Author Archives: Ben Chapman

Ben Chapman

About Ben Chapman

Dr. Ben Chapman is a professor and food safety extension specialist at North Carolina State University. As a teenager, a Saturday afternoon viewing of the classic cable movie, Outbreak, sparked his interest in pathogens and public health. With the goal of less foodborne illness, his group designs, implements, and evaluates food safety strategies, messages, and media from farm-to-fork. Through reality-based research, Chapman investigates behaviors and creates interventions aimed at amateur and professional food handlers, managers, and organizational decision-makers; the gate keepers of safe food. Ben co-hosts a biweekly podcast called Food Safety Talk and tries to further engage folks online through Instagram, Twitter, Facebook, YouTube and, maybe not surprisingly, Pinterest. Follow on Twitter @benjaminchapman.

Everyone has a camera – even the restaurant operators

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Doug and I have been talking about marketing food safety for years – the oft misunderstood concept. If you’re doing a good job at food safety tell everyone about it – differentiate yourself from your competitors. Complementing this idea is transparency and disclosure. Everyone has a camera.

In 2005 some keen public health folks in Korea started soliciting food safety-related pictures from diners as they ate and ordered at restaurants. The authorities wanted to enlist citizens to look for violations to place additional pressure on businesses to be decent food safety citizens – and to fine them for bad practices.

Five years ago we started a project, citizen food safety, on Instagram. Collectively capturing food safety, in the broadest terms through the lens of the camera phone-wielding public. This wasn’t just for the food safety nerds; its for the Interweb’s population of eaters: the regular folks who shop, eat at restaurants, visit farmers markets, cook or eat.

The hashtag #citizenfoodsafety still pops up sometimes on social media.

According to Xinhuanet, Health officials in the Chinese city of Hangzhou are actively calling on restaurant operators to be more transparent and put up cameras and offer patrons a live look on what’s going on in the kitchen. I love it. This advances #citizenfoodsafety.

Sure, folks can do weird stuff in blind spots, but this is a cool progression.

In an effort to alleviate food safety concerns that shroud China’s booming takeout services, the capital city of Zhejiang Province said over 150 restaurants had offered such services on a popular takeout app.

Hangzhou’s administration for market regulation said it was part of the city’s campaign to turn its eateries into “sunshine restaurants,” which install cameras or have open kitchens to allow for customer supervision.

The online live vetting aims to eliminate the “blind spot” as more restaurants jump on the mobile internet bandwagon to promote their takeout services, said Wang Jinchao, an official with the administration.

Consumers will feel relieved as they can see what happens in the kitchen, while the restaurants will be prompted to comply with the rules, according to Wang.

FDA’s update on Romaine-linked outbreak investigation – it is California stuff

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The normal folks who I hang out with at the hockey arena have already started asking when they can start eating Romaine again (who knew there were so many Caesar fans).

FDA’s answer to when is soon

Some places never stopped serving it. 

Earlier today I told Korin Miller at Yahoo the below:

If you happen to visit a restaurant that tries to claim its romaine is safe, it’s really best to avoid the food. “I would send it back,” Benjamin Chapman, an assistant professor and food safety extension specialist at North Carolina State University, tells Yahoo Lifestyle. “When the CDC comes out with a message that says ‘Don’t eat romaine lettuce,’ you should heed that advice,” he says. “Right now, we don’t have any indication that it’s romaine from any certain part of the country or a certain company. It’s a standing blanket statement.”

And now we’ve got more information (that’s how quickly this stuff moves).

FDA announced late today that they have narrowed their investigation to field grown Romaine from Central Coast growing regions of northern and central California.

All other lettuce is as safe as it was last week before the announcement.

FDA is taking things a step further, in a really positive way in concept – asking producers to label where it came from.

Based on discussions with producers and distributors, romaine lettuce entering the market will now be labeled with a harvest location and a harvest date or labeled as being hydroponically- or greenhouse-grown. If it does not have this information, you should not eat or use it.

There is no recommendation for consumers or retailers to avoid using romaine lettuce that is certain to have been harvested from areas outside of the Central Coast growing regions of northern and central California. For example, romaine lettuce harvested from areas that include, but are not limited to the desert growing region near Yuma, the California desert growing region near Imperial County and Riverside County, the state of Florida, and Mexico, does not appear to be related to the current outbreak. Additionally, there is no evidence hydroponically- and greenhouse-grown romaine is related to the current outbreak.

During this new stage of the investigation, it is vital that consumers and retailers have an easy way to identify romaine lettuce by both harvest date and harvest location. Labeling with this information on each bag of romaine or signage in stores where labels are not an option would easily differentiate for consumers romaine from unaffected growing regions.

Food Safety Talk 170: Pants Pants Pants!

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The show opens with a discussion of technology and cyber Monday, before segueing to Ben’s missing tooth. From there the guys do a deep dive into the recent E. coli O157:H7 in romaine lettuce outbreak before turning to listener feedback. They cover heating breastmilk, putting bleach on the food of homeless people, temperature monitoring devices, proper methods for thawing turkey, reconditioning cutting boards, and air quality of dairy processing plant all based on listener feedback. Buckle up, this is a bonus sized episode.

You can download episode 169 here and at iTunes.

Show notes so you can follow along at home:

CDC’s Romaine clapback

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Maybe it’s Californian Romaine, maybe not, but there looks to be some contradiction between messages from FDA’s Scott Gottlieb and CDC’s Director, Robert Redfield.

Redfield announced this after Gottlieb’s tweets indicating that the source of illnesses is likely California.

CDC continues to investigate a multistate outbreak of E. coli O157 infections linked to romaine lettuce. We understand this outbreak is of concern to many Americans – especially with so many gathering for meals this Thanksgiving week. CDC’s disease detectives are working with federal regulatory partners to investigate and determine the source of contamination as quickly as possible. We will continue to provide more information as it becomes available. The good news is we were able to detect and identify the outbreak quickly through our disease surveillance system, which can prevent further illness.

However, until we know more, it’s crucial that Americans continue to follow the guidance that CDC issued. There are no exceptions – all romaine lettuce must be discarded, regardless of brand, type, or if it is in a mixture. We also continue to urge people to follow our tips to help prevent E. coli illness. In addition, we remind clinicians that antibiotics are not recommended for patients in whom E. coli O157 is suspected until diagnostic testing rules out this infection.

FDA’s Gottlieb says Romaine likely came from California (other regions might be off the hook)

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Scott Gottlieb, FDA Commissioner took to the Twitter this morning while many were buying TVs and Himalayan salt lamps to talk about the Romaine-linked E. coli O157 outbreak.

I imagine there’s lots of pressure out there to lift the blanket statement from CDC to avoid all Romaine. Especially if the dates of harvest/transition from one location to another make it so it’s not likely that lettuce from certain regions would be linked to the outbreak.

Some sort of identification is great – because how would a consumer know what to ask about or how to figure out the source without it.

 

 

Flour power: NEJM paper on 2016 outbreak

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A couple of weeks ago Duncan Hines brand cake mixes were recalled because of Salmonella. Maybe it was the flour. Flour comes from dried wheat that’s milled and not heat treated (because it messes with the gluten). As the Salmonella dries out it gets hardier and survives for months (or longer).

In 2016 pathogenic E. coli (both O121 and O26 serogroups) was the culprit in another raw flour outbreak. The good folks involved with that investigation (Crowe and colleagues) published their findings this week in the New England Journal of Medicine.

The outbreak began in December 2015 and lasted through to September 2016. Fifty-six cases in 22 states were identified.

The biggest takeaway for me was this (such a great explanation of how an investigation works):

Open-ended telephone interviews then were conducted with 10 patients, all of whom stated that they baked frequently or regularly consumed home-baked foods. Five of the patients recalled baking during the week before illness onset, and 3 others reported thatthey might have baked during that period. Of the 5 case patients who remembered baking, 4 reported eating or tasting homemade batter or dough, 3 of whom used brand A flour. The fourth used either brand A or another brand. Two of the patients (a resident of Colorado and a resident of Washington) still had the bags of brand A flour that they had used in the week before illness onset.

Shortly thereafter, state investigators identified 3 ill children who had been exposed to raw flour at restaurants in Maryland, Virginia, and Texas. Restaurant staff had given them raw dough to play with while they waited for their food to be served.

Folks in the media or the hockey arena often ask how these outbreaks get solved. This is how – lots of interviewing, hypothesis generating and then a case-case or case-control analysis. It’s part detective work, part statistics and all science. Sometimes the interviews are messy but this one shows what happens when it works.

Trace-back investigation of the two bags of brand A flour collected from patients in Colorado andWashington revealed that the flour from Colorado was unbleached all-purpose flour manufactured on November 14, 2015, and the flour from Washington was bleached all-purpose flour manufactured on November 15, 2015. The two bags were produced in the same facility. The flour that was used in the raw dough given to the children exposed in the Maryland, Virginia, and Texas restaurants also was from this facility, as was flour from three additional bags collected from case patients residing in Arizona, Califor- nia, and Oklahoma.

Romaine again: leafy green linked to illnesses in Canada and US

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I’m not really a salad fan. I know it’s not cool to admit that, but I love lots of other types veggies (so don’t email me about my nutrition)>

One of the salads I can handle (although it’s not my favorite) is Caesar – Romaine with a yogurt-based garlic, lemon and olive oil mixture with some asiago and bacon is doable.

Caesar and Romaine is off the menu right now after E. coli O157 has been linked to 18 cases in Canada and 32 cases in the U.S. 

Fascinating part of this one is (as PHAC states), 

Laboratory analysis indicates that the illnesses reported in this outbreak are genetically related to illnesses reported in a previous E. coli outbreak from December 2017 that affected consumers in both Canada and the U.S. This tells us that the same strain of E. coli is causing illness in Canada and the US as was seen in 2017 and it suggests there may be a reoccurring source of contamination. Investigators are using evidence collected in both outbreaks to help identify the possible cause of the contamination in these events.

CDC notes that this outbreak is not linked to the one that was traced to Yuma.

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. PulseNet is the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC. DNA fingerprinting is performed on E. coli 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. WGS gives a more detailed DNA fingerprint than PFGE. WGS performed on E. coli bacteria from ill people in this outbreak showed that the strains were closely related genetically. This means that the ill people were more likely to share a common source of infection.

As of November 20, 2018, 32 people infected with the outbreak strain of E. coli O157:H7 have been reported from 11 states. A list of the states and the number of cases in each can be found on the Map of Reported Cases page.

Illnesses started on dates ranging from October 8, 2018 to October 31, 2018. Ill people range in age from 7 to 84 years, with a median age of 24. Sixty-six percent of ill people are female. Of 26 people with information available, 13 (50%) were hospitalized, including one person who developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

Illnesses that occurred after October 30, 2018, might not yet be reported due to the time it takes between when a person becomes ill with E. coli infection and when the illness is reported. This takes an average of two to three weeks.

Ongoing outbreak and reoccurring source makes a recall (and no Romaine consumption) a good idea for now.

Over 80 outbreaks linked to leafy greens since 1995 – is pretty good justification.

Norovirus is hard to get rid of, especially in a shelter

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I’m still here, just like norovirus.

I can’t really imagine what it’s like to have your community and homes destroyed by fire. I really struggle to find the words or feelings to describe what residents of California are going through. Viewing the social media posts and videos of folks fleeing the flames is emotional.

A few years ago an outbreak linked to a Denver homeless shelter made it into the barfblog new and notable category. Forty folks who depended on the emergency food were affected by violent foodborne illness symptoms after eating donated turkey. Fourteen ambulances showed up and took those most affected to area hospitals.

Getting into a shelter or temporary housing because of the fires and then acquiring norovirus is a terrible situation.

Butte County Public Health Department says that over 140 individuals housed in a Camp Fire shelters likely have norovirus. 

Since the shelters opened to house Camp Fire evacuees, 145 people have been sick with vomiting and/or diarrhea. As of Wednesday evening, there were 41 people experiencing symptoms at the following shelters:

Neighborhood Church: 179 total evacuees at the shelter, 21 currently experiencing illness

Oroville Nazarene Church: 352 total evacuees at the shelter, 10 currently experiencing illness

Butte County Fairgrounds: 142 total evacuees at the shelter, 9 currently experiencing illness

East Avenue Church: 200 total evacuees at the shelter, 1 currently experiencing illness

The number of sick people is increasing every day. Twenty-five people have been to the hospital for medical support. Staff serving the shelters have also been sick.

Norovirus can quickly go through a food shelter with many people living in close quarters. Once the virus is there, it is hard to get rid of.

As one friend of the blog posted on social media, having norovirus and using a public bathroom to deal with the symptoms must be particularly degrading.

This one is weird, 21 boxes: Salmonella causes limited Cap’n Crunch cereal recall

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I’ve seen a lot of recalls, this is the first time I remember seeing only 21 boxes distributed to five specific stores. I’d like to know the back story on this one (maybe some avid barfblog readers can help).

The Quaker Oats Company, a subsidiary of PepsiCo, Inc., today announced a voluntary recall of a small quantity of Cap’n Crunch’s Peanut Butter Crunch cereal due to the potential presence of Salmonella. While the potentially affected product only reached five specific Target stores and is limited to 21 boxes of one variety with two Best Before Dates, Quaker is initiating the voluntary recall to protect public health.

The recall was initiated as the result of a routine sampling program by the company, which revealed the finished product may contain bacteria.

The product being recalled was distributed in limited quantities only to the five Target stores listed below. This recall only includes 21 outstanding boxes purchased after Nov 5.

This is some Willy Wonka golden ticket type stuff. I wonder if this was a market withdrawal that happened, except all but 21 boxes were pulled before sales. On the shelf quick, than off the shelf. Except for 21.

 

Posting restaurant grades is a good thing; does it make food safer? It’s hard to tell

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I’ve long been a fan of posting restaurant inspection scores, grades, happy faces, whatever. The philosophy I subscribe to is that the inspection work is done with public money and the public should have access to the results. Whether the info is posted on the door, or a website, it should be accessible.

For a while lots of folks have wondered whether the posting matters, public health wise. I want to believe it does, but I’m still not sure.

The biggest issue in real life experimentation and hypotheses is that there are lots of other factors that could lead to an outcome. And if the outcome you’re looking for is reduction in Salmonella illnesses, you likely can find it if you look. Like Melanie Firestone and Craig Hedberg did in their EID paper that was released this week.

But I’m not convinced that less Salmonella was a result posting grades alone. And I don’t think they are either, since Firestone and Hedberg  highlight the other factors in their limitations:

First, this was a quasiexperimental, ecologic study that represents an association and not a causal relationship. Second, the NYC restaurant letter grade program involved multiple changes to sanitation enforcement in addition to letter grade posting; changes included inspection frequency, greater risk for fines, improvements to online resources, and additional training opportunities.. As a result, we could not determine which factors contributed the most to the reduction in Salmonella infections.

It’s good stuff, we need more data on these things. Posting grades is good, and absolutely should be done. So is increasing consequences and oversight – but how much each factor matters is still unknown. And what about other pathogens like norovirus and pathogenic E. coli?