Category Archives: Food Safety Policy

Less food poisoning associated with employee paid sick time?

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I refer to parenting as hypocrisy disease.

And there’s been more than a few times when Amy has said to me, practice what you preach.

Like barfing and going to work.

People should not work when they are sick.

But in the world of food, people are going to lose their jobs if they don’t show up.

Hsuan et al. write in the American Journal of Preventative Medicine that:

Previous studies suggest an association between paid sick leave (PSL) and better population health, including fewer infectious and nosocomial gastrointestinal disease outbreaks. Yet few studies examine whether laws requiring employers to offer PSL demonstrate a similar association. This mixed-methods study examined whether laws requiring employers to provide PSL are associated with decreased foodborne illness rates, particularly laws that are more supportive of employees taking leave.

Methods:

The four earliest PSL laws were classified by whether they were more or less supportive of employees taking leave. Jurisdictions with PSL were matched to comparison jurisdictions by population size and density. Using difference-in-differences, monthly foodborne illness rates (2000-2014) in implementation and comparison jurisdictions before and after the laws were effective were compared, stratifying by how supportive the laws were of employees taking leave, and then by disease. The empirical analysis was conducted from 2015-2017.

Results:

Foodborne illness rates declined after implementation of the PSL law in jurisdictions with laws more supportive of employees taking leave, but increased in jurisdictions with laws that are less supportive. In adjusted analyses, PSL laws that were more supportive of employees taking sick leave were associated with an adjusted 22% decrease in foodborne illness rates (p=0.005). These results are driven by campylobacteriosis.

Conclusions:

Although the results suggest an association between more supportive PSL laws and decreased foodborne illness rates, they should be interpreted cautiously because the trend is driven by campylobacteriosis, which has low person-to-person transmission.

Association of paid sick leave laws with foodborne illness rates

Am J Prev Med. 2017 Sep 1. pii: S0749-3797(17)30359-8. doi: 10.1016/j.amepre.2017.06.029. [Epub ahead of print]

Hsuan C, Ryan-Ibarra S, DeBurgh K, Jacobson DM

https://www.ncbi.nlm.nih.gov/pubmed/28870665

Norovirus modeling: Stay at home after the barfing and pooping is gone

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Duret et al. write in Risk Analysis:

We developed a quantitative risk assessment model using a discrete event framework to quantify and study the risk associated with norovirus transmission to consumers through food contaminated by infected food employees in a retail food setting.

This study focused on the impact of ill food workers experiencing symptoms of diarrhea and vomiting and potential control measures for the transmission of norovirus to foods.

The model examined the behavior of food employees regarding exclusion from work while ill and after symptom resolution and preventive measures limiting food contamination during preparation.

The mean numbers of infected customers estimated for 21 scenarios were compared to the estimate for a baseline scenario representing current practices. Results show that prevention strategies examined could not prevent norovirus transmission to food when a symptomatic employee was present in the food establishment. Compliance with exclusion from work of symptomatic food employees is thus critical, with an estimated range of 75–226% of the baseline mean for full to no compliance, respectively.

Results also suggest that efficient handwashing, handwashing frequency associated with gloving compliance, and elimination of contact between hands, faucets, and door handles in restrooms reduced the mean number of infected customers to 58%, 62%, and 75% of the baseline, respectively.

This study provides quantitative data to evaluate the relative efficacy of policy and practices at retail to reduce norovirus illnesses and provides new insights into the interactions and interplay of prevention strategies and compliance in reducing transmission of foodborne norovirus.

Quantitative risk assessment of norovirus transmission in food establishments: Evaluating the impact of intervention strategies and food employee behavior on the risk associated with norovirus in foods

Risk Analysis, Vol. 37, No. 11, 2017

DOI: 10.1111/risa.12758

Duret et al.

http://onlinelibrary.wiley.com/doi/10.1111/risa.12758/epdf

 

E. coli: Flour fights not such a good idea

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In June, 2009, an outbreak of shiga-toxin producing E. coli (primarily O157:H7) in Nestle Toll House cookie dough sickened at least 77 people in 30 American states. Thirty-five people were hospitalized – from cookie dough.

The researchers could not conclusively implicate flour as the E. coli source, but it remains the prime suspect. They pointed out that a single purchase of contaminated flour might have been used to manufacture multiple lots and varieties of dough over a period of time as suggested by the use-by dates on the contaminated product.

The study authors concluded that “foods containing raw flour should be considered as possible vehicles of infection of future outbreaks of STEC.”

So it wasn’t much of a surprise when 56 people fell sick from with the outbreak strain of E. coli O121 from Dec. 2015 to Sept. 2016 were linked to raw General Mills flour.

The peer-reviewed summary of the outbreak investigation was published last week in The New England Journal of Medicine.

Abstract below:

In 2016, a multijurisdictional team investigated an outbreak of Shiga toxin–producing Escherichia coli (STEC) serogroup O121 and O26 infections linked to contaminated flour from a large domestic producer.

Methods

A case was defined as infection with an outbreak strain in which illness onset was between December 21, 2015, and September 5, 2016. To identify exposures associated with the outbreak, outbreak cases were compared with non-STEC enteric illness cases, matched according to age group, sex, and state of residence. Products suspected to be related to the outbreak were collected for STEC testing, and a common point of contamination was sought. Whole-genome sequencing was performed on isolates from clinical and food samples.

Results

A total of 56 cases were identified in 24 states. Univariable exact conditional logistic-regression models of 22 matched sets showed that infection was significantly associated with the use of one brand of flour (odds ratio, 21.04; 95% confidence interval [CI], 4.69 to 94.37) and with tasting unbaked homemade dough or batter (odds ratio, 36.02; 95% CI, 4.63 to 280.17). Laboratory testing isolated the outbreak strains from flour samples, and whole-genome sequencing revealed that the isolates from clinical and food samples were closely related to one another genetically. Trace-back investigation identified a common flour-production facility.

Conclusions

This investigation implicated raw flour as the source of an outbreak of STEC infections. Although it is a low-moisture food, raw flour can be a vehicle for foodborne pathogens.

Shiga toxin–producing E. coli infections associated with flour

N Engl J Med 2017; 377:2036-2043, November 23, 2017, DOI: 10.1056/NEJMoa1615910

Samuel J. Crowe, Ph.D., M.P.H., Lyndsay Bottichio, M.P.H., Lauren N. Shade, B.S., Brooke M. Whitney, Ph.D., Nereida Corral, M.P.H., Beth Melius, M.N., M.P.H., Katherine D. Arends, M.P.H., Danielle Donovan, M.S., Jolianne Stone, M.P.H., Krisandra Allen, M.P.H., Jessica Rosner, M.P.H., Jennifer Beal, M.P.H., Laura Whitlock, M.P.H., Anna Blackstock, Ph.D., June Wetherington, M.S., Lisa A. Newberry, Ph.D., Morgan N. Schroeder, M.P.H., Darlene Wagner, Ph.D., Eija Trees, D.V.M., Ph.D., Stelios Viazis, Ph.D., Matthew E. Wise, M.P.H., Ph.D., and Karen P. Neil, M.D., M.S.P.H.

http://www.nejm.org/doi/full/10.1056/NEJMoa1615910

Food Safety Talk 140: Dr. Linda is a Friend of Mine

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In this episode Don and Ben are joined by Gordon Hayburn from Trophy Foods.  Gordon talks about his experiences in food safety, focusing on his time in the food industry, and his expertise in audits.

Episode 140 can be found here and on iTunes.

Show notes below so you can follow along at home.

Kansas veterinarian says the same food safety rules that apply to humans also apply to pets

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When I got fired as a full professor from Kansas State University in 2013, my department chair actually kept a straight face as he said, if I didn’t show up on campus, he would have no choice, and that “I didn’t work well with others.”

Bureaucratic BS.

They wanted my salary, didn’t like what I said to cattle folks, and started a whole on-line thingy I had proposed after getting dumped.

Best and brightest get promoted.

There were several colleagues in the college of veterinary medicine I worked quite well with.

One was Kate KuKanich, associate professor of clinical sciences in Kansas State University’s College of Veterinary Medicine.

We hit the road and did handwashing studies in hospitals, co-supervized vet students who did cool investigative work on petting zoos, and she brought us duck eggs.

Kate made K-State’s Thanksgiving of PR, and full kudos for going through the process.

“Thanksgiving is a time when a lot of people think that giving tidbits of the food to pets it thoughtful. A small piece of turkey breast, which is low in fat and salt, is OK for a dog or cat in moderation. But, because we love our pets, we can often overdo it and ignore food safety rules that affect both our health and the health of our pets.”

Each year around Thanksgiving, KuKanich and colleagues at Kansas State University’s Small Animal Hospital treat multiple cats and dogs that have pancreatitis — an inflammation of the pancreas. The condition often manifests in pets that have eaten fatty human foods, such as meat trimmings and bacon, rather than their normal diet. Foods high in salt can be hazardous to pets with heart disease.

I thought it was drunks that got pancreatitis.

KuKanich advises pet owners to keep pets’ meals and treats as normal as possible during the holidays in order to avoid a recipe for disaster. She also said that the same food safety rules that apply to humans also apply to pets. These include:

  • Turkey and other meats must be cooked to 165 degrees Fahrenheit before dogs, cats and humans eat it. Raw and undercooked meats as well as their juices can contain germs that can cause serious illness in both people and animals.

“Sometimes people think that it’s OK to give a pet raw or undercooked meat because pets’ ancestors come from the wild,” KuKanich said. “Any raw meat, such as the gizzard of the turkey, can make our pets sick because they can be contaminated with bacteria. A meat thermometer is best way to know our meats are food safe and cooked to the proper temperature for everyone’s safety.”

  • Bones, such as a hambone, drumstick or rib, also can be dangerous because they can become lodged in the esophagus of dogs, requiring emergency endoscopy or surgical removal.
  • Pet owners should wash their hands in warm, sudsy water before and after feeding their pet. Pets’ food and water bowls and measuring cups used to dispense their food also should be cleaned regularly.

“Handwashing prior to cooking, eating and food storage is important to keep food and family members safe,” KuKanich said. “It also is a good idea to either avoid petting our furry friends during food prep and meals or to wash hands frequently so that we keep both the food and the pets safe.”

  • Juices from raw turkey and other meats will contaminate anything it touches in the kitchen, including counter space, utensils, other food and pet dishes.
  • Pets and people should not eat cooked and dairy-based food that has been sitting at room temperature for longer than 2 hours. Two hours is the longest food should sit at room temperature before it is refrigerated or frozen, according to a food safety specialist at Kansas State University Olathe.

Additionally, while sweets and deserts may affect our waistline, they can be hazardous to an animal.

Kate’s got the basics right.

Kansas State is fortunate to have her.

Our publications can be found on-line.

The vomit machine lives on; norovirus can aerosolize during vomit events

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I’ve been lucky to be close to some excellent projects, some of the stuff and knowledge created through these projects ends up mattering to food safety nerds – especially those who are making risk management decisions. Former NC State student Grace Tung-Thompson’s PhD project on vomit spray and norovirus is one of the most impactful. The work was carried out as part of the USDA NIFA-funded NoroCORE project led by my friend Lee-Ann Jaykus.VOMIT-BLOG-HEADER-698x393

I’ve talked to lots of Environmental Health Specialists, retailers and food service food safety folks about what Grace and fellow graduate student Dominic Libera put together and many respond with a weird level of enthusiasm for the barf project.

Mainly because a real question they struggle with is how far will virus particles travel from an up-chuck event – knowing this, and then cleaning and sanitizing helps limit the scope of a potential outbreak.  Grace’s work was published in PLOS ONE a while ago, we used it as a centerpiece for a Conference for Food Protection issue on vomit clean up in 2016 (which, maybe, could be included in the oft rumored 2017 Food Code) and the Daily Beast  covered the work today.

A couple of years ago, PhD student Grace Tung Thompson demonstrated something incredibly gross: When a person vomits, little tiny bits of their throw-up end up airborne. You could ingest them just by breathing air in the same room. As if that weren’t disconcerting enough, if the person got sick from a virus, there could be enough viruses in the air to get you sick, too. Just try not to think about that the next time the person in the row behind you throws up on an airplane.
So how do you get rid of airborne viruses? “There is no known technology that will eliminate norovirus if it’s in the air,” Jaykus said, “and there really aren’t a lot of technologies—safe technologies—that even are likely to work.” Her research team recently experimented with misting antiviral compounds into spaces as an alternative to disinfecting surfaces individually, and it worked, but not completely. This technique, known as fogging, can only be used in spaces that can be cleared out and contained, like bathrooms, for example. “I think we need that technology, and that technology is really, really important, but how the heck we’re going to develop it? I’m at a loss for words.”

From an individual perspective, the best you can do is get yourself far away from a vomiting incident; Jaykus recommends at least 100 feet. If you were in the middle of a meal at a restaurant and someone at the next table threw up, you’d probably be wise to stop eating, and to wash yourself and your clothes when you are able.

From the perspective of a restaurant owner, the best course of action is to do a really, really good job of the cleanup. Commercial vomit and fecal matter cleanup kits are catching on with bigger companies in the foodservice industry, says Jaykus. They provide personal protection, including disposable coveralls and respirator masks, in addition to the material required to pick up and wipe down the mess.

Eating broken glass sucks; Trader Joe’s salad recalled

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Friend of barfblog and mentor Tanya MacLaurin told me a story when I was in grad school that I still use when telling folks about physical hazards.

It goes sorta like this (or this is the version I remember):

Tanya was running food services at Kansas State and had a really big event with donors and university administrators. She came into the kitchen and saw her staff picking something out of a couple of hundred of salads that were prepped and ready to go our for service. Someone had broken a fluorescent light that was situated over the staging area and everyone was scrambling to pick out the glass.

A great risk manager, Tanya shut down the coverup operation.

Glass removal by eyesight isn’t a great critical control point.

In related news, a supplier of Trader Joe’s salads is recalling a whole bunch of prepared salads due to glass contamination.

Green Cuisine, a San Fernando, Calif. establishment, is recalling approximately 36,854 pounds of chicken and turkey salad products that may be contaminated with extraneous materials, specifically hard silica and glass fragments, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The ready-to-eat chicken and turkey salads were produced from Nov. 4 – 15, 2017. The following products are subject to recall:

* 10.5-oz. clear plastic individual serving packages containing “TRADER JOE’S White Meat Chicken Salad with celery, carrots and green onions” with a “Use By” date of November 10 – 21, 2017.

* 11.0-oz. clear plastic individual serving packages containing “TRADER JOE’S CURRIED WHITE CHICKEN DELI SALAD with toasted cashews, green onion and a bit of honey” with a “Use By” date of November 10 – 21, 2017.

* 10.25-oz. clear plastic individual serving packages containing “TRADER JOE’S TURKEY CRANBERRY APPLE SALAD TURKEY BREAST MEAT WITH SWEET DRIED CRANBERRIES, TANGY GREEN APPLES, PECANS AND SAGE” with a “Use By” date of November 10 – 21, 2017.

The products subject to recall bear establishment number “P-40299” inside the USDA mark of inspection. These items were shipped to retail locations in the following states: Arizona, California, Colorado, Idaho, Louisiana, New Mexico, Nevada, Oklahoma, Oregon, Texas, Utah and Washington.

‘Look where some people poo’ Global citizen’s Taylor Swift parody

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Yasmine Gray of Billboard writes  Global Citizen — a social action platform dedicated to solving the world’s biggest problems — released a Taylor Swift parody video for a cause. Bringing attention to one of the most pressing issues in global development, the “Look What You Made Me Do” spoof draws attention to sanitation and toilet access.

Worldwide, 4.5 billion people lack access to safe and working toilets and sanitation, while 892 million people are forced to defecate outside in the open or into bodies of water. Poor sanitation is linked to the transmission of many deadly diseases, including cholera, diarrhea, dysentery, hepatitis A, typhoid, and polio, and 3.4 million people — mostly children — die from water-related diseases each year, with one in nine child deaths caused by diarrhea.

“Look Where Some People Poo” is the latest in a series of musical parodies Global Citizen has created to educate and inspire people around the world to take action. Past videos have included an Adele parody about calling Congress and a Bruno Mars parody concerning women’s rights.

Ahead of World Toilet Day (Nov. 19), the organization is asking supporters to sign a petition calling on the World Bank to commit to prioritizing basic sanitation.

 

 

What’s in your weed?

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In Hawaii, one of the testing labs certified by the state to check the quality of medical marijuana said they found contamination in more than half of the samples from the black market.   

The lab, Steep Hill Hawaii, says over 50 percent of the black market product had contaminants that included mold, yeast, and pesticides. 

The lab says that doesn’t mean all homegrown products are bad, but patients should be aware of what’s in their medicine. 

“I personally was shocked to find out how much stuff was in black market cannabis that you would never expect. E. coli, which comes from fecal matter. Salmonella, which comes from raw egg and chicken. We found that on product we tested,” said Michael Covington, of Steep Hill Hawaii. 

In Canada, CannaDrinks may be all the rage in some parts of the world, but there are some serious health concerns surrounding new products being formulated.

Sure it sounds cool, to order some cannabis-infused drinks at the bar for you and your buddies. However, a leading food safety expert is warning that these cool drinks may be dangerous, and the public (apparently) needs to take note.

While a $245 million deal was penned between Constellation Brands and Canopy Growth last week, for a 10 percent stake of CP, Canada’s largest cannabis producer, to produce the new CannaDrinks, Rick Holley claims the drinks are problematic, “[Producers] could screw this all up if they don’t get into the mechanics of how to safely prepare and develop new food products,” he said, adding, “They could kill people!”

BNN reported that Constellation Brands told them via email that the company, “has a long-standing commitment to producing products with the highest quality standards and that comply with all regulations.”

According to Lawrence Goodridge, a McGill University food safety expert (Larry, you’re an expert), alcohol has the advantage of killing bacteria and toxins in sealed bottles or cans, whereas cannabis-infused products may not, “Because cannabis is a plant, there are certain concerns — like the possibility of pesticides used in production, or the type of fertilizer used, or the potential presence of heavy metals that could be toxic to humans,” said Goodridge, adding that, “Bacteria like e-coli or listeria that could be on the plant and that could make it onto the food, whether it is drinks or edibles, the risk is the same — but alcohol is special because we know that helps to kill some of those toxins.”

Also, Sikora et al. identified a case of Hepatitis A associated with cannabis use.

We identified a case of acute Hepatitis A virus (HAV) infection linked to cannabis use. The local Public Health department received report of a man in his mid-20s with a classic presentation of hepatitis – jaundice, abdominal pain, vomiting, general malaise, and dark urine – as well as elevated serum aminotransferase levels and a positive anti-HAV IgM. Upon questioning, he reported no contact with ill individuals, or travel outside his metropolitan area. His exclusive source of water was the local municipal supply. He reported consuming mainly pre-packaged lower risk foods from large chain-style supermarket stores and eating at several local restaurants. While administering the questionnaire, the investigator identified that the patient smoked cannabis. Upon request, the patient agreed to provide a sample of cannabis for testing purposes. A viral elution of fresh cannabis leaves was completed. The sequences derived from the patient’s serum sample and the eluate from the cannabis leaves were identical, but did not match any other HAV sub-genotype 1B sequences from Canadian isolates within the National Microbiology Laboratory database. Hepatitis A virus can survive >60 days when dried and kept at room temperature and low humidity; HAV can remain infectious in water at room temperature for 300 days. It cannot be concluded with certainty that the cannabis was the source of the hepatitis A; however, as other sources were excluded, or were of lesser probability, the association of cannabis with his disease acquisition remains strong.

 

Ready-to-eat meals may be popular but have risks

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Eugene Boisvert of Au News writes that more than 40 per cent of ready-to-eat meals tested by South Australian health types contained an unsatisfactory level of bacteria, according to survey results published in the Eastern Health Authority’s annual report this month.

The SA Health survey said one of the tested meals contained 310 times the safe level of Bacillus cereus, and another had almost 13 times the safe level of E. coli, which comes from feces.

Out of 98 meals bought at local supermarkets and shops with a shelf life of 10 or more days, 42 had an unsatisfactory microorganism count.

Eastern Health Authority chief executive Michael Livori said more small businesses were trying to capitalise on the growing popularity of ready-to-eat meals without understanding the health risks involved.

“Most manufacturers who are normally in this business will (understand the risks) but there’s an increase in small businesses or retailers getting into this realm but not without risk,” Mr Livori said.

The SA Health survey and subsequent report, published in June, was sparked by Eastern Health Authority concerns about the standard of manufacturing processes of ready-to-eat meals.

The SA Health report recommended measures to prevent bacteria growing in ready-to-eat meals, including that they be heated to at least 90C for 10 minutes when being cooked.

Meanwhile, the Eastern Health Authority issued 10 businesses with prohibition orders in 2016/17, banning them from preparing, selling or transporting food until they cleaned up their act, compared with three in the previous two financial years.