From the E. coli O121 in low-moisture foods file: flour power edition

It’s all so confusing. There’s a cluster of E. coli O121 in Canada. Sort of a big one. 24 people ill in four provinces (British Columbia, Saskatchewan, Alberta and Newfoundland and Labrador) going back to November 2016.

These illness came on the tail end of another E. coli O121 outbreak in the U.S. linked to Gold Medal brand all purpose flour.

Today, CFIA (that’s the Canadian Food Inspection Agency for those following along at home) announces a recall of Robin Hood brand all purpose flour distributed in four provinces (Alberta, British Columbia, Manitoba, Saskatchewan) due to E. coli O121 contamination – linked to one illness.

In the new world of whole genome sequencing it would seem easy to say whether these clusters are linked – or totally different. And is the single illness CFIA reports part of the E. coli O121 cluster? Is it different?

My head hurts.

Earlier this year Natalie Seymour and I organized a workshop on STEC in flour. Karen Neil of CDC, Tim Jackson from Nestle and Scott Hood from General Mills spoke about challenges in flour food safety. The workshop focused on stuff like, there’s no kill step in the milling process, there’s literally tons of commingling and although it’s not intended to be eaten raw – sometimes it is (in cookie dough, cake mix).

And a risk factor in the 2016 Gold Medal-linked outbreak was kids handling raw tortilla and pizza dough in restaurants.

There’s some other stuff known about flour – generic E. coli species have been found in flour in NZ.

A survey conducted on wheat and flour milling in Australia showed no detectable Salmonella, 3.0 MPN/g of generic E. coli and 0.3 MPN/g of B. cereus recovered on average from 650 samples (from two mills).

And a US study found generic E. coli in 12.8% of commercial wheat flour samples examined.

So, yeah, flour.

Red Robin has second hepatitis A incident in two weeks, this time in Missouri

Two weeks ago I wrote that I were a food business owner I’d be worried about hepatitis A.

Individuals can shed the virus without showing symptoms and even a Hep A positive handwashing superstar will result in lineups outside the business or at the health department while patrons get their post-exposure shots.RedRobinLogo1-300x214

Authors of a 2000 Journal of Food Protection paper on the cost effectiveness of vaccinating food handlers arrived at the conclusion that the public health benefit of vaccinating for hep A doesn’t outweigh the costs – but doesn’t factor in all the bad publicity, hassle and incident management costs. The stuff that a Stroudsburg, PA Red Robin restaurant is going through right now.

The corporate Red Robin folks must be working overtime, as an identical situation has popped up at a Missouri outlet of the chain. Same story, different location. According to USA Today, up to 5,000 may have been exposed to hepatitis A following after a food handler was diagnosed with the virus.

Health officials worry that as many as 5,000 people could have been exposed to hepatitis A at a Red Robin restaurant here after a worker was diagnosed with the virus.

Springfield-Greene County Health Department officials received a report Tuesday about the illness, which can affect the liver, and worked with state and federal officials to get enough vaccine shipped so people who went to the restaurant May 8 to 16 can be immunized.

The goal is to get as many customers vaccinated within 14 days of their possible exposure, officials said Wednesday. Otherwise, the shot won’t work, so they’ve set up clinics through the Memorial Day holiday weekend.

“Upon being informed of the incident, the Springfield Red Robin took all safety measures to ensure the well being of our guests and team members including arranging the inoculation of all Springfield team members with the immune globulin prophylaxis shot,” Red Robin Gourmet Burgers officials said in a statement.

Wonder how many incidents it takes for a company to tip the scales to benefit outweighing cost on providing or requiring food handlers to have a hep A vaccination.

Hepatitis A linked to Red Robin restaurant in Pennsylvania

If I were a food business owner I’d be worried about hepatitis A. Individuals can shed the virus without showing symptoms and even a Hep A positive handwashing superstar will result in lineups outside the business or at the health department while patrons get their post-exposure shots. RedRobinLogo1

Authors of a 2000 Journal of Food Protection paper on the cost effectiveness of vaccinating food handlers arrived at the conclusion that the public health benefit of vaccinating for hep A doesn’t outweigh the costs – but doesn’t factor in all the bad publicity, hassle and incident management costs. The stuff that a Stroudsburg, PA Red Robin restaurant is going through right now.

According to the Pocono Record, the Pennsylvania Department of Health is looking into a Red Robin food handler who was recently diagnosed with hepatitis A.

“The Disease Prevention and Control Law prohibits us from providing further details as the investigation is ongoing at this time,” said Aimee Tysarczyk, press secretary/director of communications for the state Health Department.

“As the investigation continues and if any public health risks evolve, the department will provide additional information to ensure the safety and well-being of the public, as needed,” Tysarczyk said.

In a statement to the Pocono Record, Red Robin said:

“On May 5, 2014, Lehigh Valley Restaurant Group was informed by the Pennsylvania Department of Health that an employee at the Red Robin restaurant in Stroudsburg, Pa., had contracted Hepatitis A.

“The employee has not been in the restaurant since April 27, 2014, and will not return to work until he has been granted medical clearance.

The welfare of our guests and team members is Red Robin’s top priority.

“We are working closely with the health department to go beyond what is required.

With the last restaurant exposure listed as April 27 there isn’t a huge window to administer IgG shots.