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.

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.

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.

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?

Tragic stories around infant botulism have popped up over the past couple of years and, as a dad, reading them is like a gut-punch.

In 2011, infant Amanda Zakrzewski was diagnosed with infant botulism and had to undergo 9 days of antitoxin treatment in hospital. Amanda wouldn’t eat, her eyes glassed over and she wasn’t able to suckle due to the paralysis the botulinum outgrowth caused. The result was months of rehab.

Also in 2011, 16-week-old Logan Douglas was temporarily blinded and paralyzed from infant botulism. He fully recovered after six months, but at one point the illness was so severe that doctors had discussed turning off life support systems as the toxin was attacking his body.

Logan’s illness was linked to honey that his pacifier was dipped into.

Kinda like the four infants from Texas whom FDA says have acquired the terrible illness from pacifiers filled with honey.

The FDA is reminding parents and caregivers not to give honey to infants or children younger than one year of age. This includes pacifiers filled with or dipped in honey.

The FDA has received reports from the state of Texas that four infants have been hospitalized with botulism. All four infants had used pacifiers containing honey. These pacifiers were purchased in Mexico, but similar products also appear to be available in the U.S. through online retailers.