Yearly Archives: 2015

Food companies, step it up: US multistate foodborne outbreaks, 2010-2014

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Multistate outbreaks cause more than half of all deaths in foodborne disease outbreaks despite accounting for only a tiny fraction (3 percent) of reported outbreaks in the United States, according to a new U.S Centers for Disease Control report.

fact-sheet-vs-final-thumbnail-page-3_cropRecent outbreaks of foodborne illness linked to tainted cucumbers, ice cream and soft cheeses show the devastating consequences when food is contaminated with dangerous germs before it reaches a restaurant or home kitchen.

Highlights from the report on multistate foodborne outbreaks during 2010-2014 include:

• An average of 24 multistate outbreaks occurred each year, involving two to 37 states.

  • Salmonella accounted for the most illnesses and hospitalizations and was the cause of the three largest outbreaks, which were traced to eggs, chicken and raw ground tuna.
  • Listeria caused the most deaths, largely due to an outbreak caused by contaminated cantaloupe in 2011 that killed 33 people.
  • Imported foods accounted for 18 of the 120 reported outbreaks. Food imported from Mexico was the leading source in these outbreaks, followed by food imported from Turkey.

The report recommends that local, state, and national health agencies work closely with food industries to understand how their foods are produced and distributed to speed multistate outbreak investigations. These investigations can reveal fixable problems that resulted in food becoming contaminated and lessons learned that can help strengthen food safety.

The report highlights the need for food industries to play a larger role in improving food safety by following best practices for growing, processing, and shipping foods. In addition, food industries can help stop outbreaks and lessen their impact by keeping detailed records to allow faster tracing of foods from source to destination, by using store loyalty cards to help identify what foods made people sick, and by notifying customers of food recalls.

“Reacting to problems isn’t sufficient in today’s food system, nor is it the best way to practice public health,” Dr. Kathleen Gensheimer, director of FDA’s Coordinated Outbreak Response & Evaluation Network, said in a teleconference.

TSA4Gensheimer stressed that in the past, food safety has been focused on reacting to outbreaks, but new regulations set to take effect in 2016 will require companies to take a science-based approach to building safety controls into food production.

“Industry is a very critical partner,” she said.

For example, although it is still not clear what caused the E. coli outbreak at Chipotle, Gensheimer said on the call that the company has shared “all of their records and is working with us in any way possible to give us information about their suppliers.”

Gensheimer also said after the current investigation ends, the company expressed interest in meeting with FDA and the CDC to work out ways to prevent future outbreaks.

CDC Director Dr. Tom Frieden said state-of-the-art disease tracking tools, and the introduction of gene tools, are helping to quickly track down the source of food-borne outbreaks in collaboration with state and national partners.

Frieden said disease detectives are “cracking the cases much more frequently than in past years because we have this new DNA fingerprinting tool being used increasingly,” but many cases still go unsolved.

He said companies are also stepping up to help, noting new requirements at Wal-Mart Stores Inc for food suppliers that set new control for suppliers to reduce contamination and the wholesaler’s Costco’s use of membership card lists to notify customers about recalled foods.

The leading causes of multistate outbreaks – Salmonella, E. coli, and Listeria – are more dangerous than the leading causes of single-state outbreaks. These three germs, which cause 91 percent of multistate outbreaks, can contaminate widely distributed foods, such as vegetables, beef, chicken and fresh fruits, and end up sickening people in many states. 

“Americans should not have to worry about getting sick from the food they eat,” said CDC Director Tom Frieden, M.D., M.P.H. “Top-notch epidemiology and new gene sequencing tools are helping us quickly track down the source of foodborne outbreaks – and together with our national partners we are working with the food industry to prevent them from happening in the first place.”

Introduction: Millions of U.S. residents become ill from foodborne pathogens each year. Most foodborne outbreaks occur among small groups of persons in a localized area. However, because many foods are distributed widely and rapidly, and because detection methods have improved, outbreaks that occur in multiple states and that even span the entire country are being recognized with increasing frequency.

Methods: This report analyzes data from CDC’s Foodborne Disease Outbreak Surveillance System to describe multistate foodborne outbreaks that occurred in the United States during 2010–2014.

Results: During this 5-year period, 120 multistate foodborne disease outbreaks (with identified pathogen and food or common setting) were reported to CDC. These multistate outbreaks accounted for 3% (120 of 4,163) of all reported foodborne outbreaks, but were responsible for 11% (7,929 of 71,747) of illnesses, 34% (1,460 of 4,247) of hospitalizations, and 56% (66 of 118) of deaths associated with foodborne outbreaks. Salmonella (63 outbreaks), Shiga toxin-producing E. coli (34), and Listeria monocytogenes (12) were the leading pathogens. Fruits (17), vegetable row crops (15), beef (13), sprouts (10), and seeded vegetables (nine) were the most commonly implicated foods. Traceback investigations to identify the food origin were conducted for 87 outbreaks, of which 55 led to a product recall. Imported foods were linked to 18 multistate outbreaks.

Conclusions: Multistate foodborne disease outbreaks account for a disproportionate number of outbreak-associated illnesses, hospitalizations, and deaths relative to their occurrence. Working together, food industries and public health departments and agencies can develop and implement more effective ways to identify and to trace contaminated foods linked to multistate outbreaks. Lessons learned during outbreak investigations can help improve food safety practices and regulations, and might prevent future outbreaks.

MMWR November 3, 2015 / 64(Early Release);1-5

Samuel J. Crowe, PhD1,2; Barbara E. Mahon, MD2; Antonio R. Vieira, PhD2; L. Hannah Gould, PhD

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm64e1103a1.htm?s_cid=mm64e1103a1_w

vitalsigns-multistateoubreaks-lesscommon-moreseriou_crop 

37 now sick from E. coli O26 linked to Chipotle; focus on produce

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I’d rather have microbiologically safe food.

chipotle.ad.2Health officials say 37 people have E. coli in Washington state and Oregon amid an outbreak tied to Chipotle restaurants in the Northwest, an increase from 22 cases reported earlier.

Washington health officials are still testing samples from people who have fallen ill in Clark, Cowlitz, Island, King and Skagit counties to see if they all have the same form of the potentially deadly illness.

Officials say most of those sickened by E. coli have eaten at the Mexican food chain.

Nine people in Washington and three in Oregon have been hospitalized, but no one has died. People with E. coli connected with the outbreak have ranged in age from 5 to 60.

Dr. Scott Lindquist, state epidemiologist, says knowing the type of E. coli that’s sickened nearly two dozen people will help officials determine the exact source of the illness.

Food from six Chipotle stores connected with the outbreak is being tested. Lindquist says officials may know by Wednesday what type of food tests positive for the same microorganism. They’ve asked Chipotle to turn over information about its food suppliers so officials can determine where the product came from.

chipotlawayMeanwhile, Chipote is taking a hit on its antibiotics stance.

Dan Charles of NPR writes that when you’re a nationwide food company, it can be tough to live up to your own lofty marketing slogans.

Chipotle claims to serve only “food with integrity.”

That’s not the same as microbiologically safe food.

Chipotle is also having difficulty living up to another claim: Its promise to sell only meat that’s “antibiotic-free” — or “produced without the use of antibiotics.”

It’s an increasingly popular label among consumers. Chipotle has ridiculed its drug-using competitors with catchy online videos featuring cartoon versions of big meat factories, where machines inject animals with drugs that turn them grotesquely plump.

In reality, though, Chipotle’s hard line on antibiotics isn’t quite as uncompromising as the ads make it seem. The company’s suppliers can, in fact, use these drugs.

“Under our protocol, if an animal is sick and needs to be treated with antibiotics, then it’s treated with antibiotics, but then it’s removed from our program,” says Chris Arnold, Chipotle’s director of public relations.

That animal is sold to someone else, who usually pays less for the animals than Chipotle does. And Chipotle can say that its animals never get antibiotics.

“It’s easier to explain to people,” Arnold says.

Now, though, Chipotle is being forced to do a bit more explaining, because it’s running into some trouble living up to its marketing slogans: It’s running into a pork shortage.

A lot of farmers don’t want to raise pigs the way Chipotle demands. It’s not so much because of restrictions on antibiotics. Chipotle also requires suppliers to let pigs root around outdoors or in buildings with dirt floors.

So to get enough pork, Chipotle has turned to a British supplier, named Karro.

And Karro has a different policy on antibiotics. It treats pigs when they get sick, and when they recover, those pigs go right back into the regular pork supply.

Some will become Chipotle’s carnitas. Chipotle restaurants that serve pork from this supplier will have a little sign explaining how that pork is different.

Actually, the pork itself isn’t different at all. There shouldn’t be traces of antibiotics in any of it.

Veterinarian Gail Hansen points out that such residues are against the law in all meat, “so you’re not eating antibiotic-laden meat.”

 

LA County fixes glitch in online reporting of restaurant closures

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Restaurant and market closures resulting from public complaints are now posted on the Los Angeles County Department of Public Health website after the county fixed an issue with its data management software.

larry.david.rest.inspecDue to that the county’s Environmental Health Director Angelo Bellomo called a “software bug,” information about closures that occur during complaint investigations were previously unavailable on the county’s online inspection database.

Rolled out in 2013, the software, Envision Connect, tracks inspection data for retail food facility, food truck, housing, and swimming pool inspections, but it does not track investigations into public complaints about restaurants.

As of Oct. 21, all restaurant closures, which can occur during routine and owner-initiated inspections, complaint investigations and reinspections, are posted online, according to a health department report submitted to the Los Angeles County Board of Supervisors on Friday.

“We’ve plugged the gap,” Bellomo said.

The fix is one of several recommendations being implemented after a Los Angeles News Group review of nearly two years of restaurant inspection data found the county’s 17-year-old grading system allows many restaurants and markets to operate with major health threats and gives those facilities high health grades.

Friday’s report is the second monthly progress report on the implementation of those recommendations.

Handwashing in the field: soap or sanitizer or both

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Effective hand hygiene is essential to prevent the spread of pathogens on produce farms and reduce foodborne illness.

dirty.handsThe U.S. Food and Drug Administration Food Safety Modernization Act Proposed Rule for Produce Safety recommends the use of soap and running water for hand hygiene of produce handlers. The use of alcohol-based hand sanitizer (ABHS) may be an effective alternative hygiene intervention where access to water is limited. There are no published data on the efficacy of either soap or ABHS-based interventions to reduce microbial contamination in agricultural settings.

The goal of this study was to assess the ability of two soap-based (traditional or pumice) and two ABHS-based (label-use or two-step) hygiene interventions to reduce microbes (coliforms, Escherichia coli, and Enterococcus spp.) and soil (absorbance of hand rinsate at 600 nm [A 600]) on farmworker hands after harvesting produce, compared with the results for a no-hand-hygiene control.

With no hand hygiene, farmworker hands were soiled (median A 600, 0.48) and had high concentrations of coliforms (geometric mean, 3.4 log CFU per hand) and Enterococcus spp. (geometric mean, 5.3 log CFU per hand) after 1 to 2 h of harvesting tomatoes. Differences in microbial loads in comparison to the loads in the control group varied by indicator organism and hygiene intervention (0 to 2.3 log CFU per hand). All interventions yielded lower concentrations of Enterococcus spp. and E. coli (P < 0.05), but not of coliforms, than were found in the control group. The two-step ABHS intervention led to significantly lower concentrations of coliforms and Enterococcus spp. than the pumice soap and label-use ABHS interventions (P < 0.05) and was the only intervention to yield significantly fewer samples with E. coli than were found in the control group (P < 0.05). All interventions removed soil from hands (P < 0.05), soap-based interventions more so than ABHS-based interventions (P < 0.05).

ABHS-based interventions were equally as effective as hand washing with soap at reducing indicator organisms on farmworker hands. Based on these results, ABHS is an efficacious hand hygiene solution for produce handlers, even on soiled hands.

 Ability of hand hygiene interventions using alcohol-based hand sanitizers and soap to reduce microbial load on farmworker hands soiled during harvest

Journal of Food Protection®, Number 11, November 2015, pp. 1930-2102, pp. 2024-2032(9)

de Aceituno, Anna Fabiszewski; Bartz, Faith E.; Hodge, Domonique Watson; Shumaker, David J.; Grubb, James E.; Arbogast, James W.; Dávila-Aviña, Jorgé; Venegas, Fabiola; Heredia, Norma; García, Santos; Leon, Juan S.

http://www.ingentaconnect.com/content/iafp/jfp/2015/00000078/00000011/art00014

Canadian college newspaper scores poop scoop of the century

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It was the best of flushes, it was the worst of flushes; it was the age of comfort, it was the age of thriftiness; it was the epoch of relief, it was the epoch of inequality; it was the season of one-ply, it was the season of two-ply; it was the beginning of a new roll, it was getting down to the last square; we were all going direct to the bathroom on the top floor, we were all watching our dreams go down the toilet.

student-journalist-laura-woodward-and-the-cover-of-the-ryerson-eyeopenerSuch were the dramatic terrors and inequities revealed in an investigation published in a student newspaper at Ryerson University in Toronto last week. A tenacious student reporter discovered that those in positions of power at the college had been hoarding a treasure that students were desperate for, creating a system of plumbing inequality.

The blockbuster story on Water Closet–gate begins, “There’s two-ply toilet paper at Ryerson — and if you’re a student, you don’t get any.”

The Eyeopener discovered a box of the two-ply goodness on the bottom of the Student Campus Centre (SCC), which raised questions of which bathrooms they’re used in.

Student washrooms are stocked exclusively with that translucent, gotta-fold-it-thirteen-times one-ply.

The top two floors of Jorgenson Hall — 13 and 14 — carry the thick, absorbent two-ply.

The story is accompanied by an infographic titled “Unflushing Toilet Paper: A Ryerson Tissue.”

The university president, Sheldon Levy, whose office is “steps away from the two-ply supplied bathroom,” told the Ryerson Eyeopener that the revelation of a “two-tiered” toilet system was “shocking” and “embarrassing.” The National Post did some follow-up reporting and found that other universities in Ontario have a far fairer system when it comes to distribution of strategic reserves of extra-soft and quilted wealth. An official at the University of Guelph bragged, “We have one-ply tissue campus wide, from the president’s washroom to the student residences.”

And when I was a student there, I regularly stole toilet paper. One-ply. There was a metal clip that needed to be depressed and the roll would slide off.

23 sick: It’s E. coli O26 at Chipotle, stock falls

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I never liked Chipotle. How can that much smugness and superiority be crammed into one restaurant in Manhattan, Kansas?

chipotlawayBut when Amy was pregnant with Sorenne, she had Chipotle cravings and I would dutifully comply.

(I had a brief procedure at the hospital this a.m. that involved knocking me out, and when the nurse informed me I could go and Amy was there to pick me up, she asked if I wanted to finish my tea. I said, no, she’s here, I better go.

She said I was an obedient husband.

I said no, just learned a — little –bit over the years).

After 23 cases of what is apparently E. coli O26 linked to Chipotle restaurants led to the voluntary temporary closure of 43 of its Pacific Northwest eateries, shares in the company went down.

“We assume this outbreak is much broader than we’ve seen,” said Dr. Katrina Hedberg, Oregon‘s state health officer and epidemiologist.

JoNel Aleccia of The Seattle Times reports that in Oregon, health officials say they’ve identified the outbreak strain as E. coli O26, one of several types of Shiga toxin-producing bacteria that can cause severe illness. E. coli O26 was linked to an outbreak tied to raw clover sprouts that sickened 33 people who ate at Jimmy John’s restaurants in 2012, according to the Centers for Disease Control and Prevention.

Washington officials have not yet named the specific bug.

“Right now, we don’t know whether all of the cases identified are even going to turn out to be the same strain,” said Dr. Marisa D’Angeli, Washington state medical epidemiologist. Some cases may turn out to be E. coli O157:H7, a strain often associated with undercooked ground beef, while others may be E. coli O26 — or something else.

chipotleWashington state epidemiologist Dr. Scott Lindquist says more people are being tested.

Laura Ries, president of Atlanta marketing strategy firm Ries & Ries, said the decision to immediately close the 43 restaurants in Washington and Oregon will help the brand in the long term. She says the chain “went above and beyond what they needed to do.

Attorney Bill Marler of Seattle law firm Marler Clark who is involved in other lawsuits against Chipotle restaurants, agreed, and says people should not assume a company that focuses on local and fresh ingredients is going to be immune from food safety issues.

But he says three cases of foodborne illness in a few months shows Chipotle is not paying attention to food safety like it should.

In September, more than 60 people who ate at Chipotle restaurants in Minnesota were sickened by Salmonella, and in August, nearly 100 customers and staff were infected by norovirus at a Chipotle restaurant in Simi Valley, California.

One new case was reported in Oregon on Monday, bringing the case count in the state to four people, including two who were hospitalized. There were no new cases in Washington state, where 19 have been sickened, including seven hospitalized.

“This is a refreshing company to work with,” Lindquist said. “They want to get to the bottom of this.”

Health officials suspect a produce item was to blame, such as leafy greens, tomatoes, cilantro or parsley. Beef is also associated with E. coli, which lives in the intestinal tracts of cattle. But it’s highly unlikely that all six locations failed to thoroughly cook the meat, Marler said.

Heat kills E. coli. But produce is eaten raw. If it’s contaminated, it’s difficult to clean it with water.

30 sickened in over a year: New test to find source of UK E. coli O55

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The E. coli O55 mystery continues in Dorset, UK.

It first emerged in July 2014, when two children were hospitalized with acute kidney problems and has since caused outbreaks of infectious diarrhea.

e.coli.O55.issacTo date the O55 strain has affected 30 people, 10 of them children in areas including Bournemouth, Poole, Weymouth, Blandford and Christchurch. It also affected two cats.

All 10 children and one adult were hospitalized after they developed the complication of hemolytic-uremic syndrome (HUS) which affects the kidneys.

Noeleen McFarland, from Public Health England, told BBC’s Inside Out South: “When it was confirmed we knew we had uncovered something unusual that hadn’t been seen in the UK before.”

Despite an investigation, tests and screening, the source of the strain, which produces a toxin that can lead to fatal kidney failure, has never been traced.

Public Health England said any previous cases of the O55 strain in the UK had been associated with travel.

Following the outbreak, officers were sent out to investigate and test play parks, swimming pools and restaurants visited by those infected seven days prior to them being ill.

“Everything we investigated, tested and sampled was all negative,” Mrs McFarland said.

e.coli.O55Isaac Mortlock, aged four, from Bournemouth, was hospitalized after contracting the strain.

Isaac’s mum Gabrielle Archer said: “His kidney function didn’t return to normal and we’ve been told he will need a transplant in the future.”

A new test is being developed to detect the O55 strain and it is hoped the test will be ready for use on animals in the new year.

The new test is being worked on by scientists at the Animal and Plant Health Agency (APHA), based in Surrey using microscopic magnetic beads which picks out the E. coli O55.

OMG: safe food Queensland says raw eggs risky (sorta)

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The Melbourne Cup horse race starts in a couple of hours and the twitter-comms types at safe food Queensland have said something, in writing, I’ve never seen before:

omg“Avoid eating raw foods such as salad dressings and sauces made with raw eggs e.g. mayonnaise, hollandaise and aioli or uncooked foods containing raw eggs e.g. cookie dough, mousse, cheesecake, tiramisu.

“Check to see if sauces or salad dressings are pasteurized.”

About time.

The safe food advisory also contains poor attempts at humor such as, “It’s the race that stops a nation so don’t let food poisoning have you galloping!”

(Grimace).

It wasn’t me: Fig & Olive says third party responsible for Salmonella outbreak

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I’m no lawyer, but given strict liability in the U.S., Fig & Olive, is taking an, uh, unique approach.

wasn't.meThe restaurant chain Fig & Olive denies it was responsible for an outbreak of Salmonella at its DC location that the city’s health department said sickened more than 60 people.

Fig & Olive “denies that it was negligent or that its actions caused damage to plaintiff” in regard to several counts in a complaint filed in September by Laura Donahue, an Arlington woman who ate croquettes with truffle oil at the restaurant and was hospitalized.

“If plaintiff sustained the injuries and damages alleged,” the New York chain writes in its answer, “said injuries and damages were due to the acts or omissions of a third party over which this defendant had no control.”

The restaurant’s DC location was closed for six days while the DC Department of Health investigated. Fig & Olive’s West Hollywood, California, location was linked to the outbreak later in September. The DC Department of Health and Department of Forensic Sciences told Washingtonian at the time that the Centers for Disease Control had “confirmed that this is now a multiple state investigation tied to Fig and Olive food establishments.”

Cider again? 6 sick with crypto linked to Illinois fair

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After attending the same event in Barry, Illinois, Oct. 17, Adams County Health Department says there’s been an outbreak of cryptosporidiosis disease in Pike County, Illinois.

pike.county.fall.color.driveAdams County Health Department Director of Clinical and Environmental Services Shay Drummond says the health department is helping Pike County Health Department investigate the parasitic illness that has infected six people.

County Health Department RN, BSN Jan Bleich says everyone infected had been at the Pike County Fall Color Drive. The source, she says, may have been apple cider.

Bleich says some of the people were hospitalized.

Drummond says the disease is caused by microscopic parasites called cryptosporidium, which is found in water, food, soil or on surfaces or dirty hands that have been contaminated with human or animal feces that are infected.

Cryptosporidium can be spread by swallowing contaminated water from swimming pools, fountains, lakes and rivers. The parasite can survive for long periods of time in chlorinated drinking and swimming pool water. It can also be spread by swallowing water, ice or drinks contaminated with poop from infected people or animals, or by eating undercooked food or drinking unpasteurized or raw apple cider or milk that is contaminated. People can also get it from touching their mouths with contaminated hands.