Dirty UK hospitals serving out-of-date poorly stored food

I wrote a letter to the hospital in Brisbane where my friend has been holed up, complaining about serving sandwiches with raw sprouts to sick people – or anyone.

brisbane-hospital-foodThere was some totally unscientific answer about how these sprouts were special because they came from a different place and they disappeared from the sick persons menu for a few weeks.

The sprouts are now back.

Nothing new, food hygiene reports obtained by the Press Association under the UK Freedom of Information Act and data from the UK Food Standards Agency (FSA) concluded that dirty hospitals are serving out-of-date food to patients.

Meals are being prepared in mouldy kitchens, putting vulnerable patients at “high risk” of food poisoning, while others have unclean worktops, food trolleys and sinks.

FSA data also revealed poor rankings for hundreds of care homes and children’s nurseries.

Some 400 hospitals, hospices, care homes, nurseries and school clubs are currently listed as needing “major”, “urgent” or “necessary” improvement.

One care home was infested with cockroaches while another had evidence of rats.

The Patients Association has called the findings “shameful” and “immensely worrying”.

The Food Hygiene Rating Scheme – which rates organisations and businesses from zero to five – is run by the FSA and councils in England, Wales and Northern Ireland.

The investigation found:

Eight health and care premises currently have a zero rating – which means urgent improvement is necessary. None are hospitals.

Some 187 have a rating of one – which means major improvement is necessary. Three of these are hospital premises, including the private Priory Hospital in Altrincham, Cheshire (because in the UK, like its bastard child, Australia, private is considered better, except when it comes to the basics)..

hospital-foodAnd 205 are ranked as two – improvement necessary. They include six hospitals and about 100 care homes. Among those given the ranking of two was Glenfield Hospital in Leicester.

At Glenfield Hospital in Leicester, an inspection of its kitchens serving patients found:

Sliced chicken two days past its use-by date (hello, Listeria?).

Staff had created their own date labels for when they thought food should be used, creating a “high risk” for patients who might develop food poisoning (food fraud)).

The experts also found leaking sinks, “inadequate” knowledge among staff about how to handle food safely, and mouldy areas, including the salad preparation room.

Food was being kept in fridges with temperatures up to 13C despite rules saying they should be 5C or below to prevent bacteria developing.

Darryn Kerr, director of facilities at Leicester’s Hospitals, said the organisation was “disappointed” by the ratings.

He said catering services were brought back in-house in May after being run by an external provider.

Parkview Residential Care Home in Bexleyheath, south-east London, was found to have an “infestation of Oriental cockroaches” during an August inspection.

The kitchen was closed voluntarily for the second time following a previous warning and inspectors gave it a zero rating.

Ivy House care home in Derby, which specialises in dementia care, scored zero after inspectors found evidence of rat activity.

Polysorbate as possible E. coli food poisoning fix

Chris Waters, an associate professor of microbiology and molecular genetics at Michigan State University and colleauges report in the journal Biofouling that polysorbate, a safe additive found in everything from ice cream to cosmetics, seems to slow the toxic effects of E. coli poisoning.

alfalfa-sprouts-featuredThe findings show that polysorbates attack the protective biofilm in which E. coli lives and renders the deadly bacteria harmless.

“Biofilms are multicellular communities of bacteria that are usually encased in a protective slime,” says Waters. “We found that polysorbate 80 obliterates the biofilm and takes away the E. coli’s ability to damage the host during infection. We think this is due to blocking the ability of E. coli to produce toxin.”

Specifically, the team focused on the potent strain isolated from Germany that swept through Europe in 2011, causing thousands of infections and more than 50 deaths. Waters and Shannon Manning have previously studies this strain. Having samples of the bacteria at hand helped the team, led by Rudolph Sloup, a graduate student in microbiology and molecular genetics, isolate compounds that inhibited biofilms.

However, the results didn’t come easily. Waters and his team scoured scientific literature to identify anti-biofilm compounds, but none of them inhibited biofilms of this E. coli strain. Finally, the team found that the 20th compound tested, polysorbate 80, obliterated E. coli’s ability to form biofilms in the lab.

The next step was to determine if the compound was effective in an animal model of the disease by administering polysorbate 80 to infected mice in their drinking water.

“During our animal infection studies, polysorbate 80 had no effect on the numbers of infecting E. coli. This was a little shocking, especially based on how promising our earlier tests had been,” Waters says. “Later, though, our pathology tests showed that polysorbate 80 essentially blocked all toxicity, even though it didn’t reduce the number of bacteria.”

“Antibiotic use can often cause more harm than good with these types of E. coli infections because it causes the bacteria to release more toxin and it drives antimicrobial resistance,” Waters says. “Our results indicate that polysorbate 80 makes this strain of E. coli harmless, without these negative side effects. This approach also doesn’t disrupt patients’ natural microbiome leading to a healthier gut.”

Since polysorbate 80 is categorized as a GRAS (generally regarded as safe) compound, it doesn’t require FDA approval to be used as a treatment. Along with its potential for disarming the deadly German E. coli outbreak, polysorbate 80 could potentially help tackle more-common E. coli infections such as traveler’s diarrhea.

The next steps for this research will be to identify how polysorbate 80 inhibits biofilm formation and test its activity in other infection models.

Additional researchers from Michigan State and the University of Texas contributed to the study. Partial funding came from the National Institutes of Health and a Strategic Partnership Grant from the MSU Foundation.

Polysorbates prevent biofilm formation and pathogenesis of Escherichia coli O104:H4

The Journal of Bioadhesion and Biofilm Reseach, Volume 32, Issue 9, http://dx.doi.org/10.1080/08927014.2016.1230849

http://www.tandfonline.com/doi/abs/10.1080/08927014.2016.1230849?journalCode=gbif20&

Escherichia coli biotype O104:H4 recently caused the deadliest E. coli outbreak ever reported. Based on prior results, it was hypothesized that compounds inhibiting biofilm formation by O104:H4 would reduce its pathogenesis. The nonionic surfactants polysorbate 80 (PS80) and polysorbate 20 (PS20) were found to reduce biofilms by ≥ 90% at submicromolar concentrations and elicited nearly complete dispersal of preformed biofilms. PS80 did not significantly impact in vivo colonization in a mouse infection model; however, mice treated with PS80 exhibited almost no intestinal inflammation or tissue damage while untreated mice exhibited robust pathology. As PS20 and PS80 are classified as ‘Generally Recognized as Safe’ (GRAS) compounds by the Food and Drug Administration (FDA), these compounds have clinical potential to treat future O104:H4 outbreaks.

Salmonella positive sprouts sold in Ireland

Seán McCárthaigh of The Times reports that EU inspectors auditing food hygiene practices in Ireland found European regulations were being broken, particularly in relation to seeds and sprouts.

kevin-allen-sproutIn November last year, four official samples of sprouts tested positive for salmonella. However, the batch was placed on the market without waiting for the final analytical results.

The Department of Agriculture said it had increased controls on businesses involved in the production of sprouts.

The European Food Safety Authority has estimated that food of non-animal origin was associated with 10 per cent of outbreaks of E.coli across the EU between 2007 and 2011; 35 per cent of hospitalisations and 46 per cent of deaths.

It linked leafy greens eaten raw as well as bulb and stem vegetables such as tomatoes and melons with salmonella and fresh pods, legumes and grains with E. coli.

The inspectors said the system of official controls in Ireland on food producers was supported by a well-functioning network of adequately staffed and equipped laboratories.

The EU report found that 13 per cent of registered primary producers of non-animal food were inspected last year.

There are 761 registered producers of fruit, vegetables and potatoes in Ireland as well as 88 producers of leafy green vegetables, 30 producers of soft fruit, 17 producers of sprouted seed, 301 producers of potatoes only and 225 others including 80 mushroom producers.

36 sickened: Sprouts are a known cause of foodborne illness

The U.S. Centers for Disease Control (CDC), several states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of Salmonella Reading and Salmonella Abony infections.

amy-sprouts-guelph-05Thirty-six people infected with the outbreak strains of Salmonella Reading or Salmonella Abony were reported from nine states.

Seven ill people were hospitalized. No deaths were reported.

Epidemiologic and traceback evidence indicated that alfalfa sprouts supplied by Sprouts Extraordinaire of Denver, Colorado were the likely source of this outbreak.

On August 5, 2016, Sprouts Extraordinaire recalled alfalfa sprout products from the market due to possible Salmonella contamination.

This outbreak appears to be over. However, sprouts are known to cause foodborne illness and outbreaks

Public health investigators used the PulseNet system to identify illnesses that may have been part of this outbreak. PulseNet, coordinated by CDC, is the national subtyping network of public health and food regulatory agency laboratories. PulseNet performs DNA fingerprinting on Salmonella bacteria isolated from ill people by using techniques called pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS). CDC PulseNet manages a national database of these DNA fingerprints to identify possible outbreaks.

Thirty-six people infected with the outbreak strains were reported from nine states. Of those ill people, 30 were infected with Salmonella Reading, 1 was infected with Salmonella Abony, and 5 were infected with both.  A list of the states and the number of cases in each can be found on the Case Count Map page.

Illnesses started on dates ranging from May 21, 2016 to September 10, 2016. Ill people range in age from less than 1 year to 72, with a median age of 30. Fifty-six percent of ill people were female. Seven ill people reported being hospitalized, and no deaths were reported.

This outbreak appears to be over. However, sprouts are known to cause foodborne illness and outbreaks.

Epidemiologic and traceback evidence indicated that alfalfa sprouts supplied by Sprouts Extraordinaire of Denver, Colorado were the likely source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Of the 31 ill people who were interviewed, 18 (58%) reported eating or possibly eating alfalfa sprouts in the week before illness started. This proportion is significantly higher than results from a 2006 survey of healthy people, in which 3% reported eating raw alfalfa sprouts on a sandwich in the week before they were interviewed. Ill people in the current outbreak reported eating raw sprouts on sandwiches from several restaurants.

sprout-salad-aust-aug-15Federal, state, and local health and regulatory officials performed a traceback investigation from five restaurants where ill people reported eating alfalfa sprouts. This investigation indicated that Sprouts Extraordinaire supplied alfalfa sprouts to all five of these locations.

On August 5, 2016, Sprouts Extraordinaire recalled its alfalfa sprout products from the market due to possible Salmonella contamination. These products were sold in boxes labeled “5-lb Living Alfalfa.” Read the Advice to Restaurants, Retailers and Consumers.

This outbreak appears to be over. However, sprouts are known to cause foodborne illness and outbreaks. More information about steps to reduce your risk of getting sick from eating sprouts is available on the Advice to Restaurants, Retailers and Consumers page.

At A Glance

Case Count: 36

States: 9

Deaths: 0

Hospitalizations: 7

A table of sprout-related outbreaks is available at: http://barfblog.com/wp-content/uploads/2016/02/Sprout-associated-outbreaks-2-23-16.xlsx

30 cases of salmonellosis linked to Sprouts Extraordinaire

According to CDC, sprouts are back at it again with the illnesses.

I don’t eat them, but if I did, I would want to know a whole lot about the seed source and who was growing them – fairly hard to do when they arrive as garnish on a salad or on a sandwich.

CDC is collaborating with public health officials in several states and the U.S. Food and Drug Administration (FDA) to investigate a multistate outbreak of Salmonella Reading and Salmonella Abony infections.Alfalfa-sprouts

Thirty people infected with the outbreak strains have been reported from nine states. Of those ill people, 24 were infected with Salmonella Reading, 1 was infected with Salmonella Abony, and 5 were infected with both.

Illnesses started on dates ranging from May 21, 2016 to July 20, 2016. Ill people range in age from less than 1 year to 72, with a median age of 30. Fifty-three percent of ill people are female. Five ill people have been hospitalized, and no deaths have been reported.

Epidemiologic and traceback evidence available at this time indicate that alfalfa sprouts supplied by Sprouts Extraordinaire of Denver, Colorado are the likely source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Of the 27 ill people who were interviewed, 17 (63%) reported eating or possibly eating alfalfa sprouts in the week before illness started. This proportion is significantly higher than results from a 2006 survey of healthy people, in which 3% reported eating sprouts on a sandwich in the week before they were interviewed. Ill people in the current outbreak reported eating raw alfalfa sprouts on sandwiches from several different restaurants.

Federal, state, and local health and regulatory officials performed a traceback investigation from five restaurants where ill people reported eating alfalfa sprouts. This investigation indicated that Sprouts Extraordinaire supplied alfalfa sprouts to all five of these locations.

On August 5, 2016, Sprouts Extraordinaire recalled its alfalfa sprout products from the market due to possible Salmonella contamination. These products were sold in 5-pound boxes labeled “Living Alfalfa Sprouts”.

A historical selection of sprout outbreaks can be found here.

Salmonella from organic sprouts, grown in China, sickened people in Finland

Two new cases of Salmonella enteritidis are being investigated in Finland after an earlier outbreak linked to imported organic mung bean sprouts.

Bean_sproutsAccording to the European Commission’s Rapid Alert System for Food and Feed, an outbreak of Salmonella enteritidis in Finland appears to be caused by organic mung beans sprouts from China, via the Netherlands

The sprouts have been withdrawn from the market.

More details can be found in the Food Quality News article.

Sanitation sucks: Federal court orders Minnesota sprout and noodle company to cease operations

On July 15, 2016, the U.S. District Court for the District of Minnesota entered a consent decree of permanent injunction between the United States and Kwong Tung Foods, Inc., doing business as Canton Foods; its president and owner, Vieta “Victor” C. Wang; and its vice-president, Juney H. Wang, for significant and ongoing violations of the Federal Food, Drug, and Cosmetic Act (FD&C Act) and its implementing regulations. The business, located in Minneapolis, Minnesota, sells rice and wheat noodles, and mung bean and soy bean sprouts.

Canton 2The U.S. Department of Justice brought the action on behalf of the FDA. The complaint that accompanied the consent decree alleges that Kwong Tung Foods, Inc. has an extensive history of operating under unsanitary conditions in violation of current Good Manufacturing Practice (cGMP) regulations and the FD&C Act. The FDA conducted multiple inspections, most recently in 2014 and 2015, and the FDA investigators observed repeated unsanitary conditions, including, rodent excreta pellets too numerous to count, improper cleaning, mold-like substances on equipment, failure to prevent cross-contamination from allergens and improper employee sanitation practices. Despite receiving a Warning Letter and participating in regulatory meetings with the FDA, Kwong Tung Foods, Inc., and Victor and Juney Wang failed to take adequate corrective actions to ensure the safety of their food. Additionally, the FDA worked with the Minnesota Department of Agriculture (MDA) to resolve this matter.

“The FDA expects food companies to follow cGMP regulations, and when a company does not address violations and sanitary protocols are being neglected, it poses potentially hazardous conditions,” said Melinda K. Plaisier, the FDA’s associate commissioner for regulatory affairs. “The FDA is taking the necessary actions to protect consumers and the U.S. food supply.”

Food, especially produce, is vulnerable to contamination with pathogenic microorganisms if exposed to unsanitary conditions during growing, harvesting, packing, holding or manufacturing, processing or transportation. Rodents in a facility are an additional cause for concern as they can sometimes carry and transfer bacteria and pathogenic microorganisms, like Salmonella, onto food. Salmonella can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems.

As a result of this action, Kwong Tung Foods, Inc. is prohibited from directly or indirectly receiving, processing, manufacturing, preparing, packing, holding, and/or distributing any article of food at or from its facility. If Kwong Tung Foods Inc. intends to resume operations, the company must notify the FDA, and, among other requirements, retain an independent food safety expert to ensure Kwong Tung Foods, Inc. has and implements, to the FDA’s satisfaction, an appropriate written Sanitation Control Program. If it resumes operations, Kwong Tung Foods, Inc. must also retain an independent laboratory to conduct analyses of its food processing environment and food products, and provide employee training on sanitation and appropriate food handling techniques.

Although no illnesses have been reported in connection with Kwong Tung Foods Inc., consumers with complaints about any FDA-regulated products can report problemsto their district office consumer complaint coordinator.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

Salmonella in organic sprouts in Australia, again

Every time I publicly complain about the lack of information in Australian food safety notices, someone writes in to say, people got the information they needed, and how can you have any dessert if you don’t eat your pudding.

mung_beans1So in the wake of two outbreaks involving raw sprouts packaged in South Australia that sickened over 300 Aussies with Salmonella, the New South Wales Food Authority advises us plebes that Forest Gate Organics has recalled its Mung Bean Sprouts from fruit and vegetable stores and health food stores in NSW, QLD and VIC due to microbial (Salmonella) contamination.

No information if anyone is sick. No information on how this Salmonella positive was detected. Nothing. How will anyone learn?

So much for going back to sleep: After 300 sickened with Salmonella from sprouts, another positive linked to same Adelaide facility

At the end of April 2016, South Australia Health’s chief medical officer Paddy Phillips said after an outbreak of Salmonella Saintpaul linked to sprouts sickened over 300, “This business was completely compliant with all our investigations and there is no reason to believe there are any further issues with the production of bean sprouts at this factory.”

salm.sprout.adelaide.This is the factory (right, exactly as shown). I keep saying it’s like 1978 here, and there’s probably a VW microbus out back loaded with Salmonella-infectd sprout plants.

Today, SA Health is once again urging the public to throw out their bean sprouts after a dramatic surge in salmonella cases and discovery of the dangerous bacteria in packaged sprouts sold by Thebarton producer Star Tu — the second time it has been detected at the producer this year.

Officials have ordered Star Tu to recall all of its products and stop selling immediately after Salmonella Saintpaul samples were found in packaged bean sprouts.

A packager of Star Tu products, Sunshine Sprouts, has also been ordered by SA Health to stop selling any products containing Star Tu mung bean sprouts.

SA Health chief public health officer Professor Paddy Phillips said the public should either throw out their bean sprouts or return them to the place of purchase.

Since the start of last December there have been 271 cases of confirmed Salmonella Saintpaul notified to SA Health resulting in 47 people being admitted to hospital.

South Australia usually sees around 15 to 20 cases each year.

sprout.adelaide“Our investigations then led us to the Star Tu factory and we found a positive Salmonella sample taken from a piece of equipment. Once this was cleaned and further inspections took place there was no evidence indicating any further risk.

Dumbass.

Finding Salmonella on a piece of equipment in no way provides confidence that the problem has been solved and shows a complete lack of knowledge of how raw sprouts become contaminated at seed.

But that’s why Paddy gets the big bucks.

“Yesterday it was confirmed that since these investigations, five sealed bags produced by Star Tu were contaminated with Salmonella, and given this new evidence we have issued this factory with an order to recall and stop selling. We are also today advising South Australians to either throw out their bean sprouts or return them to the place of purchase and we are recalling all products that have come from this factory.

Li Tu, whose family owns the Star Tu business, said it had been “growing and distributing high quality bean sprouts for over 20 years”.

“As well as meeting SA Health standards, we also have had robust food safety programs since 1999 with annual checks and inspections,” he said.

Unknown“Our factory was described as being as clean as a hospital by one of SA Health’s employees.

“We’re obviously not in the business of making people sick so we do not take this matter lightly. We are working closely with SA Health to find the source of the problem.”

Bullshit.

Raw sprouts are an unnecessary health hazard. But they are happily served up at hospitals and aged-care facilities and other places where the immunocompromised can be found in oblivious Australia.

An updated table of raw sprout related outbreaks is available at: http://barfblog.com/wp-content/uploads/2016/04/Sprout-associated-outbreaks-4-27-16.xlsx

Never underestimate the power of denial.

Erdozain, M.S., Allen, K.J., Morley, K.A. and Powell, D.A. 2012. Failures in sprouts-related risk communication. Food Control. 10.1016/j.foodcont.2012.08.022

http://www.sciencedirect.com/science/article/pii/S0956713512004707?v=s5

Nutritional and perceived health benefits have contributed to the increasing popularity of raw sprouted seed products. In the past two decades, sprouted seeds have been a recurring food safety concern, with at least 55 documented foodborne outbreaks affecting more than 15,000 people. A compilation of selected publications was used to yield an analysis of the evolving safety and risk communication related to raw sprouts, including microbiological safety, efforts to improve production practices, and effectiveness of communication prior to, during, and after sprout-related outbreaks. Scientific investigation and media coverage of sprout-related outbreaks has led to improved production guidelines and public health enforcement actions, yet continued outbreaks call into question the effectiveness of risk management strategies and producer compliance. Raw sprouts remain a high-risk product and avoidance or thorough cooking are the only ways that consumers can reduce risk; even thorough cooking messages fail to acknowledge the risk of cross-contamination. Risk communication messages have been inconsistent over time with Canadian and U.S. governments finally aligning their messages in the past five years, telling consumers to avoid sprouts. Yet consumer and industry awareness of risk remains low. To minimize health risks linked to the consumption of sprout products, local and national public health agencies, restaurants, retailers and producers need validated, consistent and repeated risk messaging through a variety of sources.

sprouts.adelaide