and Containerboard Association — was an extension of one he performed in 2013. The first study tested 50 RPCs, the 2014 study involved 160 RPCs.

In the 2014 study, RPC samples from five Canadian packing facilities were pulled from different lots of trays that had been delivered on pallets wrapped with plastic film. Corrugated cartons from those facilities were not tested for comparison, Warriner said.

The study found that 13% of the RPCs tested positive for generic E. coli, but none tested positive for salmonella; 73% exceeded bacterial load levels, although that doesn’t mean they tested positive for E. coli, salmonella, listeria or other pathogens commonly associated with foodborne illness outbreaks.

“The results of the study have confirmed that a high proportion of RPCs are of poor sanitary status due to inadequate sanitation or post-cleaning contamination,” Warriner said in the study’s conclusion.

Trevor Suslow, produce safety specialist and plant pathologist at University of California-Davis, also conducted a recent study of RPCs, “Assessment of General RPC Cleanliness As Delivered for Use in Packing and Distribution of Fresh Produce.” Corrugated Delivers sponsored efforts to publicize the results and International Paper sponsored the testing.

Suslow said his research shows inconsistencies in the system for handling pooled RPCs. The difference between the Canadian study and Suslow’s is that his research tested RPCs with visible organic matter or residual produce material.

“The main takeaway from that is that we found, other than in a few cases across a few different weeks or pallet loads, the units that looked visually clean and dry had very similar viable or living microbial indicator counts compared to the ones we pulled apart for cause,” he said.